Inledning: Eftersom den psykodynamiska psykoterapin har kraftig konkurrens från andra terapiformer, samtidigt som kraven på effektivitet, snabbhet och evidens från hälso- och sjukvårdsetablissemanget är starka, är det viktigt att som psykodynamiker delta i diskursen kring den psykodynamiska psykoterapins vetenskapsteoretiska status. Hur kan man karakterisera den psykodynamiska psykoterapin om den dels inte är identisk med psykoanalys, dels heller inte automatiskt kan inordnas i det medicinsk-biologiska paradigmet? Uppsatsen har som syfte att definiera och undersöka om psykodynamisk psykoterapi kan betraktas som behandling och/eller en moralisk etisk praxis. Frågeställningar: Psykodynamisk psykoterapi – är den en egen humanvetenskap? Hur kan man definiera och se på behandling och behandlingsmål i den psykodynamiska psykoterapin? Metod: Litteraturstudie med en hermeneutisk ansats. Resultat: Det finns olika sätt att se på den psykodynamiska psykoterapin när det gäller dess vetenskaplighet. Frågan om psykodynamisk psykoterapi är behandling i gängse medicinsk bemärkelse, har heller inget enkelt entydigt svar. Till synen på behandling hör också målet med densamma. Hur man betraktar behandlingsfrågan blir också vägledande för hur man ser på behandlingsmålet. En skiljelinje går mellan uppfattningen om den psykodynamiska psykoterapin som vetenskap och/eller teknik. Diskussionen om psykodynamisk psykoterapi är en vetenskap eller flera, har betydelse för dess ställning i den vetenskapliga världen. Diskussion: Valet av litteraturstudie som metod avgjordes på grundval uppsatsens syfte och karaktär. Det är möjligt att se den psykodynamiska psykoterapin i annat vetenskapligt ljus än det positivistiska t.ex. fenomenologiskt och hermeneutiskt. Psykodynamisk psykoterapi kan ses både som en vetenskap och en teknik samt som en etisk verksamhetspraxis. Slutsatsen för uppsatsarbetet är att man kan se på den psykodynamiska psykoterapin som en moralisk, etisk behandlingsmetod som med både hermeneutiska och fenomenologiska metoder/tekniker söker uppnå inre frihet, självkännedom och ansvarstagande för medvetnare livsval hos subjektet. Behandlingsmålet blir då att minska neurotiskt och annat lidande hos subjektet samtidigt som lidandets omedvetna ursprung integreras.

Parent-infant psychotherapy is a small but growing field in South Africa. Its potential to contribute to mental health services in South Africa is, by contrast, vast. This thesis contributes towards much-needed research on the state of the field in the country and its potential applications across different sectors. Drawing on Daniel Stern’s concept of ports of entry, it is argued that an expansion of ports of entry offers an important integrating tool through which different aspects of parent-infant psychotherapy can be examined and adapted to the South African context. A history of parent-infant psychotherapy in South Africa is offered, together with an analysis of the experiences of current practitioners in the field. These aspects of the thesis draw on interviews with key stakeholders. The dominant context of private practice is then explored through two case study based papers. The first explores the meaning of symptoms in parent-infant psychotherapy. The second introduces the ‘grandmaternal transference’ as an important but under developed port of entry. These different aspects of parent-infant psychotherapy in South Africa are then considered through the prism of ports of entry in order to argue for a flexing of the psychoanalytic frame. Implications for the growth of the parent-infant psychotherapy field in South Africa are considered.

Uma criança, para um desenvolvimento emocional saudável, necessita de um ambiente acolhedor, que possa atender a suas necessidades básicas, sem provocar invasões nesse processo, ambiente este denominado por Winnicott de suficientemente bom. Pode-se refletir que uma criança que sofreu maus-tratos experienciou momentos de invasão no seu processo de integração que poderiam prejudicar seu desenvolvimento posterior e que seria de grande importância uma psicoterapia como possibilidade de elaboração de suas vivências e sustentação de seu crescimento. Partindo deste pressuposto, o presente trabalho objetivou realizar um diálogo entre teoria e prática, prática esta advinda de um processo psicoterapêutico de uma criança que sofreu abuso físico por parte de sua mãe, retirada de seu lar e abrigada em uma instituição, baseando-se em uma perspectiva winnicottiana do desenvolvimento emocional. As sessões eram realizadas na própria instituição onde a criança se encontrava abrigada, tendo sido realizadas 106 sessões de ludoterapia de orientação psicanalítica, com freqüência semanal de três vezes por semana, no período de Novembro de 2001 a Fevereiro de 2003. Pôde-se perceber que, através da ludoterapia, a criança pôde desenvolver-se emocionalmente, elaborando vivências traumáticas e experienciando um ambiente não intrusivo e acolhedor, podendo trabalhar aspectos relativos a sua identidade, casa e família. O atendimento continua até o presente momento, através da inserção de uma nova psicoterapeuta. / A child, for a healthy emotional development, needs a welcoming environment, named by Winnicott as a good enough environment, which can take care of the child’s basic necessities without invading him in his process. It can be though that a maltreated child has experienced moments of invasion in his integration process that could prejudice his ulterior development and a psychotherapy would have a great importance as a possibility of traumatic experience’s elaboration and of a holding for his growth. Taking this view in to consideration, the present work has aimed a dialogue between theory and practical work based in a Winnicott’s perspective of the emotional development. The practical work comes from a psychotherapeutic process of a child who has suffered physical abuse perpetrated by his mother and was living in an institution for maltreated children. The total of 106 sessions occurred in the institution where the child used to live, in a frequency of three sessions per week, from November of 2001 to February of 2003. It was possible to notice that, through the play therapy, the child could develop himself emotionally, elaborate traumatic experiences and experiment a supporting and non-intrusive environment. It was possible to work psychological aspects related to his identity, home and family. The play therapy continues until the present moment through the insertion of a new therapist.

Submitted by William Justo Figueiro (williamjf) on 2015-07-27T21:36:49Z No. of bitstreams: 1 12d.pdf: 2303688 bytes, checksum: b00af738d3624732d6c3ebf9624e1114 (MD5) / Made available in DSpace on 2015-07-27T21:36:49Z (GMT). No. of bitstreams: 1 12d.pdf: 2303688 bytes, checksum: b00af738d3624732d6c3ebf9624e1114 (MD5) Previous issue date: 2014-02-27 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Essa Dissertação de Mestrado em Psicologia Clínica teve como foco a análise das mudanças ocorridas no primeiro ano de psicoterapia psicanalítica de uma criança e do processo psicoterápico deste mesmo período. A análise das mudanças foi realizada com base no Método de Rorschach e o processo psicoterápico com base no Child Psychotherapy Q-set (CPQ). No enfoque da psicoterapia psicanalítica foi realizado um estudo pautado pela abordagem descritivo longitudinal, adotando-se o procedimento de estudo de caso único e sistemático. Participaram deste estudo um menino de 7 anos de idade, acompanhado em psicoterapia durante o período de um ano e sua terapeuta. Para avaliar as mudanças ocorridas o Rorschach foi aplicado ao iniciar a psicoterapia, após seis meses de tratamento e após um ano. O CPQ foi aplicado em duas sessões do início da psicoterapia, duas sessões após três meses, duas sessões após seis meses, duas sessões após nove meses e duas sessões após um ano de tratamento, para identificar as características do processo psicoterápico ao longo do tempo. Os resultados revelaram a efetividade da psicoterapia psicanalítica, evidenciando, através do Método de Rorschach que houve mudanças significativas em diferentes níveis e dimensões da organização e do funcionamento da personalidade. O uso do CPQ permitiu uma caracterização do processo terapêutico, no que diz respeito às atitudes da criança, do terapeuta e da interação entre ambos, como também possibilitou o acompanhamento de mudanças na dinâmica de interação paciente-terapeuta ao longo do tempo. / This Psychology Master Dissertation has focused on the change´s analysis in the first year of a child psychoanalytic psychotherapy and the psychotherapeutic process. The change´s analysis was performed based on the Rorschach Method and the psychotherapeutic process’ analysis was based on the Child Psychotherapy Q-Set (CPQ). A study guided by the longitudinal descriptive approach was made, adopting the Systematic Case Study procedure. Participants were a 7-year-old boy and his therapist. The boy was treated in psychoanalytic psychotherapy. To evaluate changes Rorschach was applied at the beginning of the psychotherapy, after six months and after one year of treatment. The CPQ was administered in two sessions in beginning the of psychotherapy, in two sessions after three months, in two sessions after six months, in two sessions after nine months and in two sessions after one year of treatment, to evaluate the features of the psychotherapeutic process over time. The main findings showed the effectiveness of psychoanalytic psychotherapy, displaying through the Rorschach Method that were significant changes at different levels and dimensions of the organization and functioning of the personality. The use of the CPQ allowed the therapeutic process characterization, regarding to the child’s attitudes, the therapist’s ones and the interaction between them. It also enabled the monitoring of changes in the patient-therapist’s interaction over time.

This work in two parts – entitled Symbolic Function and Meaning: An Investigation of the Species-Specific Essence of Psychoanalytic Psychotherapy – could be characterized as an interpretation of the above-mentioned therapy and the meaning of its particular experience. In the first part, besides a licentiate thesis, four topics are examined: the therapeutic framework, the transference – especially in neurotic form – and its interpretation, psychotherapy with borderline patients, and therapy with psychotics. This has been done by combining studies of literature with analyses of the transference meaning of a number of illuminative clinical examples or vignettes – anecdotes, i.e. narratives with a significant point – the main part of which are the outcome of the author’s own activity in the form of participant observation as a psychotherapist. The general conclusion is that promoting the symbolic function is the essential ingredient in the psychoanalytic form of therapy – its very rationality – and how it effectuates its unique therapeutic potentiality; a characterization which, despite obvious differences in the adequacy of symbolic functioning, is valid irrespective of whether the patient is diagnosed as neurotic, borderline or psychotic. In the second part – essentially of a theoretical nature in contrast to the preceding one – the study is influenced by philosophical hermeneutics, and in this process assimilates its particular conceptuality. The continued analysis of the research object shows that it is misleading, in view of its ontology, to conceptualize it in medical terms as treatment. Aimed at promoting the symbolic function by the transference being interpreted, psychoanalytic psychotherapy instead operates in an ethical dimension and is rather what Aristotle terms a praxis, on the one hand; on the other hand, it is moreover implicitly human science action research into intersubjective appropriation of meaning. In this latter respect, the investigation highlights the fact that the very special interview method in the form of free associations, with their reflexivity, gives the psychoanalytic form of psychotherapy the potential to be not only a qualitative research method but also simultaneously metaresearch. The analyses of the transference meaning of clinical anecdotes in the first part have thereby been able to be methodologically clarified retroactively as psychoanalytic metaresearch.

Uma criança, para um desenvolvimento emocional saudável, necessita de um ambiente acolhedor, que possa atender a suas necessidades básicas, sem provocar invasões nesse processo, ambiente este denominado por Winnicott de suficientemente bom. Pode-se refletir que uma criança que sofreu maus-tratos experienciou momentos de invasão no seu processo de integração que poderiam prejudicar seu desenvolvimento posterior e que seria de grande importância uma psicoterapia como possibilidade de elaboração de suas vivências e sustentação de seu crescimento. Partindo deste pressuposto, o presente trabalho objetivou realizar um diálogo entre teoria e prática, prática esta advinda de um processo psicoterapêutico de uma criança que sofreu abuso físico por parte de sua mãe, retirada de seu lar e abrigada em uma instituição, baseando-se em uma perspectiva winnicottiana do desenvolvimento emocional. As sessões eram realizadas na própria instituição onde a criança se encontrava abrigada, tendo sido realizadas 106 sessões de ludoterapia de orientação psicanalítica, com freqüência semanal de três vezes por semana, no período de Novembro de 2001 a Fevereiro de 2003. Pôde-se perceber que, através da ludoterapia, a criança pôde desenvolver-se emocionalmente, elaborando vivências traumáticas e experienciando um ambiente não intrusivo e acolhedor, podendo trabalhar aspectos relativos a sua identidade, casa e família. O atendimento continua até o presente momento, através da inserção de uma nova psicoterapeuta. / A child, for a healthy emotional development, needs a welcoming environment, named by Winnicott as a good enough environment, which can take care of the child’s basic necessities without invading him in his process. It can be though that a maltreated child has experienced moments of invasion in his integration process that could prejudice his ulterior development and a psychotherapy would have a great importance as a possibility of traumatic experience’s elaboration and of a holding for his growth. Taking this view in to consideration, the present work has aimed a dialogue between theory and practical work based in a Winnicott’s perspective of the emotional development. The practical work comes from a psychotherapeutic process of a child who has suffered physical abuse perpetrated by his mother and was living in an institution for maltreated children. The total of 106 sessions occurred in the institution where the child used to live, in a frequency of three sessions per week, from November of 2001 to February of 2003. It was possible to notice that, through the play therapy, the child could develop himself emotionally, elaborate traumatic experiences and experiment a supporting and non-intrusive environment. It was possible to work psychological aspects related to his identity, home and family. The play therapy continues until the present moment through the insertion of a new therapist.

Syftet med denna studie var att undersöka hur terapeuters personlighetskonfiguration aktualiseras i relation till patienten tidigt i terapin samt samband mellan olika mönster av samstämmighet eller komplementaritet mellan patientens och terapeutens personlighetskonfiguration och dess betydelse för utfall.  I 33 par bestående av patient och terapeut klassificerades terapeuterna som antingen i huvudsak anaklitiska eller introjektiva utifrån Prototype Matching of Anaclitic-Introjective Configuration (PMAI) av två oberoende bedömare vilka uppvisade god interbedömarreliabilitet (kappa =0,63). Resultatet visar en signifikant större förbättring för den samstämmiga gruppen. Studien pekar på betydelsen av att terapeuten tidigt anpassar sin stil att relatera till patientens personlighetsbaserade orientering på relaterande eller autonomi/självavgränsning.