How to Find My, " Eight Introductory Lectures on Neuropsychoanalysis/Psychotherapy", Here on My Blog

​If you are interested in reading my posts entitled " Eight Introductory Lectures on Neuropsychoanalysis/Psychotherapy", scroll down to their beginning on June 27, 2026.  You will find that they are in chronological order except for Lecture Six, Part 2, and Lecture Six, Part 1.

My Five additional posts on Neuropsychoanalytic Diagnosis are not part of the Lectures above, but you will find them as you scroll down to December 1, 2025.

I hope you are successful at locating all of these posts on Neuropsychoanalysis/Psychotherapy, and I look forward to your comments and questions regarding them. 

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Eight: Conclusion " Giving a Case Presentation"

As a student or experienced clinician, have you ever been asked to give a neuropsychoanalysis/psychotherapy case presentation? Then this post is for you. I have recently developed a case presentation outline for those wishing to give a case presentation. I would like to share that outline with you in this post: The first information you want to provide in your case presentation is Descriptive Data. This data tells the age, gender identity, relationship status, sexual orientation, ethnicity, occupation, and physical description of your patient.

Following this description of your patient you will want to share the Presenting Problem. The presenting problem is what the patient says has brought them to therapy. Most often the patient will present with some unpleasant feeling. Maybe they are depressed. Maybe they are anxious. Maybe they have lost someone dear to them and are experiencing grief. Perhaps they have been fired from their job. They might be full of rage. Whatever symptom or unpleasant feeling has brought them to therapy is what you want to share in a few sentences. The presenting symptom and unpleasant feeling will tell you what basic need/drive/emotion is not being met in their present living. There are seven such needs/drives/emotions: FEAR, PANIC/GRIEF, CARE, LUST, RAGE, SEEKING, and PLAY. Knowing what need is not being met and thus resulting in an unpleasant feeling, will begin to inform you of the unworkable, repressed prediction based in their unresolved childhood conflicts is causing their symptom.

Next you will want to speak to the History of the Presenting Problem. When did their symptom/unpleasant feeling begin? When did they get depressed or anxious, or sad or angry, etc? You will focus in on the major unmet need that is not being met and is thus leading to the unpleasant feeling. Point out the one major need of the seven ones above that has not been sufficiently met. This unmet need results from their unworkable childhood prediction. A patient's predictions may also related to their developmental stage. All seven emotional needs are trying to get met at the same time in all the developmental stages. But one need demands most to be met in each stage. Your oral/infant stage patient's prediction may often be related to their attachment ( PANIC/GRIEF) need. Your anal/toddler stage patient's prediction may be determined by their RAGE need. And your oedipal/preschool stage patient's prediction will often relate to the solving of their PLAY need. The level of realism in your patient's prediction will further inform you of the level of their defenses. The earlier childhood predictions are less realistic and require more primitive defenses. The later childhod predictions are usually more realistic and need only the more mature defenses to fend off the resultant unpleasant feelings. Based on the defenses your patient ultizes, you will be able to discern at what level of defenses they are functioning: Are they fixated in or have they revressed to the psychotic level, the narcissitic/borderline level, or the neurotic level? Knowing the level of their defensive functioning will also help you in your treatment plan, and the type of therapy they need ( I will say more about this below.)

Next you delve further into your patient's History. In presenting your patient's history you will want to include any past therapy experiences they have had. Have they ever seen a psychiatrist? What medications have they taken? Have they ever been hospitalized for mental illness? Is there a history of suicide attempts? You will further want to know if they have abused any substances in the past.

Most importantly you will want to share in your presentation a Developmental History covering the major stages of development in your patient's life. You will share their earliest memory, their childhood memories, their adolescent experience, their young adulthood, their middle adulthood, and their senior years. In this developmental history you will particularly write about their relationships with family and close friends, and what those relationships were like, looking particularly for extrtransference patterns with parents and significant others. You will further note major losses they have experienced during their lifetime. A history of their romantic relationships will also need to be included, noting again extratransference repetitive patterns. You will also want to share what hobbies they have, how they spend their leisure time, what was their education experience, what is their religious background and present practices, and have they been married and have they had children. In their history you will particular focus on what is the faulty prediction that has led to their not getting their basic need met.

Following this history you will share what you think is your patient's Neuropsychoanalytic Diagnosis. In other words, based on everything you have learned about your patient and their history, about their defenses and the level of their pathology, about their repeated relationship patterns in transference and extratransference patterns, and their non workable prediction and it's resultant unpleasant feelings. All this information leads to your Neuropsychoanalytic Formulation. Your neuropsychoanalytic formulation means, to the best of your ability, share your hypothesis of what has gone wrong in their lives in the past, internally and externally, and how they have unsuccessfully sought to resolve their conflicts ( through the non workable repressed prediction) to make them the person they are today. This prediction they are repeating today will clearly not have worked well for them, and that is why they have come to therapy, to rid themselves their resultant unpleasant feeling from which they suffer. You will particularly speak to how their presenting problem is the symptom of the underlying, unresolved conflict that is unconscious and originated in their childhood.

Once you have shared your diagnosis of your patient's condition, then you next share your Treatment Plan of how you plan to help them get healthier through treatment. In neuropsychoanalysis there are two major treatments: Psychoanalysis and Psychotherapy. Psychotherapy can be further divided into insight oriented or supportive therapy. Insight therapy deals primarily with unconscious predictions, whereas supportive therapy focuses mainly on preconscious predictions. Most therapies are some combination of insight and support. The choice of therapy treatment is best for your patients depends on several key factors, including their level of functioning, motivation etc. Present which type of therapy you plan to use with your patient, and what the process will be like.

The next step in your case presentation is to provide an Overview of the therapeutic Process to Date. In this section your summarize the beginning, middle, and ending phase of the therapy and how it went. You will emphasize major themes addressed, issues and concerns dealt with, relationships explored, repeated transference and extratransference patterns recognized and worked through, counter transference, resistances to therapy, defenses used by the patient, what has been accomplished and how your patient has improved, as well as what is yet to be done in the treatment. In summarizing each phase of therapy you will particularly focus on how you have helped your patient see their unhealthy repetitive pattern, (resulting from their unworkable prediction), and how they have hopefully progressed (by working through) with such insight into creating a new healthier prediction. You will further note how this healthier and more workable prediction is being lived out in their lives in the present.

Having presented all of the above you are ready to share a Few Sessions of Clinical Material detailing how their treatment has gone. You will do this by providing a video or audio recording of several sessions, or detailed process notes where you write down from memory everything you can remember that was said during the sessions. You will also note how you felt in these sessions as they progressed, and what you felt was or was not accomplished in each session. You will particularly note transference and extratransference relationship patterns, resistances/defenses and countertransference. Note how in the sessions the patient is not only repeating their older unhealthy pattern (from their faulty prediction), but what progress has been made in forming a new and healthier prediction. With the presentation of actual therapy sessions you have now completed your case presentation. The conclusion of any case presentation consists of feedback, questions, and discussion.

I hope this brief outline of a neuropsychoanalysis/psychotherapy case presentation has been helpful for you and that you will look forward to presenting your next case to a group of interested listeners.

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Seven, Part 3 "Treatment Case Example Mr. C" Ending Phase

As Mr. C's treatment is ongoing, I would like to imagine in this section how his ending phase of treatment might proceed. Gradually Mr. C began to develop a new prediction in his present life that allowed him to remove obstacles that stood in the way of meeting his needs. As a result his RAGE ceased to exist. He was then able to give up his defense of reaction formation against the RAGE, because its cause had been eliminated, by the new workable prediction he was now living by in his present life. He also became more comfortable with normal anger and frustration, and as a result was more assertive with those around him, including his therapist.

Whenever Mr. C would fall back into the old pattern of not successfully removing frustrating objects from his life, and feeling the RAGE once again, I would point this out to him again and again in many different situations. Together we kept working through the old prediction until he was able to make changes in these patterns on his own. I felt as this point Mr. C might be ready for termination. He agreed. During the ending phase Mr. C would at times repeat the old prediction. This is because the new prediction does not get rid of the old one. It is formed alongside the old one (Solms). But with time and working through, the new prediction won out most of the time over the old one. Eventually, Mr. C could experience on his own when the new prediction was working, and this helped him to adopt it more regularly. The more he implemented the new prediction, the less RAGE he felt, and the healthier he became. Thus, his therapy sessions came to a natural end.

I hope this case of Mr. C has helped you see how helpful neuropsychoanalytic therapy is for those who are capable and willing to engage in it.

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Seven, Part 2 " Treatment Case Example Mr. C" Middle Phase

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MIDDLE PHASE .

At the same time I was assessing Mr. C's unpleaurable feeling of RAGE and how it resulted from the unmet need of impediment removal, I began to look to his history and his interactions with me to discover his unconscious, repressed prediction. Mr. C was suffering unnecessarily because he was trying to live out a repressed, childhood prediction that may have worked for him as a child but it certainly was not working for him as an adult. There were many times in his adult life when he needed to be angry and even to RAGE, but he was unable to do so, lest he overreact and destroy those he loved. His main defense was reaction formation. When he should have felt anger he felt it's opposite instead--love. Therefore he could never take care of himself with others or get some of his basic needs met. He could never successfully remove impediments that were in his way. I spent the opening phase of therapy helping Mr. C come to realize what had happened to him that day in his car, and why he was having angry feelings toward those he loved as well as angry dreams.

The next phase of treatment was the Middle Phase. Because his unconscious, repressed prediction could not be remembered and worked through, we had to look at other routes for determining what was the prediction. This is where transference and extra transference work came into play. Transference has to do with the relationship of the patient with the therapist. Extra transference has to do with the patient's relationship with everyone else. It is true that the patient cannot remember the prediction from childhood, but he does repeat the pattern in his relationships today--both with the therapist and his significant others. This means that the memory of the prediction is now only a procedural memory--an action patten or an emotional response. With my interpretations of these repeated patterns in his relationships, Mr. C began to realize he did not express anger or rage appropriately in all his relationships.

By pointing this pattern out to him again and again he was able to see it in the present. This is called Working Through. The therapist helps the patient work through the repetition of the pattern in many different contexts.  We next explored Mr. C's history to see where his repressed, unconscious prediction/solution originated. Over time he was able to see this pattern of where other people would have been angry, he was not. Once Mr. C was able to see this pattern of an inability to express anger appropriately, he was eager to understand why this was the case. But he still did not know where the solution started and exactly what was the childhood situation that first led to the repressed prediction.

So after he shared some memories of his interactions with him mother where he was not angry but should have been, I ventured a Reconstruction of where the pattern may have begun. Throughout the treatment Mr. C had made various references to his not feeling childhood anger at his mother. I attempted therefore to reconstruct his childhood years where he clearly should have been angry at her but was not. We looked especially at some severe spankings he received from his mother. I said something like," Your little childhood mind could not handle the thought that you not only loved your mother, but in that moment you also wanted to destroy her in order to stop the pain. So you put that thought out of your mind." You repressed that thought. Your mind rendered it unconscious. The problem is you have now continued to act on that thought even though you cannot remember it. And you continue to act on it today. And though you could repress the thought you could not repress the feeling and you continue to feel the RAGE toward her and other women in your life today. This is called "the return of the repressed." And to protect yourself from this unbearable feeling of RAGE that will not go away, you defended yourself with the defense of reaction formation, which causes you to feel the opposte of anger, which is love. But in the car that day your defense of reaction formation broke down and failed to work. Thus your RAGE, with all its original power, energy and bodily explusion was once again felt. The thought (childhood prediction/solution )remains repressed, but the feeling returns.

With this reconstruction and explanation Mr. C began to understand his suffering in the present more clearly. He realized how it was being repeated today in his adult life and where it may have come from originally in his childhood. Once he way this through my interpretations and reconstructions, he found hope that together we could do something about it. He could actually change the pattern! He could change it to an adult pattern that works. He could explore a more workable prediction than the childhood one that was so clearly dysfunctional. With his adult resources he could now come up with better solutions. He could learn that adults can tolerate loving and hating feelings toward their Mothers and other significant persons at the same time. That he could tolerate ambivalent feelings toward his loved ones, and not destroy them and lose them as objects of his love. So Mr. C began to look at workable adult predictions that he could implement, and not just the childish one he had first come up with as a young child.

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Seven, Part 1 "Treatment Case Example Mr. C" Beginning Phase

BEGINNING PHASE.

Mr. C (an imaginary patient), is a 3o year old , married, male, community college teacher with 2 children. He called to make a first appointment for psychoanalytic psychotherapy after recently having an overwhelming abreaction of anger. He was driving down the road and spilled a drink on his new suit. He felt his wife would be angry at him and scold him for his carelessness. In anticipating seeing her he began saying to himself, "I wish she would just leave me alone." As he repeated this phrase in his mind, he suddenly started screaming in anger," Leave me alone!! Leave me alone!! Leave me the Hell alone!!" The anger became so intense he had to pull over to the side of the road. There in his car a rage he had never felt before, accompanied by trembling and seizure like contractions, came to his consciousness. As a result, he screamed and screamed at someone from his past to leave him the Hell alone!! It took him several hours to finally calm down and eventually relax.

This experience scared Mr. C and that is why he was calling for a therapy appointment. After gathering some necessary information from Mr. C, I scheduled an initial appointment with him to see if we might work together in neuropsychoanalytic psychotherapy. According to my neuropsychoanalysis studies, Mr. C was telling me that he was suffering from the basic emotional need of RAGE (somewhat akin to the Aggression Drive in Freudian Theory.) As you will recall from my previous Blog Posts, this is one of the seven basic emotional needs that drive us as human beings. The other six are: Attachment (PANIC/GRIEF), CARE, FEAR,(Safety Need) LUST, (Sex) SEEKING, and PLAY. Rage, anger, or irritability is aroused in patients who are not able to successfully remove obstacles or impediments to getting their basic emotional needs met. So in the initial phone call and the first assessment session, Mr. C spoke of his problem of feeling this deep body trembling RAGE. I knew then that he had problems in removing people or things that were preventing him from meeting his other needs. And that the resultant RAGE he was feeling had been well defended against throughout his life.

What I came to find out in the first few sessions with Mr. C was that he had a conflict between the two basic emotions of RAGE and Attachment (PANIC/GRIEF).  He had been very close to his mother growing up but at times his mother would greatly frustrate him to the point where he wanted to lash out at her-- to get rid of her--even to destroy her. But his little childhood mind feared that if he expressed such RAGE at his mother that he would destroy her and lose her, and he knew he could not live without her. This conflict between RAGE and Attachment (PANIC/GRIEF) resulted in Mr. C feeling guilt , which is a secondary emotion. Freud defined guilt as aim inhibited aggression. So Mr. C had gone through his life unable to feel RAGE, that is until that day in his car when his defense against the feeling of RAGE broke down and he felt it ( a powerful abreaction) with its full bodily force.

Now neuropsychoanalytic treatment has taught me that Mr. C was clearly not getting his basic need met of removing obstacles from his life that were interfering with his meeting his other needs. The question is, "Why was Mr. C not able to do this?" The answer was this conflict between his RAGE at his Mother and his need for remaining Attached ( PANIC/GRIEF) to her for the love she also provided him. But why had Mr. C not realized that one can have loving feelings and hateful feelings toward one's Mother, and that the hateful feelings will not destroy her? Why had he not learned that ambivalent feelings toward his loved ones is what living in relationship reality is like? Why was Mr. C's ego not able to work out a workable compromise/solution/prediction with his Id? The answer is that Mr. C was not thinking like an adult. He was thinking like a child. He was acting out an unconscious, repressed, prediction (fantasy, wish, belief, faulty ego solution) of: You either love your Mother and keep her close to you, or you hate and destroy your Mother and lose her forever. This is how Mr. C's little child mind thought. His little Ego could not work out a workable solution/prediction to his Id drive demands( basic emotional needs.) So Mr. C's childhood Ego solved the problem of how not to destroy the woman whose love he so desparately needed. But the prediction was not a good one. It was not a workable prediction. It was a childish prediction. It was the best prediction he could come up with at the time, but it clearly was not working for him in his adult life.

This is the problem with patients who come to us for neuropsychoanalytic psychotherapy. They are all to some extent trying to live their adult lives based on unconscious, repressed, childhood predictions. And they do not know that these childhood predictions are repressed and unconscious. They cannot know this. These early solutions have been automatized. They have been pushed deeply into the child's unconscious mind and they are now non declarative. Which means they cannot be declared. They cannot be remembered. They cannot be known. They are unconscious. Mr. C had no idea that at some point in his childhood when he was most frustrated by his mother and felt an impulse of destructive rage toward her, that his little child Ego created a solution/prediction that went like this: " Oh my, I cannot have this thought or this idea. If I have it I may act on it and I may destroy the very woman I cannot live without. So I have to push this intolerable thought into my unconscious mind where it is no longer available for me to think it, remember it, or even know I ever had it." So Mr. C's Ego repressed this thought or idea or fantasy or wish--it is called by many different names.

But what Mr. C also did not know was that although he could cognitively repress this thought or fantasy, he could not affectively repress it. He would still feel the RAGE Feeling. He just had no idea why. He had no conscious awareness of the thought, wish, or solution his mind had come up with as a child. Meaning that the feeling of RAGE toward his mother was still there, and much as he wished not to feel it, he could not help doing so. So, then what was Mr. C's little child mind supposed to do with the remaining unbearable RAGE? He had to develop a defense against the RAGE. This defense would protect Mr. C from feeling the uncomfortable and unbearable RAGE. The defense mechanism Mr. C's childish mind chose was Reaction Formation. In using this defense Mr. C felt the opposite of his hateful feelings toward his Mother. He did not feel RAGE. He only felt love toward her. And as long as this defense was working for Mr. C he did fine. Matter of fact it had worked for him well into his adult life. That is until his defense began to fail and the feeling of RAGE came into his consciousness. This is called "the return of the repressed." That is when Mr. C called and asked for a therapy appointment.

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Six, Part 3 " How to Treat the Mind" Ending Phase/New Prediction

Once your patient's new prediction wins out over the old one, they will get their basic emotional need met, and they will no longer need treatment. The unpleasant feeling/symptom that brought them to therapy will also go away because it was only there due to the unmet basic need. So now your patient is likely to say they are feeling much better, their relationships are now working, and they are getting their basic need met. If you agree with your patient then you can discuss an appropriate termination date.

The termination process is also an important and necessary phase in neuropsychoanalysis/psychotherapy. Again, this ending phase of the work is standard discussion in psychoanalytic treatment, so I will not go over that common knowledge here. What I will say has to do with the unique contribution of neuropsychoanalysis theory and technique to the Ending Phase. And that contribution is to remember that in neuropsychoanalytic therapy you can never get rid of an unconscious, automatized, repressed prediction from childhood. You can only help your patient develop a new one alongside the old one. This is why therapy takes a long time. The patient has to gradually learn the new prediction, and gradually implement it in their lives. During this last termination/ending phase you help your patient understand this, and make sure they are capable of doing this work now on there own. As the patient becomes more and more sure that the new prediction is fully in place in their lives, the more confident they will be in ending the treatment. And if in the future, through deleterious events in their lives, the patient is unable to work through their regressed states on their own, they can always return to therapy for a brief or extended time.

So this is how you conduct neuropsychoanalysis/psychotherapy that is based in psychoanalytic theory and technique, with contributions and alterations from neuroscience. It is the integration of these two fields that constitutes neuropsychoanalysis/psychotherapy.

Introductory Lectures on Neuropsychoanalysis/Psychotherapy: Lecture Six, Part 1 " How to Treat the Mind" Defense Analysis

DEFENSE ANALYSIS

In earlier lectures I have spoken about the role of interpretation in neuropsychoanalytic treatment. I explained the part played by both transference and extratransference interpretations. But we cannot always begin with these type of interpretations. Why is this the case? Because of DEFENSE. Part of the way our minds operate is we defend ourselves from unpleasant feelings in order not to feel them. To feel the feelings would make us too uncomfortable. So we defend ourselves from the discomfort.

When patients come to treatment because their defenses have failed them (which is most often the case), they will be feeling their unpleasant feelings. But when their feelings are adequately defended against, these defenses must be interpreted before transference and extratransference interpretations are attempted. Only after interpreting these defenses can we move to transference and extratransference interpretations of the unworkable, repressed, childhood prediction. For example, let's say when you were a young child your Father would scold you harshly everytime you asked him to PLAY with you. And you wanted to destroy him, kill him, or somehow remove him from the home. But he was bigger and stronger than you, and you could not get rid of him. You felt RAGE toward him as an unwanted obstacle getting in the way of your meeting your PLAY needs. You were also afraid, however , if you expressed your RAGE roward him for being in your way, he would harshly punish you. So you had a conflict that needed resolving. But your little ego was not mature enough to come up with a good solution/prediction to the conflict. So you came up with the best prediction you could at the time which was, " I cannot remove him and get my PLAY needs met, so I will comply with him and forgo meeting those needs."

This was not a workable prediction because the obstacle who stood in the way of your getting your need met was still there. But it was the best solution you could come up with at the time. So to get rid of the anxiety of an insoluable conflict/inadequate prediction, your ego repressed it into your unconscious ( This is primary repression in Freud.) But because the prediction did not work ie, the frustrating obstacle was not removed, you were still left with the feeling of RAGE ( due to prediction error.) Now your ego had to call on the other defense mechanisms to defend you against the feeling of RAGE (Freud referred to these other defenses as secondary or after pressure defenses.)

These defenses would be either the more realistic neurotic defenses such as reaction formation and isolation of affect, or the less realistic narcissistic/borderline/psychotic level defenses such as splitting, introjection, projection and disavowal. Your ego at this time chose the neurotic level defense mechanism of reaction formation. The reaction formation caused you not to feel RAGE but to feel it's opposite, love. But, here is the most important part--your RAGE feeling did not really go away. It was still there-- just defended against.

Now as an adult your rage is so well defended against that you find yourself unable to express RAGE at all--even when you need to. This greatly limits your life. So in order to "undefend" your childhood RAGE you need a neuropsychoanalytic analyst/therapist to help you interpret the reaction formation defense against it-- to dismantle it, so you can feel the RAGE, learn where it came from, understand the unworkable prediction that led to it, and eventually change to a new prediction that will eliminate the need for it. The eventual new prediction will allow you to remove obstacles like your Father from your life. It will say," Instead of destroying persons like my Father who get in the way of my PLAY need, I will assert myself with them and demand they stop. If they refuse, I will end my relationship with them."

And since the new prediction works, and you have successfully removed the obstacle in your way, you no longer feel the RAGE. There is no longer any need for the RAGE, and therefore it does now indeed go away. And since there is now no RAGE, there is no need for the reaction formation defense against it.

In Modern Freudian psychoanalytic treatment this process is called Defense Analysis. As shown above, we follow a similar process in neuropsychoanalytic treatment. The difference comes in understanding the relationship of primary repression to the secondary after pressure defenses. ) Neuropsychoanalysis believes primary repression represses the unworkable childhood prediction. The other after pressure defense mechanisms then defend against the resultant unpleasant feeling. It is these after pressure defenses that the neuropsychoanalytic clinician must interpret first, before being able to interpret the repressed prediction that has caused the unpleasant feeling. The repressed prediction itself then is best interpreted through transference and extratransference interpretations. The interpreted repressed, unworkable old prediction is then eventually replaced with the new workable prediction. But replacing the old prediction with the new one requires what psychoanalytic treatment calls " Working Through."