A urgência : um percurso entre a saúde mental, a psiquiatria e a psicanálise

Abstract

This thesis aims to formalize and substantiate, in a theoretical corpus, the contribution that psychoanalysis can make to the notion of urgency and to the treatment of patients in situations of crisis and mental health urgency. Through theoretical research, mainly in Freud and Lacan, I sought to investigate how psychoanalysis understands the notion of urgency, distinguishing it from the fields of medicine and psychiatry. To answer this question, I intend to situate the deference of a singular experience of the psychoanalytic clinic, which is to receive a patient in a situation of acute mental suffering, in which a clinical intervention that cannot be expected is necessary. This experience was circumscribed in the context of the presence of the psychoanalyst in institutions that receive individuals in a clear state of emergency and mental health crisis – such as the CAPSs and CERSAMs of the Psychosocial Care Network. From a preliminary reading of Freud and Lacan's clinical cases, it can be argued that, contrary to what is commonly thought, psychoanalysis has been concerned with urgencies since its inception. We sought to investigate urgency in Freud's work, based on a syntagm highlighted by Lacan in Freud's text – die Not des Lebens, the urgency of life –, finding allusions to the instinctual pressure that imperiously demands satisfaction. Considering that, by locating the presence of instinctual urgency in Freudian semantics, Lacan opened up an epistemic path for us to trace urgency in his teaching. Although we will find it as a conceptual word, it will not be impossible, however, to flirt with it in important operating concepts, such as the passage to the act and the performance, as short-circuited clinical consequences of anguish; at the moment of concluding a logical time mutilated from its time to understand; and in the privacy of an unbearable reality, not covered by the shadows of discourses, semblances and amusements, which defend us from it.