MESTRINER, Sonia M.M.E. (1989) – O Procedimento de Desenhos-Estórias em crianças asmáticas [The Drawing-and-Story Procedure in asthmatic children]. Doctoral Thesis. São Paulo (SP), Instituto de Psicologia da USP, 234 pp.
The objective of the present study was to determine the psychodynamics of asthmatic children and to differentiate them from normal children by the Drawing-and-Story Procedure (D-E) introduced by Trinca in 1972, thus contributing to the expansion of D-E use in the area of clinical diagnosis of personality. Two groups of boys aged five to ten years were compared in terms of D-E results. Group I consisted of 30 patients with moderate and serious asthma attended at an outpatient clinic, and group II consisted of 30 public school children matched with those of group I according to sex, age and intellectual level. Evaluation was both qualitative and statistical. In the statistical evaluation, three experienced psychologists, who were aware of a synthesis of the psychodynamics of asthmatic children, assigned individually the 60 D-E protocols to one of the following three categories: A (asthmatic), N (normal) and DK (don’t know). When the frequencies of A and N assignments were correlated with the clinical condition of the subjects – A and N – for each evaluator by means of the contingency coefficient, significant associations at a 0.001 level were obtained. The evaluators did differentiate asthmatic from normal children. Qualitative evaluation consisted of a survey of the characteristic psychodynamics of asthmatic children based on the pooled results of free inspection of the material by two evaluators according to psychodynamic point of view. In the qualitative evaluation, the dynamics of the psyche characteristic of asthmatic children were brought up, by bringing together the results of free inspection of the material by two evaluators. It was found that asthmatic children have an internal world carrying destructive impulses. They live intense persecutory anxieties, because they project and displace their impulses. They have a suffocating and cruel superego that generates anxieties. Having little capacity for elaboration and reparation, they use intense defense mechanisms. In consequence of this dynamic, that involves impulses and super control, these children present inhibitions and impoverishment of the personality, a bad self image, lack of self confidence, a tendency to be immature, fear of a defense rupture and loss of self control. They have fantasies related to space – to prison and liberty – and claustrophobic anxieties. When the impulsive and anxiety charge becomes too intense, a fall of the defenses can occur and an asthmatic crisis can have an outbreak. The respiratory system serves the expression of the conflicts and fantasies regarding the lack of freedom, because its vital function involves expansion and contraction.