Esta dissertação tem como objetivo investigar como a raça e o racismo afetam a prática dos psicólogos. A partir de uma leitura histórica da construção do que é ser negro no Brasil, discute-se as formas como a Psicologia pode contribuir para o enfrentamento do sofrimento causado pelo racismo. Adota-se a compreensão da raça enquanto uma construção social que reverbera em diversas faces do racismo, entre elas o racismo institucional, que pode refletir e determinar a forma como os negros acessam seus direitos. Apoiada na psicanálise vincular e no conceito de alianças inconscientes de Kaës, averigua-se se e como profissionais do campo da clínica psicológica identificam problemas relacionados ao racismo, analisando como eles atuam diante dessa problemática. As entrevistas abertas tiveram como base os pressupostos de Bleger e realizadas com três profissionais que atuam em dispositivos clínicos em serviços públicos e privados na região metropolitana de São Paulo. Em seguida, identificou-se de que modo as questões raciais são expressas no campo da clínica nesses dispositivos. Foram encontrados aspectos comuns entre as narrativas estudadas com relação ao racismo operar como uma transmissão psíquica entre as gerações e observou-se que há ambiguidade na diferenciação do racismo a outros tipos de preconceitos. Reconheceu-se a contradição entre desejo e a culpa entre as vítimas do racismo nos relatos dos entrevistados. Evidenciou-se a problemática do lugar do negro nos espaços sociais e a relevância dos territórios onde eles podem ou não ocupar. Na clínica psicológica, admitiu-se a existência de estruturantes psíquicos, responsáveis pelo delineamento do sofrimento de ser negro, e que, nessa dimensão, há um espaço para elaboração desse problema. Percebeu-se a importância de respeitar o sujeito enquanto si mesmo antes de fazer os recortes sociais necessários. Além disso, foi descoberta a necessidade de se realizar parcerias para o enfrentamento do racismo, destacando-se ainda o valor da apropriação histórica para que os fenômenos raciais possam ser compreendidos e superados. Este estudo conclui que a atuação da Psicologia se faz necessária política e socialmente / This dissertation aims to investigate how race and racism have affected the practice of psychologists. From a historical reading of what it means to be black in Brazil, we discuss the ways in which Psychology can contribute to confronting the suffering caused by racism. The understanding of race is adopted as a social construction that reverberates on several branches of racism, including institutional racism, which can reflect and determine how blacks access their rights. Based on Linkage Psychoanalysis and on the concept of Unconscious Alliances by Kaës, we investigate whether and how professionals in the field of Psychology Clinic identify problems related to racism, analyzing how they act in face of this issue. Open interviews were conducted based on the assumptions of Bleger and carried out with three professionals who work in clinical settings in public and private services in the metropolitan region of São Paulo. Then, it was identified how racial issues are expressed in the clinical field. Common aspects were found among the narratives studied regarding racism operating as a psychic transmission between generations. Moreover, it was observed ambiguity in the differentiation of racism from other types of prejudices. The contradiction between desire and guilt among the victims of racism in the interviewees\' accounts was acknowledged. The problematic of the place of the black in social spaces and the relevance of the territories where they can or cannot access were evidenced. In the psychological clinic, the existence of psychic structurants was admitted as responsible for the delineation of the suffering of being black, and in this sense, there is room for further elaboration. The importance of respecting the individual before making necessary social evaluations was recognized. In addition, we discovered the need to realize partnerships to combat racism, highlighting the importance of historical appropriation so that the racial phenomena can be understood and overcome. This study concludes that the performance of Psychology becomes politically and socially necessary

Made available in DSpace on 2016-04-28T20:38:37Z (GMT). No. of bitstreams: 1 Vitor Faustino Sampaio.pdf: 1096064 bytes, checksum: d96d880b48ba1326c5e27b161c2962a3 (MD5) Previous issue date: 2013-01-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The research objective was to understand the meaning of self knowledgement in a existential phenomenological perspective as from an experience where the opening to self knowledge is found. We´ve chosen as an experience the practice of Aikido and the authorial reflections about it. The use of personal narrative, making the research building, became the own experience witnessing and investigation method, founded on Martin Heidegger´s hermeneutics. Questions about the self knowledgement emerged from the personal report about the author experience from he´s Aikido´s practice. We explained those questions as self caring disposal, and submitted it to a phenomenological analysis, done in three essays: The comprehension of its self as access to the way , where we explore the meaning and explain the knowledge of its self as a walking through the existence on its execution; The self knowledge and being-with , as from reflections about the others, we learn them as inseparable part of knowing its self, and we also reflect about the dwelling in the human ethos; The self knowledge and bodyhood , on this essay we discern the conception of body on the philosophical history from the conception of bodyhood for Heidegger´s Ontology. By doing so, we could think about the body (bodyhood) as fundamental for understanding the human existence. The conceptual probation we realize on these essays, allows us to understand those were the possible aspects to be accessed from the initial narrative. Such aspects we analyzed opened the reflection about the self knowledge´s theme that permeates the human existence on its everydayness, and its implications when thinking the Existential Phenomenological Clinics practices / O objetivo da pesquisa era compreender o que significa conhecer si mesmo em uma perspectiva fenomenológico existencial a partir de uma experiência em que há abertura para este conhecer-se. Escolhemos como experiência a prática do Aikido e as reflexões autorais oriundas desta prática. O uso da narrativa pessoal, perfazendo a construção da pesquisa, tornou-se testemunho da própria experiência e método de investigação da pesquisa, fundamentada na hermenêutica da facticidade de Martin Heidegger. A partir do relato pessoal do autor sobre sua experiência e compreensão na prática do Aikido, surgiram questionamentos sobre o conhecer si mesmo, que explicitamos como disposição do cuidar de si. Submetemos tais questionamentos a uma análise fenomenológica realizada em três ensaios distintos: O entendimento de si mesmo como acesso ao sentido , em que exploramos o que significa si mesmo e esclarecemos o conhecimento de si como um caminhar pela própria existência em sua realização fática; Conhecer si mesmo e ser-com , a partir das reflexões sobre os co-existentes, apreendemos os outros como parte indissociável do conhecer si mesmo, e refletimos sobre o habitar no ethos dos homens; Conhecer si mesmo e corporeidade , neste ensaio, ao diferenciarmos a concepção de corpo na historia da filosofia da concepção de corporeidade na Ontologia Fundamental, pudemos pensar sobre o tema do corpo (corporeidade) como fundamental na compreensão do existir humano. O aprofundamento conceitual realizado nestes ensaios nos permitiu compreender que estes foram os aspectos possíveis de serem acessados via a narrativa inicial. Estes aspectos analisados nos abriram para a reflexão sobre tema do conhecer si mesmo que permeia o existir humano em sua cotidianidade e suas implicações no pensar a clínica fenomenológico existencial

Made available in DSpace on 2016-04-28T20:38:41Z (GMT). No. of bitstreams: 1 Maria Helena Carvalho de Oliveira.pdf: 7402478 bytes, checksum: 6416a0d4f012af98bef0be176cc30585 (MD5) Previous issue date: 2013-05-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research intends to understand how art contributes to a widening of the field of affects which interfere with clinical activity in Psychology. In analysis, through the follow-up of processes, including those belonging to the author with her own affects, experiences and encounters, trigger situations which discuss the state of the art; the work of Frida Kahlo as a passage way in the relationship life-art, and some scenes, fragments and syntheses, which articulate themselves in the central question of the research: life, art, affects and clinical activity, organized with the fundamental support of the philosophy of Deleuze, which helped me thinking more strongly about an open therapeutic space, in some deviant way which overflows the consulting room and the classroom. In my daily practice of the art-informed making of psychology, I understand life as an intensive map composed by passages, possibilities and landscapes where, with the strength of sensitivity, each person produces their own artwork, which is not necessarily an object, but instead their own lives, a transitional space towards some kind of emancipatory transformation, autonomous, critical and creative / Esta pesquisa busca compreender como a arte contribui para o alargamento do campo dos afetos que atravessam a relação do fazer clínico na psicologia. Em análise, por meio do acompanhamento de processos, inclusive os da própria autora com os seus afetos, experiências e encontros, situações disparadoras que discutem o estado de arte; a obra de Frida Kahlo como via de passagem na relação vida-arte, e algumas cenas, fragmentos e sínteses, que se articulam na questão central da pesquisa: vida, arte, afetos e clínica, organizada com o auxílio principal da filosofia de Deleuze, que me ajudou a pensar mais fortemente num espaço terapêutico aberto, num caminho de desvio que transborda o consultório e a sala de aula. Na minha prática cotidiana dos fazeres da psicologia atravessados pela arte, entendo a vida como um mapa intensivo composto por passagens, possibilidades e paisagens onde, com a força da sensibilidade, cada um produz a sua própria obra de arte, que não é necessariamente um objeto, mas sim a própria vida, um espaço de trânsito rumo a algum tipo de transformação emancipatória, autônoma, crítica e criativa

Cette thèse part de la proposition d\'une rencontre possible entre psychanalyse et génétique médicale par le biais des soins offerts aux enfants porteurs de syndromes génétiques, notamment le syndrome de l\'X fragile. Nous avons trouvé dans les recherches en épigénétique une voie de rapprochement de ces différents champs du savoir. L\'idée selon laquelle l\'environnement est capable de modifier l\'expression des gènes représente la rupture d\'un certain déterminisme génétique autrefois accepté, et ouvre un espace où penser la singularité. Notre travail propose d\'élargir le concept d\'environnement, en y considérant la relation de l\'enfant avec l\'Autre, lieu du langage, comme opérateur de marques sur son corps : marques symboliques, constituées dès le tout début de la rencontre de l\'infans et de ceux qui s\'occupent de lui. C\'est justement dans cet espace d\'échange avec l\'Autre qu\'a lieu l\'émergence d\'un sujet. Nous avons opté pour les concepts de sujet et de transfert pour soutenir l\'articulation de la clinique psychanalytique et de la génétique médicale en ce qui concerne le traitement. Nous avons donc exposé trois cas cliniques issus de notre pratique, d\'enfants traversés par le diagnostic de l\'X fragile afin d\'illustrer de quelle manière les conceptions de sujet et de transfert se reflètent dans la clinique. Tenant compte que la psychothérapie est également prise comme objet d\'étude de l\'épigénétique, et qu\'elle est donc considérée comme un environnement capable de provoquer, voire de renverser des marques épigénétiques, l\'enjeu de notre travail repose sur la proposition suivante : et pourquoi pas la psychanalyse également ? La psychothérapie psychanalytique, ancrée sur le transfert, ne peut-elle pas, elle aussi, laisser des marques sur le petit patient / The current thesis assumes a possible encounter between psychoanalysis and medical genetics based on the treatment applied to children carrying genetic syndromes such as the Fragile X Syndrome. Epigenetic studies are a way to approximate different knowledge fields. The assumption that the environment is able to change gene expression strays from the genetic determinism we once believed and opens the way for us to reason about singularity. The proposition in the present study lies on expanding the concept of environment, by taking into consideration the relation between the child and the Other in the environment in question, as well as the place of language as the operator marking the childs body. These symbolic marks start emerging in the first encounter between the infans and caregivers. The subject emerges precisely 3 within an environment of exchanges that is set with the Other. The concepts of subject and transference were chosen to support the treatment articulation between psychoanalytic clinic and medical genetics. Thus, the present study reports three clinical cases followed by the authors, which involved children diagnosed with fragile X syndrome. These cases illustrate how the aforementioned concepts affect the clinical practice. Since psychotherapy has also been taken as the object of epigenetic studies, and as it is considered an environment able to cause, and even reverse, epigenetic marks, the current study relies on the following proposition: why not psychoanalysis as well? Can the psychoanalytic psychotherapy, anchored in the concept of transference, leave marks on the little patient too?

A partir da Reforma Psiquiátrica, observamos uma valorização da participação da família no tratamento, buscando por alternativas de atenção a esses familiares nos serviços. Acrescentando ao debate os desafios da aproximação da clínica ao Sistema Único de Saúde, o conceito de clínica ampliada surge, associando a noção de subjetividade à de cidadania e enfatizando a importância de lidar com a singularidade de cada situação concreta como parte de contextos e relações sociais. Em consonância com essas preocupações, existe, em um Hospital-Dia de Psiquiatria, um Programa de Assistência Familiar. Dentre diversas atividades oferecidas nesse programa, as Reuniões Familiares são o contexto específico de estudo desta pesquisa. Essas reuniões são conduzidas a partir de contribuições da terapia familiar de uma orientação construcionista social, que tem como foco os processos de construção e transformação de sentido. A presente pesquisa teve como objetivo analisar a aproximação de uma prática com famílias (as reuniões familiares) à noção de clínica ampliada no cuidado em saúde mental. Especificamente, visou: a) compreender o processo de produção de sentidos nessa prática, analisando a construção de recursos conversacionais na interação, bem como seus efeitos para as transformações de sentidos de problema e de si ao longo do processo; e b) descrever como esses recursos contribuem para a ampliação da prática clínica com famílias. Para isso, 33 reuniões familiares (os atendimentos de três famílias) foram acompanhadas na instituição. Essas sessões foram gravadas em áudio e transcritas integralmente, constituindo-se, assim, o corpus de pesquisa. Uma compreensão construcionista social sobre a prática de pesquisa orienta metodologicamente este trabalho. Todas as sessões foram submetidas a uma análise temático-sequencial do processo de produção de sentidos. A partir disso, descrevemos a negociação e transformação de sentidos em torno de um problema considerado, pelo paciente e pela família, como central em suas vidas. Para cada caso, o principal recurso conversacional construído no processo terapêutico foi analisado e descrito. São eles: a) convidar o social para dentro do individual; b) tecer o diálogo familiar; e c) conhecer a si em outras vozes. A análise de cada caso considerou: como algo foi construído como um problema a ser trabalhado; como o uso do recurso se deu; e que efeitos esse uso produziu no decorrer do caso. Oferecemos como tese uma leitura construcionista social para a clínica ampliada, chamando atenção para como a ampliação da clínica se produz a partir dos efeitos de determinados modos de se relacionar no contexto das práticas. É no momento interativo que profissionais e pacientes, ao conversarem sobre suas questões de saúde, conjuntamente criam entendimentos sobre quem são, o quê são seus problemas e o que podem fazer com relação a eles. Discutimos como o uso dos recursos se constrói nas interações e contribui para a prática da clínica ampliada. Descrevemos essas práticas como politicamente implicadas. Em última instância, a pesquisa descreve recursos práticos para profissionais interessados em trabalhar em um enquadre crítico e transformador no cuidado em saúde mental / Since the Brazilian Psychiatric Reform, we have witnessed an increased value of family participation in treatment. Alternatives of attention to family members in the context of services have been sought. When the challenges of bringing clinical practices into the Unified Health System are added to the debate, the concept of the expanded clinic arises, and this concept associates the notions of subjectivity and citizenship. Emphasis is placed on the importance of dealing with each concrete situation as part of contexts and social relations. A Program of Family Care in a Psychiatric Day Hospital exists in line with these concerns. This program offers several activities for families. Family Reunions are amongst these activities, and they are the specific context of this research. The contributions of a social constructionist orientation for family therapy guide family reunions with a focus on processes of meaning making. This research aimed to analyze the approximation of a practice with families (family reunions) to the notion of the expanded clinic in mental health care. The research specifically aims to: a) understand the process of meaning making in this practice, while analyzing the construction of conversational resources in the interaction, as well as their effects to the transformations of the meanings of problem and self throughout the process; and b) describe how these resources contribute to the expansion of clinical practices with families. Thirty-three family reunions (three family cases) were followed in the institution. These sessions were audio recorded, and fully transcribed, in order to constitute the research corpus. A social constructionist understanding about research practices is the methodological guide for this investigation. All sessions were submitted to a thematic-sequential analysis of the process of meaning making. We have described the negotiation and transformation of meanings about a problem that was considered, by the patient and by their family, as central to their lives. For each case, the main conversational resource constructed during the process was analyzed and described. These conversational resources are: a) inviting the social into the individual; b) weaving family dialogue; and c) knowing yourself in other voices. The analysis of each case considered: how something was constructed as a problem to be worked out; how the use of the resources was carried through; and the effects the use of this resource created throughout the case. We offer, as our thesis, a social constructionist reading of the expanded clinic, where we call attention to how the expansion of clinical practice is crafted from the effects that particular ways of interacting create in the context of practices. It is in the interactive moment that professionals and patients jointly generate understandings about who they are, what their problems are, and what they can do in relation to them, while they talk about their health issues. We discuss how the use of these resources is constructed in interactions, and how this use can contribute to the practice of the expanded clinic. We also describe clinical practices as politically committed. The research ultimately describes practical resources for those professionals interested in working within a critical and transformative frame in mental health care

A presente pesquisa procurou estudar o sintoma psicomotor na infância, este abrange distúrbios como dislexias, disortografias, problemas de coordenação e equilíbrio e alguns diagnósticos de Transtorno de Deficit de Atenção e Hiperatividade cujos casos vem aumentando exponencialmente na atualidade. A etiologia do sintoma psicomotor por muito tempo permaneceu obscura e relacionada exclusivamente a lesões e distúrbios neuronais, os quais deixavam como únicas alternativas tratamentos medicamentosos e reeducativos. Com os estudos psicanalíticos iniciados por J. Lacan e M. Mannoni acerca desses sintomas, a etiologia se tornou gradativamente mais clara, e os relacionou a fantasia familiar em que a criança é imersa como objeto de satisfação. Dessa forma, este trabalho visou pesquisar a formação deste tipo de sintoma, o gozo e fantasia da criança e cuidadores envolvidos nessa relação. Para tanto foi realizada uma pesquisa bibliográfica sobre os conceitos psicanalíticos e atendimentos clínicos a crianças com sintomas psicomotores através do Laboratório Sujeito e Corpo da Universidade de São Paulo. Os resultados indicam que o gozo no sintoma psicomotor envolve duas pessoas, mais frequêntemente mãe ou pessoa na função materna e o filho, os quais se colocam em uma relação de interdependência, a ponto de não haver espaço para uma autonomia e independência necessárias ao desenvolvimento da criança. Os sintomas psicomotores são resultado de uma satisfação fantasística que envolve o corpo da criança nessa relação / This research sought to study the psychomotor symptoms in childhood, it includes disturbances such as dyslexia, dysorthographies, problems with coordination and balance and some diagnoses of Hyperactivity and Attention Deficit Disorder which cases have been exponentially increased at the present. The etiology of the psychomotor symptoms for a long time remained obscure and exclusively related to injury and neuronal disorders, which has left as the only alternatives medical and reeducational treatments. With the psychoanalytic studies started by J. Lacan and M. Mannoni about these symptoms, the etiology became gradually clearer, and it was related to the family fantasy in which the child is immersed as objects of satisfaction. Thus, this study aimed to investigate the constitution of this symptom, the enjoyment and fantasy of children and caregivers involved in this relationship. To achieve these goals, it was made a bibliographical research on psychoanalytic concepts and clinical attendances for children with psychomotor symptoms through the Sujeito e Corpo Lab, at the University of São Paulo. The results indicate that the joy in psychomotor symptom involves two people, more often the mother-child, which arise in a relationship of interdependence and leave no space for autonomy and independence necessary for the child development. The psychomotor symptoms are the result of a fantasmatic satisfaction which envolves the children body in this relationship

Self-assessment forms and diagnostic tests were used to assess benefits of a treatment program that addressed tinnitus and hyperacusis severity in a population of 30 veterans (29 males, 1female) between the ages of 43 and 79. Patients were enrolled in the treatment program for an average of 20.8 months (range=12-31 months). For the purposes of this study, tinnitus was defined as the subjective perception of a sound lacking an environmental correlate. Hyperacusis was defined as the over-sensitivity to an environmental sound present at a level that would not produce excessive loudness for individuals with normal hearing sensitivity. Treatment strategies included guided counseling regarding auditory and neurological mechanisms of tinnitus coupled with sound therapy designed to reduce the tinnitus disruption. Sound therapy instruments utilized by the subjects included hearing aids, cochlear implants, bedside noise generators, and near-level tinnitus maskers. The tinnitus handicap inventory (THI), self-assessment forms, and loudness discomfort level (LDL) testing were administered to assess benefit of the treatment program. Subjects were first interviewed using an interview form adapted from Jastreboff and Jastreboff, 1999. The THI was then administered in interview format to all patients. Initial sessions were approximately two hours in length. Follow-up sessions lasted approximately one hour. Most patients returned for at least three follow-up visits over the course of their treatment. The correlation between the patients hearing thresholds and the tinnitus handicap inventory (THI) score were poor, consistent with previous reports. Pre and post-testing with the THI indicated that 36.7% of the test subjects experienced significant improvement in tinnitus handicap. The total scores and all sub-scale scores on the THI showed statistically significant improvements. An analysis of the self-assessment forms revealed that 27% of the subjects experienced improvement with concentration, 27% experienced improvement with sleep, 36.7% experienced improvement with quiet recreational activities, and 23.3% experienced improvement with social activities. LDL testing was administered at the initial and post treatment sessions with twenty-two of the thirty subjects. LDL testing indicated that hyperacusis severity was reduced by 13.6% in the right ear and 4.6% in the left ear from the initial evaluation to the post treatment evaluation. Regarding test subject satisfaction with the treatment program, 93.3% expressed satisfaction, and 90% indicated they would be unhappy if asked to return their sound generating devices. Test subjects appeared to be satisfied with their overall experiences with the tinnitus treatment program. The clinical implications of these findings will be discussed.

This presentation will discuss the challenges that clinical supervisors face when trying to balance efficient graduate student training and patient welfare in university voice clinics. We will propose a model in which we seek to balance the needs of the patient, student clinician, and clinical instructor.

Now more than ever, speech clinicians are being required to justify the effectiveness of their work by showing results. There are different ways to measure outcomes. For example, outcomes may be measured by testing to determine if change has occurred regarding clinical goals, or by comparing the cost of the treatment to the benefit of the treatment to determine if the treatment was economically sound. Another type of measure is subjective outcomes, such as client satisfaction. Subjective outcomes are difficult to define and measure and few studies of this type have been reported in the literature. Because clinical outcome is dependent, at least to some extent, on client satisfaction (Williams, 1994), and because few studies have been reported in the literature regarding client satisfaction with speech and language services, this area became the focus of the current study. This study sought to answer the following questions: (a) Did the parents think their child benefrtted from the articulation intervention services received at the clinic? and (b) What were parents' attitudes regarding the clinical atmosphere and staff? The Consumer Satisfaction Measure of the American SpeechLanguage- Hearing Association (ASHA) was used in this study because it is broad in scope and contains statements relating to the research questions of the current study. Answers to the research questions were derived from the responses to the survey that was mailed to the parents of 86 children who had received articulation services from the PSU Speech and Hearing Clinic. Ninety-five percent of the parental responses regarding whether parents felt that their children benefited from services obtained at the PSU Speech and Hearing Clinic were positive, indicating that parents were satisfied with the services received. Ninety-one percent of the parental responses regarding parent's attitudes toward the clinical atmosphere and staff were positive. It appears that parents hold favorable views regarding the clinical atmosphere and staff and that they were satisfied with the services their children received at the PSU Speech and Hearing Clinic.

The purpose of this study was to investigate the survey as a method of assessing client satisfaction with clinical services and to then assess parental satisfaction of clinical services at Portland State University's language clinic using the survey method. The survey asked questions regarding the parents' perceived benefits from the clinic, their perception of the skills of the clinicians who served their children, and the parents' perception of the clinical atmosphere. Eighty-five Consumer Satisfaction Surveys were mailed to 81 parents of children receiving services at Portland State University Speech-Language Clinic between the years 1987 and 1994. Eleven surveys were returned, all containing a signed consent letter, representing a 13% rate. Determining the cause behind the poor response rate for this particular survey was not difficult. No surveys were returned from the years 1987 through 1989. The highest percentage of return was from the year 1994 (38% ), indicating that higher response rates were achieved if the client was polled within 1 year of using clinical services. To further substantiate this conclusion, two of the parents contacted by telephone refused to participate in the survey, and gave length of time as the reason behind their refusal. The overall response to the survey was positive, indicating a high rate of satisfaction among the survey respondents with the services provided at the Portland State University Speech-Language clinic.