Em busca de um rosto: uma clínica psicanalítica com pacientes submetidos a cirurgias reconstrutoras da face

Abstract

The current study, beginning from the Freud idea of helplessness and from ideas on the psychoanalytic clinic and theory, in particular the Donald Winnicott ones, aims at underlining the job of the psychologist attached to patients holding facial deformities during the course of their reconstruction. It is also intended to offer contribution for the knowledge and understanding of the traumatic event of the sudden facial disfugure and to reflect on the relevant practical and heoretical aspects on the psychologist graduation, which will direct or inderectly interfere on its insertion in a hospital staff for facial reconstruction surgeries; in other words, it was intended to identify the aspects based on the psychonalytic clinic and theory, the psychologist would contribute for the clinic with sensitizing and affected patients by so drastic circumstances. Regarding the knowledge and understanding of traumatic events, the theme grows supported by Freud ideas of helplessness and trauma, by the current meaning of scheme and body image, and by the subjective construction of the face, which by its turn requires elucidation of illusion and identification processes, and of the importance of the mirror ring function in the facial reconstruction. It was equally reconsidered both the "uncanny", non-familiar face as the reinterpretation of this uncanny face, and of the chaos in an attempt to set up another structure and ways to speed up the dynamic of the process of the reconstruction of the patient. From the clinic point of view, the transference, in addition to the holding, is characterized as a too of acess to the patient, as a possible way to reach the identification of a new face, of the self physical image and of itself, making reconstructions possible. By its turn, the hospital psychologist graduation in this study is viable in the meeting of the hospital and private clinic, both distinct in their particularities. Toe first presents a new structure mostly based on the interdisciplinary, while the second supports it, but both promote conversations between them. These three pillars allow the constitution of a specific methodology for a deep understanding and a more effective face reconstruction of patients traurnatically reached by accidents which caused their sudden facial disfigure. Toe methodology herein described has been systemized as of the declaration of a patient that determined the orientation of its (facial) reconstruction, "from inside to outside", - which indicates the vital function of the psychologist to be rethought, reconstituted and based within the hospital staff - after ali a practice of multiple and consecutive reconstructions.