Recaída y autoengaño

TITLE: Relapse and self deception.

AUTOR: Sirvent, Carlos; Villa Moral, María; Blanco, Pilar; Delgado, Raquel; Fernández, Clara

FUENTE: Interpsiquis 2013. 14º Congreso Virtual de Psiquiatria.com

PALABRAS CLAVE: Recaída, Engaño, Autoengaño, Insight, Conciencia del problema, Motivación, Tratamiento,

KEYWORDS: Relapse, Deceive, Self deception, Insight, Awareness, Motivation, Treatment

RESUMEN: El autoengaño patológico está presente en buen número de procesos, sobre todo aquellos que son susceptibles de recidivar, en especial los que tienen un curso episódico como ciertos trastornos adaptativos y neuróticos en general, procesos somatopsíquicos, trastornos disociativos, trastornos de la conducta alimentaria, trastornos facticios, trastornos de la personalidad, adicciones, simulación, trastornos de estado de ánimo, incumplimiento terapéutico, duelo, problemas de identidad, etc. Aspectos limítrofes como la falta de conciencia del problema, de insight y de motivación abocan hacia el autoengaño, retroalimentándose mutuamente. Recaer o no en un proceso, depende de un diálogo interno mediatizado no solo por la psicopatología en cuestión (pulsiones, temores, etc.) sino por el autoengaño. Se alcanza el cénit o momento crítico cuando el sujeto -tras una pugna cognitiva en la que “lo que debo hacer” equivale a “lo que quiero hacer”- justifica el ya inminente c omportamiento de recaída. Presentamos un doble estudio, uno cuantitativo y otro cualitativo. El primero consiste en un estudio retrospectivo donde se comparaba el nivel de autoengaño de sujetos que recayeron con otros que habían superado situaciones de riesgo, para lo cual se aplicó el inventario IAM- 40. La muestra la constituían 190 pacientes (82 mujeres y 102 varones) diagnosticados de adicción. El segundo estudio, cualitativo, consistió en cinco grupos de discusión (focus-groups) de 8 miembros cada uno, que debatieron sobre el proceso de recaída y su relación con el autoengaño en base a su propia experiencia. Los componentes de dichos grupos habían recibido la suficiente formación sobre el autoengaño, de manera que aportasen datos sin contaminar la exposición.
Pathological self-deception is present in many processes, especially those which are susceptible to recidivism, in particular those which have an episodic evolution, such as certain adaptive disorders or neurotic disorders in general, somatopsychic processes, dissociative disorders, eating disorders, factitious disorders, personality disorders, addiction, malingering, mood disorders, incompliance with therapy, grieving, identity problems, etc. Border aspects as the lack of awareness, insight and motivation leads toward self-deception, feed on each other. Relapse or not into a process depends on an internal dialogue mediated not only by the psychopathology in question (pulsions, fears, etc.) but self-deception. It reached the zenith or critical moment when the subject after a cognitive conflict in which «what to do» means «I want to do» justifies the imminent relapse behavior. We present a qualitative study, consisting of a series of focus groups of addicted subjects into 5 groups of 8 members to debate on the relapse process and its relation to self-deception based on their own experience. The components of these groups had received sufficient training on deception, so adduce uncontaminated exposure data.

ABSTRACT: Pathological self-deception is present in many processes, especially those which are susceptible to recidivism, in particular those which have an episodic evolution, such as certain adaptive disorders or neurotic disorders in general, somatopsychic processes, dissociative disorders, eating disorders, factitious disorders, personality disorders, addiction, malingering, mood disorders, incompliance with therapy, grieving, identity problems, etc. Border aspects as the lack of awareness, insight and motivation leads toward self-deception, feed on each other. Relapse or not into a process depends on an internal dialogue mediated not only by the psychopathology in question (pulsions, fears, etc.) but self-deception. It reached the zenith or critical moment when the subject after a cognitive conflict in which «what to do» means «I want to do» justifies the imminent relapse behavior. We present a qualitative study, consisting of a series of focus groups of addicted subjects into 5 groups of 8 members to debate on the relapse process and its relation to self-deception based on their own experience. The components of these groups had received sufficient training on deception, so adduce uncontaminated exposure data.

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