Um caso de transtorno de personalidade borderline atendido em psicoterapia dinâmica breve

Trata-se de um caso de Transtorno de Personalidade Borderline, encaminhado para a área de Psicoterapia Dinâmica Breve (PDB) do Centro de Psicologia Aplicada da UNESP - Bauru/SP. O foco delimitado consistiu em trabalhar as características depressivas do paciente, buscando ajudá-lo a elaborar o luto pela perda de sua mãe. A análise deste caso veio corroborar a hipótese de que pacientes com transtorno de personalidade borderline também podem ser beneficiados com a PDB. A peculiaridade desta modalidade de atendimento está relacionada ao estabelecimento de objetivos terapêuticos (foco) condizentes com as reais possibilidades e limites de cada paciente.

A manifestação da vontade da criança na disputa judicial da guarda: escuta psicanalítica/

Currently, in custody disputes, the child has the right to be heard and to have its opinion considered, according to its age and maturity. The psychologist/psychoanalyst who works in the Family Court is required to produce a Report with the purpose of helping the Court´s decision. The present research aims to discuss and to find guiding principles for the hearing of the declaration of the child´s will in a custody dispute by its parents, from a psychoanalytical perspective. The case of a nine year old girl that affirmed in Court the desire of living with the mother and seeing the father only once a year is the starting point of this theoretical research over the psychoanalytic fundaments of the hearing of the case, how it appeared in that experience and how it was reflected in the report. Throughout this work, the peculiarities of psychoanalysis as a way of understanding the subject and the conditions that must be observed so that a sctrictu sensu analytic hearing is possible are studied. Then we present a reflection of the case, in the light of the theories studied, verifying that we could observe in the experience: i) the assumption of a subject of the unconscious, divided and desire full that constitutes itself from the oedipic structuration, that leads to the difference between speech and speak; ii) the concept of the child as having a sexuality of its own; iii) a hearing based on the ethic principles of psychoanalysis and the analysts'' formation. In the final considerations, we state that the institutional demand of a meaning for the case is a great difficulty for the analyst since he works from a place of 'not-knowing"

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

Práticas de cura místico-religiosas, psicoterapia e subjetividade contemporânea

Nous avons analysé les résultats d'une recherché sur les pratiques de guérison mystico-religieuses (chez les Églises Évangéliques et Catholique Renovée, et chez l'Oumbanda). Ainsi que leur comparaison avec le traitement fourni, chez les Ambulatoires de Santé Mentale publiques, aux individus se plaignant de souffrance psychique. L'analyse statistique a révélé que les pratiques de guérison mystico-religieuses sont efficaces à la solution des problèmes de ceux qui les ont cherché, en surmontant, dans le court délai, l'efficacité obtenue par les pratiques ambulatoriales. Un des principaux moyens d'efficacité des pratiques de guérison mystico-religieuses consiste dans l'offre de sens de diverses nuances, d'où se ressort le sens radical de teneur imaginaire, qui implique en des adhésions institutionelles du type fanatique ou ritualistique en bonne partie des cas. Les pratiques de guérison mystico-religieuses semblent fonctioner comme des orthopédies des maladies de l'individualisme contemporain, en réinstallant, par des moyens syntoniques, quelque fonctionalité de la catégorie individu. Comme suite de l'analyse, nous arrivons à l'hypothèse sur l'existence d'une Culture du Mysticisme en état avancé de formation dans le contexte brésilien, comme conséquence des caractéristiques culturelles et des effets de la perturbation des rapports du sujet avec le domaine du symbolique, dans les sociétés de consommation mondialisées à exclusion sociale accentuée et affectées par une importante crise de sens, conséquence de l'ébranlement des idéaux les plus basilaires du libéralisme.

Psicoterapia grupal no transtorno obsessivo-compulsivo

There are few published papers about group psychotherapy for patients with obsessive-compulsive disorder (OCD), and usually restricted psychoeducational, support or cognitive-behavioral approaches. This article describes the experience of group psychotherapy for OCD patients started in 1996 in Botucatu Medical School - Unesp, São Paulo, Brazil. The two-hour sessions occur once a month, with 6 to 10 female patients, and are based on psychodramatic techniques. Psychotropic prescriptions are given after the sessions. In the beginning, aggressive obsessions were more prominent and were reported with much anguish and shame. Gradually, the themes changed from OCD specific issues (symptoms, pharmacological treatment, outcome, need of exposure and response prevention) to deeper and more personal psychodynamic aspects. The psychodramatic approach (techniques of double, mirror, role inversion, search for prymary scenes) has mostly shown: difficulty in accepting their own human mistakes or negative emotions due to excessive personal demands. This seems to generate guilt, low self-esteem, idealization of others, difficulty in enjoying pleasant situations, fear of taking responsibilities and of losing control (madness/aggressiveness). The group has been considered very important by the patients, since sharing experiences helps to diminish feelings of isolation, shame and guilt, stimulates the exposure to feared situations and enhances self-esteem. The fact that all participants have the same disorder favors group cohesion and provides relief, as they see in the others some of their afflictions and are able to share similar feelings and experiences. Many times the burden of the symptoms are dealt with humor. The confidence in such therapeutic setting is helping the identification and resolution of personal conflicts and contributing to the adherence to pharmacological treatment. The group also provides valuable training experiences for resident physicians in psychiatry.

Comparação, em mulheres inférteis, de teste de avaliação psicológica com a análise psicanalítica clássica

This study aims to compare a psychological evaluation test to classical psychoanalysis in infertile women. Two hundred women were submitted to the Psychological Evaluation Test (PET). The sum of the scores for the responses ranged from 15 to 60 points, with scores ≥ 30 points being defined as psycho-emotional maladjustment (cut-off point: median + 25%). For comparison, a psychologist submitted the patients to a psychological examination simultaneously, who was unaware of the PET results. From the 200 patients, 66 (33%) presented a test with ≥ 30 points (psycho-emotional maladjustment) and 134 (67%) a test with < 30 points (normal). Upon psychological examination, 105 (52.5%) presented an abnormal evaluation and 95 (47.5%) a normal evaluation. For the PET, statistical analysis showed 82% efficiency, 62% sensitivity, 98% positive predictive value, 99% specificity, 70% negative predictive value, likelihood ratio for a positive test result 62, and likelihood ratio for negative test result 0.38. The PET proved to be a useful clinical instrument, being of help for the selection of patients with psychological needs induced by infertility.