PSYCHODYNAMICS AND EXECUTIVE DYSFUNCTION: A NEUROBIOLOGICAL PERSPECTIVE

The purpose of this article is to illustrate how neurobiological deficits and subcortical structures contribute to psychodynamic processes. Specifically, this paper seeks to enhance our clinical understanding of the consequence of such contributions by clarifying how a person might select and maintain dysfunctional behaviors or responses. Viewing the brain from an evolutionary perspective, with physical and mental survival as the goal of evolved brain function, specific dysfunctional behaviors are shown to be context and time dependent regulatory or modulatory procedures, which compensate for missing neural connections. This paper describes two courses of treatment with the same patient, first for procrastination and later for perversion. In each treatment deficits are identified and compensatory skills are discussed.