The “Dis-Affected” Patient: Reflections on Affect Pathology

Abstract

The author attempts to conceptualize a phenomenon that frequently passes unnoticed for a considerable period of time in the course of an analysis. An apparently "normal" psychoanalytic discourse may reveal that the analysand who produces it is using words and ideas that are largely, perhaps totally, devoid of affect for him; instead, the analyst tends to become "affected." This may appear in a wide variety of clinical categories: "narcissistic personality disorders," "psychosomatic personalities," "as-if characters," etc. The author does not seek to add to the clinical categories but to study, from the point of view of the psychic economy, the manner in which this specific form of psychic functioning is maintained: in other words, the vicissitudes of unavailable affect.

The Overlap Between Alexithymia and Asperger’s Syndrome

“…Krystal notes the tendency of Alexithymic individuals to treat people as if they were machines. McDougall (1984) notes their great fear in intimacy situations and the problems experienced by these individuals in understanding social groups. Persons with Asperger's syndrome have similar problems.…”

Alexithymia, Emotional Awareness and Perceived Dysfunctional Parental Behaviors in Heroin Dependents

“…Even so, clinic reports have theorized about the presence of emotional deficits most likely determined across development in a good portion of these subjects. Psychoanalysts have contributed their hypothesis about emotion regulation difficulties among drug addicts, emphasizing an early-determined emotional undifferentiation in these individuals (Krystal and Raskin 1970) and the presence of intolerable and uncontainable emotions (McDougall 1984). Moreover other theorists report drug use as a coping mechanism to regulate certain emotions such as anger or sadness, with some similarity to Khantzian's ideas about the self-medication hypothesis (Khantzian 1985).…”

Do psicodiagnóstico à intervenção em adictos: contribuições do Rorschach e do atendimento clínico

“…Dentre eles, Bergeret (1983Bergeret ( , 1991, Hervé (1998) McDougall (1984) delimita os comportamentos adictivos em uma suposta "estrutura adictiva", em que a atuação representaria uma maneira compulsiva de evitar um transbordamento afetivo. Birman (1993Birman ( , 2003 desenvolve uma terceira vertente segundo a qual diferencia usuários de drogas de toxicômanos pela inserção destes na estrutura perversa, o que não ocorre com os primeiros, que poderiam ser neuróticos, psicóticos ou perversos e para os quais a droga circularia de forma diversificada na economia psíquica.…”

“…A característica mais mencionada entre os diversos autores (AMORIM, 2003;BENTO, 1986;BERGERET, 1983BERGERET, , 1991BIRMAN, 1993BIRMAN, , 2001BIRMAN, , 2003BITTENCOURT, 1993;BRUSSET, 2004;CHAUVET, 2004;ESCOBAR, 2006;FENICHEL, 1945FENICHEL, /1981FREIRE, 2006;GURFINKEL, 1995;LE POULICHET, 1989;LIBERMAN, 1980;MCDOUGALL, 1984MCDOUGALL, , 2004OLIEVENSTEIN, 1985;RABINOVICH, 2003;ROCHA, 2003;SOUZA, 1995;SZTULMAN, 1997;YAZIGI;AMARAL, 2006) refere-se à incapacidade desses indivíduos de pensarem, refletirem, adiarem e a substituição dessas habilidades pela ação. São sensíveis às tensões decorrentes das necessidades, mas não são capazes de decodificá-las em termos verbais de modo a satisfazê-las.…”

“…Uma outra dimensão da conduta dos pacientes adictos com importantes reflexos no âmbito terapêutico é a dificuldade de simbolização e conseqüente irrupção do agir, já citada anteriormente como uma observação que aparece com freqüência nos trabalhos dos autores que exploram essa dinâmica (AMORIM, 2003;BENTO, 1986;BERGERET, 1983BERGERET, , 1991BIRMAN, 1993BIRMAN, , 2001BIRMAN, , 2003BITTENCOURT, 1993;BRUSSET, 2004;CHAUVET, 2004;ESCOBAR, 2006;FENICHEL, 1945FENICHEL, /1981FREIRE, 2006;GURFINKEL, 1995;LE POULICHET, 1989;LIBERMAN, 1980;MCDOUGALL, 1984MCDOUGALL, , 2004OLIEVENSTEIN, 1985;RABINOVICH, 2003;ROCHA, 2003;SOUZA, 1995;SZTULMAN, 1997;YAZIGI;AMARAL, 2006). Liberman (1980) discute os quadros psicopatológicos com relação aos estilos de comunicação.…”