The mandala graphic of cancer patients:

) have used them when caring for cancer patients;

-From a psychotherapeutic perspective, with the aid of a mandala, patient evaluation can be carried out in groups, individually or in pairs. Conventionally, its use aims at restoring the person's internal stability, allowing him or her to express conscious and unconscious issues, and in reducing mental stress, it fosters the fullness of the healing. Psychological changes in the patient can be noticed;

-We have approached the mandala as a projective test, leaving all spiritual views to one side. The study of the psychological functioning of the patients in question was our aim.

INTRODUCTION

-14 participants were interviewed individually ; -administration of the resilience scale of Wagnild and Young (1993), translated by Jourdan-Ionescu, Ionescu, Lauzon, Tourigny and Ionescu-Jourdan (2010). This scale evaluates two dimensions which are self-confidence, confidence in the future and personal skills.

-They were asked to delineate three sections on a basic mandala. These sections represent their past, their present and their future. To color in the mandala circles, a set of 24 felt pens were at their disposal. The interview which followed the coloring consisted of pre-set questions (favorite color, least favorite color, appreciation of different periods of time represented on the mandala), then a time in which to speak freely.

PROCEDURE

In this poster, the mandalas of two participants representing opposite ends of the resilience scale are presented.

Can the mandala show the level of resilience of cancer patients ?

The perception of temporality through the mandala, as well as the colors used should shed light on their resilience.

QUESTION OF RESEARCH AND HYPOTHESIS

Alicia Fakhry (1), Evelyne Bouteyre (1), Géraldine De Blasi (2)

(1) Aix-Marseille-Université -Laboratoire LPCS (2) : Centre hospitalier universitaire de Rouen alicia.fakhry@etu.univ-amu.fr At the level of the realization of the mandala :

RESULTS

-The situation of the participant with the weak level of resilience underlines the following paradox: adherence to the medical evidence (very positive care outcomes) leads the participant to define the future in a positive light. However, the colors unmask a poor investment (a reduced number of colors; mostly cold colors). The time taken to realize the mandala also reveals a difficult investment in the future (the sections representing the past and the present took two to three times longer). In conclusion, the patient's weak level of resilience is a true reflection of the coloring realized.

-The participant presenting a strong level of resilience gives a particular place to each period of his life, the past is given the least space; the future is the most developed. These periods are all given warm colors, and their arrangement in the mandala follows the time construction of the thread of life. This use of color shows the patient's capacity to position himself calmly in his present and future life. The section to which he devoted the most time was the future, indicating optimism and his important investment. The patient projects himself beyond the period of illness, without however denying its presence. He integrates the cancer as an experience in the process of shaping his life.

At the therapeutic care level :

The realization of the mandala went beyond its potential of expression of a psychic state. In publicizing the relation participant/psychologist, it allowed the patient to take stock of the place of the illness in his life and enabled him to elaborate it further. In the light of this, it seems entirely appropriate to consider this particular use of the mandala as a way of expressing a level of resilience. It is up to the professional to take it into account in patient care and follow-up. -Future : « The Future, I am unable to think about it, nor to see it taking shape, I hope it will be better. I hope there will not be a recurrence (silence). All the same, I put in some beige, one really needs a color a bit lighter than black (silence). »;

CONCLUSIONS

-The mandala allowed the participants to express their anguish and their serious depressive state linked with their illness, as much in their discourse as in the different time spaces and choice of colors;

-Following the coloring, the patient asked: « Do all the patients react to the illness like me ? I realize I am not doing very well. » Based on these findings, she was allowed to apply for psychological support.

Participant 2

-Man aged 28, single, with testicular cancer;

-High resilience level : 153;

-Order and time of establishing stages in his life on the mandala: 1/past (3'10), 2/present (5'06), 3/future (12'49).

-Here the past is represented by the circle in the center and the primary sections are in a pink color. The present is defined by the green, yellow and red sections -Future : « I have reprioritized my life, I think that the future will be more positive. Of course, I cannot say that everything will be rosy. There will be difficulties which will nuance this teddy bear world, it is for that reason that I used orange, it is an in-between color, for if I have difficulties, in the end they will be seen in perspective. »; »;

-The choice of colors does not change according to the periods of life. The participant explains that : "at the end of the day, it is all just the continuity of life, it does not matter, it is my path, I accept everything that comes my way. ».

Participant 1 -

 1 woman aged 21, single, with Stage II breast cancer; -Weak resilience level : 95; -Order and time of establishing stages in her life on the mandala: 1/past (12'23), 2/present (9'45), 3/future (4'30); -Past : She is unable to recollect events and has no memories, they are like « patterns of unconnected dots without any meaning ». The section representing the past is full of these little dots; -Present : « I am weary of this illness , I have lost my hair, I have lost my friends, I have lost my job … My life does not really have any meaning since I fell ill … I used only black and white because that represents the way I see my life. »;

  . The future corresponds to the orange, and the dark and light pink sections; -Past : « This is the base of my life, of my person. I am very grateful for what I have been able to live, the events have made me what I am. »; -Present : « I used green to represent the cancer, like in the comics, you know. I also used red and pink to show the love that is around me, and which I have felt more intensely since becoming ill, I pay more attention to it in fact. »;


Anne Zabern

Evelyne Bouteyre Verdier

Extract from a program promoting resilience in child

welfare: working on emotional functioning as a protective factro (PF)


domain: shs shs.psy stat

text:
M A Roques

M Pietri

E Bouteyre

    The Life line, a qualitative assessment tool for resilience: its use with an incest victim From theory to practice: assessment of resilience-based intervention programs -Bucharest (Roumania) -27 octobre 2017

Introduction

Subject

Individual variables: coping strategies (Brand et Alexander, 2003) Variables related to the abuse

Social variables

Emotional expression (Shapiro, Kaplow, Amaya-Jackson & Dodge, 2012)

Disclosure of the abuse (Finkelhor, 1990) Positive parental reaction (Elliot and Carnes 2001) Positive institutional reaction

Avoidance (Fortier, 2009) Self-accusation (Frazier, 2003) Seeking social support (Jonzon et Lindbald, 2004) Extended duration of the abuse (Kendall-Tackett et al, 1993) Emotional closeness with the perpetrator(Banyard et al.

2002)

Presence of violence (Beichman et al. 1992) Negative parental reaction (DeBecker,2009)

Risk factors

Protective factors

• Incest is considered a traumatic experience as it can lead to consequences. However, these consequences can vary in their intensity,

• This finding raises question about the detection of the protective factors implicated in the consequences of this type of trauma.

Risk factors and protective factors implicated in the trauma of incest

Method and Case Presentation

 Objective: To present the Life line as a relevant and efficient tool to qualitatively assess the resilience of incest victims from the risk factors and the protective factors at work in the resilience process.

 Hypothesis: The Life line will allow the identification of factors that stem from:

• The indivdual himself

• His environment • His family and his social circle

In order to verify this hypothesis, we conducted a case study  The Life line:

By synthesizing the major life events of participants in a graphic way, the Life line draws on the participants' subjectivity as it collects informations characterized by their perceptions and their representations of the past, the present and the future (Burrick, 2010).

 Procedure:

1. The resilience was assessed on the french translation of the Recilience Scale (Wagnil et Young, 1993;translation by Ionescu, Masse, Jourdan-Ionescu et Favro, 2009) 2. An interview was then conducted during which the participant was asked to draw and comment on her Life line.

 Presentation of the case study

• Myriam is 31 years old, she is an only child. She is married and works as a specialized educator;

• She was abused by her father between the ages of 5 and 12;

• High level of resilience: 149 (the level can vary from 25 to 175)

• The first event Myriam writes on her Life line is the incest she experienced. All the other events she writes are positive. She says : « Accepting the incest I experienced helps me make my way through life. I don't like to say that I rebuilt after the abuse, I built despite what happened»;

• About her family relationships, Myriam says that she moved away to the other side of the country to isolate herself from her family. She says that she is not in touch with her father anymore but she keeps a close relationship with her mother; when talking about the incest, Myriam says: « For a long time I thought it was my fault, I thought that I was responsible for my father's behaviors. Today, I understand that I was just a kid and that I didn't do anything wrong, he is the perpetrator »;

• Myriam concludes the meeting saying : « Psychologically, I think I'm starting to overcome the consequences thanks to the self-help groups, it makes me think a lot, it's a real work for me. Psycholocial work helps me as well. I also go to the ostheopath, I start to get to know myself and to develop self-confidence »;

• About the Life line, Myriam says: « It's an interesting exercise, it allows to bring order to the events we experienced and to have a visual representation. It allows me to make connections about my life » .

Objective and Hypothesis

Conclusion

• Myriam's high level of resilience seems to be in line with her Life line that is mostly composed of significant positive events;

• Myriam knows that she experienced other negative events. She says : « Today, I want to focus on what goes well in my life, on the positive things ». She adds « It's different for the incest, of course if was a negative event in my life, but today, I have learnt to cope and to live with it. This devastating event made me the strong person I am today ». Thus, the negative events Myriam experienced do not seem to be psychologically integrated . Positive events

Negative events

•

  Myriam 's Life line and discourse refer to the following protective and risk factors: • Myriam's case study show the relevance of the Life line in identifying the risk factors as well as the protective factors perceived by the individuals themselves. When writing their Life line, the individuals comment on their life stories. . • From this case study, we can conclude that the Life line appears to be a relevant tool to qualitatively assess the resilience of incest victims by: o The visual aspect of the Life line as the life events are noted on the line; o The way the person appropriates the guideline and draws his Life line;o The discourse that accompanies the creation of the Life line.

Emotional expression :

 expression Myriam says that she often meets with her psychologist and attends a self-help group every month Disclosure of the abuse: Myriam disclosed the incest she experienced when she was a teenager Positive parental reaction: Myriam is supported by her mother Positive institutional reaction: After Myriam's disclosure, her father was incarcerated, juged and condemned Self-accusation: For a long times, Myriam felt guilty and blamed herself for the abuse she experienced Lenght of the abuse: 7 years Emotional closeness with the perpetrator: Yes Acknowledgment: this study is conducted in partnership with the International Association of Incest Victims (