Hylton, Valerie Leone; (1992) Temporal lobe epilepsy: Aura and the place of psychological treatment (a psychotherapeutic model from the Jungian perspective). Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

On the basis of investigations of epilepsy-related experiential phenomena in Neurology Outpatient and analytical praxis populations, the data collected is considered within the primary context of the patient's own sense of being-in-the- world. Complex psychical aurae, dreams and biographical data, and relationships between these three modalities are discussed. Data is approached from three complementary perpectives: (1) findings of Neuro- Psychiatry which acknowledge the "psychopathological" relevance of aura material, (2) theoretical foundations of Jung's Analytical Psychology (or, "Archetypal Medicine", as its development into psycho-somatics is denoted), and (3) historical and current data from Clinical Neurology pertaining to dreams and aurae. The investigations seek a better understanding of the potential role of psychotherapy in the management of temporal lobe epilepsy (TLE) which, because of the tendency to concentrate on drug or surgical treatment, has been under-emphasized. Surgery has not yet established a clear model for the mechanisms of such experiental phenomena. However, findings about the limbic and neocortical system point to the patient' own temperament as much as to the precise location within that system in the determination of these phenomena. Coming out of this work, then, is a theoretical and practical psychotherapeutic model from the combined perspectives of Neurology and Analytical Psychology / Archetypal Medicine, with specific application to TLE. Mythologems hypothesized as primary determinants of the psycho-somatic predicament, generally and individually, are amplified, and the clinical material further correlated. The psychical phenomenon receiving paradigmatic emphasis, is the episodic sensation of imminent death, which has been suggested as diagnostic of TLE, and for this phenomenon I introduce the term (after Ziegler 1980) "aporetic aura". It is proposed to demonstrate that aporetic and other psychical aurae provide access to the individual's psychodynamics which is comparable to regular dreams, and when analyzed alone or in combination with dreams, offer the possibility of insightful relief accompanied by reduction in both seizure frequency and intensity, as well as perhaps permitting the reduction of medications with their too-often further handicapping side-effects.

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