"How, of all The Millions of People ": Re-Examination of a Question From an Early MRI Research Project.

"How, of all the millions of people in the world, did the two of you get together?", a question to be addressed conjointly to a couple, part of a Structure Family Interview developed during the early heydays of the Mental Research Institute at Palo Alto, California, is analyzed in terms of structure, process and outcome of responses to it, and discussed as a powerful research and clinical tool with current potentials, as it provides in a succinct fashion remarkable insights into a narrative that is constitutive of the couple and, by omission or commission, revealing in terms of the couple's evolution.

In search of a new identity: An institutional consultation at a sub-acute inpatient unit in a general hospital.

INTRODUCTION: Hospitals are constantly morphing under the pressure of ever-evolving health care technologies, procedures, and reimbursement practices. In turn, healthy institutional identities and personnel allegiance contribute to counterbalance the potentially destabilizing effects of those changes. An institutional consultation was requested at a general hospital recently created sub-acute unit (SAU) due to malaise and dissatisfaction in the nursing staff. METHOD: The consultation included a total of 3 group meetings with the SAU nursing staff as well as observation of procedures and milieu in this and adjacent units. In the course of this process, a structure of demeaning narratives about the unit and the nursing personnel's own role in the context of changes within the hospital was detected, destabilized, and transformed, and the kernel of a new identity for the unit was developed, using a shift in a routine evaluation procedure for patient's progress as a fulcrum for generating change. RESULTS: Follow-up evaluation indicated a qualitative improvement in the unit milieu and nurses' job satisfaction, resonating with an enhancement in the staff's identification with the unit's reformulated mission as part of a constructive continuum of care. This improvement was also acknowledged and rewarded by hospital administration. DISCUSSION: While maintaining a stance of positive connotation, assumptions of good intent, and a systemic view of the organization, demeaning collective narratives can be transformed through timely interventions that restitute pride and meaningfulness to the personnel and improve the unit's quality of care. (PsycINFO Database Record

Proxemics in Couple Interactions: Rekindling an Old Optic.

Utilizing as a lens the interpersonal implications of physical interpersonal distances in social contexts (a set of variables present during the professional discourse during the 1960s and 1970s, to then fade away), this article explores interactive process displayed by the protagonic couple in Bela Bartok's opera "Bluebeard Castle," an exercise aimed at underlining the value of maintaining proxemics as an explicit level of observation for clinical practice and interpersonal research.

The pathway between conflict and reconciliation: coexistence as an evolutionary process.

A normative sequence of six stages is proposed to describe the process of evolution from open conflict to harmonious coexistence, as well at its devolution from the latter to the former. The stages may be termed Confrontation, Truce, Collaboration, Cooperation, Interdependence and Integration. Each of the six stages constitutes an amalgam of practices, narratives and prevalent emotions in a relational "game" that tends to resist change. At the stage of Confrontation, each party assumes that any act of the other is motivated by ill intent, and active hostility prevails. In Truce or Freeze, acts of hostility are curtailed by a real or virtual "neutral zone" controlled by powerful third parties. The dominant emotions are resentment, anger, and mistrust. Collaboration retains some assumptions of ill intent while certain activities in common are carried out. The third party looses visibility, and the dominant emotions include ambivalence. Cooperation entails the assumption of neutral intent of self and other, while activities in common are planned and carried out. Key emotions include cautious compassion for the other. Interdependence is characterized by active involvement in planning toward the common good. The dominant emotions are trust and forgiveness. At the other end of the spectrum, parties at the stage of Integration are actively involved in projects aimed at the common good and each supports the other's growth. The dominant emotions are solidarity and a friendly trust. Movement from one stage to another shares certain characteristics with other complex systems. For professionals aiming to facilitate evolutionary change, whether in interpersonal or in international relations, the systemic cohesion of each stage constitutes the main challenge, and the promise of similar cohesion at the next stage provides the main hope.

Personal social networks and health: conceptual and clinical implications of their reciprocal impact.

Social networks affect positively or negatively a person's health, and a person's health affects, in turn, the network's availability. This article discusses this double dynamic, recommends the routine exploration of patients' social networks, and offers a mapping tool that allows detection of strengths and weaknesses of those processes so as to facilitate interventions that improve the social support's health-enhancing effect.

Bebês difíceis, progenitores difíceis: um modelo baseado no ajuste recíproco / Difficult babies, difficult parents: a model based on reciprocal fit

Na vida cotidiana, a suposição de que nossos filhos “são uma benção” que nos traz, desde o início, paz e felicidade, esbarra com a realidade de que de tanto em tanto nascem filhos que desde o início são percebidos pelos pais (e às vezes pela comunidade de profissionais consultados) como difíceis e frustrantes – e talvez, se os bebês falassem, viceversa - gerando círculos viciosos que conduzem a profecias autocumpridoras. Este artigo discute de maneira um tanto interativa o problema complexo do “ajuste recíproco” entre os estilos do bebê e dos pais.

In our daily life, the assumption that our children “are a bless” that bring us peace and happiness from the beginning contrasts with the fact that now and then there are children who, from the start, are seen by their parents (and by the community of consulted professionals as well) as difficult and frustrating – and maybe, if babies could speak, they would say the opposite – creating a vicious circle that leads to autofullfilled profecies. This text discusses in an interactive manner the complex problem of the “reciprocal fit” between the baby and the parents styles.

Bebês difíceis, progenitores difíceis: um modelo baseado no ajuste recíproco / Difficult babies, difficult parents: A model based on reciprocal fit

Na vida cotidiana, a suposição de que nossos filhos “são uma benção” que nos traz, desde o início, paz e felicidade, esbarra com a realidade de que de tanto em tanto nascem filhos que desde o início são percebidos pelos pais (e às vezes pela comunidade de profissionais consultados) como difíceis e frustrantes – e talvez, se os bebês falassem, viceversa - gerando círculos viciosos que conduzem a profecias autocumpridoras. Este artigo discute de maneira um tanto interativa o problema complexo do “ajuste recíproco” entre os estilos do bebê e dos pais.(AU)

In our daily life, the assumption that our children “are a bless” that bring us peace and happiness from the beginning contrasts with the fact that now and then there are children who, from the start, are seen by their parents (and by the community of consulted professionals as well) as difficult and frustrating – and maybe, if babies could speak, they would say the opposite – creating a vicious circle that leads to autofullfilled profecies. This text discusses in an interactive manner the complex problem of the “reciprocal fit” between the baby and the parents styles.(AU)

Saudades at the edge of the self and the merits of 'portable families'.

The treatment of a Mexican American patient who was referred due to hallucinations reveals a world of 'magic realism' that is far from infrequent in elderly people with a small and dwindling social network--especially if they come from cultures where the boundaries between the inner and the outer world are fuzzy. Respecting these traits allows for the development of treatment approaches that can evolve satisfactorily without disrupting the patient's inscription in this dual world.

O antigo culto de madame: quando os terapeutas trocam curiosidade por certeza / The ancient cult of madame: when therapists trade curiosity for certainty

Uma experiência precoce de furor sanandi, a qual levou a um trágico fim, é lembrada como uma estrutura para a apresentação e discussão do tratamento de uma família onde o processo terapêutico conduzido pelo terapeuta pode ter excedido as necessidades e expectativas dos membros da família. Isto é seguido por uma discussão sobre problemas potenciais causados pela fascinação do terapeuta pelas histórias das famílias, já que seus efeitos podem ser epistemologicamente não só interrompidos, como também contraditórios àquelas recomendações de Cecchin pela “curiosidade” como um dito central da postura do terapeuta. (AU)

Uma experiência precoce de furor sanandi, a qual levou a um trágico fim, é lembrada como uma estrutura para a apresentação e discussão do tratamento de uma família onde o processo terapêutico conduzido pelo terapeuta pode ter excedido as necessidades e expectativas dos membros da família. Isto é seguido por uma discussão sobre problemas potenciais causados pela fascinação do terapeuta pelas histórias das famílias, já que seus efeitos podem ser epistemologicamente não só interrompidos, como também contraditórios àquelas recomendações de Cecchin pela “curiosidade” como um dito central da postura do terapeuta. (AU)

Interfaces: toward a new generation of systemic models in family research and practice.

After reviewing Engel's bio-psycho-social proposal and Kandel's "principles for an integration between mind and brain," the author introduces a set of akin propositions that aim at integrating neurosciences, genetics, the mind, and the social world into a succinct set of systemic formulations focusing on interlevel interfaces, with profound implications for the training, practice, and research in the field of family processes and therapy.

Crisis en una familia tradicional de Kosova: una nota etnográfica / A crisis in a traditional Kosovar family: An ethnographic vignette

Este artículo detalla la evolución de una crisis compleja en una familia extendida de Kosovo, y cómo fue lidiada por sus miembros quienes respetaron los mandatos de esa cultura abiertamente patriarcal pero crearon oportunidades importantes para el cambio. Esta descripción incluye información acerca del contexto cultural e histórico de su trama, así como una discusión acerca de un proceso natural (es decir, no en un contexto terapéutico) que se orientó hacia la resolución de la crisis de una manera culturalmente congruente

Crisis en una familia tradicional de Kosova: una nota etnográfica / A crisis in a traditional Kosovar family: An ethnographic vignette

Este artículo detalla la evolución de una crisis compleja en una familia extendida de Kosovo, y cómo fue lidiada por sus miembros quienes respetaron los mandatos de esa cultura abiertamente patriarcal pero crearon oportunidades importantes para el cambio. Esta descripción incluye información acerca del contexto cultural e histórico de su trama, así como una discusión acerca de un proceso natural (es decir, no en un contexto terapéutico) que se orientó hacia la resolución de la crisis de una manera culturalmente congruente

A family approach to severe mental illness in post-war Kosovo.

This study describes the effects of a psychoeducational multiple-family group program for families of people with severe mental illness in post-war Kosovo that was developed by a Kosovar-American professional collaborative. The subjects were 30 families of people with severe mental illnesses living in two cities in Kosovo. All subjects participated in multiple-family groups and received family home visits. The program documented medication compliance, number of psychiatric hospitalizations, family mental health services use, and several other characteristics, for the year prior to the groups and the first year of the groups. The families attended an average of 5.5 (out of 7) groups, and 93% of these families attended four or more meetings. The uncontrolled pre- to post-intervention comparison demonstrated decreases in medication non-compliance and hospitalizations, and increases in family mental health service use. The program provided training for mental health professionals, led to policy change in the Ministry of Health, and resulted in dissemination to other community mental health centers. This study provides preliminary evidence that a collaboratively designed and implemented psychoeducational, multiple-family program is a feasible and beneficial intervention for families of people with severe mental illness in impoverished post-war settings.

Memoria, recuerdos y transformaciones del Lanús: homenaje al maestro / Memory, recollection and transformation of ¶El Lanús÷: homage to the master

El autor realiza un emocionado y evocativo homenaje a Mauricio Goldenberg, a partir de un diálogo posible, con el maestro inspirador de esta ponencia. Habla de la historia reciente argentina, sobre todo del fenómeno que se dio a partir de los años 60. Ilumina esta historia con el recuerdo de figuras como: Goldenberg. Enrique Pichon Riviere, Guillermo Ferschut, F. Ulloa. E. Rolla, J. Zack, V. Barenblit, O. Fernandez Moujan, V. Galli, Hernan Kesselman, A. Perez, D. Romano, L. G. Ricon, G. Stein, E. Veron, F. Korn, E. De la Aldea, A. Kornblit. Termina rescatando que la semilla ha dado sus frutos y sigue vigente en todo el pensamiento ligado a la Salud Mental en la Argentina, a partir de aquella experiencia en El Lanús a mediados de los años cincuenta (AU)