“I can’t find my red!” Methodical doubts for a psychoanalytic approach to neurocognitive disorders

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Agostino Pastore
Publishing Year 2024 Issue 2024/2
Language Italian Pages 25 P. 17-41 File size 304 KB
DOI 10.3280/RSF2024-002003
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Treating patients suffering from neurocognitive disorders is a tough challenge for each clinician to cope with. Dementia shows a complex of variety of overlapping symptoms, ranging from neurology to psychiatry, making it difficult to categorize patients and their phenomenology through a rigid separation of medical branches. Its epidemiological expansion forces medics to reconsider the way they think, not just the demented subject, but the subject itself, caught within medical dispositif. Hence, here will be discussed 1) the status of subject, 2) a potential role of psychoanalysis in approaching neuro-psychiatric symptoms and 3) some issues on the therapeutic relationship, which represent obscure resistance points when facing neurocognitive disorder phenomenon. Aim of this article is to enlight these shadows through the lens of Lacanian psychoanalisys, as a precious instrument to prevent the inevitable practice of desubjectification.

Keywords: dementia, Alzheimer’s Disease, Neurocognitive Disorders, Mild Behavioral Impairment (MBI), Behavioural and psychological symptoms in dementia (BPSD, psychoanalysis, Lacan, subject, subjectification, transfert, desubjectification.

  1. Zeman A. Neurology is psychiatry – and vice versa. Pract Neurol. 2014;14(3):136-44
  2. McKeith I, Cummings J. Behavioural changes and psychological symptoms in dementia disorders. Lancet Neurology. 2005;4(11):735-42
  3. Mega MS, Cummings JL, Fiorello T, Gornbein J. The spectrum of behavioral changes in Alzheimer’s disease. Neurology. 1996; 46:130–5.
  4. Ismail Z, Smith EE, Geda Y, Sultzer D, Brodaty H, Smith G, et al. Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement. 2016;12(2):195–202.
  5. Taragano FE, Allegri RF, Krupitzki H, Sarasola DR, Serrano CM, Loñ L, et al. Mild behavioral impairment and risk of dementia: a prospective cohort study of 358 patients. J Clin Psychiatry. 2009;70(4):584–92.
  6. Rascovky K et All. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011; 134(Pt 9):2456-77.
  7. McKeith IG et All. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017; 89(1):88-100.
  8. Chen P, Guarino PD, Dysken MW, Pallaki M, Asthana S, Llorente MD, Sano M. Neuropsychiatric symptoms and caregiver burden in individuals with Alzheimer’s disease: the TEAM-AD VA cooperative study. J Geriatr Psychiatry Neurol. 2018; 31(4):177–185
  9. Clavreul J. Il rovescio della psicoanalisi. Discorso psicoanalitico e discorso medico. Dedalo Libri, Bari, 1981. https://www.alzint.org/about/dementia-facts-figures/ al 31/03/2024
  10. Lacan J. Televisione. 1973 in Altri Scritti. Torino: Einaudi, 2013.
  11. Lacan J. Radiofonia. 1970 in Altri Scritti. Torino: Einaudi, 2013.
  12. Lacan J. Funzione e campo della parola e del linguaggio in psicoanalisi. 1953 in Scritti (Volume I). Torino: Einaudi, 2002.
  13. Miller JA, Biologia lacaniana ed eventi di corpo, in La psicoanalisi n° 28, 2000.
  14. “Sappiamo già che i sintomi nevrotici sono il risultato di un conflitto che sorge a proposito di un nuovo modo di soddisfacimento della libido”. S. Freud, Introduzione alla psicoanalisi (1915-1917) in Opere 1915-17, vol. 8. Introduzione alla psicoanalisi e altri scritti. Boringhieri, Torino 1978
  15. Malabou C. Sofferenza cerebrale, sofferenza psichica e plasticità (2011) in C. Malabou, S. Žižek. Il trauma: ripetizione o distruzione? Un confronto tra psicoanalisi, filosofia e neuroscienze. Città di Castello: Galaad Edizioni, 2022.
  16. Žižek S. Descartes e il soggetto post-traumatico (2008) in C. Malabou,
  17. S. Žižek. Il trauma: ripetizione o distruzione? Un confronto tra psicoanalisi, filosofia e neuroscienze. Città di Castello: Galaad Edizioni, 2022.
  18. Jack CR, Bennett DA, Blennow K, Carrillo MC, Feldman HH, Frisoni GB, Hampel H, Jagust WJ, Johnson KA, Knopman DS, Petersen RC, Scheltens P, Sperling RA, Dubois B. A/T/N: An unbiased descriptive classification schemi for Alzheimer disease biomarkers. Neurology. 2016; 87(5):539-47.
  19. Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, Holtzman DM, Jagust W, Jessen F, Karlawish J, Liu E, Molinuevo JL, Montine T, Phelps C, Rankin KP, Rowe CC, Scheltens P, Siemers E, Snyder HM, Sperling R. NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia. 2018;14(4):535-562.
  20. Murray A.D., A new biomarker classification system for AD, independent of cognition: Agnosticism is a start. Neurology. 2016; 87:456-457.
  21. Lacan J. Il Seminario Libro XI. I quattro concetti fondamentali della psicoanalisi. 1964. Torino: Einaudi, 2003.
  22. American Psychiatric Association. Manuale Diagnostico e Statistico dei Disturbi Mentali. Quinta edizione. DSM-5. Raffaello Cortina Editore 2014.
  23. Van der Linde MR, Dening T, Matthews FE, Brayne C. Grouping of behavioural and psychological symptoms of dementia. Int J Geriatr Psychiatry. 2014; 29:562-8.
  24. Naasan G, Shdo SM, Rodriguez EM, Spina S, Grinberg L, Lopez L, Karydas A, Seeley WW, Miller BL, Rankin KP. Psychosis in neurodegenerative disease: differential patterns of hallucination and delusion symptoms. Brain. 2021: 144; 999–1012.
  25. Monteiro IM, Boksay I, Auer SR, Torossian C, Ferris SH, Resiberg B: Addition of a frequency-weighted score to the Behavioral Pathology in Alzheimer’s Disease Rating Scale: the BEHAVE-AD-FW: methodology and reliability. Eur Psychiatry. 2001;16(suppl 1): 5s-24s.
  26. Perez-Mandriñan G, Cook SE, Saxton JA, Miyahara S, Lopez OL, Kaufer DI, Aizenstein HJ, DeKosky ST, Sweet RA: Alzheimer disease with psychosis: excess cognitive impairment is restricted to the misidentification sybtype. Am J Geriatr Psychiatry 2004; 12:449-456.
  27. Seeman MV. Undertanding the Delusion of Theft. Psychiatry Q. 2018, 89:881-889.
  28. de Bilbao F, Bonavitacola P. The abuses of a certain knowledge, The International Journal of Psychoanalysis. 2016; 97(6) 1677-1696,
  29. Freud S. Nevrosi e Psicosi (1923). In: L’io e l’Es e altri scritti. In: Opere Vol. 9. Torino: Bollati Boringhieri, 1977.
  30. Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, Ogar JM, Rohrer JD, Black S, Boeve FD, Manes F, Donkers NF, Vanderberghe R, Rascovsky K, Patterson K, Miller BL, Knopman DS, Hodges JR, Mesulam MM, Grossman M. Classification of primary progressive aphasia and its variants. Neurology. 2011, 76:1006-14.
  31. Flanagan KJ, Copland DA, Chenery HJ, Byrne GJ, Angwin AJ. Alzheimer’s disease is associated with distinctive semantic feature loss. Neuropsychologia. 2013, 51(10):2016-25.
  32. Freud S. Psicopatologia della vita quotidiana (1901). In: Tre saggi sulla teoria sessuale e altri scritti. In Opere Vol. 4. Torino: Bollati Boringhieri; 1982. p. 51-297
  33. Lacan J, Il Seminario Libro V. Le formazioni dell’inconscio. 1957-58. Torino: Einaudi, 2004.
  34. Lacan J., Il Seminario. Libro XX. Ancora. 1972-73. Torino: Einaudi, 2011.
  35. M. Recalcati. Jacques Lacan. Desiderio, godimento e soggettivazione.
  36. Milano: Raffaello Cortina, 2012.
  37. P. Vigorelli (a cura di), La conversazione possibile con il malato Alzheimer, Milano: Franco Angeli, 2004.
  38. Freud S., in Tecnica della psicoanalisi (1911-12) in Casi Clinici e altri scritti. In: Opere Vol. 6. Torino: Bollati Boringhieri; 1981. p. 513-43.
  39. Cheston R, Ivanecka A. Individual and group psychotherapy with people diagnosed with dementia: a systematic review of the literature. Int J Geriatr Psychiatry, 2017. 32:3-31.
  40. J.Lacan. La direzione della cura. 1958 in Scritti (Volume II). Torino: Einaudi, 2002.
  41. Miller JA. Introduzione alla clinica lacaniana. Roma: Astrolabio, 2012.
  42. Lacan J. Il Seminario Libro XI. I quattro concetti fondamentali della psicoanalisi. 1964. Torino: Einaudi, 2003.
  43. Lacan. Il Seminario Libro VIII Il Transfert. 1960-1961. Torino: Einaudi, 2008.
  44. Miller JA, Della natura dei sembianti (corso tenuto presso il Dipartimento di Psicoanalisi dell’Università di Parigi VIII, lezione dell’8 gennaio 1992). La Psicoanalisi, 1993, 14.

Agostino Pastore, “Non trovo il mio rosso!” Dubbi metodici per una cura psicoanalitica dei disturbi neurocognitivi in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2024, pp 17-41, DOI: 10.3280/RSF2024-002003