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Summary

Theory and clinic
On the Freudian basis of psychoanalytical psychosomatics: a study about current neuroses.
Admar Horn e Miguel Calmon du Pin e Almeida
The Psychoanalyst and his Art:
We need to have a little of both: the mystic and of the scientist

Adalberto A. Goulart
Geniusness and Madness – Reflections over group phenomena, transformations and common sense
Claudio Castelo Filho
Re-thinking Obsessive Neurosis through the light of the “self’s” primitive experiences
Paulo de Moraes Mendonça Ribeiro

Studies interdisciplinares
Body and Subjectivity – Dialogue between medicine and psychoanalysis
Liana Albernaz

On the Freudian basis of psychoanalytical psychosomatics: a study about current neuroses.
Using the need to learn to listen to borderline states as their point of departure, the authors search in their reading of current neurosis the Freudian bases for the efforts to theorize on these new forms of illness, in which the trivial is given a special role to play. This is a clinical practice marked by rhythms, intensities and small movements that oblige the analyst to place parentheses (even if only partially and for a short while) around the model of psychic apparatus as conceived in The Interpretation of Dreams.
These endeavors to set up a metapsychology of borderline states make special references to the Paris School of Psychosomatic (IPSO) and present its fundamental concepts of somatic regression and psychosomatic detachment.

The Psychoanalyst and his Art:
We need to have a little of both: the mystic and of the scientist

The author begins by his own experience, comparing two creative moments: the poetical and the clinic psychoanalytic (insight and interpretation). He elaborates a theoretic study, inspired in the mythology of the chaos, before the world’s creation and the organization of things. He develops the theme by reviewing important papers about the psychoanalytic creativity comprehension. His attempt is to show how important the psychosexual development is at the creative process and illustrates it with two clinical extracts and a poem. The author insists on the importance of the analyst intuition ( mystic side) by the encounter of unconscious between the patient and the analyst in connection with technical discipline (scientist side).

Geniusness and Madness – Reflections over group phenomena, transformations and common sense
The author uses Klein’s concept of projective identification and Bion’s ideas about Container and Contained to develop his reflections about the genius and the madman who are frequently seen as equal. The genius could or not become a schizophrenic according to his capacity or incapacity to tolerate the strength of the emotional experiences that are felt due to his talent of getting in direct contact and grasp of the evolutions of “O” (and publish them as transformations in K). The ordinary schizophrenic usually has nothing of a genius. He is only incapable of tolerating any genuine contact with his emotional experiences. The possibility of tolerating the anguish due to the presence of a genius in a community would be directly connected with its robustness and maturity - otherwise it would tend to fragmentation (likewise in the schizophrenic) or to suffocate the genius, destroying the origin of a menace to the establishment and as a consequence, leading to the impossibility of its growth and evolution. The idea of “common sense” as proposed by Bion is an important parameter in the differentiation of productions of psychotic nature from genial ones.

 

Re-thinking Obsessive Neurosis through the light of the “self’s” primitive experiences
The author derives from the concept of the ‘autistic-contiguous position’ described by T. Ogden (1989) to give second thoughts to the “obsessive neurosis” and suggests a new understanding of this psychopathology’s dynamics . He thinks that this ‘neurosis’ could be seen as manifestation of a ancient catastrophe in the human development.
The autistic-contiguous form of organizing the individual’s experience comes from the sensory concreteness and builds a “sensory floor” (Grotstein 1987), above which the self experience can (or can not) be configured. The quality of the first object relations is of most importance to build a stable structure of this ‘sensory floor’, because this ‘floor’ is built by the conjugation of the ‘reverie’ function (Bion) with the ‘holding’ (Winnicott). When there are difficulties within these primary object relations, there may be gaps on the ‘autistic-contiguous’ form of organizing the self experience. The symptoms and defenses obsessive-compulsives are seen as manifestations of the first efforts that the baby makes in the direction of ordering and linking his/hers primary sensory experiences.
Differently from the classical concept of the ‘obsessive neurosis’, which was understood as a result of Oedipus’ Conflicts that were not well elaborated in the person’s mind, the author suggests a shift in the concept in direction to something more primitive: the individual’s mind structure or the construction of his ‘sensory floor’.
The author uses clinical material from a patient (a creative one, a poet) with strong obsessive-compulsive symptoms to illustrate the ideas proposed.


Body and Subjectivity – Dialogue between medicine and psychoanalysis
The theme of this paper is the investigation of the growing tension between clinical practice and biotechnological knowledge of contemporary western medicine. In order to circumscribe this issue, the concepts of body and subjectivity, central categories of the current paradigmatic crisis are highlighted, accompanying them through two conductor wires: that of modern science and that of psychoanalysis opposing to their ontological, epistemological and anthropological conceptions.
The constitution of medical rationality is founded in modern science. Thus, the medical knowledge takes the disease as universal and treats the human body as a machine. The amputation of other dimensions of the body and the dissipation of the subjects generates suffering and ill being in students, doctors and patients with ethical consequences.
Psychoanalysis is summoned up to join in this discussion due to the fact its foundation is on clinical experience. Accompanying the Freudian path, the ruptures that psychoanalysis makes with the modern paradigm are presented. Opposing the machinelike-body concept that sustains the biomedical knowledge, the body-subject concept is presented, constructed on the basis of Freudian formulations, as being fundamental for clinical practice.
It is proposed that it is possible for there to be coexistence of these two antagonistic conceptions within contemporary western medicine. Assuming the paradoxical presence in clinical practice of these two bodies, the machinelike-body and the body-subject, can make the practice of medicine more human, ethical and efficacious.

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