OPERATIONAL HYPOTHESIS:
CROSSED VULNERABILITY

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As we mentioned before, most professionals use the concept of co-morbidity to define Dual Diagnosis. Nevertheless, we prefer to use the term Crossed Association, as we believe:


It is equally descriptive and we feel that it gives an added operational value.
In this sense, we base our working hypothesis for the treatment of this type of patients in the concept of crossed vulnerability.

 

This term implies the following elements:


- Crossed…, as the imbalance on one of the Dual Diagnosis axes (either the psychopathological or the drug addiction) leads to an alteration on the other axis, and therefore in the clinical picture. In this sense, we can see in our practice how a psychotic imbalance tends to precede a consumption situation, or, the opposite, how a consumption situation causes a psychotic imbalance which leads to a psychiatric destabilizing process. - …Vulnerability, in so far as someone with Dual Diagnosis shows a lower tolerance threshold of resistance to stress arising from life situations of different nature.


The concept also relates to other elements, on which the intervention process bases itself.


- Tolerance threshold: Our work focuses on strengthening the tolerance threshold to stress caused by life situations.


- Creation of confrontation alternatives: At the end of the day, more appropriate alternatives for confronting stressful situations need to be offered.
In this sense, the direct communication of the patient’s internal states with the professional, or person of reference, constitutes an important protection factor. 

 

- Risk factors and protection factors: It is necessary to know the potential accelerating factors of a relapse, and of all the other, maintenance or boosting factors for the accomplishments achieved in the process. Even though many of those factors are general (as they cause stress to the population as a whole) others are specific to each patient.



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