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PieroSogno

Krista: thirty plus years of treatment in a borderline group

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Abstract

This article describes as a patient, Krista, after twenty-five years of group therapy begins to resolve her capacity to mourn. She has resolved her aloneness issues and has developed the capacity for sadness. She has taken in the solid introject of Dr. Shaskan and has been able to remain “affectively connected to the therapist…in the face of current ambivalence, that is, libidinal object constancy must have been achieved”. Krista has moved from a state of aloneness to one of lonliness in which she can miss Dr. Shaskan and long for him, all manifestations of libidinal object constancy. At the same time, her primitive guilt is modified so that she can experience his loss with anger with minimal destructive self-punishment: she develops a psycho-somatic illness shortly after his death. In conclusion, what happens for Krista is that in her capacity to mourn Dr. Shaskan, she develops the capacity to mourn for her own life and her own tragedies. In so doing, she begins to explore the issues that are illustrated in Dr. Adler’s phase three; namely, the reliving of old experiences. She begins to confront the sexual abuse she has received from her father and uncle and to begin a life long task of repair from this horror. Krista is able to sustain a long-term relationship with a male figure and begins to confront and resolve conflicts in her life.

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FunzioneSalute

Group Psychotherapy in the Public Sector: The Impact of the Organisation on the Primary Task

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Abstract

In this paper we will discuss psychoanalytic group psychotherapy in the process of treating complex patients as part of their clinical management, both of which are set within the context of a large and changing public sector organisation in the United Kingdom. Included in this we will examine how the many correlative services can be slotted together, acting like a jigsaw of provision, and consider their impact upon group psychotherapy. We will explore how this can lead to the organisation being both a container of high levels of disturbance, but also become a platform for the projection of both an individual pathology and the anxieties within the group itself, there by potentially both enabling and compromising the quality of patient care. Furthermore, we will consider how the organisational dynamics interact with and at times conflate the disturbance within the group itself, the psychotherapists and the patients, thus creating a system where a complex set of dynamics continually moves Read more

FunzioneSalute

Group dimensions in an Adult Mental Health Inpatient Unit

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Abstract

Human beings are immersed in group settings of one kind or another all life long and even when individual mental suffering exacerbates to the point of needing hospitalization, people find themselves sharing space, time and emotions with others. A mental health crisis breaks the individual and family balance and expresses itself with acute and extreme thoughts, emotions and behaviors. Psychiatric hospitalization, although traumatic, gives the patient and his/her relatives an opportunity of living all the alterations in a protected environment also offering them an explanation for these alterations. Clinicians aim to intervene as soon as possible after the onset of a crisis in order to enable the individual to overcome it and to return to normal functioning, Read more

EscherAdolescenti

Therapeutic Crossroads: Adolescents, Families, Groups. Experiences in a Dedicated Service

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Abstract

The authors reflect on the cultural and macro-social transformations which are effecting adolescents and their families and the consequent youth difficulties and possible developments.
Different aspects of working in a Psychological Counselling Service with young people between eighteen and twenty-five and their families are illustrated; the therapeutic team’s aim is to offer on different levels and with different tools (individual, family and group therapies, Communities, therapeutic teams) a “colpo d’ala” (‘at one stroke’), in other words, an immediate opportunity for those in need of support to get back on their individual ‘road’ to recovery. Attention is focalized on the theme of clinical work utilizing a network of different proposals, made necessary to deal with the condition of today’s adolescents in difficulty, who above all have serious deficiencies in their capacity to develop and maintain real affective and social relationships, Read more

GiornateRomane

Evaluation of psychodynamic multi-family group therapy for psychiatric patients and their families. A proposal of a process-outcome assessment protocol

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Abstract
In the community perspective about the treatment of serious mental illness through the multi-family groups (Badaracco, 2004; Scholz & Asen, 2010), empirical research with psychiatric patients should focus, according to the literature (de Albuquerque et al., 2010; Karamlou et al. 2010), on the evaluation of correlation between outcome variables, therapeutic factors, perceived burden of care and characteristics of family’s structure, in order to understand what roles they play in mediating Read more

GiornateRomane

C.I.P.R.E.S. contribution to rehabilitation in multifamily psychoanalysis’ approach

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Abstract
In this paper, which integrates narrative moments, theoretical approaches and methodological aspects, the author focuses on the centrality of the Multifamily intervention (initially in the form of Assembly and later as Multifamily Group of Psychoanalysis) in the organization and practice of rehabilitation Day Care Center C.I.P.R.E.S., one of the first rehabilitation services in Uruguay.
Born in the delicate phase of recovery after the heavy democratic dictatorship, the Centre is organized around the needs of free exchange, Read more

PsichiatriaGruppo

Therapeutic group as a laboratory of freedom of expression

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Abstract

This contribution is inspired by the experience of conducting a therapeutic group for adult patients within a medium security psychiatric community in Milan. Using some session excerpts, a close connection is established between affirmation of identity of individuals and the group, along with freedom of expression, as the Read more

FormeCircolari

Homogeneous time-limited groups and eating disorders

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Abstract

This work describes some hypotheses on the functioning of the homogeneous time-limited group mechanism used in the treatment of eating disorders, led with a psychoanalytic vertex observation. The work is divided into 4 main parts. In the first part, the authors describe the meaning of homogeneous group and its characteristics particularly in terms of  specific therapeutic elements and group functioning. In the second part, an analysis of the homogeneous group within the treatment of eating disorders is carried on. In the third part of the work, Time-limited group psychotherapies are presented, being these characterized from a prearrangement of the term; concepts which appear specific of time-limited group, such us Read more

sogno e gruppo

Dreamtelling as a request for containment and elaboration in group therapy

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Abstract

The traditional, intrapersonal way of working with dreams has been enriched by an interpersonal approach (Ferenczi, 1913, Kanzer 1955). Dreaming may no longer be viewed as an exclusively internal and autonomous working-trough (event) occurrence, as classical approaches suggest (Freud 1900, 1932, Meltzer 1983). Containment and elaboration of the exciting and the dreadful in dreams can be placed on a continuum from autonomous through dependent. Sharing a dream with a therapist or a therapy group may be done (unconsciously) in order both to represent the self (Neri 1996) and “use” significant others to further the unfinished psychic work of the dream. When the dreamer’s own container for the unbearable is insufficient or damaged, he may search for an external container, as he may have done in his childhood . Group participants may sometimes serve as appropriate recipients for split-off emotions, and by listening to their “echoes” all involved may be helped to integrate projections and work them through. A clinical vignette of a Read more

Migrazioni

The theme of Nostalgia across the Thread Dreams

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Abstract

Story of a young migrant in a group of analytic psychotherapy carried out in a Mental Health Service.

The institutional context allows an original therapeutic setting that is not superimposable to others: the belonging to a public institution must be considered as a positive and powerful structural element in the institutional field.

The woman begins therapy with a serious anxious symptomatology of insomnia and the fear to be suffocated from whatever she swallows. The disorder began during a trip in her country of origin where she wanted to introduce her Read more

MatissePsicoterapiadiGruppo

The difficult patient in group: blendig the mayor psychoanalitic prespectives

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Abstract

As Horwitz (1977) noted, “Paradoxically, the very qualities and deficits that make the …patient a problematic group member are the same deficits that are often best treated in a group setting” (p.404). This is because group psychotherapy is the medium nonpareil for highlighting and ameliorating the associated relationship conflicts that these difficult patients have. It has long been known that patients with chaotic, amorphous, and fragile egos are suited to group treatment because of the diminished intensity of transference compared to individual treatment and the opportunity for patients to self-titrate the intensity of their involvement (Freedman, Sweet, 1954). The group has a social reality of its own which counteracts these patients propensity to regress. Members can be quite supportive to one another. Read more

MatisseFormazione

Group psychotherapy: the practice and the formation of homogeneous short term groups

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Abstract

In fact psychiatric diagnoses, (not geriatric), are grouped, using the DSM-IV nomenclature, into ten psychiatric problems: general anxiety disorders, social phobia, obsessive-compulsive disorders, agoraphobia, panic attacks (with or without agoraphobia), disorders from post-trauma stress, schizophrenia, abuse and dependence on drugs and alcohol.
In a recent work we proposed to group the first six problems into the “anxiety disorders”, and to add “eating disorders”, “personality disorders” and “psycho-geriatric disorders”. Thus we have seven groups of problems that we will look at from another perspective. Read more

MatisseFormazione

Reflections on supervising groups of HIV positive patients with personality disorders

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Abstract

This paper is a critical reflection on the supervision of two groups of HIV positive patients with personality disorders for the duration of five years. The patients all suffered from personality disorders of various degrees, and they had became HIV infected through drug abuse or heterosexual or homosexual contact. The groups met twice a week for an hour and a quarter in the San Luigi Centre at the San Raffaele Hospital in Milan. They were open groups of men and women, counting eight participants in each Read more

GiocoLegame

The physical space to the psychic space: the shark and the journey of the group

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Abstract

The discussion deals with the construction of a psychic space that borns by uses real parts of the room as a mental setting of the therapist. The article describes a fundamental issue, common to the setting of child psychotherapy (both group and individual): the importance of physical space, represented by the child’s movements. This space can be transformed into a psychic space, an “imaginary place” where young patients can experience deep fears and anxieties.
The therapist’s countertransference, who moves inside the room and interacts with the children, changes anger and destructiveness in representations such as the volcano, the lava to become “moving emotions” (acted, named, told, in any case lived). These are the foundations for building a mental space, a way Read more

Migrazioni

Presentation “Group and Migration”

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Abstract

In the introduction some fundamental ideas that are relative to the analysis of immigration processes and cultural exchange are illustrated according to psychoanalytic parameters. In addition, a new, in depth interpretation that suggests both points of connection and divergence between the different essays in the issue is given. This clarifies the central theme of the issue in a most detailed way. 

This issue of Funzione Gamma collects contributions which look at the wide-ranging, complex theme of the meeting-conflict theme from varying cultural backgrounds. Today, this takes shape mainly in the dynamic of the relationship between the immigrant and the host country. Above all given the increase of immigration-emigration flows as a result of the current process of globalisation. The general theme is well examined in Lorenzo d’Orsi’s essay which looks at the problems that have arisen from the recent situation that is connected to the social policies immigration. His approach is anthropological which takes on the forms of racism and marginalisation that make cultural difference a problem. His suggestion that allows us Read more