Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

El "Fedro" de Platón: un ejercicio de buena retórica engañosa

En este artículo me propongo mostrar que lo que Sócrates hace con Fedro a lo largo de toda la obra no es otra cosa que utilizar la auténtica retórica (con su doble carga, dialéctica y psicológica) que es descrita en la segunda parte del diálogo. Las tensiones, rivalidades y celos de la situación inicial entre ellos expone un perfil representativo de relaciones entre interlocutores con perspectivas intelectuales opuestas. Es preciso disolver la resistencia emocional por medio de una serie de pasos graduales, estratégicos, y ‘engañosos’ (no se puede develar el propio juego desde el principio). Hay que partir de acuerdos, siquiera parciales, para continuar dialogando. Sin embargo, Sócrates también introduce nociones nuevas acerca del amor, pero éstas pasan desapercibidas a un Fedro obsesionado con la imitación de su enamorado Lisias. Hasta que Sócrates decide cortar el juego y cruzar el río. Este corte provoca un giro en ambos personajes: Fedro se dispone a escuchar lo que Sócrates quiere contarle (el mito del carro alado) y Sócrates se revela ante sí mismo como un personaje capaz de ‘encantar’ a Fedro con la belleza rapsódica del relato y superar su propio temor de convertirse en una bestia devoradora. Al final Sócrates muestra su juego a Fedro y le enseña cómo ha sido posible llegar a un auténtico diálogo filosófico, donde pueda tener lugar la enseñanza y el aprendizaje recíprocos.

Rightful Resistance in the Colombian conflict. A theoretical reflection based on a Peace Community

This article considers the opportunities of civilians to peacefully resist violent conflicts or civil wars. The argument developed here is based on a field-based research on the peace community San José de Apartadó in Colombia. The analytical and theoretical framework, which delimits the use of the term ‘resistance’ in this article, builds on the conceptual considerations of Hollander and Einwohner (2004) and on the theoretical concept of ‘rightful resistance’ developed by O’Brien (1996). Beginning with a conflict-analytical classification of the case study, we will describe the long-term socio-historical processes and the organizational experiences of the civilian population, which favoured the emergence of this resistance initiative. The analytical approach to the dimensions and aims of the resistance of this peace community leads to the differentiation of O`Brian’s concept of ‘rightful resistance’.