Entre a insanidade e a imoralidade: uma análise histórico-conceitual da classe dos transtornos da personalidade

Abstract

This dissertation consists of a historical-conceptual analysis of the scientific rationale that underlies the diagnostic class of personality disorders (PD). The category now known as PD is indebted to theories and traditions of psychopathology that predate its systematization in contemporary diagnostic manuals. While this tradition is, on the one hand, concealed by descriptive syntheses and operational criteria, on the other, it persists as an indelible heritage. With such an inquiry, we aim to offer clues about the scientific rationale – understood here as a specific set of epistemological and philosophical foundations – that lies at the origin of the concept of PD. For this, a theoretical study of a historical-conceptual nature was conducted. The selected bibliography comprised works by classical authors in psychiatry, dated from the early 19th century to the early 20th century. From this literature, nosological entities, clinical descriptions, and psychopathological concepts that may be considered precursors to the concept of PD were mapped and analyzed. Subsequently, we examined Jacques Lacan’s position regarding the issue of personality, psychic causality, and the psychopathological phenomenon, based on his doctoral thesis, and we proposed a reading of the tensions it may bring to the field of personality psychopathology. As a result, we propose that the concept of personality disorder is indebted to three major epistemological events: the introduction of the partial insanity doctrine; the psychiatrization of the abnormal; and the constitution of a psychopathology of character, temperament, and/or personality itself, which takes the form of psychiatric typologies. We also discuss the psychiatric discipline’s process of mirroring the natural sciences’ scientific models, which has taken place since its foundation. In this context, we turn to Jacques Lacan’s doctoral thesis as an alternative reading of the relationship between personality and the psychopathological phenomenon, opposing the immediate transposition of a general metapathology from the field of somatic pathologies to the field of psychopathology. Finally, we suggest that how a psychiatric category – such as PD – is conceptualized has the power to dictate its institutional and social trajectories, making a critical reading of the ethical, clinical, and political consequences of its conceptual arrangements relevant.