Psychoanalysis is one of the main therapeutic orientations in the field of mental health. However, in recent decades the greatest influence of biological psychiatry, inspired by neurosciences, and psychological currents with greater affinity with it, such as cognitive-behavioral psychology, is notable.
Under this scenario, recent years have witnessed problems, counterpositions and articulations among psychoanalysts, psychiatrists and / or neuroscientists about the validity of methods in the conception and treatment of mental illnesses.
The opposition scientific knowledge versus theoretical speculation resting on the value construction of science as access to a true knowledge about the nature of the human being that allows an effective intervention in the sufferings. From this approach, the absence of scientificity is the main criticism to psychoanalysis.
Oppositions extend to therapeutic strategies: on the one hand, psychoanalytic criticism of the extensive use of psychotropic drugs in the context of criticism of the medicalization of behavior.
On the other hand, the neuroscientific criticism about the attention of research and the control of psychoanalytic disorders calls into question not only the scaffolding of the theory but the effectiveness of psychoanalytic interventions.
The confrontations between both perspectives reproduce the subject-brain tension, inherent in the mind-body dualism that crosses psychiatry from its origins and that is expressed through the dilemma between a conception of man as a bodily and cerebral being versus a conception of man as being social and that speaking. While the psychoanalytic perspective conceives mental illnesses as a product of psychic life, the biological perspective conceives them as any other physical illness. Both involve different notions of person, different models of causality and different expectations of how a patient can change over time.
The contrast between different models of understanding of mental suffering (biological / subjective) is part of the work of purification, under which it is discussed if mental illnesses are physical or spirit conditions and if their therapy goes through analytical listening or intervention evidence-based psychiatric. The discussion itself reflects the work of separation / purification that occurs through these dichotomous constructions while an attentive observation of the intervention processes reveals the mediation work that brings together the “hybrid” objects created through the frameworks of both perspectives: The brain and the psychic life. That is, hybrid objects (real and built / natural and social) that come into existence through psychoanalytic and biological conceptual categories.
Despite the tensions between the two perspectives, the levels of purification that delineate their borders, and the mediation processes that dilute the dichotomies, a worldwide level assisted in a process of increasing biologization of psychiatric conditions.
The path that psychiatry takes from the 50s to the present is characterized by the passage of a psychoanalytic hegemony in the conception and treatment of mental illnesses to a biological hegemony. In this process, the gaze of the psychiatric knowledge on the problems of childhood, the responsibility of the parents and the Oedipus complex, towards the neurotransmitters, receptors and the route of chemical information in the brain. Through this passage there will be a hegemonization and universalization of American thought as a model of theoretical-practical organization of world psychiatry. The form that psychoanalytic thinking in the psychiatric field takes in each country makes a considerable difference when it comes to understanding the transformations from one model to another. Professional and economic interests, the role of the State in the field of health, cultural characteristics, disciplinary traditions, are just some of the factors that consolidate the differences in the dissemination of these approaches in each country and their subsequent transformation and / or coexistence.
From new technologies, life becomes a set of intelligible vital mechanisms, between molecular entities that can be identified, manipulated, mobilized, and recombined in new intervention practices, which are not constrained by the apparent normativity of A natural vital order. In this process, it is the same notion of biology that is disrupted, it is no longer a predetermined destination but is open to intervention, to the redesign of vital capacities. Consequently, the modern division between nature and society is resignified.
The molecularization of biomedicine allowed to show a biology open to modifications, in constant interaction with the environment. In that context, the scientific perception is generated that the environment creates stress that is literally written in the processes of cellular development.
In this context, the notion of plasticity result important as it indicates that life experiences may result in persistent changes in gene expression, and in brain structures. The notion of plasticity gives the place to processes of continuity between the psychological and the neuronal as long as it is understood that subjective experiences have biochemical marks, which in turn modify personality structures. In this interactive dynamic between experience and brain biology, the space for therapeutic change is produced, in which the joints between psychoanalysis and neurosciences are also inscribed
The notion of a plastic brain that modifies its structure and neural connections from the influence of the context enables specific discourses in particular in the field of education and psychotherapy. These ideas are plotted in the following newspaper article: “Plasticity demonstrates that the neuronal network is still open to change. You can always change what it was. Plasticity demonstrates the uniqueness of each individual, which is finally revealed biologically determined not to be fully determined by the biological, to receive the incidence of the other and of history, which makes each individual, to some extent, the modeler of his own brain” (“Science is reconciled with Freud” La Nacion Newspaper).