A TCC PARA OS TRANSTORNOS DO EXAGERO: SUPERANDO A RESISTÊNCIA

Apresentação em tema: "A TCC PARA OS TRANSTORNOS DO EXAGERO: SUPERANDO A RESISTÊNCIA"— Transcrição da apresentação:

1 A TCC PARA OS TRANSTORNOS DO EXAGERO: SUPERANDO A RESISTÊNCIA
Renata Brasil Araujo

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3 Transtorno por uso de substância
Transtornos do Exagero Transtorno por uso de substância c Internet Jogo patológico Comprar compulsivo Sexo compulsivo Tricotilomania Transtorno da compulsão alimentar periódica.

4 POR QUE AS PESSOAS SIMPLESMENTE NÃO PARAM DE EXAGERAR?
Por que as pessoas não mudam o comportamento? Por que as pessoas não melhoram? Por que repetem sempre a mesma coisa?

5 RESISTÊNCIA “Qualquer coisa no comportamento, pensamento, resposta afetiva e estilo interpessoal do paciente que interfere em sua habilidade para utilizar o tratamento e adquirir uma habilidade para lidar com problemas fora da terapia e depois que ela foi concluída” Leahy, 2008

6 Dimensões da resistência seriam estilos de coping hiperdesenvolvidos
For reproduction steps for this slide, refer to the PowerPoint template titled “Static text effects for PowerPoint slides” (STATIC_TEXT.potx), slide number 17.

7 SmartArt custom animation effects: basic radial (Intermediate)
Resistência Moral Vitimização Validação Aversão ao risco Auto-incapacitação Esquemática Auto-consistência SmartArt custom animation effects: basic radial Also under Bevel, to the right of the Top list, in the Height box, enter 30 pt. Press and hold SHIFT, and then on the left circle, drag a corner adjustment handle toward the center to decrease the size. (Intermediate) On the Home tab, in the Font group, in the Font Size box, enter 40, and then click Bold. To reproduce the SmartArt on this slide, do the following: On the Home tab, in the Slides group, click Layout, and then click Blank. Drag the top circle slightly toward the bottom of the slide. On the Insert tab, in the Illustrations group, click SmartArt. In the Choose a SmartArt Graphic dialog box, in the left pane, click Relationship. In the Relationship pane, click Basic Radial (sixth row, second option from the left), and then click OK to insert the graphic into the slide. To reproduce the line effects on this slide, do the following: Press and hold CTRL, and then select each of the four lines connecting the circles in the SmartArt graphic. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Line Color in the left pane, select Gradient line in the Line Color pane, and then do the following: On the slide, select the SmartArt graphic, and then click one of the arrows on the left border. In the Type your text here dialog box, in the top level bullet, enter the text for the center circle of the graphic. In the second-level bullets, enter the text for all the other shapes in the SmartArt graphic. In the Type list, select Linear. In the Direction list, select Linear Right (first row, fourth option from the left). With the SmartArt graphic still selected, on the Design tab, in the Themes group, click Colors, and then select Median. Under Gradient stops, click Add or Remove until two stops appear in the drop-down list. Under SmartArt Tools, on the Format tab, in the Size group, do the following: Also under Gradient stops, customize the gradient stops as follows: Select Stop 1 from the list, and then do the following: In the Shape Height box, enter 5”. In the Stop position box, enter 0%. In the Shape Width box, enter 7.5”. Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left). Under SmartArt Tools, on the Design tab, in the SmartArt Styles group, click SmartArt Styles, and then under Best Match for Document select Intense Effect (fifth option from the left). Select Stop 2 from the list, and then do the following: On the Home tab, in the Font group, click the button next to Font Color, and then under Theme Colors select Black, Text 1 (first row, second option from the left). In the Stop position box, enter 100%. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click 3-D Format in the left pane, and in the 3-D Format pane, under Surface, do the following: In the Transparency box, enter 100%. Also in the Format Shape dialog box, click Line Style in the left pane, and in the Line Style pane do the following: In the Material list, under Special Effect, select Soft Edge (first row, second option from the left). In the Width box, enter 3.5 pt. In the Lighting list, under Neutral, select Harsh (first row, fourth option from the left). In the Dash type list, select Round Dot (second option from the top). In the Angle box, enter 30°. Press and hold CTRL, and select all five shapes in the SmartArt graphic. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Shadow in the left pane. In the Shadow pane, in the Presets list, under Outer select Offset Bottom (first row, second option from the left), and then do the following: To reproduce the animation effects on this slide, do the following: On the Animation tab, in the Animations group, click Custom Animation. On the slide, select the SmartArt graphic, and then in the Custom Animation task pane, to the following: Click Add Effect, point to Entrance, and select More Effects. In the Add Entrance Effect dialog box, under Moderate, select Zoom. In the Transparency box, enter 65%. In the Size box, enter 103%. In the Blur box, enter 9 pt. In the Angle box, enter 90°. Click the arrow to the right of the zoom entrance effect, and then select Effect Options. In the Zoom dialog box, do the following: In the Distance box, enter 3 pt. To reproduce the SmartArt effects on this slide, do the following: On the Effect tab, in the Zoom list, select In from Screen Center. On the slide, select the center circle in the SmartArt graphic, and then on the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click 3-D Format in the left pane, and in the 3-D Format pane do the following: On the Timing tab, in the Speed list, select 1 seconds (Fast). On the SmartArt Animation tab, in the Group graphic list, select From center one by one. Under Bevel, in the Top list, under Bevel, select Circle (first row, first option from the left). In the Custom Animation task pane, expand the contents of the list by clicking the double arrow under the zoom entrance effect, and then do the following: Also under Bevel, to the right of the Top list, in the Width box, enter 24 pt. Select the first effect (zoom entrance effect), and under Modify: Zoom, in the Start list, select With Previous. Also under Bevel, to the right of the Top list, in the Height box, enter 12 pt. Select the second effect (zoom entrance effect), click Change, point to Entrance, and then select More Effects. In the Change Entrance Effect dialog box, under Basic, select Wipe. On the slide, select the top circle in the SmartArt graphic, and then on the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, and in the Fill pane do the following: Click the arrow to the right of the second effect (now wipe effect) and select Effect Options, and then in the Wipe dialog box do the following: Click Solid fill. Click the button next to Color, and then under Theme Colors select Orange, Accent 2 (first row, sixth option from the left). On the Effect tab, in the Direction list, select From Bottom. Also in the Format Shape dialog box, click 3-D Format in the left pane, and in the 3-D Format pane do the following: On the Timing tab, in the Delay box, enter 0.5. On the Timing tab, in the Speed list, select 0.5 seconds (Very Fast). Also under Bevel, to the right of the Top list, in the Width box, enter 20 pt. Select the fourth effect (zoom entrance effect), click Change, point to Entrance, and select More Effects. In the Change Entrance Effect dialog box, under Basic, select Wipe. Also under Bevel, to the right of the Top list, in the Height box, enter 15 pt. Press and hold SHIFT, and then on the top circle, drag a corner adjustment handle toward the center to decrease the size. Click the arrow to the right of the fourth effect (now wipe effect) and select Effect Options, and then in the Wipe dialog box, do the following: On the Home tab, in the Font group, in the Font Size box, enter 20. Drag the top circle approximately 0.5” to the right. On the Effect tab, in the Direction list, select From Left. Select the right circle in the SmartArt graphic, and then on the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, and in the Fill pane do the following: Select the sixth effect (zoom entrance effect), click Change, point to Entrance, and select More Effects. In the Change Entrance Effect dialog box, under Basic, select Wipe. Click the button next to Color, and then under Theme Colors click Gold, Accent 4 (first row, eighth option from the left). Click the arrow to the right of the sixth effect (now wipe effect) and select Effect Options, and then in the Wipe dialog box, do the following: Press and hold SHIFT, and then on the right circle, drag a corner adjustment handle toward the center to decrease the size. Select the eighth effect (zoom entrance effect), click Change, point to Entrance, and then select More Effects. In the Change Entrance Effect dialog box, under Basic, select Wipe. On the Home tab, in the Font group, in the Font Size box, enter 28 pt. Drag the right circle slightly toward the right corner of the slide. One the slide, select the bottom circle in the SmartArt graphic, and then on the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, and in the Fill pane do the following: Click the arrow to the right of the eighth effect (now wipe effect) and select Effect Options, and then in the Wipe dialog box, do the following: On the Effect tab, in the Direction list, select From Right. Click the button next to Color, and then under Theme Colors click Green, Accent 5 (first row, ninth option from the left) Under Bevel, in the Top list, select Circle (first row, first option from the left). To reproduce the background on this slide, do the following: Also under Bevel, to the right of the Top list, in the Width box enter 24 pt. Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following: Also under Bevel, to the right of the Top list, in the Height box enter 12 pt. Press and hold SHIFT, and then on the bottom circle, drag a corner adjustment handle away from the center to increase the size. In the Type list, select Radial. In the Direction, list click From Center (third option from the left). On the Home tab, in the Font group, in the Font Size box, enter 28. On the slide, select the left circle in the SmartArt graphic, and then on the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, and in the Fill pane do the following: Click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 35% (third row, second option from the left). In the Color list, under Theme Colors select Olive Green, Accent 3 (first row, seventh option from the left). Also under Bevel, to the right of the Top list, in the Width box, enter 30 pt.

8 RESISTÊNCIA DE VALIDAÇÃO
Demanda por: empatia, entendimento, assistência do terapeuta Quem se vê como defeituoso pode interpretar como invalidante uma terapia focada em distorções do pensamento

9 AUTO-INVALIDAÇÃO Paciente recusa-se a aceitar suas próprias necessidades Auto-invalidação é um problema central para a terapia Dificuldade para identificar, aceitar a legitimidade das suas necessidades Vê a terapia como sem sentido ou perturbadora

10 AUTOCONSISTÊNCIA Coerência cognitiva 1 Regularidade do viés 2

11 Navegar é preciso Acreditar durante muito tempo que o mundo terminava em um abismo foi adaptativo Aprendemos a navegar dentro deste mundo Se a crença sobre a forma do mundo fosse muito variável não teríamos saído dos portos

12 COERÊNCIA (CONSISTÊNCIA) COGNITIVA
Modelo de autoverificação (Swann): pessoas procuram informações que comprovem seu autoconceito (positivo ou negativo) Desejamos consistência interna Reduz incerteza e complexidade Processamento mais rápido das informações (não é preciso fazer exceções ou esquemas diferenciados) O processo fica mais rápido e eficiente, não obrigatoriamente mais preciso “Vantagens” da consistência

13 Teorias sobre si mesmo Tendência a desenvolver vieses inconscientes em favor de características semelhantes às nossas. Estamos satisfeitos com nossas teorias sobre nós mesmos, mas raramente as testamos. Gostamos de pensar: “comigo isto não acontece, mas...” Mlodinow, 2013

14 Regularidade do viés O que facilita é que somos tendenciosos, não temos plasticidade. “Viciamos” em alguns vieses Caminho para ir para a roça

15 RESISTÊNCIA ESQUEMÁTICA
O paciente vive dentro de uma congruência cognitiva com seus esquemas) Esquema afeta a reconstrução da memória Distorce a informação para “caber no esquema” Difícil pensar em “nova evidência” Esquema iniciais mal-adaptativos “Deu certo até agora, por que mudar?” Quais os modos de enfrentamento?

16 RESISTÊNCIA ESQUEMÁTICA
Identificar o esquema Compartimentalizar o esquema: sua identidade não é reduzível ao esquema

17 RESISTÊNCIA ESQUEMÁTICA
Conceitualizar o caso Experimentos para examinar a validade dos esquemas Abordar a reatância Associar o esquema à transferência Ficar atento para os vieses cognitivos que vitaminam o esquema

18 RESISTÊNCIA MORAL O paciente vive sob uma “tirania do dever”
Ênfase hipertrofiada no self como causa e responsável Pode pensar que a terapia vai transformá-lo em relapso e imoral Categorizar : bons “deveria” e maus “deveria” Se este norte fosse aplicado a todo mundo, como seria? Ex: “Devo ser perfeito” Ser responsável é sinônimo de colocar forte pressão sobre si mesmo

19 RESISTÊNCIA DE VITIMIZAÇÃO
O sujeito só se reconhece no papel de vítima “ Coisas ruins acontecem com pessoas ruins” “Coisas boas acontecem com pessoas boas” Isto não deveria ter acontecido comigo por que eu não merecia”

20 RESISTÊNCIA DO TIPO AVERSÃO A RISCOS
Muito capital Maximizar ganhos Pouco capital Minimizar perdas

21 Evitar mais perda Qual a meta? Efeito perda em cascata
(Advanced) 3-D wood block with texture and engraved text To reproduce the shape effects on this slide, do the following: On the Home tab, in the Slides group, click Layout, and then click Blank. On the Home tab, in the Drawing group, click Shapes, and then under Rectangles, click Rectangle (first option from the left). On the slide, drag to draw a rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following: In the Shape Height box, enter 3”. In the Shape Width box, enter 3”. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, and then in the Fill pane, select Picture or texture fill. Click the button next to Texture, and then click Oak (fifth row, third option from the left). Also in the Format Shape dialog box, click Line Color in the left pane, and then in the Line Color pane, then select No line. Also in the Format Shape dialog box, click 3-D Rotation in the left pane, and then in the 3-D Rotation pane, do the following: Click the button next to Presets, and then under Perspective click Perspective Left (first row, second option from the left). In the X box, enter 40°. In the Y box, enter 10°. In the Perspective box, enter 20°. Also in the Format Shape dialog box, click 3-D Format in the left pane, and then in the 3-D Format pane, do the following: Under Bevel, click the button next to Top, and then under Bevel click Circle (first row, first option from the left). Click the button next to Bottom, and then under Bevel click Circle (first row, first option from the left). Under Depth, in the Depth box, enter 200 pt. Under Surface, click the button next to Material, and then under Standard, click Warm Matte (second option from the left). Click the button next to Lighting, and then under Neutral, click Soft (first row, third option from the left). In the Angle box, enter 270°. Also in the Format Shape dialog box, click Shadow in the left pane, and then in the Shadow pane, click the button next to Presets, and then under Perspective, click Perspective Diagonal Upper Right (first row, second option from the left). To reproduce the text effects on this slide, do the following: On the slide, right-click the rounded rectangle, click Edit Text, then enter text. Select the text. On the Home tab, in the Font group, select Arial Rounded MT Bold from the Font list, and then select 36 from the Font Size list. Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane, and then in the Text Fill pane, do the following: On the Home tab, in the Paragraph group, click Center to center the text within the rectangle. Also in the Format Text Effects dialog box, click Shadow in the left pane, and then in the Shadow pane, do the following: Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 130, Green: 101, and Blue: 58. Select Solid fill. In the Distance box, enter 5 pt. In the Transparency box, enter 25%. Click the button next to Presets, and then under Inner click Inside Diagonal Top Left (first row, first option from the left). To reproduce the background on this slide, do the following: Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following: In the Type list, select Linear. Click the button next to Direction, and then click Linear Down (first row, second option from the left). Under Gradient stops, , click Add gradient stops or Remove gradient stops until four stops appear in the slider. Also under Gradient stops, customize the gradient stops that you added as follows: Select the first stop in the slider, and then do the following: In the Position box, enter 0%. Select the second stop in the slider, and then do the following: Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 196, Green: 178, and Blue: 152. In the Position box, enter 45%. Select the third stop in the slider, and then do the following: Click the button next to Color, and then under Theme Colors click Tan, Background 2, Darker 90% (sixth row, third option from the left). In the Position box, enter 72%. Select the fourth stop in the slider, and then do the following: Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 66, Green: 62, and Blue: 50. In the Position box, enter 100%. Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 149, Green: 128, and Blue: 107. Efeito perda em cascata

22 AUTO-INCAPACITAÇÃO Síndrome de Gabriela...

23 Transtornos do Exagero - Desafios
Resistências que podem ser aplicadas a quaisquer outros quadros clínicos Abrir mão de um comportamento que tem em sua essência o prazer

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26 OBRIGADA E... UM BEIJO EXAGERADO!