The Milan Approach, History, and Evolution.

The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn: embodied experience as preconceptual know-how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances: the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one's own presuppositions and prejudices that limit one's capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.

Los dos autores se proponen subrayar las continuidades y las discontinuidades que organizan la terapia sistémica de Milán después de la separación de Selvini Palazzoli y Prata, y comunicar las enseñanzas de Luigi Boscolo y Gianfranco Cecchin desde el comienzo de la formación en 1978 hasta la actualidad. Después de haber hablado de algunas etapas importantes en el trabajo hasta la muerte de los dos maestros, el artículo subraya dos aspectos nuevos e importantes. 1. Hablamos acerca del giro corpóreo: la experiencia personificada como conocimiento preconceptual desde el cual se estructuran los conceptos. Hablamos acerca de las conexiones entre los cuerpos y los problemas sociales que representan formas de conocimiento y comprensión. 2. En este periodo de guerra, violencia y tiranía hablamos acerca de la epistemología y la ontología como posturas complementarias: la necesidad de dejar que los demás se den a conocer permitiéndoles comunicar sus propias condiciones de participación. El esfuerzo terapéutico es el de desactivar los peligros de las presuposiciones y los prejuicios propios que limitan la capacidad de una persona para describir y elaborar hipótesis. Hay antologías sociales, comunidades con una intensidad moral fuerte, realidades históricas y sociales que necesitan que los terapeutas adopten una postura, ya que deben tomar partido y ser conscientes de las categorías que utilizan. La ontología histórica y social se ocupa del cambio continuo de síntomas en relación con el cambio continuo del panorama social en el contexto en que vivimos. Vivimos según los cuerpos que somos.

Cognitive and Personality Factors Implicated in Pain Experience in Women With Endometriosis: A Mixed-Method Study.

OBJECTIVE: The impact of pain on quality of life and mental health of women with endometriosis is well known. However, the role that personality traits and coping strategies might have in influencing pain experience is still poorly understood and was the chief purpose of this study. MATERIALS AND METHODS: We conducted a mixed-method sequential explanatory study, composed of a quantitative survey followed by qualitative interviews. The first quantitative phase included 162 women with endometriosis who completed a battery of validated questionnaires. After statistical analysis, a semistructured qualitative interview has been developed and conducted with 6 of them, in order to help explain findings obtained in the first phase. Thereafter, both analyses were combined in a metamatrix. RESULTS: From the metamatrix, it emerged that acute pain experience, fear of its occurrence, its unpredictability, and control difficulties are the main concerns of women with endometriosis. Worry trait characteristics (ie, the need for control, anticipatory anxiety, intrusive worry thoughts) and maladaptive thoughts such as coping strategies (ie, self-blame, rumination, catastrophizing) were common in this sample and seem to indirectly affect pain experience. Indeed, the unsuccessful struggle in controlling pain reinforces negative thoughts/beliefs and feelings of powerlessness, leading, in turn, to psychological distress and higher pain experience. DISCUSSION: From the study emerged a model of onset and maintenance of acute pain in women with endometriosis. Findings have clinical implications for the medical team and psychologists.