Contribution of the Freudian Theory of Psychosis in the Diagnosis of Mental Disorder

Abstract

The article presents my research in psychoanalytic psychopathology on the psychic etiology of psychosis, carried out between 2012 and 2020 at Universidade Federal Fluminense (Volta Redonda, Brazil). In Brazil, patients with various mental disorders rely on the Brazilian Unified Health System which aimed at treatment and psychosocial rehabilitation services. These services are called Psychosocial Care Centers (CAPS). There is an innovation in mental health treatment because they replace the treatment model for mental disorders directed only at hospital admissions. The clinical treatment of mental disorders in CAPS is organized into unique therapeutic projects. It is characterized by a multidisciplinary team in an open, non-hospital environment, close to the patient’s place of residence. Since 1996, the SUS-Brazil diagnostic guidelines are used to conduct epidemiological studies, formulate public policies on mental health, and establish its funding for the mental health network. These manuals ignore the presence of etiological factors of a psychological nature and exclude the theoretical framework in the definition of disorders. The absence of consideration of etiological factors and the exclusion of theoretical frameworks is evident in the way the DSM-5 defines the spectrum of schizophrenia, resulting in the predominance of schizophrenia in the clarification of psychotic disorders and, consequently, in the weakening of the classic category of psychosis. My research aims to contribute to psychosis by examining the role of delusion in the onset of psychosis, triggering events, and stabilizing the psychotic structure. This article aims to present the hypothesis of the psychic etiology of psychosis from the contributions of Sigmund Freud. This theorizing is significant as it introduces the hypothesis of loss, restitution, and recovery into the psychiatric lexicon of the opposition between schizophrenia and paranoia. To this end, this article exhibits a survey of Freudian references to emphasize the construction of an original theory of psychosis, where: 1) The consideration of the functioning of drives is relevant in isolating psychic etiology from its triggers; 2) A redefinition of the concept of delusion signals the originality of the Freudian theory of the stabilization of psychoses: delusion is defined as a psychic effort of recovery, an attempt at reaching a cure.