{"id":3729,"date":"2026-03-03T06:54:04","date_gmt":"2026-03-03T06:54:04","guid":{"rendered":"https:\/\/damianruiz.eu\/?p=3729"},"modified":"2026-03-03T06:54:04","modified_gmt":"2026-03-03T06:54:04","slug":"la-tos-i-el-toc","status":"publish","type":"post","link":"https:\/\/damianruiz.eu\/ca\/la-tos-i-el-toc\/","title":{"rendered":"La tos y el TOC"},"content":{"rendered":"

<\/h3>\n

Dami\u00e1n Ruiz<\/span><\/h1>\n

 <\/p>\n

Pr\u00f2leg d\u2019introducci\u00f3 al Seminari-Confer\u00e8ncia impartit el 27 de febrer a l\u2019ISCREB de Barcelona per Dami\u00e1n Ruiz, psic\u00f2leg general sanitari (COPC) i analista jungi\u00e0 (membre de l\u2019Institut Jung de Barcelona i de la IAAP)<\/b><\/p>\n

Imaginem que una persona comen\u00e7a a tossir.<\/strong>
\n<\/span>La tos pot ser lleu i passatgera, com passa en un refredat com\u00fa. Pot tractar-se d\u2019una tos seca, irritativa, conseq\u00fc\u00e8ncia d\u2019al\u00b7l\u00e8rgies o de contaminaci\u00f3 ambiental. Pot ser productiva, acompanyada de mucositat, indicativa d\u2019infecci\u00f3 respirat\u00f2ria. Pot ser persistent i cr\u00f2nica, com en l\u2019asma o en la malaltia pulmonar obstructiva cr\u00f2nica. Pot anunciar una pneum\u00f2nia incipient. Pot ser s\u00edmptoma de reflux gastroesof\u00e0gic. En casos m\u00e9s greus, pot ser el primer signe d\u2019una tuberculosi o fins i tot d\u2019un c\u00e0ncer de pulm\u00f3.<\/span><\/p>\n

En tots aquests casos, la tos no \u00e9s la malaltia. \u00c9s el s\u00edmptoma.<\/span><\/p>\n

\u00c9s la manifestaci\u00f3 visible d\u2019un proc\u00e9s org\u00e0nic subjacent. El metge responsable no es limita a suprimir-la sense m\u00e9s. Interroga el seu origen, investiga la seva causa, explora el context cl\u00ednic. La tos \u00e9s un senyal. L\u2019objectiu no \u00e9s silenciar el senyal, sin\u00f3 comprendre qu\u00e8 la produeix.<\/span><\/p>\n

Ara imaginem un escenari diferent.<\/strong><\/p>\n

Suposem que les institucions m\u00e8diques, les organitzacions pol\u00edtiques i el sistema sanitari decidissin invertir tots els seus recursos exclusivament a fer desapar\u00e8ixer la tos. Es desenvolupen potents antituss\u00edgens. S\u2019elaboren protocols efica\u00e7os per reduir el reflex tussigen. Es publiquen estudis que demostren la disminuci\u00f3 estad\u00edstica d\u2019episodis de tos en la poblaci\u00f3.<\/span><\/p>\n

Alguns professionals aconsegueixen que la tos desaparegui en la majoria dels pacients, independentment del seu origen. Es genera un moviment de suport acad\u00e8mic, institucional i econ\u00f2mic al voltant dels qui \u201chan curat la tos\u201d.<\/span><\/p>\n

Per\u00f2 el problema pulmonar, infecci\u00f3s o inflamatori que n\u2019era la base roman intacte.<\/span><\/p>\n

Alguns pacients desenvoluparan complicacions posteriors. Altres aprendran a conviure amb la causa subjacent mentre la tos estigui controlada. L\u2019estad\u00edstica mostrar\u00e0 \u00e8xit simptom\u00e0tic. Tanmateix, l\u2019arrel del problema no haur\u00e0 estat abordada.<\/span><\/p>\n

Aquest escenari, que resultaria inacceptable en medicina, \u00e9s sorprenentment familiar en el camp del trastorn obsessivocompulsiu.<\/span><\/p>\n

El TOC \u00e9s un s\u00edmptoma. M\u00e9s enll\u00e0 d\u2019una possible predisposici\u00f3 gen\u00e8tica, sol emergir en el context de circumst\u00e0ncies traum\u00e0tiques, estressants o desorganitzadores, puntuals o prolongades, sovint durant la inf\u00e0ncia o l\u2019adolesc\u00e8ncia. Les obsessions i les compulsions constitueixen la manifestaci\u00f3 visible \u2014la punta de l\u2019iceberg\u2014 d\u2019una organitzaci\u00f3 ps\u00edquica que ha quedat estructurada al voltant de la por, la inseguretat i la necessitat de control.<\/span><\/p>\n

El s\u00edmptoma obsessiu no \u00e9s el problema essencial. \u00c9s l\u2019expressi\u00f3 d\u2019un conflicte m\u00e9s profund.<\/span><\/p>\n

Tanmateix, all\u00f2 que es troba \u00e0mpliament validat en l\u2019actualitat \u00e9s la reducci\u00f3 del s\u00edmptoma: eliminar la \u201ctos\u201d o aprendre a gestionar-la de la manera m\u00e9s funcional possible. El que sovint queda en segon pla \u00e9s la pregunta que en medicina seria obligat\u00f2ria: qu\u00e8 est\u00e0 produint aquesta tos? Quin proc\u00e9s subjacent est\u00e0 generant el s\u00edmptoma?<\/span><\/p>\n

En l\u2019\u00e0mbit psicol\u00f2gic, la q\u00fcesti\u00f3 equivalent seria: quina estructura ps\u00edquica, quines experi\u00e8ncies primerenques, quines configuracions relacionals i simb\u00f2liques han donat lloc a l\u2019aparici\u00f3 d\u2019obsessions i compulsions?<\/span><\/p>\n

Resulta cridaner que all\u00f2 que mai no es permetria en medicina \u2014ignorar la causa org\u00e0nica d\u2019un s\u00edmptoma i limitar-se a suprimir-lo\u2014 pugui considerar-se suficient en psicologia.<\/span><\/p>\n

La tos no \u00e9s la malaltia.
\nEl TOC no \u00e9s l\u2019arrel del conflicte.<\/strong><\/p>\n

En ambd\u00f3s casos, el s\u00edmptoma assenyala alguna cosa que exigeix ser compresa. Silenciar-lo pot oferir alleujament immediat. Per\u00f2 comprendre\u2019l pot transformar l\u2019estructura que el produeix.<\/span><\/p>\n

www.damianruiz.eu<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Dami\u00e1n Ruiz   Pr\u00f2leg d\u2019introducci\u00f3 al Seminari-Confer\u00e8ncia impartit el 27 de febrer a l\u2019ISCREB de Barcelona per Dami\u00e1n Ruiz, psic\u00f2leg […]<\/p>\n","protected":false},"author":6,"featured_media":3738,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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