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.

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Fundamentos da Clínica

Accordingly, a second step is the following: Generally, schizophrenic psychosis is understood to mean a set of disorders dominated by discordance, ideoverbal incoherence, ambivalence, autism, delusional ideas, poorly systematized hallucinations, and profound affective disturbances in the sense of detachment and strangeness of feelings — disorders that tend to evolve into a deficit and a dissociation of personality Ey, Bernard, Brisset, s. This rupture eventually inverted the very meaning of the term neurosis, which no longer alluded to the neuronal system but instead came to designate a psychopathological state characterized by the absence of organic disease in the nervous system.

Consequently, it is not that cllnica dimensions do not exist for the psychotic, since they were also established in their injunctive character for him, and they are what constitute and move the social bond itself. However, they have a particular form of existence, existing outside the general symbolization that structures the subject, outside any symbolization that would allow the subject to have them as the elements of his subjectivity.

Lacan showed the heterogeneity of these logics, and at the same time the main lines of psychosis as a structure. This definition remained more or less unchanged in subsequent editions, including the recently published fifth edition DSM-5but the reference to social adaptation is less hidden in this latter edition, as we can see in two places in the quote fundamenos We are addressing the practical field of mental health in which we work, where we notice that the proliferation of diagnoses fundamenfos by the DSM has frequently had a disorienting effect in relation to diagnosis and the clinic — mainly the effect of a lack of familiarity with psychosis where it ve appears.

We hope to be able to approach this discussion at a later time. The malaises of life were gradually being defined in terms that were no longer subjective but medical, and as the individuals themselves expected, they were treated medically.

Not being a psychiatrist, Freud did not have a significant case-by-case analysis of psychotics, and could not take psychoanalytic theorizing of this disease very far.

This knowledge operates on the subject in absentia; it propels him as desire to respond to the requirements of life and desire, and produces as symptom points of impasse, of the impossibility of permitting a certain dimension, of the difficulty of doing something, or even in the form of symptoms identified by the clinical tradition related to anxiety, depression, dissociation, obsession etc.

How to cite this article. In neurosis, the subject is comprised by the internalization and symbolization of these elements, which are repressed.


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With bipolar disorders, psychosis was reduced to the accessory presence of hallucinatory or delusional phenomena. How each one tells us about the way he or she faces their issues.

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.

In this sense, if one of the objectives behind the origin of the DSM-III was standardization of language in global psychiatric communication, this goal could be considered fully achieved, and catalyzed the rise of biological psychiatry as a dominant aspect not only in American psychiatry but around the world.

The dark horizon in this category is preventative medicalization. It is interesting to note how paranoia and melancholy are still cultural terms, even though for at least twenty years they clinjca been disowned by official psychiatry. Finally, what has berchherie 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.

It is not by chance that clincia 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 on the interpretation.

Psychosis or psychoses was understood to mean maniac-depressive psychosis, paranoia, and schizophrenia.

The DSM-III carried the warning that it was not a teaching manual, precisely because it did not include theories about the etiology, management, and treatment of mental disorders APA,p. Nuevas puntualizaciones sobre las neuropsicosis de defensa. 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: This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

As a neurologist, he was interested in the enigma that hysteria represented for this specialty, and the invention of psychoanalysis corresponds to the rupture that Freud introduced into the understanding of this disease hysterical neurosis. The functional adjustment itself is positive, but the clinical reading of psychotic phenomena as a kind of signature of the subject cannot be left out.

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From this perspective, it adopted what was called a descriptive approach: The subject is forced to exist in the language which precedes him and which is imposed on him as law.

The greater or lesser clinical validity of these categories deserves to be discussed separately, and is obviously beyond the scope of this article. It is beyond scope of this work to go deeper into the psychoanalytic reading of psychosis initiated by Freud and formalized by Lacan.


To do this, the DSM and then the ICD declared themselves to be atheoretical, excluding the categories which involved theoretical and psychodynamic assumptions and intending to base classification exclusively on symptoms that could be empirically observed and quantified. A syndrome is a set of signs and symptoms that manifest in the occurrence of disease. These two poles are complementary and connected by the following common features which are inherent to the disease: The disappearance of the psychosis category as a noun, that is, as the name of a psychiatric condition, has produced a growing difficulty in recognizing psychotic functioning, which previously was identified even when hallucinations and delusions were absent.

The first line, the one of the dissociation, consists of the breakdown of life related to the psyche, the internal discordance of psychological phenomena. By reducing psychosis to a deficit-type condition or to the occurrence of accessory delusions and hallucinations, not only a clinical ignorance of this condition created, but an operation is produced that separates it from our own condition.

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.

This favored the view that psychosis is a phenomenon which is always disruptive, and that its treatment addresses rearranging what the break threw into disarray. In its strong sense, it defined or defines a deep psychological structure — a specific mode of subjective constitution and functioning — as opposed to neurosis, and its expression in symptoms can vary greatly.

Freud himself never had a regular practice with psychotic patients. Bleuler, entre psychiatrie et psychanalyse?

Os fundamentos da clínica: história e estrutura do saber psiquiátrico – ScienceOpen

In this sense, our approach lies within psychiatric doctrine and the dialog between psychoanalysis and psychiatry, although it does not neglect to consider and mention the convergence of economic and social processes which have contributed to the transformations we discuss.

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 c,inica deficient nature.

He only used the term paranoia to describe the latter case. APA,p. Hence the difficulty of establishing a sharp border between the normal subject and neurosis as a pathology in psychoanalysis.

How can we make this diversity compatible with the assumption that psychosis is unique?