Do ato à palavra: tentativa de suicídio do sujeito adolescente atendido sob orientação psicanalítica no contexto hospitalar

Abstract

Suicide is a multidetermined phenomenon present in all age groups, cultural and social, and it is configured in a highly complex theme, thus that requires increased attention in view of the range of variables involved in the process. The suicide in adolescence has an epidemiological relevance of deaths in this population, highlighting the importance of thinking about specificities of that moment, stressed by several events in the social and subjective sphere and its expression in the psyche. The aim of this study is to analyze the dimension of suicide among adolescents under psychoanalytical care in the hospital setting, and specifically to analyze (1) the process of signification face the suicide attempt in a context of hospitalization in an Intensive Care Unit; (2) the psychic mechanism of the subject towards the other against the suicidal context, limiting the range of the act and the dimension of the bond; (3) the institution's discursive logic in the face of the adolescent suicidal attempt and the different demands addressed to the psychoanalyst and (4) to reflect the intervention strategies based on the psychoanalytic clinic in the work with adolescents before the context of suicide. The act and its consequences in the psychoanalytic clinic are prioritized, from the perspective of the subject's relationship with the other, outlined by the action to the word, by the act to the signifier. There is an almost direct relationship, in the psychiatric discourse, between the presence of a disorder and the suicide attempts, with no discussion between other elements in a multifactorial field. This is a study of a clinical case construction, according to the psychoanalytic perspective on the adolescent suicide attempt admitted in the context of ICU hospitalization. Data analysis was supported by Freudo Lacanian psychoanalysis. From the theoretical investigation of the clinical constructions of two cases, it was possible to state that the dimension of the act can only be valued by the subject who positions himself in front of his act, implicating himself in his speech. The cases under discussion point to a singular plot that highlights the suicide attempt and its significance a posteriori, based on its own form of inscription in the field of the Other. A practice in psychoanalysis inserted in an institution works from a clinical-institutional device that bets on the word as a promoter of the subject's emergence. Therefore, conducting an investigation in a context of adolescence suicide clinic can favor the construction of interventions aimed to the promotion and care of these subjects.