Da melancolia ao luto: desafios e possibilidades na análise das neuroses narcísicas de tipo melancólico

Abstract

In this research we want to examine the challenges and therapeutic possibilities in the analysis of melancholic narcissistic neuroses. For that, we ll first go over some conceptions of melancholy along History, arriving at the psychoanalytical conception, chiefly with Freud and Karl Abraham. These psychoanalysts locate melancholia among the narcissistic affections, so we ll follow examining post-freudian and contemporary authors and their approach to narcissism, amongst them Klein, Riviere and Rosenfeld. We ll try to focus, on the one hand, the factors that hamper the treatment of these affections, in special the patients difficulty with the work of mourning, and the negative therapeutic reaction; on the other hand, the elements that constitute or contribute to their therapy. The objective of this research is an enrichment of the comprehension of the metapsychology of melancholy, needed, among other reasons, due to a theoretical and clinical empoverishment that happened with the replacement of the term melancholy by the term depression, mainly in the second half of the 20th century. We propose that this enrichment in the comprehension of the melancholic clinical picture could be helpful in the treatment of narcissistic affections, that include many of the cases being recently diagnosed as depression. Our starting point will be the report of a case of melancholy, where the transferencial relationship raised questions to the analyst, such as: what are the specific defences and resistances in these cases, and how do these impact in the transference-countertransference? If the melancholic suffers from inertia, how to avoid that the analysis of melancholy suffers the same problem? What are the limits to the treatment of melancholy? What are its ways of treatment? How to help the melancholic to develop or recover the capacity to do the work of mourning, and the capacity to love?