Treating without diagnosis: Psychoanalysis in medical settings in Argentina

Abstract

This article is part of a larger research project the aim of which is to understand the discursive conditions of access and adherence to an outpatient mental health service at a public hospital in Buenos Aires, Argentina. The focus is on the historical conflict between medical discourse and psychoanalytical discourse as it emerges in the negotiation of treatment and diagnostic sequences at first consultations. This allows us to observe, on the one hand, patients who, socialized in medical discourse, and even in psychiatric discourse, expect the usual organization which first offers a diagnosis, however transitory, and then a treatment recommendation. On the other hand, however, psychoanalysts tend to reject diagnostic labels and offer treatment without further justification. This has an impact on the adherence of patients, and allows us to argue for the need of negotiating with medical discourse in order to guarantee engagement and continuity in treatment.