Discussão psicanalítica sobre o transtorno de pânico com estudo de caso [Psychoanalytical discussion about panic disorder with case study]

OLIVEIRA, P. C. de. Discussão psicanalítica sobre o transtorno de pânico com estudo de caso [Psychoanalytical discussion about panic disorder with case study]. Master’s Dissertation – USP. São Paulo (SP), 2016. 

Available on: doi: 10.11606/D.47.2016.tde-08122016-172719

The main objective of this work is to discuss the place of panic disorder in Freud’s and post-Freudian psychoanalytic metapsychology. Initially, the panic disorder is presented here under the psychiatric perspective. Afterwards, having its association with Freud´s constructions about anxiety neurosis in sight, Freud’s anxiety theories will be spoken about having his and Laplanche’s texts as basis. Laplanche, as he criticizes the second anxiety theory of the psychoanalysis father, points out to a possible third anxiety theory as a reflex of the direct implication of the death instinct concept on the first two. Therefore, there are some discussions about Freud’s instinct theories based on Freud’s texts and Garcia-Rozas and Laplanche’s writings. In this exercise of creating this third anxiety theory there is a strong Laplanche based emphasis on sexuality as a psychoanalysis turning point and a reconstruction of Freud’s supporting theory, leading to a new concept: the generalized seduction. In this process, Klein’s work, seeing under concepts such as original masochism and auto-aggression, allowed Laplanche, as he created his seduction theory, to rename the death instinct as sexual death instinct. Thus, Freud’s idea of the anxiety neurosis as a consequence of a sexual instinct attack is reformulated by this sexual specification, as Freud’s demoniac sexuality. This part of sexuality is dominated by the sexual death instinct and is the one that excites, turns off and overflows. Subsequently, there will be presented some specific considerations on panic disorder made by national and international post Freudian psychoanalytical authors. A qualitative research based on Turato will be shown in order to produce reality based data to be articulated with psychoanalytical theories on panic disorder and the anxiety neurosis theories raised by Laplanche´s metapsychological discussion. This research consists of a unique case study systematized in a comprehensive diagnosis process, followed by psychotherapy. The psych diagnosis occurs in two semi guided interviews, followed by a Drawing-and-Story Procedure. The psychoanalytic psychotherapy sessions’ reports were discussed in group supervision. The collected data are analyzed based on Turato’s content analysis perspective and the referenced studies on Drawing-and-Story Procedure, especially emphasizing Tardivo. In this analysis, psychoanalytic concepts and tools such as unconscious manifestations, anxiety handling, transference, countertransference, interpretation and holding are used as references. At last, the data is articulated with the theory, as highlighted by Sigal, pointing out to Laplanches consideration about the implantation and intromission of the enigmatic signifier. Therefore, creating and understanding about the panic disorders installation. There are also some discussions about specific management in order to confront psychotic spots formed by unassimilated remains, which the primal repression fail marks, common in patients that manifest panic disorder.

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