As especificidades da construção do caso clínico no hospital: um método psicanalítico de trabalho em equipe

Abstract

The threads that weave this research link my research journey throughout the experience of composing a multidisciplinary team of health residents at a university hospital in the city of Salvador, between 2020 and 2022. Writing and defending my residency completion paper (TCR) led to the elaboration of a research problem that forms the basis for this investigation: how to think about the construction of the clinical case in the hospital context as a working method for the analyst together with the team? In this sense, the general objective of the study is to analyze the specificities of the construction of the clinical case as a method of psychoanalytic work in the hospital context. The specific objectives are a) To investigate, based on psychoanalytic theory, the notion of construction of the clinical case; b) To reflect on this construction of the case and its effects on the conduct of treatment for the hospitalized subject; c) To discuss the construction of the case as a method of transmitting the know-how of the psychoanalytic practitioner together with the multidisciplinary team in the hospital context. The qualitative, exploratory and retrospective research is guided by the framework of Freudian and Lacanian psychoanalysis, and uses the construction of the clinical case as a methodological resource. The literature review allowed us to identify the construction of the case under two operating modes: as a clinical work method and as a research method within health institutions. In view of the studies located in this investigation and supported by the objectives, the present research focuses on the operationality of the construction of the case as a psychoanalytic work method in the hospital. And thus, in the theoretical framework, we initially discuss psychoanalysis in extension, signaling the clinical practice in the context of health institutions and demarcating the specificities of the analyst's work in the hospital environment, based on the notions of entry and insertion, transfer of work, theory of the four discourses and logical time. The construction of the case was divided into three sections of analysis: I - the moment of seeing and the anticipation of a conclusion, II - the time to understand and III - A moment to finalize and reflect: theoretical-clinical repercussions on the path of this construction. The construction of the Abayomi case together with the team contributed to a way of inserting the psychoanalytic practitioner based on the transfer of work, and which provided an opportunity for the transmission of the psychoanalytic discourse in the hospital setting, culminating in discussions about the direction of the treatment and enabling a discursive turn regarding the interventions and the way of reading the case.