Sedation indicated?-rethinking existential suffering: a narrative review.

BACKGROUND AND OBJECTIVE: The indication "existential suffering (ES)" for palliative sedation therapy is included in most frameworks for palliative sedation and has been controversially discussed for decades. The appellative character of ES demands rapid relief and sedation often appears to be the best or only solution. ES is still poorly understood and so often neglected by health care professionals due to a lack of consensus regarding assessment, definition and treatment in the international medical literature. Based on a selective review of the literature on ES we propose a different view on the underlying processes of ES and the resulting consequences on medical treatment. METHODS: A narrative review was performed after PubMed search using key terms related to ES and sedation, covering the period from 1950 to April 2023, additionally a selective search in specialist literature on Existential Analysis. Reverse and forward snowballing followed. The language of analyzed publications was restricted to English and German. KEY CONTENT AND FINDINGS: ES is a multidimensional experience that tends to turn into despair and ultimately into a wish to die due to perceived hopelessness and meaninglessness. Pharmacological treatment or sedation do not meet the holistic needs of existential sufferers. The risk of harmful effects by continuous deep sedation seems to be significantly increased for existentially suffering patients. Professional caregivers are burdened by the appellative character of ES, limited treatment options and perceived empathic distress. Without a holistic understanding of the human condition in palliative care, ES cannot be fundamentally alleviated, and existential sufferers have no opportunity to transform and thus mitigate their condition. The recognition of underlying causes of suffering-moods is facilitated by the comprehensive approach of Existential Analysis. CONCLUSIONS: The presented concept of Existential Analysis and the triad of ES are useful instruments for health care professionals to recognize and support underlying moods of existentially suffering patients. Further studies are required. Comprehensive training for professional caregivers on ES is essential to enable them to reflect on their own existential concerns and finiteness as well as those of patients. Continuous deep sedation for ES must remain the exception, equivalent to a last resort option.

'The poetry of psychiatry': existential analysis and the politics of psychopathology in Franco's Spain.

This article examines the presence and influence of the work of Swiss psychiatrist Ludwig Binswanger and existential analysis (Daseinsanalyse) in Spanish psychiatry in the central decades of the 20th century. First, and drawing on various printed and archival sources, it reconstructs the important personal and professional ties that Binswanger maintained with numerous Spanish colleagues and describes the notable dissemination of his work in Spain through bibliographical reviews, scientific events, academic reports, university lectures and translations. Next, it reviews the incorporation of the postulates of existential analysis into the discourse of Spanish psychiatrists and assesses their most elaborate and original contributions to the foundations of 'anthropological-existential' psychiatry or the 'existential-analytical' interpretation of certain disorders or clinical conditions. And, finally, it tries to clarify the assessment according to which the (inevitable) instrumentalisation of existential analysis in the context of Franco's Spain first compromised the critical recognition of its true possibilities (and limits) and later contributed to the discrediting of psychopathological research among Spanish psychiatrists.

The silence of Laing and its echo in Szasz's essay on antipsychiatry.

BACKGROUND: As has been evaluated in a previous paper, Thomas S. Szasz redoubled his attacks against R. D. Laing in a series of articles which were published in The New Review (TNR) during the 1970s. Laing, however, consciously decided not reply to Szasz, a task taken up instead by Leon Redler on behalf of the Philadelphia Association (PA). AIMS/OBJECTIVE: The main purpose of this paper is to shed light on the motives which led to Laing to decline to take part in TNR debate. Secondly, I evaluate the impact this had on the writing of Szasz in his widely read book, Antipsychiatry. Quackery squared, published in 2009. METHODS: In order to gain a balanced perspective of the issues involved, I review all oral and written sources which I have been able to locate, including correspondence with mental health professionals who met Laing and Szasz in person. RESULTS AND CONCLUSIONS: My conclusion is that Laing and members of PA would have preferred for Szasz to meet Laing in person to discuss antipsychiatry. However, Szasz opted not to see Laing personally when he traveled to London, whilst Laing decided not to reply to Szasz's harsh criticisms either in public or in print. As a result, the debate on antipsychiatry was brought to an unsatisfactory close, only to be reopened by Szasz in his book on antipsychiatry, published long after Laing's death (1989), and hence requiring others to respond in his memory.

The effects of psychological meaning-centered therapies on quality of life and psychological stress: A metaanalysis.

ABSTRACTObjective:Many psychotherapists speak with clients about meaning in life. Meaning is an neutral evidence-based term for a subjective sense of purpose, values, understanding, self-worth, action-directed goals, and self-regulation. Since little is known about its effectiveness, our study aimed to determine the effects of meaning-centered therapies (MCTs) on improving quality of life and reducing psychological stress. METHOD: Independent researchers selected and scored articles in multiple languages in multiple search engines. Weighted pooled mean effects were calculated following a random-effects model. Sensitivity analyses included moderators, study and sample characteristics, risk of bias, randomization, types of MCT, control condition, and outcome instruments. RESULTS: Some 52,220 citations included 60 trials (total sample N = 3,713), of which 26 were randomized controlled trials (N = 1,975), 15 nonrandomized controlled trials (N = 709), and 19 nonrandomized noncontrolled trials with pre/post measurements (N = 1,029). Overall analyses showed large improvements from baseline to immediate posttreatment and follow-up on quality of life (Hedges' g = 1.13, SE = 0.12; g = 0.99, SE = 0.20) and psychological stress (g = 1.21, SE = 0.10; g = 0.67, SE = 0.20). As effects varied between studies, further analyses focused only on controlled trials: MCT had large effect sizes compared to control groups, both immediate and at follow-up, on quality of life (g = 1.02, SE = 0.06; g = 1.06, SE = 0.12) and psychological stress (g = 0.94, SE = 0.07, p < 0.01; g = 0.84, SE = 0.10). Immediate effects were larger for general quality of life (g = 1.37, SE = 0.12) than for meaning in life (g = 1.18, SE = 0.08), hope and optimism (g = 0.80, SE = 0.13), self-efficacy (g = 0.89, SE = 0.14), and social well-being (g = 0.81, SE = 13). The homogeneity of these results was validated by the lack of significance of moderators and alternative ways of selecting studies. Metaregression analyses showed that increases in meaning in life predicted decreases in psychological stress (ß = -0.56, p < 0.001). SIGNIFICANCE OF RESULTS: MCT strongly improves quality of life and reduces psychological stress. MCT should be made more widely available, particularly to individuals in transitional moments in life or with a chronic or life-threatening physical illness as they explicitly report meaning-centered concerns.

Solidão: do patológico ao ontológico / Loneliness: from pathological to ontological / Soledad: del patológico a lo ontológico

O objetivo do presente artigo é problematizar o fenômeno da solidão enquanto experiência significativa, no horizonte de nossas relações sociais e afetivas, considerando a legitimidade de sua significação patológica, bem como a primazia de sua ressignificação ontológica. Destaca-se o caráter ontológico da solidão em oposição ao seu horizonte hermenêutico técnico-científico e biomédico destacando os limites desta abordagem, no tocante à compreensão existencial do fenômeno da solidão. Explicita-se a dimensão ontológica da solidão a partir da fenomenologia de Heidegger ressaltando os fundamentos de uma analítica existencial e a reflexão da solidão enquanto tonalidade afetiva que constituem o ser humano enquanto ser-no-mundo e com-os-outros. Problematiza-se a insuficiência da concepção patológica da solidão para compreendê-la enquanto experiência existencial originária e que se estabelece no horizonte de nossa temporalidade, a partir dos existenciais do ser-com e da tonalidade afetiva da angústia. Ressalta-se a proximidade entre a angústia e a solidão enquanto isolamento existencial, e a importância de se estabelecer junto à angústia e à solidão o que Heidegger denomina de pensamento meditante para a abertura de novos sentidos que permitam o resgate da responsabilização de nossos projetos existenciais, nossa singularização e liberdade. (AU)

The purpose of this article is to discuss the phenomenon of loneliness as a significant experience in the horizon of our social and affective relationships considering the legitimacy of their pathological significance, as well as the primacy of their ontological resignification. It highlights the ontological character of loneliness from their technical-scientific and biomedical hermeneutical horizon highlighting the limits of this approach regarding existential understanding of loneliness phenomenon. Explains the ontological dimension of loneliness from Heidegger's phenomenology highlighting the foundations of an existential analysis and the reflection of solitude while affective tonality which constitute the human being as being-in- the-world and being-with. Problematizes the failure of pathological loneliness concept to understand it as an existential original experience and that establishes in the horizon of our temporality, from the existential being-with and the anguish affective tone. We emphasize the closeness between anguish and loneliness as existential isolation and the importance of establishing with the anguish and solitude what Heidegger will call meditative thinking for the opening of new meanings that allow the rescue the responsibility of our existential projects, singularity and freedom. (AU)

El propósito de este artículo es analizar el fenómeno de la soledad como una experiencia significativa en el horizonte de nuestras relaciones sociales y emocionales teniendo en cuenta la legitimidad de su significado patológico y la primacía ontológica de su reinterpretación. Destaca el carácter ontológico de la soledad desde su horizonte hermenéutico técnico-científico y biomédico. Explica la dimensión ontológica de la soledad de la fenomenología de Heidegger destacando las bases de un análisis y reflexión de la soledad existencial aunque la tonalidad afectiva que conforman al ser humano como ser-em-el-mundo y ser-con-el-outro. Discute la insuficiência del concepto de la soledad patológica destacando los límites de este enfoque con respecto a la comprensión existencial del fenómeno de la soledad para entenderla como una experiencia existencial originaria y se instala en el horizonte de nuestra temporalidad, a partir de los existenciales do ser-con-el-otro y el tono afectivo de angustia. Enfatizamos la cercanía entre la angustia y la soledad como el aislamiento existencial, y la importancia de establecer con la angustia y la soledad que Heidegger llamará pensamiento meditative para la apertura de nuevos significados que permiten el rescate de la responsabilidad pornuestros proyectos existenciales, singularización y nuestra libertad. (AU)

A desconstrução da psicossomática na análise existencial de Heidegger e Boss / The deconstruction of psychosomatics in Heidegger’s and Boss’ Daseinsanalysis / La déconstruction de la psychosomatique dans la Daseinsanalyse de Heidegger et de Boss / La deconstrucción de la psicosomática en el análisis existencial de Heidegger y de Boss

O presente artigo coloca em questão a compreensão tradicional da psicossomática por meio da dicotomia soma e psique e a relação de causalidade presente nessa tradição para, então, mediante uma perspectiva crítica, propor outra compreensão, com base na fenomenologia-hermenêutica de Heidegger e a Daseinsanálise de Boss. Este coloca, ainda, em questão a denominação psicossomática que mantém a dualidade da qual se pretende libertar.(AU)

This article brings into question the traditional understanding of psychosomatics by taking into account the dichotomy between soma and psyche and the causal relation present in this tradition. It suggests, from a critical point-of-view, a different understanding based on Heidegger’s phenomenology-hermeneutics and Boss’ Daseinsanalysis. This article also calls into question the term ‘psychosomatics’, which preserves the duality that has to be eliminated.(AU)

Cet article remet en question le concept traditionnel de la psychosomatique au moyen de la dichotomie entre soma et psyché et du rapport de causalité qui caractérise cette tradition. Par la suite, il propose, à partir d’un point-de-vue critique, une autre compréhension basée sur la phénoménologie herméneutique de Heidegger et sur la Daseinsanalyse de Boss, et met également en question le terme « psychosomatique » qui préserve la dualité qu’on cherche à supprimer.(AU)

El presente artículo cuestiona la comprensión tradicional de la psicosomática mediante la dicotomía soma y psique, además de la relación de causalidad presente en esa tradición para proponer, a través de una perspectiva crítica, otro entendimiento basado en la fenomenología-hermenéutica de Heidegger y en el análisis del Dasein de Boss, que además pone en entredicho la palabra “psicosomática”, que mantiene la dualidad de la cual pretende liberarse.(AU)

A desconstrução da psicossomática na análise existencial de Heidegger e Boss / The deconstruction of psychosomatics in Heidegger’s and Boss’ Daseinsanalysis / La déconstruction de la psychosomatique dans la Daseinsanalyse de Heidegger et de Boss / La deconstrucción de la psicosomática en el análisis existencial de Heidegger y de Boss / Die Dekonstruktion des Psychosomatischen in der Daseinsanalyse von Heidegger und Boss / 在海德格尔和博斯的存在注意分析的心身解构

O presente artigo coloca em questão a compreensão tradicional da psicossomática por meio da dicotomia soma e psique e a relação de causalidade presente nessa tradição para, então, mediante uma perspectiva crítica, propor outra compreensão, com base na fenomenologia-hermenêutica de Heidegger e a Daseinsanálise de Boss. Este coloca, ainda, em questão a denominação psicossomática que mantém a dualidade da qual se pretende libertar.

This article brings into question the traditional understanding of psychosomatics by taking into account the dichotomy between soma and psyche and the causal relation present in this tradition. It suggests, from a critical point-of-view, a different understanding based on Heidegger’s phenomenology-hermeneutics and Boss’ Daseinsanalysis. This article also calls into question the term ‘psychosomatics’, which preserves the duality that has to be eliminated.

Cet article remet en question le concept traditionnel de la psychosomatique au moyen de la dichotomie entre soma et psyché et du rapport de causalité qui caractérise cette tradition. Par la suite, il propose, à partir d’un point-de-vue critique, une autre compréhension basée sur la phénoménologie herméneutique de Heidegger et sur la Daseinsanalyse de Boss, et met également en question le terme « psychosomatique ¼ qui préserve la dualité qu’on cherche à supprimer.

El presente artículo cuestiona la comprensión tradicional de la psicosomática mediante la dicotomía soma y psique, además de la relación de causalidad presente en esa tradición para proponer, a través de una perspectiva crítica, otro entendimiento basado en la fenomenología-hermenéutica de Heidegger y en el análisis del Dasein de Boss, que además pone en entredicho la palabra “psicosomática”, que mantiene la dualidad de la cual pretende liberarse.

Dieser Artikel stellt das traditionelle Konzept des Psychosomatischen in Frage und stützt sich dabei auf die Dichotomie zwischen Soma und Psyche, sowie auf die Kausalitätsbeziehung, die dieser Tradition zu eigen ist. Mittels einer kritischen Perspektive schlägt dieser Artikel ein neues Konzept vor, das auf Heideggers Phänomenologie-Hermeneutik und der Daseinsanalyse von Boss basiert. Boss stellt dabei den Begriff „Psychosomatik“ in Frage, da er die Dualität beinhaltet, von der man sich zu befreien versucht.

本文提出分析对心身的传统，其对索玛和精神的二分法及因果关系。在此基础上再通过所以通过海德格尔的现象-诠释学和博斯的存在分析从一个批判的角度建立另一个认识。他虽然希望脱离但还保持身心定义中的双重性。.

The current dialogue between phenomenology and psychiatry: a problematic misunderstanding.

A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called "phenomenology" has finally nothing to do with phenomenology. This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders.

El Análisis Existencial en la escuela: de la restricción al encuentro creativo / Existential Analysis in school: the restriction to creative meeting

Este artículo expone una revisión y una serie de reflexiones en torno al Análisis Existencial sobre el diagnóstico y la intervención psicológica en contextos escolares. Se revisaron y contrastaron las contribuciones de distintos autores representativos del modelo biomédico y del modelo bio-psico-socio-espiritual en torno a la intencionalidad del psicodiagnóstico escolar. Se discute sobre la aplicabilidad de estas propuestas (modelo biomédico y modelo bio-psico-socio-espiritual) al Análisis Existencial en los programas de ayuda a niños, niñas y adolescentes que pasan por diferentes dificultades para afrontar situaciones propias de la existencia humana que se presentan en contextos escolares.

This article summarizes some theoretical reflections about the personal and Existential Analysis on diagnosis and psychological interventions in school settings. Were reviewed and contrasted the contributions of various authors representative of the biomedical model and the bio-psycho-socio-spiritual about the intentionalities of the school psychodiagnostic. We discuss the applicability of these proposals (bio-medical model and bio-psycho-socio-spiritual) to Existential Analysis in programs to help children and young people whom throw out to different difficulties, specificly to human existence that presented in school settings.

Emotional experience: applying person-centered approach to the practice of existential analysis / Experiência emocional: aplicando a abordagem centrada na pessoa para a prática da análise existencial / Experiencia emocional: aplicando el enfoque centrado en la persona a la práctica del análisis existencia

This article focuses on the issue of integration of the ideas of person-centered and existential approaches. Specifically, it shows how C. Rogers's notion of "necessary and sufficient" conditions for a successful therapy is firmly embedded in the practice of existential analysis and logotherapy, and works as a basis for confronting interventions. The paper analyses similarities and differences of the work with emotional experiences in E. Gendlin's focusing and A. Längle's personal existential analysis. It was shown that, despite the divergence in terminology, there is considerable similarity in their value principles and theoretical guidelines. The potential contribution of combining these two approaches to psychotherapy is discsussed. The paper concludes with a practical case illustration.(AU)

Este artículo está enfocado en el asunto de la integración de las ideas de la psicoterapia centrada en el cliente y la psicoterapia existencial. Específicamente, demuestra cómo la noción de C. Rogers de "los necesarios y suficientes" condiciones para el éxito de psicoterapia está profundamente incluida en la práctica del análisis existencial y la logoterapia, y funciona como la base para las intervenciones de confrontación. El artículo analiza las similitudes y diferencias en el trabajo de "focusing" de E.Gendlin y análisis existencial personal de A. Längle. Está demostrado que a pesar de las divergencias de la terminología, hay una similitud considerable en sus principios, valores y direcciones teóricas. La posible contribución a la combinación de estos dos enfoques en psicoterapia está discutida. El trabajo se concluye con una ilustración de un caso práctico.(AU)

Este artigo enfoca a questão da integração das idéias de abordagens centradas na pessoa e existenciais. Especificamente, ele mostra como a noção de C. Rogers de condições "necessárias e suficientes"; para uma terapia bem sucedida está firmemente incorporado na prática da análise existencial e logoterapia, e funciona como uma base para enfrentar intervenções. O trabalho analisa as semelhanças e diferenças do trabalho com as experiências emocionais em E. Gendlin de foco e análise existencial pessoal de A. Längle. Mostrou-se que, apesar da divergência de terminologia, há uma semelhança considerável em seus princípios de valores e diretrizes teóricas. A contribuição potencial de combinar essas duas abordagens para a psicoterapia é discsussed. O artigo conclui com um caso de ilustração prática.(AU)

Emotional experience: applying person-centered approach to the practice of existential analysis / Experiência emocional: aplicando a abordagem centrada na pessoa para a prática da análise existencial / Experiencia emocional: aplicando el enfoque centrado en la persona a la práctica del análisis existencia

This article focuses on the issue of integration of the ideas of person-centered and existential approaches. Specifically, it shows how C. Rogers's notion of "necessary and sufficient" conditions for a successful therapy is firmly embedded in the practice of existential analysis and logotherapy, and works as a basis for confronting interventions. The paper analyses similarities and differences of the work with emotional experiences in E. Gendlin's focusing and A. Lãngle's personal existential analysis. It was shown that, despite the divergence in terminology, there is considerable similarity in their value principles and theoretical guidelines. The potential contribution of combining these two approaches to psychotherapy is discsussed. The paper concludes with a practical case illustration...

Este artículo está enfocado en el asunto de la integración de las ideas de la psicoterapia centrada en el cliente y la psicoterapia existencial. Específicamente, demuestra cómo la noción de C. Rogers de "los necesarios y suficientes" condiciones para el éxito de psicoterapia está profundamente incluida en la práctica del análisis existencial y la logoterapia, y funciona como la base para las intervenciones de confrontación. El artículo analiza las similitudes y diferencias en el trabajo de "focusing" de E.Gendlin y análisis existencial personal de A. Lãngle. Está demostrado que a pesar de las divergencias de la terminología, hay una similitud considerable en sus principios, valores y direcciones teóricas. La posible contribución a la combinación de estos dos enfoques en psicoterapia está discutida. El trabajo se concluye con una ilustración de un caso práctico...

Este artigo enfoca a questão da integração das idéias de abordagens centradas na pessoa e existenciais. Especificamente, ele mostra como a noção de C. Rogers de condições "necessárias e suficientes"; para uma terapia bem sucedida está firmemente incorporado na prática da análise existencial e logoterapia, e funciona como uma base para enfrentar intervenções. O trabalho analisa as semelhanças e diferenças do trabalho com as experiências emocionais em E. Gendlin de foco e análise existencial pessoal de A. Lãngle. Mostrou-se que, apesar da divergência de terminologia, há uma semelhança considerável em seus princípios de valores e diretrizes teóricas. A contribuição potencial de combinar essas duas abordagens para a psicoterapia é discsussed. O artigo conclui com um caso de ilustração prática...

Produção de artigos sobre logoterapia no Brasil de 1983 a 2012 / Production of papers about logotherapy in Brazil from 1983 to 2012

Este trabalho é um estudo sobre publicações cientificas em Logoterapia no Brasil. Em 26 de novembro de 2012 lançou-se o termo descritivo "Logoterapia or Viktor Frankl" em duas bases de dados abertas: BSV Psicologia ULAPSI Brasil e no Google Acadêmico. Selecionou-se publicações de periódicos classificados pela CAPES. Identificou-se 51 artigos cujos dados foram tratados no Microsoft Excel. A análise mostrou que: as publicações foram feitas entre 1983 e 2012, em 29 periódicos, em sua maior parte com Qualis A2. A amplitude de variação das páginas foi de quatro a 25, com 11 de média. 28 trabalhos tinham revisão bibliográfica por modalidade de pesquisa, sete pesquisa de campo e seis experimental. O tema mais abordado foi sentido da vida. 38% dos autores eram de instituições nordestinas, 75% da área de psicologia e 55% pós-graduados ou pós-graduandos strictu sensu. O número crescente de publicações aponta o atual interesse dos brasileiros nesta abordagem, porém são poucos os artigos publicados. (AU)

This research is about Brazilians papers in Logotherapy. In November 26, 2012 was made one search in two open databases (BSV Psicologia ULAPSI Brasil and Google Acadêmico) using the expression "Logoterapia or Viktor Frankl". Were selected papers of journals with evaluation in the CAPES. Was found 51 papers that was analyzed with Microsoft Excel. Was found that:had papers between 1983 and 2012, in 29 journals, frequently classified with Qualis A2. The pages' variation breadth was for four to 25, with 11 by average. 28 papers had bibliography revision how type of research, seven how fieldwork and six how experimental research. The subject most mentioned was meaning of live. 38% of authors were by nort-east Brazil's institutes, 75% by field on psychology and 55% had post graduated or were doing it. Was concluded that there are crescent interest about Logotherapy in Brazil however papers about this subject even are few in this country. (AU)

Produção de artigos sobre Logoterapia no Brasil de 1983 a 2012 / Production of papers about Logotherapy in Brazil from 1983 to 2012

Este trabalho é um estudo sobre publicações cientificas em Logoterapia no Brasil. Em 26 de novembro de 2012 lançou-se o termo descritivo "Logoterapia or Viktor Frankl" em duas bases de dados abertas: BSV Psicologia ULAPSI Brasil e no Google Acadêmico. Selecionou-se publicações de periódicos classificados pela CAPES. Identificou-se 51 artigos cujos dados foram tratados no Microsoft Excel. A análise mostrou que: as publicações foram feitas entre 1983 e 2012, em 29 periódicos, em suamaior parte com Qualis A2. A amplitude de variação das páginas foi de quatro a 25, com 11 de média. 28 trabalhos tinham revisão bibliográfica por modalidade de pesquisa, sete pesquisa de campo e seis experimental. O tema mais abordado foi sentido da vida. 38% dos autores eram de instituições nordestinas, 75% da área de psicologia e 55% pós-graduados ou pós-graduandos strictu sensu. O número crescente de publicações aponta o atual interesse dos brasileiros nesta abordagem, porém são poucos osartigos publicados...

This research is about Brazilians papers in Logotherapy. In November 26, 2012 was made one search in two open databases (BSV Psicologia ULAPSI Brasil and Google Acadêmico) using the expression "Logoterapia or ViktorFrankl". Were selected papers of journals with evaluation in the CAPES. Was found 51 papers that was analyzed with Microsoft Excel. Was found that:had papers between 1983 and 2012, in 29 journals, frequently classified with Qualis A2. The pages' variation breadth was for four to 25, with 11 by average. 28 papers had bibliography revision how type of research, seven how fieldwork and six how experimental research. The subject most mentioned was meaning of live. 38% of authors were by nort-east Brazil's institutes, 75% by field on psychology and 55% had post graduated or were doing it. Was concluded that there are crescent interest about Logotherapy in Brazil however papers about this subject even are few in this country...

A espacialidade na compreensão do transtorno do pânico: uma análise existencial / The spaciality in the understanding of the panic disorder: an existential analysis / La Espacialidad en la compreensión del transtorno de panico: una análisis existencial

O texto apresenta um caso clínico sob a luz da análise existencial de Ludwig Binswanger. Elege-se a espacialidade como categoria central na compreensão clínica aqui apresentada. Em um primeiro momento, será apresentado ao leitor o conceito de espacialidade segundo a ontologia fundamental de Heidegger, em Ser e Tempo. Feito isso, o artigo traz à luz o conceito de pânico, de acordo com a análise existencial. O relato do caso clínico, bem como sua análise, conforme os conceitos apresentados, desvelará de que forma o pânico pode ser entendido como um transtorno no modo de espacializar. Essa compreensão nos dará subsídios para um entendimento existencial do transtorno do pânico, bem como nos possibilita pensar em formas de condução do tratamento, diferente das tradicionais.(AU)

This text presents a clinical case under the light of the existential analysis of Ludwig Binswanger. It is chosen spaciality as central category in the clinical understanding presented here. At a first moment, basic on the essential ontology of Heidegger in Being and Time, will be presented to the reader the concept of spaciality. Made this, the article brings to the light the concept of panic, in accordance with the existential analysis. The story of the clinical case, as well as its analysis, will reveal of that it forms the panic can be understood as a disorder in the way of to space of the individual. This understanding in will give us subsidies for an existential agreement of the panic disorder, as well as in makes possible to think about forms of conduction of the treatment, differently of the traditional ones.(AU)

Este trabajo presenta un estudio de caso a la luz del análises existencial de Ludwig Binswanger. Elige a la espacialidad como uma categoria central en la comprensión del caso. En un primer momento, el lector se introducirá el concepto de espacialidad de acuerdo a la ontología fundamental de Heidegger, en Ser y Tiempo. A continuación, el artículo saca a la luz el concepto de pánico, de acuerdo con el análisis existencial. El caso clínico y su análisis dará a conocer como el pánico se puede compreender como un transtorno en el modo de espacializar. Esa comprensión subsidiará para un entendimento existencial del transtorno de pânico, mientras possibilitará piensar en modos de conducción del trataimiento, diferente de los tradicionales.(AU)

A espacialidade na compreensão do transtorno do pânico: uma análise existencial / The spaciality in the understanding of the panic disorder: an existential analysis / La Espacialidad en la compreensión del transtorno de panico: una análisis existencial

O texto apresenta um caso clínico sob a luz da análise existencial de Ludwig Binswanger. Elege-se a espacialidade como categoria central na compreensão clínica aqui apresentada. Em um primeiro momento, será apresentado ao leitor o conceito de espacialidade segundo a ontologia fundamental de Heidegger, em Ser e Tempo. Feito isso, o artigo traz à luz o conceito de pânico, de acordo com a análise existencial. O relato do caso clínico, bem como sua análise, conforme os conceitos apresentados, desvelará de que forma o pânico pode ser entendido como um transtorno no modo de espacializar. Essa compreensão nos dará subsídios para um entendimento existencial do transtorno do pânico, bem como nos possibilita pensar em formas de condução do tratamento, diferente das tradicionais...

This text presents a clinical case under the light of the existential analysis of Ludwig Binswanger. It is chosen spaciality as central category in the clinical understanding presented here. At a first moment, basic on the essential ontology of Heidegger in Being and Time, will be presented to the reader the concept of spaciality. Made this, the article brings to the light the concept of panic, in accordance with the existential analysis. The story of the clinical case, as well as its analysis, will reveal of that it forms the panic can be understood as a disorder in the way of to space of the individual. This understanding in will give us subsidies for an existential agreement of the panic disorder, as well as in makes possible to think about forms of conduction of the treatment, differently of the traditional ones...

Este trabajo presenta un estudio de caso a la luz del análises existencial de Ludwig Binswanger. Elige a la espacialidad como uma categoria central en la comprensión del caso. En un primer momento, el lector se introducirá el concepto de espacialidad de acuerdo a la ontología fundamental de Heidegger, en Ser y Tiempo. A continuación, el artículo saca a la luz el concepto de pánico, de acuerdo con el análisis existencial. El caso clínico y su análisis dará a conocer como el pánico se puede compreender como un transtorno en el modo de espacializar. Esa comprensión subsidiará para un entendimento existencial del transtorno de pânico, mientras possibilitará piensar en modos de conducción del trataimiento, diferente de los tradicionales...

The existential analysis of anorexia nervosa: from psychiatric science to its foundations / El análisis existencial de la anorexia nerviosa: de la ciencia psiquiátrica a su fundamentación

The field of anorexia nervosa is experiencing a great deal of activity at present with predominantly practical and empirical issues. In contrast, theoretical and methodological considerations have rather been neglected. The term existential analysis (Daseinsanalyse) was introduced by Binswanger basing his approach on Martin Heidegger, to characterize a method for investigating psychopathological phenomena. The Daseinsanalytic view of the anorexia nervosa and its world ask just to look at the phenomena themselves, as they confront the psychiatrist. The statements are extremely strict, careful, and subtle, descriptions and expositions of the essential aspects and features of anorectics, of their being-in-the-world.

El campo de la anorexia nerviosa está experimentando una gran actividad, especialmente en los aspectos prácticos y empíricos. Por el contrario, las consideraciones teóricas y metodológicas han sido descuidadas. El análisis existencial (Daseinsanalyse) fue introducido por Binwanger basándose en Martin Heidegger, para caracterizar un método para investigar los fenómenos psicopatológicos. La perspectiva analítico-existencial de la anorexia y su mundo sólo pide mirar los fenómenos mismos, tal como le hacen frente al psiquiatra. Sus aseveraciones son descripciones estrictas, cuidadosas y sutiles que exponen los aspectos esenciales de las anorécticas, su ser-en-el-mundo.

La soledad grandiosa: el narcisismo como fenómeno antroplógico-existencial / The splendid solitude: narcissism as anthropological-existencial phenomenom

La problemática del propio valer, el tema del narcisismo, despliega su efecto no sólo en el experienciar personal, sino que ocurre en forma considerable en el intercambio con otras personas. En la primera parte de las consideraciones, esta característica esencial del narcisismo, que se encuentra en la base de la formación de los síntomas. se explica antroplógicamente y se señala su dimensión sociológica como también histórico-cultural. Reflexiones sobre el desarrollo psicológico, importantes para la comprensión del narcisimo, se refieren al significado del proceso evolutivo y a la confrontación consigo mismo, que contribuyen a la formación del Yo. En la segunda parte se describen las condiciones interpersonales del desarrollo de las estructuras del Yo. A continuación se relacionan las estructuras yoicas con un concepto central de la psicología humanista: con el ser persona. Sobre este trasfondo se entiende el narcisismo como un trastorno que tiene su lugar antropológico justamente en este interjuego entre la estructura del Yo y el ser persona. Esto puede ser considerado como un aporte específico del Análisis Existencial a la comprensión del narcisismo. En la última parte se describen brevemente la psicopatología y la psicopatogénesis del trastorno a la luz de esta comprensión.

The problems around the worth of one's self, the theme of narcissism, manifest themselves not only in one's personal experience, but to a large degree also in one`s interaction with other people. In the first part of the article this essential characteristic of narcissism that underlies the formation of symptoms is explained anthropologically. At the same time the sociological and cultural-historical dimensions will the pointed to. Reflections pertaining to the psychology of development and important for understanding narcissism point to the importance of the lifelong process of development and self-confrontation that contribute to the formation of the "I". In the second part the interpersonal as well as intra-personal prerequisites of a development of the structures of the "i" are described. The structures of the "I" are finally brought into relation with a central concept of humanistic psychology: with personhood. Against this background narcissism is seen as a disorder that has it anthropological place in the interaction between the structure of the "I" and personhood. This may be seen as the specific contributuion of existencial analysis to the understanding of narcissism. In the last part and in the light of this understanding of narcissism. In the last part and in the light of this understanding the psychopathology an the psychogenesis of this disorder will be described briefly.

Trastornos de la personalidad y génesis de los traumas: análisis existencial de los trastornos de la personalidad condicionados por traumas / Personality disorders and genesis of trauma existencial analysis of traumatized personality disorders

El tema de la traumatización tiene una relevancia existencial muy especial. El Análisis Existencial (AE) considera que lo específico de la traumatización grave está en la experiencia del "horror", en la que se vivencia lo abismal del Ser (en vez de la Nada). Esta experiencia central de la traumatización es analizada en dos niveles. El nivel procesal es estudiado a través del análisis de la estructura del Yo. Se va comparando el modelo de la estructura del Yo del AE con el de Ch. Scharfetter. En el nivel estructural, un trauma grave afecta las cuatro dimensiones de la existencia completa. Esto explica tanto la aparición de un TSPT (trastorno por estrés post-traumático), como el alto índice de comorbilidad de este trastorno. Como consecuencia directa del trauma, debido a una paralización en la esfera procesal, se produce una disminución de intercambios con la estructura existencial, que se caracteriza por pérdida de mundo, empobrecimiento de las relaciones, pérdida de sí mismo y de futuro. La vivencia es acompañada por típicas reacciones de coping - más que nada reflejos de posición de muerto y un activismo de la primera Motivación Fundamental (MF). Terapéuticamente se hace necesaria una reestructuración de las relaciones existenciales fundamentales y de las funciones personales. El modelo de las MF señala pasos terapéuticos específicos para superar el desarraigo existencial y para movilizar las funciones personales mediante el empleo de factores "inespecíficos", como el diálogo y el encuentro.

The topic of traumatizing has a particulary great existential relevance. In existential analysis the specificity of grave traumatizing is considered to be the experience of "horror" at seeing the abysmal side of one's being (instead of the void). This central experience in traumatizing is looked at on two levels. The process level is examined via an analysis of the self-structure, with the existential-analytical model of self-structure being close to the one propounded by Ch. Scharfetter. On the structural level all four fundamental dimensions of fulfilled existence are touched by grave traumatizing. This explains the genesis of PTSD (post -traumatic stress disorder) as well as the high comobidity factor of this disorder. As a direct consequence of trauma the interaction with the existential structure is reduced, causing a loss of world, relationship, self and future. Characteristic coping reactions accompany all experience - above all death-feigning reflex and activism on the first fundamental motivation. Therapy must restructure the existential fundamental references and the functioning of the person. The model of the fundamental motivations provides specific therapeutic steps for overcome the existential deracination and to mobilise the functions of the person with the help of non-specific factors such as dialogue and encounter.

Desvelando o sentido do cuidado de enfermagem: vivências do ser com câncer / Clarifying the meaning of nursing care: experiences of the human being with cancer

Ao longo da história, o câncer sempre foi estigmatizado como sinônimo de morte, e apesar do avanço ocorrido nas últimas décadas, ele ainda traz consigo a sensação de morte iminente. O câncer atualmente é considerado um problema de saúde pública devido a sua alta prevalência. O ser com câncer está inserido nas diversas instituições de saúde. O cuidado ao ser com câncer requer um envolvimento de diversas áreas de conhecimento, por se tratar de uma assistência bastante complexa. Diante do exposto, utilizei como questão de investigação: Qual o sentido do cuidado de enfermagem para o ser com câncer? E como objetivo, compreender qual é o sentido do cuidado de enfermagem na perspectiva do ser com câncer. Trata-se de um estudo fenomenológico que utilizou como referencial a Análise Existencial de Viktor Frankl, que através de uma visão existencialista discorre sobre situações de sofrimento, culpa e morte e como fundamentos os valores vivenciais, criativos e atitudinais. A pesquisa foi realizada em um hospital público da cidade de Salvador, que atende a diversas especialidades e presta serviço, também, na área oncológica a nível ambulatorial e de internação. Os colaboradores da pesquisa foram 12 seres com câncer em tratamento ambulatorial e em unidades de internação do hospital. Eles aceitaram participar do estudo e assinaram o termo de consentimento livre e esclarecido. As entrevistas foram realizadas nos meses de setembro e outubro de 2009 com o uso do gravador no intuito de obter a fidedignidade das informações coletadas. Foram utilizadas duas questões, uma de aproximação: o(a) senhor(a) tem recebido cuidados de enfermagem desde que chegou aqui? E outra norteadora: Qual o significado do cuidado de enfermagem para o(a) senhor(a)? O processo de análise do discurso foi desenvolvido na perspectiva de Martins e Bicudo. Dos relatos dos seres emergiram três grandes categorias: Desvelando os valores que atribuem sentido às vivências de cuidado de enfermagem do ser com câncer, que teve como subcategorias: revelando os valores vivenciais na religiosidade do ser com câncer diante da finitude da vida, revelando os valores atitudinais no agir da equipe de enfermagem e revelando os valores criativos no agir da equipe de enfermagem; Desvelando as vivências do ser com câncer em busca de cuidados, que teve como subcategorias: criando vínculos nas relações de cuidados, comparando as vivências de cuidado e acesso ao tratamento, expressando sentimentos que atribuem sentido ao cuidado de enfermagem; Revelando as vivências do ser com câncer com os cuidados de enfermagem, e como subcategorias: expressando sentimentos que atribuem significado ao cuidado de enfermagem ao cuidado de enfermagem e qualificando o cuidado recebido pela equipe de enfermagem. Compreende-se que o desvelar do sentido do cuidado nas vivências do ser com câncer através da revelação do fenômeno possibilitou apreender os significados de busca pelo cuidado, do cuidado recebido, das vivências de estarem com câncer, de apreender o sentido do cuidado e os valores que atribuem significado, sem exaurir outras possibilidades.(AU)

Fibromyalgia Syndrome (FMS) Cases Responsive and Unresponsive to Balneo-Morita Therapy / 日本温泉気候物理医学会雑誌

Objective<br>Seventeen patients with FMS were treated with balneo-Morita therapy, which combines the balneotherapy with Morita therapy. After one year of treatment, patients with favorable outcome were compared with those with poor outcome.<br>Subjects and methods<br>The mean treatment period was 4.3 weeks. The outcome after one year of treatment was assessed. Patients who were able to return to work without a relapse of FMS were classified into the responsive group (13 cases, 74.6% in all), and those who showed a relapse or were not able to return to work were classified into the unresponsive group (4 cases, 23.5%). The cases of these two groups were compared in terms of biological (physical), psychological, social and existential status induvidually.<br>Results<br>There was no significant difference in sex or age distribution between the two groups. In terms of disease entity, FMS can be classified into psychosomatic type (hyperadaptation type) and neurotic type (possible presence of psychosocial-existential problems which are difficult to resolve such as great trauma, or the conditions ranging from neurosis to psychosis). Cases of neurotic type were prevailing in the unresponsive group. Patients were assessed to find out in which of the particular features of biological, psychological, social and existential aspects the notable problems proper to each patient lie.<br>The number of patients having psychological problems was higher in the unresponsive group, with a significant difference. In one case of the unresponsive group, the condition changed into ME/CFS (myalgic encephalopathy/chronic fatigue syndrome).<br>Discussion<br>In the treatment of these patients, the somatic approaches or physical therapy such as pharmacological therapy or simple balneotherapy, should be given more importance for cases of the psychosomatic type. However, psychological therapy should be added to this treatment for cases of neurotic type. The efficacy of the balneo-Morita therapy was compared between the groups as classified by the type of the disease. The therapy was effective in 91.6% of the cases of psychosomatic type, while the efficacy rate was 40.0% for cases of neurotic type. During the period of the balneo-Morita therapy, a tendency of dependency on therapists may appear in patients. Although involution may be allowed transiently for the purpose of introducing catharsis, autonomy should be enhanced eventually. <i>Yuatari</i> (balneo-phenomenon, or balneo-intoxication) is a phenomenon, that develops in psychosomatic confusion resulting from sudden release from tension after the start of balneotherapy. This phenomenon is regarded as catharsis, from which patients are encouraged to establish a new self. Through this therapeutic experience, the therapists lead the patients from involution to autonomy without being so instructed, finally to cause a change in the way of living. In cases of psychosomatic type, this conversion was relatively easily achieved, but in cases of neurotic type such conversion was difficult. It is considered that difficulty in such conversion is attributable to psychological factors of patients (strength of self, severity of trauma, presence or absence of meaning, autonomy).