Significados da dor musculoesquelética crônica: uma perspectiva da psicossomática psicanalítica

Abstract

Objective: To know and analyze the meanings involved in the life history of people with chronic musculoskeletal pain from the perspective of the psychoanalytic psychosomatic. Method: qualitative research, anchored by the theoretical reference of the psychoanalytic psychosomatic. The study was attended by 20 people who presented chronic muscular pain and who were treated with physical therapy in a clinic in a city in the interior of the State of São Paulo, as they were invited to talk about their pains and their lives. Data collection was performed through semi-structured interviews and analyzed through thematic content analysis. Results and Discussion: The participants' ages ranged from 18 to 82 years, the majority of them female and gonarthrosis was the most prevalent disease. Most of the participants presented pain for more than 5 years. The analysis of the material resulted in two themes "Life under pain, life difficult and "My life, my body is a hematoma, a chronic pain". The first theme reflected the life of existences and lives in the reports of actions for patients and work for lived in many cases patients in life processes. In the second theme, there are opportunities that are associated with the reporting of intense sufferings. This theme was deployed in two sub-themes: "Emotional-affective suffering" and "After a feeling, a pain comes". The first sub-theme was related to experiences of illness and / or loss of family members, situations of intrafamily violence, abandonment, relationships denoting lack or absence of adverse effects, in addition to conflicting relationships between family members. The second sub-theme covers the explicit accounts in which such experiences occasioned physical pain. In general, the results permeate an important issue for the psychosomatic - the link between biography and pain. There have been reports of events in their lives, of significant experiences in which the participants more or less consciously associated these experiences with their chronic musculoskeletal pain, since such pains appeared almost simultaneously, only some time later or were associated with some significant event . Conclusion: From the perspective of the psychoanalytic psychosomatics, several meanings of chronic musculoskeletal pain were identified, from violence, threats, resentments, illnesses, deaths, guilts and marital separations. From what was presented in this study it is important to consider the importance and necessity of investigating the subjectivity, biography and experience of people living with chronic musculoskeletal pain as part of the professional conducts for the treatment and management of pain, even though instruments to attest to the presence of alexithymia or to understand that the explanations of somatizations are in the failure of representation.