By Paul Watzlawick, Víctor Abelardo Martínez de Lapera
A primera vista, todos los hablantes estamos de acuerdo sobre el sentido del termino realidad: es el terreno seguro, l. a. base inconmovible de nuestras vidas, lo opuesto a opinion o punto de vista specific y subjetivo. Con su estilo caracteristico, Watzlawick les muestra a sus oyentes y lectores l. a. fragilidad de este consenso. No recurre para ello a complicadas reflexiones sistematicas, filosoficas o historicas, reservadas a especialistas; su exposicion se centra mas bien en las innumerables paradojas y contradicciones de l. a. vida cotidiana. Con los angeles ayuda de algunas citas brillantes y oportunas, el autor hace tomar conciencia a sus lectores de como l. a. realidad no es otra cosa que el sentido o sinsentido que tienen las cosas y los acontecimientos en nuestras vidas. Es una purple de relaciones que cada uno de nosotros se construye a lo largo de su vida. En psicoterapia, este es un punto de partida del todo decisivo: poco a poco estrategia de los pequenos pasos, por oposicion a cambio brusco y revolucionario podemos ir dotando de sentido a nuestros gestos, de manera que hasta lo absurdo empiece a tener significado. Al concluir los angeles lectura de estas paginas, el lector tiene l. a. sensacion de haber puesto una piedra mas en los muros de l. a. propia casa.
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Hostel, small group horne, wardencontrolled flat). g. Humphreys, Lowe and Blunden, 1984; Freedman, 1988b). Although taking a very broad approach and gathering information from carers and relatives as weH as the dient, those approaches do not involve direct observation of the dient in performing any tasks noted. A better approach is that of Cassidy et al. (1986) based on the STAR profile (Williams, 1982) which involved observing dients in the performance of tasks. Important in the assessment and gathering of information for planning is the speed by which it can be done and the facilities available for assessment.
Community teams facing these difficulties should consider employing a worker whose job is to liaise with various wards and hospital staff, to keep track of changes, and keep the staff informed of the community developments. This person could also keep close contact with those residents who don't have community care workers involved 39 INSTITUTION TO COMMUNITY with them, and to collect important information from staff prior to their departure. Time spent liaising between the hospital and community could enable closer links to develop between the two which could be invaluable to work with residents, due to move.
Institutionalization Numerous writers have pointed to the importance of lack of community contact in the process of institutionalization (Barton, 1956; Goffman, 1961; Sommer and Osmond, 1973). This can result in the 'loss' of friends and relatives, and of the knowledge and skills necessary for social interaction and use of community facilities. Institutionalization has been described as an 'iatrogenic (physicianinduced) disease' (Brody, 1973), manifested in people in long-stay hospitals by depersonalization, dependence, low self-esteem, lack of occupation or fruitful use of time, geographic and social distance from family, friends and cultural milieu, lack of freedom, desexualization and infantilization, crowded conditions and negative, disrespectful or belittling staff attitudes.