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These authors point out a paradigm shift that is not limited to the classification of mental diseases, and reaches the question of hegemony among the knowledge that constitutes the psychiatric and psychological clinic, and the sphere of social representations relative to the individual and to the normal and the pathological.
The DSM-III carried the warning that it was not a teaching manual, precisely because it did not include theories about the etiology, management, and treatment of mental disorders APA,p. The stated intention of these modifications was to create as much consensus as possible in flinica classifications, regardless of which school the psychiatrist followed. In this way, the term psychosis came to be used for this group of diseases.
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These two poles are complementary and connected by the following common features which are inherent to the disease: Freud,p. He only used the term paranoia to describe the latter case. Names like melancholy and paranoia were abandoned in favor of depressive disorder mild, moderate, or severe, with or without somatic symptoms, with or without psychotic symptoms and persistent delusional disorder, respectively. The functional adjustment itself is positive, but the clinical reading of psychotic phenomena as a kind of signature of the subject cannot be left out.
Note how a century and a half of debate, during which the position that prevailed was to consider delusions and hallucinations less important than the profound splitting of mental and emotional functioning, was resolved in a reductionist manner.
The very substitution of the term disease with the term disorder, as we have stated earlier, is part of this process. The nosographic structure established by Emil Kraepelin around the turn of the twentieth century guided psychiatry for the next hundred years.
In the words of Lacanp. To prevent this, the practical and theoretical knowledge constructed around and based upon the notion of psychosis must continue to be developed for those who are interested in madness, not as a syndrome or a disorder that can be regulated, but as a phenomenon that illuminates the fundamentals of the human condition, and touches its limits and contradictions.
The Freudian terms of intersection between paternal inheritance and assumption of sex by the subject are considered by Lacan as dimensions established by language itself, by the symbolic, for every subject.
At the end of the study period, participants are evaluated to see if their symptoms have improved, to assess whether the medication has a therapeutic efficacy that is statistically superior to the placebo. Current pathological classifications prioritize a physicalist approach.
Fundamentos da Clínica
For this reason, the German school was noted for producing broad categories of classification, while the French school was known for its description of conditions characterized by their differences and specific qualities. As in the DSM, the diagnosis of maniac-depressive psychosis is no longer used. What Hecker added was the identification of anomalies in syntactic construction and a tendency to deviate from the normal way of speaking and writing — formal changes in language that, according to Hecker, express a profound breakdown of the Ego and are early indications of the clinicaa weakening that will occur later.
Generally, schizophrenic psychosis is understood to mean a set of disorders dominated by discordance, ideoverbal incoherence, ambivalence, autism, delusional ideas, poorly systematized hallucinations, and profound affective disturbances in the sense of detachment and strangeness of feelings — disorders that tend to evolve into a deficit and a dissociation of personality Ey, Bernard, Brisset, s.
How can we make this diversity compatible with the assumption that psychosis is unique? We can say that the strength of the concept forced the DSM to include it again. They also demonstrate how a fundamdntos system exclusively based on symptoms has favored increasing emphasis on pharmacological treatment. This article discusses the changes which have occurred in the diagnostic classification systems for fundamentls illness, fundamentls regarding the conceptual weakening of the psychosis category, at the same time that schizophrenia has become dominant as the only condition recognized as psychotic.
We will recall its fundamental bases that are sufficient for the argument we are pursuing here. According to Ey, the absence of a rigorous definition does not prevent most clinicians from understanding it in practice with regard to the diagnosis of schizophrenia: XXIV; emphasis in the original.
Therefore, the mechanism is the introduction via identification of unconscious knowledge about desire and the sexual, knowledge that forms the subject himself, but which remains inaccessible to him in terms of consciousness.
However, they have a particular form of existence, existing outside the general symbolization that structures the subject, outside any symbolization that would allow the subject to have them as fundamengos elements of his subjectivity. This is what clinida at the heart of the distinction between neurosis and psychosis and supports the affirmation of psychosis as a structure, as opposed to bedcherie idea of psychosis as a deficit.
While the terminology was undergoing these adjustments, in which the notion of psychosis indicated severe mental diseases separated from neurological diseases and neurosis, Emil Kraepelin reordered the psychiatric classification of diseases in terms of three major clinical entities: Additionally, the fact that any multinational company eager to get its medications approved bercherue the American market must present effectiveness and safety testing according to these same requirements finally led to global compliance with the new manual, promoting the global expansion of American psychiatry at the expense of the French and German traditions which had constituted psychiatry up to this point.
I wish to thank Fernanda Costa Moura for her indispensable guidance in the research and in crafting the thesis, as well as in the final writing of this article. This established the terms psychosis and neurosis as antonyms, each hosting a certain group of psychological diseases.
Dictionnaire taxinomique de la psychiatrie. By emphasizing the criteria for evolution and fundametnos introducing the dimension of the course of the disease over timeKraepelin: During this same period, Magnan distinguished the mixed states organic brain lesions, senile dementia, neuroses [hysteria], epilepsy, alcoholism etc.
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This is an Lq Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly gundamentos.
Freud formulated that the formation of the subject corresponds to the introduction of these subjective elements into the psyche, although they are housed in the unconscious, as unconscious knowledge i. It can be said that throughout the twentieth century, these three disorders characterized the field of psychiatry. This is pa of the most controversial categories of clinical practice, and for sure carries the most risk of a moral approach to the patient.
The first is that although it claims to be free of theory, the DSM actually is related with the pragmatism of Peirce and empiricist theses.
And these formations are not, in relation to these issues, a merely haphazard reaction, but in fact quite the opposite: The second consequence is that conditions which had previously been recognized as psychotic have been relocated to fit under the heading of personality disorders. According to Ey, the absence of a rigorous definition does not prevent most clinicians from understanding it in practice with regard to the diagnosis of schizophrenia:. It is beyond scope of this work to go deeper into the psychoanalytic reading of psychosis initiated by Freud and formalized cllinica Lacan.
Ds showed the heterogeneity of these logics, and at the same time the main lines of psychosis as a structure.