Abstract

We aim to examine the possibilities for an interdisciplinary dialogue between Psychoanalysis and gender theory, as expressed in studies about violence on Collective Health, to approach occurrences of aggression and abuse in family life and their possible impacts on health, with particular attention to the psychological impacts on children and women, as well as in the family group as a whole. Based on classical authors for both disciplinary contributions, we examine a concrete case taken from a family care situation. This examination consists of three interpretative dimensions: first, considerations on the individual case in its family context; second, the case seen from the perspective of cultural issues; and third, the relation between culture and its individualized expression in the case. We show the possibility of conducting an approach that integrates the intrapsychic dimension, which concerns the functioning of the inner world of the individuals involved, with the sociocultural and historical realities that constitute their context of life. With the aim of a comprehensive care of the cases, we highlight the practical importance of combining reflection and action of psychodynamic nature, a result of the examination of the intrapsychic impacts of violence from concepts such as trauma and terror, with recognition of cultural expressions in the individual and family realms, which strengthen normative acceptances of aggressions, victimizations, silencing, and trivialization of violence. The interdisciplinary dialogue makes possible to understand the development of culturally reinforced feelings and behaviors, such as fear and shame in the victims and repetition of violence in the aggressors.

Keywords:
Violence; Family; Psychoanalysis; Gender; Health

Introduction

This article aims to contribute to interdisciplinary readings on domestic violence and its impacts on the family. The motivation of this study starts from the construction of a dialogue between Psychoanalysis and gender theory in studies focused on Collective Health, as a field of integration between disciplines of human and social sciences or philosophy and knowledge aimed at the health-disease processes and their social determinants. We are driven by the question: is it possible to articulate several systems of references in approaching the dynamics of violence in the family?

We immediately need to specify these references. From the perspective of gender, we are based on (Scott, 1986SCOTT, J. Gender: a useful category of historical analysis. The American Historical Review, New York, v. 19, n. 5, p. 1053-75, 1986.) and on what is produced on Collective Health from such reference (Araújo; Schraiber; Cohen, 2011ARAÚJO, M. F.; SCHRAIBER, L. B.; COHEN, D. D. Penetração da perspectiva de gênero e análise crítica do desenvolvimento do conceito na produção científica da Saúde Coletiva. Interface - Comunicação, Saúde, Educação, Botucatu, v. 15, n. 38, p. 805-818, 2011.). In this study, we articulate our ideas with Scott's historicist approach, which will allow us to develop two additional elaborations: the one that state in detail the historical changes of family as a group of diversified individuals, and the one in which the historical-cultural constructions around male and female, beyond positions in the social structure, are taken here as sociocultural identities, as masculinities and femininities in exercise in the social relations of gender. The articulation with health issues and their harms will be sought within these formulations (Schraiber et al., 2005SCHRAIBER, L. B. et al. Violência dói e não é direito: A violência contra a mulher, a saúde e os direitos humanos. São Paulo: Unesp, 2005. (Saúde e Cidadania).).

Similarly, from the psychoanalytic perspective, we are based on (Freud, 1976aFREUD, S. Além do princípio do prazer, psicologia de grupo e outros trabalhos. In: FREUD, S. Edição standard das obras psicológicas completas de S. Freud. Rio de Janeiro: Imago, 1976a. v. XVIII, p. 13-85., ^1976bFREUD, S. Estudos sobre a histeria. In: FREUD, S. Edição standard das obras psicológicas completas de S. Freud, Rio de Janeiro: Imago, 1976b. v. II. p. 184-231.) and (Klein, 1991KLEIN, M. Notas sobre alguns mecanismos esquizoides. In: KLEIN, M. Obras Completas de Melanie Klein, v. III. Rio de Janeiro: Imago, 1991. p. 17-43.), already in dialogue with a psychosocial perspective (Mandelbaum, 2010MANDELBAUM, B. Psicanálise da família. 2a. ed. São Paulo: Casa do Psicólogo, 2010., ²⁰¹⁴MANDELBAUM, B. Trabalhos com famílias em Psicologia Social. São Paulo: Casa do Psicólogo, 2014.), seeking to problematize the dynamics of family relationships between the affections and anguishes associated with paternal authority, and this relation is already problematized as an unequal historic construction of male and female individuals in private life, exposing the permission of culture on the establishment of "terror" inside the house.

This interdisciplinary dialogue serves for building a more complex and comprehensive set of tools that enable us to approach the experience lived by people - mostly women and children - who are victims of violence within the family. The experience can and must be thought of in its psychic, relational, and social dimensions, which are inextricably articulated in singular ways in each case, if we are concerned with the possible interventions in the field of violence.

A family and a case

The presented report fragment was extracted from the record of the care service for families that experience different situations of violence. It presents a terrifying atmosphere, exposing one of the concrete expressions of domestic violence - and here we understand violence as the action of someone that can invade the limit of other and, by force, impose oneself (Berenstein, 2000BERENSTEIN, I. Notas sobre la violencia. Psicoanalisis - Revista de la Asociación Psicoanalítica de Buenos Aires, Buenos Aires, v. XXII, n. 2, p. 257-272, 2000.). This domestic violence is chronic and daily repeated, creating an experience in which mind and body merge into sensations of disintegration, helplessness, and fear. The experiences in the relationship of intimacy with the other make this fear emotionally unreachable and "almighty" in relation to the victim's life and body.

"Terror" is a word that names this experience well, approaching what occurs in the private life and in the familiar scope to other situations - such as war and torture, in which extreme experiences (whether physical or psychological) are mobilized (Herman, 1997HERMAN, J. Trauma and recovery. The aftermath of violence: from domestic abuse to political terror. New York: Basic Books, 1997.).

(Arendt, 1994ARENDT, H. Sobre a violência. Rio de Janeiro: Relume Dumará, 1994.) indicates an "extreme" nature of violence that Freud (since his early work of therapy with hysterical patients) stated as an "excessive" nature of the violent situations of sexual nature experienced in childhood and perpetrated by the adults of the same house. Psychoanalysis finds there its origins; Freud relies on this occurrences to propose the first model of psychic apparatus: the unconscious as the repository of childhood experiences suppressed from consciousness because of their excessive nature before the comprehension capacity from the child. Freud could observe with his female patients that these experiences fall into silence, but not into oblivion. They remain active and are repeated in various expressive modalities, such as symptoms, inhibitions, and anguishes lacking in representation. These experiences ask for elaboration; not to be properly forgotten - according to Freud there is never complete oblivion - but to gain understanding in forms accessible to the conscience and no more as disabling and enigmatic psychic or somatic symptoms. They are "traumatic" events, as Freud has appointed. They are part of our psychic identity and continuously demand the search for construction of meanings to the lived experiences. If Freud assigned to Psychoanalysis an etiological character, i.e., a binding with a source for the understanding of the psychic phenomenon, he granted to the trauma the status of origin of the psychic symptom. The trauma, in this case, is a psychic commotion, meaning ruin, destruction, or loss of one's own form (Ferenczi, 1981FERENCZI, S. Reflexiones sobre el traumatismo. In: ______. Obras completas. Madrid: Espasa Calpe, 1981, v. 4, p.153-163.).

In one of the first psychoanalytic writings of Freud, Studies on hysteria (¹⁹⁷⁶FREUD, S. Além do princípio do prazer, psicologia de grupo e outros trabalhos. In: FREUD, S. Edição standard das obras psicológicas completas de S. Freud. Rio de Janeiro: Imago, 1976a. v. XVIII, p. 13-85.), the trauma is assumed to be the origin of the psychic conflict that generates the symptom. It is a shock in the real experience that hits, like a quake, the defenses of the I. (Freud, 1976bFREUD, S. Estudos sobre a histeria. In: FREUD, S. Edição standard das obras psicológicas completas de S. Freud, Rio de Janeiro: Imago, 1976b. v. II. p. 184-231.) describes it in terms of "shame and silence". According to him, at the time of its production, the shame would be one of the responsible reasons for the inability to speak or even think about the event, which tends to express itself, as we said, symptomatically, in various forms of psychic and physical suffering. For this reason, therapeutically, Freud sought to break the silence and surpass shame, by hypnosis or listening to the patients, so that the traumatic experience could be reported and elaborated. We note, still, that the importance of shame to the silencing of the traumatic experience and the resulting illness have been recovered by contemporary psychoanalysts, particularly those dealing with the psychological impacts of social disasters such as wars, genocide, mass rape, and torture (Benghozi, 2010BENGHOZI, P. Malhagem, filiação e afiliação. São Paulo: Vetor, 2010.).

The cases and culture

According to (Freud, 1976aFREUD, S. Além do princípio do prazer, psicologia de grupo e outros trabalhos. In: FREUD, S. Edição standard das obras psicológicas completas de S. Freud. Rio de Janeiro: Imago, 1976a. v. XVIII, p. 13-85.), the psychic reality is formed in response to reality: the anguish resulting from the trauma, which composes the suffering of victims of violence is, at the same time, a trigger signal of their psychic defenses, organizing their way of being in the world. Psychoanalysis, however, over its construction of more than a century, relativized the events of reality in favor of the drive of each of us and of the others in us and for us, in the production of the disorders. Psychoanalysts, in general, gave up trying to discover the historical events that produce trauma to look into the internal reality of their patients. Freud himself reports, in a letter to Fliess (Freud; Fliess, 1986FREUD, S.; FLIESS, W. A correspondência completa de S. Freud para W. Fliess. Rio de Janeiro: Imago, 1986.), the discovery of the importance of fantasy in the configuration of reality, blurring the boundaries between internal and external realities, with complex and important impacts for Psychoanalysis. This is one of the reasons why we consider the interdisciplinary dialogue essential, although difficult, since the different disciplines operate from diversified theoretical and methodological references. In the specific case of the studies and interventions in the field of domestic violence, Psychoanalysis is nourished by the dialogue with sociology, history, and the cultural and gender studies to remember that it is not possible to reduce the understanding of the phenomenon, if we want to operate some transformation in it, only to an intrapsychic dimension. The "abused child" and the "woman who is beaten up" are not only sexual fantasies, but relational standards that occur in diverse forms in different sociocultural contexts, closely linked to hegemonic ideas of masculinity and femininity. When Psychoanalysis put these elements of social reality aside and deal with violence against women or children only in its intrapsychic dimensions - although this is a present dimension and that demands understanding - at best this science performs a partial and fragile therapeutic, since it silences aspects from reality that tend to perpetuate. When the psychoanalyst does not recognize the violence actually suffered and urging to be abolished, and attribute everything to psychism and fantasy, he/she might also be violent. (Ferenczi, 1981FERENCZI, S. Reflexiones sobre el traumatismo. In: ______. Obras completas. Madrid: Espasa Calpe, 1981, v. 4, p.153-163.) says that trauma occurs in two stages: the first is the traumatic event itself and the second is the non-recognition by a third party, whom the victim asks for aid, that the trauma in fact occurred and could not have occurred. Hence his recommendation for the psychoanalysts to consider and show the recognition of the pain produced by the actual event, so that its elaboration, within certain limits, can occur.

In turn, Psychoanalysis brings an unique and essential contribution to interdisciplinary dialogue by deepening into the subjective dimensions involved in violence. Because violence, like all human phenomenon, will be acted, experienced, and understood from the singular ways with which everyone of us perceives reality and interacts with it - ways that also originate in the personal and family history of each person. Melanie (Klein, 1991KLEIN, M. Notas sobre alguns mecanismos esquizoides. In: KLEIN, M. Obras Completas de Melanie Klein, v. III. Rio de Janeiro: Imago, 1991. p. 17-43.) brought an important contribution to the psychoanalytic study by showing in detail the interplay of affections and anxieties that color our relationships and constitute our internal and external reality. According to Klein, external reality is difficult to be perceived in its objectivity, separated from the individual, being only reachable in an unstable way, when we can see something that goes beyond us, that is not ours, but from the other. Because we project our inner world on the outer world, throwing shadows on it. The possibility of recognizing the other depends, according to Klein, on the acquisition of a confidence, related to childhood experiences, since the ones experienced by the baby with his mother, in the existence of a reality that is good, stable, and caring. This confidence is such that, compared to the absence, frustration, and waiting, will emerge the tolerance and the ability to wait, preserving the outer object of the hate attacks from the baby.

It is proficuous to use these elaborations of Klein to understand the psychic functioning triggered against traumatic events, when reality confronts the child with violent and terrifying situations, because, such as Klein deals with the mechanisms triggered by the baby's psyche against anguishes of annihilation, the experiences of violence arising from reality favor certain modes of emotional operation that are disorganizers of the being in the world. These operating modes tend to crystallize, since the very situation of violence is recurring, producing in the victims the anguished fear of its repetition and making them prisoners to permanent surveillance and seizures. The trauma also produces the need to seek safety and protection, as we see in the above reported case in which mother and daughters are together in a room, while the other spaces of the house are of danger, since, in these, they can meet with the aggressor, which threatens them. The father is not always violent, but this way of reacting to his presence can remain and prevent other more amorous ways of interacting, consolidating, in reverse, the figure of the attacker father and reaffirming his position as a bad person.

Keeping the aggressor only in this position, as well as always keeping oneself as victim, is also crystallizing or essentializing positions that are not necessarily fixed. This crystallization is a way to react to the trauma of violence (such as we considered this far), and represents a psychic and subjective configuration of division of the inner world and also of the outer world, generating an inability to more global and dynamic understanding of the relationships between these worlds. So, with (Klein, 1991KLEIN, M. Notas sobre alguns mecanismos esquizoides. In: KLEIN, M. Obras Completas de Melanie Klein, v. III. Rio de Janeiro: Imago, 1991. p. 17-43.), we say that the experience of violence leads us to adhere to a partial and tight view of the other, preventing the psychic functioning by which a contrary motion - of dynamic integration of the various aspects of the other - can also be experienced and constitute a learning experience for the child, before the contradictions and ambivalences that we all have.

Thus, to undergo violence is frustrating, thus, to our ability to move on from divisions to integrations as learning for life, to deal with the various relationships we build throughout our lives. This process is particularly harmful in domestic violence because, on the one hand, the child finds himself/herself the victim of violence by those who should protect him/her, and, on the other, since the family is his/her primary learning of socialization, his/her experience of the outer world will be exposed to this difficult mark with which he will have to deal for being and acting in this world. The extensive review about intimate partner violence and sexual violence from the perspective of the studies with women and men, conducted by the World Health Organization, shows a strong association between having lived or witnessed violence in childhood and experience situations of violence in adult life, as victims or aggressors (WHO/LSHTM, 2010WORLD HEALTH ORGANIZATION; LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva: World Health Organization, 2010.), and the cultural issues of gender are a differentiator between these two last conditions - being a victim or aggressor -, as we will consider later.

From what we have said so far, we hope to have shown that, if it is important to approach and know the singular case in its intrapsychic dimension, it is also important to consider it in family and social contexts. Regarding this last perspective, many studies contribute to approach this issue from the sociocultural perspective, and the contributions of gender studies are particularly productive in that direction (Heise, 1998HEISE, L. Violence against women: an integrated, ecological framework. Violence Against Women, Lexington, v. 4, n. 3, p. 262-290, 1998.; Heise; Ellsberg; Gottemoeller, 1999HEISE, L.; ELLSBERG, M.; GOTTEMOELLER, M. Ending violence against women. Population Reports, Baltimore, v. 27, n. 4, p.1-43, 1999.; Schraiber et al., 2005SCHRAIBER, L. B. et al. Violência dói e não é direito: A violência contra a mulher, a saúde e os direitos humanos. São Paulo: Unesp, 2005. (Saúde e Cidadania).), to which we will return below.

Additionally, we highlight here the contributions of family Psychoanalysis, as they allow us to understand violence also from the perspective of the psychic dynamics among relatives, in the approximation of an unconscious group structure whose rules of organization and functioning relate to a sociohistorical and cultural place, both to the life experiences in this family group (which are not only limited to the current family nucleus) and to the families of origin of each of its members. This implies the need to know the cultural history and the previous family history of the current nucleus, dialoguing with the recurring patterns of interaction and communication among members. If, as already said, violence fix positions, refusing different possibilities on group dynamics, and if, as a reaction, rules of silence and searches for isolation are established (which is culturally reinforced, as we shall see), the recognition of the family as this location not only possible, but even usual of violence, in its various manifestations, is an important starting point for a therapeutic work of the case itself and beyond it.

The contribution of Psychoanalysis in the dialogue with cultural, social, and historical studies is not for recognizing the family or individuals as violent, it is for allowing an understanding that violence is not a product of the inner world or of the outer world in isolation, but that it results from the private ownership that each individual or family accomplish from the interaction between these worlds. In Freud, and from him, in the field of Psychoanalysis, the boundaries between the inner and the outer are, if not abolished, merged. And violence always emerges in the "between": between people, between situations, between relationships. Psychoanalysis will give visibility to the ruptures in these relationships, by the work of drawing up the experience of violence. This is essential so that the cycle of violence does not proliferate in succeeding generations. Violence is traumatic and, therefore, tends to repetition. Hence the need of children to understand their parents, which involves the recognition of subjective peculiarities, but also of their family and cultural histories. To elaborate critically is to understand, making cohabitation another possible way of relational situation.

The fear, anguishes, and shame of the victims turn into silences and fatalities in the case of girls, generally reiterating in women, as they become adults, the place of the victim; for the boys, the acts of violence are generally transformed in common occurrences, reiterating, most of the times, as they become adults, the place of the attacker (Schraiber et al., 2005SCHRAIBER, L. B. et al. Violência dói e não é direito: A violência contra a mulher, a saúde e os direitos humanos. São Paulo: Unesp, 2005. (Saúde e Cidadania).; Couto; Schraiber, 2005COUTO, M. T.; SCHRAIBER, L. B. Homens, saúde e violência: novas questões de gênero no campo da saúde coletiva. In: MINAYO, M. C. S.; COIMBRA JUNIOR, C. E. A. (Org). Críticas e atuantes: Ciências Sociais e Humanas em Saúde na América Latina. Rio de Janeiro: Fiocruz, 2005. p. 687-706.). These two strange and opposite situations are products and reproduce the cultural elements of trivialization of violence, creating in the family important differentials concerning the silences and the acceptance of violence as a way of dealing with gender differences.

Culture and the cases

Although the cases express the situation that each individual experience in society and allow an approximation of singular manifestations, within the plurality of social life, each case externalizes the product of a synthesis: the outer world that is internalized by the individuals, read and represented (or re-presented) in their own interiority, which is externalized in individual behavior (Sartre, 1987SARTRE, J. P. Questão do Método. In: PESSANHA, J. A. M. (seleção de textos) Sartre. Vida e Obra, 3a. ed. São Paulo: Nova Cultural, 1987. (Coleção Os Pensadores).). Therefore, there is a common substance to the different individuals, which speaks to us of culture and reveals the rules of life in society. But, also, it reveals the individual appropriation, with differentiated valuations of the materiality of social life, of the inequalities of situations experienced, and of the different opportunities for change. This dual revelation enables us, on the one hand, to reach the meanings regarding the acceptance, or not, of violence as a norm to deal with conflicts in family or in society, and, on the other, to also reach the vulnerabilities regarding the social supports and the concrete possibilities of facing situations of violence. We can say, then, that culture operates in two directions in the relation with the individual: internalized, somehow, to all individuals, composing with their inner self before the world that is already there for each individual; and externalized in discourses and actions. Therefore, culture can be rescued, in studies and researches, as an element of sociohistorical connection of individuals territorialized in certain (social) spaces and (historical) times, and in the way that each one internalizes and exteriorizes it, encompassing at the same time the common sociohistorical - what is shared in social life - and the plurality, what distinguishes us in social life. In both dimensions, in which cultural norms are, with and for them, values and objective possibilities for the relations of the individual with the society are inscribed. Such values and their concrete exercises in the intersubjective relations are affirmed or rejected. Thus, cultural norms provide or obstruct the individuals' achievements.

Following (Scott, 1986SCOTT, J. Gender: a useful category of historical analysis. The American Historical Review, New York, v. 19, n. 5, p. 1053-75, 1986.), when she considers the historical construction of masculine and feminine as sociocultural norm in the conceptualization of gender, we can say that this construction operates socially as a reference for the configuration both symbolic and material of social life and thus contributes to define the perception and behavior of individuals. Thus, men and women will differ as social individuals, in terms of what is expected from them and of what they will consider as their actions and responsibilities in social life to be recognized as men and women.

Historically, men always had more presence and performance in public life, and they were established as the (only) individual of politics. Such competence resulted in equal importance as a social worker and as an agent of this same social element in private life. Therefore, a male identity of the family provider is established, building socially the image of the family and each of its members as "property" of the man, because of the material support that this man will bring and because he is socially constructed as the ethical and moral guardian of this same family, educating, guarding, and controlling its members for public life. To the eyes of society and everyone in the family - especially in patriarchal family structures such as those that still today define modes of relationship and configure a certain normativeness in our country - it is the man who defines and monitors the behavior of its members, and at the same time is the representative of the family in society.

As an individual that has been preferred for public life, the man also establishes himself as an individual endowed with greater freedom than women, freedom for being and circulating in the public and private realms, articulating them. Thus, men will be, as a whole, individuals with greater power: political, economical, cultural, moral, and sexual, as workers, parents, spouses, leaders, political agents, educators etc., even if they might occupy positions that are different from this reference, which is the hegemonic as social norm, in the relationships they experience in their daily lives (Couto; Schraiber, 2005SCHRAIBER, L. B. et al. Violência dói e não é direito: A violência contra a mulher, a saúde e os direitos humanos. São Paulo: Unesp, 2005. (Saúde e Cidadania).). Thus, as considered before, the individualized expressions of the male are plural, which also will be processed in terms of the expressions of individuals with lower power by women, in the family and sexual-affective relationships that these individuals build together, in hetero- or homo-conjugality.

Nevertheless, such plurality in gender relations is the hallmark of inequality. Its common substance are the various ruptures historically inscribed in these referentials, creating crises in the traditional identities of male and female, which radicalize the very relationship between individuals of male and female identity toward violence, with men as perpetrator individuals and women as violated individuals.

Thus, with the economic and cultural changes that currently cross the families and in which the contemporary attributions of men and women no longer fully adhere to the historically constructed identities, the traditional gender relations are stage for progressive conflicts, arising from the new performances of the individuals in the public and private life. When these conflicts are "resolved" in the form of violence, we define this violence of intimate and familiar life relations as "gender violence" (Schraiber et al., 2005SCHRAIBER, L. B. et al. Violência dói e não é direito: A violência contra a mulher, a saúde e os direitos humanos. São Paulo: Unesp, 2005. (Saúde e Cidadania).). This gender nature is quite researched in the case of violence against women (Heise; Ellsberg; Gottemoeller, 1999HEISE, L.; ELLSBERG, M.; GOTTEMOELLER, M. Ending violence against women. Population Reports, Baltimore, v. 27, n. 4, p.1-43, 1999.), and even for men, in cases of violence between them, we can recognize elements of gender, in which the victimized man is put by the perpetrator in a situation of inferior, "more feminine" individual (Couto; Schraiber, 2005COUTO, M. T.; SCHRAIBER, L. B. Homens, saúde e violência: novas questões de gênero no campo da saúde coletiva. In: MINAYO, M. C. S.; COIMBRA JUNIOR, C. E. A. (Org). Críticas e atuantes: Ciências Sociais e Humanas em Saúde na América Latina. Rio de Janeiro: Fiocruz, 2005. p. 687-706.).

Thus, we can say that it is around this gender normativeness, common to different cases, that we will find the foundations of reflection to the understanding of the differences between men and women that come from families that experience violent situations or from previous personal experiences of violence, and dislocate, in the adult life, to opposing positions in violent relationships: one becoming the aggressor, and the other, the victim. It is also in this gender referential that we will find understanding relating to the very high frequency of violence against women, as well as the distinction in sexual violence that marks them, even in different cultural and social contexts. As (Heise, 1998HEISE, L. Violence against women: an integrated, ecological framework. Violence Against Women, Lexington, v. 4, n. 3, p. 262-290, 1998.) says, there are four topics consistently found in societies with high magnitude of violence against women, indicating the gender subordination in these situations. They are: cultural or legal norms giving men property right over women; male control over the family wealth; male control of decisions in general; and notions of masculinity associated with domination and sovereignty, being given to men more freedom and power to delimit female behavior in the name of male honor.

Finally, we want to remind that if the cultural and social normativeness is in the cases, then they are presented to care services and to professionals in their singularities, whether in health field, in psychological assistance, or in the care to people in situations of violence. In this realm of care of the cases, this dual reading of their constitutions will be vital to develop a more comprehensive and more powerful care for facing violence, as well as the most difficult action to undertake.

References

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