Stroke Hemiplegia and Specular Image: Lessons From Self-Portraits
Stroke Hemiplegia and Specular Image: Lessons From Self-Portraits
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中风偏瘫和镜面影像：自画像的教训
DOI：
10.2190/f0g2-gw5c-4wg0-kbwl
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
M. Perrigot
中科院分区：
文献类型：
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作者：
C. Morin;P. Pradat;G. Robain;Y. Bensalah;M. Perrigot
偏瘫患者在自我意识方面存在困难，这要么是由于身体意象的特定神经障碍，要么是由于他们的I意象的心理问题。这两种类型的困难都与拉康（1966 a）定义的镜面图像有关（即，将身体与身份的象征性和想象性成分联系起来的心理结构，并中和了母子交换中涉及的真实的对象）。本研究旨在分析近期左右脑血管病变对镜面反射成像的影响。对308名左右脑损伤的中风患者和对照参与者的自画像进行了多变量分析。这揭示了三种主要的自画像类型：1）直立，完整和穿着衣服的自画像主要由正常参与者绘制。2)在所有参与者组中都发现了直立的自画像，没有衣服，手和/或嘴和眼睛，主要是在言语障碍患者中。缺乏手和面部特征表明，任何突然的障碍都会给身份的象征性和想象性方面带来挑战，无论是否由脑损伤引起，而缺乏对称性和垂直性表明，即使在脑损伤中，身体形象也可能保留其结构价值。3)这不是身体意象的神经系统疾病的情况下，因为倾斜的肖像与单侧遗漏主要是由右脑病变的患者绘制。事实证明，这些单方面的遗漏不仅是认知缺陷的结果，而且反映了镜像的破碎，在一种情况下，伴随着物体的不适当的外观。
Hemiplegic patients suffer from difficulties in self-awareness, either due to specific neurological disturbances of body image or to psychological problems with their I images. Both types of difficulty have to do with the specular image as defined by Lacan (1966a) (i.e., the psychic structure that links the body with the symbolic and imaginary components of identity, and neutralizes the real objects involved in mother-child exchange). This study is devoted to analyzing how recent right and left brain vascular lesions affect specular image. Multivariate Analysis of 308 self-portraits of right and left brain injured stroke patients and control participants was performed. This revealed three dominant types of self-portrait: 1) Erect, complete, and clothed self-portraits were predominantly drawn by normal participants. 2) Erect self-portraits, lacking clothes, hands, and/or mouth and eyes were found in all groups of participants, predominantly in patients with speech disorders. Lack of hands and face features are indications of the challenge brought to the symbolic and imaginary aspects of identity by any sudden handicap, whether or not caused by a brain lesion, while symmetry of lacks and verticality show that body image may retain its structuring value even in brain lesions. 3) This is not the case in neurological disorders of body image, since inclined portraits with unilateral omissions were predominantly drawn by patients with right brain lesions. These unilateral omissions proved not only to result from cognitive deficiencies, but also to reflect the fragmentation of specular image, and in one case, the concomitant undue appearance of the object.