Violence and Family Life Psychoanalytic and Gender Approaches

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violencia intrafamiliar y psicoanalisis
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  422 SaúdeSoc.SãoPaulo,v.25,n.2,p.422-430,2016 DOI10.1590/S0104-12902016145768 Violence and family life: psychoanalytic and gender approaches 1 Violência e vida familiar: abordagens psicanalíticas e de gênero 1 This article is based on a study presented at the IV Simpósio de Pesquisas do Centro de Atendimento a Vítimas de Abuso Sexual (CAVAS)/UFMG (IV Symposium of the Care Center for Victims of Sexual Abuse) – “Plots of perversion: domestic sexual violence” (November, 2013) and published in the collection França, C. P. (org.) Tramas da perversão: a violência sexual intrafamiliar  . São Paulo: Escuta, 2014, v. 1, p. 33-46. Financial support from CNPq’s productivity scholarships. Correspondence LiliaBlimaSchraiberAv.Dr.Arnaldo,455,2ºandar,sala2174.SaoPaulo,SP,Brasil.CEP01246-903. 422 Abstract We aim to examine the possibilities for an inter-disciplinary dialogue between Psychoanalysis and gender theory, as expressed in studies about  violence on Collective Health, to approach occur-rences of aggression and abuse in family life and their possible impacts on health, with particular attention to the psychological impacts on children and women, as well as in the family group as a whole. Based on classical authors for both disciplinary contributions, we examine a concrete case taken from a family care situation. This examination consists of three interpretative dimensions: rst, considerations on the individual case in its family context; second, the case seen from the perspective of cultural issues; and third, the relation between culture and its individualized expression in the case. We show the possibility of conducting an ap-proach that integrates the intrapsychic dimension, which concerns the functioning of the inner world of the individuals involved, with the sociocultural and historical realities that constitute their context of life. With the aim of a comprehensive care of the cases, we highlight the practical importance of combining reection and action of psychodynamic nature, a result of the examination of the intra-psychic impacts of violence from concepts such as trauma and terror, with recognition of cultural expressions in the individual and family realms, which strengthen normative acceptances of aggres- Belinda Mandelbaum UniversidadedeSãoPaulo.InstitutodePsicologia.DepartamentodePsicologiaSocial.SãoPaulo,SP,Brazil.E-mail:belmande@usp.br Lilia Blima Schraiber UniversidadedeSãoPaulo.FaculdadedeMedicina.DepartamentodeMedicinaPreventiva.SãoPaulo,SP,Brazil.E-mail:liliabli@usp.br Ana Flavia P. L. d’Oliveira UniversidadedeSãoPaulo.FaculdadedeMedicina.DepartamentodeMedicinaPreventiva.SãoPaulo,SP,Brazil. E-mail:aolive@usp.br  SaúdeSoc.SãoPaulo,v.25,n.2,p.422-430,2016 423  sions, victimizations, silencing, and trivialization of violence. The interdisciplinary dialogue makes possible to understand the development of cultur-ally reinforced feelings and behaviors, such as fear and shame in the victims and repetition of violence in the aggressors. Keywords:  Violence; Family; Psychoanalysis; Gen-der; Health. Resumo Busca-se examinar as possibilidades de diálogo interdisciplinar entre a psicanálise e a teoria de gênero, tal como tem sido usada em estudos acerca da violência na Saúde Coletiva, para abordar ocor-rências de agressão e abuso na vida familiar e seus possíveis impactos na saúde, com especial atenção às repercussões psíquicas nas crianças e mulheres, bem como no grupo familiar como um todo. Com base em autores clássicos para ambos os aportes disciplinares, examina-se um caso concreto extraído de situação de atendimento à família. Esse exame é composto de três dimensões interpretativas: pri-meiro, considerações sobre o caso individual em seu contexto familiar; segundo, o caso visto da perspec- tiva das questões culturais; por m, a relação entre a cultura e sua expressão individualizada no caso.  Aponta-se para a possibilidade de se realizar uma abordagem que integre a dimensão intrapsíquica, que diz respeito ao funcionamento do mundo inter-no dos sujeitos envolvidos, à realidade sociocultural e histórica que constitui o seu contexto de vida. E com vistas a uma atenção mais integral dos casos, aponta-se a importância prática de combinar a ree -xão e intervenção de natureza psicodinâmica, fruto do exame dos impactos intrapsíquicos da violência a partir de conceitos como trauma e terror, com reconhecimentos das expressões culturais no plano individual e familiar, que reforçam aceitações nor-mativas de agressões, vitimizações, silenciamentos e banalizações das violências. O diálogo interdis-ciplinar permite compreender o desenvolvimento de sentimentos e comportamentos, reforçados culturalmente, tais como medos e vergonhas nas  vítimas e reiteração das violências nos agressores. Palavras-chave: Violência; Família; Psicanálise; Gênero; Saúde. Introduction This article aims to contribute to interdisciplin-ary readings on domestic violence and its impacts on the family. The motivation of this study starts from the construction of a dialogue between Psy-choanalysis and gender theory in studies focused on Collective Health, as a eld of integration between disciplines of human and social sciences or phi-losophy and knowledge aimed at the health-disease processes and their social determinants. We are driven by the question: is it possible to articulate several systems of references in approaching the dynamics of violence in the family? We immediately need to specify these referenc-es. From the perspective of gender, we are based on Scott (1986) and on what is produced on Collective Health from such reference (Araújo; Schraiber; Cohen, 2011). In this study, we articulate our ideas with Scott’s historicist approach, which will allow us to develop two additional elaborations: the one that state in detail the historical changes of fam-ily as a group of diversified individuals, and the one in which the historical-cultural constructions around male and female, beyond positions in the social structure, are taken here as sociocultural identities, as masculinities and femininities in exercise in the social relations of gender. The ar-ticulation with health issues and their harms will be sought within these formulations (Schraiber et al., 2005). Similarly, from the psychoanalytic perspective, we are based on Freud (1976a, 1976b) and Klein (1991), already in dialogue with a psychosocial perspective (Mandelbaum, 2010, 2014), seeking to problematize the dynamics of family relationships between the affections and anguishes associated with paternal authority, and this relation is already problematized as an unequal historic construction of male and female individuals in private life, expos-ing the permission of culture on the establishment of “terror” inside the house. This interdisciplinary dialogue serves for build-ing a more complex and comprehensive set of tools that enable us to approach the experience   lived by people – mostly women and children – who are vic-tims of violence within the family. The experience  424 SaúdeSoc.SãoPaulo,v.25,n.2,p.422-430,2016 can and must be thought of in its psychic, relational, and social dimensions, which are inextricably ar-ticulated in singular ways in each case, if we are concerned with the possible interventions in the eld of violence. A family and a case The father enters the silent house late at night. The mother and two daughters, aged 5 and 8 years, are watching TV in the children’s bedroom, in the dark and quietly. They hear the noise of the entrance of the father – the key in the lock, the  steps toward the room, and the silence sinks in apprehension. He walks into the room where they are, turns the beds, one of them over the older girl, on top of her nose, which bleeds. Nothing is  said, the mood is of muted and paralyzing terror.  He leaves. The silence of mother and daughters with the father comes from several days and  foreshadows the departure from home. The terror is extended beyond these days and the ones of  separation. At the sight of the father, each time, the girls are taken by anxiety and by the desire that this meeting would not occur. One day, in an unexpected meeting in the street, the father  strongly holds the younger girl, who struggles with fear, trying to escape from the scary hug. Impossible, as the father is much bigger and  stronger. The experience of the child is of des-peration and annihilation.  (Oral report collected from family psychotherapy session) The presented report fragment was extracted from the record of the care service for families that experience different situations of violence. It presents a terrifying atmosphere, exposing one of the concrete expressions of domestic violence – and here we understand violence as the action of some-one that can invade the limit of other and, by force, impose oneself (Berenstein, 2000). This domestic  violence is chronic and daily repeated, creating an experience in which mind and body merge into sen-sations of disintegration, helplessness, and fear. The experiences in the relationship of intimacy with the other make this fear emotionally unreachable and “almighty” in relation to the victim’s life and body.“Terror” is a word that names this experience well, approaching what occurs in the private life and in the familiar scope to other situations – such as war and torture, in which extreme experiences (whether physical or psychological) are mobilized (Herman, 1997).  Arendt (1994) indicates an “extreme” nature of violence that Freud (since his early work of therapy with hysterical patients) stated as an “ex-cessive” nature of the violent situations of sexual nature experienced in childhood and perpetrated by the adults of the same house. Psychoanalysis nds there its srcins; Freud relies on this oc - currences to propose the rst model of psychic apparatus: the unconscious as the repository of childhood experiences suppressed from conscious-ness because of their excessive nature before the comprehension capacity from the child. Freud could observe with his female patients that these experiences fall into silence, but not into oblivion. They remain active and are repeated in various expressive modalities, such as symptoms, inhibi-tions, and anguishes lacking in representation. These experiences ask for elaboration; not to be properly forgotten – according to Freud there is never complete oblivion – but to gain understand-ing in forms accessible to the conscience and no more as disabling and enigmatic psychic or so-matic symptoms. They are “traumatic” events, as Freud has appointed. They are part of our psychic identity and continuously demand the search for construction of meanings to the lived experiences. If Freud assigned to Psychoanalysis an etiologi-cal character, i.e., a binding with a source for the understanding of the psychic phenomenon, he granted to the trauma the status of srcin of the psychic symptom. The trauma, in this case, is a psychic commotion, meaning ruin, destruction, or loss of one’s own form (Ferenczi, 1981). In one of the rst psychoanalytic writings of Freud, Studies on hysteria (1976), the trauma is as- sumed to be the srcin of the psychic conict that generates the symptom. It is a shock in the real experience that hits, like a quake, the defenses of the I. Freud (1976b) describes it in terms of “shame and silence”. According to him, at the time of its production, the shame would be one of the respon-  SaúdeSoc.SãoPaulo,v.25,n.2,p.422-430,2016 425  sible reasons for the inability to speak or even think about the event, which tends to express itself, as we said, symptomatically, in various forms of psychic and physical suffering. For this reason, therapeuti-cally, Freud sought to break the silence and surpass shame, by hypnosis or listening to the patients, so that the traumatic experience could be reported and elaborated. We note, still, that the importance of shame to the silencing of the traumatic experience and the resulting illness have been recovered by contemporary psychoanalysts, particularly those dealing with the psychological impacts of social disasters such as wars, genocide, mass rape, and torture (Benghozi, 2010). The cases and culture  According to Freud (1976a), the psychic real-ity is formed in response to reality: the anguish resulting from the trauma, which composes the suffering of victims of violence is, at the same time, a trigger signal of their psychic defenses, organizing their way of being in the world. Psy-choanalysis, however, over its construction of more than a century, relativized the events of reality in favor of the drive of each of us and of the others in us and for us, in the production of the disorders. Psychoanalysts, in general, gave up trying to discover the historical events that produce trauma to look into the internal reality of their patients. Freud himself reports, in a let-ter to Fliess (Freud; Fliess, 1986), the discovery of the importance of fantasy in the configuration of reality, blurring the boundaries between internal and external realities, with complex and impor-tant impacts for Psychoanalysis. This is one of the reasons why we consider the interdisciplin-ary dialogue essential, although difficult, since the different disciplines operate from diversified theoretical and methodological references. In the specific case of the studies and interventions in the field of domestic violence, Psychoanalysis is nourished by the dialogue with sociology, history, and the cultural and gender studies to remember that it is not possible to reduce the understanding of the phenomenon, if we want to operate some transformation in it, only to an intrapsychic di-mension. The “abused child” and the “woman who is beaten up” are not only sexual fantasies, but relational standards that occur in diverse forms in different sociocultural contexts, closely linked to hegemonic ideas of masculinity and feminin-ity. When Psychoanalysis put these elements of social reality aside and deal with violence against women or children only in its intrapsychic dimen-sions – although this is a present dimension and that demands understanding – at best this sci-ence performs a partial and fragile therapeutic, since it silences aspects from reality that tend to perpetuate. When the psychoanalyst does not recognize the violence actually suffered and urging to be abolished, and attribute everything to psychism and fantasy, he/she might also be  violent. Ferenczi (1981) says that trauma occurs in two stages: the first is the traumatic event itself and the second is the non-recognition by a third party, whom the victim asks for aid, that the trauma in fact occurred and could not have occurred. Hence his recommendation for the psy-choanalysts to consider and show the recognition of the pain produced by the actual event, so that its elaboration, within certain limits, can occur. In turn, Psychoanalysis brings an unique and essential contribution to interdisciplinary dia-logue by deepening into the subjective dimensions involved in violence. Because violence, like all human phenomenon, will be acted, experienced, and understood from the singular ways with which everyone of us perceives reality and interacts with it – ways that also srcinate in the personal and family history of each person. Melanie Klein (1991) brought an important contribution to the psychoanalytic study by showing in detail the interplay of affections and anxieties that color our relationships and constitute our internal and external reality. According to Klein, external reality is difcult to be perceived in its objectiv -ity, separated from the individual, being only reachable in an unstable way, when we can see something that goes beyond us, that is not ours, but from the other. Because we project our inner world on the outer world, throwing shadows on it. The possibility of recognizing the other depends, according to Klein, on the acquisition of a con -
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