Fundamental Psychopathology Research Articles

The red thread of politics in Fundamental Psychopathology

The red thread of politics in Fundamental Psychopathology

Em busca da paz: Sobre o “Dar das pedras brilhantes”, de João Guimarães Rosa

The following article serves as a reflection within the field of study on relations of power based on the Critical Theory of studies on Subjectivity and Power. The focus of the study is on the literary works of Joao Guimaraes Rosa, and in particular one of four tales published posthumously entitled “ O Dar das Pedras Brilhantes ” [The Giving of Shining Stones]. By highlighting metaphors, characters, and the historical-political context, the article examines unique situations in which pathos (suffering/passion) and authoritarianism guide our search for manifestations of symbolic political strength and power. The article is linked to the Integrated Research Project entitled “Pathos e Saude nas Republicas das Letras [Pathos and Health in the Republic of Letters] (Guimaraes Rosa, James Joyce & Lima Barreto)”, carried out as part of the Fluminense Federal University’s Post-Graduate Political Sciences Program (PGCP-UFF), the University Association for Research into Fundamental Psychopathology (AUPPF), the Laboratorio Cidade e Poder (LCP) [City and Power Laboratory], and the Laboratory for Research into Contemporary Psychopathologies (LAPSICON), both belonging to the Fluminense Federal University.

Psychoanalytical Investigation of Clinical Phenomena in Psychosis, in the Pandemic Context of COVID-19

Recent international studies on the impact of the COVID-19 pandemic on mental health motivated the writing of this article. The article presents the preliminary results of the research conducted by me at the Laboratory of Fundamental Psychopathology in Studies on Subjectivity and Humanitarian Emergencies, of the Graduate Program in Psychology at the Federal University of Rio de Janeiro (UFRJ, Brazil). There were five months of theoretical survey of the theme based on the following research problem: what is the impact of social isolation and uncertainty about the future, on the functioning of the self in psychosis? The purpose of the article is to expose the results of the first phase of research on the topic, which consisted of a systematic review of the scientific literature on the topic of humanitarian emergencies, locating pandemics in this classification and specifically asking about the impact of COVID-19 on disorders related to the functioning of the self in psychosis, I finally maintain the relevance of developing a clinical protocol for the psychological approach of these situations, within the framework of the impacts of the COVID-19 pandemic about subjective functioning.

Teologia de Psicoanálise: Proposta de Campo de Pesquisa a Partir da Psicanálise e Teologia Cristã

It is a reflection that seeks interdisciplinary links between Christian Theology and Psychoanalysis, with the aim of investigating possible conceptual similarities between the proposed fields and propose a field of reflection we call Psychoanalytic Theology. Methodologically, it is a theoretical and conceptual review, which conjures up theoretical and epistemological contributions that we deem relevant to such an approach (Paradigm of Complexity and Fundamental Psychopathology), plus the contribution of O. Pfister. The goal is to provide a clinical know-how where the patient/believer becomes subject of his discourse, subjectivity and therefore its pathos , where his belief becomes important to understand their suffering and healing, and where one emerges theology aired by psychoanalytic contributions in ways that constitute a new and fruitful interdisciplinary field in the humanities.

La función de la mirada clínica en el tratamiento de niños con quemaduras

El tema del presente trabajo se centra en la función clínica de la mirada. Partiendo de los postulados clínico-teóricos de la Psicopatología Fundamental, el pathos psíquico impuesto por la destrucción de piel constituye el eje de nuestro análisis. Proponemos observar algunos elementos del tratamiento clínico a niños hospitalizados por quemaduras para mostrar la importancia de un dispositivo (visual) que funcione como: 1. sutura sobre la abertura desestructurante que ataques físicos y psíquicas generan debido a la violenta y sorpresiva destrucción de piel, 2. abrigo y restitución de tejidos simbólicos que invistan las resignificaciones de pathos en un cuerpo con quemaduras.

Supplement on eating disorders

This special edition of the Latin-American Journalof Fundamental Psychopathology offers its readers anumber of texts by Brazilian clinicians with vastexperience in psychotherapy and research related toeating disorders. All the papers published here werepresented at the Fifth International Congress ofFundamental Psychopathology and the Eleventh BrazilianCongress of Fundamental Psychopathology, whosespecific theme was eating disorders. The congress, heldat the Ponta Mar Hotel in Fortaleza, Ceara, Brazil, fromSeptember 5th to 9th, 2012, brought together over 500professionals and students from many differentcountries, and evidenced the importance of this type ofpsychopathology, which affects growing numbers ofpersons in the world today. The articles here deal withthe topic from different approaches, showing its multi-conceptual nature. In the world of psychotherapy andclinical research that takes subjectivity into account, wecannot expect to find a single practical and conceptualapproach. It is therefore easy to see the need forpublications that describe advances in the research andthat promote discussion among professionals who usethe various approaches.

Pathos, violence and power: the ethical implications of Fundamental Psychopathology

This III International Congress and IX Brazilian Congress ofFundamental Psychopathology gathers us today in Niteroiaround the theme: Pathos – Violence and Power. Guided by thisimportant debate proposal, I thought appropriate in thisconference to tackle a central problem directly linked to thisthematic, though paradoxically little discussed among us: that ofthe ethical implications of Fundamental Psychopathology. Iintend to show that the ethical issue has always been presentever since this field was created by Pierre Fedida. But, above all,I hope to demonstrate that the constitution of this new approachof psychopathology is organized around some truly ethicalpositionings relative to the theoretical, clinical and researchpractices whose object is human suffering and passions.For this purpose, my rather risky approach will try tocorrelate, within the given time, three decisive dimensions ofFundamental Psychopathology: its historical inscription, thedescription of its main proposals and the questioning of itsepistemological assumptions. This methodological option musttherefore renounce beforehand to any pretension to exhaust theissue with which it deals and limit itself to critically clarify thedecisive impact of the ethical dimension on the constitution ofthis field.

Algumas Considerações Sobre um Dispositivo de Assistência à Saúde

The present study portrays the construction and the path of development of a permanent health promotion device throughout the last 23 years, with the purpose of increasing the assistance resources, through the search of integrated actions, from a broad clinical perspective supported by Psychoanalysis. This achievement relies on a critical-reflexive posture, based on the fact that the mere application of the device created by Freud loses its consistency when applied in different contexts from the original one. Therefore, the Psychology Service of the Surgical Area (PSCA) of the University Hospital Antonio Pedro (UHAP) of the Federal Fluminense University (FFU) has developed integrated assistance to patients, family members and health team members aiming to help them cope with the critical circumstances that affect them, when their bodies, through the disease, make them realize the transitory character of life itself when they go through the critical experience of unbearable suffering. It is important to punctuate that the perspective of the developed study integrates in a singular manner assistance, teaching, and research, in association with The Fundamental Psychopathology, Psychoanalysis, and Psychosomatic Laboratory.

Psychose post-traumatique: contribution à une théorisation dynamique du traumatisme aigu post-immédiat: Post-traumatic psychosis: the contribution of an acute post-immediate trauma to a dynamic theorization

In his recent publication (2004), in which he favors the psycho-dynamic approach, M. Bertrand underlines the importance of traumatic matter at the heart of new clinical, methodological and epistemological challenges of psychopathology.Our contribution ("post-traumatic psychosis") comes within that prospect in reference to the semiology of traumas generated by extreme situations, such as the tsunami in South Asia (December 2004), the terrorist attacks in Madrid (March 2004) or the hostage taking in North Ossetia (September 2004). Four principle sets of themes lead us to suggest a traumatic psychosis when the person shows symptoms of a neurotic psychic structure: 1. There's no traumatic representation or psychic inscription of the event. Sideration (and its stupor-like confusion symptoms) or panic flight (together with hallucinations or acute delirious fits) often illustrate this first clinical aspect. 2. According to the psychodynamic frame of reference, psychic processes tend to ignore the pleasure/displeasure principle. They are governed by the "invasion" of affects of pain and compulsion to repeat. 3. The models of neurosis and psychic conflict are not efficient in the management of the "quota of affect" and the drive influence. 4. It would be necessary to add, from a psychopathological point of view, the appearance of temporary fits of mental confusion, self-destructive and autolysis behavior.The frame of reference of a DSM IV type "descriptive" psychopathology (ie acute Stress Disorder) seems to de inadequate to convey the implemented post traumatic stakes. If trying to soothe the symptoms is undeniably important, psychic disorganizations that generate a semiology that is essentially present in the symptomatology of the psychoses cannot be ignored. A first clinical approach makes it possible to specify the argumentation of our proposal: "a post-traumatic psychosis". It is supported by five main syndromic classes: 1) the symptoms are often more or less temporary delirious fits (delirious ideas or perceptions of a persecutory, cenesthetic or hypochondriac nature), mental confusion (oneiroid state, anxiety and stupor), phases of depersonalization and derealization, severe death pangs, serious physical disorders, divides close to schizophrenic-type dual personalities; 2) the adhesiveness marks the impossibility for the victims to keep away from a trauma. The objects are bound, persecuting and adhesive; 3) traumatic temporality imposes a factual and current omnipresence of the trauma. It destroys the temporal projections of the patient as well as an anamnesic reconstruction; 4) the "traumatic body" is not that of hysterical neurosis conversions. The somatic semiology marks operational-type functioning (P. Marty); 5) traumatic compliance doesn't work on the level of facilitations that lead to the formation of symptoms. The identity structure appears disorganized by the dismantling of the primary psychic envelopments.A second theoretical approach makes it possible to promote this immediate psychotic-type post-traumatic psychopathology. Four considerations of fundamental psychopathology support our contribution: 1) Pictogramic inscription. The severe traumatism does not produce the polarity required for the process of "self-fathering" described by P. Aulagnier in connecting with original processes. Traumatic adhesiveness does not separate the victim from the trauma. It splits the necessary mediation spaces and distance for the emergence of representation processes. 2) Pain affect. The pain affect generated recalls the first experiences of the newborn, primitive agony and anaclitical collapse; the "narcissistic contract" is broken and the patient lives without a secure base or a sufficiently good and supporting psychic container (D.W. Winnicott). 3) Anxiety status. The anxiety is not of neurotic nature but truly annihilating. It is often similar to anxieties caused by disasters, psychoses due melancholy (H. Ey) or more "archaic" anxieties that have been observed in hebephrenic pathologies. 4) Body dismantling. The trauma results in "mute somatizations that cannot be symbolized" (M. Bertrand). They appear in sensory outward signs such as dermatosis, pruritus, diarrhea, hemorrhagic periods or persistent headaches for example. These two clinical and theoretical aspects of the severe forms of trauma confirm the unconscious traumatolytic aim of the victim's psychological destruction. The semiological forms most impervious to therapeutic processes seem to be, in reference to hostage-takings or terrorists acts, those where the patient was conformed with a trauma "that was not carried out" like mock hangings or executions. Suicidal dimension seems to be the ultimate recourse so as not to sink into insanity and to keep a subjective position when faced with barbarian figures.

O sofrimento psíquico na perspectiva da psicopatologia fundamental

Partindo da palavra PSICOPATOLOGIA, o autor mostra, de forma resumida, como cada contexto histórico tentou "decompor" o sofrimento psíquico em seus elementos de base para classificá-lo, estudá-lo e tratá-lo. Após uma breve apresentação da psicopatologia na contemporaneidade, o autor introduz os pressupostos da Psicopatologia Fundamental e suas contribuições na compreensão do sofrimento psíquico. Ainda que não seja objetivo do texto participar do debate atual sobre as diretrizes curriculares que norteiam a formação do psicólogo, o autor toma o estudo do conhecimento (logos) da alma (psyché) - a psicologia - como exemplo de um dos campos de aplicação da Psicopatologia Fundamental.

O conceito de velhice: da gerontologia à psicopatologia fundamental

É pertinente falarmos de um conceito psicanalítico de velhice? Este artigo pretende responder a essa questão analisando a concepção de velhice dada pela gerontologia – essa ótica multidisciplinar calcada nas ciências positivistas –, passando pela metapsicologia psicanalítica basicamente atemporal, até chegar à possibilidade oferecida pela psicopatologia fundamental, que talvez seja a única que faculte a abordagem da velhice sustentada na psicanálise pelo viés do phatos.

Sonho, um observatório psíquico: psicopatologia fundamental e subjetividade

Este artigo tem como objetivo situar o sonho na psicopatologia fundamental, a qual se estabelece na dimensão da subjetividade. O caráter onírico guarda em sua essência a condição de miragem e de observação dos fenômenos psíquicos que se encontram destacados no processo psicanalítico. Desta maneira, pensar no lugar do sonho torna-se a principal condição deste processo, em que o sujeito, ao mesmo tempo contempla os resgates e reencontros dos seus movimentos psíquicos, da mesma maneira que engendra um espaço propício a eles. Desta maneira, propõe-se debater os aspectos constituintes do estado depressivo e as nuances marcadas pela sua passagem, no setting psicanalítico. Assim, a manifestação onírica parece tornar-se um observatório destas passagens constituídas a partir de um sonho sonhado pela dupla analítica, que é transformado em história analítica.

Psicopatologia e o viver criativo

A condição em que nasce o ser humano é uma condição de crise porque lhe faltam recursos diante das ameaças da vida. Mediante um trabalho criativo, sustentado pela mãe, o bebê cria recursos de sobrevivência e é por eles criado. A superação desta crise primeira torna-se base e modelo para a superação criativa de tantas outras crises da existência. Sobre a criatividade frente à psicopatologia fundamental versa este trabalho. A investigação de autores psicanalíticos – Freud e Winnicott, especialmente o último – é feita dentro do marco clínico e visa finalmente a própria clínica e a vida.

A insônia, o sono ruim e o dormir em paz: a “erótica do sono” em tempos de Lexotan

Este trabalho tem por objetivo discutir, sob a perspectiva da psicopatologia fundamental, o problema do sono e de suas perturbações. Busca-se delimitar algumas articulações entre o plano propriamente subjetivo dos sintomas relacionados à insônia e sua inscrição no contexto sociocultural contemporâneo. Dá-se um enfoque privilegiado às formas do homem de hoje relacionar-se com a dimensão de desamparo de sua existência.

A contribuição da Psicopatologia Fundamental para a Saúde Mental

O texto traz reflexões sobre a intersecção da psicopatologia fundamental com a saúde mental. Inicialmente, o autor apresenta uma breve digressão sobre as mudanças no conceito grego de pathos, desde sua origem até o seu uso mais comum: o sentido médico de doença. Discute-se também as origens da psicopatologia como disciplina organizada. Em seguida, apresentam-se os fundamentos histórico-teóricos da psicopatologia fundamental, suas concepções quanto à origem e à organização do aparelho psíquico e suas relações com as outras psicopatologias. Finalmente, o autor discute a aplicabilidade dos princípios norteadores da psicopatologia fundamental às políticas de saúde mental.

Schizophrenia is a caused by patient’s prefrontal lobe becoming inert and inactive!

I have struggled with schizophrenia throughout my life. I present the case report of my life to demonstrate that the fundamental psychopathology that caused various symptoms of schizophrenia in me was that my prefrontal lobe had become inert and inactive. Once I reactivated my prefrontal lobe by various prefrontal lobe mediated cognitive exercises, my symptoms of schizophrenia resolved. On the basis of this case report, I hypothesize that the basic psychopathological disturbance in the patients of schizophrenia is that their prefrontal lobe becomes inert and inactive and reactivating that inert and inactive prefrontal lobe by various cognitive exercises may control their symptoms.

Esquizofrenia e miscigenação

Este trabalho, realizado no âmbito do Laboratório de Psicopatologia Fundamental do Programa de Estudos PósGraduados em Psicologia Clínica da Pontifícia Universidade Católica de São Paulo – PUC-SP, relata o caso de Pedro, jovem poliglota que acabou desenvolvendo, não se sabe desde quando, uma língua própria terminando por provocar um certo sofrimento. Descreve, em seguida, o procedimento psicoterapêutico adotado e algumas implicações metapsicológicas daí decorrentes. Estabelece, finalmente, uma relação íntima e complexa entre o pathos e a cultura.

Transferência – uma regressão alucinatória

A transferência é analisada em seu caráter regressivo alucinatório, sendo objeto de pesquisa realizada pela autora sobre “A dimensão corporal da transferência”, junto ao Laboratório de Psicopatologia Fundamental da PUC-SP. O processo transferencial favorece extraordinariamente a instauração de movimentos regressivos, evidenciando uma via sensorial inerente à comunicação analista-analisando. As noções de regressão e repetição em psicanálise permitem a compreensão de que certas manifestações corporais são a expressão de uma memória corporal redespertada. O texto aponta a utilidade da revalorização do sensível face a algumas sintomatologias contemporâneas, cujo denominador comum é a incapacidade de representação.

Psicopatologia Fundamental: de una cierta transmision

La psicopatología fundamental, conformada a partir del trabajo universitario y teórico de Pierre Fédida, se constituye como punto de encuentro de diferentes disciplinas en relación al sufrimiento humano, y plantea interrogantes metodológicas, entre otras, cómo establecer un diálogo que articule distintos recortes teóricos, y de qué manera tratar las diferencias relativas. El tema de las diferencias está presente tanto por el lado de los métodos de investigación y de intercambio, como por el de la concepción de una estructura institucional que acoja esas diferencias. El psicoanálisis puede hacer contribuciones a estos temas, en la medida en que se ve confrontado a una doble alteridad: tópica – la relación conciencia/inconsciente – e intersubjetiva, ya que es condición del dispositivo analítico poder acoger la subjetividad del otro en tanto radicalmente otro. Hay una homología estructural entre los niveles intrapsíquico, intersubjetivo, interteórico e interdisciplinario en lo que hace a una epistemología de la alteridad. El saber en psicoanálisis escapa a toda tentativa de institucionalización pues es propio a la alteridad de su objeto resistir y dejar siempre un resto. De manera similar, la psicopatología pundamental tampoco se adecua a una institucionalización del saber. Es un espacio vacío – khôra – que acoge movimientos metafóricos inherentes a la producción de saber, y al no-saber que en forma complementaria lo acompaña. El “nombre del padre” opera así, no como fidelidad a una letra, sino como habilitación a la creación y soporte de lo figurable a venir, a partir del acto fundacional de khôra.

Multi-impulsivity of Japanese patients with eating disorders: primary and secondary impulsivity

Several studies have noted that multi-impulsive bulimia nervosa tends to be refractory to treatment. However, it is not known whether these impulsivities are an expression of more fundamental psychopathology or simply the consequence of chaotic eating behaviors. Studies of the temporal relationship between the onset of eating disorder and the occurrence of impulsive behaviors will facilitate a better understanding of these issues. Subjects consisted of 60 patients with anorexia nervosa restricting type (AN-R), 62 patients with anorexia nervosa binge-eating/purging type (AN-BP), 114 patients with bulimia nervosa purging type (BN) and 66 control subjects. Impulsive behaviors and childhood traumatic experiences were assessed by self-report questionnaire. Multi-impulsivity (defined by at least three of the following: heavy regular alcohol drinking; suicide attempt; self-mutilation; repeated shoplifting of items other than food; sexual relationships with persons not well known to the subject) was found in 2% of AN-R, 11% of AN-BP, 18% of BN and 2% of control subjects. Eighty percent of BN patients with multi-impulsivity had a history of suicide attempts or self-mutilation history prior to the onset of bulimia nervosa. In BN patients, there tended to be a relationship between childhood parental loss or borderline personality disorder and multi-impulsivity. In conclusion, primary impulsivity (chronological prior occurrence of impulsive behaviors) does exist even in a very different culture, although the number of patients of this type is very limited.