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1 Artigo extraído da tese intitulado -Significados psicossociais da perda urinária para mulheres de condições socioeconômicas menos favorecidas: um estudo clínico-qualitativo, apresentado ao LIFE EXPERIENCES OF BRAZILIAN WOMEN WITH URINARY INCONTINENCEABSTRACT: Our aim was to amplify the knowledge about the life experiences with urinary incontinence of Brazilian women. Were used the clinical-qualitative method with semi-directed interview. Eight women, housemaids, the 30 to 45 years, low socioeconomic status, with complain of urinary incontinence and never seek treatment, were selected by the "snowball" technique, and the size closing was by saturation criterion. The content analysis technique and psychodynamic approaches allowed the creation of two categories: one hidden problem and lonely life experience. For women, urinary incontinence is a problem that should be hidden, one obstacle in interpersonal interactions, a stigma that prevents the search for treatment. They live in fear and shame. They silenced, suffer alone, and to resist, react with the loneliness. The conclusions were that incontinent women prefer silence to having to ask for help, the insulation in was the protection form and aloneness, survival.DESCRIPTORS: Urinary incontinence. Qualitative research. Women's health. Life change events. Psychosocial impact. VIVENCIAS DE LAS MUJERES BRASILEÑAS CON INCONTINENCIA URINARIA RESUMEN:Nuestro objetivo fue profundizar los conocimientos acerca de las experiencias con la pierda de orina de mujeres brasileñas. Utilizamos el método clínico-cualitativo y entrevistas semi-dirigidas. Ocho mujeres incontinentes, empleadas domésticas, con edad entre 30 a 45, bajo estatus socioeconómico y que nunca trataran la incontinencia urinaria, fueran seleccionadas por la técnica de "bola de nieve" y pelo criterio de saturación. La técnica de análisis de contenido con enfoque psicodinámico permitió la creación de dos categorías: una cuestión encubierta y una experiencia solitaria. Para las mujeres, la incontinencia urinaria es un problema que debe ser ocultado, un obstáculo en las interacciones interpersonales y un estigma que impide la búsqueda de tratamiento. Viven en el miedo y vergüenza. Silencian, sufren solas y reaccionan con la soledad. Concluimos que estas mujeres prefieren el silencio a tener que pedir ayuda, encuentran en el aislamiento, la forma de protección, y en la soledad, la supervivencia.DESCRIPTORES: Incontinencia urinaria. Investigación cualitativa. Salud de la mujer. Acontecimientos que cambian la vida. Impacto psicosocial.

RESUMOObjetivo: Discutir os significados da vivência de episódios maníacos para pacientes com transtorno bipolar (TAB). Métodos: Trata-se de uma pesquisa qualitativa, feita por meio de entrevistas semidirigidas em profundidade, em uma amostra fechada pelo critério de saturação com oito pacientes com TAB em remissão. A técnica de tratamento de dados foi feita por meio da análise de conteúdo das entrevistas transcritas na íntegra e categorização. Os resultados foram submetidos à validação externa, no Laboratório de Pesquisa Clínico-Qualitativa do Departamento de Psicologia Médica e Psiquiatria da Unicamp, composto por 37 pesquisadores do método, entre eles mestrandos, doutorandos, pós-doutorados e pesquisadores seniores. Resultados: Foram identificadas três categorias -Ambivalência e vergonha: pensar ou não pensar sobre os episódios maníacos; Organizando sentimentos pessoais: a remissão como um momento de autoconsciência; Episódios maníacos estruturando relações interpessoais versus projeções da angústia. Conclusão: Os achados da presente pesquisa contribuem para a maior compreensão dos quadros maníacos no TAB, que podem auxiliar nas reflexões acerca da relação profissional-paciente, para elaborar estratégias para aderência e para as medidas terapêuticas e preventivas da recorrência dos episódios. Podem auxiliar a equipe de saúde envolvida no acompanhamento desses casos e também os pesquisadores na investigação da contribuição dos significados aqui discutidos nos fenômenos de aderên-cia ao tratamento e de um melhor prognóstico. ABSTRACTObjective: To discuss the meanings of the experiences of manic episodes in patients with bipolar disorder (BD). Methods: This is a qualitative research, done through semi-structured in-depth interviews in a sample closed by saturation criterion with eight patients with BD in remission. The technical data processing was done through qualitative content analysis of the transcribed interviews and categorization. The results were validated by peer-reviewers from the Laboratory of Clinical-Qualitative Research of the Department of Medical Psychology and Psychiatry, Unicamp consisting of 37 researchers of the method, including, masters,

Introduction: The complexity of factors involved in anorexia nervosa (AN) and the recommendations of prominent health organizations underscore the importance of reflecting on therapeutic interventions aimed at patients' family members. Objective: To expand knowledge about the mother-daughter relationship in AN, with a focus on developing a conceptual framework that is able to improve the treatment of the disorder, reduce factors that perpetuate it and improve prognosis. Method: A clinical method, anchored by psychodynamic references, was employed in a group of family members of patients with eating disorders. The group met weekly, and sessions were led by psychologists from the eating disorder outpatient clinic of a university hospital. Results and Discussion: Common characteristics in the mother-daughter relationship in cases of AN were identified. The issue of mutual control, the dialectic between omnipotence and impotence, and the relationship of devotion, passion and annihilation between mothers and daughters are phenomena that form the basis of AN, with a direct influence on the severity of each case and on treatment success. Conclusion: Our findings allowed us to identify important aspects in the mother-daughter relationship in AN, which may improve the clinical interventions aimed at treating the disorder.

RESUMO Objetivo Compreender o transtorno afetivo bipolar (TAB) e suas implicações pela perspectiva dos filhos adultos de mães que receberam o diagnóstico quando eles eram crianças. Métodos Pesquisa qualitativa, por meio de entrevistas semiestruturadas de questões abertas em profundidade com 21 filhos de pacientes do Ambulatório de Psiquiatria Geral de Adultos do HC/Unicamp. A técnica de tratamento de dados foi feita por meio da análise de conteúdo das entrevistas transcritas na íntegra e categorização. Resultados Os significados psicológicos atribuídos pelos filhos à experiência de ter uma mãe com TAB possibilitaram a elaboração de um esquema da infância, adolescência à vida adulta. Os achados revelam que na infância a instabilidade da mãe, característica do TAB, gera sentimentos de culpa e desamparo nos filhos, pela percepção da introspecção materna nos períodos dos episódios em contraste com os momentos de remissão, nos quais percebem envolvimento emocional e disponibilidade para a maternidade. Na adolescência, os filhos contestam as demandas de suas mães. Demonstram identificação com os sintomas maternos. Na vida adulta, há percepção de melhora na relação mãe-filho diante da abdicação das escolhas pessoais para a dedicação aos cuidados à mãe. Os achados revelam que a compreensão do TAB feita por meio da experiência dos filhos com suas mães fica apenas na racionabilidade, pois eles não conseguem manejá-la de forma efetiva e sentem-se aprisionados. Conclusões A equipe de saúde pode auxiliar os filhos desde o manejo de questões cotidianas até o diagnóstico precoce de psicopatologias ao se dedicar ao acolhimento deles quando da vinda de suas mães ao tratamento.

Introduction:Eating disorders (ED) are severe psychiatric disorders affecting mainly teenage girls and young women. There is evidence that family aspects play important role in the etiology and outcome of ED. Aspects related to the patients’ father have been poorly studied.Objectives:To understand emotional experiences and life events of father of adolescent girls diagnosed with anorexia nervosa or bulimia.Method:Qualitative in-depth interviews were carried out with men, fathers of adolescent girls in outpatient treatment at a southern Brazilian general hospital.Results:Sample was composed mostly by men who spent their childhood in the countryside. All of them had lived with their parents at least until the adolescence. Contrary to what clinicians often hear from mothers of ED patients, subjects were concerned about their daughters’ health, wished to see them overcome ED and were well informed about the disorder. They reported that one of the most important events of their lives was their daughter birth. Subjects also reported feeling of powerlessness. They tended to blame the mother for the ED emergence or maintenance, but recognized some relation between the disorder onset and a certain distance in father-daughter relationship. They recognized that their aggressive temper might have interfered with family relationships.Conclusion:Findings may contribute to understand life experiences and emotional characteristics of fathers of ED adolescents and this may help to keep them motivated to the treatment. This understanding can contribute to therapists to help fathers to regain their ability to care for their daughters, getting close to them again and improving father-daughter relationship.

ResumoA partir de conceitos da teoria psicanalítica, é feita uma discussão teórico-clínica em que o brincar serve como meio de expressão e de comunicação na psicoterapia psicanalítica de uma menina de nove anos e de um menino de sete anos de idade, ambos com mutismo seletivo, atendidos duas vezes por semana em um hospital público. Trata-se de um estudo qualitativo, que utiliza o método psicanalítico. As discussões teóricas são ilustradas pela história de vida e por vinhetas das sessões nas quais o brincar permitiu o acesso e o trabalho do mundo interno das crianças, possibilitando que começassem a verbalizar e a produzir representações simbólicas. Palavras-chave: psicologia da criança; ludoterapia; psicanálise; mutismo seletivo. PLAYING AS A MEANS OF COMMUNICATION IN SELECTIVE MUTISM CHILD PSYCHOTHERAPY AbstractFrom psychoanalytic theory concepts, there is a theoretical and clinical discussion about the use of playing as a means of expression and communication in the psychoanalytic psychotherapy of a girl of nine years old and a boy of seven years old, both diagnosed as selective mutism, attended twice a week in a public hospital. It is a qualitative study, using the psychoanalytic method. The theoretical discussions are illustrated by the history of life and fragments of few sessions in which the playing could access and work with the internal world of the child, which they could begin to talk and produce symbols and thoughts.

IntroductionConsidering both the complexity of factors that composes the anorexia nervosa (AN) and the recommendation of important organizations related to health, it becomes fundamental the reflection on psychotherapeutic interventions proposed to patient's relatives.ObjectivesExpand the knowledge about the mother-daughter relationship in AN in order to develop a conceptual framework that improves the way to handle with this disorder, to reduce the factors that maintain it and to improve the prognosis.MethodClinical method, through clinical observation regarding a group of patients’ relatives with eating disorders at an outpatient service at a university hospital in the Southeast Brazil.ResultsWe have identified common characteristics in the mother-daughter relationship in AN, that maintain the structure of anorexic patients, influencing directly on the severity of each case and therapeutic possibilities. The mutual control: anorexic's mothers showed the need of controlling their daughters, denying the daughter's individuality, trying to become tutors of their actions and thus also become controlled by them; The dialectic between omnipotence and impotence: sense of powerlessness in face of numerous failed attempts to help their daughters, with feelings of guilt, as if they were fully responsible for the daughter's disorder; The relationship of devotion, passion and hostility between mother and daughter: with a fused attitude with her daughter, the mother is even more limited to understand their real needs, invading their personal space.ConclusionsThe findings allowed to identify important aspects of mother-daughter relationship in AN, that can improve clinical interventions for the treatment.