[Asomatognosia and oral drive: a psychoanalytical perspective]. / Asomatognosie et troubles de l'oralité. Une lecture psychanalytique.

ABSTRACT

OBJECTIVE: The psychoanalytic concept of specular image refers to the complex construction that associates the body image with the language coordinates of the individual, thus making him/her a human subject. The acquisition of this specular image implies the loss of corporeal exchanges between mother and child, i.e., the "neutralization" of those body parts or extensions where these exchanges take place. These conceptions of body image and subjectivity lead to the hypothesis that neurological disturbances of body schema may alter the patients' subjectivity and their relation to the lost "object" insofar as they alter body image. MATERIAL: In the present paper, we present two patients aged under 50, with a unique first ever stroke due to ischemia in the right middle cerebral artery territory and asomatognosia. METHODS: On one hand, Bisiach's protocol was used to assess hemiplegia, sensory troubles, visual troubles, hemineglect and anosognosia, and adapted to assess asomatognosia. On the other hand, subjective data were gathered during a semistructured interview and a self-portrait test. RESULTS: This showed that asomatognosia was accompanied by a destructuration of body image and aberrant oral manifestations involving the paralyzed hand. DISCUSSION-CONCLUSION: The psychological positive phenomena accompanying asomatognosia might correspond to the intrusion of the lost object in the patients' psychic reality, due to the alteration of body schema and body image.