{"id":2310,"date":"2019-01-30T05:47:14","date_gmt":"2019-01-30T05:47:14","guid":{"rendered":"http:\/\/www.ruxandravoinea.ro\/?p=2310"},"modified":"2019-02-17T11:35:22","modified_gmt":"2019-02-17T11:35:22","slug":"psihosomatica-taramul-dintre-boala-fizica-si-cea-psihica","status":"publish","type":"post","link":"https:\/\/www.ruxandravoinea.ro\/index.php\/2019\/01\/30\/psihosomatica-taramul-dintre-boala-fizica-si-cea-psihica\/","title":{"rendered":"Psihosomatica, t\u0103r\u00e2mul dintre boala fizic\u0103 \u0219i cea psihic\u0103"},"content":{"rendered":"<p>Psiho-somatica reprezint\u0103 un domeniu relativ nou (1968 primul studiu extins al psihosomaticii f\u0103cut de Franz Alexander \u0219i colaboratorii la Institutul de Psihanaliz\u0103 din Chicago) \u0219i complex, presupun\u00e2nd cuno\u0219tin\u021be \u0219i abilit\u0103\u021bi din dou\u0103 domenii complexe: medicina \u0219i psihologie &#8211; psihoterapia. Este important un tratament dual c\u00e2nd este necesar: psihoterapeutic \u0219i medicamentos. Un medic f\u0103r\u0103 cuno\u0219tin\u021be despre bolile psihice ce pot fi influen\u021bate de corp sau un psiholog ce nu de\u021bine no\u021biuni despre corp nu pot face un diagnostic diferen\u021biat, observ\u00e2nd bolile ce sunt la grani\u021ba dintre somatic \u0219i psihic. Aici avem \u00een vedere trei posibilit\u0103\u021bi, ale c\u0103ror grani\u021be sunt relative:<\/p>\n<ul>\n<li>boli fizice ce pot avea \u00een timp o component\u0103 psihic\u0103<\/li>\n<li>dificult\u0103\u021bi psihologice ce pot duce la boli fizice<\/li>\n<li>boli ce pot fi recunoscute de la \u00eenceput ca av\u00e2nd ambele componente<\/li>\n<\/ul>\n<h4>Winnicott, pediatru \u0219i psihanalist face o scurt\u0103 introducere \u00een psihosomatic\u0103:<\/h4>\n<blockquote>\n<ol>\n<li>Cuv\u00e2ntul &lt;psiho-somatic&gt; este necesar \u00eentruc\u00e2t nu exist\u0103 un cuv\u00e2nt simplu care s\u0103 fie adecvat pentru descrierea anumitor st\u0103ri clinice.<\/li>\n<li><img decoding=\"async\" loading=\"lazy\" class=\"alignleft wp-image-2320 size-medium\" src=\"http:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/martin-brosy-758535-unsplash-300x169.jpg\" alt=\"medicina psihosomatica boli fizice\" width=\"300\" height=\"169\" srcset=\"https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/martin-brosy-758535-unsplash-300x169.jpg 300w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/martin-brosy-758535-unsplash-768x432.jpg 768w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/martin-brosy-758535-unsplash-1024x576.jpg 1024w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/martin-brosy-758535-unsplash-1920x1080.jpg 1920w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Cratima al\u0103tur\u0103 \u0219i separ\u0103, simultan, cele dou\u0103 aspecte ale practicii medicale care sunt constant \u00een vedere \u00een orice discu\u021bie pe aceast\u0103 tem\u0103.<\/li>\n<li>Cuv\u00e2ntul descrie cu acurate\u021be ceva care este inerent acestei practici.<\/li>\n<li>Psiho-somaticianul se m\u00e2ndre\u0219te cu capacitatea sa de a c\u0103l\u0103ri doi cai, cu un picior pe fiecare dintre \u0219ei, cu ambele fr\u00e2ie \u00een m\u00e2na st\u00e2ng\u0103.<\/li>\n<li><img decoding=\"async\" loading=\"lazy\" class=\"alignright wp-image-2322 size-medium\" src=\"http:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/piron-guillaume-367208-unsplash-300x200.jpg\" alt=\"medicina chirurgie psihosomatica\" width=\"300\" height=\"200\" srcset=\"https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/piron-guillaume-367208-unsplash-300x200.jpg 300w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/piron-guillaume-367208-unsplash-768x512.jpg 768w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/piron-guillaume-367208-unsplash-1024x683.jpg 1024w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/piron-guillaume-367208-unsplash-1620x1080.jpg 1620w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Trebuie g\u0103sit un agent care tinde s\u0103 separe cele dou\u0103 aspecte ale tulbur\u0103rii psiho-somatice, s\u0103 dea un rol cratimei.<\/li>\n<li>Acest agent este, \u00een fapt, o disociere \u00een pacient.<\/li>\n<li>Boala \u00een tulburarea psihosomatic\u0103 nu este acea stare clinic\u0103 exprimat\u0103 \u00een termeni de patologie somatic\u0103 sau de func\u021bionare patologic\u0103 (colit\u0103, astm, eczem\u0103 cronic\u0103). Persisten\u021ba unui clivaj* \u00een func\u021bionarea Eului pacientului, sau a unor multiple disocieri constituie adevarata boal\u0103.<\/li>\n<li><img decoding=\"async\" loading=\"lazy\" class=\"alignleft wp-image-2332 size-medium\" src=\"http:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/pretty-drugthings-703305-unsplash-300x194.jpg\" alt=\"homeopatie psihosomatica boli psihice\" width=\"300\" height=\"194\" srcset=\"https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/pretty-drugthings-703305-unsplash-300x194.jpg 300w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/pretty-drugthings-703305-unsplash-768x497.jpg 768w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/pretty-drugthings-703305-unsplash-1024x662.jpg 1024w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/pretty-drugthings-703305-unsplash-1670x1080.jpg 1670w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Aceast\u0103 stare de boal\u0103 a pacientului este ea \u00eens\u0103\u0219i o organizare defensiv\u0103 cu cauze foarte puternice, iar din acest motiv este foarte u\u0219or pentru doctorii bine informa\u021bi, bine orienta\u021bi \u0219i chiar bine echipa\u021bi s\u0103 e\u0219ueze \u00een eforturile lor de a vindeca pacien\u021bi cu tulbur\u0103ri psihosomatice.<\/li>\n<li>Dac\u0103 motivele acestei tendin\u021be de e\u0219ec nu sunt bine \u00een\u021belese, medicii practican\u021bi \u00ee\u0219i pierd speran\u021ba. Apoi, subiectul psihosomaticii divinde subiect pentru studiu non-clinic sau teoretic, iar asta este relativ u\u0219or, deoarece teoreticianul este deta\u0219at \u0219i nu este presat de responsabilitatea fa\u021b\u0103 de pacien\u021bi. Teoreticianul poate pierde contactul cu disocierea \u0219i este capabil s\u0103 vad\u0103 prea u\u0219or din ambele prespective.<img decoding=\"async\" loading=\"lazy\" class=\"alignright wp-image-2319 size-medium\" src=\"http:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/marco-bianchetti-539177-unsplash-300x200.jpg\" alt=\"impreuna compasiune iubire\" width=\"300\" height=\"200\" srcset=\"https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/marco-bianchetti-539177-unsplash-300x200.jpg 300w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/marco-bianchetti-539177-unsplash-768x512.jpg 768w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/marco-bianchetti-539177-unsplash-1024x683.jpg 1024w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/marco-bianchetti-539177-unsplash-1620x1080.jpg 1620w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/li>\n<\/ol>\n<p>Doresc s\u0103 spun limpede c\u0103 for\u021bele aflate la lucru \u00een pacient sunt teribil de puternice. Dilema psiho-somaticianului practicant este \u00eentr-adev\u0103r o realitate.<\/p>\n<p>&nbsp;<\/p>\n<h6>\u00cen acest stadiu al argument\u0103rii trebuie men\u021bionate una sau dou\u0103 complica\u021bii:<\/h6>\n<ul>\n<li>Unii medici practican\u021bi nu sunt cu adev\u0103rat capabili s\u0103 c\u0103l\u0103reasc\u0103 doi cai deodat\u0103. Ei stau pe una dintre \u0219ei \u0219i conduc cel\u0103lalt cal din h\u0103\u021buri, sau pierd contactul cu el. La urma urmelor, de ce ar fi doctorii mai s\u0103n\u0103to\u0219i, din punct de vedere psihiatric, dec\u00e2t pacien\u021bii lor? Ei nu au fost selecta\u021bi pe criterii psihiatrice. Propriile disocieri ae doctorului trebuie luate \u00een considerare, al\u0103turi de disocierile din personalitatea pacien\u021bilor.<\/li>\n<li>Pacien\u021bii pot avea mai mult dec\u00e2t o singur\u0103 boal\u0103. Un b\u0103rbat cu o tendin\u021b\u0103 spre spasm coronarian, secundar confuziei emo\u021bionale, poate avea de asemenea \u0219i arterit\u0103 calciform\u0103, sau o femeie cu fibrom \u0219i menoragie poate avea, desigur, \u0219i o imaturitate sexual\u0103. \u0218i a\u0219a mai departe. \u00cen asamblu, ipohodriacii sunt cei care e\u0219ueaz\u0103 \u00een a fi examina\u021bi, atunci c\u00e2nd au cancer de s\u00e2n sau hipernefrit\u0103, \u0219i exist\u0103 \u0219i pacien\u021bi \u00een am\u0103nun\u021bit \u0219i c\u0103rora nu li s-a descoperit nimic pe baza testelor fiziologice. Astfel c\u0103 urmeaz\u0103 o cale gre\u0219it\u0103. Am auzit uimitoare pove\u0219ti de neglijare, unele credibile.<\/li>\n<li>Mul\u021bi pacien\u021bi nu scindeaz\u0103 \u00eengrijorarea lor medical\u0103 doar \u00een dou\u0103; clivajul se face \u00een mai multe fragmente, iar noi, ca doctori, ne trezim ac\u021bion\u00e2nd \u00een rolul unuia dintre aceste fragmente. Am folosit termenul de &lt;dispersia agen\u021bilor responsabili&gt; pentru a descrie aceast\u0103 tendin\u021b\u0103. Asemenea pacien\u021bi sunt exemple citate \u00een cazurile supravegheate de asisten\u021b\u0103 social\u0103, \u00een care dou\u0103zeci sau treizeeci sau chiar mai mul\u021bi agen\u021bi s-au implicat pentru a calma stresul unei singure familii. Pacien\u021bii cu multiple disocieri exploateaz\u0103 de asemenea clivajul natural din profesia medical\u0103 astfel:<img decoding=\"async\" loading=\"lazy\" class=\"alignleft wp-image-2324 size-medium\" src=\"http:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/rawpixel-617402-unsplash-300x200.jpg\" alt=\"tratement medicamente placebo\" width=\"300\" height=\"200\" srcset=\"https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/rawpixel-617402-unsplash-300x200.jpg 300w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/rawpixel-617402-unsplash-768x512.jpg 768w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/rawpixel-617402-unsplash-1024x683.jpg 1024w, https:\/\/www.ruxandravoinea.ro\/wp-content\/uploads\/2019\/01\/rawpixel-617402-unsplash-1620x1080.jpg 1620w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/li>\n<li>medical<\/li>\n<li>chirurgical<\/li>\n<li>psihiatric<\/li>\n<li>psihanalitic<\/li>\n<li>psihoterapeutic<\/li>\n<li>homeopat<\/li>\n<li>osteopat<\/li>\n<li>vraci<\/li>\n<li>diverse servicii auxiliare<\/li>\n<\/ul>\n<\/blockquote>\n<p>&nbsp;<\/p>\n<h6><strong>Bibliografie<\/strong><\/h6>\n<p>D.W. Winnicott, (2006) <a href=\"https:\/\/carturesti.ro\/carte\/spaima-de-prabusire-64627\">Spaima de pr\u0103bu\u0219ire<\/a>, Editura Funda\u021bia Genera\u021bia<\/p>\n<p>Dic\u0163ionarul critic de psihanaliz\u0103 (2013), <span class=\"titlu-autor\"><a href=\"http:\/\/www.edituratrei.ro\/vendor.php\/charles-rycroft\/786\/\">Charles Rycroft<\/a><\/span><\/p>\n<h6><strong>Note explicative:<\/strong><\/h6>\n<div>clivajul = proces prin care o structur\u0103 psihic\u0103 \u00ee\u0219i pierde integritatea \u0219i este \u00eenlocuit\u0103 de dou\u0103 sau mai multe structuri par\u021biale; atitudinea emo\u021bional\u0103 fa\u021b\u0103 de cele dou\u0103 structuri este \u00een general antitetic\u0103, fiind tr\u0103it ca &#8220;bun&#8221; (tolerant, binevoitor etc.), cel\u0103lalt ca&nbsp; &#8220;r\u0103u&#8221; (resping\u0103tor, r\u0103uvoitor etc.)<\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div class=\"linkbox\">\n<p>Ruxandra Voinea,<\/p>\n<p>Psiholog \u0219i Psihoterapeut<\/p>\n<p>Telefon: <a href=\"tel:0724551022\">0724551022<\/a><\/p>\n<p>Email: <a href=\"mailto:voinea_ruxandra_cristina@yahoo.com\">voinea_ruxandra_cristina@yahoo.com <\/a><\/p>\n<p><a href=\"mailto:valorificarepersonala@gmail.com\">valorificarepersonala@gmail.com <\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Psiho-somatica reprezint\u0103 un domeniu relativ nou (1968 primul studiu extins al psihosomaticii f\u0103cut de Franz Alexander \u0219i colaboratorii la Institutul de Psihanaliz\u0103 din Chicago) \u0219i complex, presupun\u00e2nd cuno\u0219tin\u021be \u0219i abilit\u0103\u021bi din dou\u0103 domenii complexe: medicina \u0219i psihologie &#8211; psihoterapia. Este important un tratament dual c\u00e2nd este necesar: psihoterapeutic \u0219i medicamentos. Un medic f\u0103r\u0103 cuno\u0219tin\u021be despre bolile psihice ce pot fi influen\u021bate de corp sau un psiholog ce nu de\u021bine no\u021biuni despre corp nu pot face&hellip; <br \/> <a class=\"read-more\" href=\"https:\/\/www.ruxandravoinea.ro\/index.php\/2019\/01\/30\/psihosomatica-taramul-dintre-boala-fizica-si-cea-psihica\/\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":2323,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_mi_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0},"categories":[6],"tags":[],"aioseo_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Psihosomatica, t\u0103r\u00e2mul dintre boala fizic\u0103 \u0219i cea psihic\u0103 - ruxandravoinea<\/title>\n<meta name=\"description\" content=\"Psiho-somatica un domeniu relativ nou \u0219i complex, presupun\u00e2nd cuno\u0219tin\u021be \u0219i abilit\u0103\u021bi din dou\u0103 domenii complexe: medicina \u0219i psihologie \u2013 psihoterapia. 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