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eISSN: 2373-6445

Psychology & Clinical Psychiatry

Review Article Volume 11 Issue 3

Infans insistence: from medicated silence to infringement appeal 

Adriana Simões Marino

Department of Psychology, University of São Paulo, SP, Brazil

Correspondence: Adriana Simões Marino, Department of Psychology , Master and PhD in Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil

Received: April 24, 2020 | Published: June 30, 2020

Citation: Marino AS. Infans insistence: from medicated silence to infringement appeal. J Psychol Clin Psychiatry. 2020;11(3):90-93. DOI: 10.15406/jpcpy.2020.11.00678

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The text starts from a question about the specificity of the psychoanalytic clinic with children. Through excerpts from a clinical case, it addresses the power of care with children, in its dimension of teaching about psychoanalytic listening. It brings the concepts of unconscious and fundamental fantasy, in addition to covering notions about the direction of treatment and children in psychoanalysis. Then, it addresses the issue of the production and dissemination of diagnoses and therapies that corroborate the subjective silencing of what is a manifestation of the structural infantile in the human. Finally, it investigates the theme of the infraction as a symbolic appeal, of subjective recognition and the right to voice, at the heart of the way of life inscribed in the discourse of capitalism.

Keywords: offense, kid, medicalization, psychoanalysis

Fragments of a teaching

The clinic with children was, from the beginning, a privileged space for my training as a psychoanalyst. I refer to the importance in terms of teaching and transmission that the clinic with children can offer. If, with psychoanalysis, we learn that it is always about listening to the subject regardless of chronological age - since the unconscious does not recognize negation, contradiction and chronological time - we have that the time of the unconscious follows its own logic. and that it is always a listening to the subject of the unconscious, of desire, according to the psychoanalytic ethics that guides us.

Even attentive to the psychoanalytic theory, which teaches us that floating listening does not discriminate the subject by their age group, it is common to ask ourselves, if there is any specificity of the clinic with children. After all, there are phases of life that bring particularities, such as children who still do not speak, I mean, in order to articulate their thoughts through spoken language.

Infans, as we learned from Ariès,1 is the one who does not speak, who is distinguished from the adult by a non-appropriation of speech. So, if psychoanalysis is based on the rule of free association, how will psychoanalysis take place with children who have not yet reached this articulation of language expressed through speech? The answer is (as we learned from precursors of psychoanalysis with children): through playing. Would playing, then, be a specific feature of the analysis with children? Here, the Winnicottian analysts would bring us a warning, because playing is beyond what we can apprehend at first sight, in that it can be apprehended as a means and objective of any treatment and regardless of age.2 So, are there specifics of the clinic with children or not?

Supervisors usually ask: “Don't you have a play box for each child in your office?”; "A family of dolls?"; "Paints, chalk, colored pencils, dolls?" I have a single box with a series of trinkets, some games and the same room with two armchairs, a desk, divan, tables to support plants and handkerchiefs, bookshelves piled with books and lampshades. The room, it is possible to say, seems not very playful. But I also care for children and it is with them that I learn a lot about what you do when you do psychoanalysis. They teach, always and each time, the radicality contained in Lacan's following warning.3

This is exactly the difficulty of the one I try to get as close as I can to the analyst's discourse - he must find himself at the opposite pole to any desire, at least confessed, to dominate. She said at least confessed not because she has to hide it but because, after all, it is always easy to slip back into the discourse of domination, of mastery.

It is easy to slip into mastery, that is, to that place of power of the Lord. It is also easy, and especially with children, to slip into the university discourse, putting the subject in the place of a student - one who is not yet sufficiently grown and adapted to the adult world.Such conception is aligned with the notion of childhood as a phase of life to be overcome during its biological, psychological and social development. However, psychoanalysis finds itself averse to the alleged adaptations and norms inherent to civilization. It is the opposite of “adultices”, as mentioned by Mafalda,4 Quino's character.

To illustrate these risks, I bring to mind a fragment of a session with a four-year-old child, which occurred in 2008. In a session, after times when the child was entertained with some trinkets, I ask: “You will not speak ?”. To which she promptly replied: "I'm already talking!" As Lacan5 referred, the psychoanalyst pays with his words - which rise to the category of interpretation -, with his own person - borrowed from the unconscious phenomena caused by the transference - and with his losses. Anyway, it was necessary for the analyst to pay with her ears if she really wanted to listen to her. These were times when I learned the radicality contained in listening to psychoanalysis.

That same child was the one who became, in another session, the Hulk. Just to put it in context, it was brought by the parents, who said they were “very dynamic”, “intelligent” and who liked to play on the computer. In those times, he claimed to be the "bionic man" and even the "spider man". A year earlier, they changed schools because of the “punishments” of the former teacher. It so happened that he has since abandoned the toilet to make way for the diaper again. The justification given by the child was that the toilet was the "frog mouth", that "talked", "kept talking".

The object (feces) had been cathexed and articulated to the significant dimension of language, that is, the child started to fixate itself in a relationship with that object. In this particular relationship of retention, difficulty letting go, falling or losing something of himself and impasse to symbolic exchanges, the child responded to the always traumatic encounter with what the symbolic Other lacks, identifying himself with a masculine position - with bionic tones or spider - and feared the mouth of the toilet.

The themes that covered the two years of analysis were feces, dirt and disorder, often explored in the office bathroom (which also became a setting). I used to take paints (at the time, I bet on this tactic) until, one time, it was transformed. Nothing was left out: he painted hands, arms, feet, legs and his face all green. She then said that she looked like the Hulk. In the next session, the child said that he no longer needed the play box and his parents said that he was pooping in the toilet. He built a "house" with a quilt from his office and played "little house". She was the mother who would not let her analyst daughter leave the house. He would come and go, poop where there would be a bathroom and say that the analyst daughter could not leave. He brought "gifts" of small drawings made on cards and gave names to the figures with guttural sounds.

After a while, he demanded the diaper again, but this time, with the presence of a malaise for not being more "little child". She started to identify herself with a “princess” and to worry about the diaper that she demanded. He began to count boys and girls cards and, differentiating them, he chose to keep the girls' cards. A year and a half later, he changed schools again because the teacher “fought”. She said she “did nothing”, but the teacher said she “did everything”. At the new school, the teacher was distressed when she and a classmate disappeared for hours.

In a session with the child, the mother and father were able to confront the teacher's notes when looking at the daughter's place as a subject. After all, the justification given by the child was that they followed "magical footprints". After that session, when they left the door, the child said that the analyst "would stay there with the ghosts". After all, this is the place of analyst when it comes to the child that permeates the fantasy. It deals with the child as the subject of a clinic that is always a montage of fiction about the structural child, beyond or beyond childhood as a phase of life.

As is common in visits to children, the transient phobia with the private one has disappeared - which indicates that it is not the case to exclude discussions about possible particularities in the clinic with children. We continued the sessions, resuming the ghosts that she said she left at each session there, until the moment when the family moved to another city. The child had already abandoned the diaper, giving other symptomatic features in the context of his neurosis. There were other developments in the course of the sessions, but I think the fragments are sufficient for what we are working on in this text. The child is at the heart of the concept of structure in psychoanalysis, as a result of a process that leaves a rest that allows the construction of a response under the mark of a fiction. As far as the unconscious ghost is concerned, we are always childish.

The logic of fantasy, of children as a place where fantasy is built - which determines its impossibility of interpretation - allows us to apprehend that it is a question of highlighting what the infans were repressed (it could not be said), making use of it as a way the subject to position himself in front of the world. Fantasy is the subject's response to the traumatic encounter with the signifier. This signifier of desire, that is, of the lack of/in the Other that crosses the constitution of the subject, is a tipping point, a significant operation that generates a rest that is impossible to signify.6 The constitution of the subject attests that the fantasy is found at this moment in which one is subject, that which becomes the effect of the significant chain, positioning itself in relation to the world.

As Prates7 tells us, it is an operation that goes through the conception of the phases of life, as it refers to a rest that is inaccessible to consciousness, constitutive of the unconscious. Of this remainder, given the lack of knowledge about sex, the subject creates the object that is both the cause of desire and the object of enjoyment. In an analysis, the truth status of fantasy is revealed, through its construction through the articulation of the Other scene in signifiers. But it is always a speech without words, that is, there is something childlike that remains as impossible to be all-said.

When we resume that infantile amnesia is that which the infant forgets that has been forgotten, it remains to build our house of cards until it can collapse, as if by grace of a child's play, like traces of a canvas painted in green. This is the direction of an analysis.

Infans silencing

With the fragments of sessions brought earlier, we worked on some theoretical elements about the structural child, the timelessness of the subject of the unconscious and the construction of fantasy in a process of analysis. More especially, I tried to highlight how I learned from this child somewhat about psychoanalytic listening, in addition to teaching myself about clinical management and treatment direction. However, as I wrote about these clinical excerpts, I found, with some surprise, that I had omitted something. The lapse is that it was this same child whom teachers and coordinators of three schools - where he studied during most of the time spent in analysis - said it was a case of Attention Deficit Hyperactivity Disorder (ADHD).

It is about the deception promoted in silencing strategies, such as that which is found in the abuse of diagnoses and psychotropic drugs in our times, which we will address at this moment. We run the serious risk of allegedly removing children from their condition of subject, which refers to the impossibility of adapting to unconscious desire. Despite the fact that it was possible to carry out work with the child, his family and school workers, in the sense of considering the so-called “scientific” and common sense regarding the possible consequences of this diagnosis, it is important to say that the work was not without difficulties. While fantasy is constructed in an analysis, some ghosts can be deconstructed in the social sphere.

The scientific development of the 19th century became involved in the concept of “norm” and found its spread, precisely, in school and health institutions. Rationalization became a requirement, as Canguilhem8 taught us, also in politics and economics "under the influence of a nascent industrial machinery" that led to "what has been called normalization ever since" (pp. 209-210) The Latin word norm means "square" and normals "perpendicular". It is a requirement imposed and not reflected on an existence considered hostile and foreign to what escapes a widespread interior as a rule, becoming normative.

At that same time and, therefore, under the influence of the norm, medicine was marked by the search for a mechanistic understanding, of a truth based on the determinism of biological functioning considered regular in man. The second half of the twentieth century, on the other hand, reflected the advances of this model of science, with the developments in organic psychiatry, psychopharmacology and neurology.9

In the time that the analysis of the fragments brought with the child, I attended another child of the same age and I was able to learn something about the effects of methylphenidate hydrochloride - a psychostimulant present in medications such as Ritalin® and Concerta®. This child, whose mother's complaint was that she was "naughty" and who had climbed twice through the house's gate to the roof of the garage, also changed. However, his transformation was not due to the green color of a Hulk, but a significant change in his ways of relating to others in the world. He started to sit in the sessions, played little and spoke prudently - as if, since then, he took care of what he was going to say. In other words, he came to embody Mafalda's “adultice”.

The diagnosis of ADHD is fundamentally clinical, that is, there are no biological markers about this disorder.10 It should be noted, as pointed out by Amarante and Torre,11 the power of the pharmaceutical industries and research funded by laboratories in determining diagnoses and treatments whose focus is on medications and psychotherapies based on behavioral corrections and adaptations. These authors warn that “Brazil is one of the countries where the greatest medicalization of childhood occurs worldwide”. According to research data from the Regional Council of Psychology of São Paulo,10 in this municipality, the amount of methylphenidate pills purchased doubled between 2008 and 2010.

In the search for the ingestion of substances that silence what goes against what causes social discomfort, medications are used with a view to normalizing or normalizing behavior. True “chatting”. By suppressing symptoms, they make silencing the best invitation to good contemporary social conviction, namely, individualism. The medicalization of the social, as Foucault12 taught us, concerns precisely a process of restriction to the medical discourse of everything that concerns the most diverse human manifestations. In this way, we agree with Amarante and Torre11 that “a certain form of knowledge production in this field can create realities of diseases, treatments, institutional, social, cultural and political practices”.

It is possible to infer that there are no limits when it comes to the creation of new diagnostic categories for new drugs. In the words of Quinet,13 it is opportune to question whether, instead of having “drugs that are increasingly effective in combating new evils resulting from the transformation of society, are they not the 'evils' that are now created and categorized into new syndromes? then to be treated by the new drugs? ”.

Faced with the imperatives of normalization and standardization, children end up finding in the definition of childhood an impulse to silence. Such a definition, imbued in the conception of the individual in a peculiar condition of development, concerns the person who is not yet considered a subject. Thus, with the increase in prescriptions for psychotropic drugs in childhood, what is evident is that the child has become an object of neuroscientific medical discourse, which, as we intend to emphasize, started to seek its suppression through the silencing of behaviors considered to be in disagreement. In this overlap, what happens is that the child must give up his place as a subject in favor of an impossible adaptability.

Between psychotropic drugs and the silencing of subjectivity, are we not facing the same concept of infans, that is, the one who does not speak? In view of technological advances, are we not going back to a time when the child was not entitled to a voice?

Infringement appeal

Faced with the insistence of the world of “adultices” to appropriate the child as the one who does not speak (infans), it is possible to apprehend another phenomenon of our civilizational malaise, namely, the infraction. From the psychoanalytic framework, these acts considered to be outlaws can be considered from the subjective crossing by the dictates of the way of life produced within Capitalism.14 In this way of life, human relations are marked by a logic in which individualism and access to consumption objects are privileged. In the words of Lacan,3 what stands out in what he developed as a “discourse of the capitalist”-a variation of the master discourse - is not the divided subject of the unconscious, but completed via capital accumulation, rejecting symbolic castration . Commodity objects are imagined with a false completeness. In this way, this discourse denies castration, the constitutive lack of desire, making it believe that it would be possible to satisfy - through goods consumed or used to consume - a promise of full satisfaction.

At first, then, we can say that the infraction is in the wake of this discourse that, by denying castration, would put the paternal function in check. However, the signifier of the Name-of-the-Father is a concept brought by Lacan5 to address this function. It is an operation that includes the subject in the symbolic register, that is, it allows the child to stop being a passive object of maternal desire, to constitute his subjectivity and insert himself in the world of language, in culture.

The author is categorical in saying that it is not about the strong or weak role, present or absent from the father, to assert his presence in the structure. Despite the influence it may have on a subject's fantasy, the figure of the father in the family, it is not a condition for the existence of the Name-of-the-Father as a structuring and organizing function of subjectivity. For psychoanalysis, the father has the role of agent of symbolic castration. As a signifier that promotes the paternal metaphor, its structural and logical result is the production of subjects submitted to the language code and, therefore, submitted to the phallic law. But, if the phallic significance stems from this significant incidence, the capitalist's discourse reveals a social problem, insofar as only a few will be able to access consumer goods; others will be left out.

It is in this sense that we understand that there is an “appeal” in the infraction, a demand for recognition and an exit inscribed in the phallic function (it is not exactly outside the law in psychoanalytic terms). The symptom, as a metaphor, is constructed so that the subject does not perceive himself to be missing. Thus, it is interesting to reflect that the offense, while referring to the symbolic instance (phallic output), corresponds to individualism and the craving for consumption, disseminated by Capitalism. After all, this discourse proclaims access to the object, the indulgence of desire. In this discourse, therefore, violence can be understood as a manifestation of a right of full satisfaction, as it acquires a dimension of correlation to individual freedom and free trade that are updated in consumption.

While carrying the ambitious expectation of fulfilling the adult's desire, children harbor the collective ideals crossed by the discourses present in the culture. In their outlaw acts, there are subjects who relate to objects in a particular way: through violent capture, usurpation of objects whose financial value is not the only prerogative. The infraction may be flawed because it is significant, insofar as it seeks to annul the third instance corresponding to the symbolic father; it opposes the discourse of the master who proclaims for the ideal worker and the order for his functioning.

According to Rosa,15 the delinquent act is a form of bond that reveals a social symptom, insofar as alienation is crossed by the perverted relationship of objects offered by Capitalism, which lose their character of exchange (symbolic way). Thus, outlaw acts characterize a manifestation of an outlaw law that perversely crosses the symbolic function. It is in this sense that we understand that these acts can be understood as a subjective position crossed by the discourse of capitalism, that is, of a culture that privileges individualism and consumption.

Final considerations

This work had as objective to bring out an outline about some impasses coming from the clinic with children, emphasizing its formative character. In the fragments brought, the psychoanalyst's listening was shown as what is against the discourse that intends an aseptic normalization of subjectivity. If, on the one hand, there is an insistence on not listening to the child, placing him in the place of silencing infans, a psychoanalyst finds himself in a position in which "adultices" give way to the ungovernable and ineducable subject of unconscious desire.

It is as opposed to “chattering” that a child, as a subject, can face the speeches and their normative practices. It is not fortuitous, therefore, that we frequently find outlaw acts even in children and adolescents, who sign up as symbolic appeals, for recognition within the way of life produced by Capitalism itself. It is a way of saying that it is part of what the culture of our times privileges. But, especially with children, these acts give rise to an appeal. Precisely, the need to recognize that the infansjá is speaking.16,17





Conflicts of interest

The authors have no conflicts of interest relevant to this article.


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