The Internal Nexuses of the Social Determination of Health: a historical and dialectical materialist analysis of health and psychic suffering
Schizophrenia, Biomedical Model, Exploitation-Oppression Unity, Ontology of Social Being
The Cartesian, dualist foundation has been the hegemonic model for apprehending the structure of psychic suffering from the end of the 18th century to the present day, either through subjectivist and idealistic bases of understanding the phenomenon, or through mechanistic materialistic bases. Taking schizophrenia as an object, we seek to unravel how the proposed model for its investigation is based on theories intertwined with the ideology of eugenic bourgeois sociability, which prioritizes profit and commodifies the diagnosis, and therefore disregarding theories about the reality of the object, opting for aphoristic conformations. To this end, we developed a bibliographical study that aims, first, to analyze the ontological roots of the main ways of treating schizophrenia today, idealistic and materialistic, and second, to point out the paths for an apprehension of the dynamics and structure of the constitution of schizophrenia from the complex here called “internal links” of the social determination of health, namely: epigenetics, biological plasticity, the subsumption of the biological to the social and social reproduction. The literature analysis is based on the Ontology of Social Being, by Lukács, in the development of higher psychological functions, by Vygotsky, in neuropsychology, by Luria and Vygotski, and in pathopsychology, by Zeigarnik. It is expected, therefore, to reveal the social determination of schizophrenia, as a complex potentiated by expressions of the social issue, the result of capitalist sociability, constituted by the exploitation-oppression unit.