Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0053
Trends in Psychiatry and Psychotherapy
Original Article

Approaching patients with hyperreflectivity and perplexity: an empirical qualitative investigation

Abordando pacientes com hiper-reflexão e perplexidade: uma investigação qualitativa empírica

Sidse Marie Arnfred; Paul Møller; Annette Sofie Davidsen

http://dx.doi.org/10.1590/2237-6089-2017-0053 Trends Psychiatry Psychother, vol.40, n3, p.216-225, 2018
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Abstract

Abstract Objective Perplexity and hyperreflectivity are considered important aspects of self-disorders in patients with schizophrenia, yet knowledge of the appropriate psychotherapy for these patients is sparse. We aimed to explore how phenomenological psychologists or psychiatrists described their approach to these patients and their own emotional response when hyperreflectivity and perplexity emerged in therapy or consultations. Methods Four e-mail interviews with experienced clinical researchers within the field of phenomenology and schizophrenia were examined using a double hermeneutic qualitative analysis. Results The informants offered reassurance by authority and the encouragement of sharing of experiences interlaced in the beginning of therapy. Later they went on relating expressions of hyperreflectivity and perplexity to emotions, life events and goals. They described feelings of admiration and professional recognition along with worry, insecurity and sadness. Conclusion The list of primary themes covers what might seem very basic therapeutic interventions. However, the careful and open-minded manner in which these were carried out was noteworthy. The double task of staying closely attuned to the patient’s airy reflections and, at the same time, when the patient was ready for it, carefully making links to domains of the patient’s everyday life, was clearly molded to patients with fragile attachment.

Keywords

Phenomenology, psychotherapy, schizophrenia, subjectivity, self-disorders

Resumo

Resumo Objetivo A perplexidade e a hiper-reflexão são consideradas aspectos importantes dos desordens do self em pacientes com esquizofrenia, porém o conhecimento sobre o tipo mais apropriado de psicoterapia para esses pacientes é escasso. Nosso objetivo foi explorar como psicologistas fenomenológicos ou psiquiatras descrevem suas abordagens a pacientes aos pacientes e sua própria resposta emocional, quando a hiper-reflexão e a perplexidade emergem durante a terapia ou as consultas. Métodos Quatro entrevistas feitas por e-mail com pesquisadores clínicos experientes na área de fenomenologia e esquizofrenia foram examinadas usando análise qualitativa dupla hermenêutica. Resultados Os informantes ofereceram confiança via autoridade e motivação para compartilhar experiências, interligadas, no início da terapia. Subsequentemente, eles seguiram relacionando expressões de hiper-reflexão e perplexidade a emoções, eventos de vida e objetivos. Eles descreveram sentimentos de admiração e reconhecimento profissional juntamente com preocupação, insegurança e tristeza. Conclusão A lista de tópicos primários engloba o que poderiam parecer intervenções terapêuticas muito básicas. No entanto, a forma cuidadosa e aberta como essas intervenções foram conduzidas é digna de nota. A tarefa dupla de estar atento às reflexões aéreas do paciente e, ao mesmo tempo, quando o paciente está pronto, cuidadosamente estabelecer relações com os domínios de sua vida diária, foi claramente moldada para pacientes com vínculo frágil.

Palavras-chave

Fenomenologia, psicoterapia, esquizofrenia, subjetividade, desordens do self

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