Risk of Injury to Retroperitoneal Structures in Prone and Lateral Decubitus Transpsoas Approaches to Lumbar Interbody Fusion: A Pilot Cadaveric Anatomical Study.

Introduction The retroperitoneal approach for lateral lumbar interbody fusion (LLIF) originally described an initial posterolateral fascial incision enabling finger dissection from behind the peritoneum and guidance of instruments through a second direct-lateral fascial incision. It has since become common for single direct-lateral incisional access to the retroperitoneum. This study attempted to quantify the distance of the peritoneum from posterior landmarks in the space, assess the risk of peritoneal violation in each access trajectory (i.e., posterolateral versus direct lateral retroperitoneal dissection), and determine whether there are differences based on patient position (prone versus lateral decubitus). Methods In three prone cadaveric torsos, Steinman pins were percutaneously placed mid-disc at each level L2-5 bilaterally (for a total of 18 prone approaches). Open dissections exposed the retroperitoneum including the quadratus lumborum and psoas muscles, maintaining the natural reflection of the peritoneum. Visual assessment qualified whether any pin violated any retroperitoneal structure. Distance from the anterior border of the quadratus lumborum to the posterior-most reflection of the peritoneum was measured. For comparison, three additional torsos were positioned in lateral decubitus, and the above steps were repeated, only unilaterally (for a total of nine lateral decubitus approaches). Results In prone, no pin violated the peritoneum; three (3/18 total approaches) violated the kidney, all at L2-3 (3/6 approaches at L2-3). In lateral decubitus, all three L2-3 pins violated the kidney (3/3 approaches at L2-3); five of the six remaining pins from L3-5 violated the peritoneum (totaling eight violations in the nine total approaches). The incidence of any violation was significantly greater in lateral decubitus vs. prone (8/9 vs. 3/18, p=0.0006). The structure at risk (kidney vs. peritoneum) was significantly associated with disc level (p=0.0041): all kidney violations occurred at L2-3 and all peritoneal violations occurred at L3-4 or L4-5. Distance from the quadratus lumborum to the posterior-most reflection of the peritoneum averaged 8.7 cm (range: 6-10) in prone, and 2.9 cm (range: 2.5-3.2) in lateral decubitus (p=0.0129). Conclusion A cadaveric study of retroperitoneal anatomy demonstrates that there is an increased distance from the quadratus lumborum to the peritoneum in prone versus lateral decubitus and that the trajectory of approach to the lumbar discs risks violation of the peritoneum more frequently when accessing directly laterally versus posterolaterally. In either approach, care should be taken to identify and release the peritoneal reflection to create a safe passage to the lumbar discs.

The grammar of paradox: Deciphering Winnicott's language theory.

This paper illuminates how the psychoanalytic work of Winnicott and Wittgenstein's philosophy on language complement each other in elucidating a "psychoanalytic language game". The paper takes a close look at the grammar and linguistic mechanisms which underlie psychoanalytic work. Wittgenstein's linguistic turn from positivism is discussed; his ideas like 'family resemblance', 'aspect seeing' and 'language games' are examined in order to shed light on the paradoxical communication at play in Winnicott's potential space. The paper looks at the potentiality central to therapeutic work, arguing that it accords with what Wittgenstein calls the grammatical optative mode, as Freud already indicated in his theory of dreaming.

Clínicas do Testemunho na elaboração do traumático: violência de Estado na ditadura civil-militar brasileira / Clínicas del Testimonio en la elaboración de traumatismos: la violencia de Estado en la dictadura cívico-militar brasileña / Testimony Clinic and trauma: State violence in Brazilian civil-military dictatorship

Na ditadura civil-militar brasileira (1964-1985) ocorreu uma violação sistemá-tica de Direitos Humanos por parte do Estado, o que impôs à sociedade medo e silenciamento. Pessoas vítimas dessas violências não tiveram espaço social que legitimasse a realidade e o sofrimento de suas vivências. Em 2012, foi lançado o projeto Clínicas do Testemunho, iniciando um trabalho de reparação psíquica dessas vítimas. Estudando as especificidades do trauma de violência de Estado e tortura política e apresentando os conceitos de espaço potencial e de testemunho, o objetivo do artigo é estabelecer um diálogo entre esses conceitos e o trabalho realizado pelas Clínicas do Testemunho, para compreender como esta reparação psíquica pode se dar na prática. Trata-se de um estudo teórico fundamentado na Psicanálise. Conclui-se que o testemunho é uma ferramenta potente para se trabalhar o traumático. Discutir o tema é um posicionamento político, de resgate da história, memória e verdade.

En la dictadura militar brasileña (1964-1985), hubo violación sistemática de los Derechos Humanos por parte del Estado, que impuso miedo y silencio a la sociedad. Las personas víctimas de esta violencia no tenían un espacio social que legitimara la realidad y el sufrimiento de sus experiencias. En 2012, se lanzó el proyecto Clínicas del Testimonio, comenzando un trabajo de repa-ración psíquica de esas víctimas. Al estudiar las especificidades del trauma de la violencia del Estado e de la tortura política, y los conceptos de espacio potencial y testimonio, el objetivo de este artigo es dialogar eses conceptos con el trabajo echo por las Clínicas de Testimonio, para comprender cómo se podría practicar esta reparación psíquica. Es un estudio teórico basado en el Psicoanálisis. Se concluye que el testimonio es una herramienta potente para trabajar el traumático. Discutir el tema es una posición política, rescate de la historia, memoria y verdad.

During the Brazilian civil-military dictatorship (1964-1985), Human Rights were systematically violated by the State, inflicting fear and silence on the country's citizens. Victims of violence did not have a social space that legi-timized the reality and suffering of their experiences. In 2012, the project Clinicas do Testemunho, (Testimony Clinic) was launched, working with the psychological reparation of these victims. Studying the specificities of State violence trauma and political torture, and also the concepts of Potential Space and testimony, this article aims to establish a dialogue between these concepts and the work developed by the Clinicas do Testemunho to understand how this work could take place in practice. This is a theoretical study based on Psychoanalysis that concludes that the testimony of those who witnessed it all is a powerful tool to work with trauma. Discussing the topic is also political, reclaiming history, memory, and truth.

Regressão à dependência e o brincar: novos sentidos da transferência em Winnicott / Regression to dependency and play: new meanings of transference in Winnicott

O texto reflete sobre o significado da transferência para Winnicott. Apoiado num caso, o texto busca articular esse conceito aos de regressão à dependência, brincar e presença viva do analista como suportes da análise.

The text reflects on the meaning of the transference to Winnicott. Supported in one case, the text seeks to articulate this concept with those of regression to dependency, play and the analyst's living presence as support for analysis.

Lo que quiere decir jugar según François Zourabichvili y Donald Winnicott / What it means to play according to François Zourabichvili and Donald Winnicott

A partir de la lectura de El Arte como juego, en el que François Zourabichvili compara la manera en la que la estética da lugar al juego en filosofía con la manera en que el juego conduce a la pregunta por el arte en psicoanálisis, el presente artículo interroga el lugar y la función del juego y del arte en filosofía y en psicoanálisis. El arte, presentado como un juego de desciframiento, encuentra en esta articulación un carácter activo, en oposición a la tendencia a situarlo en el registro de la pura contemplación. La hipótesis del juego, que lleva a Winnicott a dar a éste un estatuto de practica referida a la pulsión creativa, es importante no solo en la clínica infantil, sino que es, en su capacidad de intervenir en el área indeterminada de lo informe (transicional, potencial, de la ilusión), un pilar de toda la clínica analítica. Winnicott desarrolla en efecto, a partir de la idea de lo informe, una une teoría del espacio que convoca a la vez el sueño y lo real, en la medida en que se trata de un espacio en el que el sueño no solamente proporciona una satisfacción ilusoria, sino que crea también una ilusión de control de lo real. De este modo, la espacialización tiene efectos sobre la simbolización. El demuestra así ser el lugar de una génesis preposicional del individuo, la matriz de una gramática donde el sujeto abre paso al objeto del cual él mismo emerge y se separa. El arte como juego tiene que ver, entonces, con una experiencia de lo informe, en la que el individuo se vive en unión con el mundo y consigo mismo, una experiencia tanto reflexiva como subjetiva

Comparing the way in which aesthetics gives rise to a form of playing in philosophy with the way in which playing leads to the question about art in psychoanalysis, this article interrogates the function of playing and art in philosophy and psychoanalysis. Art, presented as a deciphering game, finds in this articulation an active character, as opposed to a pure contemplation. On the other hand, playing becomes a form of practice related to creative drives, not only in child psychoanalysis, but in its ability to intervene in formless spaces (transitional, potential, space of illusion), a pillar of the entire analytical clinic Winnicott develops from this idea a theory of space that summons both the dream and the real: a space in which the dream not only provides an illusory satisfaction, but also creates an illusion of control of the real. Thus, spatialization has effects on the symbolization, on the prepositional genesis of the individual, the matrix of a grammar where the subject gives way to the object from which he emerges and separates. Art as a game is presented, then, with an experience of the formless in which the individual lives in union with the world and with himself, both a reflexive and subjective experience

Dreaming and Experiencing in the Potential Space.

The author presents some clinical sequences from two sessions in order to illustrate his thoughts about dreaming, about experiencing in analysis, and about the clinical realization of the potential space. When the dreamer's conscious and unconscious relationship with her own dream turns the latter into a living psychic object, the experience that the dreamer can have of the dream occupies an intermediate area, placing itself between the internal world and external reality. When the dreamer lets the dream-experience affect the experience of external reality, a further transformation can take place in the analysis, since this intermediate intrapsychic area can become a transitional area between the patient and the analyst. The analyst and the patient were able to create a potential space in which, in addition to the transference repetition of cumulatively traumatic situations, an experience was generated that gave rise to embryonic processes of integration between dissociated aspects of the patient.

O espaço potencial: da origem à evolução / El espacio potencial: del origen a la evolución / Potential space: from origin to evolution

Estudo sobre o conceito e a teoria do espaço potencial de D. W. Winnicott. Realizou-se uma leitura exaustiva da obra desse autor e de estudiosos dela. Não há consenso entre estes sobre o momento em que o espaço potencial se constitui na linha do amadurecimento do indivíduo e acerca das expressões utilizadas para nomeá-lo. Para Winnicott, o espaço potencial é o locus de um processo que acontece no indivíduo, iniciando-se em uma área intermediária, com seus fenômenos e objetos transicionais, e evolui para o brincar, para o brincar compartilhado e para as experiências culturais.

Estudio sobre el concepto y la teoría sobre el espacio potencial de D. W. Winnicott. Se realizó una lectura exhaustiva de la obra de ese autor y de estudiosos de ésta. No hay consenso entre éstos sobre el momento en que el espacio potencial se constituye en la línea de la maduración del individuo y acerca de las expresiones utilizadas para nombrarlo. Para Winnicott, el espacio potencial es el locus de un proceso que ocurre en el individuo, que se inicia en un área intermedia, con sus fenómenos y objetos transicionales, y evoluciona para el juego, para el juego compartido y para las experiencias culturales.

It is a study on the concept and theory of potential space by D. W. Winnicott. An exhaustive reading of the author's work and her scholars was carried out. There is no consensus among them on the moment when potential space constitutes in the line of maturation of the individual and on the expressions used to name it. For Winnicott, potential space is the locus of a process that happens in the individual, which begins in an intermediate area with its phenomena and transitional objects, and evolves to playing, shared playing and cultural experiences.

O brincar e o espaço potencial no ambiente virtual / Playing and potential space in the virtual environment

Este artigo analisa os impactos subjetivos advindos das novas formas de interação permitidas pelos avanços tecnológicos no campo virtual. Foram realizadas entrevistas semiestruturadas com seis participantes adultos que possuíam um personagem em jogos online com um complexo mundo virtual. A estratégia metodológica para análise das entrevistas seguiu a análise temática do seu conteúdo e interpretações psicanalíticas winicottianas. Pôde-se constatar que a atividade criativa inserida nesses jogos permite uma interação particular entre o sujeito e o personagem pertencente ao universo virtual, se estabelecendo como potência para a constituição de um espaço potencial e para a emergência de novos processos de subjetivação.

This article analyzes the subjective impacts from new forms of interaction allowed by technological advances in the field of virtuality. Semi-structured interviews were conducted with six adults participants who had a character in online games with a complex virtual world. The methodology for the analysis of the interviews followed the thematic analysis of its content and winicottian psychoanalytic interpretations. It was found that creative activity inserted in these games allows a particular interaction between the subject and the character belonging to the virtual world, establishing itself as potency to constitute a potential space and the emergence of new processes of subjectivity.

Adolescência e falhas na transicionalidade: a busca pela criação de espaço potencial no tratamento / Adolescence and transitionality failures: creating potential space in the treatment

A autora aborda o tema da transicionalidade considerando questões teóricas e técnicas sobre o mesmo. São apresentados dois casos clínicos de pacientes adolescentes limítrofes com falhas na constituição de um espaço potencial e que negam a alteridade nas relações, sofrendo ao perceberem a impossibilidade de manterem os objetos sob seu controle onipotente. O trabalho é primordialmente baseado na teoria de Donald Winnicott e também busca refletir sobre conceitos de autores contemporâneos como Daniel Kuperman e Thomas Ogden

The author approaches the topic of transitionality considering theoretical and technical points about it. The author presents two clinical cases of adolescent patients with failures in the constitution of a potencial space who deny the alterity in the relationships, suffering when they perceive the impossibility of keeping the objects under their omnipotent control. The article is primarily based on the theory of Donald Winnicott and seeks to reflect on the concepts of contemporary authors such as Daniel Kuperman and Thomas Ogden

BETWEEN PSYCHOANALYSIS AND TESTIMONIAL SPACE: THE ANALYST AS A WITNESS.

The aim of this article is to think of the place of the witness as a third place that the analyst, in the clinical space of trauma, is able to sustain. According to Ferenczi, in traumatic dreams a third is already being summoned. It is not the witness of the realm of law, nor the place of the father or the symbolic law. This is a third space that can be called potential, interstitial space, indeterminate and formless, where something that at first would be incommunicable circulates and gradually takes shape. This space allows and supports the literalness of a testimonial narrative, its hesitations, paradoxes and silences. More than a trauma theory, the notion of a potential space would be the great contribution of psychoanalysis to the treatment of trauma survivors, establishing the difference between the task of a psychoanalyst and the one of a truth commission.

Exílio, repatriação e falso self: rupturas e suturas / Exilio, repatriación y falso self: rupturas y suturas / Exile, repatriation and false self: ruptures and sutures

Partindo da temática Exílios e repatriações, a autora irá considerar as rupturas precoces no psiquismo e a defesa self falso, que pela cisão mantém o self verdadeiro em exílio. Indaga se a busca do verdadeiro self, objetivo da análise, segundo Winnicott, pode ser considerada uma forma de repatriação, e examina então os significados de self, exílio e pátria. Aborda também as possíveis formas de sutura promovidas pela experiência analítica e suas extensões.

Partiendo de la temática Exilios y repatriaciones, la autora considerará las rupturas tempranas en el psiquismo y la defensa self falso, que, a través de escisión, mantiene el self verdadero en exilio. Indaga si la búsqueda del verdadero self, objetivo del psicoanálisis, según Winnicott, podría ser considerada una forma de repatriación. Examina, entonces, los significados de self, exilio y patria. Aborda también las posibles formas de sutura promovidas por la experiencia analítica y sus extensiones.

Starting from the current issue's theme, that is Exiles and repatriations, the author will consider premature ruptures in the psyche and the defense of the false self ­ a false self that keeps the true self in a state of exile through the ego defense mechanism of splitting. According to Winnicott, the pursuit of the true self is the purpose of psychoanalysis. This paper questions whether this pursuit may be considered a way of repatriation. As such, the author examines the meaning of self, exile, and homeland (or fatherland). This paper also studies possible sorts of sutures which may be provided by the psychoanalytic experience and its extensions.

THE DIALOGICAL SELF IN PSYCHOANALYSIS.

This paper describes the shift that appears to be taking place in contemporary psychoanalysis, as reflected among intersubjective approaches, from a monological conception of the self to a dialogical one. The monological self emphasizes the separation between mind, body, and external world, focusing on the representational and descriptive/referential function of language. In contrast, the dialogical self emphasizes practices, the permeable nature of relationships between subjects, and the constitutive function of language. This paper attempts to explain the growing emphasis on the dialogical self, understood from a theoretical, metatheoretical, and technical point of view, using contemporary intersubjective approaches to illustrate this shift.

O analista como testemunha / The analyst as a witness / L'analyste en tant que témoin / El analista como testigo

A proposta deste artigo é pensar o lugar da testemunha como um lugar terceiro que o analista, na clínica do traumático, é capaz de sustentar. Nos sonhos traumáticos, segundo Ferenczi, já existe a convocação de um terceiro. Não se trata da testemunha da esfera do Direito, tampouco do lugar do pai ou da Lei simbólica. Trata-se de um terceiro espaço que pode ser chamado de potencial, espaço intersticial, indeterminado e informe no qual circula - e aos poucos ganha forma -, algo que a princípio seria incomunicável. Esse espaço permite e suporta a literalidade da narrativa testemunhal, seus titubeios, paradoxos e silêncios. Mais do que uma teoria do trauma, a noção de espaço potencial seria a grande contribuição da psicanálise às pesquisas teóricas e clínicas com sobreviventes de campos de extermínio, de situações de tortura e de violência.(AU)

The aim of this article is to think of the place of the witness as a third place that the analyst, in the clinic of trauma, is able to sustain. According to Ferenczi, in traumatic dreams a third is already being summoned. It is not the witness of the realm of Law, nor the place of the father or the symbolic Law. This is a third space that can be called potential, interstitial space, indeterminate and formless, where something that at first would be incommunicable circulates - and gradually takes shape. This space allows and supports the literalness of a testimonial narrative, its hesitations, paradoxes and silences. More than a trauma theory, the notion of a potential space would be the great contribution of psychoanalysis to the theoretical and clinical research with survivors of death camps, situations of torture and violence.(AU)

Le but de cet article est de penser à la place du témoin en tant qu'espace troisième que l'analyste, dans la clinique du traumatique, est capable de supporter. Dans les rêves traumatiques, selon Ferenczi, il y a déjà la convocation d'un troisième. Il ne s'agit pas du témoin de la sphère du Droit, ni de la place du Père ou de la Loi symbolique. Il s'agit d'un troisième espace qui peut être nommé potentiel, espace interstitiel, indéterminé et sans forme où circule, et peu à peu prend forme, quelque chose d'abord incommunicable. Cet espace permet et soutient la littéralité du récit testimonial, ses hésitations, ses paradoxes et ses silences. En plus qu'une théorie du traumatisme, la notion d'espace potentiel serait une grande contribution de la psychanalyse à la recherche théorique et clinique avec des survivants des camps d'extermination, des cas de torture et de violence.(AU)

Resumen La propuesta de este artículo es pensar el lugar del testigo como un tercer lugar que el analista, en la clínica del traumático, es capaz de sostener. De acuerdo con Ferenczi, en los sueños traumáticos la convocación de un tercero ya existe. No se trata del testimonio del reino del Derecho, tampoco del lugar del padre o de la Ley simbólica. Se trata de un tercer espacio que se puede llamar potencial, el espacio intersticial, indeterminado y sin forma en el cual algo que al principio sería incomunicable circula y toma forma poco a poco. Este espacio permite y apoya la literalidad de la narrativa testimonial, sus vacilaciones, paradojas y silencios. Más que una teoría del trauma, la noción de espacio potencial sería la gran contribución del psicoanálisis a la investigación teórica y clínica con sobrevivientes de campos de exterminio, de los casos de tortura y violencia.(AU)

O analista como testemunha / The analyst as a witness / L'analyste en tant que témoin / El analista como testigo

A proposta deste artigo é pensar o lugar da testemunha como um lugar terceiro que o analista, na clínica do traumático, é capaz de sustentar. Nos sonhos traumáticos, segundo Ferenczi, já existe a convocação de um terceiro. Não se trata da testemunha da esfera do Direito, tampouco do lugar do pai ou da Lei simbólica. Trata-se de um terceiro espaço que pode ser chamado de potencial, espaço intersticial, indeterminado e informe no qual circula - e aos poucos ganha forma -, algo que a princípio seria incomunicável. Esse espaço permite e suporta a literalidade da narrativa testemunhal, seus titubeios, paradoxos e silêncios. Mais do que uma teoria do trauma, a noção de espaço potencial seria a grande contribuição da psicanálise às pesquisas teóricas e clínicas com sobreviventes de campos de extermínio, de situações de tortura e de violência.

The aim of this article is to think of the place of the witness as a third place that the analyst, in the clinic of trauma, is able to sustain. According to Ferenczi, in traumatic dreams a third is already being summoned. It is not the witness of the realm of Law, nor the place of the father or the symbolic Law. This is a third space that can be called potential, interstitial space, indeterminate and formless, where something that at first would be incommunicable circulates - and gradually takes shape. This space allows and supports the literalness of a testimonial narrative, its hesitations, paradoxes and silences. More than a trauma theory, the notion of a potential space would be the great contribution of psychoanalysis to the theoretical and clinical research with survivors of death camps, situations of torture and violence.

Le but de cet article est de penser à la place du témoin en tant qu'espace troisième que l'analyste, dans la clinique du traumatique, est capable de supporter. Dans les rêves traumatiques, selon Ferenczi, il y a déjà la convocation d'un troisième. Il ne s'agit pas du témoin de la sphère du Droit, ni de la place du Père ou de la Loi symbolique. Il s'agit d'un troisième espace qui peut être nommé potentiel, espace interstitiel, indéterminé et sans forme où circule, et peu à peu prend forme, quelque chose d'abord incommunicable. Cet espace permet et soutient la littéralité du récit testimonial, ses hésitations, ses paradoxes et ses silences. En plus qu'une théorie du traumatisme, la notion d'espace potentiel serait une grande contribution de la psychanalyse à la recherche théorique et clinique avec des survivants des camps d'extermination, des cas de torture et de violence.

La propuesta de este artículo es pensar el lugar del testigo como un tercer lugar que el analista, en la clínica del traumático, es capaz de sostener. De acuerdo con Ferenczi, en los sueños traumáticos la convocación de un tercero ya existe. No se trata del testimonio del reino del Derecho, tampoco del lugar del padre o de la Ley simbólica. Se trata de un tercer espacio que se puede llamar potencial, el espacio intersticial, indeterminado y sin forma en el cual algo que al principio sería incomunicable circula y toma forma poco a poco. Este espacio permite y apoya la literalidad de la narrativa testimonial, sus vacilaciones, paradojas y silencios. Más que una teoría del trauma, la noción de espacio potencial sería la gran contribución del psicoanálisis a la investigación teórica y clínica con sobrevivientes de campos de exterminio, de los casos de tortura y violencia.

Psychodynamic Factors Behind Online Social Networking and its Excessive Use.

This article discusses the psychodynamic factors behind the popularity of one form of Internet activity, online social networking (SN). It views online SN as an extension of the social self, organized in a way that is more controllable than real life relating. The SN platforms reward its users with reassuring surfaces and novel self-object experiences while at the same time induces much anxiety. The addictive quality of online SN is understood in the context of collapse of dialectical space and the defensive use of this technology.

The suprachoroidal space: from potential space to a space with potential.

Recent advances have made it possible to image the suprachoroidal space, and the understanding of its clinical applications is currently being greatly expanded. This opinion piece covers the advances in imaging techniques that enable the demonstration of the suprachoroidal space, and its implication in various retinal pathologies. It also reviews its potential uses as a route for drug delivery for the treatment of retinal diseases, and its use in innovative surgical techniques. Current research is leading the way for the suprachoroidal space to be an aspect of retinal disease diagnosis, monitoring, medical treatment, and surgical manipulation.

Revisitando el concepto de identificación proyectiva kleiniano desde una perspectiva intersubjetiva / Re-visiting the kleinian concept of projective identification from an intersubjective perspective

Se revisa brevemente la historia el concepto de Identificación Proyectiva, intentando ponerlo en relación con los actuales descubrimientos neurocientíficos acerca de las neuronas espejo y su rol en las raíces de la empatía humana. De esa exploración surgen ideas de cierta utilidad clínica para el trabajo con pacientes con núcleos psicóticos. Se plantean algunas reflexiones para la comprensión de la manera en la que se ven interferidos los procesos de simbolización en este tipo de pacientes, a partir del material clínico de un paciente afectado de Síndrome de Asperger.Palabras claves: Asperger, simbolización, espacio potencial, espacio transicional, identificación proyectiva, neuronas espejo, empatía, intersubjetividad, simulación encarnada.

The history of the projective identification concept is reviewed briefly, trying to put it in relation with current neuro-scientific findings about mirror neurons and his role in the human empathy roots. From this exploration appear ideas of clinical utility for working with patients with psychotic core. Some reflections are presented for the understanding of the way in that the symbolic processes are interfered with this kind of patients, from a clinical material of a patient affected by Asperger syndrome.

Kafka, Winnicott e a Boneca Viajante: perder, narrar, resgatar / Kafka, Winnicott and the Traveling Doll: loe, tell, rescue / Kafka, Winnicott et La Poupée Voyageuse: perdre, raconter, récupérer / Kafka, Winnicott y la Muñeca Viajera: perder, narrar, recuperar

Este artigo apresenta uma reflexão sobre o livro Kafka e a Boneca Viajante, a partir de conceitos desenvolvidos por D. W. Winnicott, tais como objetos e fenômenos transicionais, jogo do rabisco, espaço potencial, importância do brincar, fazendo-se, ainda, uma analogia com a constituição do vínculo terapeuta e paciente. A reflexão proposta permitiu ressaltar o quanto processos analíticos podem levar à vivência de experiências emocionais transformadoras, convertendo objetos perdidos nas diversas formas de cultura.(AU)

This paper consists of a reflection on the book "Kafka and the Traveling Doll," by Jordi Sierra i Fabra (2006). The book is based on Winnicottian concepts such as transitional objects and transitional phenomena, potential space, the importance of playing, and the construction of the relationship between analyst and patient. This reflection shows that the analytic process gives rise to transformative emotional experiences that can modify lost objects into different cultural phenomena.(AU)

Cet article propose une réflexion sur le livre "Kafka et la poupée voyageuse", de Jordi Sierra i Fabra (2006), construite à partir des concepts winnicottiens: objets et phénomènes transitionnels, jeu du gribouillis, espace potentiel, l'importance du jeu. Nous suggérons d'ailleurs une analogie de la construction du lien entre l'analyste et le patient. Notre réflexion met en relief à quel point le processus analytique peut engendrer des expériences émotionnelles transformatrices en changeant les objets perdus en diverses formes culturelles.(AU)

Este artículo apresenta una reflexión en torno del libro "Kafka y la Muñeca Viajera", a partir de los conceptos desarrollados por DW Winnicott, como objeto y fenómeno transicionales, el juego de garabatos, espacio potencial, importancia del jugar; también se hace una analogía con la creación del vínculo terapeuta y paciente. Esta reflexión ha permitido enfatizar que los procesos de análisis pueden conducir a experiencias emocionales transformadoras, con la conversión de los objetos perdidos en las diversas formas de cultura.(AU)

Kafka, Winnicott e a Boneca Viajante: perder, narrar, resgatar / Kafka, Winnicott and the Traveling Doll: loe, tell, rescue / Kafka, Winnicott et La Poupée Voyageuse: perdre, raconter, récupérer / Kafka, Winnicott y la Muñeca Viajera: perder, narrar, recuperar

Este artigo apresenta uma reflexão sobre o livro Kafka e a Boneca Viajante, a partir de conceitos desenvolvidos por D. W. Winnicott, tais como objetos e fenômenos transicionais, jogo do rabisco, espaço potencial, importância do brincar, fazendo-se, ainda, uma analogia com a constituição do vínculo terapeuta e paciente. A reflexão proposta permitiu ressaltar o quanto processos analíticos podem levar à vivência de experiências emocionais transformadoras, convertendo objetos perdidos nas diversas formas de cultura.

This paper consists of a reflection on the book "Kafka and the Traveling Doll," by Jordi Sierra i Fabra (2006). The book is based on Winnicottian concepts such as transitional objects and transitional phenomena, potential space, the importance of playing, and the construction of the relationship between analyst and patient. This reflection shows that the analytic process gives rise to transformative emotional experiences that can modify lost objects into different cultural phenomena.

Cet article propose une réflexion sur le livre "Kafka et la poupée voyageuse", de Jordi Sierra i Fabra (2006), construite à partir des concepts winnicottiens: objets et phénomènes transitionnels, jeu du gribouillis, espace potentiel, l'importance du jeu. Nous suggérons d'ailleurs une analogie de la construction du lien entre l'analyste et le patient. Notre réflexion met en relief à quel point le processus analytique peut engendrer des expériences émotionnelles transformatrices en changeant les objets perdus en diverses formes culturelles.

Este artículo apresenta una reflexión en torno del libro "Kafka y la Muñeca Viajera", a partir de los conceptos desarrollados por DW Winnicott, como objeto y fenómeno transicionales, el juego de garabatos, espacio potencial, importancia del jugar; también se hace una analogía con la creación del vínculo terapeuta y paciente. Esta reflexión ha permitido enfatizar que los procesos de análisis pueden conducir a experiencias emocionales transformadoras, con la conversión de los objetos perdidos en las diversas formas de cultura.

De Ana-e-seu-bebê à Ana: um percurso clínico com Winnicott / From Hanna-and-her-baby to Hanna: a clinical path with Winnicott

Segundo Winnicott, o nascimento de um bebê desencadeia em sua mãe um adoecimento/saudável que permite que esta exerça suas funções fundando condições facilitadoras ao desenvolvimento de seu filho. No caso clínico apresentado, um impasse nessa relação primordial precipitou a entrada em análise e ambos compareciam às sessões apresentando respostas à situação instaurada a partir de planos defensivos diferenciados: o adoecimento físico (bebê) e a fuga à intelectualidade (mãe). Apresentam-se alguns movimentos clínicos entendo-os a partir dos conceitos winnicottianos de integração, personalização, holding, placement e espaço potencial. Finaliza-se tecendo considerações sobre a possibilidade do espaço clínico exercer a função de espaço potencial no interior do qual a unidade mãe/bebê ganhou contornos de diferenciação, demandando, da analista, uma reflexão sobre a função que ocupou nessa cena.(AU)

The birth of a baby brings the mother to a special psychological state that allows her to exercise her maternal functions in order to create a facilitating environment for her child's development. We present a clinical case study where this relation came to a dilemma that caused a demand for psychoanalysis treatment where both came to the sessions presenting different defense mechanisms: somatic illness (baby) and rationalizing (mother). We describe some clinical movements trying to understand them from some of Winnicott's concepts of integration, personalizing, holding and potential space. We conclude by proposing that clinical space can perform the function of potential space so that the unity mother/baby might more differentiation. Some considerations about transference and counter-transference are made.(AU)