[Being born moderately premature: a risky developmental trajectory]. / Naître moyennement prématuré : une trajectoire développementale à risque.

Babies born prematurely are frequently prone to developmental disorders, which are all the more severe in babies of low gestational age. However, medium prematurity also generates its own set of difficulties, including sensory, motor, cognitive, behavioral, relational and emotional disorders. It is essential to gain a better understanding of the developmental trajectory of these children and its various ups and downs, in order to support their development as early as possible.

Auditory Personalization of EMDR Treatment to Relieve Trauma Effects: A Feasibility Study [EMDR+].

According to the WHO (World Health Organization), Eye Movement Desensitization and Reprocessing (EMDR) is an elective therapy to treat people with post-traumatic stress disorders (PTSD). In line with the personalization of therapeutic strategies, through this pilot study, we assessed in people suffering from the effects of trauma the feasibility, safety, acceptance, and efficacy of EMDR enriched with sound stimulation (by administering neutral sounds synchronized with the guided bilateral alternating stimulation of the gaze) and musical reward (musical listening based on the patients' predisposition and personal tastes). Feasibility, quantified by the number of patients who completed the treatment, was excellent as this was the case in 12 out of the 12 enrolled people with psychological trauma. Safety and acceptance, assessed by self-compiled questionnaires, were excellent, with an absence of side effects and high satisfaction. Efficacy, quantified by the number of EMDR treatment sessions required to reach the optimal scores on the Subjective Units of Disturbance (SUD) and Validity of Cognition (VOC) scales typical of EMDR protocols, revealed an average duration of 8.5 (SD 1.2) sessions, which is well below the 12 sessions considered a standard EMDR treatment duration. EMDR+ appears to be a relevant personalization of EMDR, particularly in music-sensitive people, consolidating the therapeutic alliance through a multisensory communicative bond for trauma treatment.

Effects and mechanisms of extremely cold environment on body response after trauma.

With the outbreak of the Ukrainian crisis, extremely cold environment warfare has once again become the focus of international attention. People exposed to extremely cold environments may suffer from cold damage, further aggravate trauma, trigger high disability and mortality rates, and even cause serious sequelae. To declare the effects and mechanisms of the extremely cold environment on the body after trauma, this paper reviews, firstly, physiological reaction of human body in an extremely cold environment. Then, the post-traumatic body response in an extremely cold environment was introduced, and finally, the sequelae of trauma in extremely cold environment was further summarized in the paper. The results indicated that extremely cold environment can cause a series of damage to the body, especially the body after trauma. The extremely cold factor is a double-edged sword, showing a favorable and unfavorable side in different aspects. Moreover, in addition to the trauma suffered by the body, the subsequent sequelae such as cognitive dysfunction, anxiety, depression and even post-traumatic stress disorder may also be induced. The paper summarizes the human body's physiological response in an extremely cold environment, and declares the effects and mechanisms of the extremely cold environment on the body after trauma, which may provide a theoretical basis for effectively improving the level of combat trauma treatment in extremely cold regions.

Entre destruição e subversão: o suicídio como resposta ao trauma / Between destruction and subversion: suicide as a response to trauma / Entre la destrucción y la subversión: el suicidio como respuesta al trauma

INTRODUÇÃO: O suicídio consiste em um fenômeno complexo que integra em si as diversas relações entre a vida e a morte e que, apesar dos grandes avanços científicos, continua predominantemente obscuro e enigmático ao campo científico. Os diversos modos e significados assumidos pelo comportamento suicida são fortemente influenciados por ambos os aspectos subjetivos e coletivos do contexto psicossocial em que se manifesta. Entretanto, mesmo sendo considerado um problema de saúde pública de extrema urgência e relevância social, o suicídio ainda é frequentemente tratado pela sociedade de forma reducionista e permeada por tabus e crenças problemáticas. OBJETIVO: Investigar, a partir das obras de Sigmund Freud e Sándor Ferenczi, as possibilidades de ressignificação do suicídio em decorrência do trauma psíquico, tendo como principal guia as ações e efeitos da pulsão de morte neste processo. MÉTODO: Trata-se de um estudo teórico de caráter exploratório e baseado na análise da literatura psicanalítica clássica acerca do tema. RESULTADOS: Identificou-se como principal resultado que, quando contextualizado ao cenário traumático, o suicídio pode tornar-se o último recurso de proteção contra as forças externas destrutivas. Neste sentido, ao empregar as potências da pulsão de morte objetivando a preservação do sujeito, o suicídio configura-se como principal símbolo da insubordinação frente ao trauma. CONCLUSÃO: A pulsão de morte consiste em um dos principais meios pelos quais fenômenos como o suicídio podem ser repensados e ressignificados em sua relação com as diversas esferas das vivências humanas, em especial o trauma psíquico.

INTRODUCTION: Suicide consists of a complex phenomenon that integrates the various relationships between life and death and which, despite great scientific advances, remains predominantly obscure and enigmatic to the scientific field. The different forms and meanings assumed by suicidal behavior are strongly influenced by both subjective and collective aspects of the psychosocial context in which it is manifested. It is known that suicidal behavior can assume several forms and meanings, being strongly influenced by both subjective and collective aspects of the psychosocial context in which it is manifested. However, even though it is considered a public health problem of extreme urgency and social relevance, suicide is still often treated by society in a reductionist way and permeated by taboos and problematic beliefs. OBJECTIVE: To investigate, based on Sigmund Freud's and Sándor Ferenczi's works, the possibilities of re-signifying suicide as a result of psychic trauma, having as main guide the actions and effects of death drive in this process. METHODS: It consists of a theoretical study of exploratory character based on the analysis of classical literature about the theme. RESULTS: It was identified as the main result that, when contextualized to a traumatic scenario, suicide can become the last resource of protection against destructive external forces. In this sense, by employing the powers of the death drive aiming at the subject's preservation, suicide is configured as the main symbol of insubordination to trauma. CONCLUSION: The death drive consists in one of the main ways through which phenomena, such as suicide, can be rethought and re-signified in its relation with the several spheres of human experiences, especially psychic trauma.

INTRODUCCIÓN: El suicidio consiste en un fenómeno complejo que integra las diversas relaciones entre la vida y la muerte y que, a pesar de los grandes avances científicos, sigue siendo predominantemente oscuro y enigmático para el campo científico. Los diferentes modos y significados que asume la conducta suicida están fuertemente influenciados por aspectos tanto subjetivos como colectivos del contexto psicosocial en el que se manifiesta. Sin embargo, a pesar de ser considerado un problema de salud pública de extrema urgencia y relevancia social, el suicidio sigue siendo tratado con frecuencia por la sociedad de forma reduccionista y impregnado de tabúes y creencias problemáticas. OBJETIVO: Indagar, a partir de los trabajos de Sigmund Freud y Sándor Ferenczi, las posibilidades de resignificación del suicidio como consecuencia de un trauma psíquico, teniendo como guía principal las acciones y efectos de la pulsión de muerte en ese proceso. MÉTODOS: Se trata de un estudio teórico de carácter exploratorio basado en el análisis de la literatura clásica sobre el tema. RESULTADOS: Se identificó como resultado principal que, cuando contextualizado al escenario traumático, el suicidio puede convertirse en el último recurso de protección contra las fuerzas externas destructivas. En este sentido, al emplear los poderes de la pulsión de muerte con el objetivo de preservar al sujeto, el suicidio se configura como el principal símbolo de insubordinación frente al trauma. CONCLUSIÓN: La pulsión de muerte es uno de los principales medios por los cuales fenómenos como el suicidio pueden ser repensados y resignificados en su relación con varias esferas de las experiencias humanas, especialmente el trauma psíquico.

[Latent posttraumatic stress disorder in psychiatry at the Mohammed VI university hospital in Oujda]. / État de stress post-traumatique latent en psychiatrie au CHU Mohammed VI Oujda.

INTRODUCTION: Posttraumatic stress disorder (PTSD) is a severe psychiatric disorder following exposure to a traumatic event. It is rarely diagnosed alone. High comorbidity has been observed between PTSD and other psychiatric disorders. OBJECTIVES: The purpose of this work is to evaluate the prevalence of latent PTSD in a population followed in a service of psychiatry and to describe the associated factors. MATERIALS AND METHODS: It is a descriptive cross-sectional study of 300 patients treated for psychiatric disorders, using a hetero-questionnaire containing sociodemographic data, personal and family history, clinical and therapeutic data, and characteristics of the traumatic event. The MINI was used to screen for PTSD and assess suicidal risk. RESULTS: Exposure to a traumatic event is reported by 46.7% of patients, and PTSD by 19.7%. The suicidal risk is 47.7% in the presence of this comorbidity. An ESPT is significantly associated with a schizoaffective disorder and significant suicidal risk. The recentness of the traumatic event, the presence of a state of acute stress and the absence of family psychological support are significantly associated with the occurrence of PTSD. CONCLUSION: A significant number of patients with a psychiatric disorder have undiagnosed PTSD, thus explaining their clinical deterioration. Screening and treatment of the underlying PTSD would help to improve their management.

Psychodynamic Treatment with the Addicted Person.

Psychodynamically trained clinicians have much to offer patients with substance use disorders, but lack a coherent model of treatment for addictions. This paper proposes a bipartite model for approaching addictive illness, separating the addicted person from their illness. Within this framework, the psychodynamic treatment approach seeks to discover and cultivate each person's unique humanity through the therapeutic relationship. Addiction and recovery are conceptualized not as states but as opposing dynamic forces within the individual, each requiring its own therapeutic approach. The seeds of psychodynamic work are planted from the onset of treatment through a therapeutic position of curiosity, nonjudgmental acceptance, empathy, kindness, honesty, and evolving trust. Unlike other treatment approaches, the therapeutic relationship takes center stage in driving the healing process. Countertransference challenges signal crucial opportunities to "flip the script" from dynamics of addiction to those of recovery. The author draws upon several models to illuminate this work. Khantzian's ego-deficit model describes areas of self-regulation vulnerability associated with addiction and conversely pathways to growth in treatment. Winnicott's concept of false self is translatable to the addictive self, while psychotherapy allows true self to emerge. Krystal's description of psychic trauma relates directly to the fragmentation and dissociation of experience in addictive illness. Clinical vignettes illustrate the themes discussed. Psychodynamic therapy offers the opportunity for healing of the deep psychic wounds afflicting many who suffer from addictive illness.

On Winnicott's concept of trauma.

Winnicott's clinical-theoretical matrix constitutes a distinction in underlying basic principles from both the Freudian and Kleinian models. In essence, Winnicott's concept of trauma is entirely related to the vicissitudes of the early psychic parent-infant relationship in which the mother's role is fundamental for the development of the newborn's psyche at the beginning and subsequently. While Winnicott acknowledges the difference between physical and psychic trauma, his focus is on how the interpsychic relationship, psyche to nascent psyche, contributes to the infant's intrapsychic world. Thus, early trauma is caused by psychic transmissions that emanate through and because of the mother's affective states of mind towards her fetus-becoming-an-infant and her infant-becoming-a-child. The earlier that psychic trauma occurs in the nascent psyche, the more severe the outcome of the individual's mental health. This is why Winnicott refers to psychosis as an environmental deficiency disease as distinct from psychotic defences. The author outlines Winnicott's key concepts that are intrinsic to his theory of trauma i.e. the antisocial tendency, fear of breakdown and regression. These concepts are woven into the fabric of Winnicott's theoretical matrix and highlight his perspective on psychoanalysis as a therapeutic treatment for all levels of psychic trauma.

Abuso sexual infantil, câncer e outras doenças avaliados pelo rorschach: revisão sistemática / Child sexual abuse, cancer, and other diseases assessed by the rorschach: systematic review / Abuso sexual infantil, cáncer y otras enfermedades evaluadas por el rorschach: revisión sistemática

Resumo Algumas vivências traumáticas podem suscitar alterações autoperceptivas, afetivas e cognitivas, comuns em casos procedentes dos contextos forense e clínico, o que denota a importância de verificar a origem motivadora dessas alterações. Esta revisão de literatura buscou identificar as variáveis compartilhadas e discrepantes do método de Rorschach nas avaliações de vítimas de abuso sexual e de pacientes com câncer e enfermidades do corpo. Com base no método Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), foram encontrados 11 artigos publicados entre 2008 e 2018, dos quais quatro concernem avaliações de vítimas de abuso sexual; seis, de pacientes com doenças do corpo; e um, de paciente com câncer. As variáveis compartilhadas foram: autopercepção (MOR), relacionamento interpessoal (PER, PHR, T, AG), afeto (SumC', SumY) e ajuste perceptivo (FQ-). Vítimas de abuso sexual diferiram em: autopercepção (An), relacionamento interpessoal (GHR), ideação (m, PTI) e alguns conteúdos traumáticos (Bl e Sx). Pacientes com câncer e doenças do corpo diferenciaram-se em: relacionamento interpessoal (CDI, FD), afeto (CF+C > FC, SumV), ideação (Mp, WSum6, ALOG, DV, DR), processamento (Zd, DQv, PSV, Dd), mediação (P, S-, X-%, Xu%) e controle (D, AdjD, es). Os resultados indicam o protagonismo do corpo, da autopercepção prejudicada e de sentimentos depressivos e de ansiedade. Em vítimas de abuso sexual, o corpo sinaliza marcas de vivências traumáticas, enquanto em pacientes com câncer e outras doenças, o corpo denuncia sentimentos de angústia e de morte. Os resultados contribuem para auxiliar nas avaliações e intervenções psicológicas dirigidas a essa população.(AU)

Abstract Some traumatic experiences arising from the forensic and clinical context may lead to self-perceptive, affective, and cognitive alterations, indicating the importance of verifying the origin that motivated these changes. This literature review aimed to identify the shared and discrepant variables of the Rorschach method in assessing victims of sexual abuse and patients with cancer and body diseases. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA), the review found 11 articles published between 2008 and 2018: four about victims of sexual abuse, six about patients with body diseases, and one about cancer patient. The shared variables were self-perception (MOR), interpersonal relationship (PER, PHR, T, AG), affection (SumC', SumY), and perceptual adjustment (FQ-). Victims of sexual abuse differed in regard to self-perception (An), interpersonal relationship (GHR), ideation (M, PTI), and some traumatic content (Bl and Sx). In turn, patients with cancer and body diseases differed regarding interpersonal relationship (CDI, FD), affection (CF + C > FC, SumV), ideation (Mp, WSum6, ALOG, DV, DR), processing (Zd, DQv, PSV and Dd), mediation (P, S-, X-% and Xu%), and control (D, AdjD, es). The shared results indicate the prominence of the body, the impaired self-perception, and feelings of depression and anxiety. In victims of sexual abuse, the body signaled marks of traumatic experiences, whereas in patients with cancer and other diseases it indicates feelings of anguish and death. This study contributes to assisting in evaluations and psychological interventions aimed at this population.(AU)

Resumen Algunas experiencias traumáticas pueden provocar alteraciones autoperceptivas, afectivas y cognitivas, comunes en casos originados por el contexto forense y clínico; por eso, la importancia de verificar el origen que motivó estos cambios. Esta revisión de la literatura trató de identificar las variables compartidas y discretantes del método Rorschach en las evaluaciones de las víctimas de abuso sexual y de pacientes con cáncer y enfermedades corporales. Sobre la base de Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), se encontraron 11 artículos publicados entre 2008 y 2018; de los cuales cuatro son sobre evaluaciones de víctimas de abuso sexual, seis sobre pacientes con enfermedades corporales y uno sobre paciente con cáncer. Las variables compartidas fueron: autopercepción (MOR), relación interpersonal (PER, PHR, T, AG), afecto (SumC ́, SumY) y ajuste perceptual (FQ-). Las víctimas de abuso sexual diferían en: autopercepción (An), relación interpersonal (GHR), ideación (m, PTI), y algo de contenido traumático (Sx y Bl). Los pacientes con cáncer y enfermedades corporales se diferenciaron en: relación interpersonal (CDI, FD), afecto (CF+C> FC, SumV), ideación (Mp, WSum6, ALOG, DV, DR), procesamiento (Zd, DQv, PSV y Dd), mediación (P, S-, X-% y Xu%) y control (D, AdjD, es). Los resultados indican el protagonismo del cuerpo, la autopercepción dañada y los sentimientos depresivos y de ansiedad. En las víctimas de abuso sexual, el cuerpo señala marcas de experiencias traumáticas, mientras que en los pacientes con cáncer y otras enfermedades el cuerpo denuncia sentimientos de angustia y muerte. En conclusión, los resultados contribuyen a ayudar en las evaluaciones e intervenciones psicológicas dirigidas a esta población.(AU)

A escuta analítica como instrumento de resgate e manutenção do laço social / Analytical listening as a rescue and maintenance instrument of the social bond / Escucha analítica como instrumento de rescate y mantenimiento del lazo social

O presente trabalho é fruto do projeto "Jovens em situação de vulnerabilidade social: entre o trauma e o reconhecimento" desenvolvido com bolsa de iniciação científica concedida pela FAPERJ. Ao longo do trabalho, observamos que a emergência de pequenos testemunhos mobilizava os participantes. Embora a narrativa fosse de uma experiência dolorosa, o posterior acolhimento atuava como potencializador de vínculos sociais. Nesse sentido, propomos examinar a função clínica do testemunho para a atuação dos analistas em contextos de precarização, onde há o enfraquecimento dos laços discursivos. Para isso, partimos da premissa que a vivência em condições precárias é potencialmente traumática e excludente, ainda que haja um esforço psíquico de reduzir a importância dessas situações, banalizando o sofrimento oriundo da violência simbólica a que estão submetidos. Nossa aposta é que a escuta analítica pode operar como um instrumento de cuidado, tendo na coletividade a força para o resgate e manutenção do laço social(AU).

This paper is result of a research developed with a scientific initiation grant from FAPERJ. Throughout the work, we observed that the emergence of small testimonies mobilized the participants. Although the narrative was of a painful experience, the subsequent reception acted as a potentializer of social bonds. In this sense, we propose to examine the clinical function of testimony for the performance of analysts in precarious contexts, where there is a weakening of discourse bonds. For this, we start from the premise that living in precarious conditions is potentially traumatic and excluding, even though there is a psychological effort to reduce the importance of these situations, trivializing the suffering resulting from the symbolic violence to which they are subjected. Our belief is that analytical listening can operate as a potential care instrument, having in the collectivity the strength to rescue and maintain the social bond (AU).

Este trabajo es resultado de una investigación desarrollada con una beca de iniciación científica de FAPERJ. Durante la investigación de campo, observamos que la aparición de pequeños testimonios movilizaba a los participantes. Aunque la narración fuese una experiencia dolorosa, la recepción posterior actuó como un fortalecimiento de los lazos sociales En este sentido, proponemos examinar la función clínica del testimonio para la actuación de los analistas en contextos precarios, donde hay un debilitamiento de los lazos discursivos. Para esto, partimos de la premisa de que vivir en condiciones precarias es potencialmente traumático y excluyente, a pesar de que existe un esfuerzo psicológico para reducir la importancia de estas situaciones, trivializando el sufrimiento resultante de la violencia simbólica a la que están sujetos. Nuestra apuesta es que la escucha analítica puede funcionar como un instrumento de atención potencial, con la comunidad teniendo la fuerza para rescatar y mantener el vínculo social (AU).

A experiência traumática precoce no berço das crianças "sábias" / The early traumatic experience in the cradle of wise children / La experiencia traumática precoz en la cuna de los niños "sabios"

Este ensaio busca elucidar os efeitos da experiência traumática precoce para a constituição psíquica da criança, com ênfase nas formulações de Winnicott e Ferenczi sobre o uso indevido da mente e a autoclivagem narcísica, respectivamente. Por meio de uma revisão teórica, propõe-se uma discussão acerca das relações primárias, considerando-se os efeitos das experiências traumáticas precoces para a constituição psíquica da criança. Conclui-se que ambas as reações psíquicas propostas por Winnicott e Ferenczi expressam, embora em tempos diferentes do processo de constituição psíquica, a emergência do amadurecimento precoce e cindido em decorrência do desencontro entre o universo infantil e o mundo adulto.

This essay intends to elucidate the effects of early traumatic experience on the psychic constitution of the child, with emphasis on Winnicott's and Ferenczi's formulations on the misuse of the mind and the cleavage of the ego, respectively. By means of a theoretical revision, a discussion is proposed about primary relations, considering the effects of early traumatic experiences for the psychic constitution of the child. It is found that psychic reactions proposed by both Winnicott and Ferenczi express, though at different stages of the process of psychic constitution, the emergence of precocious maturity, split due to the mismatch between the infant universe and the adult world.

Este ensayo busca aclarar los efectos de la experiencia traumática precoz para la constitución psíquica, con énfasis en las formulaciones de Winnicott y Ferenczi sobre el uso indebido de la mente y la auto-escisión narcisista, respectivamente. Por medio de una revisión teórica, se propone una discusión sobre las relaciones primarias, llevando en consideración los efectos de las experiencias traumáticas precoces para la constitución psíquica del niño. Se concluye que ambas relaciones psíquicas propuestas por Winnicott y Ferenczi presentan, aunque en tiempos distintos del proceso de constitución psíquica, la emergencia de la maduración precoz y dividida como resultado de la discordancia entre el universo infantil y el mundo adulto.

[Drawing in the elaboration of psychological trauma in a humanitarian context]. / Le dessin dans l'élaboration du traumatisme psychique en contexte humanitaire.

In humanitarian contexts where children are exposed to major traumatic events, psychological care is fundamental to enable them to escape psychological and social isolation. A group care system, that also offers time dedicated to drawing, shows how children can find the necessary internal and external resources that will help them to restore their confidence in a possible future.

No Evidence of Persistence or Inheritance of Mitochondrial DNA Copy Number in Holocaust Survivors and Their Descendants.

Mitochondrial DNA copy number has been previously shown to be elevated with severe and chronic stress, as well as stress-related pathology like Major Depressive Disorder (MDD) and post-traumatic stress disorder (PTSD). While experimental data point to likely recovery of mtDNA copy number changes after the stressful event, time needed for full recovery and whether it can be achieved are still unknown. Further, while it has been shown that stress-related mtDNA elevation affects multiple tissues, its specific consequences for oogenesis and maternal inheritance of mtDNA has never been explored. In this study, we used qPCR to quantify mtDNA copy number in 15 Holocaust survivors and 102 of their second- and third-generation descendants from the Czech Republic, many of whom suffer from PTSD, and compared them to controls in the respective generations. We found no significant difference in mtDNA copy number in the Holocaust survivors compared to controls, whether they have PTSD or not, and no significant elevation in descendants of female Holocaust survivors as compared to descendants of male survivors or controls. Our results showed no evidence of persistence or inheritance of mtDNA changes in Holocaust survivors, though that does not rule out effects in other tissues or mitigating mechanism for such changes.

From the Sunken Place to the Shitty Place: The Film Get Out, Psychic Emancipation and Modern Race Relations From a Psychodynamic Clinical Perspective.

Increasingly, as analysts and psychotherapists, we engage in racial encounters that challenge concepts of empathy, neutrality, and anonymity. This paper attempts to enter this dynamic space to uncover the utility of working within racial tensions for its inherent therapeutic value. Part of this challenge for the clinician, who often identifies and is identified as liberal, is to acknowledge the ubiquity of race as unconsciously structuralizing along with our defenses against this recognition. The intransigence of racism, as formed intrapsychically and discovered in our working functions as analysts and psychotherapists, when not actively challenged and reflected on will be explored. Attempts to explicate the indelible effects of race in the American clinician will be provided that goes beyond countertransference or enactments. Clinical examples and connections to modern cinema are utilized to provide a framework to advance our knowledge in working with racial material.

Ferenczi e os objetivos do tratamento psicanalítico: autenticidade, neocatarse, crianceria / Ferenczi y los objetivos del tratamiento psicoanalítico: autenticidad, neocatarsis, niñeria / Ferenczi and the objectives of psychoanalytic treatment: authenticity, neocatharsis, childishness

Partimos da formulação de Sándor Ferenczi de que o final da análise consistiria na superação da "mentira" por parte do analisando, indicando que esta é a resposta sintomática ao "desmentido" (Verleugnung) sofrido na situação traumática. Nesse sentido o percurso de uma análise implicaria: superar a "identificação ao agressor" decorrente das experiências traumáticas, favorecendo ao analisando o gesto inspirado em sua autenticidade; a "neocatarse" necessária para que o sujeito possa perlaborar a clivagem narcísica, livrando-se da tirania dos objetos incorporados; e a "crianceria", na forma do resgate da palavra evocativa própria da linguagem da ternura infantil.

Partimos de la formulación de Sándor Ferenczi de que el final del análisis consistiría en la superación de la "mentira" por parte del analizado, indicando que esa es la respuesta sintomática a lo "desmentido" (Verleugnung) sufrido en la situación traumática. En este sentido, el trayecto de un análisis implicaría: superar la "identificación al agresor" derivada de las experiencias traumáticas, favoreciendo al analizado el gesto inspirado en su autenticidad; la "neocatarsis" necesaria para que el sujeto pueda reelaborar el clivaje narcisista, librándose de la tiranía de los objetos incorporados; y la "niñería", en la forma del rescate de la palabra evocativa propia del lenguaje de la ternura infantil.

We start from Sándor Ferenczi's formulation that the end of the analysis would consist in overcoming the "lie" on the analyzand's part, indicating this is the symptomatic response to the "disavowal" (Verleugnung) suffered in the traumatic situation. In this sense, the path of an analysis would imply: overcoming the "identification with the aggressor" deriving from the traumatic experiences, providing the gesture inspired in its authenticity to the analyzand; the "neocatharsis" needed for the subject to work through the narcissistic cleavage, getting rid of the incorporated objects; and the "childishness", in the form of the rescue of the evocative word typical of children's affective language.

Traumas, sociodramas construtivistas e EMDR: Promoção de saúde com pessoas afetadas por catástrofes naturais / Trauma, constructivist sociodrama and EMDR: Health promotion for people affected by natural disasters / Trauma, sociodrama constructivista y EMDR: Promoción de salud con personas dañadas por catástrofes naturales

A partir de pesquisas realizadas ao longo de dez anos, com pessoas atingidas por catástrofes naturais no Brasil, em 25 cidades e 7 estados, a autora apresenta uma parte dos resultados obtidos em uma tese de doutorado em Psicologia (USAL, Buenos Aires, 2016) em parceria com a Rede de Ecobioética, Cátedra da UNESCO. Articula conceitos teóricos e práticos de sociodramas construtivistas e da terapia EMDR (Eye Movement Desensitization and Reprocessing), no que se refere à prevenção de traumas pós-catástrofes. Por análise de narrativas de 200 adultos, de níveis socioeconômicos e culturais variados, apresenta resultados que demonstram a eficácia dessas intervenções intra e interpsíquicas na promoção de saúde mental.

Based on research conducted over ten years, with people affected by natural disasters in Brazil, in 25 cities and 7 states, the author presents a part of the results obtained in a doctoral thesis in Psychology (USAL, Buenos Aires, 2016) in partnership with the Eco-Bioethics Network, UNESCO Chair. She articulates theoretical and practical concepts of constructivist sociodramas and EMDR therapy (Eye Movement Desensitization and Reprocessing), regarding the prevention of post-disaster trauma. Through the analysis of 200 adult narratives of varied socioeconomic and cultural backgrounds, she presents results that demonstrate the effectiveness of these intra and interpsychic interventions in the promotion of mental health.

A partir de investigaciones realizadas a lo largo de diez años, con personas danãdas por catástrofes naturales en Brasil, en 25 ciudades y 7 estados, la autora presenta una parte de los resultados obtenidos en una tesis de doctorado en Psicología (USAL, Buenos Aires, 2016), en colaboración con la Red de Ecobioética, Cátedra da UNESCO. Articula conceptos teóricos y prácticos de sociodrama constructivista y de la terapia EMDR (Eye Movement Desensitization and Reprocessing), en lo que se refiere a la prevención de traumas post-catástrofes. Por análisis de narrativas de 200 adultos de niveles socioeconómicos y culturales variados, presenta resultados que demuestran eficacia de esas intervenciones intra e interpsíquicas en la promoción de la salud mental.

Life History and Personality Characteristics of Marital Aggressors: Psychoanalytic Contributions / História de Vida e Características de Personalidade de Agressores Conjugais: Contribuições Psicanalíticas / Historia de Vida y Características de Personalidad de Agresores Conjugales: Contribuciones Psicoanalíticas

Abstract Research indicates that trauma (sexual, physical, and emotional abuse) is a factor commonly present in the life of marital abusers. This study aimed to investigate the life history characteristics and personality of men who perpetrated violence against women and were detained in the Central Prison of Porto Alegre, Brazil. We also identified sociodemographic characteristics, the presence of psychopathological symptoms and understood the intrapsychic dynamics involved in the participants' marital choice, as well as their perception regarding the experience of detention. Three participants filled out a personal data sheet, answered the Rorschach method, the MINI Interview, and participated in three semi-structured interviews. The interviews were examined from the interpretative analysis technique based on psychoanalytic theory. The results allow us to understand the violence committed by the participants as a result from a life story marked by traumatic experiences that produced narcissistic flaws and the expression of aggressiveness.

Resumo Pesquisas indicam que o trauma (abuso emocional, físico e sexual) é um fator comumente presente ao longo da vida de agressores conjugais. Este estudo objetivou investigar as características da história de vida e de personalidade de homens que perpetraram violência contra a mulher e estavam detidos no Presídio Central de Porto Alegre. Identificou-se também características sociodemográficas, a presença de sintomas psicopatológicos e se compreendeu a dinâmica intrapsíquica envolvida na escolha conjugal dos participantes, bem como a percepção deles a respeito da vivência de detenção. Três participantes preencheram uma ficha de dados pessoais, responderam ao Método de Rorschach, a Entrevista MINI e participaram de três entrevistas semiestruturadas. As entrevistas foram examinadas a partir da técnica de análise interpretativa baseada na teoria psicanalítica. Os resultados permitem compreender a violência cometida pelos participantes como decorrente de uma história de vida marcada por vivências traumáticas que produziram falhas narcísicas e a expressão da agressividade.

Resumen Los estudios apuntan que el trauma -ocasionado por abuso emocional, físico y sexual- es un factor comúnmente presente a lo largo de la vida de los agresores conyugales. El presente estudio objetivó investigar las características de la historia de vida y de personalidad de hombres quienes habían cometido violencia contra la mujer y que estaban detenidos en el Presidio Central de Porto Alegre. También se identificaron las características sociodemográficas, la presencia de síntomas psicopatológicos, y se comprendió la dinámica intrapsíquica involucrada en la elección conyugal de los participantes, así como su percepción acerca de la vivencia en la prisión. Tres participantes llenaron una hoja con datos personales, respondieron al método de Rorschach, la entrevista MINI y participaron en tres entrevistas semiestructuradas. Se analizaron las entrevistas por medio del análisis interpretativo con base en la teoría psicoanalítica. Los resultados permiten apuntar que la violencia cometida por los participantes es consecuencia de una historia de vida marcada por vivencias traumáticas que les produjeron fallas narcisistas y la manifestación de agresividad.

A Problemática do Trauma ou o Trauma como um Problema em Psicanálise / The Problematics of Trauma or the Trauma as a Problem in Psychoanalysis

Resumo Este artigo investiga a noção de trauma em psicanálise. Inicialmente, aborda o trauma a partir da elaboração do conceito de inconsciente, observando como a correlação entre trauma e inconsciente em Freud remete o discurso psicanalítico a um pensamento da finitude. Depois, reenvia esse enunciado para a sua condição histórica: a construção dessas noções aparece como resposta a um problema específico da modernidade colocado pelos acontecimentos da vida, do trabalho e da linguagem. Sob esse prisma, o traumático surge como figura de uma história de problemas, em que a relação entre pensamento e acontecimento precipita no discurso a diferença.

Abstract This study investigates the notion of trauma in psychoanalysis. First, it discusses trauma from the elaboration of the concept of the unconscious, showing how the relation between trauma and the unconscious in Freud refers the psychoanalytic discourse to a thought of finitude. Secondly, it sends that statement back to its historical condition: the construction of such notions appears as a response to a specific problem of modernity that comes from the events of life, work and language. In this light, the traumatic emerges as a figure of a history of problems, where the relation between thought and event brings the difference to the discourse.

Trauma, proceso y representación / Traumatisme, processus et représentation / Trauma, process and representation

El autor reflexiona desde una perspectiva contemporánea sobre el concepto de trauma y su relación con los procesos de representación. Partiendo de una dicotomía en la que todo se centraría en el conflicto intrapsíquico o bien al contrario solamente en las vivencias externas que interfieren en el desarrollo, se busca una posición sintética en que los aspectos traumáticos puedan irse integrando. Teniendo en cuenta lo traumático como algo que no solo depende de la intensidad del trauma, sino también de la capacidad de los objetos circundantes para ayudar a tramitarlo, se reflexiona sobre la actitud técnica más propicia en el analista: se da una especial importancia a su implicación en las construcciones, así como la trascendencia de poderse involucrar en la relación con los pacientes. Se trae el caso de un paciente con la historia de unos padres divorciados poco implicados en su crianza, y se relata cómo el involucrarse el analista en sus planes de veraneo supone un poderlo despertar de un cierto letargo. (AU)

The author articulates a contemporary perspective on the concept of trauma and its relationship to the processes of representation. Shifting from a dichotomy where the entire focus is on intrapsychic conflict, versus a focus only on the external experiences that interfere with development, a synthetic position, more integrative of traumatic aspects, is sought. Considering the traumatic as something that not only depends upon the intensity of the trauma, but also upon the capacity of the surrounding objects in helping to process it, the author reflects upon the most conducive technical attitude, according particular importance to the analyst’s involvement in constructions, as well as the vital importance of the ability to engage in their relationship with patients. Case material is presented, detailing a patient with divorced parents who had little involvement in his upbringing, and how the analyst becoming involved in his summer plans brought about a certain awakening from lethargy within him. (AU)

Partant d’une perspective contemporaine, l’auteur réfléchit sur le concept de traumatisme et sa relation avec les processus de représentation. A partir d’une dichotomie où tout se centrerait sur le conflit intrapsychique ou bien au contraire seulement sur les vécus externes qui interfèrent dans le développement, il cherche une position synthétique dans laquelle les aspects traumatiques peuvent peu à peu s’intégrer. Considérant ce qui est traumatique comme quelque chose qui ne dépend pas seulement de l’intensité du traumatisme mais également de la capacité des objets environnants pour aider à le traiter, il réfléchit sur l’attitude technique plus propice chez l’analyste: il attribue une importance spéciale à son implication dans les constructions, ainsi qu’à la transcendance de pouvoir s’engager dans la relation avec les patients. Il apporte le cas d’un patient avec une histoire de parents divorcés peu impliqués dans son éducation, et il raconte comment l’implication de l’analyste dans ses projets d’été suppose pouvoir le réveiller d’une certaine léthargie. (AU)

O Grupo de Suporte como espaço promotor de holding para mulheres com câncer de mama / The Suport Group as a holding promoter for women with breast cancer / Le Groupe de Soutien comme espace promoteur de holding pour des femmes ayant un cancer du sein / El Grupo de Apoyo como un espacio de promoción de sostén (holding) entre mujeres con cáncer de mama

Fundamentado na psicanálise e no conceito de suporte social, este trabalho busca explorar as repercussões psíquicas do adoecimento de mulheres com câncer de mama e o potencial de reintegração do Grupo de Suporte. Os resultados apontam para o fortalecimento das defesas psicossomáticas, através dos vínculos estabelecidos no Grupo, considerado um espaço promotor de holding, por propiciar suporte social, compartilhamento de sentimentos e melhor integração entre psíquico e somático, possibilitando a reinserção social e o enfrentamento da doença.

Anchored on psychoanalysis and on the concept of social support, this paper aims to explore the psychic repercussions of the illness of women with breast cancer and the reintegration potential by the Support Group. The results point to the strengthening of the women's psychosomatic defenses, by means of the ties created in the Group, regarded as a space that promotes holding, by providing social support, sharing of feelings and better psychological and somatic integration, making social reintegration and the confrontation of the disease possible.

Sur la base de la psychanalyse et du concept de soutien social, ce travail vise à explorer les répercussions psychologiques de la maladie des femmes atteintes du cancer du sein et de la réinsertion potentielle du Groupe de Soutien. Les résultats indiquent un renforcement des défenses psychosomatiques à travers des liens établis au sein du groupe, considéré comme un espace promoteur de maintien, pour apporter un soutien social, partage de sentiments et une meilleure intégration entre le psychique et le somatique, rendant ainsi possible la réinsertion sociale et la lutte contre la maladie.

Basado en el psicoanálisis y en el concepto de apoyo social, este trabajo pretende explorar las repercusiones psíquicas, entre las mujeres, repercusiones provenientes del diagnóstico de cáncer de mama, y el potencial de reintegración del Grupo de Apoyo. Los resultados apuntan al fortalecimiento de las defensas psicosomáticas de las mujeres, a través de los vínculos establecidos dentro del Grupo, que es considerado un espacio que promueve el sostén (holding) al proporcionar apoyo social, permitir compartir sentimientos y promover una mejor integración entre lo psíquico y lo somático, haciendo posible la reintegración social y el manejo de la enfermedad.

Basierend auf die Psychoanalyse und auf das Konzept der sozialen Unterstützung, zielt diese Arbeit darauf ab, die psychischen Auswirkungen der Erkrankung bei Frauen mit Brustkrebs und das Wiedereingliederungspotential einer Unterstützungsgruppe zu erforschen. Die Ergebnisse deuten darauf hin, dass die psychosomatische Widerstandskraft der Frauen durch die in der Gruppe geknüpften Verhältnisse gestärkt wurde. Die Gruppe wird als Raum beschrieben, der das Holding fördert, da sie soziale Unterstützung leistet, es erlaubt Gefühle zu teilen, die Integration psychologischer und somatischer Aspekte fördert, die soziale Wiedereingliederung ermöglicht und den Patientinnen hilft, die Krankheit zu konfrontieren.

Psicodrama interno no tratamento de traumas: direcionadores de manejo / Internal psychodrama in the treatment of trauma: handling drivers / Psicodrama interno en el tratamiento de traumas: direccionadores de manejo

O psicodrama interno é uma técnica de intervenção utilizada em situações de muita tensão emocional e em eventos traumáticos simples ou complexos, revelando-se ser mais seguro na prevenção de retraumatização que a dramatização clássica propriamente dita. Dependendo do desenvolvimento da sessão terapêutica, outras técnicas podem ser integradas na intervenção. Este artigo tem como objetivo apresentar direcionadores de manejo do psicodrama interno em situações traumáticas e sua fundamentação teórica baseada em recentes pesquisas da neurociência e do conhecimento empírico da prática clínica.

Internal psychodrama is one of the intervention techniques used in situations of high emotional tension and in simple or complex traumatic events, it has been shown to be safer in preventing re-traumatization than the classic dramatization itself. Depending on the development of the therapeutic session, other techniques can be integrated in the intervention. This article aims to present the handling drivers of the internal psychodrama in traumatic situations and its theoretical fundaments based on recent neuroscience and empirical knowledge of clinical practice researches.

El psicodrama interno es una de las técnicas de intervención utilizada en situaciones de mucha tensión emocional y en eventos traumáticos simples o complejos, revelándose ser más seguro en la prevención de retraumatización que la dramatización clásica propiamente dicha. A depender del desarrollo de la sesión terapéutica, podemos integrar con otras técnicas. Este artículo tiene como objetivo presentar los directores de manejo del psicodrama interno en situaciones traumáticas y su fundamentación teórica basada en recientes investigaciones de la neurociencia y del conocimiento empírico de la práctica clínica.