Folie et Société: eroding the body-mind relationship via dysfunctional paternalistic systems.

This theoretical perspective examines the proposition of shared complex trauma between a parent and child, arising from blurred relational boundaries and societal oppression, leading to inequality both at home and within the larger paternalistic system of society. Specifically, the focus is on living within a paternalistic, authoritarian system where rules are unjust, demanding obedience and compliance without questioning the behaviors of the authority. Individuals growing up in these circumstances are subject to adverse and emotionally overwhelming experiences, which lead to the creation of emotional memory images (EMIs). The delusion in which the child is caught up becomes a reality for the child as time passes. This phenomenon is recognized in psychiatry as "Folie à deux" (the madness of two or more) at the micro level, and "Folie et Société" (the madness of society) on the macro level. Complex trauma, derived from a child's exposure to multiple adverse events, can erode the mind-body relationship, impacting both mental and physical health. These traumatic experiences in early childhood can manifest as body-focused disorders in adolescents, prevailing throughout adulthood if left unattended. This article provides a theoretical perspective on dealing with the dissociation and chronic stress related to oppressive and authoritarian family systems. The broader implications of this article include highlighting the psychophysiological underpinnings of complex trauma, the relationship of a highly oppressive paternalistic authoritarian system imposed on children and adolescents, and the role of Split-Second Unlearning as a therapeutic intervention to clear EMIs and improve overall health outcomes.

Neurosyphilis-Induced Folie À Deux: A Case of Prolonged Psychosis.

Neurosyphilis presentations can include psychiatric symptoms such as psychosis, mania, depression, or changes in personality. Therefore, it can lead to a misdiagnosis with psychiatric disorders. The diagnosis is particularly difficult in a subset of patients whose psychotic symptoms are developed as a manifestation of the disease later in life. With the aim to highlight the importance of considering neurosyphilis in the differential diagnosis of late psychosis, it is presented the clinical case of a folie à deux from a Portuguese 69-year-old man, who presented symptoms of psychosis in the emergency room, ultimately diagnosed with neurosyphilis. A selective review of the literature was made using the Pubmed database, with "neurosyphilis", "psychosis", "syphilis", and "folie à deux" as keywords. Patient consent was obtained for the use of clinical data. Neurosyphilis represents the most severe consequence of an untreated syphilis infection and there is a need in the scientific community to establish tools to enhance the precision of diagnosis and treatment.

Folie À Trois: A Case of Shared Delusions Between a Patient, Her Sister, and Another Patient in the In-Patient Psychiatric Unit.

Folie à deux is a rare condition in which a single person (often with a psychiatric disorder) develops a delusion that is shared by another person. Folie à troix is when a delusion is shared by three people. This case report documents the unusual case of an individual who shared delusions with two different people simultaneously. This report inspires questions about this person, her delusions, and what made them so believable to others. It is known that the development of shared delusions most commonly occurs in relative isolation and disproportionately affects individuals with preexisting psychiatric comorbidities. Because of these risk factors, delusions in a psychiatric unit may be even more "contagious" than in the general population. To our knowledge, this case report is the first to document a newly developed delusion shared between two unrelated patients in a single psychiatric unit. While physical separation of patients is the best practice in such cases, a risk-benefit analysis is needed prior to this intervention given the social barriers that may limit such an approach. Further research is needed to diagnose, manage, and optimize treatment for shared delusions in settings such as inpatient psychiatric facilities.

[Les demoiselles de Rochefort, or a clinical illustration of madness in pairs]. / Les demoiselles de Rochefort, ou une illustration clinique de folie à deux.

Although folie à deux is a confidential entity that has disappeared from psychiatric textbooks and is disguised in current international classifications of mental disorders, which tend to obscure the fundamental notion of the dyad, recent case reports highlight the topicality of the disorder. The richness of the clinical encounter with twin sisters, presenting a common delusion of parasitic infestation, may prompt us to question the disorder differently, guided in particular by ancient writings and the analytic compass.

Hidden family rules: perspective on a dysfunctional paternalistic system and the persistence of pain.

This article explores how paternalistic control and power reside within the family system and how this may influence pain and its persistence. Drawing upon clinical case studies and existing literature, this exploration emphasises the role of paternal dysfunction in creating emotional memory images and delves into how this may influence the chronification and treatment resistance of pain (i.e., making pain "sticky"). We argue that a dysfunctional paternalistic family system, often characterised by authoritarian dynamics, emotional neglect, and abuse, results in adverse experiences and emotional memory images that create a fertile ground for the entrenchment and propagation of psychosomatic symptoms, including pain. Further, the paper emphasizes the potential intergenerational effects of such a scenario, where inherited "Family Rules" drive maladaptive coping mechanisms, which contribute to the persistence of psychological and physiological distress across generations. Understanding these complexities offers new perspectives on treating psychological disorders and their physiological ramifications. It also highlights the urgency of addressing dysfunctional familial dynamics in psychotherapeutic interventions for both immediate and long-term psychophysiological health outcomes.

As ressonâncias da loucura materna nos processos de subjetivação de uma filha / Resonances of maternal madness in the subjectivation processes of a daughter / Résonances de la folie maternelle dans la subjectivation d'une fille / Las resonancias de la locura materna en los procesos de subjetivación de una hija

Este artigo aborda as ressonâncias da loucura materna na subjetivação de uma filha a partir de um estudo de caso. Trabalhou-se com história de vida e foi realizado um diálogo com os processos de subjetivação e práticas de cuidado de si. A análise temática organizou os resultados a partir das seguintes categorias: as ressonâncias da loucura materna nos processos de subjetivação; o cuidado de si como horizonte transformador nos processos de subjetivação; o trabalho de subjetivar um legado transgeracional e a elaboração da mãe como referência de maternidade. Entre os resultados, destacam-se: a presença de afetos ambivalentes, a inconstância da presença física e da disponibilidade psíquica maternas e o desenvolvimento, por parte da entrevistada, de práticas de cuidado destinadas a si e a ao outro. Uma trajetória marcada por violência, questões de raça, gênero e classe, dificuldades sociais e econômicas que intensificaram a condição de sofrimento psíquico

This article approaches the resonances of maternal madness in the subjectivation of a daughter from a case study. We worked with life history and a dialogue was carried out with the subjectivation processes and self-care practices. Narrative interviews were thematically analyzed to organize the results: the resonances of maternal madness in the subjectivation processes; the self-care as a transforming horizon in the subjectivation processes; the work of subjectifying a transgenerational legacy; and the elaboration of the mother as a reference of motherhood. Among the results, the following stand out: the presence of ambivalent affections; the inconsistency of the maternal physical presence and psychic availability; and the development, on the part of the interviewee, of care practices aimed at herself and at the other. A trajectory marked by violence, issues of race, gender and class, social and economic difficulties that intensified the condition of psychic suffering

Cet article aborde les résonances de la folie maternelle dans la subjectivation d'une fille avec une étude de cas. Nous avons travaillé avec l'histoire de la vie et un dialogue a été mené avec les processus de subjectivation et les pratiques d'autosoins. Des entretiens narratifs ont été analysés de façon thématique pour organiser les résultats : les résonances de la folie maternelle dans les processus de subjectivation ; l'autosoins comme horizon transformant dans les processus de subjectivation ; le travail de subjectivation d'un héritage transgénérationnel et l'élaboration de la mère comme référence de la maternité. Parmi les résultats, ressortent : la présence d'affections ambivalentes, l'incohérence de la présence physique et de la disponibilité psychique maternelle et le développement, de la part de l'enquêtée, de pratiques de soins visant soi-même et l'autre. Une trajectoire marquée par des violences, des questions de race, de genre et de classe, des difficultés sociales et économiques qui ont intensifié l'état de souffrance psychique

Este artículo trata de las resonancias de la locura materna en la subjetivación de una hija mediante un estudio de caso. Se trabajó con la historia de vida y se dialogó con los procesos de subjetivación y prácticas de cuidado de sí. Se realizaron entrevistas narrativas de forma temática para organizar los resultados: las resonancias de la locura materna en los procesos de subjetivación; el cuidado de sí como horizonte transformador en los procesos de subjetivación; el trabajo de subjetivación de un legado transgeneracional y la elaboración de la madre como referente de la maternidad. Entre los resultados se destacan: la presencia de afectos ambivalentes, la inconsistencia de la presencia física materna y disponibilidad psíquica, y el desarrollo por parte de la entrevistada de prácticas de cuidado dirigidas a sí misma y al otro. Una trayectoria que estuvo marcada por cuestiones de raza, género y clase, dificultades sociales y económicas, y violencias que intensificaron la condición de sufrimiento psíquico

The plague: a case of delusional infestation with folie à deux / A praga: um caso de delírio de infestação com folie à deux

Folie à deux or Shared psychotic disorder (SPD) is a rare condition characterized by shared psychotic symptoms between two or more individuals. Delusional parasitosis (DP) is an uncommon psychiatric illness in that patients believe they are infested by insects, without evidence to support this belief. DP occurs in 5­15% of SPD. We report a case of cutaneous DP with SPD between an elderly mother and a daughter that lived together and withdrew from other social contacts for the last three years. We aim to highlight the relationship between SPD and DP, its prognosis, and clinical implications.

Folie à deux ou Perturbação Psicótica Compartilhada (PPC) é uma condição rara caracterizada por sintomas psicóticos compartilhados entre dois ou mais indivíduos. O delírio parasitário (DP) é uma doença psiquiátrica incomum em que os pacientes acreditam estar infestados por insetos, sem evidências que sustentem essa crença. O DP ocorre em 5 a 15% das PPC. Relatamos um caso de um DP cutâneo com PPC entre uma mãe idosa e uma filha que viviam juntas e afastadas de outros contatos sociais nos últimos três anos. O nosso objetivo é destacar a relação entre PPC e o DP, o seu prognóstico e implicações clínicas

A Case of Delusional Parasitosis With Folie à Deux Treated With Low-Dose Quetiapine.

A patient with a three-month history of persistent delusions of infestation presented to the emergency department with suicidal ideation secondary to complaints of worsening pruritus. Routine investigations failed to disclose any underlying organic cause for her pruritic sensations. The patient ascribed these to a parasitic infestation acquired following a brief stay at her maternal aunt's residence. Following a thorough psychiatric assessment and collateral history obtained from her aunt, it became clear that both the patient and her aunt held similar delusions of infestation. Her aunt was found to be the main inducer. The patient was admitted, successfully treated with low-dose quetiapine, and eventually deemed fit for discharge. Delusional parasitosis and folie à deux are both rare conditions that may sometimes co-occur.

Madness is other people: alterity/ipseity and the sibling archetype.

The issue of madness, always present in the hot-tempered gods - Ares, Aphrodite, and Dionysus - has to do with what the ancient Greeks referred to as alterity. It was the Greeks who 'invented' this notion. What is otherness? It is, simply said, the extensive category of the Other. Let us examine a few aspects of the way this category is presented in mythical thinking in order to understand its place in psychology and madness. Alterity has to do with the Other, who is outside or inside me; ipseity is the possibility of remaining the same. This recognition has political, historical, ethical and, of course, psychological implications. And yet, it is archetypal, because that is where, as we will see, the issues of the sibling archetype fall. The sibling, as a primordial image in the soul, is present in the psychological evolution of each individual and each culture, and its influence inevitably projects itself into the history and construction of our connections with friends, companions, partners, associates, and colleagues - i.e. with all others, before confirmation is established in the soul that madness is other people.

Le sujet de la folie, toujours présent chez les dieux impétueux - Arès, Aphrodite, et Dionysos - est en lien avec ce que les Grecs anciens ont appelé l'altérité. Ce sont les Grecs qui ont « inventé ¼ cette notion. Qu'est-ce que l'altérité? Pour le dire simplement c'est la vaste catégorie de l'Autre. Examinons quelques aspects de la manière dont cette catégorie est montrée dans la pensée mythique, afin de comprendre sa place dans la psychologie et la folie. L'altérité a à voir avec l'Autre, qui est à l'extérieur ou à l'intérieur de moi. L'ipséité est la possibilité de rester le même. Cette prise de conscience a des conséquences politiques, historiques, éthiques et bien sûr psychologiques. Et pourtant, il s'agit de quelque chose d'archétypal, parce que c'est là que, comme nous le verrons, les questions de l'archétype de la sœur ou du frère se présentent. La sœur/le frère est une image primordiale de l'âme, elle est présente dans l'évolution psychologique de chacun et dans chaque culture. Son influence se projette inévitablement sur l'histoire et la construction de nos liens avec les amis, les compagnons, les conjoints, les associés et les collègues, c'est à dire avec tous les autres, avant que s'établisse dans l'âme la confirmation que la folie c'est les autres.

El tema de la locura, siempre presente en los dioses y diosas temperamentales - Ares, Afrodita y Dionisos - tiene que ver con lo que los griegos antiguos refieren como alteridad. Fueron los griegos quienes 'inventaron' esta noción. ¿Qué es la otredad? Es, dicho simplemente, la categoría extensiva de lo Otro. Examinamos algunos aspectos del modo en que esta categoría es presentada en el pensamiento mítico para poder comprender su lugar en la psicología y la locura. Alteridad tiene que ver con la Otredad, que está afuera o dentro mío; ipseidad es la posibilidad de permanecer lo mismo. Este reconocimiento tiene implicancias políticas, históricas, éticas y por supuesto, psicológicas. Y todavía, es arquetípica, porque es allí donde se encuentran las cuestiones vinculadas al arquetipo fraterno. El hermano, como imagen primordial en el alma, está presente en la evolución psicológica de cada individuo y de cada cultura, y su influencia inevitablemente se proyecta en la historia y construcción de nuestras conexiones con amigos, compañeras, parejas, asociados y colegas - i.e. con todos los otros, antes que en el alma se establezca la confirmación de que la locura es otra persona.

A questão da loucura, sempre presente nos deuses de temperamento quente - Ares, Afrodite e Dionísio - tem a ver com o que os gregos antigos chamavam de alteridade. Foram os gregos que "inventaram" essa noção. O que é alteridade? É, simplesmente dito, a extensa categoria do Outro. Examinemos alguns aspectos da forma como essa categoria é apresentada no pensamento mítico para entender seu lugar na psicologia e na loucura. Alteridade tem a ver com o Outro, que está fora ou dentro de mim; ipseidade é a possibilidade de permanecer o mesmo. Esse reconhecimento tem implicações políticas, históricas, éticas e, é claro, psicológicas. E, no entanto, é arquetípico, porque é aí que, como veremos, as questões do arquétipo irmão incidem. O irmão, como uma imagem primordial na alma, está presente na evolução psicológica de cada indivíduo e de cada cultura, e sua influência inevitavelmente se projeta na história e construção de nossas conexões com amigos, companheiros, parceiros, associados e colegas - ou seja, com todos os outros, antes que a confirmação seja estabelecida na alma de que a loucura é outra pessoa.

Corpo, arte e loucura em Arthur Bispo do Rosário / Body, art and madness in Arthur Bispo do Rosário / Cuerpo, arte y locura en Arthur Bispo do Rosário / Corps, arts et folie chez Arthur Bispo do Rosário

Resumo Este artigo investiga a relação corpo, arte e loucura na obra de Arthur Bispo do Rosário, pelo referencial teórico psicanalítico freud-lacaniano em diálogo com outros campos do saber, a partir das seguintes interrogações: de que maneira a psicanálise dialoga com a temática da arte? Qual o estatuto da arte na psicose? Como sujeitos psicóticos fazem uso da arte, pela via das invenções, a fim de lidar com o corpo e estabilizar seu sofrimento psíquico? Nesse sentido, traçamos considerações sobre o estatuto da arte na psicanálise, levantamos algumas contribuições histórico-filosóficas sobre a relação entre arte e loucura e apreciamos a obra de Bispo à luz das proposições de Jacques Alain-Miller, com vistas a compreender os modos através dos quais a arte produzida por sujeitos em sofrimento psíquico pode servir de anteparo à loucura e favorecer a forma como eles lidam com seu corpo.

Abstract This essay investigates the relations between body, art, and madness in Arthur Bispo do Rosário's oeuvre based on the Freudian-Lacanian psychoanalytic theoretical reference, in dialogue with other fields of knowledge, drawing on the following interrogations: in what ways does psychoanalysis dialogues with the theme of art? What is the status of art in psychosis? How do psychotic individuals use art, through inventions, to deal with the body and stabilize their psychic suffering? In this regard, this paper discusses the status of art in psychoanalysis, brings some historical-philosophical contributions to the relationship between art and madness, and interprets his work in the light of Jacques Alain-Miller's propositions, to understand the ways in which the art produced by subjects in psychological distress can serve as a buffer to madness and favor how they deal with their bodies.

Resumen Este artículo analiza la relación entre cuerpo, arte y locura en la obra de Arthur Bispo do Rosario, por el referencial teórico psicoanalítico freud-lacaniano en diálogo con otros campos del saber, partiendo de los siguientes interrogantes: ¿De qué manera el psicoanálisis dialoga con la temática del arte? ¿Cuál es el estatuto del arte en la psicosis? ¿Cómo sujetos psicóticos hacen uso del arte, por la vía de las invenciones, a fin de tratar con el cuerpo y estabilizar su sufrimiento psíquico? Para ello, trazamos consideraciones sobre el estatuto del arte en el psicoanálisis, levantamos algunas contribuciones histórico-filosóficas sobre la relación arte y locura y apreciamos la obra de Bispo a la luz de las proposiciones de Jacques Alain-Miller, con miras a comprender los modos a través de los cuales el arte producido por sujetos en sufrimiento psíquico puede servir de amparo a la locura y favorecer la forma de cómo lidian con su cuerpo.

Résumé Cet essai étudie les relations le corps, l'art et la folie chez Arthur Bispo do Rosário à partir de la référence théorique psychanalytique freudienne-lacanienne, en dialogue avec d'autres domaines de connaissance, en s'appuyant sur les interrogations suivantes : de quelle manière la psychanalyse dialogue-t-elle avec le thème de l'art ? Quel est le statut de l'art dans la psychose ? Comment les individus psychotiques utilisent-ils l'art, à travers des inventions, pour faire face au corps et stabiliser leur souffrance psychique ? À cet égard, cet article discute du statut de l'art dans la psychanalyse, apporte quelques contributions historico-philosophiques à la relation entre l'art et la folie, et interprète son travail à la lumière des propositions de Jacques Alain-Miller, afin de comprendre comment l'art produit par les sujets en souffrance psychique peut servir de tampon à la folie et favoriser la façon dont ils font face à leur corps.

The mourning process and "living with the dead": Two case reports and a review of the literature.

The discovery of mummified bodies in domestic settings is not unusual in the medico-legal context. It is often a marker of social isolation, even in our urban modern society, and usually occurs among elderly people living alone or in precarious conditions. However, bereaved subjects can sometimes be found managing their grief by deliberately keeping the corpses of their loved ones at home. Investigation of these atypical cases can be challenging and often requires a multidisciplinary effort by different forensic specialists. We report two cases of people who lived for several months with the mummified remains of a relative. In both cases, the judge ordered a forensic psychiatry assessment of the survivors' competency and the reasons for this peculiar behavior, which is regarded as abnormal in our society. Case 1 describes a shared psychosis, which developed out of a condition of extreme seclusion of the entire family. Case 2 shows that even a mild personality disorder on which a series of traumatic events operates can trigger psychotic decompensation, causing extreme denial of the reality of death. The analysis of these cases contributes to our knowledge of the scantly studied phenomenon of "Living with the Dead" and raises questions about the psychopathology behind it. It is useful to identify subjects who are more prone to developing this "deviant" behavior, in order to distinguish people with mental illness from those who merely want to profit from the death of a loved one.

Folie imposée en dos hermanas gemelas

RESUMEN Folie imposée (trastorno de ideas delirantes inducidas) es una entidad poco frecuente en psiquiatría clínica. Este es un reporte de caso de dos hermanas gemelas, que requirieron internación en un servicio de psiquiatría tras la aparición de ideas delirantes de perjuicio y de contenido místico que, tras una intervención adecuada y sepa-ración de la paciente sin antecedentes de cuadros similares, recuperaron su funcionalidad previa. El trastorno de ideas delirantes inducidas tiene diferentes subtipos clínicos que se diferencian en el modo en que inician su efecto en la persona inducida. El tratamiento involucra enfoques farmacológicos y psicoterapéuticos, al igual que una importante psicoeducación sobre el cuadro.

ABSTRACT Folie imposée (induced delusional disorder) is a rare entity in clinical psychiatry. This is a case report of two twin sisters, who required hospitalization in a psychiatry service after the appearance of delusions of prejudice and mystical content that, after an adequate intervention and separation of the patient without a history of similar symptoms, recovered their previous functionality. Induced delusional disorder has different clinical subtypes that differ in how they initiate their effect in the induced person. The treatment involves pharmacological and psychotherapeutic approaches as well as an important psychoeducation on the disease.

Folie a deux in monozygotic twins with childhood trauma: A case report.

Folie a deux is a rare syndrome characterized by induction of a delusion in a susceptible person in close proximity with an individual with known delusional disorder. We report a rare case of monozygotic twins with induced delusional disorder in one of the twins. The twins had experienced childhood trauma in the form of emotional neglect and physical abuse by the father. The primary case (Twin A) was diagnosed with delusional disorder and was treated with oral antipsychotic. The secondary case (Twin B) showed resolution of symptoms after separation from twin A. The case highlights the unique presentation of induced delusional symptoms in monozygotic twins and the close association between childhood trauma and psychosis.

Enlouquecer com: o caso Ferenczi e algumas questões para a psicanálise contemporânea / To go crazy with: Ferenczis case and some questions for contemporary psychoanalysis / «Deviens fou avec¼: le cas Ferenczi et quelques questions pour la psychanalyse contrermporaine / Volverse loco: el caso Ferenczi y algunas preguntas para el psicoanálisis contemporáneo

A partir do "caso Ferenczi", como identificado em um texto de sua paciente/analista, Elizabeth Severn, o artigo apresenta e desenvolve três questões pertinentes à psicanálise contemporânea: uma crítica à ênfase na leitura diagnóstica, em especial quando normatizadora; a criação de espaços intersubjetivos em análise, e sua dimensão potencial; e a maneira como a "loucura", uma vez compartilhada, é psiquicamente mobilizadora e permite a emergência de conteúdos relevantes tanto para o paciente como para o analista. Discute-se se possibilidade de adotar uma posição não normativa frente aos elementos disruptivos do psiquismo do outro não seria, ao menos em parte, resultado da capacidade do analista em transitar por entre fragmentos de seu próprio psiquismo.

Based on the "Ferenczi case", as identified in a text by his patient/analyst, Elizabeth Severn, this article presents and discusses three issues of contemporary psychoanalysis: a critique of the emphasis on diagnostic interpretation, especially when it is standardizing, the creation of intersubjective spaces in analysis and their potential dimension and the way that "madness", once shared, psychically mobilizes and allows relevant content to emerge in both the patient and the analyst. This article further discusses whether the possibility of adopting a non-normative position towards disruptive elements of the other's psyche could be the result, at least in part, of the analyst's ability to move between the fragments of his own psyche.

Basé sur le «cas Ferenczi¼, tel qu'identifié dans un texte de sa patiente/ analyste, Elizabeth Severn, l'article présente et développe trois enjeux pertinents à la psychanalyse contemporaine: une critique de l'accent mis sur la lecture diagnostique, surtout lorsqu'elle est normative, la création d'espaces intersubjectifs lors de l'analyse et leur dimension potentielle et la manière dont la «folie¼, une fois partagée, se mobilise psychiquement et permet l'émergence de contenus pertinents tant pour le patient que pour l'analyste. On discute si la possibilité d'adopter une position non normative face aux éléments perturbateurs de la psyché de l'autre ne serait pas, au moins en partie, le résultat de la capacité de l'analyste à se déplacer entre des fragments de sa propre psyché.

Basado en el "caso Ferenczi", según lo identificado en un texto de su paciente/analista, Elizabeth Severn, el artículo presenta y desarrolla tres cuestiones pertinentes al psicoanálisis contemporáneo: una crítica al énfasis en la lectura diagnóstica, especialmente cuando es normativa; la creación de espacios intersubjetivos en el análisis y su dimensión potencial; y la forma en la que la "locura", una vez compartida, se moviliza psíquicamente y permite la aparición de contenido relevante tanto para el paciente como para el analista. Se discute si la posibilidad de adoptar una posición no normativa frente a los elementos disruptivos de la psique del otro no sería, al menos en parte, el resultado de la capacidad del analista para moverse entre fragmentos de su propia psique.

The agony of integration and the blessings of finitude - facing 'extinction points' and moments of madness.

This paper explores the inevitable pain that integration requires in our individuation process. The unspeakable agony we defended against in order to survive we now experience consciously, including moments of going out of existence at the core of our madness. Clinical examples are given of these 'extinction points' and the abject helplessness analysand and analyst suffer in the face of this destructiveness. The first and second witness to this process (usually the analyst and the psyche itself) and the primordial creative life force are recognized in the process of recovery, a recovery that recoups the blessings of our finite human living.

Cet article explore la souffrance inévitable que requiert l'intégration dans le processus d'individuation. L'indicible tourmente contre laquelle nous nous défendions afin de survivre est ce dont nous faisons maintenant l'expérience de manière consciente, y compris dans les moments de sortie de l'existence, au noyau de notre folie. Des exemples cliniques de ces « points d'extinction ¼ sont donnés, ainsi que de la détresse extrême vécue par l'analysant et l'analyste devant cette destructivité. Le premier et le second témoin de ce processus (généralement l'analyste et la psyché elle-même) ainsi que la force de vie créative et primaire sont reconnus dans le processus de rétablissement, un rétablissement qui opère le recouvrement des bénédictions de notre vie humaine limitée.

El presente trabajo explora el dolor inevitable que requiere la integración en nuestro proceso de individuación. La agonía indescriptible de la cual nos defendemos para sobrevivir, ahora la experimentamos de manera consciente, incluyendo aquellos momentos por fuera de la existencia al centro de nuestra locura. Se ofrecen ejemplos clínicos de estos 'puntos de extinción' y la abyecta impotencia que analista y analizando sufren ante esta destructividad. El primero y el segundo testigo de este proceso (usualmente el analista y la psique misma) y la fuerza vital creativa primordial son reconocidas/os en el proceso de recuperación, una recuperación que recobra las bendiciones de nuestra finitud humana.

'Come share my world' of 'madness': a systematic review of clinical, diagnostic and therapeutic aspects of folie à deux.

Folie à deux, also known as shared psychotic disorder, shows intrinsic differences when compared to other psychiatric disorders. Literature about this condition is scanty and findings about its clinical correlates are not univocal. The present systematic review aimed at critically summarizing the existing evidence about folie à deux, also focussing on psychopathological, diagnostic and treatment features. The electronic databases PUBMED, Web of Science and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles reporting original data about socio-demographic, aetiological, clinical, diagnostic and treatment features of folie à deux, providing information about both primaries and secondaries, were included. Risk of bias was evaluated using the Critical Appraisal Skills Programme (CASP) instruments. The initial search yielded 834 records. After the screening process only 9 papers were deemed eligible for inclusion in the review. Folie à deux emerged to be a heterogeneous condition with a complex etiopathogenesis. The clinical presentation of the disorder included a multi-facet aspect, going beyond the classical description mainly focussed on delusions and possibly explaining conflicting outcomes of different treatments. Diagnostic categories appear to be often reductive and the need for a dimensional approach capable of global reliability emerged.

Loucura em território: experimentando produção de saúde com beneficiários do programa “De volta para casa” / Madness in territory: experimenting health production with beneficiaries of the “Back to home” program / Locura en territorio: experimentando producción de salud com beneficiarios del programa “De vuelta a casa” / Folie en territoire: essayer production de santé avec bénéficiaires du programme “Retour à la maison”

Este artigo se propõe a refletir sobre a desinstitucionalização e o Programa de Volta para Casa, incluindo seus impactos na saúde de pessoas longamente institucionalizadas, com base na perspectiva da produção de saúde. Tem como objetivo compreender as estratégias de produção de saúde desenvolvidas por pessoas que viveram longos processos de internação em hospitais psiquiátricos e que agora residem em Serviços Residenciais Terapêuticos localizados no município de Camaragibe/Pernambuco. No que diz respeito à metodologia, foram utilizadas cinco narrativas de homens beneficiários do programa, oriundas do banco de dados de uma pesquisa multicêntrica de caráter nacional sobre o Programa de Volta para Casa. As produções narrativas foram o material e método de análise, na perspectiva de contemplar diferentes fontes e versões do fenômeno. Como resultado, tivemos a construção e análise das possibilidades de produção de saúde a partir de dispositivos como o trabalho, a autonomia, a expressão artística e a cultura.

This paper proposes to reflect about deinstitutionalization and the “Back to Home” Program, as well as their impacts on the health of long institutionalized people, based on the perspective of health production. It is based on discussions about freedom as therapeutic and a new view on health, moving the focus away from the disease and centralizing the subject, their life story and their potential for constant reinvention. The paper aims to understand the strategies of health production developed by people who have lived long processes of hospitalization in psychiatric hospitals and who now reside in Residential Therapeutic Services located in the municipality of Camaragibe (Brazil). Regarding the methodology, five narratives of male beneficiaries of the program were used. Such narratives were taken from the database of a multicenter national research on the “Back to Home” program. The narrative productions were the material and method of analysis, with the aim of contemplating different sources and versions of the phenomenon. As results, we had the construction and analysis of the possibilities of health production from devices such as work, autonomy, artistic expression and culture.

Este artículo se propone reflexionar sobre la desinstitucionalización y el Programa “De Vuelta a Casa”, y sus impactos en la salud de personas largamente institucionalizadas, con base en la perspectiva de la producción de salud. Tiene como objetivo comprender las estrategias de producción de salud desarrolladas por personas que vivieron largos procesos de internación en hospitales psiquiátricos y que ahora residen en Servicios Residenciales Terapéuticos ubicados en el municipio de Camaragibe. En lo que se refiere a la metodología, se utilizaron datos secundarios de una investigación multicéntrica de carácter nacional sobre el Programa de “Vuelta a Casa”, cinco narrativas de hombres beneficiarios del programa. Las produciónes narrativas fueron el material y método de análisis, en la perspectiva de contemplar diferentes fuentes y versiones del fenómeno. Como resultados, tuvimos la construcción y análisis de las posibilidades de producción de salud a partir de dispositivos como el trabajo, la autonomía, la expresión artística y la cultura.

Cet article vise à réfléchir sur la désinstitutionnalisation et le programme Retour à la Maison, y compris ses impacts sur la santé des personnes institutionnalisées depuis longtemps, sur la base de la perspective de la production sanitaire. Il vise à comprendre les stratégies de production de santé développées par des personnes qui ont vécu de longs processus d'hospitalisation dans des hôpitaux psychiatriques et qui résident maintenant dans des services thérapeutiques résidentiels situés dans la municipalité de Camaragibe / Pernambuco. En ce qui concerne la méthodologie, cinq récits des hommes bénéficiaires du programme ont été utilisés, à partir de la base de données d'une recherche nationale multicentrique sur le programme de retour à la maison. Les productions narratives ont constitué le matériau et la méthode d'analyse, en vue d'envisager différentes sources et versions du phénomène. En conséquence, nous avons eu la construction et l'analyse des possibilités de production de santé à partir d'appareils tels que le travail, l'autonomie, l'expression artistique et la culture.

Shared Psychotic Disorder (Folie À Deux): A Rare Case with Dissociative Trance Disorder That Can Be Induced.

BACKGROUND: Shared psychotic disorder was first introduced in the 19th century in France with the name Folie à deux. Since then, the concept of Folie à deux has been developed and produces several subtypes in France. In DSM, this disorder is called Shared Psychotic Disorder, and in ICD-10, it is called Induced Delusional Disorder. However, some of the classic subtypes of Folie à deux are not included in the above categories. CASE REPORT: We found a case of shared psychotic disorder between a 38-year-old male inducer, a Batak tribe with two female recipients, 34 and 36 years from the Batak tribe. They were found to share the same delusions and hallucinations, and inducers could make recipients into trance conditions. These three individuals did not get along with the surrounding community and often carried out activities and perform rituals together. CONCLUSION: Overall, our case has some unique features of folie à deux. In this case, there is a trance condition that can be induced that have not been reported in the literature or case reports related to Folie à deux.

Do dispositivo psicopatológico: a loucura entre os muros do discurso / On the psychopathological device: the madness between the walls of discourse / De l'appareil psychopathologique: la folie entre les murs du discour / Del dispositivo psicopatológico: la locura entre los muros del discurso

Este artigo realizou uma investigação teórica acerca das articulações entre o DSM e a lógica classificatória de Simão Bacamarte. O referido manual foi tomado pelo discurso psicopatológico hegemônico no contemporâneo a partir de uma leitura psicanalítica, enquanto a classificação de Bacamarte compõe a obra "O alienista" de Machado de Assis. Apontamos que o lugar que uma sociedade destina aos avessos da razão delimita o espaço da liberdade, revelando as formas de laço social de uma coletividade. A liberdade estaria intimamente relacionada com uma posição política, constatação que admite que se aborde a psicopatologia sob a mesma perspectiva. Depreendemos que se a loucura venceu os muros dos manicômios, ela permanece, mais do que nunca, aprisionada entre os muros do discurso das excessivas classificações, uma vez que neutraliza aquilo que faz o sujeito do inconsciente falar.

This paper reports a theoretical study of the connections between the DSM and the classificatory logic by Simão Bacamarte. The contemporary hegemonic psychopathological discourse of the DSM was taken from the point of view of a psychoanalytic reading, while Bacamarte's classification composes Machado de Assis' work "The alienist". We point out that the space a society allocates to the reverse of reason defines the space of freedom, revealing the forms of the social bond of a collectivity. Thus, freedom is closely related to a political position, a conclusion that allows to approach psychopathology from the same perspective. We find that if madness has been freed from the asylum walls, it remains more than ever trapped within the walls of the discourse of excessive DSM classifications, since that discourse neutralizes what makes the subject of the unconscious speak.

Cet article décrit une enquête théorique sur les rapports entre le DSM et la logique de la classification de Simão Bacamarte. Le DSM, caractérisé par un discours psychopathologique hégémonique contemporain, a été analysé à partir d'une lecture psychanalytique, tandis que la classification de Bacamarte compose l'œuvre littéraire « L'aliéniste ¼ de Machado de Assis. Nous soulignons que la place qu'une société destine aux envers de la raison délimite l'espace de la liberté et révèle les formes de lien social d'une collectivité. La liberté serait étroitement liée à une position politique, constatation qui admet que la psychopathologie soit abordée par la même perspective. Nous observons que si la folie a réussi à s'évader des murs des asiles, elle reste néanmoins emprisonnée par les murs du discours des classifications DSM excessives, étant donné que celuici neutralise ce qui fait parler le sujet de l'inconscient.

Este artículo realizó una investigación teórica acerca las articulaciones entre el DSM y la lógica clasificatoria de Simão Bacamarte. El DSM fue invadido por el discurso psicopatológico hegemónico en lo contemporáneo a partir de una lectura psicoanalítica, mientras que la clasificación de Bacamarte compone la obra "El alienista", de Machado de Assis. Señalamos que el lugar que una sociedad destina a los contrarios de la razón delimita el espacio de la libertad, revelando las formas de lazo social de una colectividad. La libertad estaría íntimamente relacionada con una posición política, constatación que admite que se aborde la psicopatología bajo la misma perspectiva. Comprendimos que, si la locura venció los muros de los manicomios, ella permanece, más que nunca, encarcelada entre los muros del discurso de las excesivas clasificaciones del DSM, una vez que neutraliza lo que hace al sujeto del inconsciente hablar.

Dieser Artikel beschreibt eine theoretische Untersuchung der Verbindungen zwischen dem DSM und der Klassifikationslogik von Simão Bacamarte. Der gegenwärtige hegemoniale psychopathologische Diskurs des DSM wurde unter dem Blickwinkel der Psychoanalyse übernommen, während Bacamarte's Klassifikationen aus Machado de Assis' Werk „O Alienista" („der Irrenarzt") stammt. Wir kommen zum Schluss, dass der Ort, den eine Gesellschaft der Schattenseite der Vernunft zuordnet, den Raum der Freiheit begrenzt und die Formen der sozialen Bindung einer Kollektivität offenbart. Freiheit steht in enger Verbindung mit politischer Position und diese Feststellung lässt zum Schluss kommen, dass die Psychopathologie aus derselben Perspektive angegangen werden kann. Auch wenn der Wahnsinn den Mauern der Anstalten entkommen ist, bleibt er mehr als je zuvor in den Mauern des Diskurses übermäßiger DSM-Klassifikationen gefangen, da dieser neutralisiert, was das Subjekt des Unbewussten zum Sprechen bringt.