Psychic Crisis Research Articles

Circuito dos Cuidados Psicossociais: sistematização de intervenção na crise psíquica no atendimento pré-hospitalar móvel

An experience report that aims to present the systematization of care for the management of psychic crises developed by the SAMU-DF Mental Health Center. The methodology, based on the steps of the Maguerez’s Arch, allowed both the identification of professionals’ difficulties regarding psychic crises management and the construction of the system called “Psychosocial Care Circuit’’ to guide the assistance of the mobile pre-hospital care. The Circuit has as mnemonic AEIOU, and each letter corresponds to an element evaluated as necessary for the psychic crisis intervention. Therefore, it is possible to affirm that the permanent education in health enables the transformative action of professionals, in addition to transforming the reality in which they are inserted, and that the systematization has accelerated the consolidation of the necessary skills for psychic crises care.

Psychosocial Care Circuit: the systematization of intervention in psychic crisis in mobile pre-hospital care

Um relato de experiência que visa apresentar a sistematização de atendimento para o manejo de crises psíquicas desenvolvida pelo Núcleo de Saúde Mental do Samu-DF. A metodologia, fundamentada nos passos do arco de Maguerez, permitiu desde a identificação das dificuldades dos profissionais no manejo das crises psíquicas até a construção da sistematização denominada “Circuito de Cuidados Psicossociais” para orientar a assistência no serviço pré-hospitalar móvel. O circuito tem como mnemônico “AEIOU”, e cada letra corresponde a um elemento avaliado como necessário na intervenção de crise psíquica. Assim, é possível afirmar que a Educação Permanente em Saúde possibilita uma ação transformadora dos profissionais e da realidade na qual estão inseridos, e a sistematização tem acelerado a consolidação das habilidades necessárias ao atendimento das crises psíquicas.

Sur la crise psychique : considération inactuelle

ObjectivesAs the concept of crisis has permeated all disciplinary fields, it has become less intelligible. This phenomenon is also valid in psychiatry, on account of the usage of the concept in relation with different realities. Thus, our present case study takes interest in what the psychic crisis is, so as to clarify how it appears for individual subjects through its various manifestations, whose heterogeneity has an undeniable clinical interest. MethodologyIn an attempt to provide a granular definition of the psychic crisis, we will first put forth a historical and etymological study. Then, based on a system of psychoanalytical references supplied with contributions from philosophy and particularly from phenomenology, we will address in what way any psychic crisis comes as a critical reaction to an encounter with the real, which appears as a discontinuity, an event for the subject. ResultsWe theorize that the internal disruption caused by the psychic crisis phenomenon, which tears apart the subject's representations, stems from its unique operating mode by means of the language use to interact with the surrounding world. The subject going through a crisis, and accompanied by health care professionals, will be guided to a decision that aims at creating a new livable mode following the downfall of their former objective certainty. DebateHence, we believe any psychic crisis unravels the subject as a being to themselves. However, such an epiphany is not harmless, which is why the health care professional plays an even greater role in this instance. Running counter to current practices, the health care professional must not hinder the psychic crisis when it arises, but, instead, make space for any uniquely subjective creation that is likely to come forth. ConclusionWe advocate for the emergence of a new mode of being, of dealing with the world, while facilitating the subject's fashioning of their own dynamic narrative, of the crisis they are going through. We believe, indeed, that such are the ethical prerequisites of care, with regard to the psychic crisis.

The psychic crisis and the apology of Nisean affection

The psychic crisis and the apology of Nisean affection

Práticas dos enfermeiros às pessoas em crise psíquica em decorrência do uso abusivo de drogas

Objetivo: compreender as práticas dos enfermeiros em serviço de urgência e emergência às pessoas em situação de crise psíquica decorrente do uso abusivo de drogas. Método: pesquisa descritiva, abordagem qualitativa realizada com 19 enfermeiros que trabalham no pronto-socorro de um hospital geral no interior do Rio Grande do Norte. Os dados foram coletados através de uma entrevista semiestruturada, e após foram submetidos à análise de conteúdo. Resultados: os enfermeiros enfatizam que suas práticas são focadas nos sinais e sintomas da crise psíquica ou usam a escuta como instrumento de prática. Além disso, relataram que as dificuldades enfrentadas nas práticas são o preconceito ao usuário de drogas, a falta de capacitação na área de saúde mental e a estrutura física inadequada do hospital. Conclusão: evidenciou-se a necessidade de qualificação do enfermeiro para cuidar de pessoas que fazem uso abusivo de drogas e maior envolvimento dos serviços que compõem a Rede de Atenção Psicossocial.

Okonkwo and David's Fall: A Social- Psychological Analysis

Almost in every sphere of life social factors shape human thoughts and behaviors. This writing attempts to survey the social-psychological grounds accountable for the ‘fall’ of the black protagonist Okonkwo in Chinua Achebe’s Things Fall Apart and of the white protagonist David Lurie in J.M. Coetzee’s Disgrace. My intention behind picking up two opposite personalities of different social background is not to show the ‘comparative study’ in the sense of the term but to focus on the working of human inner truth and its cyclic response to particular social factors and imposition. An individual’s psychic crisis will arise if he has to receive any unexpected domination, interference or oppression. Likewise, the suppressed feelings of the ‘oppressed’ expose themselves if chance appears. Okonkwo, the Igbo hero of colonized Nigeria, cannot acclimate to the profound changes brought about by the British colonizers and is subjugated in the clash between two cultures and commits suicide to avoid humiliation from the colonizers. As a product of post-apartheid South Africa, David, along with his daughter, is severely assaulted by the newly powerful Blacks as a response of malevolence towards the former colonizers. With some exceptions, the parallel stories of the protagonists holding graceful positions in society and leading lives of free choice at the outset of the novels; going through the transitional period of wrongdoings resulted from individual faults and receiving punishment of facing harsh reality; and ultimately meeting their collapse as a consequence of the intrusive of external forces will ascertain that when panic and prejudice; hatred and resentment; lust for power and dominance come to the fore, effort at reconciliation is disregarded. If this state of affairs emerges, disintegration of human condition is unavoidable. ‘Role reversal’ may occur but ‘long-term peace’ is a concept like a mirage. Examination of psychological working and its relation to social condition can explore this state. This paper will endeavor to study the core causes regarding the inevitability of the fall of Okonkwo and David from social- psychological perspective.

Exploring "psychic transparency" during pregnancy: a mixed-methods approach.

BackgroundPsychic transparency is described as a psychic crisis occurring during pregnancy. The objective was to test if it was clinically detectable.MethodsSeven primiparous and seven nulliparous subjects were recorded during 5 min of spontaneous speech about their dreams. 25 raters from five groups (psychoanalysts, psychiatrists, general practitioners, pregnant women and medical students) listened to the audiotapes. They were asked to rate the probability of the women being pregnant or not. Their ability to discriminate the primiparous women was tested. The probability of being identified correctly or not was calculated for each woman. A qualitative analysis of the speech samples was performed.ResultsNo group of rater was able to correctly classify pregnant and non-pregnant women. However, the raters’ choices were not completely random. The wish to be pregnant or to have a baby could be linked to a primiparous classification whereas job priorities could be linked to a nulliparous classification.ConclusionsIt was not possible to detect Psychic transparency in this study. The wish for a child might be easier to identify. In addition, the raters’ choices seemed to be connected to social representations of motherhood.

Okonkwo and David's Fall: A Social- Psychological Analysis

Almost in every sphere of life social factors shape human thoughts and behaviors. This writing attempts to survey the social-psychological grounds accountable for the ‘fall’ of the black protagonist Okonkwo in Chinua Achebe’s Things Fall Apart and of the white protagonist David Lurie in J.M. Coetzee’s Disgrace . My intention behind picking up two opposite personalities of different social background is not to show the ‘comparative study’ in the sense of the term but to focus on the working of human inner truth and its cyclic response to particular social factors and imposition. An individual’s psychic crisis will arise if he has to receive any unexpected domination, interference or oppression. Likewise, the suppressed feelings of the ‘oppressed’ expose themselves if chance appears. Okonkwo, the Igbo hero of colonized Nigeria, cannot acclimate to the profound changes brought about by the British colonizers and is subjugated in the clash between two cultures and commits suicide to avoid humiliation from the colonizers. As a product of post-apartheid South Africa, David, along with his daughter, is severely assaulted by the newly powerful Blacks as a response of malevolence towards the former colonizers. With some exceptions, the parallel stories of the protagonists holding graceful positions in society and leading lives of free choice at the outset of the novels; going through the transitional period of wrongdoings resulted from individual faults and receiving punishment of facing harsh reality; and ultimately meeting their collapse as a consequence of the intrusive of external forces will ascertain that when panic and prejudice; hatred and resentment; lust for power and dominance come to the fore, effort at reconciliation is disregarded. If this state of affairs emerges, disintegration of human condition is unavoidable. ‘Role reversal’ may occur but ‘long-term peace’ is a concept like a mirage. Examination of psychological working and its relation to social condition can explore this state. This paper will endeavor to study the core causes regarding the inevitability of the fall of Okonkwo and David from social- psychological perspective.

MOBILE EMERGENCY MEDICAL SERVICES IN THE PSYCHOLOGICAL CRISIS AND THE PSYCHOSOCIAL PARADIGM

ABSTRACT The objective was to know the perception and interventions of basic support teams of the mobile emergency medical service in a situation of psychic crisis. This was a qualitative and descriptive research study conducted in the state of Santa Catarina, with four professional teams of the Basic Support Units in Mobile and Emergency Service. The data were collected from April to June of 2011, through semi-structured interviews. Collective Subject Discourse was used to organize and analyze data and to discuss the Psychosocial Paradigm. From the results, three discourses emerged with the main ideas: crisis behavior disorder and psychological instability; hallucinations and aggressiveness; intervention with physical or pharmacological restraint and referral. It is concluded that the concept of crisis is linked by professionals to the positivism of psychiatry, and pre-hospital care follows protocol measures in attending the person in mental crisis, far from the principles determined by the psychosocial paradigm.

Becoming Teachers’ Little Epics: What digital storytelling might reveal

This paper discusses pre-service teachers’ use of multi-modal tools to produce three-minute films in light of critical moments in their teaching practice. Two cases are considered; each centers on a film, a “little epic” that was produced by a future teacher who attempts to work within an anti-racist framework for social justice. Findings point to how multimodal tools are effective for engaging meaningfully with unresolved conflicts. However, in the face of trauma experienced, the future teachers’ efforts to work within a social justice framework may be pushed to the margins. This pedagogy / research sheds light on the workings of the inner landscape of becoming teachers, and highlights the dynamic of education as a psychic crisis compounded by the demands of the social.

Investigation of motivation for providing support to children with malignant diseases

Hair loss in children hospitalized for malignant diseases treatment is most visible manifestation that dramatically influences their later self-confidence. Further, this could strongly affect possible development of psychic crisis. Scientific researches on motivational aspects of involvement for provision of non-formal categories of support to patients with malignant diseases are infrequent. Therefore, this topic should be more investigated in future. Humanitarian initiative 'Kilometer of hair', as unique philanthropic activity at territory of Serbia in year 2015, had as an aim to collect hair for preparation of wigs for children treated for malignant diseases. The main question in our study was definition of key motives for hair donation. We classified three main groups of motives. Altruism was detected as motivation in almost one-half of all interviewed subjects. Second group included almost one third of all subjects and their main motivation for hair donation was empathy. The smallest percentage of hair donors was motivated with some kind of public approval and welcome from society. We believe that further research in this area could give some directives for program planning of further improvement of social awareness for psychosocial support to children with malignant diseases.

Temporal Lobe Epilepsy (TLE) , “déjà vu” phenomenon and religious experiences

A lot of controversies appear regarding temporal lobe epilepsy to bridge the gap between religion and neuroscience. TLE was described in literature in 1869 by Russian writer Dostoievski (who suffered from epilepsy), in his work ”The Idiot”, when the hero Prince Myshkin described his epileptic feelings of sublime sacredness of the inner light. Neurotheology is the science trying to understand the brain activities and to find an integration in religion concepts. TLE aura or psychic crisis is defined by simple or complex hallucinations, mystic divine experience, unpleasant experience of fear and deja vu phenomenon. Neppe and Funkhouser (2006) described the notion as already seen, but it means also already heard,met, heard or visited. The“deja vu” phenomenon is always a subjective experience which can appear in normal subjects or in pathologic states like TLE, schizophrenia or other types of psychosis. It can also be a subjective paranormal experience. Neppe’s definition is now universally used, defined as ‘any subjectively inappropriate impression of familiarity of the present experience with an undefined past’ (Neppe, 1983). Deja vu has an impact on neuroscience and descriptions from history and literature and the multitude of descriptions from experiences demand various scientific explanations.

Intervention in situations of psychic crisis: challenges and suggestions of a prehospital care staff

A qualitative and descriptive research, aimed at knowing how the pre-hospital care professionals perceive the interventions towards people in mental crisis. The study was developed in Santa Catarina with four teams of basic life support units of the Department of Mobile Emergency Care, during April to June 2011. The Collective Subject Discourse was used as the method of analysis. Two themes emerged: Awareness of the difficulties in meeting a person in mental crisis and Suggestions in the search for a closer attention to the person in mental crisis. The difficulties mentioned were related to the lack of training and a local to forward the patients, suggesting a better training and systematization of care. We conclude that it is necessary to invest in the educational process, based on new care strategies guided by the principles of SUS and of the psychosocial paradigm, and revisit the strategy of protocols as guidelines and not as standardizing systems.

The mass murderer history: Modern classifications, sociodemographic and psychopathological characteristics, suicidal dimensions, and media contagion of mass murders

Multicide and other mass killings are sufficiently dramatic to excite great interest from clinicians, criminologists and behavioral scientists. This paper revisits the history of the mass murderer, an entity that has progressively distinguished itself from the serial killer. The functional difference between mass and serial homicide is quite obvious, particularly in setting, time, victim status and modus operandi. Classification of these acts requires a number of parameters. The causes of mass murders are multiple and complex: although they rarely seem to be related to psychotic mental pathologies, they are always an expression of suffering that manifests itself in a psychological crisis that is both homicidal and suicidal. Several research teams have studied the sociodemographic and etiopathogenic characteristics of mass murderers and, in particular, the perpetrators of school killings. In addition to prevalent personality traits, these actions often jointly include suicides and homicides, which are brought together in the same psychic crisis. In keeping with the theory of little identity support, previous crimes influenced some mass murderers. Suicides and mass-murders are likely to be imitated. The media appears to play a crucial role in preventing the occurrence of imitation or copycat tragedies. The WHO recommendation regarding how to transcribe suicide and by extension, homicide, in the media is necessary.

Depth, Significance, and Absence


 
 
 In view of Judith Butler’s assertion that identity as an effect is generated by “cultural apparatus” (Gender Trouble 199), this article interrogates the age-ef- fects generated by early twenty-first century mainstream British theatre. To ana- lyze the complex ways in which age is played out on the British stage—which seem at once both to challenge and to reiterate long-standing assumptions about age—it examines five productions seen in the autumn/winter season of 2011/12. It considers to what extent these productions disrupt the generation of normative age-effects and explores the often contradictory consideration of age in the “multiple realities of performance” (Lipscomb “The Play’s the Thing” 117). This exploration enlists the theories of Butler and others, including Anne Basting, who proposes a model of performance that enacts the body in its “temporal depth” (Stages of Age 22); Anca Cristofovici, who offers a conceptu- alization of the aged body as “significant form” (“Touching Surfaces” 275); and Kathleen Woodward, who ponders the psychic crisis resulting from a rejected, and therefore absent, reflection of the aging body (Aging and its Discontents 53–71). Viewing the staging of age through the lenses of “depth,” “signifi- cance,” and “absence” exposes the meanings of specific age performances and uncovers the age-effects of a theatre responding to the changing context of an aging Britain.
 
 

“Jesus, When Did You Become So Bourgeois, Huh?”

In Chicana/o cultural production, upward mobility has often signified cultural betrayal, and representations of middle-class Chicana/os have been largely absent. This essay surveys the historical and sociological reasons for that tendency, arguing that much of Chicana/o cultural production has exhibited anxiety around representations of class. However, Chicana/o texts that portray middle- and upper-class Mexican Americans, especially in the past decade, suggest the emergence of an alternative identity politics. Richard Rodriguez’s 1982 memoir, Hunger of Memory, articulates the psychic crisis that can arise when one negates a minority identity in order to identify as middle class. By contrast, The George Lopez Show (2002–7) suggests that Chicanos can ascend to the middle class while still retaining a working-class consciousness. Finally, Michele Serros’s young adult novel Honey Blonde Chica (2006) shows how transnational social hierarchies linking the United States and Mexico are also involved in expanding and policing the boundaries of ethnic identity. All three texts dramatize an anxiety about the instability of the class status they represent while also indexing the status of middle-class Mexican Americans in the contemporary Mexican American cultural imagination.

What it means to be an adult child of a person with dementia

The prevalence of dementia as a disease has increased worldwide with advancing age and growing population numbers, affecting whole families. However, most previous research does not separate the spouses or cohabitants from the adult children, but instead regards all next of kin involved in the everyday care of the person suffering from dementia as caregivers. This has made it difficult to find previous research regarding what it means to be an adult child of a person with dementia, and as such, the aim of this study is to explore that topic. The method used was narrative interviews analysed using phenomenological hermeneutics. Our comprehensive understanding showed that to be an adult child of a person with dementia means being burdened with the responsibility to act on behalf of the diseased parent despite a deep sense of grief and loss, which leads to frustration and despondence. The adult children's existence and reality are threatened not only by the loss of the parent but also by the possibility that one day they too may inherit the disease. This could be compared to a psychic crisis, which is defined as a situation that leads to radical changes in the afflicted person's relationship to life and reality, or, simply, “an upset in a steady state.” The findings suggest that adult children of people with dementia are in need of support for a substantial period of time in order to adapt to the fact that they have lost a parent who is still alive. They also need information about the disease and the process of diagnosis and treatment to feel more a part of the process, as well as understand the behavior and needs of their parent.

Self Injury in Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a prevalent mental-health problem among adolescents and young adults, predominantly affecting women. Frequently this disorder is accompanied by self-injuring or auto-aggressive behaviour. In the majority of cases, psychic or physical trauma is determined as being the aetiological factors. This condition is illustrated in the case study of a fifteen-year-old female patient suffering from BPD; a single dose of Belladonna C 200 helped her substantially. Trying to find a remedy for the patient in this case, the method of Polarity Analysis was implemented. Polarity Analysis is an advancement of Boenninghausen's concept of contraindications. It includes the calculation of a probability of healing for any remedy that has to be evaluated by differential diagnosis, with the help of polar symptoms (i.e. symptoms which may be contradictory, e.g. worse cold/better cold). This method can enhance the accuracy of homeopathic prescribing considerably. In this case, which otherwise would typically require a long lasting psychotherapy, diffusion of the deep psychic crisis was achieved by means of implementing this unconventional approach.

"Paternalism" and Recovery

Back to table of contents Previous article Next article LetterFull AccessLetterHerbert S. Peyser M.D.Richard A. Shadoan M.D.Herbert S. Peyser M.D.Search for more papers by this authorRichard A. Shadoan M.D.Search for more papers by this authorPublished Online:1 Dec 2006https://doi.org/10.1176/ps.2006.57.12.1812AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Paternalism" and RecoveryTo the Editor: The Open Forum in the November issue by Patricia Deegan and Robert Drake ( 1 )—"Shared Decision-Making and Medication Management in the Recovery Process"—is important. The authors state, "Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence." They write that compliance interventions "are often designed to increase clients' behavioral conformity to a practitioner's view of optimal treatment." We hope that not all clinicians view compliance in this way. The authors state that "shared decision making assumes that two experts—the client and the practitioner—must share their respective information and determine collaboratively the optimal treatment." Who could argue against this approach, especially for persons with mental illness who are higher functioning? There is deep truth here but also a deep problem. Medication compliance may diminish symptoms, but there is much more to recovery than symptom relief. Recovery goals today include the ability to work and to have relationships with family, friends, and coworkers. The pursuit of these goals may well require participating in psychoeducation and group and family work, learning interpersonal and occupational skills, and finding housing, medical care, and other support to achieve self-government and increase self-esteem and empowerment. Astute treating psychiatrists must listen to and work with their patients, not impose preconceived notions of their own—either by undue pessimism regarding the patient's recovery or by encouragement of unrealistic expectations. Working with patients always includes consideration of side effects and unwelcome consequences of even the most helpful medications.The authors do not give us specifics, but both the devil and the deity are in the details. Disability and disempowerment of patients arise not just from the profession of psychiatry and society but, more importantly, from biopsychosocial pathology and patients' life stresses. The clinician must be experienced in understanding the interplay between patients' biopsychosocial vulnerability and their degree of stress."Paternalism" is given a pejorative connotation by the authors, but in psychic crisis, isn't someone in the parental role often what the troubled person needs and is looking for? Deegan and Drake use the word "client," which derives from a Latin word meaning "leaning on"—referring to "leaning on" a benevolent expert to help and who listens, understands, and works with another as much as and whenever possible. The two clearest examples of the need for so-called "paternalism" are in the case of co-occurring disorders (substance use disorders and other mental illnesses) and of acute psychosis with delusional thinking. Patients in the former group can often spend their disability check on alcohol and drugs before they pay for housing and food, and patients in the latter group are dangers to themselves or others if they stop taking medication.Whenever possible, and certainly for patients with milder mental disorders, we strongly support" shared decision making with medication management." But for patients with co-occurring disorders and acute psychosis, shared decision making is not always possible because the disease can be serious, even dangerous. Such a client may not be able to be "an expert" and needs to be approached in a so-called "paternalistic manner."Dr. Peyser is in private practice in New York City and on the faculty of Mt. Sinai Medical Center and St. Luke's-Roosevelt Hospital. Dr. Shadoan is in private practice in San Francisco and is clinical professor at the University of California, San Francisco.Reference1. Deegan PE, Drake RE: Shared decision making and medication management in the recovery process. Psychiatric Services 57:1636-1639, 2006Google Scholar FiguresReferencesCited byDetailsCited ByUsing Tensions in Practice to Promote the Integration of Treatment and Rehabilitation in a Recovery-Oriented SystemCanadian Journal of Community Mental Health, Vol. 28, No. 2LetterH. Steven Moffic, M.D.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterClaire Henderson, B.M.B.Ch., Ph.D.Chris Flood, B.Sc., M.Sc.George Szmukler, M.D., F.R.C.Psych.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterPatricia E. Deegan, Ph.D.Robert E. Drake, M.D., Ph.D.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterMiodrag Ristich, M.D.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterRobert Bernstein, Ph.D.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterMatthew J. Smith, Ph.D., M.S.W.1 January 2007 | Psychiatric Services, Vol. 58, No. 1LetterDeborah A. Perlick, Ph.D.Robert A. Rosenheck, M.D.Richard Kaczynski, Ph.D.1 January 2007 | Psychiatric Services, Vol. 58, No. 1 Volume 57Issue 12 December, 2006Pages 1812-1813PSYCHIATRIC SERVICES December 2006 Volume 57 Number 12 Metrics PDF download History Published online 1 December 2006 Published in print 1 December 2006

Oi Mother, Keep Ye' Hair On! Impossible Transformations of Maternal Subjectivity

Motherhood is commonly referred to as a transformational experience. Where the psychoanalytic literature articulates the maternal subject and her development, transformation is figured as a working through of infantile issues prompted by the psychic crisis that motherhood represents. Juxtaposing recent autobiographical accounts of the transition to motherhood with the work of Irigaray, and using my own experiences of early motherhood, I look at the way motherhood as a transformational experience is represented as either the movement from unity towards fluidity, or its reverse, the movement from fluidity to the hardening of desire around the unity of the child. I use a discussion of wigs to show how transformation itself is caught by its own material effects, inevitably failing to pass itself off as the magical movement from one state to another. The transition to motherhood is understood as both the painful and playful realisation of the impossibility of transformation itself.