Defensive care: social defense in health institutions
Keywords:
Social defenses, Health institutions, Elizabeth Menzies, Wilfred R. BionAbstract
The present work consists of an approach to the concept of Social Defense that consolidates a way of applying psychoanalytical thinking to human institutionalities. The author briefly describes the path taken by psychoanalytic theory to delimit this concept, subsequently emphasizing its implications for health institutions. It points out the importance of considering the ways in which individual defenses tend to collude with the unconscious mechanisms of the institutionalized group when certain conditions are decisive for the containment of primitive mental states. Emphasized here is the possibility of these dynamics having concrete effects on the health and competency of workers, on the treatment of their patients and, above all, on the loss of meaning that these individuals experience in their relations with the institution. Two vignettes are included to illustrate these dynamics.
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References
Bell, D. (1996). Primitive mind of state. Psychoanalytic Psychotherapy, 10, 45-57.
Bion, W.R. (2014). Experiences in groups and other papers. In Mawson, C. (Ed.). The complete works of W.R. Bion, (Vol. 4). Londres: Karnac. (Trabalho original publicado em 1961)
Bion W.R (2014). Learning from experience. In Mawson, C. (Ed.). The complete works of W.R.Bion, (Vol. 4). Londres: Karnac. (Trabalho original publicado em 1962)
Freud, S. (1921). Group psychology and the analysis of the Ego. In Freud, S. Edição standard das obras completas de Sigmund Freud, (Vol. 18). [S.l.:s.n.].
Gabbard G. (2009). Tratamientos en psiquiatría dinámica: hospital informado dinámicamente y tratamiento en hospital de día. In Psiquiatría psicodinámica en la práctica clínica, (3. ed.). Buenos Aires: Médica Panamericana.
Gabbard G. (2014). Treatments in dynamic psychiatry: multiple-treater settings. In Psychodynamic Psychiatry in Clinical Practice, (5.nd ed.). Washington: American Psychiatric Publishing.
Halton W. (2015). Obsessional-punitive defences in care systems: Menzies Lyth revisited. In Armstrong, D. & Rustin, M. (Eds.). Social defences against anxiety : explorations in a paradigm. Londres: Karnac.
Hinshelwood, R.D. & Skogstad, W. (2000). Observing organisations: anxiety, defence and culture in health care. Londres: Routledge.
Jaques, E. (1955). Social systems as a defence against persecutory and depressive anxiety. In Klein, M., Heimann, P. & Money-Kyrle, R.E. New directions in psychoanalysis. Londres: Tavistock.
Kernberg, O.F. (1987). Filosofías contrastantes del tratamiento hospitalário para la psicopatología grave. In Trastornos graves de la personalidad. estrategias psicoterapeuticas. México: Manual Moderno.
Kernberg, O.F. (1998). Ideology, conflict and leadership in groups and organizations. New Haven: Yale University Press.
Klein, M. (2017). On identification. In The collected works of Melanie Klein, (Vol. 3). Londres: Karnac. (Trabalho original publicado em 1955)
Klein, M. (2017). Envy and gratitude. In The collected works of Melanie Klein, (Vol. 3). Londres: Karnac. (Trabalho original publicado em 1957)
Menzies, I. (1988). Containing anxiety in institutions: Selected essays, (Vol. 1). Londres: Free Association.
Menzies, I. (1989). The dynamics of the social: Selected essays, (Vol. 2). Londres: Free Association.
Obholzer, A. & Roberts, V.Z. (2006). The unconscious at work. Individual and organizational stress in the human services. The members of the tavistock clinic consulting to institutions workshop. Londres: Routledge.
Roberts, V.Z. (2006). The self-assigned impossible task. In Obholzer, A. & Roberts, V.Z. The Unconscious at Work. Londres: Routledge.
Segal, H. (1986). Notes on symbol formation. In The work of Hanna Segal: a Kleinian approach to clinical practice. Londres: Free Association. (Trabalho original publicado em 1957)
The Guardian (2019). California family furious after hospital uses robot to tell grandfather he’s dying. 9 Marzo 2019. https://www.theguardian.com/us-news/2019/mar/09/californiarobot-tells-grandfather-dying#img-1
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Atribuo os direitos autorais que pertencem a mim, sobre o presente trabalho, à SPPA, que poderá utilizá-lo e publicá-lo pelos meios que julgar apropriados, inclusive na Internet ou em qualquer outro processamento de computador.
I attribute the copyrights that belong to me, on this work, to SPPA, which may use and publish it by the means it deems appropriate, including on the Internet or in any other computer processing.
Atribuyo los derechos de autor que me pertenecen, sobre este trabajo, a SPPA, que podrá utilizarlo y publicarlo por los medios que considere oportunos, incluso en Internet o en cualquier otro tratamiento informático.
