Temporalidade e Corpo numa Proposta de Formação do Psicólogo para o Trabalho com Povos Indígenas / Temporality and Body in Proposal for Training Psychologist in the Work with Indigenous Peoples / Temporalidad y Cuerpo en una Propuesta de Formación del Psicólogo para el Trabajo con Pueblos Indígenas

O artigo aborda práticas do serviço Rede de Atenção à Pessoa Indígena ­ vinculado ao Departamento de Psicologia Experimental do Instituto de Psicologia da Universidade de São Paulo ­, no período de 2015 a 2017, visando discutir os impactos de mudanças nos procedimentos de visitas às comunidades para a formação do psicólogo. A exposição do corpo do psicólogo em formação a contextos ritualizados segundo padrões distintos de sua cultura de origem faz emergir inquietações e angústias que caracterizam o modo de relação com a alteridade. Como ferramentas para elaboração desse modo de relação, os Guarani das comunidades visitadas nos propõem diálogos em que a prioridade é o estabelecimento de uma sintonia adequada com a sintonia do outro, preliminar à discussão e encaminhamento de projetos que abordam temas difíceis relativos a situações de vulnerabilidade psicossociais que as comunidades enfrentam....(AU)

The article deals with the practices of the Amerindian Support Network ­ linked to the Department of Experimental Psychology of the Institute of Psychology of the University of São Paulo ­ in the period from 2015 to 2017, aiming at discussing the impacts of changes in procedures for visiting the communities for training psychology students. The exposure of the body of the psychologist in training to ritualized contexts from different cultural patterns, in contrast to the students' original culture, gives rise to unease and disquieting feelings that characterize the relationship with alterity. As tools for the elaboration of this mode of relation, the Guarani from the communities we visited proposed to us dialogues in which the priority was to establish an adequate attunement to the attunement of the other. This attunement is apreliminary condition to discuss and forward projects that deals with challenging issues related to situations of psychosocial vulnerabilities the focused communities face....(AU)

El artículo aborda prácticas del servicio Red de Atención a la Persona Indígena ­ vinculado al Departamento de Psicología Experimental del Instituto de Psicología de la Universidad de São Paulo ­ en el período de 2015 a 2017, con el objetivo de discutir los impactos de cambios en los procedimientos de visitas a las comunidades para la formación del psicólogo. La exposición del cuerpo del psicólogo en formación a contextos ritualizados según patrones distintos de su cultura de origen hace emerger inquietudes y angustias que caracterizan el modo de relación con la alteridad. Como guías de elaboración de este modo de relación, los guaraníes de las comunidades visitadas nos proponen diálogos en los que la prioridad es el establecimiento de una sintonía adecuada con la sintonía del otro, preliminar a la discusión y encaminamiento de proyectos que abordan temas difíciles relativos a situaciones de vulnerabilidad psicosociales que las comunidades enfrentan....(AU)

La imitación y el entonamiento afectivo en el juego social temprano / Imitation and affect attunement in early social play

Con el objetivo de estudiar las pautas adultas de imitación y entonamiento afectivo que ocurren en las situaciones de juego social temprano entre adulto y bebé, se realizó un estudio longitudinal de caso único, con una díada adulto-bebé. La edad del bebé en la primera sesión, según la convención piagetiana [año; mes (día)], fue: 00; 3 (05) y en la última sesión: 00; 6 (28). Se filmaron 8 sesiones de interacción espontánea de la díada, en su hogar, cada 15 días. De cada sesión se seleccionaron los primeros 10 minutos de juego social temprano. Con este material se generó una video-secuencia de juego social temprano a la que se le aplicó un código observacional con categorías para las pautas de actividades de coincidencia maternas (imitación y entonamiento afectivo). Los datos obtenidos en este estudio indican que las actividades de coincidencia maternas de imitación y entonamiento afectivo aparecen en todo el período estudiado, con una frecuencia de dos eventos de coincidencia por minuto de juego social temprano. Se observó que las pautas de entonamiento afectivo materno casi duplican a las de imitación entre los 3 y 6 meses de vida del bebé. Asimismo, se registró que la mayoría de los entonamientos afectivos fueron transmodales y que la madre utilizó su voz como modalidad conductual privilegiada para establecer coincidencias comportamentales con su bebé, ya sea a través de la imitación o del entonamiento. Las imitaciones maternas más frecuentes ocurrieron como respuesta a las vocalizaciones del bebé y los entonamientos afectivos fueron provocados principalmente por los movimientos del bebé.

This paper focuses on two specific matching activities of maternal behavior in early social play: imitation and affect attunement. Imitationis a pattern of frequent interaction between adult and baby, providing a pleasant experience to both participants. In that context, imitation is not only bi-directional, but it is the adult who imitates more frequently. Affect attunement is an intuitive and fleeting interaction pattern, through which the adult attunes to the baby's affective state. It is a matching activity, where the amodal features of the infant's behavior (intensity, temporal organization, spatial pattern and / or quantity) are reflected through a different conduct. Previous research indicates that during the first 6 months of the baby's life, the adult very often uses imitation as well as affect attunement for interacting (which involves performing a different behavior than the baby's in which the adult matches the intensity, temporal pattern, spatial pattern, and / or the amount of the child's original behavior). Maternal affect attunement events have been observed from 2 months of age, and the frequency ratio between affect attunement and maternal imitation has been observed to change in ontogenetic development: between the baby's 2nd and 6th months the adult's imitative activity occurs at higher rates; while in the second half of the first year of life, the relationship is reversed. This paper presents the results of a longitudinal case study on a mother-infant dyad, about maternal imitation and affect attunement behaviors in early social play situations between the 3rd and 6th months of the baby's life. According to Piaget's convention [year; month (day)], the baby's age was 00; 3(05) in the first session, and 00; 6 (28) in the last session. Every 15 days, a total of 8 sessions of the dyad's spontaneous interaction, were filmed in their home. From each session, the first 10 minutes of early social play were selected. With this material a video-sequence of early social play was generated to which an observational code with categories for maternal matching activity patterns (imitation and affect attunement) was applied. The percentage of each category's occurrence in each evolutionary period was calculated. The data obtained in this study indicate that maternal matching activities of imitation and affect attunement appear from the beginning of the studied period. These results confirm those previously obtained in other studies that show the early emergence of adult imitation and affect attunement behavioral patterns. The data also indicate that matching activities of imitation and affect attunement appear throughout the studied period with a frequency of two events perminute of early social play. These results partially confirm those previously obtained in other studies. The new information obtained in our study concerns the frequency of both reciprocity patterns, and the type of behavior of the mother and baby involved in these matching activities. Patterns of maternal affect attunement almost double those of imitation between the baby's 3rd and 6th months. It was also reported that most affect attunements were transmodal and that the mother used her voice as a privileged way to establish a behavioral match with her baby, either through imitation or affect attunement. The most frequent maternal imitations occurred in response to the baby's vocalizations, and affect attunements were caused mainly by the baby's movements. Without detracting from the dyad's intense vocal activity already registered in the field's literature, the high frequency of affect attunements in response to infant movement highlights a trait less noticed in previous research: the adult's mastery in reading the baby's body and movement.

El Entonamiento Afectivo en las Interacciones Tempranas Adulto-Bebé: una Revisión / Affect Attunement in Early Adult-Infant Interactions: A Review / A Sintonização Afetiva nas Interações Precoces Adulto-Bebê: uma Revisão

Resumen Este artículo presenta una revisión de las investigaciones sobre entonamiento afectivo en interacciones tempranas adulto-bebé, que siguen la definición original propuesta por Stern. El entonamiento afectivo constituye una pauta de interacción intuitiva que sirve para sintonizar con el estado afectivo del bebé momento a momento. Si bien este concepto ha sido claramente definido y ampliamente aceptado, hasta ahora hay pocos estudios realizados. La mayoría de ellos son estudios observacionales y transversales que se concentran en la descripción de situaciones de juego social madre-bebé durante el primer año de vida del infante. Se reflexiona sobre la escasa cantidad de trabajos realizados en el área y se proponen futuras vías de investigación: la prolongación de su estudio en el segundo año de vida y en poblaciones con dificultades del desarrollo; la evaluación de la incidencia de la disposición corporal y de la presencia de objetos en la frecuencia de entonamiento afectivo en interacciones espontáneas.

Abstract This article reviews research on affect attunement in early adult-infant interactions, following Stern's original definition. Affect attunement is a pattern of intuitive interaction to share the affective state of the infant. Although this concept has been clearly defined and widely accepted, until now few studies on this have been done. Most of those that have been done are observational and cross-sectional focusing on the description of mother-infant social play situations during the infant's first year. The article reflects on the scarceness of work done in this area and proposes future research areas: continuation of the study into the second year of life and in populations with development difficulties, an evaluation of the role of body disposition and the presence of objects in the frequency of affect attu-nement in spontaneous interactions.

Resumo Este artigo apresenta uma revisão das pesquisas sobre sintonização afetiva em interações precoces adulto-bebê, que seguem a definição original proposta por Stern. A sintonização afetiva constitui uma pauta de interação intuitiva que serve para sintonizar com o estado afetivo do bebê momento a momento. Ainda que esse conceito tenha sido claramente definido e amplamente aceito, até agora, há poucos estudos realizados. A maioria deles são estudos observacionais e transversais, que se concentram na descrição de situações de jogo social mãe-bebê durante o primeiro ano de vida da criança. Reflexiona-se sobre a escassa quantidade de trabalhos realizados na área e propõem-se futuras vias de pesquisa: a pro-longação do estudo no segundo ano de vida e em populações com dificuldades de desenvolvimento; a avaliação da incidência da disposição corporal e da presença de objetos na frequência de sintonização afetiva em interações espontâneas.

Sobre el establecimiento de la sintonía en la primera sesión y la defensa del paciente / About the stablishment of attunement during the first session and the patient's defense

Tras definir el concepto de sintonía, describir la muestra (la primera sesión o entrevista inicial de 20 pacientes con sus respectivos terapeutas) y el método (el algoritmo David Liberman, ADL), y presentar el repertorio de las intervenciones prototípicas del terapeuta, el trabajo analiza el establecimiento del vínculo de sintonía entre paciente y terapeuta y sus perturbaciones, así como las defensas del paciente durante la sesión en el momento de establecer la sintonía. Luego el trabajo procura establecer nexos entre los resultados referidos a las dificultades para lograr la sintonía y los resultados de los estudios de las defensas y su estado al intentar sintonizar con el paciente. El trabajo concluye que importa más el estado de la defensa que la severidad clínica que esta ponga de relieve.

After defining the concept of attunement, describing the sample (20 patients having gone through their first session or first interview with their corresponding therapists), defining the method (the David Liberman algorithm, DLA), and presenting the repertoire of the prototypical interventions of therapist, the paper analyzes the establishment of attunement between therapist and patient, the perturbations on the tuning, as well as the defenses used by patients while the attunement is established. Then the paper tries to establish a link between the results regarding difficulties on accomplishing attunement and the results from studying the patients' defenses and the state of defense when the therapist attempts to tune with the patient. The paper concludes that for establishing attunement, it is more relevant the state of the patients' defense rather than the clinical severity of this mechanism.

Understanding of "Attunement Disorder" from Phenomenological-Anthropological Perspective : Inquiry into the Use of the Term "Attunement" in Psychiatric Literature / 신경정신의학

The Korean Neuropsychiatric Association has decided that the existing nomenclature "Schizophrenia" should be replaced with "Attunement disorder" in order to mitigate prejudices from the general public. In this process, "attunement" was meant to express the harmonious relationship and organic integration among the various substructures of global mental functioning. However, the term "attunement" and related concepts had occupied an important position in discourses surrounding the fundamental concept of schizophrenia. In this regard, the historical vicissitudes of the term "attunement" in the context of schizophrenia research was discussed. The term "attunement" is an English translation of Heideggerian expressions "Befindlichkeit" and "Stimmung". It is used by Heidegger to convey the emotional experience of Dasein's inextricable entanglement with the surrounding interpersonal world. Heidegger's philosophical works formed the theoretical foundation for the so-called Phenomenological-anthropological psychiatry. Psychiatrists influenced by this approach argue that patients with schizophrenia suffer from a sense of alienation and bewilderment resulting from loss of normal attunement. In addition, they stress that the loss of attunement brings about distorted self-experience, which leads to strange and uncanny life experiences exiled from intersubjectivity based society. From the phenomenological perspective, mind or consciousness is not a solipsistic Cartesian reason confined to the brain, but an intentional existence embedded in the interpersonal and intersubjective worlds. In the developmental period, intentional relationship between the consciousness and the world has been acquired from repeated shared experiences with other people via intersubjectivity. The intersubjective experiences also contribute to maintenance of solid attunement even after reaching mature adulthood. Whatever the reason, losing the tacit understanding of the world will cause disintegration of the foundation of intersubjectivity and confusion with regard to the certainties of self and the world. This state was described as "Attunement disorder". Recent emphasis on neurobiological understanding of schizophrenia has impeded the proper appreciation of Phenomenological-anthropological understanding of schizophrenia, one of the valuable heritages of psychiatry. Meanwhile, the concept of phenomenological understanding or embedded cognition has recently gained renewed attention among neuroscientists studying neurobiological correlates of consciousness. Standing on the pivotal point witnessing the conceptual change from "Schizophrenia" to "Attunement disorder", reappraisal of the past heritage from modern perspectives would be a valuable endeavor for advancement of psychiatry.

Use of the Terms "Schizophrenia" and "Schizophrenic" in the South Korean News Media: A Content Analysis of Newspapers and News Programs in the Last 10 Years

OBJECTIVE: In this study, we explored the meaning attributed to the words "jungshinbunyeolbyung" (schizophrenia) and "jungshinbunyeol" (schizophrenic) in South Korean newspapers and news programs in the last 10 years. METHODS: We screened the websites of three national newspapers and the broadcasts of three nationwide television news programs from January 1, 2001, to December 31, 2010. We classified a total of 490 articles and 257 news segments by category and quantitatively and qualitatively analyzed them. The articles and news segments were assigned to one of the following categories based on their use of the term "schizophrenia": 1) negative, 2) neutral or positive, 3) incidental, and 4) metaphorical. RESULTS: The negative viewpoint accounted for 349 incidences (46.7%), while the neutral and positive viewpoints included 225 incidences (30.1%). Incidental uses accounted for 95 incidences (12.7%), and metaphorical uses accounted for 78 incidences (10.4%). The majority of the negative uses focused on violence or dangers posed by patients (137 mentions, 37.8%), while the metaphorical uses mainly focused on the idea of splitting (51 mentions, or 65%). CONCLUSION: This study showed that the South Korean news media do not provide balanced information about schizophrenia to the public. This study also showed that no significant move has been made toward a more positive use of the term since a previous study was conducted on the subject. Although the term schizophrenia has given way to "attunement disorder," it will be difficult to establish the new term as the standard if the South Korean media continue to use the term "schizophrenic symptom." Even though the term has been changed, guidelines are necessary to encourage the mass media to provide balanced articles and reduce prejudice.

Comparison of Stigma according to the Term Used for Schizophrenia : Split-Mind Disorder vs. Attunement Disorder / 신경정신의학

OBJECTIVES: In Korea, the term for schizophrenia has been changed from 'split-mind disorder' to 'attunement disorder'. This study compared the stigma of, and prejudice against, people with schizophrenia, according to use of the term 'split-mind disorder' or 'attunement disorder'. METHODS: We conducted a survey of 360 college students majoring in nursing science in order to assess their prejudice regarding the danger posed by schizophrenia and discrimination regarding relationships and privileges for patients with schizophrenia using the social stigma scale and the discrimination scale for patients with mental illness, respectively. Study subjects were randomly divided into two groups, and the same scales were assigned to each group using different instructions, beginning with either 'split-mind disorder' or 'attunement disorder'. RESULTS: In multivariate analysis, scores for prejudice with regard to the danger posed by, and discrimination against, patients with schizophrenia were significantly higher in the group assigned the term split-mind disorder, compared with the term attunement disorder. Scores for discrimination with regard to relationships and privileges were significantly lower for subjects with experience to contact the mentally ill, compared to those without such experience. CONCLUSION: Our findings suggest that renaming split-mind disorder as attunement disorder can result in reduced prejudice and discrimination against people with schizophrenia. In addition to renaming schizophrenia, implementation of anti-stigma campaigns, including contact with schizophrenia patients, may help to reduce discrimination against them.

O lugar da experiência afetiva na gênese dos processos de subjetivação / The place of the affective experience in the genesis of the subjectivation processes / La place de l'expérience affective dans la genèse des processus de subjectivation / El lugar de la experiencia afectiva en la génesis de los procesos de subjetivación

Dada a atualidade e a importância dos afetos na gênese dos processos de subjetivação, este artigo tem como objetivo central discutir as teses formuladas por Daniel Stern, autor que vem se dedicando nos últimos anos a observações minuciosas dos processos primários de subjetivação do infante, prestando uma atenção especial ao tema da experiência afetiva. Partindo de uma localização dos afetos em sua teoria, passamos a uma discussão a propósito da forma temporal dos sentimentos no contexto das relações interpessoais, para então analisarmos dois dos principais conceitos formulados por ele, quais sejam, os de afeto de vitalidade e sintonia afetiva. Ao longo desta discussão também serão contemplados outros temas relevantes, tais como as noções de interação afetiva, empatia e comunicação emocional.

Given the importance and the relevance of the affects in the genesis of the subjectivation processes, this article has as its central objective to discuss the theses formulated by Daniel Stern, author who has focused, in recent years, detailed comments on the primary processes of subjectivation of the infant, giving a special attention to the subject of the affective experience. Starting from a localization of the affects in his theory, we discuss the temporal form of feelings in the context of the interpersonal relations, to discuss then two of the main concepts formulated by him: vitality affects and the affective attunement. Throughout this discussion other relevant subjects will also be contemplated, such as the notions of affective interaction, empathy and emotional communication.

Donnée actualité et l'importance des affections dans la gênese des processus de subjectivation, cet article a comme objectif central discuter les thèses formulées par Daniel Stern, auteur qui vient se consacrant ces dernières années à des commentaires minutieux des procédures primaires de subjectivation de l'infant, en prêtant une attention spéciale au sujet de l'expérience affective. En partant d'une localisation des affections dans sa théorie, nous passons à une discussion à propos de la forme temporel des sentiments dans le contexte des relations interpersonnelles, pour alors analyser deux des principaux concepts formulés par lui, c’est-à-dire, les affections de vitalité et la syntonie affective. Au long de cette discussion aussi seront envisagés autres sujets importants, tels comme les notions d'interaction affective, l'empathie, et la communication émotionnelle.

Dada la actualidad y la importancia del afecto en la génesis de los procesos de subjetivación, este artículo tiene como objetivo central discutir las tesis formuladas por Daniel Stern, autor que viene en estos últimos años se dedicando a comentarios minuciosos de los procesos primarios de subjetivación del infante, dando una atención especial al tema de la experiencia afectiva. Partiendo de una localización del afecto en su teoría, pasamos a una discusión a propósito de la forma temporal de los sentimientos en el contexto de las relaciones interpersonales, para después analizar dos de los conceptos principales formulados por él, que son el afecto de vitalidad y la sintonía afectiva. A través de esta discusión otros temas relevantes también serán contemplados, por ejemplo, las nociones de interacción afectiva, de empatía y de comunicación emocional.