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.
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