O efeito-equipe e a construção do caso clínico

Abstract

This thesis has as its main goal to investigate how the notion of construction of the clinical case, presented by Freud in Constructions in Analysis (1937b/1975), can contribute to the praxis of construction of clinical cases with mental health teams, oriented, as Zenoni (2004) puts it, by an impossible of the structure with which we are all confronted, to a real inherent to the speaking being. In the first chapter, we put our praxis into context, presenting our work with teams, as well as a reflection on that which is named in the psychoanalytical literature as clinical case construction in institutions. In the second chapter, we develop the notion of construction, which is the subject of Freuds Constructions in Analysis, as being central to the analytical experience. The poets sentence, highlighted by Freud, allows us to understand the construction in analysis as a bait of falsehood that takes a carp of truth. Thusly, the validity of the analysts construction cannot be considered neither by sheer acquiescence from the patient, nor by the analysts authority, but rather by its effects, which can be gathered in fragments of what was seen and heard, which lead us back to that which Freud (1937b/1975) named in this text as fragment of historical truth. In the process of trying and understanding what would this fragment of historical truth be, we came across with Moses and monotheism, a work contemporary with Constructions in Analysis. In the third chapter, we propose that the fragment of historical truth is once more brought forth in his work on Moses, in which the inventor of psychoanalysis reappraises his theory of trauma and the temporal dimension which defines it, that is, there is a first mark, originally repressed, which will come back a while after. The traumatic is defined only as that which insists in repetition and returns. In that manner, we only know what is traumatic a posteriori, as something that obscurely insists in the symptom. In the forth chapter, the reflection instigated by the text on Moses lead us to the reading of the seminar The other side of psychoanalysis. In this seminar, Lacan (1969-70/1992) analysis Freuds Moses and monotheism, Totem and Taboo, and Oedipus as myths, that is, as epic narratives to approach the impossible of the structure, which was, for us, the key to consider the construction in psychoanalysis as a way to touch, from the logic of the subjects constitution through language, the impossible of the structure. Finally, we reach the fifth and last chapter of the thesis, in which we retake the case construction with mental health teams in light of an experience. This allowed us to support our proposition, that is, the construction of the clinical case is a psychoanalytical method used with mental health teams that, by grounding the impossibility in the core of the structure in which the subject engenders him/herself, will enable some professionals to face the limit of a knowledge and to produce a concerned knowledge, which we name team-effect.