Psicoterapia psicanalítica da fobia: o uso de imagens em um estudo de caso [Psychoanalytic psychotherapy of phobias: the use of images in a case study]

GRANADO, L. C. Psicoterapia psicanalítica da fobia: o uso de imagens em um estudo de caso [Psychoanalytic psychotherapy of phobias: the use of images in a case study]. Doctoral Thesis – Instituto de Psicologia da USP. São Paulo (SP), 2011.

 Available on: doi: <10.11606/T.47.2011.tde-22072011-161704> 

This paper aims to describe the attendance of a patient by using images related to her phobia in the clinical context. It is a proposal for a differentiated framing in psychoanalytic psychotherapy based on the theory of objects and transitional phenomena by Winnicott, which refers to an area where realities, both internal subjective and external objective contribute and constitute the area of play. The Freudian theory about anguish is reviewed from the very beginning when the phobia was considered a symptom which could appear in diverse mental disorders. The term anguish hysteria was proposed by Freud in 1909 to describe the nosological entity in which the phobia is the central question and whose mechanism is similar to that of hysteria. This work was developed by using the clinical method and a presentation of a detailed case study. A 37-year-old female patient sought treatment for arachnophobia. In her psychodiagnosis, the Drawing-and-Story Procedure by Walter Trinca was applied. Her psychotherapy was conducted in 19 attendances, for which two folders were arranged with the help of the patient, one with photographs that reminded of spiders and another with pictures of real spiders and webs. The case was understood as anguish hysteria and treated in a rapid and intense psychotherapeutic process. It is discussed that the imagery established an oniric language in the sessions and the oniric context is a field of symbolization, just like the area of play. The associations made with the use of images were predominantly around the spider theme; such associations were compared to the role played by fantasies in the dreaming activity, which is carried out by the waking consciousness, in relation to the latent content of dreams. It is discussed that the transitionality provided by the imagery allowed an activity of figurability and at the same time it would have allowed a process of thinking by images, having images associated with words all along the way. The patient achieved her inner transformation, a re-creation of herself in which her sexual pulsion of death (in Laplanche’s conception) was transformed from an objectalizing function (Green) into a sexual pulsion of life, with its processes of integration and synthesis, enabling the constitution of units and links. It can be considered that healing did take place, as proposed by Herrmann. It is concluded that the present case study demonstrated the potentiality of using images to favor symbolizations and elaborations within the psychoanalytic psychotherapy of phobias. Further investigations in this area may respond to the question of possibilities towards generalizing the experience reported herein.

Walter Trinca Copyright 2001 – All rights reserved.

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