Neuroscience and the Death Drive

Adrian Perkel is a registered practising clinical psychologist based in Cape Town, South Africa. He has been lecturing, writing, supervising other professionals, and practising psychotherapy since 1989. His work is deeply informed by psychoanalysis and neuroscience. He is the author of Unlocking the Nature of Human Aggression: A Psychoanalytic and Neuroscientific Approach (2023).

‘Adrian Perkel takes us on an adventurous journey through psychoanalysis and contemporary neuroscience in this bold book. He narrates a story in which the protagonists are aggression and the paradoxes of destruction and conservation of the death drive. Their integration and interpretation lead to innovative emphases about how to understand various psychopathologies and why this necessitates changes towards a more active psychotherapeutic technique to reckon with Freudian dual-drive theory. The argument is often surprising and inspiring when exploring clinical depths and widths. Put playfully, Perkel presents a psychoanalytic Bob Dylan affronting Velcro phenomena implied in every ‘paradogma’.’ Dr Mark Kinet, MD, psychiatrist, psychoanalyst and author of various books on Psychoanalysis and Neuropsychoanalysis, including The Spirit of the Drive in Neuropsychoanalysis (Routledge). 'Adrian Perkel’s new book, ”Neuroscience and the Death Drive: The Nature of Symptoms, From Formulation to Treatment,” reconfigures our understanding of the death drive in terms that will probably render it both more accessible and plausible to psychoanalytic theoreticians. It is, simply, conceived to be a manifestation of the self’s drive to protect itself from the annihilatory experiences that threats originating from both within the organism and outside it can occasion. In response, the self mounts a counterattack, much like an immune system would, against perceived invaders, employing automatized defenses often established in the preverbal era, before memory can be encoded with language. Interestingly, consciousness is also conceived as originating in the brainstem, rather the cortex, the cortex representing that part of the brain which is responsible for creating representational thought that allows the organism to differentiate the various compromises that it faces. Perkel also provides a thoughtful and carefully documented review of libido as a source of psychopathology, noting that Freud unfortunately neglected the dual drive theory that he established in “Beyond the Pleasure Principle.” Perkel’s work paves the way for us to reconsider defense as a consequence of trauma rather than a response to unacceptable libidinal urges. This is a remarkably important paradigm shift for us to undertake and one that has profound implications for our work, as Perkel demonstrates. He ably ties in contemporary conceptions of neuroscience with his thesis.'Dr Richard Wood, PhD, psychoanalytically oriented clinical psychologist and author of ‘A Study of Malignant Narcissism: Personal and Professional Insights’ (Routledge) 'Dr Perkel’s new book, Neuroscience and the Death Drive, is a bold offering whose chief aim is to complete Freud’s death drive. As an extension of his brilliant work on aggression, this exciting new work incorporates classical psychoanalytic writing and theorising situating it within contemporary neuroscientific thinking, and expertly rises to the work’s two-fold challenge, namely: outlining new and detailed formulations around aggression’s central role in psychic life, and providing novel approaches to treatment. This is essential reading for all mental health professionals curious about the enduring presence (and importance) of an essential drive.'Dr Michael Owen, PhD, Editor of Psychoanalytic Practice, Lecturer/ Clinical Psychologist

• 1. The Character of Symptoms 2. The Multiplicity of Subjectivity 3. The Ascendance of Libido and Psychic Conflicts 4. Masturbation: Somatic Self-engagement 5. Anxiety 6. Depression 7. Sexual Dysfunction 8. Addiction 9. Eating Disorders 10. Personality and its Disorders: Derivations and Deviations 11. On Treatment Implications