Body-centred neglect is essentially a defect in space formation, while object-focused neglect is a disorder of object formation. The patients described here both benefited from neuropsychological therapy for neglect, but not from the same programme.

SummaryBackgroundIt is well known that traumatic brain injury often changes the way the patient perceives reality, which often means a distortion of the perception of self and the world. The purpose of this article is to understand the processes of identity change after traumatic brain injury.Case ReportWe describe progressive deterioration in personal identity in a former physician who had sustained a serious head injury (1998), resulting in focal injuries to the right frontal and temporal areas. He regained consciousness after 63 days in coma and 98 days of post-traumatic amnesia, but has since displayed a persistent loss of autobiographical memory, self-image, and emotional bonds to family and significant others. Qualitative ‘life-story’ interviewing was undertaken to explore the mental state of a patient whose subjective, “first person” identity has been disengaged, despite the retention of significant amounts of objective, “third person” information about himself and his personal history (though this was also lost at a later stage in the patient’s deterioration).Identity change in our patient was characterized by a dynamic and convoluted process of contraction, expansion and tentative balance. Our patient tends to cling to the self of others, borrowing their identities at least for the period he is able to remember. Identity is closely connected with the processes of memory.ConclusionsThe results will be examined in relation to the microgenetic theory of brain function. The brain mechanisms that may account for these impairments are discussed. Findings from this study have important implications for the delivery of person-focused rehabilitation.

This paper is devoted to illustrating how process neuropsychology and neurolinguistics, based on microgenetic theory androoted in process thought, can help to explain the often baffling symptomatology of brain damage. Our purpose is to present an overview of this difficult and complex subject matter for readers, with particular emphasis on its creative potential. The essence of microgenetic theory in neuropsychology is an account of the phases in brain process through which successive mind/brain states arise and perish over the duration of the psychological present, measured in milliseconds. According to the theory, mental states are rhythmically generated out of a “core” in the anatomically deepest and phylogenetically oldest parts of the central nervous system, over phases to the outermost and youngest regions of the brain, the neocortex. The clinical applications are only one aspect of the creative potential of microgenetic theory. Indeed, the elegance of the theory consists in the way in which it can be extended into a number of different fields of endeavor, providing a kind of “unified field theory” for the explanation of often rather diverse phenomena. This provides an opportunity for neuropsychology and neurolinguistics to resume the interdisciplinary discourse they were founded to conduct.

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