Challenges of the Psychoanalyst’s Work in the General Hospital: The Antinomy Between Psychoanalysis and Medicine

Abstract

The article addresses the challenges of the psychoanalyst in the General Hospital where there is a prevalence of treatment of organic diseases in the Real of the body. The objective was to analyze, through a clinical vignette, the effects of the clinical management of the psychoanalyst in the hospital setting. Freud’s clinical device of free association as well as Jacques Lacan's theory of discourses were used to demonstrate that, from the singular and the contingent and the construction of the clinical case, it is possible to create universal concepts. The psychoanalyst's work at the General Hospital is to listen to the subject, who, through free association, is anchored in language in a particular way: when speaking, he exposes his fantasies, develops a possible knowledge about his illness and his body, in an attempt to associate the word with the Real of the body. In the General Hospital, it is the disease and not the patient that is treated: the technique is superior to the subject. Psychoanalytic listening, on the other hand, gives place to the subject, subjugated by the disease. We consider medical knowledge as a scientific knowledge that can not be ignored and we recognize the advances made in this field, especially with the support of current technological resources. However, we also consider that it is important to contemplate the risks of exalting scientific knowledge and disregarding all the factors involved in the production of a disease, such as social, economic, political and subjective ones.