{"id":2822,"date":"2024-11-18T09:12:58","date_gmt":"2024-11-18T09:12:58","guid":{"rendered":"https:\/\/damianruiz.eu\/?p=2822"},"modified":"2024-11-18T09:12:58","modified_gmt":"2024-11-18T09:12:58","slug":"el-tractament-de-la-depressio-major","status":"publish","type":"post","link":"https:\/\/damianruiz.eu\/ca\/el-tractament-de-la-depressio-major\/","title":{"rendered":"El tractament de la depressi\u00f3 major"},"content":{"rendered":"

Dami\u00e1n Ruiz<\/span><\/p>\n

 <\/p>\n

La depressi\u00f3 major afecta a entre un cinc i un set per cent de la poblaci\u00f3 americana i europea.\u00a0<\/span><\/p>\n

A nivell terap\u00e8utic la combinaci\u00f3 de psicof\u00e0rmacs m\u00e9s tractament psicol\u00f2gic \u00e9s el que ve utilitzant-se habitualment per a les persones que pateixen aquest trastorn. En els casos m\u00e9s greus s’ha assajat amb ter\u00e0pies d’estimulaci\u00f3 cerebral.\u00a0<\/span><\/p>\n

Els resultats s\u00f3n ambivalents per\u00f2, avui dia, res s’ha mostrat prou efectiu com per a considerar que hi ha una \u00fanica ter\u00e0pia adequada. Sempre dependr\u00e0 del pacient i de la seva idiosincr\u00e0sia, aix\u00ed com complexitat.<\/span><\/p>\n

Pel que respecta a mi treball amb la hip\u00f2tesi que tot trastorn psicol\u00f2gic t\u00e9 un component biol\u00f2gic, probablement una predisposici\u00f3 gen\u00e8tica, m\u00e9s un desencadenant circumstancial. I sobre el bioqu\u00edmic no es pot incidir perqu\u00e8 marca tend\u00e8ncia per\u00f2 qu\u00e8 es pot fer amb all\u00f2 que ha quedat incrustat en la psique de la persona ja sigui una cosa viscuda en el ventre matern (Frank Lake, 1914-1982), els primers moments de vida (Wilfred Bion, 1897-1979, Donald Winnicot, 1896-1971) o posteriorment.<\/span><\/p>\n

En tot cas les experi\u00e8ncies sofertes amb un clar component traum\u00e0tic ja sigui puntual o durant un per\u00edode de temps, m\u00e9s breu o m\u00e9s llarg, s\u00f3n, en la gran majoria de casos, imprescindibles perqu\u00e8 la predisposici\u00f3 biol\u00f2gica s’activi i fins i tot es faci cr\u00f2nica.\u00a0<\/span><\/p>\n

Llavors imaginem alg\u00fa que en el m\u00e9s profund de la seva psique inconscient, tota aquesta informaci\u00f3 que no accedeix a ser processada pel cervell racional per\u00f2 que condiciona la vida de la persona, viu un conflicte de forces psicol\u00f2giques molt oposades, per exemple la tend\u00e8ncia cap a l’autodestrucci\u00f3 (impuls tan\u00e0tic, Freud, 1856-1939) i la tend\u00e8ncia a la transgressi\u00f3 en la vida real, transgressi\u00f3, per exemple, del codi moral de l’ambient familiar o \u00e8tic circumdant. S\u00f3n energies nervioses molt poderoses que poden portar a prostrar i inhabilitar a la persona per a la vida.<\/span><\/p>\n

Imaginem que a trav\u00e9s de diverses t\u00e8cniques, an\u00e0lisis de somni, exercicis projectius, di\u00e0leg terap\u00e8utic, anal\u00edtic, etc\u2026arribem a descobrir el gran conflicte subjacent. La q\u00fcesti\u00f3 \u00e9s, en aquest cas, qu\u00e8 fem a partir d’aqu\u00ed.<\/span><\/p>\n

Els psicof\u00e0rmacs, dels quals s\u00f3c partidari si milloren la condici\u00f3 del pacient, poden tamb\u00e9 enfortir el conflicte perqu\u00e8 actuen de mode gen\u00e8ric, \u00e9s com, d’algun mode, proveir de nous refor\u00e7os a cadascun dels combatents.<\/span><\/p>\n

Per aix\u00f2, una vegada que el pacient reconeix la lluita interna, les oposicions que bateguen internament, i aix\u00f2 ha requerit un treball terap\u00e8utic previ, cal passar, segons el meu mode de veure, a l’acci\u00f3.<\/span><\/p>\n

Per\u00f2 l’acci\u00f3 ha de tenir un sentit, no es tracta de sortir a passejar, fer esport i distreure’s, tant de bo fos tan senzill. L’acci\u00f3 ha de ser focalitzada a aconseguir que la pulsi\u00f3 eros (de vida), encara que estigui en condicions d’inferioritat, fins i tot si la pulsi\u00f3 de mort \u00e9s molt m\u00e9s poderosa, arribi un moment que venci i retorni a la \u201cexist\u00e8ncia real\u201d al pacient.<\/span><\/p>\n

Aquesta acci\u00f3, al principi, ha de ser gaireb\u00e9 \u00fanica, i ha de ser repetida una vegada i una altra fins que la persona la incorpori com a rutina i encara que li costi un enorme treball realitzar-la.<\/span><\/p>\n

En alguns casos la combinaci\u00f3 d’exercicis corporals i determinat tipus de respiraci\u00f3, un esport de contacte com la boxa o la pr\u00e0ctica de la dansa africana, com a exemple, poden comen\u00e7ar a ser el punt d’inflexi\u00f3, no en si la soluci\u00f3, per\u00f2 s\u00ed all\u00f2 que inici\u00ef el canvi. Si el pacient no es veu capacitat per a iniciar aquests moviments caldr\u00e0 comen\u00e7ar a poc a poc i potser de manera molt m\u00e9s senzilla, per\u00f2 l’acci\u00f3, per molt petita que sigui \u00e9s imprescindible. Per\u00f2 insisteixo no qualsevol acci\u00f3 sin\u00f3 aquella que tingui l\u00f2gica. Personalment detesto la idea que una persona afectada per un trastorn ps\u00edquic no org\u00e0nic hagi de distreure’s o aprendre a manejar-lo per a fer-ho m\u00e9s suportable. Un terapeuta ha d’anar, per tots els mitjans adequats al seu abast, a intentar la superaci\u00f3 del problema o la seva reducci\u00f3 significativa, i a vegades s’aconsegueix i altres no, per\u00f2 si la idea de partida \u00e9s limitada probablement poc es far\u00e0. Una altra cosa \u00e9s quan hi ha una condici\u00f3 org\u00e0nica real diagnosticada i constatada per proves m\u00e8diques.<\/span><\/p>\n

Al llarg de la meva vida, a m\u00e9s de per la psicologia en els seus vessants biol\u00f2gica i psicoanal\u00edtica (especialment junguiana, la meva formaci\u00f3), m’he interessat per q\u00fcestions de tipus antropol\u00f2gic i etol\u00f2gic, llegint sobre la conducta dels animals, especialment primats (Frans de Waal, 1948-2024), per\u00f2 tamb\u00e9 sobre diferents rituals i accions de tribus primitives utilitzats per a sanar ment i cos, i encara que tot aix\u00f2 est\u00e0 descartat avui dia, potser queden els vinculats a la ayahuasca o altres subst\u00e0ncies al\u00b7lucin\u00f2genes, que poden convertir-se en addictius i, per descomptat, contraproduents per a persones amb una estructura ps\u00edquica fr\u00e0gil, \u00e9s una informaci\u00f3 que pot oferir-nos aspectes interessants i a tenir en compte.<\/span><\/p>\n

La depressi\u00f3 profunda \u00e9s, avui dia, tan personal, \u00e9s a dir respon tant a la idiosincr\u00e0sia de cada pacient que els tractaments no poden ser m\u00e9s que personalitzats. Potser algun dia la ci\u00e8ncia donar\u00e0 amb \u201cel m\u00e8tode\u201d per\u00f2 avui cal treballar terap\u00e8uticament amb tota la complexitat procedimental que aix\u00f2 suposa.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Dami\u00e1n Ruiz   La depressi\u00f3 major afecta a entre un cinc i un set per cent de la poblaci\u00f3 americana 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