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Yıl:2016; Cilt: ; Sayı: 25>> Özet
Yansıtma: Psikopatoloji ve Projektif Testler Dergisi; 2016;(25):135-157
Tutulamayan Yas
M Turgay, EU Oğuz
"Ölüm, bir yaşamı sonlandırır, bir ilişkiyi değil" M. Albom Beden/düşünce ikilisi insan varoluşunun temel bir öğesidir. Tutarlılık, bütünleşme isteği ve bağ kurma arzusunu da içerir. Herkes hayatının bir döneminde kriz, yas gibi yaşamının olağan akışını bozan iç/dış güçlüklerle karşılaşabilir, bu durumlarda bazı kişiler normal hayatlarına devam edip, hasta olmazken bazıları ise hasta olur. Psikosomatik hastalıkları ruhsal dünyanın işleyişi ile açıklayan psikanalitik görüş, zihinselleştirme kapasitesi, düşlemsel yetersizlikler, temel depresyon (nesnesiz depresyon) gibi kavramlarla psikosomatik hastalara farklı bir bakış açısı getirmiştir. Psikosomatik hastalık baskılanan dürtüler ve duygulanımlar arttığında ve biriktiğinde, öte yandan zihinselleştirme kötü olduğunda ortaya çıkmaktadır. Bu çalışmada depresif yakınmalarla başvuran, 52 yaşında, evli, 2 çocuklu, emekli bir kadın öğretmenin 10 yıl içinde anne, baba, iki ağabeyinin ölümü sonrası ortaya çıkan psikosomatik hastalıkları (KOAH, ürtiker, irritabl barsak sendromu), klinik öyküsü ve uygulanan projektif testlerin (Rorschach testi ve T.A.T) sonuçlarından bahsedilecektir. Hastanın Rorschach testinde yanit sayısının normal, kontrol çabalarının duygusal dünyanın ortaya çıkmasını engellediği, dil yapısının savunmacı olduğu, T.AT. de; kaygısını narsisistik eksen üzerinden anlattığı, hikayeleri kişiselleştirmediği, gerilediğinde çok depresif olduğu, nesne ilişkilerini anlatamadığı saptanmıştır. Hastanın borderline-narsisistik yapılanmalarda görülen yansıtma, bastırma, kontrol, idealizasyon, izolasyon, yarılma şeklinde savunma düzeneklerini kullandığı düşünülmüştür.
Unmourned Loss
"Death ends a life, not a relationship." M. Albom The dual of mind and body is the key component of human existence. Consistency consists of the need to connect and the wish for integration. Every individual may face internal/external difficulties such as a crisis or mourning a loss at one time in their lives. At these times some continue with their normal lives and not get ill whereas some experience illnesses. The psychoanalytical approach, explaining the psychosomatic diseases through the functions of the psychic world, leads to a unique understanding of these patients by the use of concepts such as mentalization, essential depression, insufficient fantasy. Psychosomatic disorders emerge when suppressed impulses and affect increase and accumulate in the absence of sufficient mentalization. This study examines a 52 year old patient: who is married with 2 children, a retired teacher, whose main complaints were depressive symptoms and started experiencing psychosomatic diseases (COPD, hives, irritable bowel syndrome) after the loss of her mother, father and two brothers within the last ten years; her clinical history and the projective test findings (Rorschach and TAT). Patient's Rorschach response number was within the normal range, her efforts of control hindered the revealing of her inner world, her linguistic structure was defensive. T.A.T. responses disclosed an expression of anxiety through narcissistic axis, a non-personalized content, becoming very depressive when regressed, an inability to express object relations, and defenses in line with an borderline/narsisistic personality structure such as projection, repression, control, idealization, isolation, repression, splitting have been observed.

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