Help needed with cerebral stroke patient

Delphine Ricci delphine.descamps at
Tue Sep 5 16:56:28 EST 2000

I need guidance, information (books, web sites; forum) and advice for a
patient, female, age 64, with a endomyocardic fibrosis (with a serious risk
of further embolic episodes) who had several micro strokes and a major
episode in 1996 which left her aphasic and hemiplegic.

The patient implements a strategy of refusal of her condition which is
characterized by hyperactivity, aggressiveness (against those who "care for
her" such nurses, family etc.), anxiety, euphoria. This behaviour is
alternated with depression, lack of interest for news and interaction,
progressive and conscious isolation. The overall pattern of her bahaviour is
actually highly dependent on pre-existent depression, anxiety, and
aggressive behaviour which emerged in the patient 40s.

The patient does not appear to be psychologically ill, she actually seems to
"mean what she says" to people. As a matter of fact this increases the
effectiveness of her verbal aggressions which occur more and more often
since the patient systematically tries to impose her will against anybody

This behaviour-  which evoques traits of a regression to adolescence -
endangers the patient. An increasingly frequent number of "rebelions" (such
as taking a plane, remaining home alone at night w/out assistance, stopping
medicines against specific prescriptions) are putting the patient life at
risk. The paradox of the patient lies in the conflict between her dangerous
and self desctructive behaviour and a self conscious, lucid, self caring
attitude which tends to compensate the eccesses of the other self.

Can you suggest readings, or any other form of support for cases like this?
Do you know of any centre which treats cerebral stroke survivors with
support therapies? 

Thanks for your help Andrea RICCI
Reply to andrea.ricci at

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