Maria Luiza de Mattos Fiore

Especialidades médicas: estudo psicossocial

This paper presents an exploratory study of the psychological and social factors related to the choice and practice of the various medical specialities, based on the sociological formulation of Bourdieu and the considerations of Dejours concerning mans encounter with his work. The study was based on the analysis of an open interview and social survey questionnaire applied on 40 active medical doctors of both sexes, different ages, and several specialities, in the city of Sao Paulo, Brazil. The results of a thorough analysis of the interviews reveals that: a) the psychological conflicts inherent in the formation of a medical identity and the practice of medicine are influenced by acquired socio-economic elements that lead to differing practical solutions and results depending on social class descent; b) the experiences of each individual, according to his/her socio-economic status, determine the organisation and complexity of his/her subjective space and, therefore, of his/her perceptions and practical behaviour; c) the hierarchy of values in Medicine can be considered as a collective defence against anxieties resulting from medical tasks and the constant dealing with situations of powerlessness.

Adesão ao tratamento clínico no transtorno de personalidade borderline

Compliance is a complex behavior, ranging from minor instances of treatment refusal to the inappropriate use of health services or even treatment abandonment. The study comprises a qualitative analysis of six patients with borderline personality disorder submitted to an open interview, a psychosocial questionnaire, a diagnostic classification through SCDI I and II and a clinical follow-up. Six behaviors made treatment compliance either difficult or impossible: impulsivity, manipulation, affective dissociation, attempted suicide, tendency to regression, and aggression. The participants who abandoned the treatment made the health team impotent, requiring social strategies to manage the situation. We hypothesized that healthy families are of great importance for compliance to treatment. For the cases in which treatment was not abandoned, non-compliance was manifested as attacks against the bonds and against the improvement, and aggression towards the health team and the institution.

Psicanálise e Universidade: a interface possível por meio da pesquisa psicanalítica clínica. Alice quebra-vidros

The relationships between Psychoanalysis, Science and Universities have been discussed since Freud and gained relevance over the 21st century as an important subject for Psychoanalysis. Psychoanalysts who work in Universities are supposed to conduct research. This article comments on possible psychoanalytical research models and supports individual case clinical research through the psychoanalytical method itself, added on qualitative research elements. The authors study the psychoanalytical psychotherapy process and the mental functioning of a borderline patient treated for four years in a public university institution. Approximately 120 of 340 sessions were registered. They were read and re-read by the investigator-psychoanalyst as if they were narratives and revealed some meaningful developments from the psychoanalyst-patient.

Rorschach and the WAIS-III after one and two years of psychotherapy

This study aimed at identifying what aspects of personality are modified after one and two years of psychoanalytic psychotherapy in adults attending a free university healthcare service in Sao Paulo, Brazil. The instruments were the Rorschach and the WAIS-III tests which were administered before and after one and two years of treatment. The participants were 34 adult individuals, both genders. After one year of psychotherapy in the Rorschach method there was an increase in effective and adaptive interpersonal relationship, an enhancement in sensitiveness related to the capacity of modulating affect, the need for close contact as well as the arousal of feelings of discomfort associated with intensification of self-regard, and a decrease in narcissistic tendencies. As well as in WAIS-III, there was an increase in motivation, attention and speed processing.

Rorschach Sistema Compreensivo na avaliação de psicoterapia psicodinâmica

The proposal aimed to evaluate changes due to psychoanalytic psychotherapy on individuals assisted in a university clinic. Thus, 68 adult subjects, both genders, were evaluated before and after one year of psychotherapy. The Rorschach Comprehensive System protocols were analyzed according to their level of complexity, half on “low” [R/+F0] and half on “high” [R0+F/]. Significant statistical differences were found for (a) increase in “low” complexity group and decrease in ‘high’ complexity group on: R; EA; es; SumY; SumShd; FC+CF+C; CF+C; M; active; FD; H+(H)+Hd+(Hd); H pure, DEPI, (b) decrease in “low” and increase in “high” on Lambda and F pure . A confluence of these results was observed; the “high” complexity group showing less turbulence of their emotions, and the “low” complexity group displaying openness to experiences, even if of a more discomforting kind. The therapy proved to be beneficial to the individuals.