Psychosocial aspects and psychotherapy in chronic patients

Aspetti psicologici e strategie di coping nella dialisi e nel trapianto renale

Aim. Although with different results, dialysis and kidney transplantation represent two effective strategies in treating chronic uraemia. Our study compares the psychological aspects of two categories of patients: on one hand those who faced kidney transplantation and have been in dialysis, on the other hand the non complaint patients treated with these therapies. Methods. We used a test for the analysis of the personality (MMPI2) and the COPE, that tests the abilities to coping used by the patient in certain conditions that can be perceived us stressful or, in any case, as unusual. With both MMPI2 and COPE we tested 120 patients that have faced haemodialysis and 50 that have been subject t…

Il percorso temporale soggettuale come linea guida del macro-processo psicoanalitico

L’autore, con il seguente scritto, propone una sua personale rivisitazione della lettura del processo psicoanalitico, partendo da un percorso soggettuale che si sviluppa a partire dalle prime relazioni con il caregiver, all’interno di un funzionamento generale dei sistemi dinamici complessi non lineari. Viene proposto, rispetto ad ogni passaggio (coscienza - coscienza della coscienza - creatività) come evoluzione del processo esposto precedentemente da Minolli (2015), la costruzione di un percorso temporale soggettuale all’interno dell’auto-(geno-feno)-organizzazione (Morin, 1980). Tale lettura del macro-processo (che interessa lunghi periodi del percorso analitico), dovrà essere successiva…

Aspetti psicologici nel trapianto renale

Quando le cose vanno bene: analisi "terminabile" o "interminabile"? Le interruzioni e le conclusioni in psicoanalisi

Criteria for the evaluation of the conclusion of the analytical path had already been dealt with by Freud (1937) in «Die endiiche und die unendiiche Analyse". In the following decades, with the change of theoretical assumptions and then with the new acquisitions in the field of Infant Research, which places the caregiver-child interaction as the foundation in the co-construction of the latter's personality, it became necessary to rethink the subject. This can be of great help to the psychotherapist, especially if the analysis is interrupted. In fact, even if the experience of unsuccessful therapeutic pathways can lead the analyst to a retrospective reflection on what happened during the the…

Devianze on line: sexting e cyberbullismo. Psicopatologia del fenomeno ed alcune considerazioni psicodinamiche

The following work, examining the widespread diffusion of some online deviant phenomena such as cyberbullying (threats persisted through e-mail and online media) and the sexting (sending offensive pornographic material not required), highlights the role they have, both in the victims and in the abusers, the personality traits, the family environment and the relationship with the peers, considering that the victims are mostly teenagers. The author traces a psychodynamic reading of the phenomena also highlighting some models of intervention for prevention. The following work also underlines the usefulness of a psychotherapeutic treatment for both the abusers and the victims, considering that …

Fattori predittivi di non compliance nel trapianto renale

Currently many authors report a kidney graft survival of 90-95% at one years post-transplantation. The patients' adherence to the immunosuppressive therapy is an important condition for maintaining graft functioning. A review of the medical literature shows that graft survival is significantly worse in non-compliance patients. As a matter of fact, 267 non compliance patients lost their graft of 7206 renal graft recipients. There are usually three different non-compliance profiles in transplantation : 1) 'Accidental non compliers' (47%) identifies those patients who sometimes forget to take the therapy. 2) 'Invulnerables' (28%) are those patients who believe that they do not need to take the…

Aspetti psicologici in dialisi e nei pazienti non collaboranti

L’emodialisi e la dialisi peritoneale, anche se rappresentano (con il trapianto) la terapia sostitutiva d’elezione dell’insufficienza renale, non sempre vengono vissute positivamente dai pazienti, a causa delle rigide prescrizioni terapeutiche e per i cambiamenti che apportano nella vita quotidiana (1,2). Ciò potrebbe incidere negativamente sulla non compliance che è definita, in entrambi i trattamenti, come l’inosservanza parziale o totale della terapia, che può essere associata alla non accettazione del trattamento sostitutivo (3). In letteratura viene stimato che il 50% dei pazienti in emodialisi ed un terzo di quelli in peritoneale abbia almeno una parziale non compliance che nella magg…

VIOLENZE ON LINE: IL CYBERBULLISMO

cyberbullismo

Environmental Stimulus Perception as an Incidence Factor in Social Interaction and Personality Development

This paper seeks to analyze the impact of perceptual process, as a way of perceiving ourselves and others, as well as personality development and social attitudes which emerge from early interactions in the primary environment. Although many studies have highlighted the importance of early social interactions for both the genetic and psychobiological components of personality development, there is actually little data that examines the influence of these genetic factors on this process. This study focuses on the genetic bases of the perception process and its role in how we experience emotions and how we perceive the surrounding environment, starting with early interactions with caregivers.…

L'identificazione proiettiva nella prospettiva della psicoanalisi contemporanea

In questo lavoro l'autore sostiene la necessitŕ di una revisione del concetto di identificazione proiettiva. Questo meccanismo di difesa, inizialmente coniato da M. Klein ed alla base del Disturbo Paranoideo di personalitŕ, viene rivisto, secondo un ottica relazionale, sia in chiave teorica che clinica e viene proposto di rinominarlo "identificazione intersoggettiva". Partendo dalle recenti scoperte delle neuroscienze e dell'infant research, viene evidenziato come l'identificazione proiettiva costituisca una modalitŕ relazionale fisiologica nelle prime fasi del rapporto madre-bambino e come poi possa diventare disfunzionale nella crescita se non viene sostituita da meccanismi difensivi piů …

Dialysis and Kidney Transplantation: Similarities and Differences in the Psychological Aspects of Noncompliance

Abstract Background Dialysis and kidney transplantation represent two effective strategies in treating chronic uremia, albeit with different results. Our study compared the psychological aspects of two categories of patients: patients who faced kidney transplantation and have been on dialysis, and noncompliant patients treated with these therapies. Materials and Methods On 170 patients (120 hemodialysis and 50 peritoneal dialysis) we used a personality analysis (MMPI2) and the COPE, which assessed the ability of patients to cope under certain conditions that can be perceived as stressful or, in any case, unusual. The screening succeeded in 11 cases among the first group and 9 in the second.…