In the plot of trauma: relations between the personality of women with breast cancer and the oncologic recurrence from a psychoanalytic psychosomatic view. / Na trama do trauma: relações entre a personalidade de mulheres acometidas por câncer de mama e a recidiva oncológica sob a ótica da psicossomática psicanalítica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

The scientific community has become increasingly interested in the psychological aspects of breast cancer over the last two decades. Several studies on this issue suggest that patients personality can affect the course of the disease, but only a few address this issue specifically. The purpose of the present study was to compare dynamic aspects and structural elements of personality in two distinct groups of women with breast cancer, in terms of the course of the disease. The sample consisted of a group of women in remission (n=8), Group 1, and another of women with recurrence (n=8), Group 2. Every participant was registered in a communitarian entity, followed the recommended medical treatment, and presented no psychiatric history. Data collection was performed through psychological interviews and administrating the Thematic Apperception Test (TAT). The obtained data were initially submitted to qualitative, descriptive, and exploratory analyses, and, later, organized in case studies. In addition, the data were interpreted under a psychoanalytic psychosomatic view based on the articulation between the theoretical propositions of Marty and McDougall. Considering the current state-of-the-art, this study has an innovative methodological design. The results show that most participants in Group 1 have an appropriate logical integration, adjustment capacity, and defensive functioning, but their impulse control is restrictive. The parental imago have essentially positive associations and the dynamics of the interpersonal relationships ranges from dominance to submission. The conflicts were associated with the oscillation between desires of passivity and rigidity or to the insustainability of narcissistic ideals were typical and the contact with ones own subjectivity seemed pitiful, but feasible. Group 2 was different because most participants adjustment capacity was compromised by a great difficulty to use their internal reality as a reference to organize their external reality. Their defensive function is sustained by the decontextualized appeal to psychological operations that suggest a poorly consistent ego structure. Impulse control is restrictive and the parental imago had a predominantly negative association. In addition, an excessive attachment to the reality due to erasing the mental dynamics led to social conformity of affect, to the contention of the imaginative activity or even to libidinal stasis. Therefore, it can be stated that operational thinking and disaffectation are the main personality characteristics of women in recurrence, evaluated in this study. Consequently, cancer recurrence can be inserted in the plot of trauma caused by the outcomes of diagnosis and treatment of the primary tumor, since these characteristics promote the replacement of symbolization by the biological reaction when potentially destructuring events occur. The present study, thus, favors the initial comprehension of the psychodynamic mechanisms through which the patients personality is capable of influence the course of breast cancer.

ASSUNTO(S)

psicanálise psychoanalysis breast neoplasms recidiva recurrence neoplasias mamárias psychosomatics personalidade. psicossomática personality.

ACESSO AO ARTIGO

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