Hysteria - Summary of case

HYSTERIA, PSYCHE-SOMA: A CASE REPORT - HISTERIO-EPILESIA?


"Do not believe in Leprechauns, They Lie Too, The Nutty Boy, Ziraldo"


1. Introduction:

The present work has as objective to trace some points about the hysteria in the modern world which in turn has been of interest to study in my clinical practice, or in my "Current Work", the "Psycho-Soma," the report a Case Report and theoretical influences that have adopted.

2. About Contemporary Clinic:

Outeiral in presenting his work "The Clinical transitional" cites Clarisse Lispector, a phrase, "To write is to try to understand, seek to reproduce the irreproducible, it is felt until the last end the feeling that remains vague and choker" That's what more than brings me inspiration right now, "I write to save someone's life, probably mine." That said, I try to contextualize the clinic, its possibilities, its impossibilities, this second, that little talk. Again citing Outeiral that translates with his undeniable sensitivity "Seeking help us endure the loneliness, uncertainty, abstinence, curiosity and not knowing that, among many other factors, are part of our daily clinical (...). Within this context I would like to talk about the hysteria, taking into consideration that theoretical revisions are made. But today we speak more of the disappearance of the "Hysterical" than the perception of its manifestations and today can be offered: or rather the question: Is there in the Modern World, time, possibility of attending this event psychic?


3. On Hysteria.

I think no need for a theoretical review of Hysteria from Freud. While Boll (2000) states that in any test on Hysteria is necessary to refer to his famous lines. According to the author in hysteria when we think of people disturbed by his sexual demands physical and sexual repressed ideas. Be oblivious to the conversion, superidentificadas with others, express themselves theatrically, daydreaming instead the existence of what it even engaging opting then for the illusion of childhood innocence to the mundanity of adult life.
BERLINCK (1997) asks: After all that has been said and written about the hysteria by psychoanalysts of yesterday and today is that there is room for anyone else to speak or say something about what is a key concern of the clinic and theories inaugurated by Freud? Here the author of "Or is it the time to listen to silence those who have something to tell us: Hysterical themselves?"
Theoretical context within which I will relate a case that was sent me some years ago that I return to this text. But for both, I think some important theoretical revision that still go on.
KHAN writes that from the earliest writings of Freud, 100 years ago, we did not have much in the literature that would allow us to better understand the hysterical, however their clinical status was mistaken for his more serious personality disorders.

"Everyone knows that Freud initially attributed this not knowing the actual episodes of sexual seduction in childhood prior to relate them to the ghosts of seduction repressed the patient expressed at present by a somatic language, but which refused to become aware psychically "(M. Khan)

Masud Khan for "it is true that the hysterical at the beginning of his psychosexual development, replaces the sexual exploitation of self-development of the body's functions I can understand why he not only proves fundamentally ambivalent and hostile to innate abilities of self, but also because a witness hostile and envious disgust in relation to any operation on the object that I loved, during adult life "


4 - Appeared Ana

Ana "appeared." I say this because she did not seek care. It was brought literally "by hand" by his neurologist in a makeshift clinic in a public service. Before entering the room talked to his doctor in particular, as she waited outside the office. He told me: "She has Histerio-Epilepsy! Already made all possible tests. Nothing found. His seizures are severe and do not respond to medications at all. We interact in a clinic to monitor your sleep. She ran away from jersey bus to his house. 40 Km He repeats: She has Histerio-epilepsy. Need to do analysis. "


5 - It is a hysterical:

BOLLA For the hysteric, your body requires a logic that he detests. Replacing his body propelled by a biology for "another" imagery symbolizing their suffering for their shares weakened, while showing little interest in the plight of these.

(He will remain indifferent to this body. His Sexuality and although it seems disharmonious sexual repression ideas, believes, paradoxically, they become a very powerful core of what was banned and that continually strives to return to consciousness. He will always be decoupling of these returns, looking cold and ascetic. Or you can do just the opposite, becoming a kind of director general of his internal world, displaying his own ideas on theater BOLLA C. 2000)

Continues the author who in the midst of these extremes, the hysteric is shown lost in his own world. A world of daydreams in which, among other possibilities may remain an eternal innocent, living with a child inside the adult body. It can transmit power with her mental state so that others with similar temperaments, can identify with their plight. Continue Boll: "He could find himself in a community of kindred, all transmitting symptoms that come and go its own internet psychic."

6 - The Mind and the Psyche-Soma:

ABRAM in his book "The Language of Winnicott," writes that the contribution made by Winnicott to Psychosomatics would start work in 1949 in a 1949 work of Mind and Its Relation to the Psyche-Soma that would have been inspired by a comment Ernest Jones in a text of 1946 in which he would write "I do not think the mind exists as an entity."
Winnicott agree, but add that in their clinical practice would have noticed that there were patients who felt his mind somewhere else, then as if this were a separate entity.

"This quote ... encouraged me to try to get my own ideas around this subject so vast and difficult. The body schema, with its temporal and spatial aspects, provides a valuable example of the diagram that the individual has of himself. From there I believe there is a clear location for the mind. In clinical practice we come across the mind as an entity located somewhere in the patient ... "
(Winnicott, Mind and Its Relation)


Winnicott used the term "mind" to describe the intellectual functioning similar to a decoupling of the individual who feels his as an entity that is not part of their sense of self. At a later point of his work, Winnicott refers to this phenomenon as "cleavage of the intellect." It is this split personality that Winnicott uses when writing about psychosomatic illnesses.

In their study Winnicott weaves a criticism of doctors who insist on seeing only the physical component of the patient, not seeing that psychosomatic disorders are located "between the mental and physical."

"These doctors are quite puzzled by his theory, interestingly, many of them overlook the importance that the physical body possesses, which is part of the brain (." (Winnicott, Mind and Its Relation))

For Winnicott, in healthy development, the psyche and soma are indistinguishable, as is the infant and child development that are involved. The individual who is supposed to sound his sense of self is part of your body.





"This is a body. The psyche and soma can not be distinguished, except by how we see. We can turn to the body or the psyche that develops. I believe that the word psyche here means the imaginative elaboration of the elements, feelings and somatic functions, or physical activity. We know that this imaginative elaboration depends on the existence and the healthy functioning of the brain, especially certain parts. The psyche, however, is not perceived by the individual as located in the brain, or even somewhere else. Little by little aspect of psyche and soma related to growing person become involved in a process of inter-relationships. This interrelationship between psyche and soma is in an early stage of development of the individual. "(Winnicott, Mind and Its Relation)


This inter-relationship between psyche and soma is the central point from which the sense of self develops.

"At a later stage, the living body, which has limits, an interior and exterior, the individual is feeling so that it can form the nucleus of the imaginative self." (Winnicott, Mind and Its Relation)

As a result, the core of self that comes from the early mother-infant relationship ends the concept of an integration between mind and body.

"Let us accept the principle that the health of an individual's development is linked to the continuity of being. The beginning of the psyche-soma is given together with certain line of development that makes the continuity of being is not interrupted, in other words, that there is a healthy development of early Blink-sum there is a need for a perfect environment. Initially this need is absolute. "(Winnicott, Mind and Its Relation)

Winnicott is referring to total identification from mother to baby, which is precisely what gives rise to a perfect environment. That means she is able to handle, manage and care for your baby with interest, protecting him, and with all the elements of love. If all goes well in the early stages, it will give the baby the feeling of being self and one lodged in his body.


7 - Hannah in attendance.

"It is clear that the hysteria has not disappeared, but she is more experienced and treated as a depression (...) to replace it is lived and accompanied, in fact, for an appreciation of the psychological processes of normalization, to the detriment of the different forms of exploitation of the unconscious (...) to psychoanalysis, psychopharmacology, for psychotherapy, homeopathy. " (ROUDINESCO 2000)



7.1: About the Setting: The place where Anne attended deserves a description. It was a public service for 20 years. It was part of a project to care for the poor. The number of queries was limited and there was started the work contract. Therapeutic consultations? Probably. Would not fit here discuss Therapeutic Consultations, although the context would merit such a theoretical split.
7.2: The service and Hannah

Ana started the treatments and their stories. At the time of just over 20 years, married with one son. According to her came from a family and a very stern father, and player of "bowling." Ana says she fell in love when her husband would have 17 years. Says not a great love, but in addition, this relationship would be a good way to leave home. Asked by me about his reported seizure-like symptoms which the neurologist had said. But something is revealed to be very interesting way: their seizures began just when she started her relationship with her boyfriend, opposing the "will of the father." His seizures were in important numbers, in different situations and even then not tied to any more specific situation, such as a stress situation, the sexual act, finally occurred randomly not responding to medication and their various attempts. His neurological examination showed no change at all.
Initially Ana shown poor will. But he was always on duty. Without delay. He trusted in attendance. I was hoping.
From the second month Hannah reports that her seizures have changed. There were so frequent and most did not happen on the street.
Asked about their relationship, their marriage says that when she started dating her, then got pregnant and she hid the pregnancy for as long as you can and when it was no longer possible to run away from home and never made contact with parents. His son was born, and only increased their seizures. I asked her why hide such a painful pregnancy and that this grandson. Why put all this time had more contact with their parents. Ana says her father, anti-marriage threatened: "If you stay pregnant I cut your head and that bum and play with them if they were bowling balls." Ana said this is a seizure. Bate, if urine, rolls her eyes and repeats several times during the seizure: "Yes sir whatever you say!" After the seizure in the office, embarrassed, scared, pissed, you have the urge to run. I tell her to calm down and said, "that's good that his seizure had occurred in the office, in a place where she was being cared for, listened to, in treatment." Ana is calmed, and his concern would be how to leave and go through service all pissed. Look for a towel table and asks if he can use the towel to go. Say yes and ask them to bring it back next session, after the towel was not mine nor hers. It was the institution, explain.
Ana fiosonomia returns with a different, quieter, more comfortable without reporting the seizure. He professes to be quieter, since between one and another session would have had no seizures. The calls continue to reduce their seizures and until then no longer occur. Wonder if she does not want to see more parents and answered that he felt more comfortable to think about it. By contract, the end of the service begins to approach. That said the next session with their child attends. I do not read. I like. At the end of the session thank you for submitting his son and score points that would be interesting if the next "query" come alone. She agrees and says: "No need to walk with him, my seizures do not happen anymore."
In the next session sits and tells me: "I dreamed that I slept with you doctor. The Lord does not dream about having sex with me? "My answer is: what good can you talk about that here. I am grateful for your interest, but I'm your therapist and that his desires were normal because I had to have helped and with it a healthy bond and important. And more importantly would be if she could keep links so that you do well without destroying itself. Ana cries and says he will miss. I tell her that another colleague would serve her and that she would not interrupt the treatment. Hannah shows in the coming consultations and sad at our last meeting said he did not want to be better serviced by anyone other than me. "If I try to worsen the doctor, in his private office." Also missed Ana


References:

ABRAN, Jan., The Language of Winnicott. Dictionary of Words and Phrases Used by Donald W. Winnicott Rio de Janeiro, Revinter (2000).
Boll, Christopher, Hyteria Sao Paulo. Listen (2000).
BERLINCK, Manuel (ed.) Hysteria, St. Paul Listen (1997).
Outeiral Jose Clinic of transitionnality fragment teenager, Rio de Janeiro, Revinter (2000).
ROUDINESCO, E (1997). El siglo del psicoanálisis a fine century. La situación en Francia: clinical perspectives y building. International psycoanalysis. The news letter of IPA. v.6, 1, p.40-45.