“A história não tem de ser o destino” : o risco psicossocial em crianças com famílias disfuncionais
2017
Na nossa experiencia num Servico de Psiquiatria e de Saude Mental da Infância e da Adolescencia confrontamo-nos com criancas e adolescentes com comportamentos de auto e hetero-agressividade, impulsividade, bullying, furtos, consumos de alcool e drogas, que tem um grande impacto nas suas vivencias, na familia, na escola e na comunidade. Estes comportamentos devem ser entendidos como uma forma de expressao do sofrimento psiquico. Ao procurarmos compreender as historias familiares destas criancas e adolescentes encontramos padroes transgeracionais que se repetem, como negligencia, abandono, abusos emocionais, fisicos e sexuais, perdas, disfuncao familiar e incapacidade de contencao e proteccao. Muitas destas criancas pretendem com estes comportamentos recuperarem o objecto amado, numa procura de limites, que lhes permitam uma maior reorganizacao interna, um sentimento de contencao e de proteccao. E necessaria uma intervencao atempada e adequada para que estas criancas e adolescentes nao corram o risco de virem a desenvolver comportamentos antisociais. Uma vez que nem todas as familias demonstram competencias como cuidadoras de criancas e adolescentes em situacoes de risco, e fundamental desenvolver apoios parentais na comunidade. Logo, e essencial uma intervencao multidisciplinar que abranja as diversas valencias nomeadamente a saude mental e intervencao social, pedagogica e juridica. A luz destas reflexoes teoricas iremos ilustrar com algumas vinhetas da nossa experiencia clinica. Due to our experience in a Psychiatric and Mental Health Service for Children and Adolescents we are often faced with children and adolescents with self and hetero-aggressiveness, impulsivity, bullying, theft, consumption of alcohol and drugs which have a great impact on their experiences, on their families, at school and in the community. These behaviours should be understood as an expression of psychic suffering. When we attempt to understand the familiar stories of these children and adolescents we can found transgenerational patterns that are repeated, as neglect, abandonment, emotional, physical and sexual abuse, loss, family dysfunction and failure of containment and protection. What many of these children are looking for with these behaviours is to recover the object beloved, in a demand for boundaries that might enable them to obtain a greater internal reorganization, a sense of restraint and protection. With timely and adequate intervention these children and adolescents might not run the risk of developing anti-social behaviours. Knowing that not all families demonstrate skills as carers of children and adolescents in situations of risk, it is important to develop parental support in the community. Thus it becomes essential to undertake a multidisciplinary intervention covering the various valences namely mental health and social, legal and educational assistance. We will illustrate these theoretical reflections with some vignettes from our clinical experience. Palavras-chave / Keywords Crianca, Adolescente, Risco, Padroes transgeracionais, Intervencao e prevencao. Adolescent, Children, Risk, Transgenerational, Prevention and intervention.
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