A reforma psiquiátrica no Brasil contemporâneo: ensaios da psicanálise lacaniana e da crítica da economia política
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2018-02-02
Autores
Goto, Carine Sayuri
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Universidade Estadual Paulista (Unesp)
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Este trabalho buscou refletir sobre a Reforma Psiquiátrica (RP) no Brasil contemporâneo, entendendo esse último termo como o momento em que vivemos, fortemente marcado pelo capitalismo e pelo Discurso do Capitalista, definido por Jacques Lacan. As reflexões expostas nesse trabalho foram suscitadas pela experiência sorocabana, na medida em que estivemos inseridos como trabalhadores. Nesse período elaboramos um Diário de Campo que nos serviu posteriormente para a composição desse trabalho. Com a intenção de subverter a organização social do trabalho, na qual alguns pensam e outros executam, sendo que a universidade pode ser uma grande representante desse modelo, destinada aos pensadores, encarnamos inicialmente o trabalhador que exercia sua prática sem desviculá-la da reflexão e, posteriormente, encarnamos o pesquisador que refletiu mais aprofundadamente sobre a experiência inicial. Para captar as transformações sociais e subjetivas optamos por uma introdução histórica para compreender o início da RP, inspirada na Reforma Sanitária e seus ideais de mudanças estruturais na sociedade, ao mesmo tempo em que fomos decifrando o interesse do Capital, em seu modo neoliberal, nas políticas públicas da saúde e na organização da medicina como mantenedora da força de trabalho, é nesse aspecto que também incluímos a psiquiatria. Na passagem do capitalismo industrial para sua versão financeirizada, procuramos refletir sobre as instituições produzidas na Saúde Mental, que sai do modelo manicomial para o modelo aberto. Nessa transformação identificamos a necessidade do capitalismo em abrir novos mercados, em um movimento incessante, necessário para sua existência. A psiquiatria comunitária marca bem essa transformação, saindo do interior dos muros dos manicômios para se disseminar na sociedade, aumentando com isso o faturamento da Indústria Farmacêutica, que no Laço Social contemporâneo corresponde a colocar a medicação no lugar de gadget. A psiquiatria DSM, assim denominada pela sua submissão ao manual de diagnósticos, foi alvo de nosso debate, na medida em que a formação dos psiquiatras se define como a-política e científica, assim como o DSM III, versão que foi marcada na história da psiquiatria pela retirada da influência psicanalítica. Como tentativa de ilustrar nosso exercício de pensamento, apresentamos no final da dissertação a experiência da cidade de Sorocaba, que no ano de 2013 iniciou o maior processo de desinstitucionalização do país, com a pretensão de fechar quatro hospitais psiquiátricos no período de três anos. Nosso trabalho buscou o diálogo da crítica da economia política, inaugurada por Karl Marx, e a psicanálise de Jacques Lacan, para pensar as transformações no campo da Reforma Psiquiátrica e Atenção Psicossocial.
This work aims to reflect on the Psychiatric Reform (PR) in contemporary Brazil, understanding this last term as the moment in which we live, strongly marked by capitalism and by the Capitalist Discourse, as defined by Jacques Lacan. The reflections exposed in this work were raised by the experience of Sorocaba, as we were inserted there as workers. During this period we prepared a Field Diary that later was used for the composition of this work. With the intention of subverting the social organization of work, in which some think and others execute, and the university can be a great representative of this model, destined to the thinkers, we initially embody the worker who acts without diverting it from reflection and, later we incarnated the researcher who reflected more deeply on the initial experience. In order to capture the social and subjective transformations we opted for a historical introduction to understand the beginning of the PR, inspired by the Sanitary Reform and its ideals of structural changes in society, at the same time as we were deciphering the interest of Capital, in its neoliberal way, in the public health policies and the organization of medicine as a provider of workforce, it is in this aspect that we also include psychiatry. In the passage from industrial capitalism to its financialized version, we try to reflect on the institutions produced in Mental Health, which goes from the asylum model to the open model. In this transformation we identify the need of capitalism to open new markets, in an incessant movement, necessary for its existence. Community psychiatry marks this transformation, leaving the walls of asylums to spread in society, increasing with this the billing of the Pharmaceutical Industry, which in the contemporary Social Loop corresponds to putting the medication in place of gadgets. DSM psychiatry, so named for its submission to the diagnostic manual, was the subject of our debate, as the training of psychiatrists was defined as a-political and scientific, as well as DSM III, a version that was marked in the history of psychiatry for the withdrawal of psychoanalytic influences. As an attempt to illustrate our thinking exercise, we present at the end of the dissertation the experience of the city of Sorocaba, which in 2013 initiated the largest process of deinstitutionalization in Brazilian history, with the intention of closing four psychiatric hospitals in a period of three years. Our work sought the dialogue of the critique of political economy, inaugurated by Karl Marx, and the psychoanalysis of Jacques Lacan, to think the transformations in the field of Psychiatric Reform and Psychosocial Care
This work aims to reflect on the Psychiatric Reform (PR) in contemporary Brazil, understanding this last term as the moment in which we live, strongly marked by capitalism and by the Capitalist Discourse, as defined by Jacques Lacan. The reflections exposed in this work were raised by the experience of Sorocaba, as we were inserted there as workers. During this period we prepared a Field Diary that later was used for the composition of this work. With the intention of subverting the social organization of work, in which some think and others execute, and the university can be a great representative of this model, destined to the thinkers, we initially embody the worker who acts without diverting it from reflection and, later we incarnated the researcher who reflected more deeply on the initial experience. In order to capture the social and subjective transformations we opted for a historical introduction to understand the beginning of the PR, inspired by the Sanitary Reform and its ideals of structural changes in society, at the same time as we were deciphering the interest of Capital, in its neoliberal way, in the public health policies and the organization of medicine as a provider of workforce, it is in this aspect that we also include psychiatry. In the passage from industrial capitalism to its financialized version, we try to reflect on the institutions produced in Mental Health, which goes from the asylum model to the open model. In this transformation we identify the need of capitalism to open new markets, in an incessant movement, necessary for its existence. Community psychiatry marks this transformation, leaving the walls of asylums to spread in society, increasing with this the billing of the Pharmaceutical Industry, which in the contemporary Social Loop corresponds to putting the medication in place of gadgets. DSM psychiatry, so named for its submission to the diagnostic manual, was the subject of our debate, as the training of psychiatrists was defined as a-political and scientific, as well as DSM III, a version that was marked in the history of psychiatry for the withdrawal of psychoanalytic influences. As an attempt to illustrate our thinking exercise, we present at the end of the dissertation the experience of the city of Sorocaba, which in 2013 initiated the largest process of deinstitutionalization in Brazilian history, with the intention of closing four psychiatric hospitals in a period of three years. Our work sought the dialogue of the critique of political economy, inaugurated by Karl Marx, and the psychoanalysis of Jacques Lacan, to think the transformations in the field of Psychiatric Reform and Psychosocial Care
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Reforma Psiquiátrica, Capitalismo, Psicanálise, Atenção Psicossocial