Fonctions de la sensorialité dans la prise en charge thérapeutique de l'autisme infantile / Funções da sensorialidade no manejo terapêutico do autismo infantil / Functions of sensoriality in the therapeutic management of infantile autism / Funciones de la sensorialidad en el manejo terapéutico del autismo infantil

La sensorialité tient plusieurs fonctions dans l'élaboration psychique de l'individu autiste et dans son évolution psychique au cours de sa prise en charge thérapeutique. Nous suivons dans cette recherche l'idée de la transformation d'un usage défensif de la sensorialité en un processus mutatif, d'une construction du moi corporel, ainsi qu'un travail de symbolisation primaire, d'inscription, de représentation et de figurabilité.Avec la psychothérapie d'un enfant autiste en institution, nous explorons les fonctions de la sensorialité sur la base de l'attention particulière portée aux éprouvés corporels dans la dimension transférentielle et contre-transférentielle. Celle-ci permet au thérapeute d'éprouver les angoisses en lien avec des expériences sensorielles primaires. En s'appuyant sur la résonnance contre-transférentielle des différentes angoisses du patient, une sensorialité partagée aide à la métabolisation des éprouvés de catastrophe primitive ayant entravé l'organisation d'un sentiment continu d'exister. Cette dynamique thérapeutique ouvre sur de nouvelles perspectives psychiques et relationnelles.

Resumos A sensorialidade assegura várias funções na elaboração psíquica do indivíduo autista e em seu desenvolvimento psíquico durante os seus cuidados terapêuticos. Nesta pesquisa perseguimos a ideia da transformação de um uso defensivo da sensorialidade em um processo mutativo, de uma construção do eu corporal, bem como de um trabalho de simbolização primária, de inscrição, representação e figurabilidade. Na psicoterapia de uma criança autista em instituição, exploramos as funções da sensorialidade se concentrando mais particularmente nas experiências corporais a partir da dimensão transferencial e contra-transferencial. Esse trabalho permite que o terapeuta experimente angústias ligadas a experiências sensoriais primárias. Com base na ressonância contra-transferencial das diferentes angústias do paciente, uma sensorialidade partilhada ajuda na metabolização das experiências de catástrofe primitiva que impedem a organização de um sentimento contínuo de existência. Esta dinâmica terapêutica abre novas perspectivas psíquicas e relacionais.

Sensoriality has several functions in the psychic elaboration of the autistic individual and in his psychic evolution during his therapeutic care. We follow in this research the idea of the transformation of a defensive use of sensoriality into a mutative process, of a construction of the bodily self, as well as a work of primary symbolization, inscription, representation and figurability. With the psychotherapy of an autistic child in an institution, we explore the functions of sensoriality based on the particular attention paid to bodily experiences in the transference and counter-transference dimension. This allows the therapist to experience anxieties related to primary sensory experiences. By relying on the counter-transferential resonance of the patient's various anxieties, a shared sensoriality helps to metabolize the experiences of primitive catastrophe that have hindered the organization of a continuous feeling of existing. This therapeutic dynamic opens up new psychic and relational perspectives.

La sensorialidad tiene varias funciones en la elaboración psíquica del individuo autista y en su evolución psíquica durante la asistencia terapéutica. Seguimos en esta investigación la idea de la transformación de un uso defensivo de la sensorialidad en un proceso mutativo, de una construcción del yo corporal, así como de un trabajo de simbolización primaria, inscripción, representación y figurabilidad. Con la psicoterapia de un niño autista en una institución, exploramos las funciones de la sensorialidad a partir de la particular atención prestada a las experiencias corporales en la dimensión transferencial y contratransferencial. Este trabajo le permite al terapeuta experimentar ansiedades relacionadas con las experiencias sensoriales primarias. Apoyándose en la resonancia contratransferencial de las diversas angustias del paciente, una sensorialidad compartida ayuda a metabolizar las experiencias de catástrofe primitiva que han impedido la organización de un sentimiento continuo de existir. Esta dinámica terapéutica abre nuevas perspectivas psíquicas y relacionales.

Research and application of relaxing therapy with decompression ball on anxieties of patients facing tooth extraction / 中国实用护理杂志

Objective To discuss the application effect of relaxing therapy with a decompression ball on anxieties of patients facing tooth extraction. Methods Totally 72 dental anxieties patients facing tooth extraction were divided into control group and intervention group. Control group was carried out routine nursing, while intervention group was implemented relaxing therapy with a decompression ball on the basic of routine nursing. The changes of anxiety score, blood pressure and heart rate of both groups before and after intervention were compared. Besides, the cooperation of both groups during operation after intervention was compared, too. Results After intervention, anxiety score of intervention group and control group was 9.92 ± 3.20 and 12.44 ± 3.32 respectively, indicating that the difference had statistical significance (t=-3.272,P<0.05). The difference value of anxiety score was 4.02 ± 2.69 and the control group was 1.56 ± 2.20. There was statistically significant difference of the two groups(t=4.273,P<0.01). The FRANKL behavior score of the cooperation degree during operation was 3.94 ± 0.23 in intervention group and 3.67±0.48 in control group with statistically significant difference (t=3.136,P<0.05). Before and after intervention, there was no statistically significant difference regarding to systolic pressure, diastolic pressure and the heart rate (P>0.05). Conclusions Relaxing therapy with a decompression ball is beneficial to relieve the anxieties of dental patients facing tooth extraction, which can also improve the cooperation degree during operation and ensure the dental treatment carried out smoothly, thus it′s worth to be extended clinically.

Research and application of relaxing therapy with decompression ball on anxieties of patients facing tooth extraction / 中国实用护理杂志

Objective@#To discuss the application effect of relaxing therapy with a decompression ball on anxieties of patients facing tooth extraction.@*Methods@#Totally 72 dental anxieties patients facing tooth extraction were divided into control group and intervention group. Control group was carried out routine nursing, while intervention group was implemented relaxing therapy with a decompression ball on the basic of routine nursing. The changes of anxiety score, blood pressure and heart rate of both groups before and after intervention were compared. Besides, the cooperation of both groups during operation after intervention was compared, too.@*Results@#After intervention, anxiety score of intervention group and control group was 9.92±3.20 and 12.44±3.32 respectively, indicating that the difference had statistical significance (t=-3.272, P<0.05). The difference value of anxiety score was 4.02±2.69 and the control group was 1.56±2.20. There was statistically significant difference of the two groups (t=4.273, P<0.01). The FRANKL behavior score of the cooperation degree during operation was 3.94±0.23 in intervention group and 3.67±0.48 in control group with statistically significant difference (t=3.136, P<0.05). Before and after intervention, there was no statistically significant difference regarding to systolic pressure, diastolic pressure and the heart rate (P>0.05).@*Conclusions@#Relaxing therapy with a decompression ball is beneficial to relieve the anxieties of dental patients facing tooth extraction, which can also improve the cooperation degree during operation and ensure the dental treatment carried out smoothly, thus it′s worth to be extended clinically.

Releitura do caso O pequeno Hans: sobre silêncios e invisibilidades / A rereading of The little Hans case: on silences and invisibilities

Passados mais de cem anos, aborda-se um ângulo possível de releitura do texto Análise de uma fobia em um menino de cinco anos, de Freud (1909). O principal recurso utilizado é uma entrevista que o próprio paciente desta primeira análise de criança concede quando contava sessenta e nove anos. Tornara-se um importante diretor de óperas. Com este adicional importante do próprio Hans – Herbert Graf e outros dados de seu histórico – consideram-se entendimentos e hipóteses adicionais sobre este caso clássico de psicanálise de crianças. O palco giratório é utilizado como imagem das visibilidades e dos silêncios na análise do pequeno Hans. A autora procura sintetizar três pontos principais do desenvolvimento teóricoclínico da psicanálise de crianças ao longo do último século.

Over one hundred years later, a possible angle of rereading the text Analysis of a phobia in a five-year-old boy, of Freud (1909), is addressed. The main resource used is an interview that the patient of this first child’s analysis himself gave when he was 69 years old. He became an important opera director. Based on a substantial contribution from Hans himself, Herbert Graf, and other data from his story, additional understandings and hypotheses on this classic case of children’s psychoanalysis are considered. The spinning stage is used as an image of the visibilities and silences in Little Hans’ analysis. The author tries to synthesize three main points of the theoretical and clinical development of children’s psychoanalysis over the last century.

Más de cien años después, se aborda un posible ángulo de relectura del texto Análisis de la fobia de un niño de cinco años, Freud (1909). El principal recurso utilizado es una entrevista dada por el propio paciente de este primer análisis de niños, cuando tenía 69 años. Se convierte en un importante director de óperas. Con esta importante contribución del propio Hans – Herbert Graf, y otros datos de su historia, se consideran interpretaciones e hipótesis adicionales sobre este caso clásico del psicoanálisis de niños. El escenario giratorio se utiliza como la imagen de las visibilidades y del silencio en el análisis del pequeño Hans. La autora trata de sintetizar los tres puntos principales del desarrollo teórico y clínico del psicoanálisis de niños durante el último siglo.

Os processos psíquicos no interior dos grupos de trabalho: para além de Bion e Pichon-Rivière / Les processus psychiques au sein des groupes de travail, au-delà de Bion et Pichon-Rivière / Psychic processes within work groups: beyond Bion and Pichon-Rivière

Este artigo visa explorar os processos psíquicos no interior dos grupos de trabalho. Partindo das pesquisas pioneiras do psicanalista inglês Bion e do psicanalista argentino Pichon-Rivière, o autor mostra que as ansiedades subjacentes à realização da tarefa, descritas por esses autores, não têm necessariamente um caráter geral, na medida em que elas foram observadas principalmente em grupos de formação e de terapia. Daí vem sua proposição de fenômenos inconscientes complementares, desde que a tarefa apresente uma dimensão operatória e que o grupo de trabalho esteja inserido em um contexto organizacional. Na última parte, são detalhadas as capacidades psicológicas individuais requeridas pelo trabalho em grupo e as perspectivas, em termos de formação e de intervenção, que sua abordagem implica...

Cet article vise à explorer les processus psychiques au sein des groupes de travail. En partant des recherches pionnières du psychanalyste anglais Bion et du psychanalyste argentin Pichon-Rivière, l'auteur montre que les anxiétés sous-jacentes à la réalisation de la tâche décrites par ces auteurs n'ont pas nécessairement un caractère général dans la mesure où elles ont été observées principalement dans des groupes de formation et de thérapie. D'où sa proposition de phénomènes inconscients complémentaires dès lors que la tâche présente une dimension opératoire et que le groupe de travail est inséré dans un contexte organisationnel. Dans une dernière partie, l'auteur détaille les capacités psychologiques individuelles sollicitées par le travail en groupe et les perspectives, en termes de formation et d'intervention, que son approche implique...

This article aims at exploring psychic processes within work groups. Starting from the pioneering research of the British psychoanalyst Bion and the Argentinean one Pichon-Rivière, the author shows that the anxieties which exists below the surface of the task realization described by these two authors can't be generalized as they have been mainly within training and therapy groups. Therefore his proposal of other and complementary unconscious phenomena when the task is an operational one and when the work group is part of an organization. In a last chapter, the author describes the individual psychological skills necessary to be able to contribute effectively to a group work and the possible consequences in terms of training and intervention...

A experiência de desamparo / The experience of helplessness

O autor faz uma breve revisão do conceito freudiano de desamparo e destaca-o como uma experiência emocional primitiva que estará na raiz matizando todos os futuros tipos de ansiedades. Compreende que nesse conceito está presente e pressuposta a visão de relações de objeto. O termo desamparo refere-se a condições primitivas de estados emocionais que permanecem inconscientes, não sendo verbalizáveis e necessitam da disponibilidade da mente do analista no contexto do setting para contribuir no campo de forma a transformar a experiência sensório-afetiva presente na condição de desamparo em representações capazes de serem verbalizáveis e pensáveis. Ilustra-se com duas vinhetas clínicas algumas formas de apresentação clínica. A primeira, estruturada numa organização defensiva, como rejeição ao vínculo emocional profundo e a segunda, com a inundação do sentimento de desespero, por falha de uma continente organização defensiva.

The author reviews briefly the Freudian concept of helplessness and underscores it as a primitive emotional experience which is in the origin and leaves a trace in all future types of anxieties. He understands that in this concept the vision of object relations is present and presumed. The word helplessness refers to primitive conditions of emotional states which remains unconscious, cannot be verbalized, and which need the availability of the analyst’s mind in the setting to contribute in the field in such a way as to transform the sensorial-affective experience present in the condition of helplessness into representations that can be verbalized and thought of. Two clinical vignettes illustrate some forms of clinical presentation. The first, structured in a defensive organization as a rejection to deep emotional bond, and the second, flooded by the feeling of despair, due to failure of a defensive continent organization.

El autor realiza una breve revisión del concepto freudiano de desamparo y lo destaca como una experiencia emocional primitiva que estará en la raíz matizando a todos los futuros tipos de ansiedades. Comprende que en ese concepto está presente y supuesta la visión de relaciones de objeto. El término desamparo se refiere a condiciones primitivas de estados emocionales que permanecen inconscientes, no siendo verbalizables y necesitan la disponibilidad de la mente del analista en el contexto del setting para contribuir en el campo de forma a transformar a la experiencia sensorio-afectiva presente en la condición de desamparo en representaciones capaces de ser verbalizables y pensables. Dosviñetas clínicas ilustran algunas formas de presentación clínica. La primera, estructurada en una organización defensiva, como rechazo al vínculo emocional profundo y la segunda, con la inundación del sentimiento de desesperación, por falla de una organización defensiva continente.