PSYCHOTERAPIA 1/2004

Grzegorz Iniewicz Depresja u dziewcząt chorujących na anoreksję psychiczną       5 Summary: The article presents data concerning the level of depression in female adolescents with anorexia nervosa. The mutual relation between depression and anorexia nervosa is not clear in spite of a lot of research. 30 adolescent girls suffering from anorexia nervosa according to DSM-IV and 30 adolescent girls without eating problems were examined. They completed the following standardized questionnaires: Eating Disorder Inventory and the Beck Depression Inventory. Significant differences between groups in depression levels were observed. Also, the correlation coefficients revealed some interesting relationships. They are presented and discussed.
Ariadna Romejko-Borowiec Zaburzenia odżywiania się jako specyficzny sposób rozwiązania kryzysu tożsamości płciowej      13 Summary: This article is dedicated to the subject of eating disorders in the context of sexual development of women in adolescence and early adulthood. Epidemiological and symptomatological data on eating disorders was reviewed and results of empirical studies on the sexuality of females with eating disorders as well as several theoretical concepts dedicated to these disorders were analysed. The results of our study, which included 73 females with eating disorders has been also presented. Methods used in the study: Life Check List, and Sentence Completion Test (SCT), a Self-rating Scale on Eating Disorders (FSE). The results suggest a comorbidity of eating disorders and negative attitude towards both sexuality and males neglecting sexual behaviour.
	Joanna Kosmala Skuteczność różnych form interwencji psychologicznych jako czynnika wspomagającego leczenie chorób nowotworowych      23 Summary: This article is aims to present the contemporary concepts and research on the effectiveness of various forms of psychological interventions in cancer treatment. In the first part of the article, the sources and forms of interventions that are not related to any psychological paradigm are presented. The main aim of these techniques - relaxation, visualization and biofeedback - is to influence the physiological mechanisms which may be helpful in overcoming the disease. The results of the research on its effectiveness and contraindications for using it are also described. Moreover the article presents the results of the studies done on the effectiveness of interventions aiming at providing social support and minimizing somatic symptoms related to surgery, chemotherapy and radiotherapy i.e. support groups, structured group therapy, group cognitive - behavioral therapy, hypnosis. These techniques' which have influence on the psychological as well as the somatic well-being of patients are also described in details. To sum up, it can be stated that the form of therapy that complies with most of the demands made to the psychotherapy of cancer patients is structured group therapy, although the other forms are also very potent, but only with reference to certain kind of problems (depressive disorders, stress, somatic symptoms).
Aleksandra Zarek Zmiany obrazu ciała w wyniku choroby i interwencji medycznych      31 Summary: The concept of the body image is a multidimensional one - it applies to the body appearance, its perception, evaluation and emotional attitude towards one's own body. Its dynamics follow physical changes, as well as environmental assessment. Most people do not accept some aspects of their body, though women tend to be less satisfied with their bodies then men. Body image disturbance is often connected with chronic illness or it is present among patients who underwent invasive medical procedures. Body image satisfaction influences the improvement in patients' functioning in motor activities - it is connected with prosthesis satisfaction and contributes to increasing the time of prosthetic usage. Body image satisfaction influences self-esteem and in consequence the undertaking social activities, as well. On the other hand, body image dissatisfaction is connected with an increased level of anxiety and depressive symptoms. Body image training should be included in patients' rehabilitation process, not only in its physical, but also the psychological aspect. Building up of a positive body image in patients and sustaining it, following treatment might be a crucial element facilitating adaptation to the illness.
	Joy Schaverien Śmierć analizowanego: przeniesienie, przeciwprzeniesienie i pragnienia erotyczne      43 Summary: This paper is offered as an exploration of transference and countertransference issues when, in the process of analysis, the analysand becomes terminally ill. Written from the point of view of the analyst, eros and boundary issues are discussed. It is proposed that those who are about to die may form particularly intense erotic attachments and that this is characteristic of a speeded up individuation process. The paper is based on the case of a suicidally depressed man who formed an immediate, dependent and erotic transference. After three months, he was diagnosed as having an inoperable lung cancer. From then on the analytic frame was challenged by pressures to act out in a number of different ways. It is argued that gender difference and the heterosexual pairing facilitated the differentiation of adult, sexual and Oedipal feelings from infantile, pre-Oedipal ones. Maintenance of the analytic frame enabled the individuation process to continue to the end.
Sławomir Murawiec Psychodynamiczne aspekty działania leków psychotropowych według koncepcji G.J. Sarwera-Fonera      67 Summary: According to G.J.Sarwer-Foner neuroleptic drugs in psychiatry offer another variable in human interactions. The therapeutic effect of the drug is not only an objective non personalized event. On the contrary, the effect of the drug in the treatment of a particular person is highly individual. The effect observed on the psychopathology and behavior depends on personalized reactions of the individual patient to the effect of the drug in terms of his/her total intra-psychic, family and social situation. Moreover, transference and counter-transference in the patient-doctor relationship influence the physiologic effects of the drugs.
	Edith Lecourt Muzyka i struktura muzyczna      77 Summary: The author deals not so much with the effects of given musical compositions on the listener - patient (old approach in musical therapy), as with searching for the specifics of musical art. She assumes that the essence of this aspect lays in the multi-vocal simultaneity. Music offers the group a communicational space. The word speaks with one voice, whereas a musical composition - with many voices simultaneously, with exception of the medieval Gregorian horal. The author analyses the process of transition throughout the history of music, from monody to polyphony, using an example of formation of the motet form. Next she shows the analogy between the musical and psychical structure on the base of psychoanalytical theories of D. Anzieu and R. Kaës. Musical structure can be considered in its group dimension as a projection of the group structure of the psychical apparatus of the individual. The "self" is rather multiple, it is a complex structure composed of different voices being in opposition with each other, in conflict or in harmony - completing each other.
Edith Lecourt Praca muzykoterapeuty w psychiatrii      83 Summary: The development of music therapy in France runs parallel to the development of psychiatry, beginning from Philip Pinel, who already spoke in his Dr.Sc. thesis in 1802 about the application of music for stimulation and imparting of dynamism of apathetic patients and calming of those stimulated. For the qualification of the patient to music therapy and the choice of the specific methods, the tool defined as the Psycho musical balance has been applied for about 25 years. During the last years, music therapy in France worked out 7 methods: 1. "feeding" by music, 2. development of the insight and analysis of audio communication (emphasis on the relational aspect), 3. building of the structure of the auditory experience, 4. development of musical thinking, free musical associations and their verbalization, 5. working with symptoms concerning the disturbances of the auditory sphere, 6. therapy of cultural identity, and 7. sensory-motor and affective methods. The meditative methods of music therapy are those most commonly used, in which music mediates in the relation, but the methods which take the isomorphism of the musical and psychical structures into account are also applied. In the conclusion of the paper, the author points to the interesting research areas taken up by the French music therapy, such as own research of the phenomenon of humming in autistic and psychotic child and studying of the sound contents of the dream among others.