| dc.description.abstract | The Thesis “For a Possible Psychoanalytic Clinic in Amyotrophic Lateral Sclerosis” reflects on
the possibility of a clinic, from a psychoanalytic perspective, with people with the
neurodegenerative disease Amyotrophic Lateral Sclerosis (ALS), also called syndrome of
incarceration. From a listening clinical position, erected through the historical invention of
psychic suffering and under the theoretical-epistemological framework of Fundamental
Psychopathology, we face the pathos - the subject's experience of suffering - in the context of
physical illness in order to consider the silenced body as a pathic body. Considering the
psychoanalytic care of neurological patients, we place among the neurological disorders in the
category of Motor Neuron Diseases, the dramatic diagnosis of ALS as a destination that
perspective for the subject the condition of “prisoner in his own body”. Then, from the point of
view of psychoanalysis and clinical psychology, we raise the issues of communicability in the
follow-up of patients whose advanced condition often imposes speech loss. As it is a qualitative
research in Fundamental Psychopathology and Psychoanalysis, we seek to promote a
transdiscursive dialogue between the different approaches about the psychopathological given in
the body condition in ALS. Thus we started from the objective of investigating the possibilities of
a psychoanalytic clinic with subjects affected by ALS in situations of incarceration syndrome. The
study participants were six professional therapists, four psychoanalysts and two psychoanalytic /
psychodynamic oriented psychologists, with experience of clinical care of people affected by
ALS. The sampling was based on convenience criteria and included psychoanalysts and clinical
psychologists who stated that they were acting on a psychodynamic / psychoanalytic basis who
have already treated or are attending patients diagnosed with ALS with dysarthria / anarthria.
These professionals were residents of the cities of Maceió, Recife, São Paulo and Rio de Janeiro
who through a semi-structured interview gave a free statement from triggering questions such as:
a) in their experience with the care of subjects affected by ALS in condition of dysarthria /
anarthria do you act with the psychoanalytic method? How?; and b) considering the techniques /
methods / strategies you use with these patients, what can be identified as being proper to
psychoanalysis? Because? The statements were analyzed in the light of a reflection with some
theoretical contributions of Psychoanalysis such as Freud's method and transference, Ferénczi's
technical innovations as touch and sensible presence, and language, the Symbolic and the Real in
Lacan, plus the notion of scopic drive. Finally we consider that the possible psychoanalytical
clinic for subjects affected by ALS is a “mosaic clinic”, whose singular assembly implies the
articulation of different resources and strategies where the technique is supported by the
transference. We conclude that it is a psychoanalytical look and a psychoanalytic listening as a
welcome, which presuppose the construction of this possible clinical mosaic in ALS where the
look itself is heard in the absence of the word. | eng |
