Desde a metade do século XX os grupos de ajuda mútua de Narcóticos Anônimos vêm se firmando como uma alternativa terapêutica válida para pessoas que desenvolvem a síndrome de "dependência química". Surgidos como uma dissidência dos Alcoólicos Anônimos, estes grupos utilizam de maneira pragmática o conceito de "adicção" para nomear esta doença e classificam-na como incurável, sendo possível apenas o controle dos sintomas. Desta forma, a sua proposta terapêutica é pautada na abstinência total do uso de qualquer substância psicoativa e em um conjunto de princípios éticos, espirituais e subjetivos que devem ser seguidos pelos participantes com o objetivo de "vivenciarem a recuperação" através de uma mudança radical de visão de mundo. Este trabalho tem como universo de pesquisa a rede de Narcóticos Anônimos da cidade de Porto Alegre. Dentro deste universo empírico um dos objetivos da pesquisa é demonstrar, através da apresentação de quatro histórias de vida de participantes dessa rede, que a categoria "membro de Narcóticos Anônimos" é menos homogênea do que aparenta ser; há espaço para a apropriação instrumental deste universo simbólico e também para a preservação de particularidades subjetivas no processo de incorporação dessa identidade. Outro objetivo é apresentar as implicações da utilização do seu conceito próprio de "adicção" enquanto doença incurável. Finalmente, através de um relato etnográfico, procura apresentar as reuniões do grupo como um espaço marcadamente ritual, mas que preserva momentos de interação e difusão de símbolos também "fora do ritual". / Since the half of the twentieth century mutual help groups such as Narcotics Anonymous have been establishing themselves as a valid therapeutic alternative for people who develop the "chemical dependence" syndrome. Emerging as a dissidence of Alcoholics Anonymous, these groups apply a pragmatic interpretation of the "addiction" concept to name that disease and classify it as incurable; they say that only the symptoms can be controlled. This way, their therapeutic approach is based on the total abstinence of any psychoactive substance use and in a set of ethical, spiritual and subjective principles that must be followed by the members with the objective of "living the recovery" through a radical change of subjective engagement in the world. This work's universe of research is the Narcotics Anonymous' network in the city of Porto Alegre. Inside this empirical universe one of the research's objectives is to demonstrate, by the presentation of four life stories of this networks' participants, that the category "Narcotics Anonymous' member" is less homogeny than it apparent to be; there is some space to instrumental appropriation of this symbolic universe and also to the preservation of subjective particularities in the process of incorporating this identity. Another objective is to discuss the implications of using the "addiction" category as a synonymous of incurable disease. Finally, this research presents an ethnographic description of the groups' meetings as composed by a rigid ritual structure, but which also preserves moments of interaction and symbol dissemination that lie "outside from the ritual".

Ce travail propose d’interroger la constitution du lien thérapeutique avec des enfants présentant des troubles autistiques ou psychotiques. Ces pathologies narcissiques-identitaires considérées comme troubles majeurs de l’intersubjectivité soumettent nos dispositifs de soins à de constants ajustements, pour accueillir ce que ces sujets nous livrent avec insistance, et qui prend la forme de comportement répétitifs. Nous sommes dans une pratique clinique extrême, aux confins du langage qui nous oblige à repenser notre cadre interne, à redéfinir nos postures, pour soutenir un travail de symbolisation. Retirés dans une sensorialité réconfortante ou absorbés dans des activités ritualisées, ces sujets nous engagent psychiquement et corporellement à « trouver-créer » comment leur faire signe pour établir le contact et relancer les processus de réflexivité entravés. La trajectoire vers l’autre, détour essentiel à la subjectivation des éprouvés corporels est à construire. Ce travail est une modélisation de cette trajectoire du retrait devant l’objet à l’attrait pour l’objet. Deux notions sont développées, celle de l’effacement et celle de l’oscillatoire, qui viennent figurer la dynamique de la rencontre, faite de rapprochements et d’éloignements. Les « états de présence » du thérapeute sont un rouage essentiel de ce processus d’attraction, dont l’accomplissement sera « le partage d’affects ». / This work presents an investigation of the therapeutic relation to children with autistic or psychotic problems. These narcissistic-identity pathologies, considered as a major problem of intersubjectivity, submit our instruments of care to constant adjustment; in order to harvest what these subjects insistently present in the form of repetitive behaviors. We find ourselves in an extreme of clinical practice, at the limits of language, which forces us to reconsider our internal framework and redefine our positions with the aim of supporting a task of symbolization. Withdrawn into a comforting sensoriality or absorbed in ritualized activities, these subjects engage us psychically and corporally to "find-create" how to draw attention so as to establish contact and relaunch the inhibited processes of reflection.The trajectory towards the other, an essential detour towards the subjectivizing of corporeal feelings, is in need of construction. This work models that trajectory from withdrawal before the object to the attraction towards the object. Two concepts are developed, that of erasure and of the oscillatory. They come to fashion the dynamics of interaction, composed of advances and retreats. The "states of presence" of the therapist are an essential cog in the process of attraction, for which attainment becomes "affective sharing".

The research deals with the empowerment of adolescent victims of family violence. The purpose of the study was to give an account of the therapeutic intervention process of two case studies, by means of a descriptive, qualitative type of research. This research was executed via semi-structured interviews by the researcher. The population in the study was limited to adolescent victims between the age of twelve to eighteen years, who are victims of family violence. The sample in this study was two respondents. The children are students at a high school in Roodepoort. After completion of the empiric study it was concluded that the adolescent who is exposed to family violence, is empowered if a therapeutic process - like the one suggested by Oaklander (1994:289) which applies gestalt play therapeutic techniques - is followed. As clearly shown in the literature, the researcher came to the conclusion that family violence has a destructive effect on the adolescent and that he can be empowered by gestalt play therapy. OPSOMMING Die navorsing handel oor die bemagtiging van adolessente slagoffers van gesinsgeweld. Die doel van die studie was om deur middel van 'n beskrywende, kwalitatiewe tipe navorsing die terapeutiese intervensieproses van twee gevallestudies te beskryf. Hierdie navorsing het met behulp van semi-gestruktureerde onderhoudvoering geskied. Die populasie in die studie was begrens tot adolessente slagoffers tussen die ouderdom twaalf tot agtien jaar wat slagoffers van gesinsgeweld is. Die steekproef in hierdie studie was twee respondente. Die kinders is verbonde aan 'n hoërskool te Roodepoort. Daar is na afloop van die empiriese studie tot die gevolgtrekking gekom dat indien 'n terapeutiese proses - soos wat deur Oaklander (1994:289) voorgestel word met die benutting van gestaltspelterapeutiese tegnieke - deurloop word, die adolessent wat aan gesinsgeweld blootgestel word, bemagtig word. Soos ook uit die literatuur duidelik blyk, het die navorser die afleiding gemaak dat gesinsgeweld vernietigend op die adolessent inwerk en dat hy deur gestaltspelterapie bemagtig kan word. / Social work / MDIAC (PLAY THERAPY)

Many of the sources indicated in this work are classical and not updated due to the fact that the origins of Gestalt Philosophy are found in classical works / Verskeie van die geraadpleegde bronne in die literatuurhoofstukke verteenwoordig klassieke werke wat nie binne die erkende periode vir relevante wetenskaplike navorsing val nie. Die oorsprong van die Gestalt Filosofie wat in hierdie studie benut is, word in hierdie klassieke werke gevind en is ook in hierdie werke geraadpleeg / The Gestalt approach was used as the contextual framework to explore how music can be used as a therapeutic medium in the treatment of the emotionally traumatized child. Music as a sensory experience was used during the therapeutic process with each case study, to facilitate the child's process towards healing. The conceptual framework of music as a therapeutic medium was researched in depth to bring clarity to the influence it has on the emotional well-being of the child. The child who entered into therapy was selected according to specific criteria, with the experience of emotional trauma being priority. The researcher also studied the concept of emotional trauma in depth and the consequences it has on a child's overall functional ability. Music was used as an expressive technique during the therapeutic process with each child. The conclusion drawn from this study indicated that the gestalt approach can be applied effectively in using music as a therapeutic medium in the treatment of the emotionally traumatized child. / Die Gestalt benadering is gebruik in hierdie navorsing ten einde 'n kontekstuele raamwerk daar te stel waarbinne musiek as terapeutiese medium in die behandeling van emosionele trauma in kinders gebruik kon word. Musiek kan beskryf word as 'n sensoriese ervaring. Hierdie sensoriese ervaring is binne die terapeutiese proses toegepas ten einde die kind se herstelproses te fasiliteer. Die studie is binne die navorsingskonteks van gevallestudieprosedures gedoen. Musiek is binne die konseptuele raamwerk bestudeer en nagevors ten einde die terapeutiese waarde daarvan in diepte te ondersoek. Hierdie in-diepte ondersoek het aan die navorser 'n duidelike beeld gegee hoe dit toegepas kon word in terapie. Deur dit toe te pas in terapie is die invloed van musiek op die emosionele welsyn van die getraumatiseerde kind gedokumenteer. Die navorsingskriteria vir insluiting in die ondersoek was gegrond op die literatuurondersoek en het onder meer die belewing van trauma ingesluit. Die belewing van emosionele trauma en invloed op die kind se geheelfunksionering was dus 'n verdere eenheid van ontleding en is in diepte deur die navorser bestudeer. Musiek is dus gebruik as 'n ekspressiewe tegniek tydens die terapeutiese proses met elke gevallestudie. Die gevolgtrekking waartoe in hierdie studie gekom kon word is dat musiek binne die konteks van die gestalt benadering suksesvol in die hantering van emosionele trauma by die kind gebruik kan word. / Practical Theology / M.Diac. (Play Therapy)

Many of the sources indicated in this work are classical and not updated due to the fact that the origins of Gestalt Philosophy are found in classical works / Verskeie van die geraadpleegde bronne in die literatuurhoofstukke verteenwoordig klassieke werke wat nie binne die erkende periode vir relevante wetenskaplike navorsing val nie. Die oorsprong van die Gestalt Filosofie wat in hierdie studie benut is, word in hierdie klassieke werke gevind en is ook in hierdie werke geraadpleeg / The Gestalt approach was used as the contextual framework to explore how music can be used as a therapeutic medium in the treatment of the emotionally traumatized child. Music as a sensory experience was used during the therapeutic process with each case study, to facilitate the child's process towards healing. The conceptual framework of music as a therapeutic medium was researched in depth to bring clarity to the influence it has on the emotional well-being of the child. The child who entered into therapy was selected according to specific criteria, with the experience of emotional trauma being priority. The researcher also studied the concept of emotional trauma in depth and the consequences it has on a child's overall functional ability. Music was used as an expressive technique during the therapeutic process with each child. The conclusion drawn from this study indicated that the gestalt approach can be applied effectively in using music as a therapeutic medium in the treatment of the emotionally traumatized child. / Die Gestalt benadering is gebruik in hierdie navorsing ten einde 'n kontekstuele raamwerk daar te stel waarbinne musiek as terapeutiese medium in die behandeling van emosionele trauma in kinders gebruik kon word. Musiek kan beskryf word as 'n sensoriese ervaring. Hierdie sensoriese ervaring is binne die terapeutiese proses toegepas ten einde die kind se herstelproses te fasiliteer. Die studie is binne die navorsingskonteks van gevallestudieprosedures gedoen. Musiek is binne die konseptuele raamwerk bestudeer en nagevors ten einde die terapeutiese waarde daarvan in diepte te ondersoek. Hierdie in-diepte ondersoek het aan die navorser 'n duidelike beeld gegee hoe dit toegepas kon word in terapie. Deur dit toe te pas in terapie is die invloed van musiek op die emosionele welsyn van die getraumatiseerde kind gedokumenteer. Die navorsingskriteria vir insluiting in die ondersoek was gegrond op die literatuurondersoek en het onder meer die belewing van trauma ingesluit. Die belewing van emosionele trauma en invloed op die kind se geheelfunksionering was dus 'n verdere eenheid van ontleding en is in diepte deur die navorser bestudeer. Musiek is dus gebruik as 'n ekspressiewe tegniek tydens die terapeutiese proses met elke gevallestudie. Die gevolgtrekking waartoe in hierdie studie gekom kon word is dat musiek binne die konteks van die gestalt benadering suksesvol in die hantering van emosionele trauma by die kind gebruik kan word. / Philosophy, Practical and Systematic Theology / M.Diac. (Play Therapy)

Cette thèse propose d’interroger un dispositif de groupe thérapeutique à médiation sensorielle olfactive. Il a été créé comme une modalité d’accueil et d’écoute de sujets criminels, rencontrés dans le cadre d’une pratique en service psychiatrique en milieu carcéral. Ce dispositif innovant se fonde sur le besoin de créativité suscité par la confrontation avec une forme de clinique de l’extrême. Le choix de l’olfaction, comme modalité de contact, ouvre un champ de réflexion original, au carrefour de la philosophie, de la psychologie développementale, des neurosciences et de la psychanalyse. La notion « d’acte-sentir » est une proposition de modélisation des processus en jeu au contact du médium sensoriel olfactif. Proposé dans des pratiques groupales ou individuelles, le médium sensoriel olfactif favorise l’émergence de formes primaires de symbolisation, considérées comme des traces d’une subjectivité en déroute. Cette écoute du langage sensori-moteur et de ses formes particulières, suscitées par la mobilisation de l’odorat, est une proposition d’un abord psychothérapeutique de sujets aux prises avec des souffrances inexprimables voire insoutenables, engageant le clinicien « corps et âme ». / This thesis questions an innovative group setting, using an olfactive medium. It was started to meet and to listen to criminal patients in a psychiatric ward in prison. This new practice relys on the need to invent a way to react to the extreme seriousness of the mental illnesses in this ward. The choice of smell, as mean to get in touch, opens a wide field of reflections at the cross roads of philosophy, developmental psychology, neurosciences and psychoanalytical theory. “L’acte-sentir” the sensing-act is a proposal to pattern the different processes linked to smell as a medium. This work fits in groups or individual set-ups. Primary forms of symbolization appear with this medium, and illustrate a lost subjectivity. Listening to these words and helping associative work, is therapeutic with these suffering patients, who cannot speak easily. This work request a full body and mind implication. Use of the sens of smell to attempt to make sens to nonsense.

The research deals with the empowerment of adolescent victims of family violence. The purpose of the study was to give an account of the therapeutic intervention process of two case studies, by means of a descriptive, qualitative type of research. This research was executed via semi-structured interviews by the researcher. The population in the study was limited to adolescent victims between the age of twelve to eighteen years, who are victims of family violence. The sample in this study was two respondents. The children are students at a high school in Roodepoort. After completion of the empiric study it was concluded that the adolescent who is exposed to family violence, is empowered if a therapeutic process - like the one suggested by Oaklander (1994:289) which applies gestalt play therapeutic techniques - is followed. As clearly shown in the literature, the researcher came to the conclusion that family violence has a destructive effect on the adolescent and that he can be empowered by gestalt play therapy. OPSOMMING Die navorsing handel oor die bemagtiging van adolessente slagoffers van gesinsgeweld. Die doel van die studie was om deur middel van 'n beskrywende, kwalitatiewe tipe navorsing die terapeutiese intervensieproses van twee gevallestudies te beskryf. Hierdie navorsing het met behulp van semi-gestruktureerde onderhoudvoering geskied. Die populasie in die studie was begrens tot adolessente slagoffers tussen die ouderdom twaalf tot agtien jaar wat slagoffers van gesinsgeweld is. Die steekproef in hierdie studie was twee respondente. Die kinders is verbonde aan 'n hoërskool te Roodepoort. Daar is na afloop van die empiriese studie tot die gevolgtrekking gekom dat indien 'n terapeutiese proses - soos wat deur Oaklander (1994:289) voorgestel word met die benutting van gestaltspelterapeutiese tegnieke - deurloop word, die adolessent wat aan gesinsgeweld blootgestel word, bemagtig word. Soos ook uit die literatuur duidelik blyk, het die navorser die afleiding gemaak dat gesinsgeweld vernietigend op die adolessent inwerk en dat hy deur gestaltspelterapie bemagtig kan word. / Social work / MDIAC (PLAY THERAPY)

Text in Afrikaans / Die doel van hierdie studie was om deur die benutting van Gestaltspelterapie, adolessente wat gedragsprobleme openbaar, bewus te maak van hulself, ten einde hul toe te rus om hul lewenssituasie meer toereikend te hanteer. Daar is veral gefokus op die aspekte van die Gestaltterapeutiese proses wat die bewustheidsvlakke van die adolessente verhoog het. Ten einde hierdie doel te bereik is die navorsing kwalitatief benader, spesifiek deur ‘n deeglike literatuurstudie en die beskrywing van individuele en groepsgevallestudies. Die informasie is ontleed deur die data-spiraal analise. Vanuit die informasie wat verkry is, deur die integrasie van die literatuur en die empiriese ondersoek, kon die benutting van Gestaltspelterapie met adolessente wat gedragsprobleme openbaar, verken en in diepte beskryf word. / The main purpose of this study was to utilize Gestalt Play therapy with adolescents that display behavior problems, to make them aware of themselves, in order to equip them to handle their life situation more effectively. The focus were specifically on that aspects of the Gestalt therapeutic approach that increase the levels of awareness. In order to achieve this goal the research was approached qualitatively, specifically through a thorough literature study and the describing of individual and group case studies. The information was processed and analised by using the data-spiral analysis. From this information it was possible to explore and describe the utilization value of Gestalt Play therapy with adolescents that display behavior problems. / Social Work / M. Diac. (Spelterapie)

Afrikaans text / Kreatiwiteit is die sentrale tema van hierdie navorsing. Die doel van die navorsing was om die relevansie en waarde van kreatiwiteit in spelterapie met seksueel-misbruikte kinders in die multi-kulturele konteks van Suid-Afrika, te ondersoek en te beskryf. Die navorsing is vanuit „n konstruktivistiese epistemologiese fundering en „n eksistensieel-fenomologiese paradigma gedoen, deur uitgebreide teoretiese en empiriese navorsing. Die teoretiese navorsingproses het eerstens op die holistiese impak van seksuele misbruik op kinders, te midde van hul spesifieke verhoudings- en omgewingskonteks gefokus. Dit het duidelik geword dat seksuele misbruik ernstige trauma by kinders veroorsaak, wat alle modaliteite van die kinders affekteer. Die voorkoms van komplekse posttraumtiese stresversteuring, vanweë langdurige seksuele misbruik, is teoreties beskryf en ook empiries bevestig. „n Sintese van gestalt-, persoonsgesentreerde en logoterapeutiese teorieë, is deur die navorser ontwikkel om die traumatiese nagevolge van die seksuele misbruik kreatief aan te spreek in spelterapie. Die verband tussen en vervlegting van kreatiwiteit en spelterapie is ondersoek en beskryf. Ook die bemagtigende waarde van kreatiwiteit om die kompleksiteit van hierdie kinders se trauma te hanteer is teoreties én empiries nagevors. Die oënskynlik teenstrydige prosesse van kreatiwiteit as „n intuïtiewe, artisitieke, én logiese, kognitiewe proses is ondersoek, om die waarde daarvan vir die navorsingsdoel te bepaal. Die aard en waarde van kreatiewe aktiwiteite en die uitdagings wat gestel word aan die terapeute om kreatief te werk te gaan om die komplekse proses van seksueel-misbruikte kinders aan te spreek, is verder teoreties en empiries nagevors en beskryf. Die noodsaaklikheid van die ondersteunende sisteme vir die kind en terapeut, in belang van „n suksesvolle afloop van terapie, is ook ondersoek, beskryf en beklemtoon.In die empiriese navorsingsproses is veelvuldige gevallestudies, met behulp van vyf deelnemende veldnavorsers gedoen, waar elkeen „n terapeutiese proses gevolg het, volgens riglyne en onder leiding van die navorser, met „n seksueel-misbruikte kind. Die benutting en waarde van kreatiwiteit is ondersoek, beskryf en geëvalueer in die samelopende proses van die navorser met elke deelnemende navorser en kind binne die diverse kulturele konteks in Suid-Afrika. Die teoretiese raamwerk van die navorser en die riglyn vir kreatiewe spelterapie met seksueel-misbruikte kinders is sodoende getoets, verfyn en afgerond as hulpmiddel in die breër Suid-Afrikaanse konteks. Die navorsingsbevinding was dat kreatiwiteit onontbeerlik is in spelterapie met kinders wat seksueel misbruik is in „n multi-kulturele konteks soos Suid-Afrika. / Creativity is the central concept of this research. The goal of the research was to explore the value of creativity in play therapy with sexually abused children in the multi-cultural South-African context. The research was done from a constructivistic epistemological foundation and existential-phenomological paradigms. Extensive theoretical research was supported and substantiated by empirical research. The theoretical research process focused on the holistic impact of sexual abuse on children in and as part of their specific context (field). It became clear that sexual abuse implies severe trauma for the child, and affects all of their modalities, and their functioning in their field. The impact of severe and ongoing sexual abuse on children, as complex post-traumatic stress disorder, was described to clarify their therapeutic needs. A synthesis of gestalt-, person-centred- and logotherapy to address the traumatic after-effects of sexually abused children creatively in play therapy, was developed and described and motivated in the research paper. The concept of creativity was defined and extensively explored an applied in the context of therapy with sexually abused children. Creativity as a cognitive process, a problem solving process, and an artistic process is explored and applied in this context. The value of creative activities, the challenges of being a creative therapist, the supportive role of the supervisor and the systems in society, was explored and described. The empirical research process was done in a participatory way in the form of a multiple case study. Five therapists followed a therapeutic process, according to the guideline, guidance and supervision of the researcher, with a child who had been severely sexually abused. The results from the research confirmed the value and necessity of creativity in dealing with the severe trauma of sexually abused children and bridging gaps in a multi-cultural setting. The theoretical framework of the researcher and a guideline for creative therapy with sexually abused children was tested in the empirical research process, and could be refined and finalised. It was concluded that the use of creativity is crucial in play therapy with sexually abused children in a multi-cultural context, such as South Africa. / Social Work / D. Diac. (Spelterapie)

Text in Afrikaans / Die doel van hierdie studie was om deur die benutting van Gestaltspelterapie, adolessente wat gedragsprobleme openbaar, bewus te maak van hulself, ten einde hul toe te rus om hul lewenssituasie meer toereikend te hanteer. Daar is veral gefokus op die aspekte van die Gestaltterapeutiese proses wat die bewustheidsvlakke van die adolessente verhoog het. Ten einde hierdie doel te bereik is die navorsing kwalitatief benader, spesifiek deur ‘n deeglike literatuurstudie en die beskrywing van individuele en groepsgevallestudies. Die informasie is ontleed deur die data-spiraal analise. Vanuit die informasie wat verkry is, deur die integrasie van die literatuur en die empiriese ondersoek, kon die benutting van Gestaltspelterapie met adolessente wat gedragsprobleme openbaar, verken en in diepte beskryf word. / The main purpose of this study was to utilize Gestalt Play therapy with adolescents that display behavior problems, to make them aware of themselves, in order to equip them to handle their life situation more effectively. The focus were specifically on that aspects of the Gestalt therapeutic approach that increase the levels of awareness. In order to achieve this goal the research was approached qualitatively, specifically through a thorough literature study and the describing of individual and group case studies. The information was processed and analised by using the data-spiral analysis. From this information it was possible to explore and describe the utilization value of Gestalt Play therapy with adolescents that display behavior problems. / Social Work / M. Diac. (Spelterapie)