A clínica psicanalítica das urgências subjetivas no hospital universitário: construção de um caso clínico / Psychoanalysis of subjective urgencies at a university hospital: construing a clinical case / La clínica psicoanalítica de urgencias subjetivas en el hospital universitario: construcción de un caso clínico

O hospital constitui-se como um contexto em que a urgência subjetiva pode vir a se apresentar de forma frequente, instaurando, para cada sujeito, uma vivência de angústia. O objetivo desta pesquisa foi investigar as possibilidades para uma clínica das urgências subjetivas no contexto de um hospital universitário em Salvador, considerando as vivências em uma residência multiprofissional. Trata-se de uma pesquisa qualitativa de caráter exploratório, em que se realizou revisão teórica sobre o tema e se construiu um caso clínico, sob orientação psicanalítica. A escolha do caso baseou-se na escuta clínica ao longo dos atendimentos e da atuação em equipe multiprofissional, considerando os impasses ao longo do tratamento. Foram utilizados registros documentais produzidos pela psicóloga residente ao longo dos atendimentos, que ocorreram durante três meses. Os resultados apontam para as contribuições da escuta psicanalítica no tratamento das urgências e na atuação em equipe multiprofissional no contexto hospitalar. A subjetivação da urgência permitiu, no caso em questão, um tratamento pela palavra do que havia incidido diretamente no corpo como fenômeno. Conclui-se pela relevância em discutir o tema da urgência e suscitar novas pesquisas, reintroduzindo no contexto hospitalar a questão sobre a subjetividade.(AU)

Hospitals are contexts in which subjective urgency can frequently materialize, triggering an experience of anguish for each subject. Hence, this research investigates the possibilities of establishing a subjective urgency clinic at a university hospital in Salvador, considering the experiences in a multidisciplinary residence. A qualitative, exploratory research was conducted by means of a theoretical review on the topic and construction of a clinical case, under psychoanalytical advisement. The case was chosen based on clinical listening during the sessions and performance in a multidisciplinary team, considering the obstacles for long-term treatment. Data were collected from documentary records produced by the resident psychologist during three months. Results point to the contributions of psychoanalytic listening to treating subjective urgencies and to the performance of a multidisciplinary team in the hospital context. In the case in question, subjectivation of urgency allowed a treatment through the word of affecting phenomenon. In conclusion, discussing urgency and conducting further research, are fundamental to reintroduce subjectivity in the hospital context.(AU)

El hospital es un contexto en el que frecuentemente se puede percibir una urgencia subjetiva, estableciendo una experiencia de angustia para cada sujeto. El objetivo de esta investigación fue investigar las posibilidades de una clínica de urgencia subjetiva en el contexto de un hospital universitario en Salvador (Brasil), considerando las experiencias en una Residencia Multiprofesional. Se trata de una investigación cualitativa, de carácter exploratorio, en la que se realizó una revisión teórica sobre el tema y construcción de un caso clínico, con orientación psicoanalítica. La elección del caso se basó en la escucha clínica a lo largo de las sesiones y actuación en un equipo multidisciplinar, considerando los impasses para el tratamiento a largo plazo. Se utilizaron registros documentales elaborados por el psicólogo residente, durante las atenciones, que se realizaron durante tres meses. Los resultados apuntan a las contribuciones de la escucha psicoanalítica en el tratamiento de urgencias y en la actuación de un equipo multidisciplinario en el contexto hospitalario. La subjetivación de la urgencia permitió, en el caso en cuestión, un tratamiento a través de la palabra de lo que había afectado directamente al cuerpo como fenómeno. Se concluye que es relevante discutir el tema de la urgencia y plantear nuevas investigaciones, reintroduciendo el tema de la subjetividad en el contexto hospitalario.(AU)

Notas sobre o pesquisar em cena(s) / Notes on researching in scenes / Notas sobre la investigación en escena(s)

O presente artigo tem como objetivo apresentar a construção metodológica desenvolvida em uma pesquisa de mestrado, na qual sustentamos a escrita de cenas como método de pesquisa da escuta clínica. As cenas do trabalho em questão foram recolhidas ao longo do tempo, no contorno da experiência de um projeto de extensão universitária de atenção à infância e adolescência em situação de vulnerabilidade social, situado em uma comunidade periférica. Apresentamos, neste texto, as interrogações que se elaboraram em torno da escolha pelo trabalho com cenas, e compartilhamos o resgate histórico dessas como um método de escrever a clínica, bem como a retomada de sua análise a partir da tradição psicanalítica. Amparadas nesta teoria e em leituras e contribuições do filósofo francês Jacques Derrida, embasamos a noção de que a cena se constitui como um lugar de produção, ao engendrar a configuração particular de elementos significantes nos processos de subjetivação e de construção social. A cena não é, então, compreendida aqui como uma representação do que acontece na clínica, mas como um modo de produzir a escuta e os seus processos de investigação.(AU)

This article aims to present the methodological construction developed in a master's research, in which the writing of scenes as a method of clinical listening research was endorsed. The scenes from the study in question were collected over time, from the experience gained in a project conducted within a university extension program on care in childhood and adolescence in social vulnerability, in a peripheral community. In this study, we present some questions that were elaborated surrounding the choices of working with scenes; and we share the historical rescue of this work as a method of writing on clinic practices and resuming their analysis from the psychoanalytic tradition. Based on the psychoanalytic theory and on the readings and contributions of the French philosopher Jacques Derrida, we corroborate the notion that the scene is constituted as a place of production, engendering the particular configuration of significant elements in the processes of subjectivation and social construction. Here, the scene is not a representation of clinical practice but one mode of producing listening and its research processes.(AU)

Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)

Abordagem de narrativas como método de pesquisa em saúde pública: aproximações conceituais e contribuições da psicanálise / Narrative research in public health: conceptual approximations and contributions from psychoanalysis / Enfoque en narrativas como método de investigación en salud pública: aproximaciones conceptuales y aportaciones del psicoanálisis

Este artigo refere-se à parte de uma pesquisa de doutorado, realizada em hospital de alta complexidade do Sistema Único de Saúde, cujos participantes são os profissionais de saúde. O objetivo deste artigo é analisar o potencial da abordagem das narrativas como método de pesquisa e intervenção nos serviços de saúde, traçando aproximações com a teoria psicanalítica. Sua relevância no campo da Saúde Pública está calcada no reconhecimento do papel do sujeito como agente de mudanças. O texto divide-se em duas partes: na primeira, explora as especificidades do trabalho na área da saúde, o paradigma da saúde pública no que concerne à gestão e possíveis contribuições da clínica ampliada para esse modelo. Na segunda parte, analisa o uso das narrativas como método de pesquisa nesse campo e as aproximações conceituais entre a narrativa em Walter Benjamin e a psicanálise em Freud. Busca na literatura referências sobre experiências análogas que fundamentem a proposta ora realizada e conclui pela importância de, no momento atual, apostar na força germinativa das narrativas como fonte criativa de novas formas de cuidar.(AU)

This article derives from a PhD research conducted with health professionals at a high-complexity public hospital from the Brazilian Unified Health System (SUS). It analyzes the potential of the narrative as a research and intervention method in health services, outlining approximations with psychoanalysis. In the field of Public Health, the narrative approach acknowledges the individual as an agent of change. The text is divided into two parts. The first presents an overview of the peculiarities involved in healthcare, the Public Health paradigm regarding service management and possible contributions from the expanded clinic to this model. The second analyzes the use of narratives as a research method in this field and the conceptual approximations between Benjamin's narrative and Freud's psychoanalysis. It searches the literature for references on similar experiences to support the present proposal and concludes by highlighting the importance of betting on the creative power of narratives as a source for new ways to care.(AU)

Este artículo es parte de una investigación doctoral, realizada con los profesionales de la salud de un hospital de alta complejidad del Sistema Único de Salud de Brasil. Su propósito es analizar el potencial del enfoque en narrativas como método de investigación e intervención en los servicios de salud, esbozando aproximaciones entre las narrativas y la teoría del psicoanálisis. Su relevancia en el campo de la salud pública se basa en el reconocimiento del rol del sujeto como agente de cambio. El texto se divide en dos partes: La primera investiga las especificidades del trabajo en el área de la salud, el paradigma de la salud pública en la gestión de los servicios y las posibles contribuciones de la clínica ampliada a este modelo. En la segunda parte, analiza el uso de narrativas como método de investigación en este campo y las aproximaciones conceptuales entre la narrativa de Walter Benjamin y el psicoanálisis de Freud. Este estudio busca en la literatura referencias sobre experiencias similares que apoyen la propuesta ahora realizada y concluye con la importancia de, en el momento actual, apostar por el poder de las narrativas como fuente creadora de nuevas formas de cuidar.(AU)

Experiencias paranormales y su relación con el sentido de la vida / Paranormal experiences and their relationship with the meaning of life

Se investigó los efectos que tienen las experiencias paranormales en la vida de las personas. Se recogieron los resultados de una muestra de 24 personas activamente interesadas en pensamiento new age y otras cuestiones esotéricas que reportaron haber tenido al menos una experiencia paranormal. Tales experiencias incrementaban el interés en cuestiones espirituales así como la sensación subjetiva de bienestar. También mostraron disminución en el temor hacia la muerte, depresión o ansiedad; aislamiento y soledad; preocupaciones y temores acerca del futuro. Una gran mayoría de los encuestados indicó que estos efectos resultaban de una combinación de más de una experiencia paranormal y trascendental espiritual. La magnitud de los cambios en el bienestar y en la espiritualidad estuvieron positivamente asociados con el número de experiencias anómalas. Los puntajes de bienestar y la importancia de la espiritualidad estuvieron positivamente asociados con los cambios en el bienestar y la espiritualidad que resultaron de las experiencias anómalas. Aunque el 45% de los encuestados indicó que la experiencia paranormal había sido atemorizante, este temor parecía ser temporal o mezclado con sentimientos positivos...

The effects that have paranormal experiences in the life of the people were investigated. The results of a sample of 24 people actively interested in thinking new age and esoteric issues that reported having at least one paranormal experience were collected. Such experiences increased their interest in spiritual matters as well as the subjective sense of well-being. They also showed a decrease in fear of death, depression or anxiety, isolation and loneliness; concerns and fears about the future. A large majority of the respondents indicated that these effects were a combination of more than one spiritual, paranormal and transcendental experience. The magnitude of the changes in welfare and spirituality were positively associated with the number of anomalous experiences. Well-being scores and the importance of spirituality were positively associated with changes in welfare and spirituality which resulted from the anomalous experiences. Although 45% of respondents indicated that the paranormal experience had been frightening, this fear seemed to be temporary or mixed with positive feelings...

Communication and laboratory performance in parapsychology experiments: demand characteristics and the social organization of interaction.

This paper reports findings from a conversation analytic study of experimenter-participant interaction in parapsychology experiments. It shows how properties of communication through which the routine business of the experiment is conducted may have an impact on the research participant's subsequent performance. In this, the study explores social psychological features of the psychology laboratory. In particular, it examines aspects of Orne's (1962) account of what he called the demand characteristics of the psychological experiment. The data come from a corpus of audio recordings of experimenter-participant interaction during experiments on extra-sensory perception. These kinds of experiments, and the phenomena they purport to study, are undoubtedly controversial; however, the paper argues that there are grounds for social psychologists to consider parapsychology experiments as a class (albeit distinctive) of psychology experiments, and, therefore, as sites in which general social psychological and communicative phenomena can be studied. The empirical sections of the paper examine interaction during part of the experimental procedure when the experimenter verbally reviews a record of the participant's imagery reported during an earlier part of the experiment. The analysis shows that the way in which the experimenter acknowledges the research participants' utterances may be significant for the trajectory of the experiment and explores how the participants' subsequent performance in the experiment may be influenced by interactionally generated contingencies.

Validation of the English and French versions of the Community Assessment of Psychic Experiences (CAPE) with a Montreal community sample.

OBJECTIVE: The aim of this study was to examine the reliability, validity and factor structure of the Community Assessment of Psychic Experiences (CAPE), a 42-item self-report questionnaire. We analyzed the internal consistency of the CAPE to determine whether the 3-factor structure (positive, negative and depressive symptoms) found by the CAPE authors would also be found in our sample. METHOD: A sample of 2275 individuals from the general community in the Montreal area completed the questionnaire in either French or English. RESULTS: The internal consistencies of the original three subscales were good and the confirmatory factor models had a good fit. The exploratory factor analysis suggested a 3-5-factor solution, without improving the alternative factor structures. The 4-factor solution separated positive symptoms into factors we called 'bizarre positive symptoms' and 'social delusions', and the 5-factor solution separated positive symptoms further and included a 'popular psychic beliefs' factor. Results suggest that the scalability might be improved by shortening the original questionnaire to 23 items with the same 3 original scales. CONCLUSION: We support the internal consistency of the CAPE. Although alternative scaling (4 and 5 factors) did not improve the model fit, researchers interested in distinguishing 3 factors of positive symptoms could find utility in these two new scales. Finally, reducing the number of CAPE items could be useful for shorter surveys. Future studies should test the implications of these suggestions.

Demographic and psychological features of déjà vu experiences in a nonclinical Japanese population.

The authors investigated the frequency and correlates of déjà vu experiences in 386 healthy adult volunteers recruited from several areas in Japan. Déjà vu experiences and related experiences were evaluated using the Inventory of Déjà vu Experiences Assessment. Déjà vu experiences were observed by 294 (76.2%) of the 386 participants. Persons who experienced déjà vu were younger and more educated than persons who had not experienced it. There were no differences in the frequency of déjà vu experiences based on sex, hand preference, or area of residence. Subsequent factor analysis associated déjà vu with precognitive dreams and remembering dreams as dream- and memory-related factors rather than with the dissociation-related factors of depersonalization, derealization, jamais vu, and daydreams or with mental activity-related factors such as paranormal quality and travel frequency. Results suggest that déjà vu experiences are associated with good memory function.

An empirical assessment of content in criminal psychological profiles.

Although criminal psychological profiling has been in use by law enforcement agencies for almost three decades, there is a paucity of empirical research examining the technique. A fundamental issue that has received little attention is the empirical evaluation of information contained in profiles composed by professional profilers. In this study, a group of profilers, police officers, psychologists, college students, and self-declared psychics were given information from a solved murder investigation, after which the participants composed a written profile predicting the probable offender. Professional profilers tended to write more lengthy profiles that contained more information about the nonphysical attributes of the offender and more information about the crime scene or the offender's behavior before, during, and after the crime. These results are discussed in terms of their implication for our broader understanding of the technique of profiling and future directions for research into profiling.

Risk perception and new age beliefs.

This is a study of risk perception in relation to New Age (NA) beliefs, including traditional folk superstition and belief in paranormal phenomena, as well as use of alternative healing practices. Data were also obtained on trust dimensions and on personality and psychopathology variables, as well as religious involvement. It was found that four factors accounted for the investigated NA beliefs, which were termed higher consciousness beliefs, denial of analytic knowledge, traditional superstition, and belief in the physical reality of the soul. NA beliefs were strongly and positively related to religious involvement, and negatively to educational level. These beliefs were also positively related to maladjustment and to concerns over tampering with nature. In regression analyses, it was found that NA beliefs explained about 15% of the variance of perceived risk, and that the most powerful explanatory factors were higher consciousness beliefs and beliefs in paranormal phenomena. Traditional superstition and use of healing practices did not contribute to explaining perceived risk.

An assessment of contextual mediation in trance states of shamanic journeys.

30 experiences of shamanic journeys derived from Harner (1990) were analyzed based on a recent coding scheme for contextual variables proposed by Lange, Houran, Harte, and Havens. Consistent with previous research, the experiential content of the trances was quite consistent with the content of the available contextual variables, and embedded cues in particular (r = .68, p < .001). As predicted, trance states of shamanic journeys are sufficiently structured to suppress contextual effects on the modality of experience. The findings suggest that the contents of shamanic trance are not solely influenced by psychopathology, biochemical effects, or cultural influences.

Female sexuality, social reproduction, and the politics of medical intervention in Niger: Kel Ewey Tuareg perspectives.

This essay explores connections between political institutions, forms of power, and women's health care concerns from a cultural anthropological perspective. I focus on the roles of different medical establishments among the Kel Ewey Tuareg of Niger--Western-European sponsored, central state, traditional herbalism and Islamic scholarship--in creating, maintaining, and disputing these constructs, through the invention and elaboration of disease categories and through the selective application of medical and reproductive models and technology to women. I also explore women's attempts to manage these forces, as they draw upon a cultural inventory that is alternately supportive and in conflict with their interests.

PIP: Among the Kel Ewey Tuareg of Niger, women's sexuality and reproductive health have become central foci of a struggle for hegemony on the part of Western European-sponsored state clinics, traditional herbalism, and Islamic scholars. This power struggle threatens to jeopardize Tuareg women's traditionally high status, prestige, and independence expressed, for example, in ownership of herds and participation in trade, the right to eject husbands from the tent, and self-representation in litigation. To protect their autonomy, Tuareg women are reluctant to acknowledge their illnesses--especially those related to reproduction. Although women desire medicines and treatments for infertility, they fear the power and mistrust the motives of the male medical specialists. State health facilities are associated with the earlier French colonial presence, and important interventions such as immunization and oral rehydration are viewed as attempts at political manipulation. Thus, care is taken to ensure that no one health practitioner accumulates too much power. During pregnancy and childbirth, for example, women may utilize the services of female herbalists, the hospital, and exorcists. Current state policies favor sedentarization and patrifocal residence, causing divisions between Tuareg men and women; at other times, ethnic-based solidarity takes precedence. Essential to an understanding of medicine in this traditional community is a political-cultural anthropological analysis of the dialectical interplay between the female body, power, and resistance.

Age differences in mystical experience.

Age differences are examined in reports of deja vu, ESP, clairvoyance, spiritualism, and numinous experience. According to the 1988 General Social Survey (N = 1481), these mystical experiences are somewhat more common now than in 1973, and deja vu, clairvoyance, and a composite mysticism score have increased with successively younger age cohorts. Further, private and subjective religiosity are positively related to overall mystical experience, while organizational religiosity is inversely related.

The experiential foundations of shamanic healing.

An experience-centered approach reveals empirical foundations for shamanic healing. This article is based on data derived from surveys of Chinese, Japanese, Caucasian-American, and African-American populations and participant observation of over thirty Asian shamans. Respondents reported anomalous events such as apparitions, extrasensory perceptions, contact with the dead, precognitive dreams, clairvoyance, and out-of-body experiences. Based on folk reasoning, these episodes support belief in spirits, souls, and life after death. Shamanic healers have a far greater propensity to experience anomalous events than general populations and to use their beliefs arising from these episodes to produce ceremonies that change clients' perceptions of their illnesses. Although the foundations supporting shamanism differ from those sustaining Western medicine, both traditions provide experiences that convince clients that specific procedural methods alleviate illness.

Supernatural beliefs, natural kinds, and conceptual structure.

This article presents cross-cultural evidence in support of the notion that adults' natural kind concepts are theory based but may be informed by knowledge/belief systems other than the biological. Three groups of subjects from western Nigeria--rural, urban, and elite--participated in the study. Subjects heard stories describing alterations of appearance; that is, one natural kind was made to resemble another in both ritual and nonritual contexts. Subjects then were required to judge the identity of the altered item and to give an explanation for the category judgment. It was predicted that subjects would make more nonpreservation-of-identity category judgments supported by supernatural explanations in the ritual contexts and that subjects' use of supernatural explanations would reflect the extent of their engagement with the supernatural. The first prediction was borne out; the second prediction was only partially supported. Discussion of the results emphasizes the importance of exploring the role of sociocultural factors in conceptual structure.

Creencia en fenómenos paranormales: implicancias sociocuclturales / Beliefs in paranormal phenomena sociocultural aspects

Se analizan las relaciones entre creencias en fenómenos paranormales y otras variables de orden sociocultural y de personalidad, en grupos de estudiantes de nivel sociocultural medio-alto y medio-bajo. Los resultados evidencian que las creencias en fenómenos paranormales son significativamente más frecuentes en el grupo de nivel-bajo y se asocian, también significativamente, con extroversión y rasgos psicopáticos, si bien otras variables de orden psicosocial pueden incidir en su evaluación