Šiuo tyrimu siekta atsakyti į klausimą, ar priklausomų nuo narkotinių medžiagų asmenų autobiografiniai prisiminimai reabilitacijos metu skiriasi nuo nepriklausomų savo konkretumu, dominuojančiais kontekstais bei subjektyviu vertinimu. Tikslui pasiekti buvo atliekamas pusiau struktūruotas interviu individualiai su 16 Vilniaus priklausomybės ligų centro ilgalaikės reabilitacijos skyriuje esančių nuo priklausomybės narkotikais besigydančių asmenų bei 15 sveikų panašaus amžiaus vyrų. Priklausomų asmenų amžiaus vidurkis buvo 26,56 metai (SD=2,73), o kontrolinės grupės amžiaus vidurkis – 24,06 (SD=1,75). Iš viso buvo surinkti 186 prisiminimai, kurie kiekvienas buvo nepriklausomų vertintojų užkoduotas pagal parengtą kodavimo schemą. Kodavimo schema buvo sudaryta iš keturių kontekstų kategorijų, joje taip pat buvo prašoma įvertinti prisiminimų konkretumą/ neapibrėžtumą, taisyklių laikymąsi. Klinikinės ir kontrolinės grupės buvo lyginamos pagal polinkį atgaminti neapibrėžtus bei konkrečius prisiminimus, polinkį juos vertinti neigiamai arba teigiamai, dominuojančius kontekstus. Abiejų grupių papasakoti ankstyvieji prisiminimai buvo lyginami pagal jų subjektyvų vertinimą bei išsiskiriančius kontekstus. Neapibrėžtumo/ konkretumo savybė buvo lyginama tarp grupių pateiktų prisiminimų į emocinius raktinius žodžius. Iš šių prisiminimų taipogi buvo siekiama išskirti dominuojančius kontekstus, palyginti jų subjektyvų vertinimą bei patikrinti kitas jų ypatybes. Nustatyta, jog priklausomų asmenų... [toliau žr. visą tekstą] / This study was conducted to answer the question weather the specificity, dominating contexts or subjective valency of autobiographical memories of drug addicted men during rehabilitation process differ from the ones of non addicted individuals. For this purpose the half structured interview was made with 16 drug addicted patients in Vilnius Center for Addictive Disorders in long-term rehabilitation department and with 15 non addicted men of the same age. Averagely drug addicted men were 26.56 years old (SD=2.73). The mean age of control group was 24.06 (SD=1,75) years. 186 memories were collected. Independent experts coded these memories using the coding scheme. The coding scheme was made of 4 contexts groups, memories’ specificity/ over-generality assessment, assessment weather they are according to instructions or not. The clinical and the control groups were compared according to the tendencies to remember more specific memories; according to more positive or negative memory assessment tendencies and the tendencies to remember the particular things, themes. The early memories of both groups were compared according to subjective emotional assessment and the contexts dominating. Also the specificity/ over-generality feature of the memories recalled to the key words was compared between the two groups. Also it was important to distinguish dominant contexts, compared to their subjective assessment, and verify the other of their characteristics. It was found that drug addicted... [to full text]

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

Thesis (Ed.D.)--Duquesne University, 2007. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 96-107).

Thesis (Ph. D.)--University of Toronto, 2007. / Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: 2670. Includes bibliographical references (leaves 166-206).

Thesis(M.S.)--Auburn University, 2005. / Abstract. Vita. Includes bibliographic references (p.95-102).

Thesis (Ph. D.)--State University of New York at Binghamton, Philosophy, Interpretation and Culture Graduate Program, 2008. / Includes bibliographical references.

Thesis (Ph.D.)--University of Melbourne, Howard Florey Institute & Centre for Neuroscience, 2009. / Typescript. Includes bibliographical references (leaves [1]-[10])

La présente recherche se propose d’examiner les multiples intérêts de faire intégrer l’approche psychanalytique dans un cadre spécifique de prise en charge pour des sujets toxicomanes : la communauté thérapeutique (CT). A partir de mon expérience clinique au Liban avec des sujets addictés, rencontrés dans une CT, j’expose les écueils de cette modalité de soin basée uniquement sur l’approche comportementale. Je décris aussi la clinique de la toxicomanie comme “clinique du semblable”. Cette clinique repose sur des processus identificatoires qui prennent appui sur un trépied : le regard social vis-à-vis du phénomène toxicomaniaque, un certain discours scientifique concernant les addictions, mais surtout sur le fonctionnement psychique propre aux sujets toxicomanes. Le point nodal de ma réflexion se trouve dans le fait qu’à la rencontre d’un soignant qui n’a pas nécessairement été usager de drogue lui-même, la plupart des patients addictés arguent qu’il n’est pas semblable à eux, donc il ne comprendrait jamais leur souffrance. Cette situation peut être considérée comme une forme de résistance, mais elle me permet de concevoir la fonction de la drogue sous l’angle de la problématique identificatoire. Je me propose donc, en me basant sur la psychanalyse, à déconstruire un pseudo-savoir constitué autour d’un phénomène complexe, savoir qui tend à figer les toxicomanes dans des notions qui mènent à des pratiques controversées (notamment en CT). J’essaye ainsi de recentrer la question de l’usage de drogue sur le patient addicté lui-même, avec ses failles et ses fantasmes identificatoires qui l’incitent à s’agréger aux communautés de personnes ayant des comportements bien codifiés. / This research intend to examine the multiple interests to integrate the psychoanalytic approach in a specific context of care for drug addicts : the therapeutic community (TC). Based on my clinical experience in Lebanon with drug abusers that I have met in CT, I expose the pitfalls of this form of care founded exclusively on the behavioral approach. I also describe the drug addiction as “clinic of the similar”. This clinic is based on identification processes that rely upon a tripod : the social opinions regarding the drug dependency phenomenon, some scientific discourse about addiction, but especially on the dependent subjects own psychological functioning. The central hub of my proposition is located in the fact that when they meet a caregiver who has not necessarily been drug user himself, most addicted patients argue that he is not similar to them, so he would never understand their pain. This situation can be considered as a form of resistance, but it allows me to conceive the function of the drug in terms of identificatory issues. I use psychoanalytic theory to deconstruct a pseudo-knowledge built around the complex phenomenon of drug addiction. This knowledge tends to freeze addicts in concepts that lead to controversial practices (including CT). I try to refocus the question of the substance abuse on the addicted patient himself, with his identification problems and fantasies that incite him to join a community of people having behaviors well codified.

O abuso de álcool e outras drogas por adolescentes é considerado, atualmente, um grave problema de saúde pública. Devido à complexidade que envolve essa questão, considera-se que a mesma extrapola o campo da saúde pública, exigindo um olhar interdisciplinar, tanto na investigação de suas condições de surgimento, quanto na produção de respostas de enfrentamento. Para lidar com essa problemática, faz-se necessário compreender a adolescência de hoje como uma operação de passagem (Rassial,1997) e uma “crise psíquica” (Melman, 1995), na qual a busca por referências ocupa um lugar fundamental. Atualmente, esse processo se desenvolve em um contexto social no qual os valores vigentes se colam a padrões de consumo marcados pelo individualismo e pela instantaneidade, confundindo as novas gerações pela falta de referências (Bauman, 1998, 2001; Milnitsky-Sapiro, 2005). Nesse contexto de hedonismo, consumismo e referenciais voláteis, o abuso de drogas pode surgir como um caminho para o alívio das tensões inerentes ao processo adolescente e como uma fuga da invisibilidade pela via do consumo, realizando simbolicamente o ideal de nossa sociedade (Conte, 1998). O presente trabalho tomou serviços de tratamento a adolescentes usuários de drogas como objeto de pesquisa, refletindo sobre as concepções que norteiam suas práticas e a forma pela qual as políticas públicas que prescrevem o campo se apresentam, ou não, em seus programas. O contexto destas instituições, suas práticas e referenciais são problematizados, juntamente com trechos de entrevistas nas quais se buscou “dar voz” aos adolescentes em tratamento nesses locais, visando saber o que pensam e como avaliam o tratamento recebido. Também foram entrevistados profissionais que trabalham nesses serviços. Como método de pesquisa utilizou-se a Descrição Etnográfica da instituição, diálogos informais, observações e consultas documentais (Milnitsky-Sapiro, 2001). Para análise dos dados procedeu-se à Análise de Conteúdo (Bardin, 1977; Milnitsky-Sapiro, 2001) do material consultado e das narrativas dos entrevistados. Os resultados desse estudo indicam uma defasagem entre o que é preconizado pelas políticas públicas e as práticas dos serviços de tratamento. Dos três serviços pesquisados, apenas um se adequava às orientações das principais políticas que regulam o setor, apesar de possuir limitações principalmente relacionadas à escassez de recursos para qualificar e ampliar o alcance de sua atuação. Como conclusão, aponta-se o fato de que as diretrizes do Estatuto da Criança e do Adolescente e do Sistema Único de Saúde, entre outras, continuarão na instância teórica enquanto não houver propostas de adequação dos serviços e de capacitação dos profissionais que trabalham com esse público, visando qualificá-los a atender as especificidades do processo adolescente no contexto atual. / Presently, drugs abuse by adolescents is considered a serious problem of Public Health.Due to the complexity involving this question, it´s been considered it overflows the public health field. It demands an interdisciplinar view as to investigate its origins as to produce answers to face it. In order to deal with this problem, we need to comprehend adolescence as a stage between childhood and adulthood (Rassial, 1997) and a psychic crisis (Melman, 1995) in which people search for references. Nowadays, this process develops in a social context in which ordinary values are attached to comsumption patterns identified with individualism and instantaneously. It confuses new generations by the lack of references (Bauman, 1998, 2001; Milnitsky-Sapiro, 2005). In this hedonism, consumism and weak references context, drugs abuse can emerge as a way to throw tensions away, as a way adolescents generally use in their process, and as a scape from invisibility by consumption, achieving simbolically our society ideal (Conte, 1998). The present work took three public institutions that accept adolescents for treatment of drug abuse as research object, thinking about the conceptions that they use in their work and the way in which public politics that surround this field are presented or not in their programs. These institutions context, their practices and the theories they use are inquired, with interviews sections in which it was wanted to “give voice” to adolescents that were being treated in this places. It was wanted to know what they think about and how they evaluate the treatment they receive. Professionals that work in these services were also interviwed. As research method, it was used Etnographic Description of the institution, informal dialogues, observations and document consulting (Milnitsky-Sapiro, 2001). In order to analyse the data it was used Subject Analysis (Bardin, 1977; Milnitsky-Sapiro, 2001) of consulted material and interviewed people narratives. Our results indicate a gap betwen what is actually assumed by the public policies and the reality of the services. From the three services researched, only one was adequate to the orientations of the main public politics that regulate this sector, in spite of having limitations related to few resources to qualificate and extend its action. As a conclusion, it is mentioned that main proposals of ECA and SUS will continue in the theoric field while they don´t have adecquation proposals for the services and qualification for professionals that work with this people to deal with specific issues of adolescents process in nowadays context.

The thesis deals with the role of a tutor in the Therapeutic community Karlov within a group of drug addicted mothers and their children. The thesis introduces the drug issue, including the general specification of a therapeutic community. The status of the non-profit organization SANANIM in the Czech Republic is described herein, as well as detailed characterization of its Therapeutic community Karlov which focuses on treating drug-addicted mothers along with their children. Another part of this thesis concentrates on the treatment of drug-addicted mothers along with their children and highlights the role of the tutor in the whole process. The last part of this work is dedicated to a qualitative research conducted within a group of abstaining mothers that received a treatment in this Therapeutic community. Over the course of this research a hypothesis that a tutor has positive influence on the relation of mother and her child/children during the treatment phase was confirmed.