MANEJO TÉCNICO DO ATENDIMENTO PSICOLÓGICO EM AMBULATÓRIO DE REPRODUÇÃO HUMANA ASSISTIDA

O presente estudo teve por objetivos: descrever o manejo técnico do atendimento psicológico, ilustrado pelo caso de uma paciente infértil de um ambulatório de reprodução humana assistida; descrever as vicissitudes no campo analítico nestes atendimentos; e sistematizar esse manejo técnico em intervenções ambulatoriais em que se privilegia a compreensão das relações transferenciais. O instrumento utilizado para a coleta de dados foram os próprios atendimentos, ou entrevistas psicológicas, baseadas no método clínico de abordagem psicanalítica. A análise e a discussão dos resultados se basearam na apresentação de um único caso, que ilustrou a técnica que se objetivou sistematizar e descrever. É apresentado o caso da Sra. S., uma mulher de 41 anos, com parceiro em união estável há cinco anos, que realizava tratamento de infertilidade no ambulatório de reprodução humana. A paciente foi atendida pela psicóloga no próprio ambulatório durante o período da segunda tentativa de gravidez. Foram realizados efetivamente três (3) atendimentos e, no período de dois meses, a paciente não compareceu a três (3) sessões. Foram criadas cinco (5) categorias de análise: 1) Escuta; 2) Configuração de Queixa Psicológica; 3) Manejo dos Conflitos; 4) Manejo da Transferência; e 5) Enquadre. Estas categorias representaram elementos do atendimento. A divisão do atendimento em categorias teve propósito didático, no entanto, a sistematização do manejo deu-se a partir do desenvolvimento destas categorias, mas não numa ordem pré-estabelecida. A Escuta refere-se à capacidade do psicoterapeuta compreender a relação estabelecida com o paciente, assim como os elementos metapsicológicos depositados no campo, a partir de seu quadro de referência teórico-metodológico. A Configuração de Queixa Psicológica refere-se à aproximação do sofrimento psíquico e dos conflitos que subjazem à queixa orgânica ou manifesta. O Manejo dos Conflitos representa o modo como são interpretados e devolvidos a um paciente os conteúdos trazidos para a sessão. Ressalta-se, no manejo dos conflitos, a eleição de um foco de trabalho em que se privilegia a situação atual da vida do paciente relacionada especificamente à sua queixa. O Manejo da Transferência refere-se à forma como os aspectos transferenciais são compreendidos e devolvidos ao paciente. A neurose e psicose de transferência são evitadas e o trabalho é preferencialmente desenvolvido a partir da interpretação de situações extra-transferenciais. Por fim, o Enquadre engloba todos os aspectos formais e dinâmicos que constituem o campo emocional sobre o qual se trabalha. Este tipo de atendimento pode ser situado entre a entrevista psicológica e o atendimento em psicoterapia breve com objetivos e tempo limitados, variando de acordo com a qualidade adaptativa do paciente e sua motivação para o atendimento psicológico. Concluímos que este modelo de atendimento ambulatorial engloba aspectos tanto diagnósticos quanto de intervenção e que o papel do psicólogo neste contexto é auxiliar o paciente atendido a compreender sua queixa em seus aspectos latentes e manifestos, além de propiciar um espaço de escuta em que os conteúdos trazidos podem ser pensados e compreendidos

Uso do protocolo no serviço de psicologia e avaliação psicodinâmica em candidatos à cirurgia bariátrica

A clínica da Obesidade Mórbida e a Cirurgia Bariátrica exige estudos e acompanhamentos do paciente. Os benefícios e riscos do emagrecimento por tratamento cirúrgico devem servir como ponto de alerta aos profissionais da saúde. O uso do questionário no serviço de psicologia é norteado pela escuta psicológica. Objetivos: 1) Descrever o perfil sócio-demográfico candidatos à cirurgia bariátrica. 2) Analisar a percepção dos pacientes sobre características de personalidade associadas à obesidade e transtornos alimentares. 3) Descrever os conteúdos psicodinâmicos da narrativa do sujeito e avaliar o sistema tensional inconsciente de dois pacientes por meio do Teste das Relações Objetais de Phillipson (TRO). Método: O delineamento metodológico com análise de dados pelo método epidemiológico e estudo de caso clínico, orientação psicanalítica. Na primeira etapa foram consultados 300 questionários do serviço de psicologia e na segunda dois pacientes com ganho de peso após 24 meses. São pacientes que procuraram tratamento em clínica especializada, em uma metrópole do sudeste brasileiro, sob consentimento pós-informado. Os questionários foram preenchidos por 227 mulheres e 73 homens; com média de idade igual a 36 anos; escolaridade ensino médio e superior, 53%; maioria casados; IMC entre grave e super mórbido (94,3%). Técnicas cirúrgicas indicadas Capella Bypass e Fobi-Capella (67%). Resultados: características psicológicas referidas pelos pacientes, a ansiedade apontou em 93,7% das respostas, seguidas por impulsividade, depressão, tolerância à frustração, baixa auto-estima, resolvedor de problemas dos outros (mais de 50%). No histórico familiar da obesidade está em mais de 70% depressão e uso do álcool em 30%; realização de psicoterapia (30%) e medicamentos para depressão e ansiedade (10%). Na segunda etapa, foi realizado o diagnóstico psicodinâmico, por meio do Teste das Relações Objetais de Phillipson com duas pacientes, cuja análise indicou necessidade de psicoterapia psicanalítica, pois tinham fixações na posição esquizoparanóide e apresentavam dificuldade em lidar com perdas e baixa motivação para mudança e insigth. Conclusões: Com a aplicação do questionário e o registro das observações empíricas, este questionário de entrevista semidirigida preenche condições de melhor acessar e avaliar os conteúdos revelados pelos pacientes. As contradições entre as respostas e o discurso, no contato individual com o psicólogo, apontam a necessidade de investimento no preparo do paciente para a cirurgia e mais acentuadamente o acompanhamento psicológico no primeiro ano do pós-operatório. Há um pensamento mágico a ser trabalhado durante a aplicação do questionário sobre as crenças frente à cirurgia e o emagrecimento e assim convocar o paciente a ocupar o lugar do sujeito implicado em seu processo pré e pós-operatório. O TRO contribuiu na compreensão do diagnóstico psicodinâmico de pacientes com ganho de peso após cirurgia e reforçou a necessidade de maior investimento no pré-operatório.(AU)

AUSÊNCIA PATERNA E SUAS REPERCUSSÕES SOBRE O DESENVOLVIMENTO INFANTIL

O presente estudo teve por objetivos a) investigar as repercussões da ausência paterna sobre o desenvolvimento da criança; b) descrever o conteúdo intrapsíquico de crianças com pais presentes e de crianças com pais ausentes no lar. Para tanto foram estudados três casos de crianças em idade escolar que freqüentavam uma instituição não governamental da cidade de Santos e utilizou-se dos instrumentos entrevista semi-estruturada com as mães e Procedimento de Desenho-Estória com Tema com as crianças. A aplicação foi feita nos seguintes termos, pediu-se ao participante que desenhasse uma criança e, em seguida que contasse uma estória sobre o desenho. Após, foi solicitado à criança que desenhasse o pai dessa criança e que contasse uma estória sobre esse mesmo desenho. Optamos também por aplicar o Teste das Matrizes Coloridas de Raven - Escala Especial com as crianças. Embora cada caso tivesse revelado suas peculiaridades, os resultados mostraram indicativos de distúrbios da identidade sexual, desamparo, insegurança, tendências depressivas, além de associação entre a ausência paterna, déficit cognitivo e/ou inibição intelectual. Foi também observado em um dos casos, dificuldades da mãe em permitir que o pai paternasse . Concluiu-se que a ausência paterna foi percebida pela criança não somente como a falta da pessoa do pai no lar, mas sim por sua omissão; somando-se ao fato de que a internalização da figura paterna não pareceu determinada pelo laço biológico, mas sim pela possibilidade de oferecimento à criança de identificação e afeto. Entendeu-se com esse estudo que o desenvolvimento psíquico saudável pode ser facilitado pela introjeção das boas figuras materno/paternas pela criança. Sendo assim, estudos dedicados ao tema da paternidade são tão importantes de serem explorados na atualidade quanto o foram aqueles destinados à maternidade ao longo da história da psicologia do desenvolvimento e da psicanálise. (AU)

Engaging autobiography:mobility trauma and international relations

This article outlines the possibilities of autobiographical stories to criticize status quo iterations of International Relations (IR). The article draws on the personal experiences of the author’s deportation order issued by the United Kingdom’s Home Office and its associated Border Agency (UKBA) to challenge the accepted assumptions of a cosmopolitan worldview as it relates to orderly international institutional design. It highlights the possibilities of trauma when border management and personal mobility collide. It suggests that mobility trauma ensues when the expectations of human mobility, outlined in Article 13 of the Universal Declaration of Human Rights, infringe the state’s role as security provider. It begins in part one with a challenge to the traditional role and understanding of international borders that sustain order within the international. It examines the unacknowledged role that human vulnerability plays within IR and institutional design while frankly engaging with human vulnerability and trauma in the second section. This section details the experiences of the author when her mobility rights were curtailed and the ensuing identity crisis prompted by such events. The final section investigates the ideas of critical cosmopolitan scholarship demanding that such discourses acknowledge and work through the possibility of failed agency when the demands of state security supersede individual mobility rights. It turns to the possibility of traumatic iterations of IR in order to probe such possibilities. The article suggests, in its conclusion, the possibility of storytelling and psychoanalysis to endorse unorthodox agency, and the possibility of a dynamic international institutional design, that challenges the status quo iterations of IR.

Teoría y práctica del neobarroco en Severo Sarduy

This dissertation analyzes the theory and practice of the Cuban postmodern writer Severo Sarduy (1937–1993) from his early adult years in Cuba to his exile period in Paris, France, where he lived until his death. By studying his narrative through the light of his theoretical essays, this paper demonstrates that the author created his own type of reading model—from and for Sarduy. His literary work is influenced by three major elements: (post)structuralism, psychoanalysis, and Buddhism, which combined form what Sarduy himself called the Neobarroque style. The Sarduyan writing is a transgressive exercise expressed through his concept of simulación. This style breaks with the traditional art concept of mimesis (the representation of reality in the western world), and therefore with the correspondence between the signifier and the signified. Sarduy does not intend to represent reality but to go beyond it, achieving by his technique of signifying exhaustion to represent absence itself. The Neobarroque of Severo Sarduy is an aesthetic of the empty signifier based on the reckless expenditure, and ultimately exhaustion, of the artifices of language that precipitates in a signifier chain towards the infinite. His language does not transmit a message but it signifies itself, that is, a means without an end. Paradoxically, this signifier chain produces an excess of metaphors beyond the material limits of language and its support, the page. The space beyond language is the hipertelic technique inherited by Sarduy from his literary master, José Lezama Lima. This is also the empty space of no signification or nonsense in which occurs the depersonalization of the speaking subject; in Buddhist terminology this becomes the dissolution of the ego. The Sarduyan language is determined by a Lacanian psychoanalytic erotic drive (pulsion) known as the Barroquean desire, a death drive which directly relates to the exile condition of the author. But the genesis of this desire lies in a primordial desire of encounter with his origin: mother, maternal language, paradise, God. That is the reason why Sarduy not only poses an aesthetic question but also an ontological one. This other dimension of the Sarduyan writing is based on a liberating drive that permeates all his work—an ontological liberation expressed through language. The empty space created in the text provides the subject with the possibility of fusion with the all. Ultimately, Sarduy strives for a language that goes beyond the symbolic limits towards a place of constant dissolution, evanesce, and death-horror vacui. This corroborates the Sarduyan statement: “la simulación enuncia el vacío y la muerte.”

Polemos and Paideia: On the Weaponization of the School in Late Capitalism

A popular refrain in the politics of American education, often buttressed by a steady stream of studies, contends that ‘we are falling behind’ students from other countries. Sometimes this decline is specified in terms of discipline, but the general premise is that American students lag behind their foreign counterparts, with special dread attached to the notion of falling behind adversaries such as China. The failure to rectify our educational inadequacies apparently portends a genuine crisis, the loss of global dominance. The articulation of such fears is particularly instructive in discerning the political role of education in late capitalism, its conceptualization and uses within the context of politics. How do the fears of falling behind speak to the political role of education in late capitalism? I draw upon the ideas of the Herbert Marcuse and his Marxist intervention into Freudian psychoanalysis. Using Marcuse’s framework, I argue that in late capitalism the political role of education, formerly understood to serve life affirming value, has been reoriented to further the aims of the death drive. The fears of falling behind, and the policies that have followed, are symptomatic of a disposition toward education that has reconfigured the school as a means of conquest, subjugation, and war.

A Musicology for Literary Language

This study analyzed the reader's relationship to the sounds embedded in a written text for the purpose of identifying those sounds' contribution to the reader's interpretation of that text. To achieve this objective, this study negotiated Heideggerian phenomenology, Freudian and Lacanian psychoanalysis, linguistics, and musicology into a reader response theory, which was then applied to Edgar Allen Poe's "The Raven." This study argues that the orchestration of sounds in "The Raven" forces its reader into a regression, which the reader then represses, only to carry the resulting sound-image // away from the poem as a psychic scar.

O Centro de Referência da Assistência Social e a Psicanálise: efeitos de uma escuta singularizada

This paper emerged from an experience of 18 months in the CRAS – Reference Center for Social Assistance – which aroused a question about the listening of the singularity in the professional practice of Psi in the context of social assistance. The literature review revealed, on the one hand, a series of studies that aim to a discussion about of the process of professional integration of psychologists in the field of social welfare, proposing and / or analyzing practices directed towards the psychosocial assistance directed to the group and for the assurance of rights, forming citizen subjects. On the other hand, supported by a psychoanalytic perspective, we found studies that point to the importance of the singularity listening considering the subjectivity and symbolic resources of those who seek help in Basic Assistance Service. In this perspective, we aim to analyze, in a posteriori, the effects of offering a singularized listening in the context of CRAS and discuss its implications for the Psi professional practice in social institution. This is a theoretical and clinical research, based on Freudian and Lacanian psychoanalysis, in which two cases, placed as investigation boosters, are analyzed in the light of the concept of the subject. We conclude that a singularized listening allowed a significant sliding and the consequent repositioning of the subject, in each case, front to their suffering. The effects collected allowed us to affirm the importance of a singular listening in the treatment of the demands that appear within the institutional framework

Lacan, Gödel, a ciência e a verdade

Jaques Lacan, the thinker who proposes a return to the fundamentals of psychoanalysis in Freud states that the math would face as a privileged way of transmission of knowledge by the science. Although he was a follower of the mathematization of nature as the foundation of modern science, for him this principle does not imply eliminating the subject that produces it. That would be equivalent to saying that there can not be a language, whatever, even the math, that may "erases" the subject assumption in science. In the text The science and the truth we will try to introduce the idea, not so simple, by the way, the truth as the cause. Citing the framework of the causes in Aristotle, Lacan will speak of a homology between the truth as formal cause, in the case of science, and the truth as material cause, on the side of psychoanalysis. Among its aims with this text, he wants to establish that the unconscious of the subject would be none other than the subject of science. The famous incompleteness theorems of logical-mathematical Kurt Gödel enter here as a chapter of this issue. Recognized as true watershed, these theorems have to be remembered as revealing even outside the mathematical environment, and Lacan himself is not indifferent to this. He makes mention of Gödel's name and draws some observations apparently modest support for his own theory. Since some technical sophisticated knowledges awaits the reader who intends understand this supposed corroboration that Gödel provides to psychoanalysis, introduce the student of Lacan in the use he makes of the incompleteness theorems is the objective of this work. In The science and the truth, which fits us to locate the name of Gödel, one must question how seize such an idea without incurring the extrapolation and abuse of mathematical knowledge, almost trivial in this case. Thus, this paper aims to introduce the reader to the reasoning behind the theorems of Gödel, acquaint him about the Lacan’s mathematical claims, and indicate how to proceed using this implicit math in the text The science and the truth.

Quando a indisciplina escolar é um sintoma? articulações psicanalíticas

From a clinical case reporting a severe “ scholarship indiscipline”, this work questioned how the indiscipline can be a symptom . To answer the question, it was analyzed the symptom concept from the Freudian - lacaneana perspective and theirs connections with “ scholarship indiscipline” subject . The research used a theoretical and clinical method , to show the connection between the case development and the psychoanalytic publications reviewing questions on the subject . It was undertook a historical analysis of the construction of disciplinary mechanism through the works of Foucault (1987, 1996), Deleuze (1988; 1992) and commentators. This historical analysis showed a dated and unnatural character of this discursive production named “ scholarship indiscipline”, revealing the indiscipline complaint comes from a social speech that imposes the idea that learn ing depends on the discipline. However , this idea type has a flaw , because always something escapes disciplining . The social answer to the escape is the complaint of indiscipline, which can be taken as a social symptom . Each child should find an answer to this speech and define the symptomatic character , or not , from itself . It was evaluated the symptom and its consequences in the clinic with the child in the Freud and Lacan teachings . The Freud view showed the symptom is the answer to a psychic work , replacing a repressed representation linked to an unbearable sexual dis satisfaction , providing a solution for the child to deal with castration and with the imposed social restrictions . A review of Freud's work undertaken by Lacan emphasizes the psycholog ical work characteristics undertaken by the speaker with its symptom by the link with the social aspect. To analyze, in each case, the position occupied by the patient of a complaint against the indiscipline can open the way to work with it. If the discipl ine is the answer of the subject towards the Other social, from psychoanalysis it is offering a help that allows reframe this response. Elucidating the symptomatic character, or not, from attitudes considered undisciplined, calls for the analysis of unique ness involved in the response of each child, their subjectivity.

“É acompanhante ou usuária?” Implicações sobre a posição da família no atendimento a crianças e adolescentes em um Centro de Atenção Psicossocial da Infância e Adolescência - CAPSi

This study emerged and founded itself with the aim to analyze the position taken by the family – and the implications in this subjective area – in attending children and adolescents in a Childhood Psychosocial Care Center (CAPSi). A secondary goal has come up as the comprehension surrounding the institutional representation made about the family and the service offered to children, adolescents and relatives. For such, the historical perspective on the relation between the State (laws and institutions) and the family was resumed, and the understanding of how it was reconciled by the medical knowledge and attended the ideological and political means. The social and ideological transformations of the 20th century culminated in the need of change required by the Psychiatric Reform and the achievement of patients on the right to return home and to their families. This new situation, permeated by the attempt of building an assistance model in Mental Health, presented a peculiarity–the close relationship between family and Mental Health services. The observations and conversations at CAPSi that were the investigation objects in this research, intended to learn on the quotidian of families and the possible treatment alternatives that would take into account the family circumstances. Conceiving the status of the families in Mental Health services is a germinal matter yet to be adjusted among the active knowledge in the post-Reform devices. The discussion about the family bonds, anchored in the theoretical perspective of Binding Psychoanalysis brought up elementary concepts such as psychic heritage, denial pact, unconscious alliances, the familiar psychic set, among other. The concept of family organizer helped to think of the family trajectories and stablishes a sort of identity for the family, as well as interferes in the establishment of its boundaries. The family path within the institution, as well as the status they establish facing the institutional approach, reflect the ghosts and the organizers shared by the group-family. It follows that the family is an important protagonist to be considered in the current therapeutic and political processes and, thus, is key to welcome the family bonds for the alliances act over the affective destinations, as well as try to remain sealed from the proposed changes.

Internação involuntária e o abuso de substâncias psicoativas - o pathos familiar

The use and abuse of Psychoactive Substances (PAS) in contemporaneity corresponds to a social issue and a public health issue. Few social phenomena entail more costs with justice and health, family difficulties, and appearances in the media than the PAS abuse comsumption. The government power has been facing this situation allocating investments and developing public policies. Despite the current Mental Health Policy, based on the principles of Psychiatric Reform that prioritizes outpatient services, the number of investments from various government spheres and families requests for admissions continue increasing. This study aimed to understand the pathos experienced by an individual toward the involuntary internment of a family member who is an abusive user of PAS. The research also aimed to investigate what led that individual to choose this type of treatment. The Psychoanalysis was the theoretical basis of this work, and the exercise of the psychoanalytic method, from the collection of bibliographic references up to the interpretation of the semi-structured interview, conducted in depth, was intended. The findings of this research gave us the oportunity of thinking about how the social callings to the family were made, especially in regard of atention and care with their family members who are user of PAS and how it affects this family individual. It also allowed to discuss how the public policies that preconize involuntary internment, affectivity, prohibitionist and mono-disciplinarity – that cross the State in the attention given to this issue – are formulated and implemented. The interview analysis showed us how happen the agencying of pathos, the libidinal aspects of joy and guilt, the desire to punish and atonement, working in family relations and in caring relations, especially in the decision for involuntary internment. The survey also made possible to understand how a mother, facing the chaotic scene of public health, helpless, finds in the involuntary internment a way to reverberate her affections.

Das saudades que se tem: a representação paterna na escrita autobiográfica de Bartolomeu Campos de Queirós

In our work, we analyze some works of Bartolomeu Campos de Queirós that compose the “autobiographical cycle”, especially those ones that bring the image of father’s absence/presence, the relationship between life and writing, as well as the father’s figurations and his intermediates and substitutes. We especially investigated the aspect of repetition about how the family relations are articulated, highlighting those ones that happen between father and son and that appear in these texts. This problematic interested us as a research object, a priori, because the works of Bartholomeu Campos de Queirós are an exponent of literature for children field, as far as they show that the childhood is not always “colorful”, happy and perfect as several productions supposedly made “for children” seek to have us believe. In addition, the selected texts that have an autobiographical characteristic and put the issue of child suffering because of the father’s absence are configured as a very rich corpus for studies related to the relation between life/work and investigations in the dialogue between Literature and Psychoanalysis. These aspects will permit us to understand why the pain of missing father be repetitive and insistent in these books. Thus, we problematize, by the selected works for this study, the concept of literature for children and young people and the notion of literary reading. We also analyzed in the “statements” given by the author the relationship between life and writing and we investigated, based on psychoanalytic studies, the literary writing as a possibility of both unconscious development of memory marked by the father’s absence – remedy – as of a perpetuation of this same conflict – poison. Furthermore, we analyzed how the relationship between son and father are processed considering the mother’s absence, since the works that have this person’s presence, she seems to mediate such relationships in a certain way.

Dark journeys: Jacques Tourneur's Experiment Perilous

An analysis of Jacques Tourneur's 1944 film

Pedem referens: art historical memory and the analogue in the work of Tacita Dean, Jeremy Millar and Lucy Skaer

This thesis explores the new art historical turn in contemporary art through close engagement with three British artworks. These are Tacita Dean’s, Section Cinema (Homage to Marcel Broodthaers), 2002, Jeremy Millar’s, The Man Who Looked Back, 2010, and Lucy Skaer’s, Leonora, 2006. Each of these artworks combines an art historical agenda with a celebration of the specificities of analogue film and photography in the context of our digital age. This thesis combines twentieth century photographic theory from Roland Barthes, André Bazin and Walter Benjamin, among others, with the psychoanalytic theory of Jacques Lacan in order to argue that the indexical qualities of analogue film and photography place the medium in close proximity to the Lacanian Real. In its obsolescence the analogue’s language of both touch and loss is heightened. Each chapter of this thesis explores a different aspect of the Real in relation to specific attributes of the analogue, such as its propensity for archiving cultural traumas, its receptiveness to chance, and its proximity to death.