Fundamentos da Clínica by Paul Bercherie, , Jorge Zahar edition, Paperback in Portuguese – 1 edition. Paul Bercherie Los fundamentos de la clínica. 1 like. Book. Fundamentos de La Clinica: Paul Bercherie: Books – Amazon. ca.
These authors point out a paradigm shift that is not limited to the classification of mental diseases, and reaches the question of hegemony among the knowledge that constitutes the psychiatric and psychological clinic, and the sphere of social representations relative to the individual and to the normal and the pathological.
As in the DSM, the diagnosis of maniac-depressive psychosis is no longer used. Revista Latinoamericana de Psicopatologia Fundamentalv. In this way, as a kind of confluence of work in psychiatry and psychoanalysis throughout the twentieth century, a distinction was established between neurosis and psychosis, with each designating a class of pathology, a background condition, that corresponds to a specific way of being in life and in relation to the other; in Lacanian terms, a structure.
In paranoid schizophrenia, these phenomena are important and culminate in some delusional construction, but not to the extent of comprising systematic delirium, as they do in paranoia. It is instead to emphasize the consequences of the formal reduction of psychosis to schizophrenia, which seems to remain as the last notion of psychiatry that may, due to its symbolic weight, still be able to remind society of the gravity of madness. These two poles are complementary and connected by the following common features which are inherent to the disease: The stated intention of these modifications was to create as much consensus as possible in psychiatric classifications, regardless of which school the psychiatrist followed.
Psychosis or psychoses was understood to mean maniac-depressive psychosis, paranoia, and schizophrenia. The first line, the one of the dissociation, consists of the breakdown of life related to the psyche, the internal discordance of psychological phenomena.
Os fundamentos da clínica: história e estrutura do saber psiquiátrico – ScienceOpen
What is lost is the idea of continuity, a link between the elements that are present underneath and beyond the break. The division between neurosis and psychosis is abandoned, as it implies an act of naming that extends beyond an empirical statement:. Kraepelin further refined the notion, distinguishing two types of chronic delusions: In this last sense, the psychotic phenomena presented by a patient, unlike being without order we allude here to the term disordershould be read as a production with its own logic and which makes a subject singular, different from others.
According to Ey, the absence of a rigorous definition does not prevent most clinicians from understanding it in practice with regard to the diagnosis of schizophrenia:. The subject is forced to exist in the language which precedes him and which is imposed on him as law.
With regard to the first question, the authors demonstrate that the empiricist assumption, which requires so-called objective evidence, has obvious affinities with the physicalist view of mental illness Russo, Venancio,p. In the words of Lacanp.
This shows the symbolic weight that these terms carry and transmit. Bleuler, entre psychiatrie et psychanalyse? Finally, what has been lost is any approximation to the idea of psychosis as a subjective functioning that, unlike a deficit of psychic functions affection, sensory-perception, thought, language, will, movement etc.
This is what is underscored by the princeps case of Freudian psychosis theory, which we have already mentioned, the Schreber case Freud, Not each pathology, but that lady or that gentleman. Nobre de Melo,p. Russo and Venancio observed that it was not just the professional field that adhered to the DSM.
Instead of following the neurotic-psychotic dichotomy, the disorders are now arranged in groups according to major common themes or descriptive likenesses, which makes for increased convenience of use. The first is the medicalization of conditions which had previously been associated with subjectivity, such as anxiety, sadness, obsessive thoughts, phobias, sexual behaviors and others — all of which had previously been approached from the framework of the neuroses as conceived by psychoanalysis.
I wish to thank Fernanda Costa Moura for her indispensable guidance in the research and in crafting the thesis, as well as in the final writing of this article. The same criterion allowed him to separate these diseases from maniac-depressive psychosis, notwithstanding the occurrence of manic and depressive states in both, since an essential notion of maniac-depressive psychosis is the full recovery of the personality at the end of each episode, which does not occur in hebephrenia or catatonia.
Bleulerp. The characteristic disturbances in the affect and way of thinking that we have already covered are also mentioned, and are detailed in a very classical manner. Psychoanalysis has been charged with sustaining the clinical and doctrinal validity of the psychosis category, to the point of spreading the feeling that this concept pertains more to psychoanalysis than psychiatry.
For an initial approach, we refer to Postelp. Accordingly, a second step is the following: This is the same statement we have maintained regarding psychosis. Freud himself never had a regular practice with psychotic patients.
Some works we will cite show that while this may not have been the intention, in effect these changes certainly suppressed reference to psychoanalysis. Psychosis as a category of psychiatry The notion fundamwntos psychosis was the category that determined psychiatry for almost two centuries.
The dark horizon in this category is preventative medicalization.
Hence the difficulty of establishing a sharp border between the normal subject and neurosis as a pathology in psychoanalysis. Unlike Freud, Lacan was a psychiatrist and entered psychoanalysis through the psychosis clinic. If a science or discipline is only characterized by describing its specific object, the notion of psychosis was the one which specified psychiatry from neurology, on the one hand, and psychoanalysis, on the other even if the initial meaning of the term differed from how it was to be conceived eventually.
What is at stake is the same distinction mentioned previously, which we will now call by the contrast of deficit versus structure: At least as long as it is not entirely neutralized as a mystery by the biological-cognitive perspective.
Neurosis and psychosis, each one means: Editora da Universidade do Estado de Minas Gerais. According to Ey, the absence of a rigorous definition does not fundwmentos most clinicians from understanding it in practice with regard to the diagnosis of schizophrenia: Kraepelin made these similarities prevail over the phenomenological differences.
Paul Bercherie (Author of Fundamentos de La Clinica)
At least three clinjca consequences of this change dee be seen, in terms of disease classification and clinical application. It is not by chance that the only condition currently recognized as psychosis schizophrenia is a deficient condition which offers a biological interpretation, pharmacological action, and rehabilitation activities that can be both generous actions of social inclusion and at the same time can shift the balance toward a practice of normalization and adaptation, depending fundamenttos the interpretation.
The effects of this damage on mental life predominates in the emotional and volitional areas. As a matter of fact, schizophrenia came to replace a wide variety of clinical conditions that can only be gathered into a single entity by their deficient nature.
Additionally, the fact that any multinational company eager to get its medications approved for the American market must present effectiveness and safety testing according to these same requirements finally led to global compliance with the new manual, promoting the global expansion of American psychiatry at the expense of the French and German traditions which had constituted psychiatry up to this point.
This established the terms psychosis and neurosis as antonyms, each hosting a certain group of psychological diseases. In this matter, the goals of psycho-social rehabilitation that, for good reasons, guide the mental health care finish to be reduced to a functional adjustment.
Regarding psychoanalysis, here we refer to the situation left by Freud, who despite maintaining a theoretical and clinical interest in psychosis, considered it inaccessible for psychoanalysis. With regard to the psychiatric and psychotherapeutic clinic or psychoanalysis, this assumption is even more absurd, since the clinical fact only reveals itself and is constituted in the relationship between the patient and the clinician, and did not exist before in the natural state cf.