Thesis (doctoral)--Ludwig-Maximilians-Universität München, 2001. / Includes bibliographical references (p. [313]-330).

Thèse - Fribourg. / Bibliography: p. [153]-154.

Thesis (doctoral)--Ludwig-Maximilians-Universität München, 2001. / Includes bibliographical references (p. [313]-330).

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Rituals of Diagnosis argues that nineteenth-century America’s literary representations of madness and its diagnosis respond to interdisciplinary efforts at cultivating a national psychology. Uniting theological and philosophical traditions with medical speculation, mental health reformers from Benjamin Rush to Dorothea Dix linked the expansion of democracy with new vulnerabilities for madness. Theories about insanity thus hypothesized relationships between freedom and responsibility. I examine how America’s first psychological fictions contributed to this rich field of discussion. Taking up novels by Charles Brockden Brown, Robert Montgomery Bird, and Oliver Wendell Holmes that pivot around the investigation of madness, I examine how literary works from the Revolutionary Era to the Civil War dramatize interpretive processes that classify transgressive behavior. I argue that the grotesque subjects at the center of these investigations—Anglo-Americans who are likened to demons, animals, and “savage” racial others—indicate the provisionality of the period’s theories of mental illness and register anxieties about affiliation and responsibility that accompanied their development. This inquiry contributes to contemporary conversations about authority, desire, and the role of violence in the American imaginary, and argues that scientific speculation and literary experimentation collaborated in constructing this imaginary. While many have acknowledged that discourses of mental health participated in codifying social and political norms, I draw explicit attention to literary form as a site for examining the motivations that fuel these discourses by showing how their narrative trajectories put medical knowledge into conversation with sentimental ideologies. Examining how these novels conjoin problems of interpretive confusion with affective confusion, I explore how these mysteries destabilize the disembodied rationality central to the perch of objectivity that sustained white supremacist interrogations of racial and gendered others. The struggle to situate the locus of social unrest into psychological and ethnic others betrays an archive of fears and fantasies contained by diagnostic procedures. / text

Cette thèse se propose d’étudier les récits de fiction de la seconde moitié du XIXe siècle qui illustrent l’idée selon laquelle la « maladie est l’état naturel du chrétien ». Les affinités électives entre religion et pathologie intéressent à la fois les auteurs réalistes et naturalistes (Émile Zola, les Goncourt, Alphonse Daudet, etc.) qui envisagent la croyance dans une perspective polémique de démystification, voire de médicalisation ; et les écrivains catholiques (Barbey d’Aurevilly, Léon Bloy, J.-K. Huysmans, Émile Baumann) qui remotivent le sens spirituel des afflictions physiques. La mise en regard d’œuvres rassemblées autour d’une unité thématique – le spectacle d’un croyant malade – mais relevant d’esthétiques et de courants de pensée dissemblables permet d’étudier la manière dont la représentation littéraire cristallise les débats de l’époque au sujet du christianisme, tout en faisant émerger des problématiques communes à des auteurs que la critique a coutume d’envisager sous l’angle restrictif de leurs oppositions. Il s’agit de mettre en lumière les relations d’influences réciproques entre des écrivains qui, par-delà leurs divergences, fondent leur représentation du religieux sur un même imaginaire pathologique et sur une même poétique de l’incarnation. Ce travail entend montrer comment le renouvellement du sentiment religieux – que ce soit dans une perspective apologétique ou au contraire critique – passe par une écriture du corps souffrant, malade ou en proie à des troubles psychophysiologiques mystérieux. Ce dernier est le lieu et l’enjeu d’une réflexion sur la foi, sur le système de pensées et de croyances du christianisme et sur les institutions ecclésiastiques. / This dissertation analyzes fictions that, in the second half of the 19th century, illustrate the idea that "sickness is the natural state of a Christian". The elective affinities between religion and pathology interest both realist or naturalistic novelists (such as Émile Zola, the Goncourts, Alphonse Daudet, etc.), whose polemical view aims at demystifying or even medicalizing beliefs, as well as catholic writers (Barbey d’Aurevilly, Léon Bloy, J.-K. Huysmans, Émile Baumann), who emphasize the spiritual meaning of physical afflictions. The parallel between fictions that are all based on the spectacle of a sick believer, but engage contrasting writing styles and currents of thought, shows how much literature crystallises the debate that is going on at the time about Christianism. It also uncovers a point of commonality between writers that critics are used to consider under the restrictive perspective of their opposition. This study aims to highlight the mutual influences that link together several writers who, beyond their differences, base their representation of religious feelings on the same pathological imaginary and the same poetics of incarnation. We argue that the renewal of religious feelings, whether it's in an apologetical or critical perspective, relies on the description of a body which suffers pain, sickness or mysterious psychophysiological disorders. Ultimately, the body conveys considerations about faith, Christian ideology and beliefs and ecclesiastic institutions.

Made available in DSpace on 2018-06-04T19:14:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-04-19 / Introdução: o modelo biomecânico de ensino e prática da Medicina, alicerçado na especialização, fragmentação e tecnologia, trouxe inúmeras vantagens para o cuidado aos doentes, tendo sido responsável pela diminuição ou abolição de grande parte do sofrimento humano decorrente de doenças e traumatismos. No entanto, por não considerar as dimensões sutis do ser humano, tão importantes na forma como os indivíduos adoecem e nos processos de cura, tal modelo trouxe consigo limitações. Ainda que novos modelos tenham sido introduzidos e incorporados em cenários didáticos e clínicos, uma das consequências desse enfoque predominantemente biomédico ainda se encontra entre as principais queixas dos usuários dos sistemas de saúde. Trata-se da desumanização em saúde. Em nosso país, o Sistema Único de Saúde – com a criação da Política Nacional de Humanização – e os sistemas de saúde privado têm buscado estratégias para enfrentar a questão. Estas dependem da presença de profissionais de saúde bem preparados de um ponto de vista técnico e humanístico. As maiores deficiências concernem à formação humanística, a qual começa a ser fomentada em algumas instituições de ensino mediante o ensino das Humanidades. Objetivo: investigar a efetividade da utilização de narrativas – relatos de História Oral de Vida de pacientes transplantados cardíacos e de seus familiares, narrativas médicas e narrativas literárias – como fonte de reflexão e recurso didático na formação humanística do estudante de Medicina e Enfermagem. Metodologia: optou-se pela escolha de métodos qualitativos alicerçados na História Oral de Vida e Fenomenologia Hermenêutica. O objeto de estudo foi uma disciplina eletiva denominada Narrativas em Saúde – um caminho para a humanização, a qual foi oferecida a dois grupos de cerca de vinte e cinco estudantes de Medicina e Enfermagem. Os dados foram provenientes de três fontes – observação participante, entrevistas dos estudantes obtidas mediante a abordagem da História Oral de Vida e narrativas apresentadas pelos mesmos em uma sessão de narrativas realizada a título de avaliação final. Os dados foram interpretados por meio da técnica de imersão / cristalização. Resultados: a partir das narrativas compartilhadas emergiram muitos subtemas, os quais foram organizados nos seguintes temas maiores: da morte ao renascimento da narrativa – um caminho para a reflexão; quebrando o isolamento para reconhecer questões emocionais e sentimentos; empatia; currículo oculto; das narrativas à humanização: fomentando o profissionalismo. Considerações finais: os resultados decorrentes da experiência didática demonstraram que, em um curto espaço de tempo, foi possível percorrer muitas das questões essenciais que povoam a vida dos profissionais de saúde, sendo que as narrativas representaram, ao mesmo tempo, um estímulo e um meio para a reflexão, propiciando um aprimoramento dos relacionamentos interpessoais, a contemplação da afetividade e o reconhecimento da necessidade constante de uma busca de sentido nas práticas da saúde. / Introduction: The biomechanical model of teaching and practice of medicine, based on specialization, fragmentation and technology, is responsible for innumerable advantages to patient care and for reducing or abolishing much of human suffering causes by diseases and injuries. However, because it does not consider the subtle dimensions of human being, so important in the way individuals become ill and in healing processes, such a model presents limitations. Although new models have been introduced and incorporated into didactic and clinical settings, one of the consequences of this predominantly biomedical approach is still among the main complaints of health systems users. It is about dehumanization in health. In Brazil, the Unified Health System – with the creation of the National Humanization Policy – and private health systems have sought strategies to face the issue. Certainly, these strategies depend on the presence of well-trained health professionals from a technical and humanistic point of view. The greatest deficiencies concern humanistic education, which starts being promoted in some educational institutions by the teaching of Humanities. Objective: to investigate the effectiveness of the use of narratives – Oral History of Life reports of transplanted cardiac patients and their relatives, medical narratives emerged in Palliative Care and literary narratives – as a source of reflection and didactic resource for humanization of medical and nursing students. Methodology: qualitative methods based on Oral History of Life and Hermeneutic Phenomenology were chosen. The object of study was an elective discipline named Narratives in Health – a way to humanization, which was addressed to two groups of twenty-five medical and nursing students. The data were collected from three sources – participant observation, interviews of students obtained through Oral History Approach and narratives presented by them in a narrative session that represented the final evaluation. The data were interpreted by immersion / crystallization techniques. Results: from the data emerged many subtopics, which were organized in the following major themes: from the death to the rebirth of narrative; breaking the isolation to recognize emotional issues and feelings; empathy; hidden curriculum; from narratives to humanization: educating good health care professionals. Final considerations: the results of didactic experience shows that, in a short period, it was possible to cover many of the essential issues that permeate the life of health professionals. The narratives represented a stimulus and a means for reflection, favouring an improvement of interpersonal relationships, the contemplation of affectivity and the recognition of the constant need for searching meaning in health practices. / BV UNIFESP: Teses e dissertações

In Franz Kafka's The Judgement many things remain unsaid. Most of all it is the unpredictable behaviour of the father figure which is difficult to understand. That has caused a large number of interpretations and the critical reception continues. At the beginning of the story, the fictional father appears weak and ill, evoking memories of disease. Therefore, the following essay explores whether the behaviour of the father figure corresponds to the symptoms of dementia. For this purpose, the diagnostic criteria for neurocognitive disorders according to the Diagnostic and Statistical Manual of Mental Disorders were compared to the text. The analysis shows that many passages in the text reflect symptoms of dementia. However, it also shows that other interpretations are possible, which is not surprising given the indeterminacy of Kafka's work. As has already been established in earlier investigations, the fictional father stands as a symbol for authority. Assuming the father has dementia means that this authority is incurably ill. Therefore, the fictional father would symbolize an almighty institution in decline whose authority cannot be questioned by the individual. This way of interpretation emphasizes the unjust distribution of power. The acting figures represent unequal relations of any kind, in which the inferior has to obey the obviously ill but overpowering authority.

Literature and medicine are not usually seen as related disciplines, but scholars have already begun producing fruitful scholarship regarding historical and aesthetic interactions between them. This thesis adds to that scholarship by examining medicine and literature in nineteenth-century Britain. More specifically, Thomas De Quincey's Confessions of an English Opium-Eater and Robert Louis Stevenson's Strange Case of Dr. Jekyll and Mr. Hyde both use nineteenth-century medical case conventions to tell their stories. Furthermore, because both works deal with addiction, divided selves, and the power that physical substances can have on morality and character, these two works provide an excellent comparison coming 65 years apart. As such, they are a great point from which to begin looking more closely at how the interactions between medicine and literature evolved during the nineteenth-century in Britain. This thesis examines the role that "scientific" discourse has played in medicine and literature as interpretive disciplines, the rhetorical techniques and innovations surrounding the intersection of the two disciplines, and the authority that each discipline derived by implicitly borrowing ideological assumptions and textual forms from the other. Confessions is a wonderful example of a Romantic, autobiographical text that clearly uses the medical case study conventions; in fact, De Quincey was often cited in the years following the publication of Confessions as an authority on opium and its uses. By the time Jekyll and Hyde was published, however, a work like Confessions could no longer hold its own in medical debates. The professional institutions of medicine and literature had changed too much. Hence, by analyzing these two works side-by-side, I intend to illustrate different narrative approaches to similar issues at the beginning and end of the century. More importantly, I hope to use these texts in conjunction with specific medical case histories to discuss each text's reliance on interdisciplinary authority.

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