Psychodynamic Significance of Seizure Content in Psychomotor Epilepsy

Abstract

Summary Two patients with psychomotor epilepsy were studied in an intensive psychotherapeutic setting. The psychodynamic significance of the highly organized seizures and the nature of the psychic phenomena encountered in these seizures were investigated. The content and structure of these highly organized psychomotor seizures have the characteristics of nonreporting emotional thought. This thought level appears normally in dreams and other altered states of awareness. In the psychomotor epileptic it appears episodically and finds motor expression because of the faulty integration of his impaired nervous system. The highly organized seizure can be understood in the same fashion as the dream; that is, dream behavior is motivated, has meaning for the individual in terms of wish fulfillment and riddance, and is in keeping with the psychodynamic patterns of the patient. The highly organized seizure can be analyzed dynamically and understood as motivated behavior. In addition, the seizure content can be modified by current experiences, particularly psychotherapy. The relationship between seizures and psychotic episodes occurring in each of the patients was studied. The seizure behavior and the behavior encountered during psychotic episodes was similar and at times identical, both in the conflict expressed and in the method of resolution. It was noted that seizures diminished when the psychosis appeared. Seizures have an adaptive value representing miscarried attempts to dispel mounting psychological tension not immediately soluble in reality.