ABSTRACT
Diante dos impactos da pandemia, a autora reflete sobre invasores impiedosos e invisíveis que penetram com veemente violência, como as cenas do inconsciente não recalcado, da mais tenra infância, que deixam restos de memória celular que se configuram como traumatismos internos e costumam se manifestar em face de traumas externos, como notaremos na clínica comentada no texto. O conceito de nachtraglich, entendido como o efeito retardado de uma lembrança traumática, fundamenta este escrito. Ilustrações clínicas de atendimentos pontuais de escuta psicanalítica por videochamada são apresentadas, a fim de abordar a vital importância, para sua sustentação, do setting interno do analista.
Due to the impact caused by the pandemic, the author reflects on the merciless and invisible invaders that come violently, as the scenes from the nonsuppressed unconscious, from the early childhood - the ones left in cellular memories that are classified as internal traumas and commonly manifest when external trauma happens, as we will notice in the clinical comments in the text. The nachtraglich concept, understood as late effect from a traumatic memory is the bases for this writing. To support this idea, certain specific counseling examples are given, as the ones done by video call, in order to show the vital importance of the analyst's internal setting.
Frente a los impactos de la pandemia, el autor reflexiona sobre los invasores despiadados e invisibles que penetran con vehemente violencia, como las escenas del inconsciente no reprimido de la tierna infancia que dejan restos de memoria celular que se configuran como traumas internos y generalmente se manifiestan frente a traumas externos, como notaremos en la clínica comentada en el texto. El concepto de nachtraglich, entendido como el efecto retardado de un recuerdo traumático, subyace a este escrito. Se presentan ilustraciones clínicas de consultas puntuales de escucha psicoanalítica por videollamada con la finalidad de abordar la vital importancia que le otorga el encuadre interno del analista.
En face des impacts de la pandémie, cette auteure réfléchit sur les envahisseurs impitoyables et invisibles qui s'introduisent d'une façon impétueuse et violente, comme dans les scènes de l'inconscient non refoulé, celles de la toute petite enfance, lesquelles laissent des restes de mémoire cellulaire qui se configurent comme des traumatismes internes et qui ont l'habitude de se manifester face aux traumatismes extérieurs, comme l'on observera dans la clinique commentée dans le texte. Le concept de nachtraglich, pris comme l'effet retardé d'un souvenir traumatique, c'est le fondement de cet écrit. On présente des illustrations cliniques de séances ponctuelles d'écoute psychanalytique via des appels vidéo, afin d'aborder l'importance vitale du setting interne de l'analyste pour son étayage.
Subject(s)
Humans , Psychoanalysis/methods , Telemedicine/methods , Pandemics , Psychological TraumaABSTRACT
Objective:To explore the feasibility of emergency video call system in remote guidance of non-medical volunteers to implement single person cardiopulmonary resuscitation (CPR).Methods:A scenario of sudden cardiac arrest with a bystander in a public place was created at Clinical Skill Training Center. 60 non-medical volunteers were randomly (ramdom number) divided into video group ( n = 40) and audio group ( n = 20). Volunteers in video group were remote instructed with the smart phone application software (APP) of Emergency Video Call System to implement CPR; the audio group receives remote voice guidance for CPR with a smart phone. The pressing depth, pressing frequency, volume of ventilation and the time of the first compression were compared between the two groups. The video group was divided into 5 subgroups to compare the cardiopulmonary resuscitation effect of 5 different models of smart phones. Ten CPR cycles were observed in each group. Results:the accuracy rate of pressing position in the video group was significantly higher than that in the audio group (91.5% vs 71.35%, P < 0.05); the proportion of pressing depth in the range of 5-6 cm was significantly higher than that in the audio group (62.79% vs. 44.73%, P < 0.05); the average pressing frequency was 100-120 times / min (70% vs. 52%, P < 0.05); the ventilation volume was 500-600 mL / time (18.25% vs. 10.75%, P < 0.05); The proportion of ventilation volume greater than 500ml / min was higher than that of audio group (64.88% vs. 43%, P < 0.05). The first pressing time was longer in the video group than in the audio group (131 s vs. 106 s, P < 0.05). There was no significant difference in the first ventilation time between the two groups (148 s vs. 144 s, P > 0.05). The total pressing pause time in video group was less than that in audio group (122.4 s vs. 164.2 s, P < 0.05). There was no significant difference in the above indicators among the five different models of smart phones in the video group ( P > 0.05). Conclusions:compared with audio remote guidance, video emergency system has obvious advantages in the accuracy of pressing position, pressing depth, pressing frequency, ventilation volume and pressing pause time, but the first pressing time is slightly longer than that of audio group. The popularization and application of the video system is supposed to improve the CPR quality and recovery success rate of non-medical personnel, and facilitated to encourage the first witness to implement CPR.