A noção de recusa na história clínica da anorexia: chaves de leitura para o contemporâneo

Abstract

This research aims to investigate the phenomenon of anorexia and the role played by refusal in its construction. From the methodological approach of the thesis, as a psychoanalytic study, it was possible to identify the determining function of refusal in sustaining the anorexic phenomenon, both through a literature review (gathering terms specifically related to anorexia) and through the place this notion assumed in the writings of psychoanalysts who focused on anorexia in their theoretical formalization efforts. The investigation was divided into three chapters, where we sought to situate the propositions related to understanding anorexia, but also the implications of this understanding for the challenges presented regarding treatment direction. Here, the issue of its connections with the contemporary is also unfolded. The formalization undertaken by such authors (and the place the notion of refusal assumes within it) became even more significant when the DSM V and the corresponding treatment protocols established significant changes in understanding anorexia. Changes that precisely aimed at the term of refusal. Reported up to DSM IV, in DSM V it is omitted and intended to be used "in specific cases" as outlined by the manual. The research path we undertook allows us to support the thesis that the removal of the term produces effects in both the clinic and culture, as this suppression affects what concerns a mark of the subject. Thus, if the notion of refusal allows us to grasp the construction of the anorexic symptom, it is also, at the same time, the theoretical formalization resulting from a listening oriented towards the subject. Refusal is a notion that preserves the subject, indicating their presence even in phenomena approaching death. It is this presence of the subject that appears in understanding the symptom, which can simultaneously provide an ethical direction to the challenges

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experienced in treatment direction. The subject, still there, marking something singular in the relationship each one establishes with the Other, is, therefore, the index of the ethics that governs both the formalization work carried out by analysts and the listening that sustains their practice. This corroborates the solidarity and, as Pura Cancina proposed, the Borromean structure of the relationships between theory, practice, and clinic. At the end of this thesis, we aim to instill propositions that allow us to affirm that it will be through refusal that the anorexic will be able to make a hole in the Other and redirect their desire.