Some remarks(considerations) about the fonction of psychoanalyst in assistential institutions

de FRECHA Graciela Pietra Pertosa


The hospital is one of ways proposed by Freud to circulate.

One question worth asking is how to think about the practice of psychoanalysis being that the conception of health which sustains Assistant Institutions conceive it so much as an restoration of a lost balance, as at the same time ordered to the world enterprise of productivity?

The gratuity of services, the promotion of solutions in a short time, in function of the ideal of happiness of the majority are coordinates which have their influence in the treatments we conduct. Medical, juridical, social demands, are the kind that are addressed to us.

Without trying to be exhaustive, these obstacles with which we face every day, allow reflections about the function and the practice of psychoanalysts in assistance institutions.

Perhaps it is necessary to come back to Freudian texts, not only to look for answers but because the reading of his texts let us reformulate questions which lead our practice today. I would like to quote one of them: "The ways of analytic therapy" where Freud expresses a will which today on his 82nd anniversary of his writing is still valid. It is about a conference pronounced par Freud at the 5th Congress at Budapest. "I would like to examine with you a situation that belongs to the future, and which may seem fantastic. You know very well that our therapeutic action is mostly limited. Faced to the magnitude of the neurotic misery that the world has, our therapeutic performance is quantitatively insignificant. "

Let’s suppose any organization lets us increase our number in such a way so that we could be enough to treat a great amount of sick people .

It is predictable that someday the conscience of society will awaken and they will be aware that everybody has the right to the help of psychoanalysts in the same way that they have access to a surgeon."

"Medical Institutions will be created in which there will be analysts, and treatment would naturally be free."

"We will all be concerned with the task of adopting new techniques to the new conditions."

"But no matter what the structure and the composition of this psychotherapy is, its most important and efficient elements will always remain those taken from former psychoanalysis, old, rigorous and free of any tendency."

We can see how Freud includes some questions of practical order: a qualitative extension of therapeutic performance to the greater sector of the population and its possible adaptations of the technique to new conditions that the practice itself demands.

But in this progress of the possibility of the treatment of sick people, he shows a direction which has ethical reasons. This means that the efficacy of this practice supposes for Freud an ethic which is that of psychoanalysis.

So, from Freud and going on to Lacan, the ethic of psychoanalysis considers the suffering of a subject, only if he does not detach himself from the responsibility that he has in connection with his desire. Lacan in the Seminary about the Ethic is going to say that the only subject’s goods is that one which serves him to pay the price to achieve the desire.

Freud invents the psychoanalysis as a social and new tie.

He discovers through transference the subject of the unconscious, and still, he discovers the fact that without it the subject could never appear.

He discovers that it is through the way of the word that a subject addresses to another how the unconscious shows itself

in act, that takes form in the act of talking.

That this unconscious knowledge that appears in the lapsus, in the failed-acts in dreams, in the symptoms are written with letters which wait for another to be deciphered.

That these letters, which are written by the unconscious knowledge, have a therapeutic effect on the body as a tie when they are decoded, different from suggestion.

Freud understood this from the very beginning but not without a profound and constant review throughout his full work. Lacan, by reading Freud formalizes the four speeches, remarking that this operates from the analyst´s speech.

He also shows that it is from the position of that who is listening that the passage from one speech to another is possible. And it is in the passage itself where time of transference articulates, the one of unconscious, the one of repetition and the one of the impulse.

Transference is a telling in relation to with a resemblant who making semblant of "a" object causes talking.

The analyst’s desire will be the name that Lacan will give to this function.

In each consultation that we receive from those who work in hospitals, in assistance institutions, the Freudian bet is renewed.

The circumstances of these meetings may be varied, according to the needs that every situation demands: it can be in a consultation room, on a bench in the garden of the hospital, every time there is no consultory room left (a very habitual situation in my country) in a guard room, in a general room where we meet, in a workshop with psychotic patients. What I want to stress is that what gives them their value is the function that they have: give place to a subject’s word.

What makes an analytic act particular is its operation in the language, through a split, a scansion, an interpretation. The analyst makes from his speech an act…

The analyst abstains from promising any kind of moral welfare. He offers to listen and he authorizes himself to intervene from the ethic of the desire and the artifice of transference.

The invitation is, then, to talk and the bet is the possibility that from a certain telling, that often enounces the subject’s alienation to another speech, by means of any punctuation, allows to make out from this telling a text.

The analyst’s desire produces the passage to speech from the telling to the talking.

The ethic of the psychoanalysis is the ethic of the good telling, and Lacan, at his Seminary "Still," says that the analyst is a rector who guides what it said.

There is no intervention strategy when dealing with neurosis, or psychosis, anguish or passage to act, except to adjust the conditions of the speech, that is to say the distribution of places and the introduction of a certain game of temporality.

To conclude, according to my experience: An analytic treatment in an assistance institute is possible any time if the act of the analyst allows a necessary turn to the analytic speech, which implies the issue of the institutional speech.

This passage from one speech to another supposes a subjective rectification, from the consistence of the being, to the splitting of the subject, which will allow the phantasm to enters in its logics, and allows the possibility that the subject be aware of his desire.

The analyst’s act, the interpretation, that supports on analyst’s desire, which is a desire of pure difference, engages the subject in the ways of the speech.

The demand of analysis is not independent from an analyst’s position with respect to his desire.

 

 

Graciela Pietrapertosa de Frecha

Member of E. F. A.

 

 

1- M. Pujó Is time money? Psychoanalysis and Hospital Nº 3 Bs As 1993.

  1. A. Benjamín Psychoanalysis and the therapeutic. Psychoanalysis and Hospital Nº 7 Bs As 1995.