Dimensões sociais da psicopatologia: um estudo sobre a influência de práticas culturais
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Data
2019-02-26
Autores
Perossi, Gabriela Rizzo
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os atendimentos e as estratégias tradicionalmente empregados na área da saúde parecem não ser suficientes para tratamento de forma adequada e efetiva dos sintomas. Neste sentido, dois aspectos chamam atenção: a limitação da perspectiva da doença enquanto uma patologia com base biológica e a centralidade do sujeito na explicação sobre o comportamento. Apenas a explicação biológica não parece ser suficiente para elucidação das “doenças mentais” e mesmo daquelas consideradas orgânicas, como patologias de pele, diabetes, hipertensão, cujos hábitos e experiências podem atenuar ou agravar os sintomas. Por outro lado, apesar de os determinantes sociais serem notados no plano aplicado, pouco se tem feito na área de saúde direcionado a esse aspecto e as propostas interventivas centram-se no nível individual, com frequência em uma perspectiva mentalista. Diante deste quadro, compreender a dimensão social da doença mental é de fundamental importância para a mudança de paradigma. Isto posto, compreendemos como objetivo interpretar, sob a perspectiva da análise comportamental da cultura, a influência de práticas culturais quanto à constituição e manutenção das psicopatologias. Com base nos pressupostos analítico-comportamentais na área da cultura e em dimensões aplicadas da atuação profissional na área da saúde mental, fundamentamos este estudo teórico na seleção, análise e interpretação de textos psicológicos. Discutimos a visão tradicional a respeito dos transtornos psiquiátricos, apontando as limitações explicativas da visão mentalista e patologizante acerca do comportamento inadequado considerado anormal ou atípico. Ademais, explicitamos a compreensão da Análise do Comportamento a respeito das psicopatologias, compreendendo-as como um fenômeno comportamental controlado funcionalmente por variáveis ambientais, selecionado e mantido por variáveis filogenéticas, ontogenéticas e culturais. Em uma perspectiva selecionista do comportamento, a dimensão cultural foi foco de análise, sendo repertórios comportamentais classificados como psicopatológicos e relacionados a práticas comportamentais em situação de grupo. Nesse sentido, contrapomo-nos ao entendimento da psicopatologia como produto de aspectos ou instâncias imateriais e consideramos que grande parte do comportamento é controlada pelo ambiente essencialmente social. A título de elucidação e compreensão da influência das práticas culturais como variáveis influentes no comportamento psicopatológico, procedemos à descrição e análise de algumas contingências da cultura ocidental possivelmente relacionadas às psicopatologias, dentre elas práticas culturais individualistas, práticas culturais que promovem o enfraquecimento de contingências naturais e práticas culturais coercitivas. Por fim, ponderamos que as análises realizadas não almejam abarcar todo o fenômeno e prover soluções ao complexo comportamento classificado como psicopatológico, mas se apresentam como discussões preliminares para compreensão da dimensão cultural e planejamento de ações em saúde que considerem medidas direcionadas a grupos e não apenas a indivíduos.
The therapys and strategies traditionally employed in health care are not enough to treat symptoms of adequate and effective manner. In this sense, two aspects call attention: the limitation of the perspective of the disease as a biologically based pathology and the centrality of the subject in the explanation about the behavior. Only a biological explanation does not seem to be sufficient for elucidation of "mental illness" and even those considered organic, such as skin diseases, diabetes, hypertension, whose habits and experiences may mitigate or aggravate the symptoms. On the other hand, although the social determinants are seen in the applied plan, little has been done in the area of health directed to this aspect and the interventional proposals focus on the individual level, often in a mentalist perspective. In this context, understanding the social dimension of mental illness is of fundamental importance for paradigm change. That said, we understand as objective interpreting, from the perspective of behavioral analysis of culture, the influence of cultural practices as the establishment and maintenance of psychopathology. Based on the analytical-behavioral concepts in the area of culture and on the dimensions of professional activity in the area of mental health, we are based this theoretical study in the selection, analysis and interpretation of psychological texts. We discuss the traditional view regarding psychiatric disorders, indicating explanatory limitations of the mentalistic and pathological view about the inappropriate behavior considered abnormal or atypical. In addition, we explain the understanding of Behavior Analysis regarding psychopathologies, understanding them as a behavioral phenomenon functionally controlled by environmental variables, selected and maintained by phylogenetic, ontogenetic and cultural variables. In a selective perspective of behavior, the cultural dimension was the focus of analysis, being behavioral repertoires classified as psychopathological and related to behavioral practices in a group situation. In this sense, we oppose understanding of psychopathology as a product of immaterial aspects or instances and we consider that much of the behavior is controlled by the essentially social environment. In order to elucidate and understand the influence of cultural practices as influential variables in psychopathological behavior, we proceed to the description and analysis of some contingencies of western culture possibly related to psychopathologies, among them individualistic cultural practices, cultural practices that promote the weakening of natural and coercive cultural practices. Finally, we ponder the analysis did not aim to cover the whole phenomenon and provide solutions to complex behavior classified as psychopathology, but are presented as preliminary discussions to understanding the cultural dimension and planning of health actions what consider activities aimed at groups and not just to individuals.
The therapys and strategies traditionally employed in health care are not enough to treat symptoms of adequate and effective manner. In this sense, two aspects call attention: the limitation of the perspective of the disease as a biologically based pathology and the centrality of the subject in the explanation about the behavior. Only a biological explanation does not seem to be sufficient for elucidation of "mental illness" and even those considered organic, such as skin diseases, diabetes, hypertension, whose habits and experiences may mitigate or aggravate the symptoms. On the other hand, although the social determinants are seen in the applied plan, little has been done in the area of health directed to this aspect and the interventional proposals focus on the individual level, often in a mentalist perspective. In this context, understanding the social dimension of mental illness is of fundamental importance for paradigm change. That said, we understand as objective interpreting, from the perspective of behavioral analysis of culture, the influence of cultural practices as the establishment and maintenance of psychopathology. Based on the analytical-behavioral concepts in the area of culture and on the dimensions of professional activity in the area of mental health, we are based this theoretical study in the selection, analysis and interpretation of psychological texts. We discuss the traditional view regarding psychiatric disorders, indicating explanatory limitations of the mentalistic and pathological view about the inappropriate behavior considered abnormal or atypical. In addition, we explain the understanding of Behavior Analysis regarding psychopathologies, understanding them as a behavioral phenomenon functionally controlled by environmental variables, selected and maintained by phylogenetic, ontogenetic and cultural variables. In a selective perspective of behavior, the cultural dimension was the focus of analysis, being behavioral repertoires classified as psychopathological and related to behavioral practices in a group situation. In this sense, we oppose understanding of psychopathology as a product of immaterial aspects or instances and we consider that much of the behavior is controlled by the essentially social environment. In order to elucidate and understand the influence of cultural practices as influential variables in psychopathological behavior, we proceed to the description and analysis of some contingencies of western culture possibly related to psychopathologies, among them individualistic cultural practices, cultural practices that promote the weakening of natural and coercive cultural practices. Finally, we ponder the analysis did not aim to cover the whole phenomenon and provide solutions to complex behavior classified as psychopathology, but are presented as preliminary discussions to understanding the cultural dimension and planning of health actions what consider activities aimed at groups and not just to individuals.
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Palavras-chave
Análise do comportamento, Behaviorismo radical, Análise comportamental da cultura, Psicopatologia, Práticas culturais, Behavior analysis, Radical behaviorism, Behavior analysis of culture, Psychopathology, Cultural practices