Fibromialgia: o diagnóstico como reconhecimento da dor.

Abstract

Fibromyalgia is one of the most frequent rheumatological diseases, whose main characteristic is diffuse and chronic musculoskeletal pain. In addition to pain, patients complain of fatigue, morning stiffness, extremity paresthesia, subjective feeling of edema and cognitive disorders. Due to the lack of an organic substrate, fibromyalgia cannot be scanned, measured or verified, being then identified only through a clinical examination, based exclusively on the patient's discourse. The diagnostic issue raises an impasse for medical knowledge, since the disease is always linked to subjective aspects. In addition to complaining about their intense physical pain, patients report difficulties in being recognized in their suffering due to the impossibility of proving the disease. In this sense, the subjects demonstrate a strong call for diagnosis as a way to legitimize their body symptoms. It was in this direction that this dissertation aimed to discuss the demand for pain recognition of subjects diagnosed with fibromyalgia. Psychoanalytic theory, specifically the formulations of Freud and Lacan, was the theoretical-clinical framework used in this construction, bringing important contributions in regard to studies on pain, on its relationship with medical knowledge, the notion of the pulsating body and the concept of demand, systematized in Lacanian theory. To carry out the research, we used the meta-analysis, a method that allowed us to reconstruct and reanalyze the clinical cases brought in the dissertation work entitled “How to listen to the body that hurts? Reflections on the event of body and transfer”, authored by Pauleska Asevedo Nobrega, presented to the Graduate Program in Clinical Psychology at the Catholic University of Pernambuco, in 2014. In the analysis of the cases, it was possible to identify at least three forms of expression of the demand for recognition: as a demand that the other/Other recognize their pain as legitimate; a demand that the pain be recognized by the Other of science; finally, as a demand for recognition of the subject itself in relation to what they feel. It was possible to conclude that pain can have different psychic functions for the subject and, for these distinctions to be validated, as well as for these demands to have a place in the subject's treatment, it is necessary to recognize the patient's pain, listening to the statement between the lines of their discourse, concerning to the uniqueness of their suffering and their own theory regarding their symptoms. We also identified the need for a dialogue between the medical field and the psychoanalytic clinic, as an essential resource for the treatment and study of bodily manifestations.