Contribuições da psicanálise de Freud e Lacan e do materialismo histórico para a terapia ocupacional: uma clínica do desejo e do carecimento na saúde coletiva
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Data
2016-02-04
Autores
Shimoguiri, Ana Flávia Dias Tanaka [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Nosso objetivo principal foi pensar as práticas em Terapia Ocupacional à luz da análise paradigmática postulada por Costa-Rosa, que define o Paradigma Psicossocial como um passo além da Reforma Psiquiátrica brasileira. A partir da práxis clínica e institucional, tentamos fundamentar uma modalidade de terapia ocupacional na qual a psicanálise do campo de Freud e Lacan e o Materialismo Histórico são os referenciais teóricos técnicos e éticos políticos. Especificamos o enfoque desta reflexão no campo da Saúde Coletiva, na Atenção Psicossocial. Partimos do Dispositivo Intercessor, como um novo Modo de Produção de subjetividade e conhecimento. De natureza transdisciplinar, o Dispositivo Intercessor parte, principalmente, da psicanálise e do Materialismo Histórico – bem como de inspirações da Análise Institucional francesa e da Filosofia da Diferença – para definir dois momentos de produção radicalmente diferentes: o momento da práxis clínica junto aos “sujeitos do tratamento” e da práxis institucional junto ao “coletivo de trabalho”; e o momento da reflexão teórica, produzida a posteriori, sobre o processo de produção realizado no primeiro momento. Nossas reflexões pretendem demonstrar que (re)inventar a clínica na Terapia Ocupacional no contexto do Paradigma Psicossocial é tão possível quanto eticamente necessário. Na terapia ocupacional psicossocial, a saúde e a subjetividade são tomadas em sua continuidade moebiana e as dimensões subjetiva e social são indissociáveis. O sujeito, conforme concebido pela psicanálise, está entre homens e entre significantes, o referente de ação será o sujeito do inconsciente e o principal ‘meio’ de trabalho será a palavra e o fazer humano, considerado pelo Materialismo Histórico como a atividade vital do processo de humanização, em que ao fazer o homem faz a si mesmo. Com revoluções discursivas, avessas ao Discurso do Mestre e da Universidade, nos posicionamos no Discurso da Histérica e no Discurso do Analista, na ética do desejo. Assim é possível recuperar o aspecto simbólico-criativo-desejante das atividades, pensadas como dispositivos clínicos capazes de proporcionar equacionamentos de certos impasses nos processamentos específicos da subjetivação. Nesse modo de relação do sujeito com seu fazer, com o significante, e com os outros, há possibilidades transferenciais mais simbólicas e menos imaginárias, menos alienantes. E, sobretudo, a produção de subjetividades singularizadas, por definição, subversivas ao instituído social dominante. Somente assim será possível caminhar na direção de suplantar as velhas terapêuticas ocupacionais alienantes pertencentes ao Paradigma Psiquiátrico Hospitalocêntrico Medicalizador, não por acaso sintônico com o Modo Capitalista de Produção.
Our main objective was to reflect about Occupational Therapy´s practices in the light of the paradigmatic analysis postulated by Costa-Rosa, who defines the Psychosocial Paradigm as a step beyond the Brazilian Psychiatric Reform. From a clinical and institutional praxis, we have attempted to found a modality of occupational therapy in which Freud and Lacan’s psychoanalysis and the historical materialism are the technical theoretical and ethical political references. We specify the focus of this reflection in the field of Collective Health, in the Psychosocial Care. We start from the Intercessor Device as a new Mode of Production of subjectivity and knowledge. Of transdisciplinary nature, the Intercessor Device originates mainly from psychoanalysis and Historical Materialism – as well as from inspirations of the french Institutional Analysis and Philosophy of Difference – to define two radically different moments of production: that of clinical praxis together with the “subjects of treatment” and of institutional praxis with the “collective of work”; and the moment of theoretical reflection, produced a posteriori, on the production process carried out along the first moment. Our reflections intend to demonstrate that (re)inventing the clinic in Occupational Therapy in the context of Psychosocial Paradigm is both possible and ethically necessary. In the psychosocial Occupational Therapy the health and the subjectivity are taken in their mobius continuity, so the subjective and social dimensions are inseparable. The subject, as conceived by psychoanalysis, is among men and between signifiers, the referent of action will be the unconscious's subject and the main means of work will be the word and the human´s doing, considered by historical materialism as the vital activity of the humanization process in which the man do to make himself. With averse discursive revolutions to Discourse of the Master and Discourse of the University, we choose the Discourse of the Hysteric and the Discourse of Analyst, in the desire's ethics. So it’s possible recovering the symbolic-creative-desiring aspect of activities, intended as clinical devices capable of equating impasses in specifics processes of subjectivity. In this mode of relationship of the man with his doing, with the signifier and with others men, there’re possibilities’s transference more symbolic and less imaginary, less alienating. Above all, the production of singularized subjectivities, by definition, subversive to the dominant social set. Only then will it be possible to move toward supplanting the old alienating occupational therapies pertaining to the Psychiatric Hospitalocentric Medicalizing Paradigm, not by chance in syntony with the Capitalist Mode of Production.
Our main objective was to reflect about Occupational Therapy´s practices in the light of the paradigmatic analysis postulated by Costa-Rosa, who defines the Psychosocial Paradigm as a step beyond the Brazilian Psychiatric Reform. From a clinical and institutional praxis, we have attempted to found a modality of occupational therapy in which Freud and Lacan’s psychoanalysis and the historical materialism are the technical theoretical and ethical political references. We specify the focus of this reflection in the field of Collective Health, in the Psychosocial Care. We start from the Intercessor Device as a new Mode of Production of subjectivity and knowledge. Of transdisciplinary nature, the Intercessor Device originates mainly from psychoanalysis and Historical Materialism – as well as from inspirations of the french Institutional Analysis and Philosophy of Difference – to define two radically different moments of production: that of clinical praxis together with the “subjects of treatment” and of institutional praxis with the “collective of work”; and the moment of theoretical reflection, produced a posteriori, on the production process carried out along the first moment. Our reflections intend to demonstrate that (re)inventing the clinic in Occupational Therapy in the context of Psychosocial Paradigm is both possible and ethically necessary. In the psychosocial Occupational Therapy the health and the subjectivity are taken in their mobius continuity, so the subjective and social dimensions are inseparable. The subject, as conceived by psychoanalysis, is among men and between signifiers, the referent of action will be the unconscious's subject and the main means of work will be the word and the human´s doing, considered by historical materialism as the vital activity of the humanization process in which the man do to make himself. With averse discursive revolutions to Discourse of the Master and Discourse of the University, we choose the Discourse of the Hysteric and the Discourse of Analyst, in the desire's ethics. So it’s possible recovering the symbolic-creative-desiring aspect of activities, intended as clinical devices capable of equating impasses in specifics processes of subjectivity. In this mode of relationship of the man with his doing, with the signifier and with others men, there’re possibilities’s transference more symbolic and less imaginary, less alienating. Above all, the production of singularized subjectivities, by definition, subversive to the dominant social set. Only then will it be possible to move toward supplanting the old alienating occupational therapies pertaining to the Psychiatric Hospitalocentric Medicalizing Paradigm, not by chance in syntony with the Capitalist Mode of Production.
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Palavras-chave
Terapia ocupacional na saúde coletiva, Atenção psicossocial, Materialismo histórico, Occupational therapy in collective health, Psychosocial care, Historical materialism, Psychoanalysis of Freud and Lacan’s fiel