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Commentary on "The pain and body language"

By Joaquim Caretti.
Psychoanalyst in Madrid

1 .- What takes this book?
This book is thinking about fibromyalgia and the pain from a different perspective to the consensus for science and meddle where there is something that does not work, clearing in a unique way. It is held in an extended care practice of patients with fibromyalgia, first treated by doctors who subsequently referred to a psychiatrist. All this within a research program agreed with the doctors themselves.
The central hypothesis of this book is that chronic pain without identifiable organic damage is related to the unconscious structure of the subject. Pain has taken the drift of the body, taking over this and that, permanently installed, it makes life unbearable to the patient. What is interesting and I leave for the debate, is that Santiago Castellanos transclínico speaks of a symptom, ie can do this in any structure. This prevents think fibromyalgia only, such as converting an expression in a hysterical structure. It is possible to understand, then, this symptom as an "all purpose", which brings us to the enigma of the relationship between body and language. We may wonder why this chronic pain is manifested in any structure, or rather, could it be that is the medicine which, under his gaze phenomenological unifies in a single diagnosis that is a pain radically different for each subject?
understand that the work of this book is to answer this question because their intention is, in most cases, bore the significant master fibromyalgia, the unifying diagnosis, where all patients are equal before the law regulating medicine for more than assert that there are no diseases but sick. This does not mean that there are no doctors who do not follow this maxim but it is a task against the current prevailing scientific discourse that believes in the diagnostic categories at face value. Physicians who inhabit the sea islands in the dominant discourse. You can bet to make islands and then a continent.

2. A political book
From what I am saying is clear, in my opinion, this book is a political book. If we understand what sustains policy Alain Badiou, "The policy is not performing as possible but politics is the creation of new possibilities" we can see that the text is a political reading of fibromyalgia that is contrary to the depoliticization of everyday life as what we live every day is exactly the realm of possibility, and this text is going to mess with the impossibility of a pain does not subside, pain that was emphasized as a real sense but showing the face of it more authentic suffers. Is a clinical trial that does not conform with the possible but aims to create new opportunities to the word via the transfer-enter the body and relieve himself. Santiago task Castellanos describes as "an operation of de-identification of the subject so he could talk about what you own and unique" is not a book
innocent as it is a sharp cut with the ideology of medical discourse: there is a sore subject that, by being included in fibromyalgia as a universal categorization, is prevented from doing work on their own unconscious. Remains attached to a signifier which, although in some cases it can help the giver of identity that is going to encourage the establishment of pain in the body. This text political combat, policy for all the same thing in the medical field, takes place in any order of life: politics, economics, psychology, ethics, culture, sports, education, health, religion, social assistance are dominated by this speech. Nothing is beyond the discourse that attempts to treat the discomfort of the plugs, in the form of suggestion, deception, storytelling, imposition or violence.
Thus this text is to argue that there is a confrontation between two ways of understanding the approach of discomfort. Cognitive-behavioral therapies-speech Master-that attempt an adaptation of the patient to their situation and psychoanalysis that seeks to put as northern approach to the symptom of any subjectivity of the speaking being. Is not this confrontation which we live also social as when we see how the dominant discourse wipes out any form of emancipatory politics subjecting the masses to the misery of a life lived in the solitude of his enjoyment? I think so. So psychoanalytic discourse is a subversive discourse, not revolutionary, as it aims to question the strength of love in all areas, making the construction of the ordinary not to mention the indelible mark of the unconscious and enjoyment. So the position of psychoanalysts never be a comfortable position, rather than remain exclusively in their offices thinking they do not have to do with politics. It is the discourse of psychoanalysis that goes beyond the psychoanalysts unique.
also want to emphasize that this book reads an ethical position that is to say for the welfare of the patient. Search the sufferer may well say his discomfort and thus find ways of its resolution, a new departure for the "pain highway" as the figure used in this book.
3. The author
Finally I want to say that this book is the fruit of the intellectual trajectory of Santiago Castellanos, but not only. It is also an expression of a course of life ranging from medicine to psychoanalysis, via the experience of the unconscious. Freud is a path: the desire to cure the non-desire to heal, the etiology of the absent cause, protector of all the unique solitude. Caretti Joaquin Rivers

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START OF THE DARK REFLECTION an unbeatable!

Distracted life around you: dolphins, forests, seas, mountains, rivers. Do not fall as fell thy brother, who suffers from a human being when the world is 5.600 million. Also it is not so bad to live alone.

I have a good time, deciding at each moment I want to do, and thanks to the solitude I know, which is essential to live.

not fall as fell thy father, who feels it is 70 years old, forgetting that Moses led the exodus to the 80 and played like nobody Rubinstein Chopin 90. Just to mention two known cases. Not

depressed, you're distracted, so you think you lost something, which is impossible, because everything was given thee. You did not even a hair of your head so you can not own anything. And life does not take away things, frees you from things. Eases you to fly higher, to reach the fullness. From the cradle to the grave is a school, so what you call problems are lessons.

not missed anyone, who died just ahead of us, because> here we go all. Besides the better of him, love is in your heart. Who can say that Jesus is dead? There is no death, no move. On the other side waiting for you wonderful people: Gandhi, Michelangelo, Whitman, San Augustine, Mother Teresa, your grandmother and my mother, who believed that poverty is closer to love, because money distracts us too much, and distances us that makes us suspicious.

Just do what you love and be happy, and doing what he loves, is blessedly condemned to success, which will arrive when you need to go, because what should be will be, and will come naturally. Do not do anything for obligation or commitment, but for love. Then there will be full, and in the fullness anything is possible. And because it moves effortlessly natural force of life, which I raised when the plane went down with my wife and my daughter that kept me live when doctors diagnosed me 3 or 4 months of life.

God gave you a human being in charge, and you yourself. To you make you free and happy, then you can share real life with others. Remember

Jesus: "Love your neighbor as yourself." Reconciled with you, stand in front of the mirror and think you're seeing this creature is God's work, and decide now to be happy because happiness is an acquisition.

addition, happiness is not a right but a duty, because if you're not happy, these bitter to all who love you. A single man who had neither talent nor the courage to live, sent to kill six million brothers Jews.

There are so many things to enjoy and our time on earth is so short that suffering is a waste of time. We have to enjoy the winter snow and spring flowers, chocolate of Perugia, the French baguette, Mexican tacos, Chilean wine, seas and rivers, brazilian soccer, One Thousand and One Nights, Divine Comedy, Don Quixote, Pedro Páramo, boleros of Manzanero and Whitman's poetry, Mahler, Mozart, Chopin, Beethoven, Caravaggio, Rembrandt, Velasquez, Picasso and Tamayo among so many wonders.

And if you have cancer or AIDS, two things can happen and both are good, and if you win, you free the body that is so annoying: I have hunger, I have cold, I have dreams, I have wanted, I have reason, I have doubts .... and if you win, you will be humble, more grateful, therefore easily happy. Free

the tremendous burden of guilt, responsibility, and vanity, ready to live each moment deeply as it should.

're not depressed, you're unemployed. Help the child who needs you, that child will be a member of your child. Help the aged, and young people will help you when you are. In addition, the service is a certain happiness, and enjoy the nature and care for those to come. Given without measure and give you no action. Ama
to become the beloved, even more to become the very love.

And do not mistake you for a few homicidal and suicidal, the majority, but it is not noticeable because it is quiet, a pump makes more noise than a touch, but for every bomb that will destroy millions of strokes which feeds life . Facundo Cabral

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You, you all
all that meat on the street
stacks, you are
for my food, all those eyes

covered gummy, like someone does not stop
never wake up, as
looking without seeing or just thirsty
of the absurd penalty of another look, you all

you are for my food, and fear deep

have the mirror glass only those eyes, the fog
they cross the dead, that
is the price I pay for my food.

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COMMENTARY TO THE BOOK: "THE PAIN AND THE LANGUAGES OF THE BODY".

By Rosa Lopez. Psychoanalyst in Madrid.

I have witnessed the history of Santiago Castellanos in psychoanalysis from the beginning, so I could verify directly how his passage from the doctor speaking to analytic discourse. I do not think that this process has been simple, or as the result of a progression in training, it really
is a qualitative change as the book shows that we have today on the table.
Why say this?, Because "being a doctor" is something that gives a strong identity and a position involving address deep-rooted disease, based on the desire to heal. I wish that initially seems very laudable, but it has its serious drawbacks because sometimes prevails over the truth of what is at stake
in human suffering, unknown, and cutting off the pace.
know the figure of the physician, standing at the place of love, holds the know with a kind of omnipotence that one is beyond question.
There are many jokes about this feature, remember one that said: What is the difference between a doctor of God?. That God does not believe physician.
But we also know, and every day, the doctor feels helpless as the check every day how their knowledge is not sufficient to account for the complexity of what goes on not speaking beings.
these doctors is divided in its function, sensitive to the uniqueness of each patient, determined that the inability of the practice did not lead to the exercise of power, which they can open this book an important horizon.
But it's not exactly written a book for doctors, is a book for psychoanalysts, as being the result of extensive research in the work of Freud, and especially that of Lacan, provides a systematic organization of knowledge of psychoanalysis on the body, a huge value to psychoanalysts insist.
could paraphrase to Wody Allen in "Everything You Wanted to Know About Sex", but it seems rather familiar. How to say otherwise?. Make a study of the text and get a full picture of the places in which Lacan talks about body language, illness or pain. Of course, each of these appointments can go deeper and deeper, in that sense there is no completeness
possible, but if I'm not mistaken they are all collected. So formidable is a study guide on the subject. Not only that, it is also very explanatory. We agree that an understanding of Lacan's not easy and requires mastery of important psychoanalytic language. But even when we
Lacanian signifiers used to and know the basics of his teaching, always have the impression of not knowing how to articulate certain concepts with others, or you do not find clear how to reconcile theory with practice. Santiago Castellanos
has done it and I say this honestly, not only because it is a good friend, but for the purpose of clarification that has occurred to me. So many times I read these words of Lacan and yet after reading the book I understand them better than before.
Why do I mention all the time not so much to Lacan and Freud?. Is due to a particular perception of my reading. For my taste, I insist on this, the first part of the book devoted to Freud is interesting and explanatory, but it has the same force as the second dedicated to the teaching of Lacan. There is a turning point in the text
Santiago begins to take flight and take off, then raising a desire to continue with the reading, highlight each paragraph, note taking and finally get some sort of satisfaction.
In this last part are presented the developments of the teaching of Jacques Alain Miller, with whom Santiago Castellanos provides a rigorous clinical differential over the body, from the neurotic symptoms, to psychosomatic phenomena and events culminating in own body of psychosis.
So far I have not mentioned what I believe is the fundamental characteristic of "The pain and body language": the abundance of clinical cases.
Notice how it begins: "A few years after starting work in medicine came to me a young actress is suffering from severe pain in the knee that prevented him from walking and working ......."
starts directly without preamble, with a clinical case with words Freud: the doctor who makes the beautiful hysterical work on the psychic cause. After this boot so the foot of the clinical encounter for the rest of the book, as the theory is illustrated with cases permanently. The second chapter
borrows a patient of Freud's famous Von Elizabeth R (true paradigm of what is now termed "fibromyalgia"), and the chapter on psychosomatic phenomena is an extensive review of the testimony of Montribo Patrik Pass, but the rest of the examples come from his own clinic.
addition to the case of the beautiful actress, if I may so call it Santiago, I've tried the rest of the clinical illustrations, which I will comment briefly.
2) The 68 year old woman diagnosed with fibromyalgia, very medicated for years, and last but not least the worst victim of therapies, they offered interpretations like this: "What happens is a viral disease, by a son and a separation. " ! That "melange" of causes! ! That confusion to the subject!.
A case of iatrogenic medical and psychotherapeutic, worse than the other.
3) The woman who could not swallow and the specialist endoscopy makes it a differential diagnosis on the spot by saying that what we have is a "bolo hysterical" adding "do not worry, I myself have suffered a hysterical bolus ". A nice example that shows how physicians now not only do not ignore the hysterical symptoms, but are sympathetic to them, most perplexing of the patient.
4) Man of the 24 boats of urine, that following the medical demand had made the huge effort to count the enjoyment of the body in 24 clearly labeled vials to see how clinical assistant was going to mix them, measuring all the liquid and then throw it away. Being a manic depressive, the agitation of the patient's reaction was immediate.
5) The woman goes silent pain in the body by symptom analysis than the allowed questioning about their femininity, their sexuality and relationship. Case which clearly verify the effects of psychoanalytic listening that the symptom
put in place. In this case, the author weaves an answer on the question open for medical statistics revealing that fibromyalgia is a disease of women.
"havoc with relationships are a constant partner in the clinic of fibromyalgia." "The demand for love on female sexuality occupies a unique role in relation to the male." "The enjoyment female has no stable location sexuation male." They extract text phrases
with demonstrating that psychoanalysis is a discourse that women could think like no other.
6) But not all affected in fibromyalgia want to leave this signifier that gives an identity and consent to sexual cause analysis, and illustrates another 57 year old patient after a period of one year preliminary interviews displayed their difficulties experience sexual pleasure and decides not to continue treatment.
7) There is another case in which not only verifies the rapid therapeutic effects, but what is more important, that were preserved over time. Effects that emerge after a hard work in which the subject has to put into play how pain and enjoyment oscillate between the relationship with the mother and the love of men. The speech
makes a turn and the subject goes from talking about pain to speak of love, so in the fifth interview manages to establish with precision the knot that is muddled.
8) But not all success in psychoanalysis, as well as those subject who did not consent to treatment because they want to know anything about the truth are those who may become worse. To illustrate the main difficulties of the clinic,
Santiago brings a case in which after the diagnosis of fibromyalgia is psychosomatic phenomena masking severe and profound depressive symptoms, allowing you to enter the Lacanian theory on the psychosomatic.
9) In the field of psychosis is an example that is like the icing on the cake. The case of the illusionist. This is a middle-aged man with hypochondriacal fears that has undergone years of behavioral treatments
absolutely fruitless and thanks to the analysis gets to build a know-how which allows it to enjoy peace of invasive suffering.
10) Finally Gonzala 45 years illustrates a clinical question that probably only psychoanalysts can grasp, as seems to contain a paradox. When the subject is very scarce resource symbolic (psychosis not well-formed delusions) fibromyalgia is itself a resource for further hooked
the Other (Health Center, specialists etc). One possible way to make life livable. So it's "consent as a lesser evil, that the patient can perform these routes with the least possible iatrogenic"

Rosa López. Comments submitted in the book "The pain and body language" in Madrid. Rosa Lopez is a member of the PLA headquarters director and teacher NUCEP Madrid.