Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-07-16T11:19:47Z No. of bitstreams: 1 dagmaralmeidasilvademello.pdf: 710099 bytes, checksum: 28793ec43a828836b81eb3f502358177 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-07-16T17:21:55Z (GMT) No. of bitstreams: 1 dagmaralmeidasilvademello.pdf: 710099 bytes, checksum: 28793ec43a828836b81eb3f502358177 (MD5) / Made available in DSpace on 2018-07-16T17:21:55Z (GMT). No. of bitstreams: 1 dagmaralmeidasilvademello.pdf: 710099 bytes, checksum: 28793ec43a828836b81eb3f502358177 (MD5) Previous issue date: 2017-02-21 / A partir de investigações sobre as paralisias, a afasia e a histeria, Sigmund Freud (1856-1939) verificou a realidade dinâmica do inconsciente e criou a Psicanálise. Em Estudos sobre a histeria (1895), trabalho que Freud desenvolveu em parceria com Josef Breuer (1842-1925), foi apresentada a hipótese de que as histéricas sofreriam de reminiscências, o que deixou claro que certos sintomas físicos, como aqueles presentes na histeria, poderiam estar associados a questões de ordem psíquica, de forma que o corpo estaria sujeito também às vicissitudes da mente. A reflexão sobre as relações entre o psíquico e o corporal, portanto, esteve presente na Psicanálise desde seus primórdios. Pierre Marty (1918-1993), embasado em pressupostos freudianos, em especial na primeira tópica psíquica, desenvolveu hipóteses acerca do funcionamento mental de “pacientes somáticos” e fundou a chamada Escola Psicossomática de Paris. Buscando conferir a adequada sustentação conceitual às suas hipóteses, Marty introduziu diversas novas noções, sendo as principais “pensamento operatório”, “depressão essencial” e “mentalização”. O objetivo geral do presente estudo é analisar o desenvolvimento de algumas noções elaboradas por Marty e discutir em que medida o autor acompanhou ou avançou em relação às premissas de Freud acerca da compreensão dos processos mentais e suas interfaces com o funcionamento orgânico. Concluímos que as concepções dos dois autores ora se aproximam, ora se distanciam, e que Marty foi capaz de aprofundar a compreensão da relação entre o mental e o corporal a partir da investigação de um campo pouco explorado por Freud. / From investigations into paralysis, aphasia and hysteria, Sigmund Freud (1856-1939) verified the dynamic reality of the unconscious and created Psychoanalysis. In Studies on Hysteria (1895), a work that Freud developed in partnership with Josef Breuer (1842-1925), it was hypothesized that hysterical women suffered from reminiscences, which made it clear that certain physical symptoms, such as those present in hysteria, could be associated with questions of a psychic nature, so the body would also be subject to the vicissitudes of the mind. The reflection on the relations between the psyche and the body, therefore, was present in Psychoanalysis from its very beginning. Pierre Marty (1918-1993), based on Freudian presuppositions, especially on the first psychic topic, developed hypotheses about the mental functioning of “somatic patients” and founded the so-called Paris Psychosomatic School. Seeking to give adequate conceptual support to his hypotheses, Marty introduced several new notions, the main ones being “operative thinking”, “essential depression” and “mentalization”. The general aim of the present study is to analyze the development of certain notions elaborated by Marty and to discuss to what extent the author followed or advanced in relation to the premises of Freud about the understanding of the mental processes and their interfaces with organic functioning. We conclude that the conceptions of the two authors are sometimes close and sometimes distant, and that Marty was able to deepen the understanding of the relation between the mind and the body based on the investigation of a field little explored by Freud.

Ce travail de thèse vise à étudier la dynamique psychique des sujets douloureux chroniques ainsi qu’à évaluer l’incidence d’une prise en charge hypnothérapeutique sur le fonctionnement psychique au sein de cette population. Cette recherche repose sur la mise en place d’une méthodologie incluant la passation du test de Rorschach, du test de l’arbre malade, et du test de MMPI-2, auprès d’une population de 36 sujets constitués en groupe clinique et témoin. Les résultats témoignent, chez les sujets douloureux chroniques, d’un fonctionnement psychique marqué par la présence d’un Moi ne parvenant pas à déployer une mobilisation défensive suffisamment efficiente pour restaurer un équilibre face à l’effraction somato-psychique que représente la douleur. Suite à la prise en charge hypnothérapeutique, les résultats révèlent des modifications au niveau de la dynamique psychique. Ils témoignent d’un renforcement de l’instance moïque permettant des remaniements au niveau de la sphère affective, de la qualité du rapport à la réalité ainsi qu’une restauration narcissique. La prise en charge engendre par ailleurs des ajustements au niveau de la consistance des limites de l’image du corps. L’incidence des modalités de fonctionnement psychique sur les effets de la prise en charge hypnothérapeutique semble fonction du niveau de psychopathologie présenté par les sujets. Les résultats obtenus traduisent les potentialités de l’hypnose en tant que technique psychothérapeutique. La prise en charge hypnothérapeutique semble exercer une incidence au niveau de l’image du corps et de l’instance moïque à même de contribuer à la restauration de l’équilibre psychique / This thesis work seeks to study the psychic dynamic of chronic pain subjects, as well as to assess the impact of a hypnotherapeutic treatment on the psychic functioning in this population. This research strategy relies on the following methodology: Rorschach test, ill tree test, MMPI-2 test, on a 36-subject population distributed in a clinical group and a witness group. On chronic pain subjects, results show a psychic functioning pronounced by the presence of an Ego that can not deploy sufficient protection to re-establish a balance following a somatopsychic break that the pain represents. Following a hypnotherapy, results show modifications of the psychic dynamic. They show a strengthening of the ego allowing a revision of the emotional sphere, as well as a better relation to reality and a narcissistic restoration. The treatment generates a better the perception of body image. The impact of psychic functioning from the effects of the hypnotherapy treatment seems to be related to the psychopathology level of the subjects. Results show that hypnosis can potentially be used as a psychotherapeutic technique. Hypnosis treatment seems to exercise an effect on the body image and the ego that may contribute to the restoration of the psychic balance

Résumé confidentiel / Résumé confidentiel

O presente projeto apresenta uma investigação sobre as experiências escolares do jovem e os seus projetos vitais, desenvolvida na Linha de Pesquisa Psicologia e Educação da Faculdade de Educação da Universidade de São Paulo, como requisito à obtenção do título de doutor. Investiga o que se passa no contexto escolar, analisando o papel da afetividade nas inter-relações entre o aluno, conhecimento e a influência no estabelecimento do projeto vital do jovem adolescente. Procura investigar como as situações de sala de aula, ou no interior da escola, podem influenciar o estabelecimento do projeto vital do adolescente. Pretende defender que, nas experiências escolares, a afetividade está presente nas relações interpessoais, com as experiências que ocorrem, no espaço escolar, e interfere na elaboração do projeto vital do adolescente; o estado emocional afeta as relações entre o professor e o aluno, podendo dificultar ou facilitar o relacionamento do adolescente com a área de interesse futuro exercendo influência no estabelecimento do projeto vital do adolescente. Para tanto, adota os pressupostos da teoria dos Modelos Organizadores do Pensamento para análise dos dados coletados. Destaca, como instrumento, a entrevista gravada e transcrita. A partir das informações coletadas, faz uma análise das mesmas e traça as categorias e os modelos organizadores do pensamento, apresentando os resultados obtidos e os novos questionamentos advindos dos mesmos resultados. / The current work presents an investigation on the school experiences of young people and their life plans, following the Psychological and Educational Research Field of the Faculdade de Educação da Universidade de São Paulo, as a requisite to the doctorate degree graduation. It investigates what is happening in the school context, analyzing the affectionateness function in the interrelationship between student, knowledge and the influence by determining the teenagers life plans. It tries also to understand how the classroom relationship, or that inside the school environment, is able to affect the planning of the young peoples life project. Yet, it is intended to sustain the idea, on the school experiences, of the existence of affectionateness in the interpersonal relation, taking as an example those experiences occurred in the school environment, that interferes on the teenager life planning; the persons emotional state affects the relationship between teacher and student, and might difficult or ease the teenager involvement with a specific knowledge field in the future, and influence the young persons life planning. Setting that as our aim, we adopt the presupposition of the Organizational Models of the Thought to analyze the collected data. Our main goal is a recorded and transcribed interview. From that database, we can analyze and estipulate the study categories and the organizational models of the thought, presenting the results we obtained and those questions generated from them.

L’insuffisance rénale est une maladie chronique, qui, parvenue à un certain stade, nécessite au patient qui en est atteint, d’avoir recours à un traitement de suppléance permettant de pallier les défaillances de la fonction du rein. Une de ces techniques, l’hémodialyse, comprend trois étapes importantes dans le parcours de la personne malade: l’annonce de la maladie, la création d’un abord vasculaire, le passage au traitement. L’annonce de l’insuffisance rénale a souvent lieu quelques années avant l’intervention de la fistule artério-veineuse et donc bien en amont de la mise en dialyse. Une étude longitudinale aurait permis de procéder au suivi complet de la personne insuffisante rénale à partir de la découverte de la maladie mais les contraintes de temps m’ont conduit à me limiter aux effets après coup de l’annonce et à me concentrer sur les retentissements du traumatisme au moment de la première effraction (création de la fistule artério-veineuse) et de seconde effraction (la mise en dialyse). Au regard des théories psychanalytiques du traumatisme, j’ai cherché à mettre en évidence la portée des effractions corporelles sur l’unité psychosomatique de la personne atteinte d’insuffisance rénale qui se différencie de celle de l’effraction psychique du traumatisme excluant une blessure physique. J’ai repris l’hypothèse de Freud concernant les névroses de guerre qui stipule que l’atteinte physique protège de la névrose traumatique, mais j’ai proposé de modifier la teneur de ses propos en les adaptant à la situation de maladie grave. Par conséquent, la visée de cette recherche est d'étudier le parcours de l'insuffisant rénal à trois temps traumatiques de la maladie dans ses dimensions à la fois psychique et somatique. Afin d'éprouver mes hypothèses, un entretien clinique est proposé lors de la première entrevue, puis des tests projectifs (TAT et Rorschach) accompagnés d'un entretien clinique sont proposés lors de la seconde rencontre. Ma population se compose de huit patients âgés de 22 à 60 ans que j’ai rencontré une première fois lors de la création de la fistule artério veineuse, un moment durant lequel j’ai pu relever que l'annonce de l'insuffisance rénale n’avait pas joué le rôle d'une angoisse signal d'alarme dans l'économie psychique. Car en effet, à l’arrivée de ce nouveau corps étranger, un débordement pulsionnel affleure mettant à jour une fantasmatique de type traumatique. La seconde phase se situe au début des séances de dialyse lors desquelles la sensorialité et les sensations sont mises au service d'une « détresse somato-psychique » convoquant un sentiment d'inquiétante étrangeté et une difficulté de délimitation des frontières corporelles.D’une part, l’analyse au cas par cas des résultats dévoile que la valeur préventive de l’annonce de la maladie quelques années avant l’intervention a été amoindrie par la violence des effractions corporelles D’autre part, l’analyse des tendances générales a mis en évidence une fragilisation de l’investissement narcissique et des repères objectaux à trois niveaux : sensoriel, sensuel, de la représentation. Plusieurs réponses ou couples de réponses face à l’évènement traumatique pouvant appartenir aux dimension régrédiente et/ou progrédiente s’inscrivant dans une histoire singulière et s’exprimant au travers d’un fonctionnement psychique propre à chacun, ont pu être dégagées comme : l’inhibition de la pensée, la rationalisation et l’intellectualisation, le masochisme (mortifère ou gardien de vie), le déni et le clivage non structurel du Moi, les processus névrotiques, les solutions opératoires (répression affective) et les solutions inadaptées.Enfin, l’examen du fonctionnement psychique aux tests projectifs ne permet pas d’établir de lien direct entre l’organisation mentale et les potentialités de réorganisation suite à l’impact du traumatisme comprenant une atteinte physique. / The renal insufficiency is a chronic disease, which, reached certain stage requires to the patient who is affected, to resort to a treatment of substitution allowing to mitigate the failures of the function of the kidney. One of these techniques, the hemodialysis, includes three important stages in the route of the sick person: the announcement of the disease, the creation of a vascular access, the passage in the treatment. The announcement of the renal insufficiency often takes place some years before the intervention of the artério-venous fistula and thus good upstream to the stake in dialysis. A longitudinal study would have allowed to proceed to the complete follow-up of the renal insufficient person from the discovery of the disease but the constraints of time drove me to limit me to the effects afterward of the announcement and to concentrate on the echoes of the trauma at the time of the first burglary (creation of the artério-venous fistula) and of second burglary (the stake in dialysis). Towards the psychoanalytical theories of the trauma, I tried to bring to light the impact of the physical burglaries on the psychosomatic unity of the person affected by renal insufficiency which differs from that of the psychic burglary of the trauma excluding a physical wound. I took back the hypothesis of Freud concerning the war neurosises which stipulates that the physical achievement protects from the traumatic neurosis, but I suggested modifying the content of its comments by adapting them to the situation of serious illness. Consequently, the aim of this research is to study the cours) of insufficient renal in three time traumatic of the disease in its at once psychic and somatic dimensions. To feel my hypotheses, a clinical consultation is proposed during the first interview, then projective tests (TAT and Rorschach) accompanied with a clinical consultation are proposed during the second meeting. My population consists of eight patients from 22 to 60 years old that I met first time during the creation of the fistula venous artério, one moment in the course of which I was able to raise that the announcement of the renal insufficiency had not played the role of an anxiety alarm in the psychic economy. Because indeed, upon the arrival of this new foreign body, an impulsive overflowing appears updating a fantastical of traumatic chap. The second phase is situated at the beginning of the sessions of dialysis when the sensoriality and the sensations are put in the service of a "somato-psychic distress " a feeling of disturbing strangeness and a difficulty of demarcation of the physical borders. On one hand, the individual analysis of the results reveals that the preventive value of the announcement of the disease some years before the intervention was decreased by the violence of the physical burglaries. On the other hand, the analysis of the general tendencies brought to light an embrittlement of the narcissistic investment and the objectals marks at three levels: sensory, sensual, of the representation. Several answers or couples of answers in front of the traumatic event which can belong in regredient and\or progredient dimensions joining a singular story and expressing himself through a psychic functioning appropriatefor each, were able to be brought out as: the inhibition of the thought, the rationalization and the intellectualization, the masochism (mortiferous or guard of life), the denial and the not structural split(cleavage) of the Me, the neurotic operating processes, the solutions ( emotional repression) and the unsuitable solutions.Finally, the examination of the psychic functioning in the projective tests does not allow to establish of direct link between the mental organization and the potentialities of reorganization further to the impact of the trauma understanding a physical achievement

O presente projeto apresenta uma investigação sobre as experiências escolares do jovem e os seus projetos vitais, desenvolvida na Linha de Pesquisa Psicologia e Educação da Faculdade de Educação da Universidade de São Paulo, como requisito à obtenção do título de doutor. Investiga o que se passa no contexto escolar, analisando o papel da afetividade nas inter-relações entre o aluno, conhecimento e a influência no estabelecimento do projeto vital do jovem adolescente. Procura investigar como as situações de sala de aula, ou no interior da escola, podem influenciar o estabelecimento do projeto vital do adolescente. Pretende defender que, nas experiências escolares, a afetividade está presente nas relações interpessoais, com as experiências que ocorrem, no espaço escolar, e interfere na elaboração do projeto vital do adolescente; o estado emocional afeta as relações entre o professor e o aluno, podendo dificultar ou facilitar o relacionamento do adolescente com a área de interesse futuro exercendo influência no estabelecimento do projeto vital do adolescente. Para tanto, adota os pressupostos da teoria dos Modelos Organizadores do Pensamento para análise dos dados coletados. Destaca, como instrumento, a entrevista gravada e transcrita. A partir das informações coletadas, faz uma análise das mesmas e traça as categorias e os modelos organizadores do pensamento, apresentando os resultados obtidos e os novos questionamentos advindos dos mesmos resultados. / The current work presents an investigation on the school experiences of young people and their life plans, following the Psychological and Educational Research Field of the Faculdade de Educação da Universidade de São Paulo, as a requisite to the doctorate degree graduation. It investigates what is happening in the school context, analyzing the affectionateness function in the interrelationship between student, knowledge and the influence by determining the teenagers life plans. It tries also to understand how the classroom relationship, or that inside the school environment, is able to affect the planning of the young peoples life project. Yet, it is intended to sustain the idea, on the school experiences, of the existence of affectionateness in the interpersonal relation, taking as an example those experiences occurred in the school environment, that interferes on the teenager life planning; the persons emotional state affects the relationship between teacher and student, and might difficult or ease the teenager involvement with a specific knowledge field in the future, and influence the young persons life planning. Setting that as our aim, we adopt the presupposition of the Organizational Models of the Thought to analyze the collected data. Our main goal is a recorded and transcribed interview. From that database, we can analyze and estipulate the study categories and the organizational models of the thought, presenting the results we obtained and those questions generated from them.

Cette étude constitue un suivi longitudinal prospectif d’une cohorte de dyades de mères présentant un trouble de personnalité borderline avec leur enfant, dans une approche comparative avec unepopulation contrôle de dyades avec des mères sans trouble psychique. Elle a pour but d’éclairer le fonctionnement intrapsychique des mères et des bébés par l’étude des interactions précoces entre les mères borderline et leur bébé de trois mois. La grossesse représente une véritable crise identitaire et narcissique nécessitant un réaménagement des imagos maternels. Celui-ci ébranle l’identité de ces mères borderline déjà fragilisée par un narcissisme défaillant. Le bébé impose une relation de dépendance de laquelle la mère ne peut s’extraire. Les interactions précoces entre ces mères et leur bébé sont décrites comme étant teintées par l’intrusivité et la répétitivité, et reflètent leur incapacité à s’accorder aux rythmes propres et aux mouvements affectifs de leur enfant. Elles seraient en difficulté au sein d’un partage intersubjectif troublé pour aider le bébé à réguler ses émotions. Cette étude a aussi pour but d’éclairer la manière dont les comportements d’attachement de ces enfants, à 13 mois, s’ancrent dans la particularité de ces dysfonctionnements interactifs. L’évaluation des représentations d’attachement chez ces enfants, âgés de 4 à 8 ans, met en lumière différentes évolutions dans la qualité de leur attachement. Enfin, une approche psychodynamique de leurs récits, au test des histoires à compléter, éclaire les particularités de leur fonctionnement psychique. / This study comprises a prospective longitudinal exploration of a cohort of mother-child dyads with mothers with borderline personality disorder, compared with a control group of dyads in which mothers don’t display any psychological disorder. The aim of this study is to elucidate the early intrapsychic functioning of these mothers and infants through the study of the early interactions between these borderline mothers and their three-month-old infants. Pregnancy represents a powerful crisis, both of identity and narcissism, necessitating a reorganization of the maternal imago. It weakens the identity of mothers suffering from borderline personality disorder who are already debilitated by a failing narcissism. The infant imposes a relationship of dependence on its mother, from which she cannot extricate herself. The early mother-infant interactions are described as being imbued with intrusion and repetition, which reflect the mother’s incapacity to attune herself to the distinct rhythms and emotional movements of her child. They show difficulties at the heart of a troubled sharing of intersubjectivity to help the infant to regulate its emotions. This study endeavours to expound the way in which the attachment behaviours of these 13 month-old infants are embedded in the distinctive features of these dysfunctional interactions. The evaluation of the attachment representations of these children, aged from 4 to 8 years, draws light on different evolutions in the quality of their attachment. Ultimately, a psychodynamic approach of their narratives during the Attachment Story Stem Battery reveals the features of their psychological functioning.