Fantasias infantis: uma escuta psicanalítica no hospital geral / Childhood phantasies: a psychoanalytical listening in the general hospital

O artigo aborda a importância das fantasias infantis presentes no trabalho clínico psicanalítico com crianças no período de residência em um hospital geral. O percurso escolhido segue o desenvolvimento que Freud faz da temática ao longo de sua obra, com entrelaçamentos da prática clínica e reflexões acerca da inserção da psicanálise nesse contexto, levando em consideração que na instituição hospitalar, predominantemente médica, há uma supremacia do orgânico frente às questões subjetivas do paciente.

The article discusses the importance of childhood fantasies present in psychoanalytic clinical work with children during a residency period in a general hospital. The chosen path follows Freud's development of the theme throughout his work, interweaving clinical practice and reflections on psychoanalysis insertion in this context, considering that in the hospital institution, predominantly medical, there is a supremacy of the organic over patient's subjective questions.

Beating phantasies: Mourned and unmourned.

This paper intends to explore the organizing function and fate of sado-masochistic phantasies in their fixed form, in the psychic life of patients who have suffered early traumas, due to environmental vicissitudes and maternal psychopathology. The theoretical starting point is provided by the Novicks' research into transitory and permanent beating phantasies in adult and child patients, their onset and their psychic function, based on an examination of Freud's paper 'A child is being beaten'. In this text Freud achieves an unprecedented syncretism, locating the phantasy at the intersection between the oedipal complex, which is a vertical structure organizing sexual and generational differences, and the fraternal dimension, which is horizontal and organizes the lateral relationship with that similar but different other who is the sibling. Reporting in some detail material from the analyses of two young women, whose clinical presentation and early traumas show some similarities, the author puts in the context of the analytic work the emerging of the sado-masochistic phantasies, emphasizing their use and function in the transference-countertransference interplay. The beating phantasies shore up a precarious sense of self, threatened with psychic depletion and death, in identification with the absent mother of early infancy. An overly close relationship with a sibling, experienced as a narcissistic double, compounds the clinical picture, to establish the triangle formed by the parent(s) and two children which features in the beating phantasy. Finally, the author explores the contribution of ameliorating factors, such as alternative identificatory figures, constitutional endowment and capacity for sublimation, to account for the different fate of the fixed beating phantasies.