Leitura etnopsicologica do segredo

quiatra\u2009garante\u2009deter\u2009um\u2009conhecimento\u2009do\u2009caso\u2009que\u2009ninguém\u2009poderá\u2009contestar,\u2009
e\u2009que\u2009terá\u2009sempre\u2009autoridade\u2009sobre\u2009as\u2009outras\u2009definições\u2009(aquelas\u2009dos\u2009enfermei-
ros\u2009psiquiatras,\u2009dos\u2009psicólogos\u2009e\u2009dos\u2009trabalhadores\u2009sociais).11\u2009Assim,\u2009o\u2009segredo\u2009
como\u2009produtor\u2009da\u2009intimidade\u2009torna-se\u2009o\u2009que\u2009permite\u2009ao\u2009psiquiatra\u2009reivindicar\u2009sua\u2009
legitimidade\u2009e\u2009sua\u2009especificidade,\u2009isto\u2009é,\u2009a\u2009autonomia\u2009de\u2009sua\u2009profissão\u2009em\u2009uma\u2009
organização\u2009constituída\u2009por\u2009múltiplos\u2009interventores,\u2009todos\u2009eles\u2009participantes\u2009da\u2009
construção\u2009dos\u2009\u201ccasos\u201d.
O\u2009psiquiatra,\u2009por\u2009conseguinte,\u2009tem\u2009relação\u2009com\u2009aquilo\u2009que\u2009há\u2009de\u2009mais\u2009real,\u2009
de\u2009mais\u2009profundo\u2009na\u2009pessoa,\u2009mas,\u2009ao\u2009mesmo\u2009tempo,\u2009aquilo\u2009com\u2009que\u2009ele\u2009se\u2009rela-
ciona\u2009torna-se\u2009também\u2009aquilo\u2009que\u2009ele\u2009pode\u2009decidir\u2009compartilhar\u2009ou\u2009não\u2009com\u2009o\u2009
resto\u2009da\u2009equipe.\u2009E\u2009isto\u2009é\u2009outro\u2009aspecto\u2009do\u2009saber\u2009fundado\u2009sobre\u2009a\u2009prática\u2009do\u2009íntimo\u2009
e\u2009do\u2009segredo:\u2009é\u2009um\u2009saber\u2009privado,\u2009de\u2009qualquer\u2009modo,\u2009que\u2009protege,\u2009ele\u2009também,\u2009
da\u2009obrigação\u2009de\u2009prestar\u2009contas\u2009às\u2009outras\u2009pessoas\u2009interessadas\u2009pelo\u2009caso.\u2009O\u2009segre-
do\u2009portanto\u2009organiza\u2009não\u2009somente\u2009o\u2009que\u2009é\u2009público\u2009e\u2009o\u2009que\u2009é\u2009privado\u2009acerca\u2009do\u2009
paciente;\u2009ele\u2009organiza\u2009aquilo\u2009que\u2009separa,\u2009mas\u2009produz\u2009a\u2009mesma\u2009organização\u2009na\u2009
prática\u2009do\u2009profissional.\u2009É\u2009mesmo,\u2009pelo\u2009contrário,\u2009o\u2009que\u2009ele\u2009sustenta:\u2009aquilo\u2009que\u2009
constrói\u2009o\u2009espaço\u2009\u201cseparado\u201d\u2009do\u2009profissional\u2009na\u2009organização\u2009das\u2009profissões\u2009fabri-
ca\u2009o\u2009espaço\u2009íntimo\u2009do\u2009paciente\u2009em\u2009terapia.
O\u2009segredo\u2009organiza\u2009aquilo\u2009que\u2009se\u2009mostra\u2009e\u2009aquilo\u2009que\u2009se\u2009esconde\u2009nas\u2009rela-
ções\u2009entre\u2009os\u2009profissionais;\u2009o\u2009segredo,\u2009em\u2009outros\u2009termos,\u2009organiza\u2009o\u2009que\u2009separa\u2009
os\u2009profissionais.\u2009É\u2009suficiente,\u2009para\u2009se\u2009convencer,\u2009colocar,\u2009como\u2009eu\u2009faço\u2009às\u2009vezes,\u2009
a\u2009 questão\u2009 seguinte\u2009 aos\u2009 interventores\u2009 de\u2009 ajuda\u2009 e\u2009 do\u2009 cuidado\u2009 que\u2009 trabalham\u2009no\u2009
setor\u2009público:\u2009há\u2009nas\u2009equipes\u2009pluridisciplinares\u2009diferenças\u2009entre\u2009o\u2009que\u2009cada\u2009um,\u2009
em\u2009função\u2009de\u2009seu\u2009papel\u2009ou\u2009de\u2009seu\u2009diploma,\u2009tem\u2009direito\u2009de\u2009não\u2009repetir\u2009a\u2009propósito\u2009
daquilo\u2009que\u2009se\u2009passou\u2009em\u2009uma\u2009entrevista?
O\u2009segredo,\u2009como\u2009as\u2009áreas\u2009de\u2009estacionamento\u2009nas\u2009instituições,\u2009pode\u2009tornar\u2009
visíveis\u2009as\u2009hierarquias\u2009que,\u2009no\u2009trabalho,\u2009jamais\u2009são\u2009declaradas\u2009como\u2009tais.
Podemos,\u2009agora,\u2009retomar\u2009os\u2009fios\u2009que\u2009havíamos\u2009tecido\u2009ao\u2009longo\u2009de\u2009nosso\u2009ca-
minhar:\u2009a\u2009princípio,\u2009podemos\u2009recordar\u2009do\u2009segredo\u2009que\u2009pesa\u2009de\u2009uma\u2009certa\u2009maneira\u2009
sobre\u2009o\u2009paciente.\u2009Ele\u2009induz\u2009não\u2009o\u2009silêncio,\u2009não\u2009o\u2009que\u2009ele\u2009se\u2009cala,\u2009mas\u2009que\u2009ele\u2009diz\u2009
aquilo\u2009que\u2009foi\u2009calado,\u2009inclusive\u2009o\u2009que\u2009se\u2009tornou\u2009segredo\u2009pelo\u2009fato\u2009de\u2009ser\u2009pensado,\u2009
experienciado\u2009e\u2009enunciado\u2009como\u2009tal,\u2009portanto,\u2009o\u2009que\u2009faz\u2009existir\u2009do\u2009segredo.\u2009Nessa\u2009
perspectiva,\u2009vemos\u2009se\u2009alterar\u2009a\u2009relação\u2009entre\u2009segredo\u2009e\u2009intimidade:\u2009não\u2009é\u2009tanto\u2009a\u2009
intimidade\u2009que\u2009cria\u2009o\u2009segredo;\u2009é\u2009sobretudo\u2009o\u2009segredo\u2009que\u2009fabrica\u2009a\u2009intimidade.\u2009
O\u2009que\u2009quer\u2009dizer\u2009nesse\u2009caso\u2009a\u2009intimidade?\u2009Ao\u2009menos\u2009duas\u2009coisa:\u2009a\u2009experiência\u2009
da\u2009interioridade,\u2009mas\u2009também\u2009a\u2009experiência\u2009da\u2009separação\u2009entre\u2009o\u2009que\u2009é\u2009interior,\u2009
privado,\u2009e\u2009o\u2009que\u2009se\u2009torna\u2009exterior,\u2009público.
O\u2009segredo,\u2009portanto,\u2009não\u2009é\u2009tanto\u2009o\u2009que\u2009se\u2009esconde\u2009ou\u2009se\u2009desvela,\u2009mas\u2009o\u2009que\u2009se\u2009
separa,\u2009o\u2009que\u2009deve\u2009ser\u2009separado\u2009e,\u2009em\u2009minha\u2009opinião,\u2009aquilo\u2009que\u2009separa.\u2009Essa\u2009última\u2009
definição\u2009cria\u2009uma\u2009ligação\u2009entre\u2009a\u2009exigência\u2009do\u2009segredo\u2009que\u2009pesa\u2009sobre\u2009o\u2009pacien-
Vinciane Despret
16\u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 Fractal:\u2009 Revista\u2009 de\u2009 Psicologia,\u2009 v.\u2009 23\u2009 \u2013\u2009 n.\u2009 1, p.\u2009 5-28,\u2009 Jan./Abr.\u2009 2011
te\u2009\u2013\u2009o\u2009segredo\u2009cria\u2009a\u2009intimidade,\u2009fabrica\u2009a\u2009interioridade,\u2009inclusive,\u2009nunca\u2009se\u2009sabe,\u2009
aprende-se\u2009a\u2009se\u2009separar\u2009(por\u2009exemplo,\u2009a\u2009não\u2009mais\u2009se\u2009desabafar,\u2009a\u2009se\u2009conter,\u2009pense\u2009em\u2009
tudo\u2009o\u2009que\u2009estes\u2009termos\u2009evocam)\u2009\u2013\u2009e\u2009aquilo\u2009que\u2009se\u2009impõem\u2009os\u2009terapeutas.
Mas,\u2009é\u2009uma\u2009última\u2009coisa\u2009que\u2009faz\u2009o\u2009segredo\u2009em\u2009nossos\u2009dispositivos,\u2009uma\u2009
coisa\u2009que\u2009ele\u2009induz\u2009sem\u2009que\u2009essa\u2009indução\u2009seja\u2009colocada\u2009em\u2009questão:\u2009o\u2009segredo\u2009
não\u2009separa\u2009apenas\u2009o\u2009que\u2009é\u2009público\u2009e\u2009o\u2009que\u2009é\u2009privado,\u2009ele\u2009separa\u2009as\u2009coisas\u2009das\u2009quais\u2009
se\u2009pode\u2009orgulhar\u2009daquelas\u2009que\u2009envergonham.\u2009Para\u2009privilegiar\u2009essas\u2009últimas.12
E\u2009essa\u2009questão\u2009é,\u2009também,\u2009uma\u2009questão\u2009política.
segunDa parte: o efeito sem nome
Gostaria\u2009agora\u2009de\u2009abordar\u2009um\u2009outro\u2009aspecto\u2009do\u2009segredo,\u2009e\u2009que\u2009me\u2009parece\u2009
interessante\u2009 para\u2009 os\u2009 psicólogos\u2009 não\u2009 clínicos.\u2009 Eu\u2009 gostaria\u2009 de\u2009 progressivamente\u2009
deslocar,\u2009com\u2009essa\u2009questão,\u2009do\u2009domínio\u2009da\u2009psicoterapia\u2009para\u2009aquele\u2009das\u2009pesquisas\u2009
em\u2009ciências\u2009humanas.\u2009A\u2009questão\u2009que\u2009vai\u2009amarrar\u2009essa\u2009reflexão\u2009gira\u2009em\u2009torno\u2009do\u2009
que\u2009eu\u2009chamo\u2009o\u2009\u201cefeito\u2009sem\u2009nome\u201d.\u2009Retornemos\u2009a\u2009princípio\u2009à\u2009clínica.\u2009
Um\u2009fato\u2009curioso\u2009me\u2009foi\u2009narrado\u2009por\u2009uma\u2009psicoterapeuta,\u2009quando\u2009evocamos\u2009
a\u2009problemática\u2009do\u2009segredo\u2009em\u2009psicoterapia.\u2009Uma\u2009de\u2009suas\u2009amigas,\u2009psicanalista,\u2009
havia\u2009decidido\u2009publicar,\u2009sob\u2009a\u2009forma\u2009de\u2009um\u2009artigo\u2009em\u2009uma\u2009revista\u2009clínica,\u2009o\u2009caso\u2009
de\u2009uma\u2009de\u2009suas\u2009pacientes.\u2009Para\u2009preservar\u2009o\u2009anonimato\u2009desta,\u2009ela\u2009havia\u2009modificado\u2009
algumas\u2009características\u2009desta\u2009paciente.\u2009E\u2009notadamente\u2009seu\u2009sexo:\u2009ela\u2009reconstruiu\u2009
o\u2009caso\u2009como\u2009se\u2009se\u2009tratasse\u2009de\u2009um\u2009homem.\u2009Ou\u2009porque\u2009esta\u2009paciente\u2009seguisse\u2009com\u2009
interesse\u2009as\u2009produções\u2009de\u2009sua\u2009terapeuta\u2009ou\u2009porque\u2009ela\u2009tivesse\u2009o\u2009hábito\u2009de\u2009ler\u2009re-
vistas\u2009clínicas,\u2009sempre\u2009que\u2009ela\u2009retomava\u2009seu\u2009caso,\u2009ela\u2009não\u2009tinha\u2009problemas,\u2009apesar\u2009
dessa\u2009transformação\u2009maior,\u2009de\u2009se\u2009reconhecer.\u2009\u2009Foi\u2009assim\u2009que,\u2009durante\u2009as\u2009sessões\u2009
seguintes,\u2009nossa\u2009terapeuta\u2009teve\u2009que\u2009trabalhar\u2009com\u2009sua\u2009paciente\u2009a\u2009difícil\u2009questão\u2009
que\u2009ela\u2009trazia\u2009para\u2009o\u2009atendimento:\u2009porque\u2009diabos\u2009sua\u2009terapeuta\u2009acreditava\u2009então\u2009
que\u2009ela\u2009fosse\u2009um\u2009homem?
Esse\u2009tipo\u2009de\u2009história\u2009corre\u2009hoje\u2009o\u2009risco\u2009de\u2009se\u2009multiplicar\u2009ainda\u2009que\u2009sob\u2009for-
mas\u2009sem\u2009dúvida\u2009menos\u2009humorísticas.\u2009O\u2009que\u2009os\u2009psis\u2009dizem\u2009de\u2009seus\u2009pacientes\u2009inte-
ressa\u2009cada\u2009vez\u2009mais\u2009a\u2009estes\u2009últimos.\u2009E\u2009esse\u2009interesse\u2009encontra\u2009hoje\u2009meios\u2009cada\u2009vez\u2009
mais\u2009numerosos\u2009de\u2009se\u2009satisfazer:\u2009testemunha\u2009isso\u2009o\u2009fato\u2009de\u2009esta\u2009paciente\u2009não\u2009ter\u2009
qualquer\u2009trabalho\u2009para\u2009encontrar\u2009os\u2009escritos\u2009de\u2009sua\u2009terapeuta.\u2009Isto\u2009evidentemente\u2009
implica\u2009o\u2009risco\u2009de\u2009arrastar\u2009os\u2009terapeutas\u2009em\u2009uma\u2009escalada\u2009de\u2009artimanhas,\u2009de\u2009trans-
formações,\u2009a\u2009fim\u2009de\u2009que\u2009seus\u2009pacientes\u2009não\u2009possam\u2009se\u2009reconhecer\u2009\u2013\u2009inclusive\u2009de,\u2009
no\u2009limite,\u2009conduzi-los\u2009a\u2009se\u2009abster\u2009de\u2009escrever,\u2009o\u2009que\u2009tornaria\u2009a\u2009transmissão\u2009e\u2009o\u2009
compartilhamento\u2009de\u2009saberes\u2009um\u2009pouco\u2009complicado\u2009ou\u2009de\u2009tornar\u2009o\u2009caso\u2009tão\u2009afas-
tado\u2009da\u2009realidade\u2009que\u2009poderia\u2009se\u2009perguntar\u2009se\u2009uma\u2009ficção\u2009não\u2009seria\u2009o\u2009caso.
A\u2009questão\u2009do\u2009anonimato,\u2009o\u2009que\u2009eu\u2009chamo\u2009\u201co\u2009efeito\u2009sem\u2009nome\u201d\u2009tenta\u2009então\u2009
hoje\u2009um\u2009limite\u2009surpreendentemente\u2009interessante.\u2009Pois,\u2009vemos,\u2009não\u2009se\u2009trata\u2009somen-
te\u2009de\u2009proteger\u2009o\u2009paciente\u2009para\u2009que\u2009ele\u2009não\u2009seja\u2009reconhecido\u2009por\u2009outros,\u2009mas\u2009final-
mente\u2009de\u2009proteger\u2009os\u2009segredos\u2009do\u2009terapeuta\u2009em\u2009relação\u2009a\u2009seu\u2009cliente.\u2009Na\u2009ausência\u2009
de\u2009que\u2009o\u2009paciente\u2009poderia\u2009vir\u2009a\u2009tomar\u2009satisfações;\u2009na\u2009ausência\u2009de\u2009que,\u2009se\u2009a\u2009terapia\u2009
é\u2009sempre\u2009um\u2009processo,\u2009e\u2009eu\u2009acompanho\u2009aqui\u2009uma\u2009observação\u2009de\u2009Thierry\u2009Mel-
Leitura\u2009etnopsicológica\u2009do\u2009segredo
Fractal:\u2009 Revista\u2009 de\u2009 Psicologia,\u2009 v.\u2009 23\u2009 \u2013\u2009 n.\u2009 1,\u2009 p.\u2009 5-28,\u2009 Jan./Abr.\u2009 2011\u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 \u2009 17
chior\u2009(2006)\u2009em\u2009\u201cGuérir\u2009par\u2009la\u2009verité\u201d o\u2009curto-circuito\u2009da\u2009descoberta\u2009comprome-
teria a cura não respeitando o timing;\u2009ou\u2009na\u2009ausência\u2009de\u2009que,\u2009ainda\u2009acompanhando\u2009
desta\u2009vez\u2009Mikkel\u2009Borch-Jakobsen\u2009(2006b),\u2009o\u2009terapeuta\u2009poderia\u2009ser\u2009legitimamente\u2009
suspeito\u2009de\u2009haver\u2009transgredido\u2009o\u2009pacto\u2009de\u2009ignorância\u2009que\u2009protege\u2009o\u2009paciente\u2009das\u2009
perguntas\u2009de\u2009seu\u2009terapeuta.
Poderíamos,\u2009além\u2009disso,\u2009demandar\u2009se\u2009a\u2009função\u2009do\u2009anonimato\u2009não\u2009se\u2009arti-
cula\u2009àquela\u2009já\u2009sublinhada\u2009aqui,\u2009a\u2009propósito\u2009do\u2009segredo\u2009e\u2009da\u2009ética\u2009da\u2009confidencia-
lidade\u2009no\u2009quadro\u2009das\u2009psicoterapias\u2009e\u2009mais\u2009largamente\u2009da\u2009medicina:\u2009proteger\u2009os\u2009
profissionais.\u2009É,\u2009com\u2009efeito,\u2009a\u2009esta\u2009conclusão\u2009que\u2009chegam\u2009ainda\u2009que\u2009por\u2009caminhos\u2009
diferentes,\u2009o\u2009antropólogo\u2009das\u2009práticas\u2009em\u2009torno\u2009da\u2009loucura,\u2009Robert\u2009Barrett\u2009(1998),\u2009
em seu Traite des fous\u2009e\u2009o\u2009sociólogo\u2009da\u2009medicina,\u2009Jean\u2009Peneff,\u2009(2005)\u2009no\u2009capítulo\u2009
consagrado\u2009ao\u2009segredo\u2009médico\u2009em\u2009seu\u2009France malade de ses médecins. Eu não 
retomarei\u2009aqui\u2009seus\u2009críticas\u2009para\u2009guardar\u2009senão\u2009o\u2009fio\u2009comum\u2009que\u2009simultaneamente\u2009
liga\u2009suas\u2009análises\u2009e\u2009se\u2009articula\u2009à\u2009questão\u2009do\u2009anonimato:13\u2009a\u2009ética\u2009da\u2009confidencia-
lidade,\u2009a\u2009prática\u2009do\u2009segredo\u2009 têm\u2009\u2013\u2009principalmente14\u2009\u2013\u2009a\u2009 intenção\u2009de\u2009proteger\u2009a\u2009
autonomia\u2009do\u2009profissional,\u2009de\u2009prevenir\u2009a\u2009possibilidade\u2009de\u2009críticas\u2009externas,\u2009isto\u2009é,\u2009
como\u2009escreve\u2009Peneff\u2009(2005),\u2009de\u2009manter\u2009os\u2009profanos\u2009à\u2009distância\u2009respeitosa.
A\u2009princípio,\u2009não\u2009podemos\u2009ignorar,\u2009essa\u2009prática\u2009do\u2009anonimato\u2009não\u2009é\u2009exclu-
siva\u2009das\u2009práticas\u2009de\u2009cuidado.\u2009Nós\u2009a\u2009encontramos,\u2009por\u2009exemplo,\u2009nas\u2009investigações\u2009
da\u2009psicologia\u2009e\u2009da\u2009sociologia.\u2009E\u2009o\u2009mesmo\u2009motivo