The quality of the psychotherapeutic process in brain-injured patients.

This paper reviews the various mental processes which occur in patients with organic brain damage and the changes to which these patients are subjected. At the early stages directly following injury, it is necessary to restructure the personality and help it emerge from the chaotic state characterizing this phase. Later treatment concentrates on giving meaning to the different object relationships and the dialectic between self-representation and object representation. Special stress is put on the therapist's role as a receptacle for the aggressive contents which the patient transfers to him and on the necessity, on he therapist's part, to master his own counter-transference reactions and to present an identification model permitting the restoration of the patient's inner world. The psychotherapeutic model is based on the already existing models in other area of mental pathology, which have been developed in recent years, in particular in the theory of narcissism and object relations.