Daniel Magalhães Goulart

Corpo e palavra: grupo terapêutico para pessoas com transtornos alimentares

Transtornos alimentares constituem relacoes problematicas com a alimentacao e a imagem de si. Seu tratamento deve contemplar multiplas estrategias, inclusive a abordagem grupal. Este estudo teve como objetivos desenvolver reflexoes sobre a grupoterapia com pessoas com transtornos alimentares atendidas em servico especializado e investigar a dinâmica psicologica dos pacientes atendidos, a partir de ressonâncias contratransferenciais. Foram analisados registros de observacao anotados em diario de campo ao longo de 21 encontros grupais consecutivos. O material foi submetido a analise de conteudo na modalidade tematica. Os resultados foram estruturados em tres eixos tematicos: vivencias impactantes mobilizadas no contato com os pacientes; demanda de ajuda dos pacientes para encontrarem as palavras perdidas, como via de acesso a representabilidade dos afetos elididos do espaco mental pela operacao de desafetacao; sentimentos contratransferenciais vivenciados pelo pesquisador. Foram discutidas as implicacoes para o tratamento, visando a busca de estrategias capazes de proporcionar um ambiente terapeutico que facilite a integracao psicossomatica.

The psychiatrization of human practices worldwide: discussing new chains and cages

Decolonizing Global Mental Health is a book that incites us to navigate through a critical perspective on the ‘scaling up’ of psychiatric treatments worldwide, as well as its controversial assumptions and social effects. Taking the Movement for Global Mental Health (MGMH)1 and the current World Health Organisation (WHO) policy as her objects of analysis, Mills proposes a complex map to understand its ramifications around the globe, by revealing a paradoxical condition: while concerns about mental health based on a psychiatric perspective are made a necessary reality for those in the Global South,2 dominant psychiatry has been the object of strong criticisms in the Global North. The author presents her main argument – and does so alongside post-colonial inspired authors, such as Frantz Fanon, Homi Bhabha and Suman Fernando – that this exportation of psychiatry from Global North to Global South is coordinated by strategies of domination and profit. This allows us to understand MGMH and WHO policy as colonial, as well as a form of ‘psychiatric imperialism’ (6). Also, with her case study in India, Mills explains how mental health non-governmental organisations (NGOs) in the global South ‘may constitute some of the capillary channels for this discourse to travel’ (9). Overall, the book offers a powerful analysis of the strength of psychiatric interpellation currently in the Global South, as well as providing strong ideas that call for action. In this sense, it is an interesting resource for students, researchers and practitioners of psychology, psychiatry, public health, social work and cultural studies.

The Relevance of the Concept of Subjective Configuration in Discussing Human Development

The topic of human psychological development has frequently been dealt with by general individualistic, teleological and moralistic theories. However, within Soviet psychology, Vygotsky and Bozhovich advanced theoretical alternatives for the study of psychological development, in which the concepts of perezhivanie and social situation of development were central. The importance of that legacy opened new ways of understanding the subjective side of psychological development. The focus of this chapter is to advance a comprehension of subjective development, on the basis of concepts that permit to integrate the diversity of social and cultural conditions of experience into processes and subjective units (subjective senses and subjective configurations), which emerge not as reflection of those social and cultural conditions, but as new qualitative subjective productions. The chapter presents two case studies, one about learning difficulties and the other about severe mental health problems. These case studies show that singularity is not reduced to an individualistic approach. Moreover, they evidence that the emergence of new subjective senses and configurations is closely related to the creation of new spaces of social integration characterised by a dialogical communication, which, in turn, is a condition for the emergence of affective processes. The concept of subjective configuration is presented as an attempt to define a unit of subjective functioning that allows us to overcome the dispersive taxonomy which characterises the history of developmental psychology.

Mental health care and educational actions: From institutional exclusion to subjective development

Abstract This paper is based on a qualitative research study within a Community Mental Health Centre in Brazil. It addresses professional actions within mental health services as a sensitive sphere in which to discuss deadlocks and critical strategies to expand practices towards deinstitutionalization. The idea of subjective development from a cultural-historical standpoint is discussed as a theoretical way to promote institutional practices which articulate education and mental health care. Subjective development is regarded as a non-universal, non-deterministic, and context-sensitive process, having the subject configuration as its unit. We argue that such discussion has heuristic value for understanding mental health as a living process, beyond hermetic diagnostic entities, overcoming the objectualization and hierarchical aspect which frequently characterize the relationship between service users and workers. Moreover, we discuss how professional actions geared toward subjective development could enhance dialogical relations capable of supporting individuals and groups to actively position themselves as subjects in their life pathways. From this point of view, individuals are not considered as an epiphenomenon of social forces, such as the result of the effects of power, but as a crucial moment of social experience.

Body and word: therapeutic group for people with eating disorders

Transtornos alimentares constituem relacoes problematicas com a alimentacao e a imagem de si. Seu tratamento deve contemplar multiplas estrategias, inclusive a abordagem grupal. Este estudo teve como objetivos desenvolver reflexoes sobre a grupoterapia com pessoas com transtornos alimentares atendidas em servico especializado e investigar a dinâmica psicologica dos pacientes atendidos, a partir de ressonâncias contratransferenciais. Foram analisados registros de observacao anotados em diario de campo ao longo de 21 encontros grupais consecutivos. O material foi submetido a analise de conteudo na modalidade tematica. Os resultados foram estruturados em tres eixos tematicos: vivencias impactantes mobilizadas no contato com os pacientes; demanda de ajuda dos pacientes para encontrarem as palavras perdidas, como via de acesso a representabilidade dos afetos elididos do espaco mental pela operacao de desafetacao; sentimentos contratransferenciais vivenciados pelo pesquisador. Foram discutidas as implicacoes para o tratamento, visando a busca de estrategias capazes de proporcionar um ambiente terapeutico que facilite a integracao psicossomatica.

Cuerpo y palabra: grupo terapéutico en los trastornos de alimentación

Transtornos alimentares constituem relacoes problematicas com a alimentacao e a imagem de si. Seu tratamento deve contemplar multiplas estrategias, inclusive a abordagem grupal. Este estudo teve como objetivos desenvolver reflexoes sobre a grupoterapia com pessoas com transtornos alimentares atendidas em servico especializado e investigar a dinâmica psicologica dos pacientes atendidos, a partir de ressonâncias contratransferenciais. Foram analisados registros de observacao anotados em diario de campo ao longo de 21 encontros grupais consecutivos. O material foi submetido a analise de conteudo na modalidade tematica. Os resultados foram estruturados em tres eixos tematicos: vivencias impactantes mobilizadas no contato com os pacientes; demanda de ajuda dos pacientes para encontrarem as palavras perdidas, como via de acesso a representabilidade dos afetos elididos do espaco mental pela operacao de desafetacao; sentimentos contratransferenciais vivenciados pelo pesquisador. Foram discutidas as implicacoes para o tratamento, visando a busca de estrategias capazes de proporcionar um ambiente terapeutico que facilite a integracao psicossomatica.