PERINA, E. M. Estudo clínico das relações interpessoais da criança com câncer nas fases finais [A clinical study of the interpersonal relationships of children with cancer in the terminal phases]. 260 p. Master’s Dissertation – Instituto de Psicologia da USP. São Paulo (SP), 1992.
Abstract: A psycho-clinical study was carried out in order to investigate the interpersonal relationships of children with cancer during the phases of progression of the sickness: relapse. Closed prognostic and terminal phase. Through the psychological care of ten children with cancer during all the phases of progression of the sickness it was possible to perceive the psychodynamic processes present in their interpersonal relationships. As well as their life experiences during the process of dying and of death. The results were interpreted through a psychoanalytic view, and indicated that as the threat of death becomes more real in the life of the children, primitive mechanisms of defense, such as denial, scission, excessive forms of introjective and projective identification, and idealization are put to work to protect them from the anguish of dissolution of their individuality and of the loss of the objects beloved. It was observed that in their interpersonal relationships there was a relation of dependence at a regressive level and desire to re-establish a symbiotic bond with the mother. The fears arising from their fantasies, increased by their death instinct which is directed to themselves and their organism, are accentuated. Following this, they project the hate and the guilt due to their terminal condition, on the Health Care Personnel or on their relatives. In this ambivalent manner, they experience intense fears of loss, anxiety and guilt due to attacks in the relation with their own “self” and with internal and external objects. Demandative anxieties and manic defenses predominate. We can remark a permanent search for “thanatologic beings”. Through this analysis it is possible to see the importance of taking preventive measures with the family of the children with terminal cancer and with the staff of professionals who assist them, in order to have an appropriate elaboration of mourning and in this way establish the possibility of effective help for the children in their process of dying.