Vivências em setting: perspectivas de profissionais de orientação psicanalítica e de participantes de processos grupais on-line

Abstract

In Paths of Psychoanalytic Therapy (1919), Freud pointed to the need for an opening of psychoanalysis to clinical expansions. Since then, numerous discussions have emerged, and what can be observed today is that mental health professionals continue to work in private practice but have also expanded their work to a variety of other contexts – reflections of the living dimension of the psychoanalytic clinic. Thus, considerations regarding the concepts of the therapeutic setting and its applicability to different circumstances remain highly relevant. The setting can be understood as a set of conditions that enable the development of a therapeutic process, allowing for the investigation and transformation of psychic phenomena within a given context. It encompasses both external aspects (such as space, fees, and time) and internal aspects, which concern the mental states that unfold during clinical processes. Considering that such understandings permeate formative processes and professional identification and that, at times, professionals are “removed” from their usual places of practice; studies on the setting demand ongoing attention. In this sense, the present dissertation aimed to investigate the understandings and experiences of the setting from the perspectives of those involved in psychotherapeutic practices. To that end, two studies were conducted. Study 1 investigated how psychotherapists of psychoanalytic orientation understand and experience the concept of setting in contexts that go beyond the standard clinical framework. It was based on interviews with nine psychologists working in diverse clinical settings, analyzed through the clinical-qualitative content analysis method. Participants reported a transition from rigid and idealized views to more flexible understandings that value the setting as an internal attitude of the analyst. They highlighted the importance of ethical stance, listening, and psychic presence as pillars of the therapeutic process. In adapting their work to institutional and virtual environments, professionals faced challenges such as lack of privacy, external interferences, and coordination with teams; management strategies, including agreements with patients and colleagues, as well as the symbolic creation of spaces for listening, proved fundamental to preserving the psychoanalytic function of the setting. The setting was thus observed as a living and relational device that requires constant reinvention in the face of contemporary realities, whose maintenance implies an ethical and symbolic construction that enables the continuity of clinical work in different contexts. Study 2 investigated the effects of an operative group conducted in a remote setting during the pandemic context. As an expanding field of practice, research on online groups is still incipient and requires further consideration; moreover, follow-up studies have proven to be relevant tools for investigating the effectiveness of such practices. Three years after the first intervention, the (re)composition of an operative group was used as a data collection method; six undergraduate psychology students agreed to participate in three new synchronous sessions. Despite challenges related to attendance and adherence, the group served as a space for reconnection and reflection on the previous experience and allowed new demands to emerge, related to the participants’ current contexts. It was concluded that the nostalgia and trust in resuming the remote group setting reinforce the relevance of such devices as tools for emotional support and bond formation. In summary, both studies reveal the vitality of psychoanalytically oriented work (alive and adaptable), capable of responding to the demands of a constantly changing world. The flexibility of the psychoanalytic setting and its capacity to foster meaningful connections through remote operative group practices were central contributions.