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The role of the fear-of-loss-of-control marker within the accounts of people affected by dementia about their illness: implications for psychotherapy
Titolo Rivista: QUADERNI DI PSICOTERAPIA COGNITIVA 
Autori/Curatori: Richard Cheston 
Anno di pubblicazione:  2015 Fascicolo: 37 Lingua: Inglese 
Numero pagine:  21 P. 45-65 Dimensione file:  181 KB
DOI:  10.3280/QPC2015-037003
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


Lo studio della consapevolezza di malattia in persone affette da demenza circa il loro stato patologico in termini sociali e psicologici può essere affrontata ponendo attenzione all’analisi dei cambiamenti dei processi psicologici nel loro verificarsi, sia nel contesto psicoterapeutico che nella vita quotidiana. Il Modello dell’Assimilazione (Assimilation Model) descrive una serie di stadi ipotizzati come il percorso di assimilazione delle esperienze problematiche che il paziente effettua nel corso di un trattamento psicoterapico efficace. Gli indicatori degli stadi dell’assimilazione fanno riferimento a tipi di eventi, riconoscibili nel discorso psicoterapeutico, associati a quegli stadi, e che possono risultare utili sia nella clinica che nella ricerca. Questo lavoro descrive i modi in cui l’azione del marcatore "timore di perdere il controllo" diventa riconoscibile nelle narrative autobiografiche delle persone affette da demenza. L’analisi di esempi del marcatore "timore di perdere il controllo" suggerisce che esso possa essere associato all’evitare di far riferimento alla demenza chiamandola con il suo nome (ciò che qui definiamo fenomeni Voldemort), oppure alle esperienze di vergogna, nonché ai timori della perdita del sé, espressi per esempio attraverso la paura di impazzire. Vengono discusse le implicazioni rispetto alla presa a carico e alla terapia da intraprendere dopo la diagnosi.


Keywords: Demenza, Malattia di Alzheimer, psicoterapia, assimilazione, perdita di controllo.

  1. Alzheimer’s Disease International (2012). World Alzheimer Report 2012. London: Alzheimer’s Disease International.
  2. Betts N., Cheston R. (2011). From warding off to working through: helping people facing a diagnosis of dementia to change their relationship with their memory problems. PSIGE Newsletter, 118: 34-42.
  3. Cheston R. (1996). Stories and metaphors: talking about the past in a psychotherapy group for people with dementia. Ageing and Society, 16: 579-602.
  4. Cheston R. (1998). Psychotherapy and dementia: a review of the literature. British Journal of Medical Psychology, 71: 211-231.
  5. Cheston R. (2013). Dementia as a problematic experience: using the Assimilation Model as a framework for psychotherapeutic work with people with dementia. Neurodisability and Psychotherapy, 1, 1: 70-95.
  6. Cheston R., Jones R. (2009). A small-scale study comparing the impact of psycho-education and exploratory psychotherapy groups on newcomers to a group for people with dementia. Aging and Mental Health, 13, 3: 410-425.
  7. Cheston R., Jones K., Gilliard J. (2003). Group Psychotherapy and People with Dementia. Aging and Mental Health, 7, 6: 452-461.
  8. Cheston R, Jones K., Gilliard J. (2004). “Falling into a hole”: narrative and emotional change in a psychotherapy group for people with dementia. Dementia: the International Journal of Social Research and Policy, 3, 1: 95-103.
  9. Gee J. (1986). Units in the production of narrative. Discourse processes, 9: 391-422.
  10. Gee J. (1991). A linguistic approach to narrative. Journal of Narrative and Life History, 1: 15-39.
  11. Gergen K., Kaye J. (1992). Beyond narrative in the negotiation of therapeutic meaning. In: McNamee S., Gergen K., editors, Therapy as Social Construction. London: Sage.
  12. Gilbert P. (1988). Shame and Guilt. Changes, 6: 50-53.
  13. Gilbert P. (1997). The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. British Journal of Medical Psychology, 70: 113-147.
  14. Gilbert P. (2000). The relationship of shame, social anxiety and depression: the role of the evolution of social rank. Clinical Psychology and Psychotherapy, 7: 174-189.
  15. Gilbert P., Andrews B. (1998). Shame: interpersonal behaviour, psychopathology and culture. Oxford: Oxford University Press.
  16. Guss R. et al. (2014). Clinical Psychology in the Early Stage Dementia Care Pathway. London: The British Psychological Society.
  17. Hermans H., Kempen H. (1992). The dialogical self: beyond individualism and rationalism. American Psychologist, 47: 23-33.
  18. Honos-Webb L., Stiles W. (1998). Reformulation of Assimilation analysis in terms of voices. Psychotherapy, 35, 1: 23-33.
  19. Honos-Webb L., Surko M., Stiles W.B. (1998). Manual for rating assimilation in psychotherapy: February 1998 version. Unpublished manuscript. Department of Psychology, Miami University, Oxford, Ohio.
  20. Honos-Webb L., Lani J.A., Stiles W.B. (1999). Discovering markers of assimilation stages: The fear of losing control marker. Journal of Clinical Psychology, 55: 1441-1452.
  21. Honos-Webb L., Surko M., Stiles W., Greenberg L. (1999). Assimilation of voices in psychotherapy: the case of Jan. Journal of Counselling Psychology, 46: 448-460.
  22. Kessler E., Bowen C.E., Baer M., Froelich L., Wahl H. (2012). Dementia worry: a psychological examination of an unexplored phenomenon. European Journal of Ageing, 9, 4: 275-284.
  23. Lishman E., Cheston R., Smithson J. (2014). The Paradox of Dementia: meaning making before and after receiving a diagnosis of dementia. Dementia: the International Journal of Social Research and Policy, published on line 27/2/14., 10.1177/147130121452078DOI: 10.1177/147130121452078
  24. Logsdon R., Pike K.C., McCurry S.M., Hunter P., Maher J, Snyder L., Teri L. (2010). Early-Stage Memory Loss Support Groups: Outcomes from a Randomized Controlled Clinical Trial. Journal of Gerontology: B Psychological Science and Social Sciences, November; 65B, 6: 691-697.
  25. Mair M. (1989). Between psychology and psychotherapy: A poetics of experience. London: Taylor & Frances/Routledge.
  26. Marshall A., Spreadbury J., Cheston R., Coleman P., Ballinger C., Mullee M., Pritchard J., Russell C., Bartlett E. (2015). A Pilot Randomised Control trial to compare changes in quality of life for participants with early diagnosis dementia who attend a “Living Well with Dementia” group compared to waiting list control. Aging and Mental Health, 19,6: 526-535., 10.1080/13607863.2014.95452DOI: 10.1080/13607863.2014.95452
  27. Newman D., Beail N. (2002). Monitoring change in psychotherapy with people with intellectual disabilities. The application of the Assimilation of Problematic Experiences Scale. Journal of Applied Research in Intellectual Disabilities, 15: 48-60.
  28. Sims D., McCrum T. (2012). Measuring the benefits. Journal of Dementia Care, 20, 4: 20-22.
  29. Stiles W. (2001). Assimilation of Problematic Experiences. Psychotherapy, 38, 4: 462-465.
  30. Stiles W., Meshot C., Anderson T., Sloan W. (1992). Assimilation of problematic experiences: The case of John Jones. Psychotherapy Research, 2: 81-101.
  31. Stiles W. (1999). Signs and Voices in Psychotherapy. Psychotherapy Research, 9, 1: 1-21.
  32. Stiles W., Honos-Webb L., Lani J. (1999). Some functions of narrative in the assimilation of Problematic experiences. Journal of Clinical Psychology, 55, 10: 1213-1226.
  33. Stiles W.B. (2001). Assimilation of problematic experiences. Psychotherapy, 38: 462-465.
  34. Varvin S., Stiles W. B. (1999). Emergence of severe traumatic experiences: An assimilation analysis of psychoanalytic therapy with a political refugee. Psychotherapy Research, 9: 381-404.
  35. Watkins B., Cheston R., Jones K., Gilliard J. (2006). “Coming out with Alzheimer’s disease”: changes in insight during a psychotherapy group for people with dementia, Aging and Mental Health, 10, 2: 1-11.



  1. Richard Cheston, Gary Christopher, Confronting the Existential Threat of Dementia pp. 73 (ISBN:978-3-030-12349-9)
  2. Hannah Aldridge, Paul Fisher, Ken Laidlaw, Experiences of shame for people with dementia: An Interpretative Phenomenological Analysis in Dementia /2019 pp. 1896, DOI: 10.1177/1471301217732430
  3. Richard Cheston, Ann Marshall, Angharad Jones, John Spreadbury, Peter Coleman, Living well with dementia groups: changes in participant and therapist verbal behaviour in Aging & Mental Health /2018 pp. 61, DOI: 10.1080/13607863.2016.1231171
  4. Richard Cheston, Emily Dodd, Gary Christopher, Charlie Jones, Tim Wildschut, Constantine Sedikides, Selective forgetting of self-threatening statements: Mnemic neglect for dementia information in people with mild dementia in International Journal of Geriatric Psychiatry /2018 pp. 1065, DOI: 10.1002/gps.4894
  5. Richard Cheston, Lauren Gatting, Ann Marshall, John H Spreadbury, Peter Coleman, Markers of assimilation of problematic experiences in dementia within the LivDem project in Dementia /2017 pp. 443, DOI: 10.1177/1471301215602473
  6. Richard Cheston, Ada Ivanecka, Individual and group psychotherapy with people diagnosed with dementia: a systematic review of the literature in International Journal of Geriatric Psychiatry /2017 pp. 3, DOI: 10.1002/gps.4529

Richard Cheston, Il ruolo dei marcatori "timore di perdere il controllo" nel contest dei racconti di persone affette da demenza rispetto alla loro malattia: implicazioni per gli interventi in psicoterapia in "QUADERNI DI PSICOTERAPIA COGNITIVA" 37/2015, pp. 45-65, DOI:10.3280/QPC2015-037003

   

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