SciELO - Scientific Electronic Library Online

vol.28 número3Homenagem a alguns pioneiros da psiquiatria gaúchaFreud e a neurobiologia da memória índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados




Links relacionados


Revista de Psiquiatria do Rio Grande do Sul

versão impressa ISSN 0101-8108

Rev. psiquiatr. Rio Gd. Sul v.28 n.3 Porto Alegre set./dez. 2006 



The contemporary psychiatrist: working per via di porre and per via di levare



Carmem Keidann; Flávio Shansis

Editors of Rev Psiquiatr RS



Affirming that the current world has grown in complexity is more than a common place. Personal relationships in such a multifaceted society are often difficult not only of being understood, but also of being experienced. Human beings become, at the same time, actors in a script of this globalized society and mere audience members of a play they only watch. The result is that 21st century people feel fragmented by the multiple approaches and possible experiences of the same phenomenon. What about the role of psychiatrists in this context?

Freud, based on what Leonardo da Vinci had affirmed about arts, made some remarks about which would be the proposal of psychoanalysis, contrasting it with suggestive therapies. The latter corresponds to per via di porre, which is the form of painting, adding colored particles on a white canvas where there was previously nothing. In sculpture, on the other hand, the process is per via di levare, since what was hidden is removed from the block of stone, and then the work that was inside appears, a method that, according to Freud, corresponds to psychoanalysis.1

Using Freud's words and bringing them to another situation, it seems that contemporary psychiatry - inserted in a multifaceted social context - needs to perform those two processes. At the same time in which, by treating a patient, we add colors to a "white canvas," based on increasingly more systematic and reliable diagnoses, we also need, for the diagnostic and therapeutic task, to remove from the "block of stone" what lies underneath - the unsaid. By doing so, we can in fact have an understanding as close as possible to reality, considering not only the external reality, but also the patient's internal world. This is the complex and hard task we have as our great challenge.

We no longer discuss whether neurosciences came to bring contemporary psychiatry wide and essential knowledge for the understanding of neuronal pathways: the canvas, which used to be white, has been colored with much information. Also, we no longer discuss whether the discoveries about the unconscious made by Freud and his followers have irreversibly widened the perception horizon of the human being for the history of humankind: what lied hidden in our block of stone has since then become visible. The challenge for the psychiatrist nowadays is how to work in those two processes without dissociating them, since they add knowledge, and do not exclude one another. How to provide care to this person with a brain that has been investigated in neurochemical details, at the same time in which we found ourselves inserted in a countertransference context approached in a very specific form by many schools and within a society in which relationship, behavioral and social identity standards have become diffuse and extremely complex?

We understand contemporary psychiatrists are required to have a wider understanding of modern human beings. This might not always be possible and we might often have to use subspecialties, as society walks as a whole in its several "niches." Nevertheless, whenever possible, we think that a psychiatric treatment should be based on good psychopathological knowledge, on reading new biochemical approaches, on permanent psychopharmacological update, on acknowledging the intrapsychic reality and on accepting new forms of social interaction.

Revista de Psiquiatria do Rio Grande do Sul is collaborating with the formation of this psychiatric profile; in this issue, there are two contributions representative of this new posture. In the first one, we present our readers with an invited editorial that does us much honor, written by Prof. Dr. Iván Izquierdo, an important researcher in Brazilian science, internationally known, who brings us a text about how important and modern are Freud's theories, focusing on the issue of memory suppression and inhibition and its application in clinical practice. The second contribution is a book review performed by our colleague Maurício Marx e Silva about the book Affect dysregulation and disorders of the self, by Allan Schore, a psychiatrist and researcher of biobehavioral sciences who has recorded data integrating neurosciences and development psychology and psychodynamics.

Therefore, we are happy to publish a consistent issue with varied themes in articles from different areas in psychiatry, offering an integrating view of the individual. By doing so, we intend to contribute with the formation of contemporary psychiatrists, helping them to work safer both per via di porre and per via di levare when providing care for their patients.



1. Freud S. (1905) Sobre a psicoterapia. In: Obras completas. Rio de Janeiro: S.E. Brasileira; 1969. vol. 7.

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons