Intervenção desenvolvimentista em psicologia da doença

 

L. JOYCE-MONIZ (*)

LUISA BARROS (*)

 

 

RESUMO

As teorias mais eloquentes da Psicologia da Saúde têm sobretudo a ver com a doença. Esta Psicologia, centrada nas significações das pessoas doentes, coloca questões metodológicas muito mais complexas do que a Psicologia interessada na promoção da Saúde.

Na perspectiva aqui defendida, as grandes dificuldades metodológicas da Psicologia da Doença provêm do paradigma estrutural que orienta os modelos cognitivistas mais frequentemente usados. Em alternativa, é apresentado um modelo desenvolvimentista de intervenção em Psicologia da Doença. Neste modelo, considera-se que a pessoa doente actua de acordo com as suas significações, e que estas podem ser representadas por um nível, que integra uma sequência de níveis de significações - associadas ao sofrimento e/ao seu confronto - cada vez mais abertas, flexíveis, reversíveis, complexas e/ou universais, e caracterizadas pelas acções de diferenciação e de restruturação mais usadas. O diagnóstico dos níveis de significação do doente, dos seus desfasamentos, quanto ao processo de doença, e das acções dialécticas associadas a esses níveis e desfasamentos, permite formular os objectivos e escolher as metodologias a utilizar de modo mais direccionado e eficaz.

Palavras-chave: Psicologia da doença, desenvolvimento, intervenção, metodologias.

 

 

ABSTRACT

The most eloquent theories of Health Psychology are related to illness. This psychology, centered on personal meanings of people who suffer from diseases, rises methodological questions much more complex than the psychology that is directed to the health promotion.

In the perspective presented in this paper, the great methodological difficulties of Illness Psychology originate from the structural paradigm that orients the most common cognitive models of intervention. Here, as an alternative, the authors present a developmental model of intervention in Illness Psychology. In this model, the ill person acts in accordance with her/his personal meanings, and these can be represented by a level, that is integrated in a sequence of levels associated with suffering and coping, that are progressively more open, flexible, reversible, complex and universal, and can be characterized by the differentiating and restructuring dialectical actions most used.

The identification of the person's level of meanings, and of the main dialectical operations and décalages (displacements), allow a more directed and effective formulation of intervention objectives and choice of methodologies.

Key words: Willness psychology, development, intervention, methodology.

 

 

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(*) Faculdade de Psicologia e de Ciências da Educação, Universidade de Lisboa.