Modelos de doença e sofrimento: Como a medicina de família e comunidade pensa a dimensão da subjetividade?

Abstract

Based on the implicit foundation in biomedical rationality regarding its object, the disease, and, therefore, the claim for objectivity in the diagnostic operation, the present study sought to reveal the thinking style that hegemonically guides physicians in the current historical time and demonstrate how the family and community medicine specialty brought a proposal for change which it calls the “new paradigm” or paradigm of biopsychosocial integrality. Through the perception that some phenomena addressed to the health area manifest themselves in an anomalous way to that expected by the medical collective, which is based on the biological dimension of illness, the division between mind and body needed to be overcome so that this area could operate with the notion of person and consider psychological and social dimensions involved in the health-disease process understood as a complex phenomenon. Thus, through a review of books and documents that guide the practice of family and community physicians and those working in Primary Health Care, we sought to determine the guidelines for approaching challenging situations, such as suffering classified in the field of mental health, and whether these are aligned with the specialty proposals. Finally, we discuss the understanding of the symptom category based on other epistemologies that create tension and different explanatory models for suffering, questioning the relevance of using protocols for mental health care, in addition to questioning the risks and potential of the actions of family and community physicians.