Nouvelles normalités Nouvelles pathologies Nouvelles ... - Psynem

6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza
de l’Adolescence
Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques
FRIDAY, May 6
Workshop 15 Perinatal intervention
INTERVENCIONES PSICOLÓGICAS EN DUELO Y ENFERMEDAD ORGÁNICA
Mónica Carugatti Hospital Privado de Buenos Aires (Buenos Aires - AR)
absent. It was the father’s therapist to immediately
refer the patient for medical evaluation.
Once admitted to a medical clinic, she was
overseen by a psychiatric - an APA candidate
who was supervised by a specialist in eating disorders-
who decided that the patient should be
“hystericed” because of her “ fantasmatic blank”,
introducing for the first three months a framework
that is better not to describe fully but that obviously
did not produce any change. After the 3
month period, the treatment showed to be very
expensive, so the head of the psychiatric department
decided to send her (with 28 kilos of weight)
to a psychiatric clinic. The parent refused and a
new approach was adopted.
In this case an interdisciplinary team took
charge. It included a physician who was a specialist
in eating disorders, a nutritionist, therapeutic
assistants, a psychologist for the patient
and psychologists for the parents who followed
therapies based on common sense and various
psychoanalytical theories. The result was that the
patient was discharged from the clinic after 20
days weighing 40 kilos.
Theories are neither religious dogmas nor
a question of faith. They are ways in which we
can explain observable phenomena, they are as
keyholes for us to see and interpret reality. They
are not “things in themselves”, immanent, eternal,
absolutely generalizable.
Dr. Sami Ali tells us about “ a positive correlation
between projection and somatization that
opens a space for a hysterical conversion to a
psychopathology by excess of the imaginative
and a negative correlation between projection and
somatization that finishes in a non conventional
somatic pathology for lack of the imaginative”. The
concepts “essential repression”, “somatization as
regression” and “impasse situation” characterized
by a “conflict without exit” is where a conflict
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reveals itself as insoluble because unthinkable (a
= no a).
These theoretical concepts, together with the
relation between movement and aggressiveness
and the theory of game that we find in Freud,
allowed me to intervene psychologically with
hospitalized children. On one side, I worked on
the elaboration of the current traumatic situation
through games and on the other side, I listened
the insoluble conflicts and looked for ways to
resolve them in particular for depressed children
having previous unprocessed bereavements.
This is the case of three male teenagers of 10,
13 and 16 years of age, who had been operated
of appendicitis. All three cases were characterized
by the lack of temperature (which disoriented
surgeons), after-surgery complications, the long
stay in hospital and the fact the children were in
a period of depression due to unprocessed bereavements
(in all three cases the grandfather had
passed away or was seriously ill and the parents
were not able to give containment and comfort
because they were very depress themselves): essential
depression, impasse, somatic regression.
Children’s Abuse
Before finishing my presentation I must refer to
a very painful issue that regards everybody who
works in a hospital or school, which is child abuse;
this phenomenon does not make any distinction
of social class or cultural level. At Buenos Aires,
judges work together with mental health team
when dealing with child abuse. Police report must
be done in all cases. My team had the mobile
number of the prosecutor’s office so we could
report any case of children at risk or abused at
any time. In the case of Munchhaussen syndrome
we treated with hospitalization and “report under
suspect”.
An experienced mental health professional can