Inledning: Depression är en av de vanligaste psykiatriska diagnoserna i Sverige (Folkhälsomyndigheten, 2017). Depression leder till att livet känns meningslöst, vilket ger lidandet en existentiell dimension. Att studera psykoterapeuters syn på lidande utifrån existentiella och psykoanalytiska perspektiv motiveras eftersom forskning har visat att interventioner som adresserar dessa specifikt har varit framgångsrika. Syftet med studien var att undersöka denna fråga ytterligare. Frågeställningar: Hur föreställer sig psykodynamiska psykoterapeuter psykiskt lidande och hur arbetar de med det i terapin? Vilken betydelse tillskriver de, de existentiella dimensionerna för det psykiska lidandet? Metod: En kvalitativ metod har använts. Sex terapeuter intervjuades med utgångspunkt från en semi-strukturerad intervjuguide, intervjuerna analyserades tematiskt. Resultat: Tre huvudteman om lidande framkom i intervjuerna: Att vara människa, skapar både möjlighet och hinder för mening och läkande, kärlekens betydelse. Diskussion: Analysen pekade på en mångfald av uppfattningar om lidandet och sättet att arbeta med det. Den visade dock på en samstämmighet vad gäller upplevelsen av kärlekens betydelse för lidandet och pekade på att psykodynamiska terapeuter, i diskussionen om konfidenters lidande i kärlek och religion, närmade sig existentiella perspektiv. / Introduction: Depression is one of the most common psychiatric diagnoses in Sweden (Folkhälsomyndigheten, 2017). Depression causes life to feel meaningless, which gives it an existential dimension. Studying psychotherapists’ views of suffering from an existential and psychoanalytic perspective is motivated since research has shown that interventions that address it have been successful. The purpose of the study was to investigate this question further. Research questions: How do psychotherapists envisage mental suffering and how do they work with it in therapy? What significance do psychotherapists attribute to the importance of the existential dimensions for mental suffering? Method: A qualitative has been used. Six therapists were interviewed based on a semi-structured interview guide, the interview responses were thematically analysed. Results: Three main themes on suffering emerged in the interview responses: To be human, suffering creates both opportunities and obstacles to meaning and healing, the importance of love. Discussion: The interviews indicated a variety of ideas about suffering and ways of working with it. However, they pointed to a consensus regarding the experience of the importance of love for suffering and showed that psychodynamic therapists, in the discussion of clients’ suffering in love and religion, approached existential perspectives.

Made available in DSpace on 2015-04-11T13:59:17Z (GMT). No. of bitstreams: 1 luciana.pdf: 1011678 bytes, checksum: 80618e2b84cf3cebc274dd2a82863e9b (MD5) Previous issue date: 2011-03-30 / O objeto de estudo da presente pesquisa foi a análise da prática terapêutica em um Centro de Atenção Psicossocial CAPS na cidade de Manaus, considerando o processo de desinstitucionalização no contexto historio cultural da Reforma Psiquiátrica Brasileira. Os objetivos específicos focalizaram: a) a construção histórica do modelo asilar ao modelo territorial atual no Estado do Amazonas; b) a dinâmica micro-institucional do CAPS estudado; c) a complexidade e contradições do trabalho da equipe multiprofissional; d) os efeitos dessa nova prática em saúde mental através de um estudo de caso clínico, destacando o percurso terapêutico antes e durante seu tratamento no CAPS. Os pressupostos teóricos esclarecem sobre o processo de desinstitucionalização, que orientam esta análise da prática terapêutica. Compreende-se que esse processo, de rompimento com o modelo das instituições totais, tem favorecido a construção de novas práticas de atenção psicossocial, voltadas a ações terapêuticas de base territorial e de inserção social. Foi utilizado o método da observação participante (em psicologia clínica), sendo a posição da observadora participante para o estudo da prática terapêutica o de observadora clínica. Como instrumentos de coleta: material documental, diário de notas e entrevista semi-estruturada. Os dados foram analisados, a partir dos pressupostos delimitados para essa pesquisa. Como observação da prática terapêutica verificou-se, no contexto histórico-cultural pesquisado, a significação de uma prática terapêutica em que se valoriza a relação terapêutica dialógica e acolhedora. Percebe-se, ainda, um movimento processual para uma prática inclusiva, com dificuldades para o acionamento das redes sociais. Conclui-se que, para além de respostas na efetivação das políticas públicas em saúde mental, o que se propõe para o serviço é encontrar alternativas técnico-profissionais internas que possibilitem um planejamento de ações em conjunto com as redes institucionais e sociais do território.

Cette thèse porte sur la compréhension de l'expérience de la douleur chronique à travers les rôles de facteurs psychosociaux : Douleur chronique comprise en tant que « douleur en situation » et socialement construite, et expérience de la douleur enracinée dans et par la vie sociale. L'expérience est ainsi fonction des significations et du sens que le sujet donne à ses situations de douleur, par l'importance des théories subjectives ou 'profanes' et des représentations sociales. De ce fait, la compréhension de l'expérience de la douleur nous amène à penser le rôle du savoir expérientiel des patients, et ainsi la place du « patient-expert » dans le système de soin. Nous explorons, par ailleurs, le fait que l'expérience, le sens donné à la douleur et le vécu auraient un lien avec la qualité de vie et la souffrance psychologique. Nos intérêts s'élargissent ainsi à la compréhension des déterminants de la qualité de vie et de la santé psychologique, notamment à travers le rôle du rapport au temps et des insertions sociales des patients. De façon plus élargie, cette thèse porte également sur les déterminants de la participation aux études longitudinales et à la prise en charge des patients au long court. En conséquence, nous inscrivons cette présente thèse dans un cadre pluriméthodologique avec des données quantitatives et discursives dans un objectif de triangulation. / Our research cover the comprehension of the experience of chronic pain through the role of psychosocial factors. These diseases are understood as "pain in situation" and socially constructed; their experience is related to and conditioned by social life. Experience becomes function of meanings and sense that patients give to their pain situations, by the importance of subjective and 'profane' theories, and social representations. Therefore, the understanding of pain experience leads us to question the role of patients' experiential knowledge and the position of the "expert patient" in the health care system. In addition, we explore the fact that the experience and the meaning gave to the pain may be related to quality of life and psychological suffering. Our interests thus broaden to include the understanding of quality of life and psychological health determinants, especially through the role of the relation to psychological time and patients' social insertions. More generally, we study the determinants of involvement in longitudinal studies and long-term patients care. Consequently, we incorporate our research interests within a multi-methodological framework using quantitative and discursive data to create triangulation

Made available in DSpace on 2016-03-22T17:27:01Z (GMT). No. of bitstreams: 1 Dissert Carmen Lopes.pdf: 95685 bytes, checksum: 14e3f1859bd36ee0efaa5d824708e7d1 (MD5) Previous issue date: 2005-05-06 / This paper presents the data of a cross-sectional made in two suburbs communities of a city in the south of Brazil in 2002, where are located UCPel s Health Centers. The objective was evaluate health mental conditions in these populations to improve the service given. In a total, 848 residents were interviewed with an average familiar wages of R$ 478,00; average age 41,1 and average schooling 6,5 years. It was evaluated psychiatric morbidity among relatives through a criterion of psychiatric hospital admissions. The implications most quoted about living with relatives who suffer from psychiatric morbidity were the restriction on work and on keeping a social contact. The prevalence of minor psychiatric disorders was of 33,8%, indicating the need of care. / Este artigo apresenta dados de um estudo transversal realizado em duas comunidades periféricas da cidade de Pelotas, onde se localizam os Postos de Saúde da UCPel. O objetivo foi avaliar condições de saúde mental nestas populações para aperfeiçoar o atendimento prestado. No total foram entrevistados 848 moradores com renda familiar média de 478,8 reais; idade média de 41,1 anos e escolaridade média de 6,5 anos. Avaliou-se morbidade psiquiátrica entre os familiares através do critério de internações psiquiátricas. As implicações mais citadas em coabitar com parentes portadores de morbidade psiquiátrica foram a restrição em trabalhar e de manter contato social. A prevalência de Transtornos Psiquiátricos Menores foi de 33,8% apontando para a necessidade de atenção neste sentido.

Analisa-se a experiência do sofrimento psíquico a partir de relatos de homens e mulheres usuários de um serviço público de saúde do município de Araraquara-SP. Considera-se a construção social do sofrimento psíquico e, portanto a conformação dos valores e normas de uma determinada sociedade e época histórica. Em outras palavras, aquilo que parece ser algo extremamente individual, ou seja, a vivência de um conjunto de mal-estares no âmbito subjetivo, expressa regularidades que são conformadas por uma dada configuração social. Utilizou-se entrevistas semiestruturadas com usuários do Centro de Atenção Psicossocial (CAPS) homens e mulheres, analisadas na perspectiva das relações sociais de gênero e sob o contexto das mudanças no sistema psiquiátrico brasileiro a partir da Luta Antimanicomial. Conclui-se que o desafio a ser enfrentado pela sociedade brasileira contemporânea na construção de políticas públicas na área de saúde mental deve levar em consideração as questões postas pela perspectiva das relações sociais de gênero / This research analyses the experience of the psychological suffering based on the testimonies of men and women users of a public health service of the municipality of Araraquara SP. It is considered the social construction of the psychological suffering and, therefore, the arrangement of values and norms of a certain society and historical epoch. In other terms, what seems to be something extremely individual, that is to say, the experience of a whole of illnesses in the subjective scope, expresses regularities that are conformed by a certain social configuration. It was used semistructured interviews with users of the Center of Psychosocial Attention (CAPES) men and women, analyzed through the perspective of the social gender relations and under the context of the changes of the Brazilian psychiatric system starting from the Anti Asylum Fight. The conclusion is that the challenge to be faced by the contemporary brazilian society in the construction of public policies in the field of mental health must take into account the questions raised by the perspective of the social gender relations

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Na contemporaneidade, padrÃes ideais de magreza, beleza, juventude e saÃde sÃo disseminados pelos discursos cientÃfico e midiÃtico, sendo impostos sutilmente pela âindÃstria do bem-estarâ. Isso contribui para o corpo ser visto pela lÃgica capitalista como um âobjeto de consumoâ submetido Ãs exigÃncias mercadolÃgicas. Os discursos mÃdico e dos media se expressam como referenciais aos sujeitos contemporÃneos, sendo o primeiro baseado na perfeiÃÃo dos corpos, enquanto o segundo no consumo e no embelezamento. O presente trabalho foi tecido por um viÃs interdisciplinar, visto que dialogamos com a Psicologia Social, PsicanÃlise, Antropologia, HistÃria e Sociologia. Apontamos o corpo em sua complexidade ao concebÃ-lo, concomitantemente, como social, singular, psÃquico, orgÃnico e cultural. Nesse sentido, uma intervenÃÃo na sua dimensÃo orgÃnica, a exemplo da cirurgia estÃtica, nÃo ocorre apartada de suas outras dimensÃes, uma vez que todas estas estÃo intimamente vinculadas. Objetivamos investigar os sentidos, sociais e subjetivos, do corpo metamorfoseado de mulheres que realizaram cirurgias estÃticas, repetidas vezes, considerando o atual contexto da sociedade de consumo. O corpo està sendo alvo de promessas de completude e de satisfaÃÃo plena, oriundas, sobretudo, dos media e da ciÃncia. O sofrimento, contudo, nÃo pode ser extirpado por completo, apesar de o bem-estar e o corpo perfeito serem alvos do atual mercado. Daà se analisar, tambÃm, as experiÃncias de sofrimento psÃquico relacionadas com as constantes cirurgias estÃticas e suas implicaÃÃes psicossociais. A abordagem qualitativa orientou este estudo no qual foram entrevistadas sete mulheres mediante entrevistas semi-estruturadas. Organizamos os relatos e os discutimos arrimados em trÃs categorias de anÃlise: a contraposiÃÃo entre o âfora-de-siâ e o âdentro-de-siâ, a contradiÃÃo entre o sofrimento e a felicidade, alÃm de o corpo ideal feminino ser legitimado pelas âindÃstrias da beleza e da saÃdeâ. Observamos que, no contexto do consumismo, o corpo assume lugar de objeto, todavia, ao escutarmos as mulheres entrevistadas, atentamos, na qualidade de psicÃloga, para um âcorpo sujeitoâ, tal como nos apresenta a PsicanÃlise, detentor de uma histÃria e uma singularidade. Essa acepÃÃo de âcorpo sujeitoâ se contrapÃe, severamente, à concepÃÃo de âcorpo objetoâ tomada pelos discursos que visam a massificar a experiÃncia subjetiva. Os discursos, referidos acima, tentam tamponar aquilo que diferencia cada sujeito, visto que a singularidade tem sido, constantemente, ameaÃada por forÃas massificadoras que visam à padronizaÃÃo, principalmente no tocante aos interesses capitalistas. Ressaltamos que nÃo desprezamos as conquistas da Medicina na atualidade, principalmente no que diz respeito aos avanÃos tecnocientÃficos relacionados Ãs cirurgias estÃticas, mas alertamos para possÃveis excessos, ou mesmo para a realizaÃÃo desses procedimentos, sem que ocorra uma implicaÃÃo subjetiva, uma atribuiÃÃo de sentidos e uma reflexÃo crÃtica. Esperamos que esta investigaÃÃo possa contribuir com as Ãreas da saÃde e da publicidade nas suas interfaces com a Psicologia Social e a PsicanÃlise, possibilitando estudos e intervenÃÃes interdisciplinares. / Nowadays, science and communication discourses propagate ideal patterns for thinness, beauty, youngness and health, which are subtly imposed by âwellness industryâ. It fosters the capitalist logic of body, that is seen as a âconsumption objectâ, submitted to market exigencies. Medical and media discourses happen to be referential to contemporary subjects, the former based on bodies perfection and the latter based on consumption and embellishment. The current study received an interdisciplinary outlook, since it exchanges ideas with Social Psychology, Psychoanalysis, Anthropology, History and Sociology. The research approaches body within its inner complexity as a social, singular, psychological, organic and cultural entity. In such sense, an intervention in its organic dimension, as aesthetic surgery, does not happen detached from its other dimensions, since all of them are intimately engaged. This study aims at investigating social and subjective senses of metamorphosed bodies of women who were repeatedly submitted to aesthetic surgeries, considering consumption societyâs current context. Body is being target of promises of full completeness and satisfaction, mostly egress from media and science. However, suffering cannot be fully expurgated, even though wellness and the idea of a perfect body are targets of current market. That is why this research analyses in addition experiences of psychological suffering related to recurrent aesthetical surgeries and their psychosocial implications. The study, which followed a qualitative approach, interviewed seven women, trough semi-structured interviews, and arranged reports, as well as researcher placed them into three analysis categories: the contraposition involving âout of oneselfâ and âinside of oneselfâ, the contradiction between suffering and happiness, and, besides, the body, legitimated by âbeauty and health industriesâ. The research points that, within consumption context, body takes the place of object, but, hearing women, the researcher, as a psychologist, attempted to a âsubject bodyâ, as Psychoanalysis introduces, which comprises a history and a singularity. Such idea of âsubject bodyâ is strongly opposed to the conception of âobject bodyâ, which discourses aiming at massifying subjective experience adopt. Such discourses try to hide things that differentiate each individual, since singularity has been often menaced by massifying forces which aim to standardize, especially on capitalist interests. The study argues that it does not undervalue Medicine conquests, mainly in the concerning to techno-scientific advances related to aesthetic surgeries, but it highlights possible excesses, or even to carry out such procedures, without a subjective implication, a sense attribution and a critical reflection. So, this work aims at contributing to health and advertising areas in their interfaces with Social Psychology and Psychoanalysis, triggering studies and interdisciplinary interventions

Analisa-se a experiência do sofrimento psíquico a partir de relatos de homens e mulheres usuários de um serviço público de saúde do município de Araraquara-SP. Considera-se a construção social do sofrimento psíquico e, portanto a conformação dos valores e normas de uma determinada sociedade e época histórica. Em outras palavras, aquilo que parece ser algo extremamente individual, ou seja, a vivência de um conjunto de mal-estares no âmbito subjetivo, expressa regularidades que são conformadas por uma dada configuração social. Utilizou-se entrevistas semiestruturadas com usuários do Centro de Atenção Psicossocial (CAPS) homens e mulheres, analisadas na perspectiva das relações sociais de gênero e sob o contexto das mudanças no sistema psiquiátrico brasileiro a partir da Luta Antimanicomial. Conclui-se que o desafio a ser enfrentado pela sociedade brasileira contemporânea na construção de políticas públicas na área de saúde mental deve levar em consideração as questões postas pela perspectiva das relações sociais de gênero / This research analyses the experience of the psychological suffering based on the testimonies of men and women users of a public health service of the municipality of Araraquara SP. It is considered the social construction of the psychological suffering and, therefore, the arrangement of values and norms of a certain society and historical epoch. In other terms, what seems to be something extremely individual, that is to say, the experience of a whole of illnesses in the subjective scope, expresses regularities that are conformed by a certain social configuration. It was used semistructured interviews with users of the Center of Psychosocial Attention (CAPES) men and women, analyzed through the perspective of the social gender relations and under the context of the changes of the Brazilian psychiatric system starting from the Anti Asylum Fight. The conclusion is that the challenge to be faced by the contemporary brazilian society in the construction of public policies in the field of mental health must take into account the questions raised by the perspective of the social gender relations

Apart from the personal and socioeconomic burdens of dementia, the immense, intangible emotional and psychological suffering endured by dementia patients, their carers and families are difficult to quantify. Alzheimer’s dementia (AD) accounts for over 50% of all dementias and is responsible for a large percentage of morbidity and mortality in older adults. It is also recognised as a disease qualitatively distinct from the normal ageing process. Identified almost 95 years ago by Alois Alzheimer, it poses a seminal problem, which in the twenty-first century is compounded by the predicted extension in human longevity. Caregivers thus bear a considerable financial, social and emotional burden due to the progressive debilitating nature of the disease. It is hypothesised that social support buffers the individual from the negative emotional effects of stressful circumstances associated with the caregiving process; and although the inevitable course of the disease cannot be stopped, improving support to caregivers may decrease feelings of isolation and improve psychological health. Caregivers of AD patients often report experiencing a lack of social support due to the nature and progression of this disease. This study thus aims to investigate the relationship between real and/or perceived social support and psychological health (depression, loneliness, and perceived burden of care) amongst a cohort of Alzheimer’s caregivers. The following standardised measuring instruments were used to elicit data: the Zarit Burden Interview (ZBI), the Beck Depression Inventory (BDI-II), UCLA Loneliness Scale, Personal Resource Questionnaire (PRQ85) and a biographical questionnaire. Data were analysed using correlation and regression statistical techniques. The main findings of this study were that there is a significant positive correlation between loneliness and depression; loneliness and personal strain (burden) as well as both role and personal strain (burden) with depression. A significant negative correlation was also found between perceived social support and loneliness. Additional findings were that participants with higher educational qualifications experienced more personal strain and role strain (burden); caregivers with patients in the two younger age groups scored higher on the BDI-II; and the cognitive status of the patient correlated with the burden experienced by the caregiver. A significant negative correlation between summaries of reactions (burden) and duration of caregiving was also reported. / Dissertation (MA)--University of Pretoria, 2008. / Psychology / unrestricted

Le Liban est fondé sur une société patriarcale dont l’une des multiples exigences est la naissance d’un garçon au sein des familles. Nous avons pu constater que cette exigence est relayée par les femmes elles-mêmes qui disent souhaiter plus que tout la maternité d’un fils, si possible le premier né. Ce désir si souvent exprimé semble donner raison à la théorie phallo-centrée de Freud qui pose pour la femme une envie primaire du pénis et de sa résolution par la naissance d’un enfant mâle. Pourtant, d’autres théories sur le développement psychosexuel de la femme ont vu le jour déjà chez les disciples directs de Freud puis dans les théorisations psychanalytiques contemporaines. Nous avons voulu explorer cette question en étudiant, grâce à des entretiens cliniques de recherche et la passation de projectifs, le développement psychosexuel de jeunes femmes libanaises à qui depuis leur plus jeune âge, leur entourage et particulièrement leur mère, leur avait explicitement évoquer le fait qu’elles avaient désiré durant leur grossesse un garçon.Si cela nous ne nous a pas permis de trancher le débat entre théorie phallo-centrée et les autres théories, notre travail a mis en évidence que quand le désir inconscient, certes mu par ses conflits inconscients reliés à son propre développement psychosexuel, rencontre le désir de répondre aux mieux à la contrainte sociale de la société patriarcale, la femme bénéficie d’un certain épanouissement. En revanche, force est de constater que dans le cas contraire, les femmes paient une lourde tribu sous formes d’accidents ou d’événements périnataux volontaires et d’une grande souffrance psychique. On a pu aussi mettre en évidence, l’induction de troubles dans les relations précoces avec leur nouveau-né fille qui font le lit à une répétition trans-générationnelle mortifère. Ainsi, à leur tour et en dépit du fait qu’elles déplorent avoir souffert de leur statut de filles-nées, elles désirent donner naissance à un garçon. / Lebanon is based on a patriarchal society whose multiple demands include the birth of a boy within families. We have seen that this requirement is supported by the women themselves, who say they want more than anything the motherhood of a son, if possible the first born. This desire so often expressed seems to support Freud's phallocentric theory, which poses for women a primary desire for the penis and its resolution through the birth of a male child. However, other theories on the psychosexual development of women have already emerged among Freud's direct disciples and then in contemporary psychoanalytical theorizations.We wanted to explore this question by studying, through clinical research interviews and the passing of projective tests, the psychosexual development of young women to whom from an early age, their environment and especially their mother, had explicitly told them that they had wanted a boy during their pregnancy.If this did not allow us to settle the debate between phallocentric theory and other theories, our work has shown that when the unconscious desire, certainly driven by its unconscious conflicts related to its own psychosexual development, meets the desire to respond as well as possible to the social constraint of patriarchal society, women enjoy a certain fulfillment. On the other hand, it must be noted that, otherwise, women pay a heavy price in the form of accidents or voluntary perinatal events and great psychological suffering. We have also been able to highlight the induction of disorders in early relationships with their newborn daughter who make the bed at a deadly transgenerational repetition. Thus, in turn, and despite the fact that they regret having suffered from their status as born girls, they wish to give birth to a boy.

En pleine extension, la population sans domicile fixe (SDF) est devenue une problématique sociétale majeure qui confronte le dispositif de veille sociale à son impuissance. L'objectif de cette recherche est de comprendre comment une frange de la population SDF parvient à entrer dans une dynamique d'insertion quand une autre se chronicise dans sa situation. Pour ce faire, trois groupes sont comparés: un groupe de 24 SDF fréquentant l'hébergement d'urgence, un groupe de 25 SDF inscrits dans une structure d'insertion et un groupe de 25 SDF, "chronicisés", accueillis dans une structure de stabilisation. Un entretien semi-directif est mené auprès de chaque participant, et sont administrées l'échelle d'anxiété et de dépression (Zigmond et Snaith, 1983) et l'échelle d'estime de soi de Rosenberg (1965). une adaptation a été nécessaire pour l'échelle de lieu de contrôle (IPAH-Jutras, 1987) et pour le Questionnaire de Soutien Social Perçu (Bruchon-Schweitzer et Quintard, 2001), également administrés. de nombreuses variables différencient significativement les groupes SDF. Ces résultats permettent d'établir des liens entre le type de prise en charge d'une part, la souffrance psychique, la qualité du lien social et la perturbation identitaire d'autre part. Totalement déstructurante pour les SDF, la situation d'hébergement d'urgence est source d'une intense souffrance psychique. Ayant préservé ce qui fonde leur identité, certains SDF parviennent à s'appuyer sur le lien social pour s'inscrire dans une dynamique d'insertion. A l'inverse, d'autres mettent en place des défenses psychiques et des stratégies de survie qui ont l'effet paradoxal de favoriser leur chronicisation tout en diminuant drastiquement leur souffrance. C'est en considérant la santé mentale des SDF et leurs stratégies d'adaptation que nous pourrons améliorer le dispositif afin que la prise en charge soit adaptée à cette population. / The growing population of homeless has become a major social issue which forces the Social Watch to face its own inefficiency. The purpose of this study is to understand how a part of the homeless manages to achieve a process of social reintegration while another stays in a chronic state of homelessness. To do so, three groups have been compared: a group of 24 homeless people using the emergency center, a group of 25 homeless registered in a social reintegration center and a group of 25 homeless, in a "chronic state of homelessness", sheltered in a center of stabilization. A semi-structured interview is carried out with each participant. their are assessed on the Hospital Anxiety and Depression Scale (Zigmond and Snaith, 1983) and the Rosenberg Self-Esteem Scale (1965). An adaptation is necessary for the Locus of Control Scale (IPAH - Jutras, 1987) and for the Perceived Social Support Questionnaire (Bruchon-Schweitzer et Quintard, 2001), which are also used. Numerous variables clearly dissociate these groups of homeless people. The results show the link between the type of social care, mental suffering, the strength of the social link and the disruption of one'x identuty. Deeply destructive for homeless people, the emergency center's environment is a source of intense psychological sufferinf. Having preserved what shapes their identity, some homeless manage to rely on this social link to start a pocess of integration. On the contrary, others build psychological fences and strategies to survive that paradoxically reinforce their chronic homelessness while drastically reducing their sufferings. By taking homeless people's mental health into account and their strategies to adapt, we will be abl to improve our plan of action so that this population can be taken care of properly.