Το "Συνειδέναι" έδωσε το παρών στο World Psychiatric Association Thematic Conference on Intersectional Collaboration, 5th European Congress of the International Neuropsychiatric Organization and 2nd Interdisciplinary Congress “Psychiatry and Related Sciences”, 30 Οκτώβρη - 2 Νοέμβρη, με τις εξής ομιλίες:
1."Genogram as a tool in evaluating the grieving process"
M. Smyrnioti, M. Panopoulou, P. Athanasouli
Introduction: The term “genogram” refers to a visual respresentation of the family system. It includes family structure, family relationships, expressed and unexpressed emotion, repetitive patterns and coping strategies. It is widely used in Systemic Family Therapy. Our aim was to observe differences in the above mentioned factors as depicted in each family's genogram before and after the death of a family member. Method: This is a theoretical research paper, based on our experiences and systematic observations while supporting families with palliative care needs, before and after the death of the Identified Patient (IP). In this ongoing qualitative pilot study, we have compared specific features of genograms (family relationships and structure, expressed emotion, behavioral patterns) before and after the death of the IP. Results: The intensity of negative emotions and dysfunctional relationships, as depicted in a family genogram before and during the IP's illness, can potentially help the psychotherapist to: (a) predict the quality of the family's grieving process after the IP passes away (normal vs pathological grief), (b) predict the shift in dynamics and the new relational patterns that are bound to emerge, ( c) intervene accordingly in order to assist the whole family go through the grieving process as smoothly as possible. Conclusion: So far, genograms have been used mostly as evaluating tools in systemic therapy practice. In addition to being a valuable source of past information and a tool for evaluating therapy progress, we believe that the genogram can be a valuable tool in predicting future family balance and imbalance shifts when working with terminal patients and their families.
2. "The interaction between social factors and patterns in the augmentation of the diagnoses of bipolar disorder"
M. Panopoulou, M. Smyrnioti, P. Athanasouli
Introduction: In recent years there has been an increase in the number of people diagnosed with bipolar disorder. There are several hypotheses in order to explain this increase. The most plausible hypothesis is the changes made to the criteria according to which someone receives such a diagnosis. Another hypothesis is that social norms of the past years push to create an environment which, in combination with the specific social conditions, can result in an exacerbation of both number of diagnoses and of the extreme emotional inflections that characterize bipolar disorder. As a result, the diagnosis of bipolar disorder acquires the dimension of a social phenomenon, instead of a mere phychiatric condition. Method: Out hypothesis is based on a systematic review of the existing literature in bipolar disorder from a Systemic Theory standpoint. Our aim is to incorporate parental, transgenerational and societal aspects in approaching this mental illness. Conclusions: A very strong hypothesis according to Systemic Theory behind bipolar disorder is that both parents behave differently towards the child, with each parent expessing an extreme – either manic or depressive. The child then is not able to reconcile the conflicting images of parents experiencing a bifurcation of standards. From a societal point of view, society according to Systems Theoy is viewed as an emotional system complete with its own chronic anxiety, projection processes, fusion and differentiation struggels and triangulations. There is an interdependency among individual, familial and societal emotional funtioning – a process known as Societal Emotional Process. Discussion: During the last 15 years, the intense and rapid political changes, combined with a suffocating global economical crisis, have created extremely turbulent and constantly changing social conditions. At the same time, societal standards of “happiness” keep rising. Grief is equated with depression and is ostracized as something unhealthy. People aim at happiness as a goal in itself, ignoring the concepts of effort, stages and progress. We live in a bipolar society, in a bipolar era, and that is portrayed in the psychopathology of everyday life.
3. Τreating a patient diagnosed with bipolar disorder: An integration of Guided Imagery and Music (GIM) and Solution Focused Brief Therapy (SFBT)
Introduction: The aim of this paper is to trace the common ground and establish a connection between verbal psychotherapy and music therapy. SFBT is a future-focused, goal-directed psychotherapeutic approach that uses precise and structured questioning and intends to mobilize the clients' imagery and inner resources. GIM is a receptive music therapy method that utilizes specifically sequenced music programmes, experienced in a relaxed state, to stimulate and sustain a dynamic unfolding of inner experiences, through images, feelings, senses, thoughts or memories elicited by the music, that are later on processed verbally. Method: GIM and SFBT were combined while working with a 35-year -old male, diagnosed 10 months ago with bipolar disorder, after being hospitalized due to a manic episode with strong spiritual features. For 8 months the patient had been receiving Systemic Psychotherapy – both individual and family therapy. His intimate relationship with music, his urge to reconnect with his now lost creativity and, most importantly, his need to comprehend his psychotic experience, a need that was very evident and very difficult to handle by both his family and the therapapist within a verbal context at that point, were motives to incorporate GIM into the therapeutic process and combine it with SFBT guided imagery techniques (the “miracle question” and the “miracle scale”). Discussion: After 5 mixed sessions: a) agreater ability to open up emotionally and share difficult thoughts and emotions b) bypass of cognitive resistance and access to core difficulties. New, deeper issues were addressed for the first time c) normalizing, integrating, providing a meaning to the psychotic episode as a meaningful part of the client's past. Both patient and therapist were provided with a new, common vocabulary that enabled revisiting and comprehending the psychotic episode d) the client acquired the ability to maintain more solid boundaries between reality and the symbolic realm, thoughts and emotions. Conclusion: Music can provide an excellent framework and grounding to support the SFBT techniques. On the other hand SFBT can provide a solid focus, structure and safety within the GIM working process. A combination of the two methods can be very effective when working with difficult population.