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O que passou, passou? Um estudo psicanalítico acerca das vicissitudes da experiência de adoecimento, tratamentos e remissão da doença em pacientes de um serviço de onco-hematologia / What has passed, is it past? A psychoanalytical study about the sickness experiences fates, treatment and remission of the disease within patients of an oncology hematology serviceCristiana Rodrigues Rua 15 August 2014 (has links)
O presente trabalho se propõe a apresentar uma sistematização teórica de minha experiência clínica enquanto psicanalista, no atendimento com pacientes que, após a remissão de doenças graves tais como diversos tipos de câncer que podem afetar a medula óssea (leucemias e linfomas), apresentavam-se como se ainda estivessem doentes, remetendo-se à doença como se esta fosse um acontecimento atual, identificando-se, em seu discurso, como doentes. Apresentamos dois casos clínicos que estavam com a doença em remissão há mais de dois anos e que foram atendidos em uma instituição hospitalar. O nosso objetivo é possibilitar a compreensão dos processos psíquicos envolvidos nos referidos casos clínicos. Estes atendimentos nortearam a formulação de uma hipótese clinico-teórica. Esta hipótese refere-se à possibilidade de estudar o problema clínico a partir do paradigma conceitual do trauma em Psicanálise, especialmente na acepção desenvolvida por Freud após 1920, com a formulação do segundo dualismo pulsional. Paralelamente, é realizado o percurso teórico que visa discutir a permanência dos pacientes atendidos no lugar de doentes, o que nos conduz à apresentação de um capítulo referente aos paradoxos envolvidos na remissão de uma doença orgânica. A articulação teórico-clínica é baseada em textos de Freud e Ferenczi, além de psicanalistas contemporâneos que têm estes autores como referência. Nesta articulação percorremos os seguintes pontos conceituais: a) a experiência do adoecimento; b) o conceito de trauma e efeito traumático para a Psicanálise; c) as teorias das pulsões; d) o trauma após 1920: as neuroses traumáticas; e) ganho secundário; f) a hipocondria em Freud; g) os paradoxos da cura em Danièle Brun e em Freud; h) sobre o trabalho do luto e da elaboração. A partir da articulação entre a clínica e os conceitos teóricos realizamos a discussão de nossa hipótese clínico-teórica. O percurso teórico-clínico realizado permite verificar que o problema clínico evidenciado pode ser entendido, conforme nossa hipótese clínico-teórica, a partir dos desenvolvimentos de Freud a propósito das neuroses traumáticas, em conjunção com o entendimento de que mesmo algo que era almejado pode não trazer alívio ou realização, mas sofrimento, conforme visto nos paradoxos envolvidos na remissão da doença. O percurso que partiu da clínica nos permite afirmar que o trabalho psicanalítico com pessoas que são acometidas por doenças orgânicas deve contemplar não somente a importância da elaboração psíquica de todo o processo de adoecimento que afeta o corpo, mas também, o que ocorre psiquicamente após a remissão da doença que traz a necessidade de elaboração, pois muitas vezes será no só depois, que estes aspectos poderão ser constatados / The following academic work proposes to present a theoretical systematization of my clinical experience as a psychoanalyst, upon service to patients who, after the remission of severe illnesses such as multiple types of cancer which can affect the bone marrow (leukemia and lymphomas), presented themselves as if they were still sick, referring to the illness as if it was a current event, identifying themselves, within their speeches, as sick people. We present two clinical cases of ones who had had the disease in remission for more than two years and they were cared at a hospital institution. Our goal is to facilitate the comprehension of the psychic processes related in these referred clinical cases. These services have guided the formulation of a clinical-theoretical hypothesis. This hypothesis refers to the possibility of studying the clinical issue from the trauma conceptual paradigm within the Psychoanalysis, especially from the approach developed by Freud after 1920, by formulating the second drives (Trieb) dualism. At the same time, it is done a theoretical trajectory that aims to discuss the attended patients stay at the sick patients place, which conducts us to the presentation of a chapter referring to the paradoxes related to the remission of an organic disease. The theoreticalclinical articulation is based on Freuds and Ferenczis texts, as well as contemporary psychoanalysts who also have these authors as reference. Within this articulation we have scrolled the following conceptual points: a) illness experience; b) the concept of trauma and traumatic effect to Psychoanalysis; c) drivers (Trieb) theories; d) the trauma after 1920: the traumatic neurosis; e) secondary earn; f) hypochondria within Freud; g) the healing paradoxes in Danièle Brun and Freud; h) about the work of grief and the elaboration. From an articulation between the clinic and the theoretical concepts we have discussed our clinicaltheoretical hypothesis. The clinical-theoretical path accomplished allows us to verify that the evident clinical problem can be understood, according to our clinical-theoretical hypothesis, from Freuds developments about traumatic neurosis, in conjunction with the understanding that even something that was desired cannot bring relief or accomplishment, but sorrow, as seen at the paradoxes related on the sickness remission. The path that started with the clinic allows us affirm that the psychoanalytical work towards people that are affected by organic diseases should include not only the importance of the psychic elaboration of the whole illness process that affects the body, but also what occurs mentally after the illness remission that brings the elaboration need, because for several times it will be at deffered action, that these aspects will be able to be determined
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"The wings of whipped butterflies" : trauma, silence and representation of the suffering child in selected contemporary African short fictionNjovane, Thandokazi January 2013 (has links)
This dissertation, which examines the literary representation of childhood trauma, is held together by three threads of inquiry. Firstly, I examine the stylistic devices through which three contemporary African writers – NoViolet Bulawayo, Uwem Akpan, and Mia Couto – engage with the subject of childhood trauma in five of their short stories: “Hitting Budapest”; “My Parents’ Bedroom” and “Fattening for Gabon”; and “The Day Mabata-bata Exploded” and “The Bird-Dreaming Baobab,” respectively. In each of these narratives, the use of ingén(u)s in the form of child narrators and/or focalisers instantiates a degree of structural irony, premised on the cognitive discrepancy between the protagonists’ perceptions and those of the implied reader. This structural irony then serves to underscore the reality that, though in a general sense the precise nature of traumatic experience cannot be directly communicated in language, this is exacerbated in the case of children, because children’s physical and psychological frameworks are underdeveloped. Consequently, children’s exposure to trauma and atrocity results in disruptions of both personal and communal notions of safety and security which are even more severe than those experienced by adults. Secondly, I analyse the political, cultural and economic factors which give rise to the traumatic incidents depicted in the stories, and the child characters’ interpretations and responses to these exigencies. Notions of subjectivity and intersubjectivity, identity and community, victimhood and survival, agency and disempowerment are discussed here in relation to the context of postcolonial Africa and the contemporary realities of chronic poverty, genocide, child-trafficking, the aftermath of civil war, and the legacies of colonialism and racism. Thirdly, this dissertation inspects the areas of congruence and divergence between trauma theory, literary scholarship on trauma narratives, and literary attempts to represent atrocity and trauma despite what is widely held to be the inadequacy of language – and therefore representation – to this task. There are certain differences between the three authors’ depictions of children’s experiences of trauma, despite the fact that the texts all grapple with the aporetic nature of trauma and the paradox of representing the unrepresentable. To this end, they utilise various strategies – temporal disjunctions and fragmentations, silences and lacunae, elements of the fantastical and surreal, magical realism, and instances of abjection and dissociation – to gesture towards the inexpressible, or that which is incommensurable with language. I argue that, ultimately, it is the endings of these stories which suggest the unrepresentable nature of trauma. Traumatic experience poses a challenge to representational conventions and, in its resistance, encourages a realisation that new ways of writing and speaking about trauma in the African continent, particularly with regards to children, are needed.
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Korttermynterapie met getraumatiseerde kleutersGrimbeek, Marinda Elizabeth 11 September 2012 (has links)
M.Ed. / The socio-political climate in South-Africa has led to an increase in the number of children experiencing anxiety-related symptoms. Children are observant and notice how their parents react and discuss with other adults the violence and uncontrollable crime rate that exists in our society at present. Society generally views childhood as a naturally happy time, free of responsibilities and worries. But the implication that children are somehow protected from the emotional effects of traumatic events is not true. Children are, in fact, as susceptible to trauma as adults. Many children have experienced incredible trauma first hand and these traumatic events can have a negative effect on the child's self concept and future functioning. Mother problem arising from the insecurity of the socio-political climate is that parents tend to feel that they have to take greater safety precautions, thus children are lacking opportunities for developing independence. Other stress aspects are the changes in family structures. One out of every three children will experience divorce, and will have to cope with the stress of reconstituted families. Not only is there stress involved in the process of divorce, but prior to the divorce conditions within the home are unbearable tense and full of conflict. Children in the South - African townships are often left in the care of extended families due to the fact that their parents may be working far from where they live and go to school. Because of the complexities and breakdown of family life, these children are often forced to get on with their lives and growing up on their own, with no or little family support. It is clear that our children of today often find themselves in positions that they are not developmentally and emotionally equipped to handle, and the instinct of survival is often what they rely on. The South African society consists of a set of complex and often polarised systems, each with its own difficulties. The need for intervention and therapy is great, but the resources are limited. Psychotherapy with a professional play therapist is just not a viable solution for many children. Not only is there a limit to the professional resources available, but a lot of parents see it as a waste of time and the financial cost can be crippling. The situational access is another problem that needs to be addressed. Many children are simply not in a physical position to gain access to therapy. It becomes clear every day that in South Africa, the Western view of individualised and specialised play therapy for children is simply not feasible in many instances. The objective of this research project is to describe the therapeutic process in order to establish certain guidelines regarding therapy with traumatized toddlers. The efficiency of this process will also be discussed. The design of this research project compelled a qualitative research strategy, where the researcher in this study is also the therapist. A participating research process is thus of importance in this project. This research project looks at the process and the implications of short term therapy, especially Narrative Therapy with toddlers between the ages of four to seven years. The project describes the therapy process of co-constructing new and preferred narratives with three clients by challenging dominant discourses of violence, death , loss and trauma. The results of the therapeutic process as well as the shortages and recommendations conconclude this research project.
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Frames, the fantastic and allegory : narrating trauma in Yann Martel’s Life of PiMill, Colleen 10 April 2013 (has links)
M.A. (English) / Yann Martel’s Life of Pi takes as its focal point a deeply traumatic event that befalls its main protagonist, Pi Patel. One effect of Pi’s traumatic experience is that it hinders his ability fully to communicate the scope and detail of his suffering. This dissertation seeks to show how, through a deftly woven, framed narrative, the use of the mode of the fantastic and an ambiguous allegory, the novel works creatively to confront the difficulties inherent in the representation of Pi’s trauma. The central tenets of trauma theory offer illuminating perspectives from which to examine the manifestation of trauma in this novel. The framed narrative, when considered within the context of Jacques Derrida’s description of the performance of the frame in The Truth in Painting, is a performance that suggests possibilities for the figurative representation of Pi’s trauma. The framed narrative engenders a profound sense of ambiguity within the text, which is necessary for the fantastic to function. The fantastic, in this novel, resonates with the experience of trauma and displays significant potential in the saying of the unsaid. Ambiguity also permeates the double narrative presented toward the close of the narrative. The double narrative is an allegory, but not a straightforward one and its unorthodox implementation is best understood in the context of the deconstructive possibilities of allegory as delineated by Paul de Man.
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"The wings of whipped butterflies" : trauma, silence and representation of the suffering child in selected contemporary African short fictionNjovane, Thandokazi January 2013 (has links)
This dissertation, which examines the literary representation of childhood trauma, is held together by three threads of inquiry. Firstly, I examine the stylistic devices through which three contemporary African writers – NoViolet Bulawayo, Uwem Akpan, and Mia Couto – engage with the subject of childhood trauma in five of their short stories: “Hitting Budapest”; “My Parents’ Bedroom” and “Fattening for Gabon”; and “The Day Mabata-bata Exploded” and “The Bird-Dreaming Baobab,” respectively. In each of these narratives, the use of ingén(u)s in the form of child narrators and/or focalisers instantiates a degree of structural irony, premised on the cognitive discrepancy between the protagonists’ perceptions and those of the implied reader. This structural irony then serves to underscore the reality that, though in a general sense the precise nature of traumatic experience cannot be directly communicated in language, this is exacerbated in the case of children, because children’s physical and psychological frameworks are underdeveloped. Consequently, children’s exposure to trauma and atrocity results in disruptions of both personal and communal notions of safety and security which are even more severe than those experienced by adults. Secondly, I analyse the political, cultural and economic factors which give rise to the traumatic incidents depicted in the stories, and the child characters’ interpretations and responses to these exigencies. Notions of subjectivity and intersubjectivity, identity and community, victimhood and survival, agency and disempowerment are discussed here in relation to the context of postcolonial Africa and the contemporary realities of chronic poverty, genocide, child-trafficking, the aftermath of civil war, and the legacies of colonialism and racism. Thirdly, this dissertation inspects the areas of congruence and divergence between trauma theory, literary scholarship on trauma narratives, and literary attempts to represent atrocity and trauma despite what is widely held to be the inadequacy of language – and therefore representation – to this task. There are certain differences between the three authors’ depictions of children’s experiences of trauma, despite the fact that the texts all grapple with the aporetic nature of trauma and the paradox of representing the unrepresentable. To this end, they utilise various strategies – temporal disjunctions and fragmentations, silences and lacunae, elements of the fantastical and surreal, magical realism, and instances of abjection and dissociation – to gesture towards the inexpressible, or that which is incommensurable with language. I argue that, ultimately, it is the endings of these stories which suggest the unrepresentable nature of trauma. Traumatic experience poses a challenge to representational conventions and, in its resistance, encourages a realisation that new ways of writing and speaking about trauma in the African continent, particularly with regards to children, are needed. / Adobe Acrobat 9.54 Paper Capture Plug-in
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Indigenous trauma volunteers: survivors with a missionMoultrie, Alison January 2004 (has links)
There is a growing body of literature on the risk for secondary trauma amongst professional trauma workers. Nonetheless, there is scant published literature on the impact of trauma work on volunteers; particularly when such volunteers are indigenous to the highly traumatized communities which they serve. The study examined a group of parents (N=16) who volunteered in a school-based trauma support project in an impoverished, gang-ridden South African urban community in which they themselves reside. Aims were to 1) Explore the psychological impact of indigenous trauma volunteerism; 2) Explore volunteers’ perceptions of costs and benefits of volunteerism. Data collection was chiefly qualitative, using focus group and individual interviews. The Professional Quality of Life: Compassion Satisfaction and Fatigue Subscales (Stamm, 2002) were administered in order to determine risk for burnout, risk for compassion fatigue and potential for compassion satisfaction. The Stressful Life Experiences Screening Short Form (Stamm, 1997) was administered in order to gather descriptive information regarding personal trauma histories. Project documentation was reviewed. Analysis and interpretation of qualitative data involved a combination of both etic (theory-based) and emic (data and context-based) techniques. The volunteers’ experiences were co-constructed in interaction with three settings: 1) Experiences of training and supervision were affirming and empowering; 2) Experiences of the school context were mediated by the degree of access and integration into the school environment; 3) Experiences of the community context were mediated by the dynamics of identification, role fluidity and inter-setting negotiation. The primary cost of involvement was distress relating to limitations on capacity to help fellow community members with whom they strongly identified, and whom they felt intrapsychically, interpersonally and socially pressured to assist. These limitations included limited client resources, limited personal resources, limited occupational resources and limited systemic resources. Other sources of distress included context-related boundary management difficulties, institutional (school-related) stressors, difficulties in persuading children to disclose abuse and material costs of volunteering. Coping was facilitated by empowering training, supervision, peer support, and self-care practices. Benefits included acquisition of psychological, interpersonal and occupational skills, improved personal relationships, social support, validation, personal healing and role satisfaction.
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Stress and traumatic symptoms among police officers: a gender analysisWilliams, Wendy Claudia January 2008 (has links)
This study assessed the extent to which exposure to traumatic events affected the traumatic stress response of male and female police officers. A convenience sample of male and female police officers (N = 66: n Male=46, n Female=20) was surveyed at an Eastern Cape police station. The following instruments were used: 1) Biographical questionnaire 2) PTSS-10 scales 3) The 39-item stress incident scale. Findings of this study indicate that the frequency of exposure to stressful incidents especially for more serious events is significant higher than that of Peltzer (2001) study. The four most frequent stressful incidents experienced by all participants were 1) Finding a corpse after murder (86.4 percent), 2) Responding to a scene involving accidental injury of a child (84.8 percent), .3) Finding a corpse (died of natural causes) (84.8 percent), 4) Duty related violence (non-shooting) (84.8 percent ).The four least frequent incidents experienced by participants were: (1) Response to the depressing social situation (71.2 percent), (2) Dragging of a corpse (74.2 percent), (3) Taking a life in the line of duty (75.8 percent), (4) Violent death of a colleague (77.3 percent ).Female participants results indicated a positive relationship between frequency of stressful incidents and total threat, anxiety, helplessness and PTSS-scale , where male participants’ results indicate no significant relationship between frequency of stressful incidents and total threat, anxiety, helplessness and PTSS-scale. Findings on male participants however indicate a positive relationship between years of service in police, age of police officers and PTSS-scale, while female participants’ results indicated no relationship between years of service in the police, age of police officer and PTSS-scale.
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The collective trauma story : personal meaning and the recollection of traumatic memories in Vancouver's Chilean communityEspinoza, Adriana E. 05 1900 (has links)
The subject of recollection of traumatic collective memories resulting from a single, unexpected
event is still a new phenomenon in the trauma-related literature, especially in the context of
exiled political refugees. The focus of this research is to explore the nexus between Chilean
exiles' personal meanings of Pinochet's unexpected arrest and release in England, and the
construction of group memories of traumatic life experiences triggered by these events.
To access the individual and collective meaning experiences of the members of this
community, this study used narrative inquiry. The participants created individual narratives of
these events, and they shared them in a group format. Through sharing these experiences in a
group setting, the participants created a "cultural group narrative." This embodied their
individual and collective experiences, their lived experiences of exile, their adaptation to a new
culture and their re-experiencing of traumatic memories and life events when hearing the news of
Pinochet. Because the researcher is also Chilean and because Latin American culture is
collective in nature, she played a dual role as both investigator and participant.
This study has several implications for counselling practice, education and supervision.
It provides further knowledge and understanding of the historical, political and cultural issues
related to traumatic experiences in both individuals and groups, as well as further understanding
of the events or situations that trigger the re-appearance of traumatic memories. The results of
this research also provide important information for therapists working in the areas of cross-cultural
counselling and the development and improvement of therapeutic approaches for dealing
with traumatic memories among political refugees and immigrant populations.
In a broader context, this study enhances the understanding of similar processes in other
ethnic communities. Finally, this study contributes to the documentation of the collective
trauma processes of the Chilean community in Vancouver, Canada. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate
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The prevalence of traumatic symptoms among police officers with different levels of service in the Vancouver Police DepartmentRam, Jessbir L. 05 1900 (has links)
Police officers are subject to stressors from traumatic incidents, day to day policing duties
as well as organizational sources. This quantitative study examined 195 serving police
officers in the Vancouver Police Department to determine what if any relationship existed
between any prevalence of traumatic symptoms and their years of experience as police
officers. Trauma symptoms were measured through the use of the Trauma Symptom
Inventory, which was administered to a randomly selected sample. The sample was
divided into seven groups based on years of completed service; recruits, 0<2 years, 2<5
years, 5<10 years, 10<15 years, 15<20 years and 20+ years. While the recruit group
showed a spike on the validity scale of Response Level and there were spikes in
Anger/Irritability and Depression among the 2<5 years and 20+ groups respectively, most
of the significant scores were among the group 10<15 years. This group showed
significantly elevated scores in Atypical Responses, Anxious Arousal, Anger/Irritability,
Depression, Intrusive Experience, Defensive Avoidance and Impaired Self Reference. In
terms of support the respondents indicated through a demographic questionnaire that
Family Support was the one most frequently endorsed at the high level, followed by
Social Support and then by Peer Support. There was also low levels of endorsement of
the Critical Item on the TSI that had to do with hurting others and problems due to
alcohol consumption and sexual behaviour. Empirical support and personal experiences
of the researcher are provided as explanations for the trends. The number of females in
the latter groups was limited due to the demographics of the population. Several
recommendations are made for future research as well as recommendations to the
Vancouver Police Department to address the findings with their sworn members. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate
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Vicariously witnessing trauma : narratives of meaning and experienceKeats, Patrice Alison 11 1900 (has links)
My interest in the process and effects of the witnessing act guides the purpose of this
study. Here, I initiate a deeper understanding of the vicarious witnessing experience from the
perspective of the witnessing participant. My central question is: How do individuals make
sense of vicariously witnessing trauma through narrative, visual, and evidence-based
representations of traumatic events in the concentration camps of Europe?
Vicarious witnessing begins with abstract representations of the event. The evidence is
witnessed firsthand, but the event itself is represented through various perspectives such as
photographic or artistic images, survivor stories, or physical remnants. Witnessing the evidence
evokes a potent embodied experience, so that a person can make the statement, "I have
imagined what another has experienced, hence I believe I know." It is through the imagination
that a witness forms a picture of the trauma. Undoubtedly, there is immense power in meeting
another's experience in the realm of imagination. Compassionate action and social justice is
based in this area of human empathy.
To best achieve my purpose, I use a narrative method that involves two types of
analysis, interpretive readings and narrative instances, as an approach to understand the
participant's experience of vicarious witnessing. Participants in this study construct three types
of narrative texts-written, spoken, and visual. Each textual perspective shapes the meaning that
the participant attempts to express. As a first level of analysis, interpretive readings of the texts
include general, specific, visual, and relational readings. Secondly, through exploring the
interaction between various parts of these texts, and between the texts themselves, I explore
three types of narrative instances--single-text, intratextual, and intertextual. Each analysis of a
narrative instance is matched specifically to each participant, and I believe, is uniquely
adequate for understanding the experience of vicarious witnessing.
My inquiry outlines how individuals make sense of vicariously witnessing trauma,
clarifies the meaning that participants make of the vicarious witnessing experience, shows the
risks and coping involved in vicarious witnessing, and presents the kinds of social action that
vicarious witnessing evokes. In the field of counselling psychology, the witnessing experience
is an important aspect of trauma theory that has been left unexplored by psychologists. My
research enlarges the social and theoretical conversation concerning the vicarious witnessing
experience. / Arts, Faculty of / Psychology, Department of / Graduate
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