Dizer do sofrimento na saúde mental: considerações psicanalíticas

Abstract

Interventions with users of a Psychosocial Care Center (CAPS), context in which the psychoanalytic researcher develops her practice, are operated from different ethical anchorages and discursive modalities. This study aims to investigate, from the psychoanalytical standpoint, the use of the word suffering by a mental health team in its care practices and to scrutinize the scope of psychoanalysis regarding the considered issues. We seek to approach this context of work, to discuss the term suffering as it affects the practices developed, to verify the relationship between the use of this term and the discourses present in the field of mental health and to elaborate possible contributions of psychoanalysis. To achieve these objectives, we characterize the field of work, considering its specificities and insertion in a broader historical process, resort to publications of other psychoanalysts about suffering and we approach how the word suffering is being used trough the construction and analysis of four clinical-institutional situations. In order to analyze such situations, we recur to the discourse theory proposed by Lacan in 1969. We point out that suffering is not always approached from a clinical discursive logic and that sometimes the interventions aim at normalizing what is considered to be out of order or noncompliant with historically situated and socially established moral parameters. Outcomes of the actions often do not respond neither to the expectations of the team nor to what is considered by the psychoanalyst as a demand from those under treatment. It is our understanding that this frustrates the team and generates effects that do not respond to the challenges of the clinic developed in the CAPS and do not align with psychoanalysis' ethical orientation. Insistence, frustration, and clinical inefficiency seem to be related to non-recognition of the impossible dimension involved in the discursive operations that underlie the practices. One of the possible treatments for the experience of a psychoanalyst in a CAPS regards sustaining the impossible in its productive dimension, as it promotes circulation of discursive modalities on suffering and its effects.