Psychological Aspects of Recovery After Brain Injury: A Focus on Psychodynamic Factors

Brain injury may cause serious motor, cognitive, and affective sequelae that significantly affect individual’s functioning, interfering with his/her independence in daily activities. Psychopathology, maladaptive coping styles and poor social cognition are frequently observed in these population of patients and are associated with poorer physical, occupational, and social outcomes. Psychological reactive mechanisms and premorbid cognitive–affective coping style are reported to play a significant role in the patient’s recovery process. Among these, mechanisms of psychological defence, such as repression/denial, may be active in patients that, after brain injury, show emotion/affective dysregulation and tend to use less efficient coping strategies. Moreover, repression/denial could influence the patient’s ability to correctly acknowledge the illness and its consequences, thus hampering his/her productive participation to the rehabilitative program, as well as his/her family and social reintegration. In this chapter, we propose and updated discussion on the possible role of psychological factors in the recovery after brain injury with a particular focus on psychodynamic mechanisms, with the aim to provide some clues for the purpose of the clinical intervention.