Relatos da pandemia: ser mulher e mãe em tempos de covid-19 / Pandemic reports: being a woman and mother in covid-19 times / Relatos de la pandemia: ser mujer y madre en tiempos del covid-19

Partindo da pergunta "Como tem sido ser mulher e mãe em tempos de pandemia?", o presente estudo convidou mulheres que são mães, em redes sociais virtuais, a partilhar um relato de suas experiências com a readaptação parental em função do distanciamento social causado pela pandemia de covid-19. O objetivo foi refletir sobre a experiência de ser mulher e mãe em tempos de covid-19 e distanciamento social, apontando algumas ressonâncias do cenário pandêmico na subjetividade dessas mulheres. O estudo teve como base o referencial psicanalítico, tanto na construção da pesquisa e análise dos relatos quanto na sua discussão. A análise dos cerca de 340 relatos coletados, os quais variaram de uma breve frase a longos parágrafos, apontou para uma série de questionamentos, pontos de análise e reflexões. A pandemia, e o decorrente distanciamento social, parece ter colocado uma lente de aumento sobre as angústias das mulheres que são mães, evidenciando sentimentos e sofrimentos sempre presentes. Destacaram-se, nos relatos, a sobrecarga das mulheres com as tarefas de cuidado dos filhos e da casa, a culpa, a solidão, a exaustão, e o sentimento de que não havia espaço nesse contexto para "ser mulher", sendo isso entendido especialmente a questões estéticas e de vaidade.(AU)

Starting from the question "How does it feel to be a woman and a mother in pandemic times?", this study invited women who are mothers, in virtual social networks, to share their experiences regarding parental adaptations due to social distancing caused by the COVID-19 pandemic. The objective was to reflect on the experience of being a woman and a mother in the context of COVID-19 and of social distancing, pointing out some resonances of the pandemic scenario in the subjectivity of these women. The study was based on the psychoanalytical framework, both in the construction of the research and analysis of the reports and in their discussion. The analysis of about 340 collected reports, which ranged from a brief sentence to long paragraphs, pointed to a series of questions, analysis topics, and reflections. The pandemic, and the resulting social distancing, seems to have placed a magnifying glass over the anguish of women who are mothers, showing ever-present feelings and suffering. The reports highlighted women's overload with child and house care tasks, the guilt, loneliness, exhaustion, and the feeling that there was no space in this context to "be a woman," and it extends to aesthetic and vanity related questions especially.(AU)

A partir de la pregunta "¿cómo te sientes siendo mujer y madre en tiempos de pandemia?", este estudio invitó por las redes sociales a mujeres que son madres a compartir un relato de sus experiencias sobre la readaptación parental en función del distanciamiento social causado por la pandemia del covid-19. Su objetivo fue reflexionar sobre la experiencia de ser mujer y madre en tiempos del covid-19 y el distanciamiento social, señalando algunas resonancias del escenario pandémico en la subjetividad de estas mujeres. Este estudio se basó en el marco psicoanalítico, tanto en la construcción de la investigación y análisis de los informes como en su discusión. El análisis de los casi 340 relatos, que variaron de una pequeña frase a largos párrafos, generó en las investigadoras una serie de cuestionamientos y reflexiones. La pandemia y el consecuente distanciamiento social parece haber agrandado las angustias de las mujeres que son madres, evidenciando sentimientos y sufrimientos siempre presentes. En los relatos destacan la sobrecarga de las mujeres con las tareas de cuidado de los hijos y del hogar, la culpa, la soledad, el cansancio, así como el sentimiento de que no hay espacio em este contexto para "ser mujer", relacionado principalmente a cuestiones estéticas y de vanidad.(AU)

Attachment processes following traumatic loss: A mediation model examining identity distress, shattered assumptions, prolonged grief, and posttraumatic growth.

OBJECTIVE: Sudden or violent death of a loved one poses unique challenges for the bereaved. Research has found such losses to be associated with higher levels of chronic psychological distress. The present study explored underlying mechanisms and risk and protective factors for both prolonged grief and posttraumatic growth, considering both human and divine attachment. METHOD: In a mixed college and community sample of 374 traumatically bereaved adults, we examined associations between adult attachment to close others, adult attachment to God, identity distress, and shattered assumptions with the outcome variables of prolonged grief and posttraumatic growth. RESULTS: Correlations indicate that religious individuals' attachment patterns in close adult relationships were partially mirrored in their relationship with God. Regression analyses indicate a curvilinear relationship between prolonged grief and posttraumatic growth. Path analyses indicate significant associations between insecure attachment strategies and prolonged grief symptoms through the mediators of identity distress and shattered assumptions. Specifically, attachment anxiety in relation to close others and God, and attachment avoidance in relation to close others, were indirectly associated with prolonged grief. Attachment avoidance in relation to God was negatively associated with prolonged grief and posttraumatic growth, but there was no evidence for mediation. CONCLUSION: Faced with the traumatic loss of a loved one, the ability and desire to effectively access relationships facilitating emotional processing and cognitive reorganization is predicated on survivors' internal working model of attachment. These results inform the assessment and treatment of individuals bereaved through sudden or violent means. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

[Depression in adolescents and multiculturality : a multifactorial analysis of psychological suffering inside a family in crisis]. / Dépression chez l'adolescent et multiculturalité : analyse multifactorielle de la souffrance psychique au sein d'une famille en crise.

The complexity of depressive diagnosis and other forms of expression of psychological suffering during adolescence explain why particular caution is required. The medico-psycho-social determinants of teenager's mental health enjoin us to support a holistic analysis of these situations. Different analysis spectra - symptomatic, environnemental, anthropological, cultural - allow us to understand a situation at different levels of interpretation. As we will see through a clinical case examination, the difficulty of depressive diagnosis in a multicultural background is increased by the ethnocentrical aspect of this category.

La complexité des diagnostics de type dépressif et des modes d'expression de la souffrance psychique à l'adolescence nous invitent à la prudence. Les aspects médico-psycho-sociaux des déterminants de la santé mentale à l'adolescence nécessitent de privilégier une analyse la plus holistique et complète possible dans les situations rencontrées. Différentes grilles d'analyse - symptomatique, environnementale, anthropologique, culturelle - permettent de comprendre une même situation à plusieurs niveaux d'interprétation. Comme nous le verrons dans la discussion autour d'un cas clinique, la difficulté du diagnostic dépressif en milieu multiculturel est encore majorée par le caractère ethnocentrique de cette catégorie.

[AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders]. / AIT (Adolescent Identity Treatment) ­ ein integratives Therapiekonzept zur Behandlung von Persönlichkeitsstörungen.

AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in adolescence and emerging adulthood the diagnosis is often delayed. In most cases, specific treatment is only offered late in the course of the disorder and to relatively few individuals. Adolescent Identity Treatment (AIT) is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, a behavior-oriented homeplan and intensive family work is part of AIT.

Current developments in the practice of individual psychoanalytic psychodrama in France.

The authors present the history of individual psychoanalytic psychodrama and its current developments as practised in France. They put forward the technique, objectives and rules, along with the indications, limits and risks that ensue from the specific nature of this therapeutic approach. Through its technical adjustments, individual psychoanalytic psychodrama provides a therapeutic option that is appropriate to the defences prevalent in many patients that cause classical psychotherapies to fail: massive inhibition, operative functioning far removed from affects or in false self mode; phobias, disavowal or splitting of the internal psychic life and emotions; prevalence of short discharge circuits in acted-out behaviours and bodily or visceral complaints and expressions. Psychodrama utilizes these defences not in order to eliminate them but to 'subvert' them so that they can continue to carry out their protective role, in particular ensuring narcissistic continuity. At the same time, psychodrama relaxes these defences and facilitates a possible filtering through of the repressed material. Through the number of actors and the diffraction of transference that this allows, psychodrama provides a possibility of adjusting the potentially traumatic effect of the encounter with the object and the instigation of the transference in the regressive dimension induced by any psychotherapeutic process.

Culturally adapted cognitive-behavior therapy: integrating sexual, spiritual, and family identities in an evidence-based treatment of a depressed Latino adolescent.

The article described and illustrated how a culturally adapted cognitive-behavioral therapy (CBT) can maintain fidelity to a treatment protocol while allowing for considerable flexibility to address a patient's values, preferences, and context. A manual-based CBT was used with a gay Latino adolescent regarding his sexual identity, family values, and spiritual ideas. The adolescent suffered from a major depression disorder and identified himself as gay and Christian within a conservative and machista Puerto Rican family. CBT promoted personal acceptance and active questioning of homophobic thoughts in a climate of family respect. CBT enabled identity formation and integration, central to the development of a sexual identity for lesbian, gay, bisexual, and transgender youth, with remission of the patient's depression and better family outcomes.

Moral agency, identity crisis and mental health: an anthropologist's plight and his Hmong ritual healing.

During anthropological fieldwork, the author had a serious accident on the outskirts of a Hmong village in the highland of Laos. However, this dramatic incident turned out to be the occasion of his ritual initiation into the local village community. An analysis of narratives of the incident reveals Hmong conceptions of the anthropologist's physical, mental and moral affliction, its causative concomitants and his ritual healing. Hmong mental health and identity are situated in a moral space of exchange relationships to significant others, challenging basic assumptions of concepts of the person widely held in psychiatry and beyond. The healing ritual transformed the author's being from indeterminate "other," in a life-threatening state of identity crisis, to a wholesome Hmong "self," in a state of health and moral agency. This exemplary rite de passage highlights the affinity of ritual healing and constitution of self in a moral space. The underlying relational concept of the person is in sharp contrast to psychiatry's concepts of the person, which are deeply shaped by values of individualism. Psychiatric services must accommodate substantial differences in the concepts of the person when treating Hmong migrants from Laos.

Existential aspects of living with addiction - part I: meeting challenges.

AIM: This paper aims to explore the existential aspects of living with addiction. BACKGROUND: This study arises from data from a previous research project carried out by the author and takes as its point of departure the patient's perspective. Addiction is described as being related to traumatic experience and to loss of control, shame, guilt and low self-esteem, but also to spirituality. This causes profound suffering and drugs are used as a means of handling this suffering. DESIGN: Hermeneutic inquiry was used to explore peoples experiences of living with addiction. METHOD: The first study was based on interviews with people with rich, personal experience of addiction. This study constitutes a secondary analysis of the same data and was conducted using a hermeneutic approach. RESULTS: On an existential level the experiences of living with addiction can be understood as a striving to meet and resolve challenges associated with spirituality caused by a person's suffering and, paradoxically, also by his/her efforts to relieve that suffering through the use of drugs. These challenges are presented as themes focusing on the conflict that must be met; meaning - meaninglessness, connectedness - loneliness, life - death, freedom - adjustment, responsibility - guilt, control - chaos. CONCLUSION: Living with addiction appears as being in the midst of a struggle with existential challenges. Furthermore, the use of drugs is paradoxical as it momentarily relieves suffering but at the same time increases it. RELEVANCE TO CLINICAL PRACTICE: Addressing the challenges will facilitate nurses interaction with addicted persons. When facing challenges, including the motivational aspects, instead of focusing on problems, health can be promoted and suffering relieved.

The Jewish child, adolescent, and family.

This brief review addresses the history, beliefs, and practices of Jewish families that have implications for clinical management of the problems and disorders of children and adolescents. It focuses primarily on the problems of the Orthodox family due, in part, to the limitations of space. There remains, however, little doubt that the clinician must be aware of the impact that Jewish heritage may have on the clinical issues at hand. This impact is significant whether the worldview of the family is characterized by strict Orthodoxy or is primarily that of an ethnic identification with less concern for belief and practice.

Hindu and Buddhist children, adolescents, and families.

The language of psychotherapy that focuses on the individual may be problematic for Hindu and Buddhist families. The focus on child and adolescent development as a separation-individuation process that moves the child into an independent life with individual goals may run contrary to family cultural values and to the Hindu and Buddhist views of interconnectedness. For the Hindu family, however, when therapy can be seen as being compatible with an evolution toward the higher self and is consistent with the shared sense of family belonging, the goals can be complementary. With the fundamental views in Buddhism that suffering derives from emotional and conceptual misunderstandings and from the resultant actions, and that change is necessary to relieve that suffering, therapy and practice may share goals. The spiritual teachings can work alongside the therapeutic work, and the improved functioning is also spiritual growth.

Creating a language for 'spiritual pain' through research: a beginning.

The findings presented in this discussion seek to make a contribution to fostering an appreciation of the importance of research on spirituality, a previously neglected dimension of health care. Qualitative research methodology based on open-ended interviews with 12 survivors of haematological malignancies was used. The interviews were transcribed verbatim and thematically analysed using the NUD*IST computer package. The preliminary findings from the study indicate a need for the development of a new language for articulating spirituality. The present discussion is an introductory attempt to begin to explore the notion of, and language for, the idea of 'spiritual pain'. The findings indicate that individuals need a strong sense of meaning-making and connection with life to be able to deal with the demands of aggressive, invasive treatments. Such a connection can be threatened by a break with the normal or expected relationships and satisfaction with life through physical, identity, relational and existential challenges and losses. When the disconnection is acutely painful (a subjective phenomenon depending on the individual) it then is experienced as spiritual pain, creating a void that challenges the individual's ability to derive any meaning from their existence. This study is seen as preliminary work, the first step in a series of articles aimed at beginning to develop, through research, a language of spiritual care.

Faith, identity, and leukemia: when blood products are not an option.

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers and gain insight and support from fellow staff members. When a competent adult patient refuses lifesaving treatment for religious or personal reasons, caregivers have a legal obligation to respect this decision. A patient's refusal of treatment adds particular challenges to the delivery of compassionate care. The case of a 50-year-old Jehovah's Witness with acute myelocytic leukemia who declined blood product support is presented. Respecting her religious beliefs during chemotherapy required balancing risk and benefit, watching her suffer while unable to intervene with what the staff saw as simple treatment, and eventually undertaking a complicated grief process. Jehovah's Witness beliefs regarding blood products are reviewed. Caregiver roles and responsibilities are discussed in the context of psychosocial, legal, familial, and ethical issues.

The psychotherapy of a modern warlock: rapprochement in a coven of white witches.

This paper describes the complex psychotherapy of a young man involved with white witchcraft and a coven of white witches during crucial phases of therapeutically activated processes of separation-individuation. Psychoanalytic concepts are applied toward a theoretical and technical understanding of such a unique therapy and of white witchcraft in general.

Anorexia nervosa in a black Zimbabwean.

In spite of the comparative rarity of anorexia nervosa in African patients, the case of a young black Zimbabwean woman which fulfils Feighner's diagnostic criteria is presented. Special reference is made to several unusual features which include the social and psychological conflicts engendered by changes of culture, the clinical symptoms, and the role of a traditional healer in her recovery. A speculative hypothesis concerning aetiology is suggested.

[To die and to be! Archetypal view of puberty crisis]. / Stirb und werde! Archetypische Betrachtung einer Pubertätskrise.

The myth of death and rebirth is illustrated by a series of drawings, sandplays and dreams produced by an adolescent during a depressive crisis. This material is compared with the symbolism in initiation rites of the primitives. Astonishing parallels are found, i.e. the same archetypal motifs, as a manifestation of the collective unconscious. The transforming energies of these symbols are revealed through the course of therapy.

Suicide and drug abuse in the medical community.

In the United States each year the equivalent of an average-size medical school graduating class commits suicide, with the highest incidence occurring in the decade following the completion of training. Of these suicides, 20% to 30% are associated with drug abuse and 40% with alcoholism. Various problem areas are considered. Role strain, leading to excessive drug use in an attempt to increase work efficiency, is coupled with a denial of the physician's own dependency needs and gratification. The problem of identity occurs in relation to the exaggerated sense of duty and obligation the physician feels in attending to the demands of the patients and their families. Medicine as magical thinking is also discussed, revealing the physician's belief in his own immunity, which is strenuously tested when he actually sets up in practice. The community's high regard for the physician further complicates the situation. Too little has been done about working with emotional problems of medical students during their training and after they begin to practice. Unfortunately, physicians feel uncomfortable in turning to colleagues for help; rather, they tend to isolate themselves, resorting to alcohol and drugs. One should question the selection of medical students and their overall training, not only in terms of academic learning but also with more consideration for the stresses and strains of the future career.