STIGMA IN CLINICAL PRACTICE

Much more is known about attitudes toward mental illness and social stigma, the viscious cycle of its consequences and how to fight the social stigma in public, but much less is known about how to combat the stigma and self stigma in clinical practice. Stigma theories have not been enough to understand the feelings and experience of people with mental illness. Conceptual framework that understands stigma as consisting of difficulties of knowledge (ignorance or misinformation), problems of attitudes (prejudice), and problems of behaviour (discrimination) have not o been enough to understand stigma dynamics in the patient therapist interaction. Understanding the psychodynamic aspects of internalized stereotype of mental illness in the patient- therapist relationship may improve our competency to deal with stigma and self stigma in clinical practice

GENDER AND SHIZOPRENIA

In accordance with the predonimant view on the neurobiolgy of schizoprenia, most of the research on the diferences in the illness between men and women has been studied on the basis of sex difference as a biological category rather than on the basis of gender as a psychosocial category. There are gender- identity difficulties observed in schizophrenia. Problems associated with gender can be a major sorce of instability and vulnerability during the development of the first and later psychotic episodes. There is a need for future research to view sex difference through gender perspectives. Findings from a gender study may have utility for the development of differential treatment interventions for men and women and may improve the outcome of the illness in general. The study of the complex role of gender in illness processes is an important research direction that would enhance our understanding of the heterogeneity in the manifestation and subjective experience of schizophrenia

Reactions of family with member with mental disorder

Cilj rada je približiti rad s obitelji s članom oboljelim od psihičkog poremećaja kao učinkovitu metodu koja treba biti dio standardnog plana liječenja većine osoba oboljelih od psihičkih poremećaja. Učinkovitost ove metode potvrđena je u znanstvenim istraživanjima i u kliničkoj praksi. U radu su opisane reakcije obitelji nakon saznanja o psihičkoj bolesti člana obitelji, edukacija o bolesti i rad na poboljšanju komunikacija u obitelji. Edukacija o bolesti osim informacija o bolesti i liječenju uključuje i rad s emocionalnim aspektima reakcije na bolest. Teme rada s obitelji uključuju simptome bolesti, razumijevanje bolesti u psihobiosocijalnom konceptu, teoriju osjetljivosti na stres, prognozu bolesti, prepoznavanje ranih znakova pogoršanja, liječenje lijekovima, psihoterapijom i rehabilitacijom, plan prevencije i stigmu. Stigma u obitelji i stigmatiziranje obitelji može biti veća prepreka oporavku od same bolesti. U radu se opisuju različite reakcije obitelji na saznanje o psihičkoj bolesti člana obitelji. Reakcije uključuju negaciju, tugu i žalovanje, doživljaj neuspješnosti, sram i stigmu. Ove reakcije mogu negativno djelovati na ishod bolesti oboljelog člana i na rizik za bolest članova obitelji, osobito kada se radi o bolesti za koju je potrebna dugotrajna podrška oboljelom članu. Cilj rada s obitelji je pomoći obitelji da se bolje nosi s bolesti oboljelog člana i da se potiču ponašanja koja pomažu oporavku od bolesti. Rad također opisuje, kroz iznošenje konkretnih primjera, metode rada s obitelji koje mogu utjecati na povoljniji ishod bolesti i smanjiti mogućnost ponovne pojave bolesti, kao što su rad s pretjeranom kritikom i pretjerano zaštitničkim ponašanjem.The aim of working with families where a member suffers from mental disorders is a cost effective method that should be part of standard treatment plan for most individuals suffering from mental disorders. The effectiveness of this method was confirmed in scientific research and clinical practice. This paper describes the reactions of the family after being informed about the mental illness of a family member, education about the illness and work to improve communication within the family. Education about the illness except information about the illness and treatment includes working with the emotional aspects of the reactions to illness. Topics include symptoms, psychobiosocial concept, the stress vulnerability theory, prognosis, detecting early signs of exacerbation, treatment including medication, psychotherapy and rehabilitation plan for prevention. Stigma in the family and family stigmatization may be greater obstacles to recovery from the illness than illness alone. The family reactions to illness include denial, sadness and mourning, the experience of failure, shame and stigma. These reactions may negatively affect the outcome of illness and increase the risk for illness of family members especially when it comes to illness which requires long-term support from the family. The goal of working with families is to help families to better cope with illness and to encourage communication that help recovery from illness. The paper also describes the specific methods of working with families such as working with the over-critical and overly protective behavior

PSYCHODYNAMIC UNDERSTANDING AND PSYCHOTHERAPEUTIC APPROACH TO PSYCHOSES

The historical development of the psychodynamic approach to psychotherapy is described. The origins of ISPS are described, and ISPS Croatia and Slovenia are introduced

TRAUMA, SHAME AND PSYCHOTIC DEPRESSION EXPERIENCED BY ex-POWs AFTER RELEASE

Modern societies are growing ever more sensitive to the various sources and many kinds of psychic traumas, resulting even in psychotic reactions or states of functioning. Especially the war captivity situation represents the prolongued basis for chronic severe psychic stress and traumatisation, that may become deleterious even for the core self of the person. Severely psychotraumatized war veterans, or ex-POWs in the aftremath of the war captivity situation, survivors of extreme forms of violence and humiliation, are very reluctant to recall traumas. This avoidant behaviour is many times one of the most prominent symptoms that should be recognised and confronted in order to start the retraumatising process of healing the previously unthinkable traumas. The authors believe that shameful feelings are at the very basis of the psychotraumatised persons\u27 withdrawal, depression, suicidal attempts, and even psychotic answers. The main feature of the first phase of any therapeutic work with these patients is the mourning process that should be gradually unfolded. The clinical examples will illustrate therapeutic work with these patients. The authors will expose some basic psychodynamic approaches and concepts regarding shame. This difficult feeling will be put in relationship with the psychotic answers. In that frame of reference the concept of \u27near psychosis\u27 will be described