L'intériorité se redéfinissant par l'expérience de la maladie somatique chronique et de ses thérapeutiques, une des formes de travail psychique que nous nous proposons d'étudier est celui de l'hypocondrie. Après avoir proposé l’hypothèse générale d’un travail de l’hypocondrie-signal d’alarme, nous avons affiné trois hypothèses : face à la mort, le travail de l’hypocondrie permet de lutter pour la vie ; face aux traumatismes, le travail de l’hypocondrie permet une surveillance de l’état traumatique et une défense contre l’état traumatique ; enfin, face à l’innommable et le non figurable de la mort, le travail de l’hypocondrie permet un travail de figurabilité et du négatif. Cinq cas cliniques de psychothérapies de sujets en insuffisance rénale chronique d’origine héréditaire, pendant leurs temps d’hémodialyse, se situent aux sources de ces réflexions. Cette clinique nous a conduits à discuter du travail de l’hypocondrie chez l’insuffisant rénal chronique hémodialysé en lien aux traumatismes cumulatifs, aux deuils infinis et aux figures de cruauté, telles que la sur-vivance, le vampirisme, l’hématophilie, l’identification cadavérique et l’introjection cannibalique. Nous avons ensuite interrogé la question du mythe transgénérationnel et des scènes primitives notamment lorsque la maladie était d’origine génétique et héréditaire. Cette discussion nous a amené à rappeler la recherche d’un corps pour rêver en lien à la réserve de l’incréable. Ce travail de rêve des plaintes, du corps et de l’hypocondrie permet une resexualisation des images crues du corps malade somatiquement, chroniquement voire génétiquement et héréditairement. Il leur (re)donne de la chair, une chair psychique. Ainsi ce travail psychique favorise une ré-animation, une ré-humanisation, et une ré-objectalisation du sujet par ce retour à un travail de mentalisation, jusqu’à l’auto-scopie du soi-cadavre, il re-substantifique le sujet. / The way the interiority of the body define itself is changing with the experiment of a somatic and chronic disease and its therapeutics. In this thesis, we propose to study the work of hypochondria. After we proposed to consider the general hypothesis of the work of hypochondria as an alarm signal, we proposed three hypothesis: dealing with death, the work of hypochondria is a fight for life; dealing with traumatisms, the work of hypochondria is a watch of the traumatic state of mind, a defense against it; finally, dealing with the unspeakable and the non figurability of death, the work of hypochondria furthers a work of psychic figurability and a work of the negative. In psychotherapy during their time of hemodialysis, five subjects with hereditary chronic renal failure are the heart of this reflections. Those clinical cases conduce us to discuss the work of hypochondria related to cumulative traumatisms, about infinite work of mourning and cruelty, as out-live, vampirism, haematophilia, corpse’s identification and corpses’ introjection. Then we worked the question of transgenerational myths and primitives scenes, especially when the chronic renal failure provide from a genetic and hereditary way. This discussion conduced us to remind us the need of a body for dreaming, related to the reserve of the uncreatable. The dreamwork of the complaints, the body and the hypochondria resexualizes the cruel images of a ill body. This brings (back) flesh, a psychic flesh. This psychic work furthers a re-animation, a re-humanization, a re-objectalisation of the subject by a way back to a work of mentalization.

Ill health, accident and death are themes common to all of Jane Austen's novels. Some illnesses are physical, whereas some of her heroines experience excessive psychological, emotional and spiritual traumas. These references are too numerous to be either coincidental, glossed over or ignored. Austen expressed an interest in the mind/body relationship, believing that illness could be brought upon in certain personalities by the sufferer herself, and it seems that she might have held theories similar to those advocated by Mary Wollstonecraft in A Vindication of the Rights of Woman and even have anticipated those on feminine hysteria, and the effects of unconscious motives on behaviour, which were advanced by Freud in works such as The Interpretation of Dreams. This study examines Austen's novels, and the origin and purpose of physical and psychological illness in these, and looks at how Austen uses illness, accident and death, and more particularly how their roles progressively change and develop. For Austen's handling of these common issues appears to vary and to develop in line with the order of composition of her novels. She places increasing emphasis on them, not just to further plot, but also to reflect character change and development. Many of the parents or guardians of Austen's heroines are inadequate. And so Austen's heroines are often deprived of commendable models, left to find their own way, alone and in need of emotional support, to confront their youthful excesses, to work their way through these and to find their own destiny despite their handicaps. Self-improvement is neither pleasant nor easy, especially where one is young, inexperienced and alone. And, where heroines exhibit unhealthy or excessive interests in anything that diverts them from their paths of virtue or usefulness, the correction may frequently be painful. Thus most of the novels are, to a greater or lesser degree, filled with references to both physical and psychological ill health. This thesis examines how Austen used these illnesses, accidents and deaths in the various novels, both in the development of plot, as well as in the development of the character of the heroine in each instance. / English Studies / M.A. (English)

Submitted by Cristiane Oliveira (cristiane.oliveira@fgv.br) on 2011-05-18T15:06:11Z No. of bitstreams: 1 71070100701.pdf: 1065077 bytes, checksum: af869b88cf592cce1617c4f69902d716 (MD5) / Approved for entry into archive by Gisele Isaura Hannickel(gisele.hannickel@fgv.br) on 2011-05-18T15:16:24Z (GMT) No. of bitstreams: 1 71070100701.pdf: 1065077 bytes, checksum: af869b88cf592cce1617c4f69902d716 (MD5) / Approved for entry into archive by Gisele Isaura Hannickel(gisele.hannickel@fgv.br) on 2011-05-18T15:17:05Z (GMT) No. of bitstreams: 1 71070100701.pdf: 1065077 bytes, checksum: af869b88cf592cce1617c4f69902d716 (MD5) / Made available in DSpace on 2011-05-18T15:19:26Z (GMT). No. of bitstreams: 1 71070100701.pdf: 1065077 bytes, checksum: af869b88cf592cce1617c4f69902d716 (MD5) Previous issue date: 2011-02-25 / Care experience in Programa de Atendimento e Estudos de Somatização do Departamento de Psiquiatria da UNIFESP/ HSP and scientific literature show that somatizing patients tend to establish an expensive relationship to hospital organization, increasing material and emotional costs. From the case study of Hospital São Paulo (HSP) and the Universidade Federal de São Paulo (UNIFESP), this work analyzed, qualitatively, which factors these organization’s culture offer to its community to allow them to build and to integrate social representations on psychic and somatic issues. Through psycossociologic methods analyses, it was noted that these organizations do not provide a culture that would help its members to deal with the anguish roused by the medical task, while dealing with somatization disorder patients. This task usually waves the possibility of death, determining hypochondria as its main anguish. / A experiência do Programa de Atendimento e estudos de Somatização do Departamento de Psiquiatria da UNIFESP/HSP e a literatura científica mostram que os pacientes somatizadores tendem a estabelecer com a organização hospitalar uma relação muito dispendiosa, tanto do ponto de vista da relação que mantem com seus profissionais quanto com relação ao volume de recursos materiais que consomem. a partir do estudo de caso do Hospital São Paulo e da Universidade Federal de São Paulo, o presente estudo analisou qualitativamente que elementos a cultura das organizações oferece a seus membros para que eles construam, coletivamente, representações sociais acerca do psíquico e do somático, e que elementos oferece para que tais representações sejam integradas, articuladas ou cindidas coletivamente por seus membros. Tendo concluído, através da análise das instâncias propostas pela metodologia psicossociológica, que as organizações analçisadas não dispõem de uma cultura que favoreça, através das representaçoes sociais, a articulação e integração psíquica das angústias despertadas pela tarefa médica em geral, e tampouco pelas angústias despertadas pelos pacientes somatizadores. Tarefa que constantemente acena a possibilidade da morte, determinando como angústia central despertada, a hipocondria.