La relación angustia depresión desde una perspectiva clínica

Se analizan, desde el punto de vista clinico, las relaciones existentes entre angustia y depresión, según la hipótesis unitaria (ambos estados serían variantes dentro de un mismo núcleo afectivo) o binaria (ambas entidades son totalmente independientes). Se expone, por último, una interpretación personal de este problema.

La Ansiedad como estigma: el estereotipo de la persona ansiosa en la población clínica, sanitaria y general

El objetivo principal de esta investigación fue la evaluación de la teoría implícita o estereotipo que diferentes grupos de población tienen de las personas con ansiedad clínica. Para ello se administró un listado de adjetivos para la heteroevaluación de la persona ansiosa a un total de 400 participantes, distribuidos en cuatro grupos: pacientes con trastorno de ansiedad, población general, médicos y diplomados en enfermería. A los pacientes ansiosos se les volvió a administrar el listado de adjetivos para su autoevaluación. Se llevó a cabo un estudio descriptivo mediante la prueba de χ2 para determinar las diferencias entre grupos en relación a los adjetivos más utilizados. Seguidamente se realizaron dos ANOVAs para establecer diferencias entre grupos a partir de la hetero-evaluación y para comprobar si había diferencias entre la heteroevaluación y la autoevaluación de las personas con trastornos de ansiedad. Los resultados muestran diferencias en la percepción de las personas ansiosas por parte de los 4 grupos; pero solo en el grupo general se detectan creencias prejuiciosas en el estereotipo que muestran de las personas ansiosas. Dichos hallazgos ponen de manifiesto las diferencias en los estereotipos de cada población referentes a las personas con ansiedad clínica

El inventario de historia de pérdidas (IHP): Presentación y utilidad clínica

Las teorías contemporáneas sobre el duelo enfatizan en el papel de la adaptación activa a la pérdida como un factor que afecta a un amplio rango de aspectos psicosociales. A pesar del considerable número de investigaciones empíricas que refuerzan este punto de vista, los investigadores comúnmente han limitado su atención a las respuestas a las pérdidas más recientes sufridas por las personas en duelo antes que estudiar su posible adaptación a las diversas pérdidas sufridas a lo largo de su historia vital. Para ello, los autores presentan el Inventario de Historia de Pérdidas (IHP), el cual evalúa sistemáticamente la forma en que las pérdidas han sido experimentadas por los sujetos y su percepción de haberse adaptado satisfactoria o insatisfactoriamente a cada una de ellas. El IHP puede ayudar en la evaluación psicológica y en la planificación del tratamiento, así como permitir la recolección de datos históricos relevantes para la investigación futura en temas de duelo y pérdida.

Questões da clínica ginecológica que motivam a procura de educação médica complementar: um estudo qualitativo

OBJETIVO: Identificar questões emocionais subjetivas da consulta ginecológica que possam interferir na relação médico-paciente e motivar a necessidade de ampliar a formação pessoal como uma atividade complementar. MÉTODO: Foi realizado um estudo clínico-qualitativo de pesquisa, por meio da técnica de entrevista semidirigida de questões abertas. Estas foram submetidas à técnica de análise temática de conteúdo e elaboração de categorias de análise embasadas no referencial psicodinâmico. Foi constituída uma amostra intencional com oito médicos ginecologistas da Região Sudeste do Brasil. RESULTADOS: A análise das entrevistas originou duas categorias temáticas sobre a relação médico-paciente: a consulta médica como "um encontro afetivo-profissional" e como "um momento de reflexão pessoal". Observou-se que a interação médico-paciente exerce importante papel na satisfação do exercício profissional, contribuindo para que o médico reflita sobre suas questões pessoais. Houve uma demanda por ensinamentos complementares que pudessem dar continência aos sentimentos internos mobilizados a partir da relação com a paciente. Há momentos de maior vulnerabilidade do médico, e o início da prática clínica é considerado um dos momentos marcantes de transição. CONCLUSÃO: Os entrevistados evidenciaram múltiplos aspectos que apontam uma forte mobilização de questões emocionais a partir do contato com as pacientes no ambiente da consulta médica. Limitações da educação médico-acadêmica dos ginecologistas entrevistados levaram à busca de complementação de sua formação pessoal, eventualmente incluindo suporte psicoterápico.

Burnout en trabajadores del área de la salud de urgencias de una clínica universitaria de tercer nivel

El trabajador del área de la salud se encuentra sometido a altos niveles de exigencia que pueden generarle un profundo y progresivo desgaste, lo que a su vez le produce bajo rendimiento tanto cognitivo como laboral. Lo anterior se conoce como el síndrome de Burnout. Objetivo: Identificar y describir la prevalencia de Burnout en el personal asistencial de urgencias de una Clínica Universitaria de tercer nivel y los factores asociados. Metodología: Es un estudio descriptivo de corte transversal. Se aplicaron dos cuestionarios: uno de datos generales y el cuestionario de Burnout de Maslach validado internacionalmente en sus tres componentes: agotamiento emocional, despersonalización y realización personal. Los datos se analizaron mediante dos modelos: uno epidemiológico y otro clínico. Resultados: Se encontró un riesgo intermedio a alto de Burnout en toda la muestra con una alta realización personal. En las personas casadas o con hijos y en los trabajadores con jornadas rotatorias se evidencia un bajo agotamiento emocional. Por el contrario, el personal de enfermería profesional y quienes se encuentran cursando otros estudios presentan un alto agotamiento emocional. El género, el tener otro trabajo y el manejo de estudiantes, no modifican la presentación del cuadro. Conclusiones: Se identificaron como factores protectores contra el síndrome de Burnout el estar casado, tener hijos y las jornadas de trabajo rotatorias con post turnos reparadores. Se encontraron como factores facilitadores del síndrome estar cursando otros estudios y pertenecer al personal de enfermería profesional.

Psicologia e saúde : problematizando o trabalho do psicólogo nas equipes municipais de saúde

Este estudo problematiza a inserção dos psicólogos nas equipes municipais de saúde, a partir da análise da experiência de um grupo formado por psicólogas que trabalham nas equipes de saúde de municípios do Vale do Taquari. São municípios pequenos: um deles tem 70 mil habitantes, os demais são menores, entre 3 e 20 mil habitantes. O estudo foi realizado no período de março de 2002 a janeiro de 2004. Partiremos do pensamento foucaultiano com relação aos dispositivos, que no nosso estudo funcionam para o disciplinamento que forma-conforma psicólogos enquanto profissionais da área da saúde. Através de encontros mensais com o grupo de psicólogas, discutimos e conhecemos suas práticas nos serviços municipais de saúde, e os conceitos de Sistema Único de Saúde (SUS) e do processo saúde-doença que sustenta essas práticas. A separação entre teoria e prática, ciência e profissão, mantida pelos cursos de graduação, aliado à manutenção de currículos voltados para a clínica tradicional (modelo médico hegemônico), mostrou que os psicólogos não se reconhecem como trabalhadores do SUS, mas importam para os serviços do Sistema práticas tradicionais, desconsiderando necessidades e especificidades do contexto sócio-econômico e cultural. A partir destas constatações entendemos que o psicólogo não se reconhece como trabalhador de saúde do SUS e, uma das razões fortes pode ser atribuída ao modelo de formação e prática que vem produzindo e reproduzindo esses modelos há 41 anos. Precisamos formar parcerias para inventar estratégias e promover mudanças nos modos de “fazer psicologia”.

A formação graduada em psicologia no Brasil: reflexão sobre os principais dilemas em um contexto pos-DCN

Criticism done to the undergraduate training process of the psychologist in Brazil raised debates known as "dilemmas of training". In recent years the classic training model, based on the Minimum Curriculum has undergone a series of changes after the National Curriculum Guidelines (DCN), modifying the context of courses. Thus, this paper aimed to investigate, in a post- DCN context how undergraduate courses in Psychology in Brazil have been dealing with the dilemmas of training. So, we decided to analyze the Course Pedagogical Projects (CPPs) of Psychology in the country. Forty CPPs, selected by region, academic organization and legal status were collected. The data was grouped into three blocks of discussions: theoretical, philosophical and pedagogical foundations; curriculum emphases and disciplines; and professional practices. The results were grouped into four sets of dilemmas: a) ethical and political; b) theoreticalepistemological; c) professional practice of the psychologist and d) academic-scientific. Courses claim a socially committed, generalist, pluralistic training, focusing on research, non-dissociation of teaching-research-extension, interdisciplinary training and defending a vision of man and of critical and reflective and non-individualistic psychology. The curriculum keeps the almost exclusive teaching of the classical areas of traditional fields of applied Psychology. Training is content based. The clinic is hegemonic, both in theory and in application fields. The historical debate is scarce and themes linked to the Brazilian reality are missing, despite having social policies present in the curricula. Currently, DCNs have a much greater impact on courses due to the influence of the control agencies, fruit of current educational policy, and the result is felt in the homogenization of curriculum discourses

No pulsar da clínica: a repetição e as produções corporais de uma criança

This study investigates the Repetition of movements shown in a stereotypical case of a child three years old. In line with the psychoanalysis model of search, this work presents fragments of the clinic process, the locus for the observation of repetitive, ritualized and choreographically movements of this child who used not to speak. The contrast between their movements and the issuance of a word verbalized at the end of the treatment caused the following question: repetition in this child production would be a reproduction of the same or would be directing for the difference? In the psychiatric speech, the stereotypes are listed as diagnostic criteria for certain mental disorders. In the psychoanalysis studies a question about the psych nature of ritualistic gestures apparently without purpose or direction is included. Thus, the route followed was the reading of the theoretical concept of repetition in the psychoanalytic works of S. Freud and J. Lacan. With Freud, the repetition is linked to the transfer and resistance. In that context, when it appears in act, in the place of the talk, it constitutes a particular way of remembering. But the existence of a force in the psychic apparatus that acts independent and involuntarily of the Principle of pleasure (the repetition compulsion) subsidizes the discovery of Freudian pulsion of death that is the tendency to return to itself. In the Lacan reading, the function of Repetition is magnified, as it fulfils two functions: the automaton - reminders of repetitive signs, and that the service of tiqué - the meeting of the subject with his lack constituent. In this sense, repetition is not simply a reproduction, but the search for new, the difference, caused by the lack of continuity that pushes the circuit. Finally, the clinic process and the theoretical readings made the comprehension of the child repetitive and choreographically movements and the pronouncement of a "good-bye", full of meaning. This repetitive scenario which is full of questions, by this very nature, insists in remains inconclusive

Prática de coordenação pedagógica e concepções acerca da atuação em psicologia escolar: desvendando um contexto, repensando caminhos

Considering the necessary approaches with the quotidian of the pedagogical field mentioned in the recent productions in Psychology about the insertion of psychologists in the school field, the objective of this work was to know and to understand the dynamics of functioning of a team of pedagogical coordination, intending to produce reflections on the possibilities of action in school psychology with these professionals. Our field of research was the Municipal School Teacher Emília Ramos (EMPER), considering its peculiar history, distinguished by a constant effort of achievement of the school success by its pupils. As subject of the study, six pedagogical coordinators participated, who worked at the school in the diurne turns, where regular classrooms of 1º cycle of basic education functioned. As procedures, we use participant observations and open interviews, focusing the activities performed by the coordinators and its possible demands to psychology. We use the analysis of content for the production of results. These results evidenced a work of coordination realized on a structured routine, but flexible, centered around the activity of conduction of groups of studies with the teachers. We grouped the demands to psychology in four thematic groups: diagnosis and attending the pupils; orientation to the families, contribution in the formation of the professionals and clinical listening of the professionals of the school. In this way, it is made clear that, in a context where happens a well articulated and consistent pedagogical work, the possible performance in school psychology is not scrumbled or confused with social and pedagogical practical others which many times takes attendance. With these information, we expect to contribute for the theoretical and practical elaborations, in Psychology and the Pedagogy, compromised with the success of the educative work realized in the public schools

As especificidades da clínica psicanalítica com crianças na neurose e na psicose: conseqüências para a direção do tratamento

This dissertation aims to answer the question: What are the specifics of psychoanalytical clinic with children in neurosis and psychosis and its consequences for the treatment direction? It constitutes a theoretical study based on Freud, Lacan and the current productions of Lacanian psychoanalysts about the clinic with children. It presents some clinical vignettes. To answer this question, were constructed four chapters. The chapter The subject constitution treats the psychoanalysis subjectivity, based on a structure from the relationship with the Other. Key concepts of Lacanian psychoanalysis are shown, necessary to understand what becomes present in clinic with children. The second chapter, The clinic of neurosis, reveals the structure of the subject in its oedipal mooring held by the Name-of the-Father, that separates the mother-child dual relationship. The child neurosis is the effect of psyche constitution and the symptoms are an interpretation of what child picks up from parents and helps him/her on the passage through the Oedipus. The analyst is there to help him/her through this path. The next chapter is entitled The clinic of psychosis. In psychosis the non-occurrence of the Name-of-the-Father is concerned. The subject is stuck in duality with the mother, and becomes what fills the Other s gap. To protect themselves, they have to be in incessant work. The analyst will be a child s partner in daily work already carried out by him/her. The last chapter, The consequences for the treatment direction, shows that the standard analytic treatment works well to the clinic of neurosis. To psychosis it s not true. Psychoanalysts thought about a different way of psychotic children treatment: the practice held in a multiprofessional team work. The practice shared by many has been a team strategy applied to the institutional practice that aims to attenuate the invasive character of the Other, facilitating the partnership between the analyst and the child in treatment and the Other contention

Abordagem clínica da atividade de trabalho do cozinheiro: interação de saberes, gênero profissional e inovação criativa

The focus of this dissertation is the study of work activities developed in the context of professional occupations characterized by varied previous schooling levels amongst those that work in them, and, at the same time, a high degree of complexity related to the typical tasks performed in the context of such professional practices. This dissertation intends to investigate the cook s professional activity, based on data from a determined specific professional genre in Natal (RN), in order to establish aspects related not only to the activity performed (activity which manifests itself empirically in registered behaviors), but also related to the real aspects of the work activity, that also compromises the non-realized options of the guiding of professional activity, be it by a matter of choice, be it due to the activity s own impediment. In this context, we tried to evaluate how much the professional activity observed keeps in relation to the reference practices of the professional genre, be it in terms of conformity, be it in terms of innovation (stylization) in relation to this genre. In addition, we tried to verify the contribution of the school and extra-school knowledge to the professional activity observed. Such work plan took on a preliminary step of the description of the socialprofessional profile of a cook in the city of Natal (RN), followed by a step of clinical labor approach, specifically utilizing as a methodological tool the simple and crossed self-confrontation procedure guided by the francophone theoretical referential of the Activity Clinic. The preliminary step in the description of profile of cooks from Natal (RN), of which 138 cooks took part in, evidenced three professional groupings, all predominantly masculine in their composition and fundamentally differentiated amongst each other by the time of professional activity, schooling type and time, work place and salary. The clinical approach step, composed by a pair of cooks, allowed us to verify elements of the cooks subordination to the professional genre, but also evidences of individual innovation (stylization) by these cooks, as well as the predominance of usage of extra-school knowledge when compared to school knowledge. We tried, in this step, to demonstrate how much the inclusion and submission to the genre dynamic, coordinated with the stylization initiatives, was able to contribute to the maintenance and amplification of the cook s power of acting in his professional practice.

Escuta clínica e atitude fenomenológica no atendimento à pessoa surda: reflexões sobre um processo psicoterápico

Psychology uses listening as a work resource. When it comes to psychotherapy, listening establishes communication and makes psychologist-client dialogue easier. This qualitative research aims to discuss the clinic listening in phenomenological attitude in existential-phenomenological psychotherapy with deaf people. This perspective is based on the thinking of German philosopher Martin Heidegger, who considers humane a being-with and being-in-the-world, always unveiling meanings. Regarding the deaf people, Libras is currently the natural language of Brazilian deaf people. In this new language configuration, communication occurs in a visual-spatial modality. Thus, listening and speech gain new dimensions, demanding different ways of understanding in the field of psychotherapy. To the development of this research, we present excerpts from therapeutic sessions narratives with a deaf client, interpreted in the light of Heidegger s hermeneutics. We consider that it is possible for the psychotherapist to listen to deaf people in phenomenological attitude. Such position, which does not naturalize and limit the humane, helps so that the clients do not feel responsible for their existence and can hermeneutically converse in their language. In this context, the psychologist must be qualified to conduct the treatment in Libras. We hope that this research can, somehow, fill the existing gap of the scientific production about such theme in the field of Psychology and, mainly, instigate discussion in the context of Psychology courses on the importance and need to qualify psychologists for the management of clinical practice with deaf people

Atendimento psicológico a estudantes universitários: considerações acerca de uma experiência em clínica-escola

O presente estudo tem como objetivo descrever o Programa de Pronto-Atendimento Psicológico ao Aluno (PPAPA). Trata-se de um serviço de atendimento psicológico oferecido gratuitamente junto à clínica-escola da Faculdade de Ciências e Letras de Assis (UNESP) e voltado exclusivamente à comunidade discente interna. Apresentaremos ao longo do artigo uma breve caracterização do serviço, algumas considerações acerca das modalidades de atendimento e estratégias de intervenção empregadas e uma sucinta problematização do manejo de questões técnicas e éticas. Por fim, alinhavaremos algumas propostas para a reestruturação do serviço.