A escuta clínica nas urgências e emergências hospitalares: articulações entre o desejo do analista, o tempo e a ética da psicanálise

Abstract

This research investigates the incidence of time in the context of urgencies and emergencies hospital settings in their relationship with the analyst’s desire. Thus, we turn to emergencies and emergencies, inquiring about the specificity of the psychoanalyst’s work in this context. A restructuring of the health concept was the key to the entry of several categories professionals in the hospital and among them, psychology. Psychoanalysis and its perspective Extension is also present in the emergence of the notion of urgency. It is known that the sector urgency and emergency within a hospital has unique characteristics that must be considered, among them the objective of achieving clinical stabilization and early detection of the diagnosis. In this context, where haste is what governs the work of the healthcare team, in a At first, there seems to be no space for listening, justifying that there is no time. However, this sector is not deprived of the emergence of emergencies considered psychic. They are these demands that, marked by the seal of a limit (it is said that the team cannot respond to such requests), lead to the summoning of the psychoanalyst. If urgency leads us to the relationship with the time and its management, it is this limit (set when the analyst is called) that will require we think about the relationships that are established between urgency, emergency and time with the analyst’s desire – fundamental notion for the psychoanalytic clinic. While medicine wants save lives, cure the sick, provide care quickly, the psychoanalyst present in Psychic urgencies want to listen to the subject in the face of their anguish. This is the perspective of the health care, in any case, but with attention to the necessary distinctions, the differences discursive ideas that separate medicine and psychoanalysis. Distinctions that at the same time allow advance in the construction of possibilities for joint action in this common space. In order to investigate the context of urgencies and emergencies in their relationship with desire of the analyst, a path followed that began with rescuing the entry of psychology into the hospital, also understanding how psychoanalysis was crossed by this space and the consequences of this crossing to the constitution of his own theoretical body. We sought to discuss the conceptual bases of psychoanalysis itself with regard to listening in hospitals and which can be inferred in the writings of psychoanalysts when they seek to articulate important elements for their work in hospitals. This was followed by the presentation of the definitions of the terms “urgency” and “emergency” in their minimum elements and which demarcate important distinctions between medicine and psychoanalysis. From the determinants that constituted the medical clinic, the psychiatric clinic and the psychoanalytic clinic, the importance of the distinction between sign and signifier was observed for understanding the cut operated between these clinics. A cut that, by insisting on the presence of the signifier and the formations of the unconscious, separates and situates the psychoanalytic clinic. Finally, it was possible to articulate the problem of time with the analyst's notion of desire - a notion that demonstrated its vitality, allowing it to articulate fundamental elements of technique and ethics in the institutional context of hospital urgencies and emergencies. After the introduction, the second chapter of the dissertation addresses historical aspects of the emergence of psychology and psychoanalysis in their relations with the hospital institution, also exploring the Katharina case, published in the work “Studies on a hysteria” (1893/1895) - report by Freud where we are faced with the break in the traditionalism in which analyzes took place. In the third chapter, the notions of urgency and emergency are worked on, with an emphasis on the notion of subjective urgency – an important notion for the practice carried out by psychologists and psychoanalysts within healthcare teams and which expresses the relevance of their contributions within the scope of healthcare practices. The fourth chapter approaches time from metapsychology and moves towards the contributions made by Lacan regarding the management of time in analysis. Such developments allow us to articulate, in the fifth and final chapter, the incidence of time in its relationship with the analyst's desire.