Open Door Review

The Rorschach was administered according to the Comprehensive System (Exner & Erdberg, 2005) and an adaptation to the R-PAS (Meyer, Viglione, Mihura, Erard, Erdberg, 2011). A statistical comparison was performed between time 1, that is, upon admission (t1) and after two years of treatment, that is, time 3 (t3). The variables of Perception and Thinking Domain are (1) Ego Impairment Index-3 ;(2) Thought and Perception Composition (3) Weighted Sum of the six Cognitive Codes; (4) Severe Cognitive Codes; (5) Form Quality Percentages ; (6) Popular [P]. Statistical significant differences were found on four out of the six variables of the Perception and Thinking Domain. The changes toward improvement on perception and thinking are notable, meaning a cognitive improvement among the patients as to reality testing, more conventional perceptions, a decrease in the interference of severe disturbances on thinking and a mental process, which indicated severe pathology. Therefore, there is a clear relationship between the mentalization based treatment or reflective function approach of the psychotherapists and the clear improvements on the perception and reasoning aspects of the patients. Fonagy, Gergely, Jurist & Target (2002) consider that um important aim of psychotherapy is the extension of mentalization. The Rorschach proved to be an ideal instrument to capture the psychic changes caused by psychoanalytical psychotherapy. Psychic changes are those that occur inside the personality due to the development of the object relations, of the capacity to think and to symbolize. It is possible that for these patients with little ego integration and with damaged object relations, the psychotherapy was an experience of significant influence. Contemporary psychoanalysis places emphasis on the analytical relationship as a changing agent, not only in the sense of transference, but mainly as the analyst " s functions related to the holding, according to Winnicott (1956), to the condition of contention and to the facilitation of communication. The true patience of the analyst, his tact, his tolerance, his empathy, his absence of judgment, and his non-critical objectivity are non-interpretative aspects that represent conditions and components of the psychoanalytical process. Therefore, for these patients, the psychotherapist as a holding, nurtured object interested in the patient " s feelings, fantasies, life history and not just interested in symptoms and psychopathology can engender an impact capable of transforming the patient " s psyches and consequently his life. G$#.1/.\! Latife Yazigi, Norma Lottenberg Semer, Maria Luiza de Mattos Fiore, Roberta Katz Abela, Tatiana Gotlieb Lerman, Thaís Cristina Marques. Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo

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