Modificación de los conflictos interpersonales de un paciente límite en psicoterapia psicodinámica
Resumen
Pacientes com Transtorno de personalidade borderline (TPB) possuem características relacionais disfuncionais que impactam seus relacionamentos interpessoais. O objetivo foi o de descrever os padrões relacionais de conflito de uma paciente com TPB da psicoterapia psicodinâmica. Trata-se de um estudo de caso sistemático. Utilizou-se o método Tema Central de Conflito nos Relacionamentos (CCRT). Juízes independentes analisaram as gravações e transcrições das sessões do tratamento. A análise foi realizada com base na frequência dos componentes do CCRT. Os resultados indicam que o conflito central da paciente se mantém o mesmo ao longo do tempo, assim como seu desejo principal, mas há uma mudança significativa nas respostas, ou seja, na forma como a paciente interage em seus relacionamentos, apresentando maior flexibilidade para lidar com os outros e os percebendo mais positivamente. O estudo fornece subsídios aos psicoterapeutas para identificar e trabalhar o padrão de relacionamento disfuncional de pacientes com TPB.
Palabras clave
Transtorno de personalidade borderline, Psicoterapia psicodinâmica, Mudança psíquica, Relações interpessoaisCitas
American Psychiatric Association [APA] (2014). Manual diagnóstico e estatístico de transtornos mentais (5a. ed). Artmed.
Bourke, Marianne E. & Grenyer, Brin F. S. (2013). Therapists’ Accounts of Psycho-therapy Process Associated With Treating Patients With Borderline Personality Dis-order. Journal of Personality Disorders, 27(6), 735-745. https://doi.org/10.1521/pedi_2013_27_108
Catto, Rosangela & Serralta, Fernanda B. (2014). Elaboração das formulações psico-dinâmicas de caso: um estudo exploratório. Diaphora: Revista da Sociedade de Psicologia do Rio Grande do Sul, 12(2), 49-57. http://www.sprgs.org.br/diaphora/ojs/index.php/diaphora/article/view/70
Castro, Flávia C. & Serralta, Fernanda B. (2019). O uso de métodos empíricos para formulação de caso: a contribuição do CCRT na avaliação de um paciente border-line (Dissertação de mestrado). Universidade do Vale do Rio dos Sinos.
Chance, Susan E.; Bakeman, Roger; Kaslow, Nadine J.; Farber, Eugene & Burge-Callaway, Katherine (2000). Core conflictual relationship themes in patients diag-nosed with borderline personality disorder who attempted, or who did not at-tempt, suicide. Psychotherapy Research, 10(3), 337-355. https://doi.org/10.1093/ptr/10.3.337
Cheavens, Jennifer S.; Strunk, Daniel R. & Chriki, Lyvia (2012). A Comparison of Three Theoretically Important Constructs: What Accounts For Symptoms of Border-line Personality Disorder? Journal of Clinical Psychology, 68(4), 477-486. https://doi.org/10.1002/jclp.20870
Cierpka, Manfred; Strack, Micha; Benninghoven, Dieter; Staats, Hermann; Dahlbender, Reiner; Pokorny, Dan; Frevert, Gabriele; Blaser, Gerd; Kächele, Horst; Geyer, Michael; Körner, Annett & Albani, Cornelia (1998). Stereotypical Relationship Patterns and Psychopathology. Psychother Psychosom, 67, 241-248. https://doi.org/10.1159/000012286
Crits-Christoph, Paul; Demorest, Amy; Muenz, Larry R. & Baranackie, Kathryn (1994). Consistency of interpersonal themes for patients in psychotherapy. Journal of Personality, 62, 499-526. https://doi.org/10.1111/j.1467-6494.1994.tb00307.x
De La Parra, Guilhermo (2013). Psychotherapy research in developing countries: The case of Latin America. Psychotherapy Research, 23(6), 609-623. https://doi.org/10.1080/10503307.2013.830794
Drapeau, Martin & Perry, J. Christopher (2009). The Core Conflictual relationship themes (CCRT) in borderline personality Disorder. J. pers. Dis., 23(4), 425-431. https://doi.org/10.1521/pedi.2009.23.4.425
Edwards, David J. A. (2007). Collaborative versus adversarial stances in scientific discourse: Implications for the role of systematic case studies in the development of evidence-based practice in psychotherapy. Pragmatic Case Studies in Psycho-therapy, 3(1), 6-34. https://doi.org/10.14713/pcsp.v3i1.892
Fonagy, Peter (2000). Attachment and Borderline Personality Disorder. Journal of the American Psychoanalytic Association, 48(4), 1129-1146. https://doi.org/10.1177/00030651000480040701
Grenyer, Brin F. S & Luborsky, Lester (1998). Positive versus negative CCRT pat-terns. In Lester Luborsky & Paul Crits-Christoph (Eds.), Understanding transfer-ence: The Core Conflictual Relationship Theme method (pp. 55-63). American Psychological Association.
Gunderson, John G. (2007). Disturbed relationships as a phenotype for borderline personality disorder. American Journal of Psychiatriy, 164(11), 1637-1640. https://doi.org/10.1176/appi.ajp.2007.07071125
Kernberg, Otto (1984). Severe personality disorders. Aronson.
Kernberg, Otto; Selzer, Michael A.; Koenigsberg, Harold W.; Carr, Arthur C. & Ap-pelbaum, Ann H. (1991). Psicoterapia psicodinâmica de pacientes borderline. Ar-tes Médicas.
Levy, Kenneth N.; Clarkin, John F.; Yeomans, Frank E.; Scott, Lori N.; Wasserman, Rachel H. & Kernberg, Otto (2006). The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy. Jour-nal of Clinical Psychology, 62(4), 481-501. https://doi.org/10.1002/jclp.20239
Lhullier, Alfredo C. (1998). Novos Modelos de Investigação em Psicoterapia. Edu-cart.
Luborsky, Lester; Barber, Jacques & Diguer, Louis (1992). The Meanings of Narra-tives Told During Psychotherapy: The Fruits of a New Observational Unit. Psycho-therapy Research, 2(4), 277-290. https://doi.org/10.1080/10503309212331333034
Luborsky, Lester & Crits-Christoph, Paul (1990). Understanding transference: the core conflictual relationship theme method. Basic Books.
Luborsky, Lester & Crits-Christoph, Paul (1998). Understanding Transference: The Core Conflictual Relationship Theme Method. American Psychological Association.
Luborsky, Lester; Diguer, Louis; Andrusyna, Tomasz; Friedman, Scott; Tarca, Cris-tian; Popp, Carol A.; Ermold, Jenna & Silberschatz, George (2004). A Method of Choosing CCRT Scorers. Psychotherapy Research, 14(1), 127-134. https://doi.org/10.1093/ptr/kph008
Luz, Anete. B. (2015). Fases da Psicoterapia. In Claudio L. Eizirik, Rogerio W. Aguiar & Sidnei S. Schestatsky (Eds.), Psicoterapia de Orientação Analítica: fun-damentos teóricos e clínicos (pp. 249-266). Artmed.
Mantilla, Moraima G. G. & Ávila-Espada, Alejandro A. (2016). Aplicación de la re-formulación alemana del método del Tema Central de Conflicto Relacional (CCRT-LU) para la evalución del cambio en un caso de duelo por pérdida de la pareja. Re-vista de Psicoterapia, 27(103), 267-282. https://dialnet.unirioja.es/servlet/articulo?codigo=5399257
Moreno, Clara M.; Schalayef, Cristina; Acosta, Silvia; Vernengo, Pia; Roussos, An-dres J. & Lerner, Beatríz D. (2005). Evaluation of psychic change through the ap-plication of empirical and clinical techniques for a 2-year treatment: a single case study. Psychotherapy Research, 15(3), 199-209. https://doi.org/10.1080/10503300512331387799
Nickell, Angela D.; Waudby, Carol J. & Trull, Timothy J. (2002). Attachment, pa-rental bonding and borderline personality disorder features in young adults. Jour-nal of Personality Disorders, 16(2), 148-159. https://doi.org/10.1521/pedi.16.2.148.22544
Ryan, Kimberly & Shean, Glenn (2007). Patterns of interpersonal behaviors and bor-derline personality characteristics. Personality and Individual Differences, 42, 193-200. https://doi.org/10.1016/j.paid.2006.06.010
Rosbrow, Thomas (1995). Review of Understanding transference: The CCRT method. Psychoanalytic Psychology, 12(4), 607-610. https://doi.org/10.1037/h0085203
Sandell, Rolf (1997). Rating the Outcomes of Psychotherapy or Psychoanalysis Using the Change After Psychotherapy Scales (CHAP): Manual and commentary. Karolins-ka Institute.
Serralta, Fernanda B.; Nunes, T. Maria & Eizirik, Claudio L. (2011). Considerações metodológicas sobre o estudo de caso na pesquisa em psicoterapia. Estudos de Psi-cologia, 28(4), 501-510. https://doi.org/10.1590/S0103-166X2011000400010
Stern, Marcia I.; Herron, William G.; Primavera, Louis H. & Kakuma, Tatsu (1997). Interpersonal perceptions of depressed and borderline inpatients. J. Clin. Psychology, 53(1), 41-49.
https://doi.org/10.1002/(sici)1097-4679(199701)53:1%3C41::aid-jclp6%3E3.0.co;2-y
Wallerstein, Robert S (2003). Psychoanalytic therapy research: Its coming of Age. Psychoanalytic Inquiry, 23(2), 375 - 404. https://psycnet.apa.org/doi/10.1080/07351692309349039
Wilczek, Alexander; Weinryb, Robert M.; Barber, Jacque P.; Gustavsson, Peter & Asberg, Marie (2000). The core conflictual relationship theme (CCRT) and psycho-pathology in patients selected for dynamic psychotherapy. Psychotherapy Research, 10(1), 100-113. https://doi.org/10.1093/ptr/10.1.100
Wellausen, Rafael (2014). Adaptação e validação do Shedler-Westen Assessment Procedure (SWAP-200) para o Brasil: avaliação dos transtornos de personalidade (Tese de Doutorado inédita). Universidade Federal do Rio Grande do Sul.
Westen, Drew & Shedler, Jonathan (2007). Personality diagnosis with the Shedler-Westen Assessment Procedure (SWAP): Integrating clinical and statistical meas-urement and prediction. Journal of Abnormal Psychology, 116(4), 810-822. https://doi.org/10.1037/0021-843x.116.4.810
Van Nieuwenhove, Kimberly & Meganck, Reitske (2020). Core Interpersonal Patterns in Complex Trauma and the Process of Change in Psychodynamic Therapy: A Case Comparison Study. Front. Psychol., 11, Article 122. https://doi.org/10.3389/fpsyg.2020.00122
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Derechos de autor 2023 Flavia Ciane Assmann Castro, Luan Paris Feijo, Betina Capobianco Strassburger, Aline Álvares Bittencourt, Fernanda Barcellos Serralta
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.