From silence to screaming for help: childhood aggression as a demand for care in the face of social sufferingAbstract
The present work aimed to investigate aggressivity complaints brought to the Mental Health Program “Brincando em Família”, seeking to understand how the social suffering generated by structural classism is associated with these complaints. In order to achieve this purpose, we adopted a qualitative approach, designed through a case study developed with a family that utilizes the Program. The exploration of clinical material followed the epistemological assumptions of psychoanalysis, and the analyses were based on the methodological technique of thematic analysis. The findings situate childhood aggression as a family symptom, whose origin lies in silencing the suffering caused by class oppression. Furthermore, aggression is also an expression of the child’s psychological and social suffering, who finds in the “rebellion” a way to demand support from both family and institutions. It is concluded that care work made to address complaints of aggressivity must be conducted through intersectoral partnerships and should involve sociopolitical dimensions..
Keywords
Aggressive behavior; Family relations; Psychoanalysis; Social class; Social vulnerability
Resumo
O presente trabalho tem como objetivo investigar as queixas de agressividade que chegam ao Programa de Saúde Mental “Brincando em Família”, buscando entender como o sofrimento social gerado pelo classismo relaciona-se com as referidas queixas. Para isso, o estudo assume caráter qualitativo, concebido através de um estudo de caso desenvolvido com uma família frequentadora do serviço. A exploração do material clínico seguiu os pressupostos epistemológicos da psicanálise e as análises apoiaram-se na técnica da análise temática. Os achados situam a agressividade infantil como um sintoma familiar, cuja origem está no silenciamento do sofrimento promovido pela opressão de classe. Ademais, a agressividade também é expressão do sofrimento psíquico e social da criança, que encontra na “rebeldia” uma forma de reivindicar amparo por parte da família e das instituições. Conclui-se, então, que o trabalho de cuidado às queixas de agressividade precisa ser realizado em parcerias intersetoriais e implicado em dimensões sociopolíticas.
Palavras-chave
Comportamento agressivo; Relações familiares; Psicanálise; Classe social; Vulnerabilidade social
Aggressiveness is the object of study in different fields of knowledge involving humans and animals, including Biology, Anthropology, Psychology and Psychoanalysis (Pavarino et al., 2006). With regard to the psychoanalytic field, it is a common position, within the existing theoretical diversity, that aggressiveness is conceived as inherent to the human experience, being constitutive of the Self and the subject’s relationship with its objects (Ferrari, 2006).
When psychoanalytic discussions about aggression are focused on childhood, the contributions of the English pediatrician and psychoanalyst Donald Winnicott stand out in their importance. His theory works essentially with children and their relationship with the environment, understanding that subjectivity is not constructed in isolation, thus focusing on the mother-baby dyad (Oliveira & Bustamante, 2020). For Winnicott, human aggressiveness is natural, innate and belongs to the condition of being alive (Bustamante, 2020), and it is through this perspective that aggressiveness will be understood in this study.
Dias (2000) comments on how, in the Winnicottian theory, aggressive acts cannot yet be called as such in the initial stages of maturation, since all aggressiveness presupposes intentionality. Winnicott therefore suggests the term “theoretical voracity” because it indicates the manifestation of intense excitement that is not intended to cause harm. The “aggressiveness” in sucking the mother’s breast or taking a toy from another child’s hands would, in fact, be expressions of “liveliness”, resulting from a primitive impulse that seeks satisfaction and not destruction.
This satisfaction experienced during the use of objects, however, does not have a libidinal character as in the Freudian theory. What happens is that the child goes through a maturation process that involves the integration of his body and, therefore, needs to experience his own strength in the environment. Satisfaction comes from the possibility of experiencing the potential of one’s own body in relation to objects, and not from the object itself. In other words, what the child seeks is not the “breast” – object – but rather “devouring” – relationship with that object (Dias, 2000).
For Winnicott, aggressiveness is also related to the creation of an external reality, which occurs through the “use of objects” mentioned previously. In the early stages of maturation, such objects are subjective and formed from the baby’s projections, but they need to be expelled from their idealized and omnipotent world through destruction so that they become real objects, external to the child’s subjective world. In this process, Winnicott highlights the importance of surviving destruction, which means “not retaliating, not changing attitude, not succumbing” (Dias, 2000, p. 32). That is, from the moment the object is destroyed and its quality is not altered, the child can see it as real and no longer as the result of his/her projections, thus establishing a relationship of true trust (Dias, 2000).
Therefore, the experience of aggressiveness in the Winnicottian theory is directly linked to the maturation process. To achieve it, a “good enough” environment is necessary, where aggressive manifestations can be welcomed and integrated into the subject’s experience. This highlights a fundamental Winnicottian principle that an individual’s potential will only be his/hers from the moment it can be experienced. Dias (2000, p. 12) highlights that:
If the environment provides satisfactory care and is capable of recognizing, accepting and integrating this manifestation of the human, the source of aggression – which, at first, is motility and part of the appetite – becomes integrated into the individual’s total personality and will be a central element in his ability to relate to others, to defend his territory, to play and to work.
Winnicott also highlights the difference between destructive behavior as an expression of “voracity”, mentioned previously, and destructive behavior as compulsion. Excessive and compulsive behaviors are understood in the scholar’s theory as manifestations of “greed”, which can evolve into an “antisocial tendency”. Greed and antisocial behavior are related to the psychological phenomenon known as deprivation, in which the child is deprived of a previous good and important experience. Hence, compulsion emerges as the search for special care, in an attempt to compensate the deprivation suffered in the past (Birman, 2006; Dias, 2000).
However, while greed is a consequence of deprivation suffered in the early stages of life, the antisocial tendency is only developed if the deprivation occurs in more advanced stages of childhood maturation, when the child has already the possibility of recognizing himself/herself as a person per se, distinct from the maternal figure. Thus, this tendency is known in Winnicottian theory as an unconscious appeal for help, since the mature child demands from the environment a kind of compensation for the failures that occurred in his/her care. If there is the idea, at some subjective level, that it is possible to reverse the damage caused by deprivation through antisocial tendencies, then aggressiveness and delinquency become part of the order of hope. The individuals thus display a protest and a distress signal (Birman, 2006; Dias, 2000; Levisky, 2017; Vale et al., 2023).
It is from this theoretical perspective that “complaints of aggression” are welcomed in the Mental Health Program “Brincando em Família” (“Playing with the Family”), a permanent teaching, research and extension program at the Federal University of Bahia (UFBA), linked to the Institute of Psychology and Social Service. The service offers mental health care to children and their families and is unofficially part of the Rede de Atenção Psicossocial (RAPS, Psychosocial Care Network) in the city of Salvador, as it fills gaps in caretaking. In Brincando em Família, demands are received and go beyond the scope of Primary Care; initially, they do not have characteristics of permanent monitoring like in the Centros de Atenção Psicossocial da Infância e Adolescência (CAPSia, Child and Adolescent Psychosocial Care Centers).
The program’s proposal is for a clinic that is similar to an expanded clinic, in which children and guardians have autonomy over their attendance at the site. There is freedom, upon prior scheduling, to attend or not attend appointments according to their needs, so that access to the service becomes less bureaucratic. The work consists of providing group care experiences, mediated by a team of hosts made up of volunteer psychologists and psychology students from the Federal University of Bahia (UFBA). Thus, Brincando em Família focuses on the bond between children, families and foster parents as a caretaking strategy, with the theoretical support of Winnicottian psychoanalysis.
The fact that it offers a free, easy-to-access and non bureaucratic service ends up influencing the audience that attends the program, which is mostly made up of black, low-income families, living in peripheral neighborhoods and with daily experiences of violence and rights deprivation (Flynn & Bustamante, 2024). Many families are also attended by other services, such as the Centro de Referência de Assistência Social (CRAS, Social Assistance Reference Center) and the Centro de Referência Especializado de Assistência Social (CREAS, Specialized Social Assistance Reference Center). Hence, those who attend Brincando em Famíliarequest us to think about mental health through an intersectional perspective.
Intersectionality studies (Gomes, 2022) will warn that social markers, such as race, gender and class, do not exclude each other in the analysis of a given phenomenon, but overlap and manifest themselves in a unified manner. Thus, it is understood that forms of oppression, such as racism, sexism and classism, confer privileges and violence through an integrality of characteristics inscribed in each other, with the aim of perpetuating the supremacy of the white, rich and cis-heterosexual man (Costa, in press).
Taking into account these social frameworks that produce violence and oppression, it is interesting to recover what is understood about social suffering, based on the discussion made by Aiello-Vaisberg (2017). The author explains how the precariousness of actual living conditions, the lack of access to resources and rights, and oppressive social relations have emotional, subjective and psychological repercussions. These repercussions are, therefore, understood as forms of social suffering, conceptualized as “sufferings that take place in contexts of oppression, discrimination and exclusion, causing feelings of helplessness, humiliation, guilt and injustice” (Aiello-Vaisberg, 2017, p. 43). By breaking with the widely held view in traditional psychoanalysis about a psychopathology essentially based on childhood and its complexes, the author’s investigations highlight the importance of the experiences in adolescence and adulthood and the social conditions to which these experiences are inscribed in order to understand human psychological suffering in a broader way.
From the theoretical outlook presented, it is evident that violence experienced in everyday life generates suffering and has an influence on the process of mental illness of oppressed subjects. Thus, intersectional studies that consider the markers of race, gender and class become fundamental for practicing within the field of mental health. In this context, discussing complaints of aggression within the scope of the “Brincando em Família” Mental Health Program requires an intersectional perspective.
Flynn and Bustamante (2024) characterized the profile of children who are taken to Brincando em Família with complaints of “externalizing problems”, taking into account variables such as age, gender, race/skin color, among others. The study was carried out using data from 2018, in which 97 children were admitted with the complaint in question. The outcome of our investigation indicated that the majority of those children were black (71.14%) and male (70.10%). Thus, we discuss how the social behavior and subjectivity of men and women are crossed by a performative gender character, a fact that, because it is based on sexism, hierarchizes the position of men and women in society.
Based on those findings, the authors draw relationships with the complaints of “externalizing problems” observed in Brincando em Família, discussing the differences in the suffering of boys and girls in a gendered symptomatization process. Furthermore, the investigation engages with the theories of Fanon and Nkosi to address issues related to the construction of black masculinity, which is structured based on hegemonic, stereotypical and racist meanings. Thus, it is understood that the incidence of complaints of “externalizing problems” about black boys symbolizes racialized and gendered suffering associated with the social representations of black men.
The study by Bustamante and Oliveira (2023), also developed in Brincando em Família, discusses childcare in families headed by women during the first year of the Coronavirus Disease 2019 (COVID-19) pandemic. Through a case study with the help of semi-structured interviews, the experience of two female heads of household who attended the program alongside their daughters was investigated. The study showed that childcare is shaped by gender mechanisms, especially the maternal mechanism, which places women in a supposed position of “innate capacity” for care.
What happens, therefore, is an overload of female work supported by mothers and other caregivers, such as grandmothers, while the participation of children’s fathers is seen as insufficient and fragile. The authors also indicate that access to public policies is precarious for many families, which is reflected in the difficulty of establishing intersectoral care for children. In this connection, the investigation indicates that Brincando em Família is an important space for children’s mental health care, as it acts as a facilitating environment for children and as an institution that promotes the reweaving (Benghozi, 2010) of family ties.
Thus, it is clear that markers of race and gender have appeared more consistently in the productions of Brincando em Família, whether through more direct research on the themes or studies characterizing users. With an intersectional perspective as the target, however, there is a lack of productions that propose to fundamentally and specifically discuss class issues in the reality of capitalism, since, as already pointed out most of the families attending the program are low-income families.
Hence, in the present study we investigated complaints of aggression in the Mental Health Program “Brincando em Família”, seeking to understand how the social suffering generated by classism, experienced by families in situations of low income and social vulnerability, is associated with these complaints. This investigation is part of a larger project that seeks to review the possibilities of developing mental health care activities for children, adolescents and their families within the scope of the “Brincando em Família” Mental Health Program.
Method
In order to fulfill our objective, this work assumes a qualitative character. It is understood that qualitative research is, in essence, interpretative, since interpretations are made of the data collected with the aim of understanding a certain social phenomenon and attributing meaning to the experiences investigated (Cresswell, 2007).
The study is characterized as an empirical psychoanalytic study, which, according to Fulgêncio (2013), involves the exploration of empirical/documentary/clinical material through data collection and analysis that follow the epistemological assumptions of psychoanalysis. The investigation took place in an expanded clinical context, that is, in a “modified setting of the psychoanalytic method of psychotherapeutic treatment” (Fulgêncio, 2013, p. 52), as the data were collected in a different setting that goes beyond the analyst-patient dyad. The setting in question is that of Brincando em Família, in which the work is based on the connection between foster caretakers, children and their families, where everyone shares the same space during the service.
The investigation was carried out through a case study – a kind of qualitative research that, within psychoanalysis, seeks to report how a certain clinical problem was announced and developed and, with this, be used as an example for psychoanalytic practice (Fulgêncio, 2013). Thus, Yin (2001) states that case studies are preferable research strategies for understanding complex social phenomena and for answering “how” and “why” questions. The author also stresses the importance of the case study for investigating situations within their actual contexts, in which the investigator has little control over the events.
For this study, we analyzed the case of Amir, a 10-year-old boy who arrived at Brincando em Família with complaints of aggression and who attends the program alongside his mother, Assaggi, and his two siblings, Rashidi and Nala. This is a black family, beneficiary of government aid which participates in a social project – called, in this research, “Espaço Africanizar” –, which promotes shelter for children and adolescents in situations of social vulnerability. For ethical reasons and to preserve the identity of the participants, fictitious names were used for people and institutions reported in this investigation. Some family data were also adapted for confidentiality purposes.
The case report was based on the analysis of all the content recorded by the Brincando em Família foster parents regarding the foster family. It is the outcome of weekly clinical consultations (on Tuesdays or Thursdays) which lasted one hour and fifteen minutes, in addition to the intense and detailed work of the team supervision. Official documents such as the first reception records, service reports, psychodiagnostic reports and supervision minutes were revisited. Through these records, we could recover the clinical facts to report the case, which were understood as the events experienced in the psychotherapy setting with a psychoanalytic basis, considering their psychic and subjective aspects as relevant (Reis, 2022).
The clinical facts recovered, that is, the data to be discussed, were reviewed with the support of the thematic analysis technique. According to Braun and Clarke (2006), thematic analysis is a qualitative analysis method that seeks to “identify, analyze and report patterns (themes) within the data” (p. 5,). With this, the authors reaffirm the benefit of thematic analysis as a flexible method, since it is applicable to different theoretical and epistemological approaches to provide rich, detailed and complex data. In the context of this study, the themes identified that provided the basis for discussions were “aggression and class suffering” and “caretaking and its potential”.
The research project that originated this article was approved by the Research Ethics Committee of a UFBA unit, under opinion 120.687. The adult member of the family participating in the study signed the Free and Informed Consent Form (FICF).
Results
The outcome of this study is based on the material generated during the period of caretaking between the family’s first day in the program (reception), until the date of the feedback conversation. This period totaled 7 meetings distributed between the end of September 2023 and the beginning of December of the same year. Meanwhile the family continued attending Brincando em Família.
It is important to note that all the care activities reported were carried out by a team, that is, by different foster caretakers who work in the program. Furthermore, subsequent discussions will be limited to Amir and Assaggi’s data, focusing on the bond between mother and the eldest child. This is because the complaint concerns mainly the child, a fact that will be used specifically in the assessment.
Arrival at the Health Service
The family arrived at Brincando em Família accompanied by a teacher from Espaço Africanizar, a project that referred the family to the service. The first reception was carried out and the complaint that was voiced by Assaggi fell mainly on Amir. According to the mother, her son does not respect boundaries, is aggressive with adults and children, swears frequently, influences his siblings to act the same way; in addition a report on a snack being stolen from a neighborhood market was mentioned. In Assaggi’s words, her son was “a good boy,” but his behavior changed drastically after they spent two years apart, during which the child went to live with other relatives in the countryside while she organized some aspects of her life. From then on, the relationship between mother and son became conflicted.
Assaggi introduces herself as her children’s “mother, father, everything” and, during the visits, she reported facing many difficulties involving motherhood, which came with intense feelings of humiliation, overload and insufficiency. There are several reports of moments in which violence is present in the family dynamics, in which she acknowledges that she is an explosive person and claims that the children “inherited” this from her. In her own words, she “has already made mistakes as a mother” and sees Brincando em Família as a space where, “just like Africanizar”, she can receive help in educating her children. This shift from Espaço Africanizar seems to represent an important deal in the family, as Assaggi refers to the project’s educator as an “angel” and expresses a lot of gratitude for her help.
The Child Who Plays and Calls for Help
Amir is described by the Brincando em Família team as an active child who usually enjoys games that involve the body, such as football, shooting, tag, etc. During his play, cautious, non-aggressive movements were noticed and physical clashes with other children were non-existent. In the program, Amir showed himself to be a sociable child, open to interactions with other children and quite creative.
On his first day at Brincando em Família, the host approached Amir for a brief introduction. When asked if he had liked the space, the child responded that “maybe he did” and, when asked if he would return for the next appointment, he replied: “will I return?” The host describes a feeling of distrust on the boy’s part regarding Brincando em Família.
Amir had continuous issues with the materiality of the treatment room while he went through the program. In addition to asking about the cost of some materials, such as the tatami mat for the floor, the child also asked several times whether he could take toys home, such as game cards and balls, claiming that there were already too many of them at Brincando em Família. The host’s intervention was always to say that it would not be possible to take them home, but that he could always play with those same items during the weekly service hours.
Material issues also appeared during a drawing game on the whiteboard, in which Amir drew a house that he claimed was his. After creating the entire structure of the residence (roof, door, window, etc.), he began to draw the symbol of famous sports brands around the house. Violence was seen in a game that Amir played with puppets, described by the child himself as a meeting between superheroes, in which they discussed ways to defeat the villains. When asked how this would be done, the child responded that “to win, they should beat the villains a lot”.
Regarding interaction with other children, a single conflict situation involving compliance with the rules was reported. During a game of dominoes, the host claims that Amir cheated by looking at her tiles and those of another child, but that she intervened, telling the boy that she was noticing the cheating and that it was not nice to play that way. Amir just laughed and got up to play with something else.
The Mother Who Protects Herself Through Silence
During the consultations, Assaggi is seen as a more reserved person, who gives short answers and does not delve into personal issues. She actually comments on the difficulty she has to talk about her life story, and the need to “take it easy”, which was always complied with by the host. However, it was noticed that subjects that did not involve motherhood or suffering, such as painting, flowers, gardening, left Assaggi excited, smiling and talkative.
As the family went through the program, Assaggi was seen in affectionate interactions with Amir. In one of those moments, the child hid in the cushions in the treatment room and his mother, upon seeing the scene, threw herself on top of him as a joke. Rashidi and Nala repeated their mother’s movement and, with laughter and good humor, the four began a game of pillow fight. In another moment of reported affection, mother and son were drawing together, with smiles and compliments on each other’s drawing, when the host asked what animal they would like to be. Assaggi responded that her animal does not exist in reality, as it would be a phoenix, which is reborn from its own ashes, just as she had to be reborn several times in her life story.
During the consultation in which there was a feedback conversation with Assaggi, the host carried out an intervention that consisted of creating and telling a playful story about a lioness and her three cubs, in order to symbolize the family’s journey in Brincando em Família. When he began telling the story, Assaggi, emotionally, asked: “Is this my story?”, and then asked the host to continue telling the story. After that event, the mother was welcomed to make comments. So, Assaggi began to report seriously and emotionally on her socioeconomic difficulties. Problems in receiving government aid, difficulties in paying the rent, unfavorable housing conditions, food shortages and unemployment are some of the issues mentioned that caused her much worry and suffering. The host also reports that Assaggi claimed that “a house of her own and a steady job” would settle her life, as she could give her children more dignified living conditions and different opportunities than those she was given as a child. Furthermore, the adult takes the opportunity to recall the violent relationship with her own mother and to comment on how difficult mothering Amir has been; she even gets to feel, in her own words, to hate the child. However, Assaggi herself recognizes that, over time, she has tried to rebuild affection, since, “as a mother, she needs to be by her son’s side”.
Discussion
Costa her work (in press, p. 7) points out how “domination is the historical abuse of power by one social group over another”, in which exploitation and violence permeate past and future generations of a given social group. From this argument, classism emerges as a form of domination, typical of the capitalist system that is supported by the division of social classes. Capitalism, as a structure that qualifies subjects based on the consumer’s notion (Costa, in press) and organizes life based on the notion of utility, assumes that all those excluded or on the edge of the system can be eliminated (Rosa, 2022). The capitalist logic then places low-income people – most of whom are black – in a situation of invisible, naturalized and systemic violence (Gomes & Silva, 2022). It is in this deadly context that Amir’s family is inserted.
The child seems to symbolize through his games this systemic violence inherent to capitalism. By playing with superhero puppets and stating that, to defeat the villains, it is necessary to “beat them up a lot”, Amir denounces the current social functioning in which those considered transgressors, bandits or villains have to suffer harsh coercion. Leite and Campos (2020) explain how this repressive dynamic is based on the “ideology of dangerous classes”, named by psychologist and historian Cecília Coimbra, in which poverty is associated with danger and, in view of this, society begins to use “social fear” to justify the punishment, repression, violence and extermination of those considered dangerous.
According to the Brazilian Public Security Yearbook (Fórum Brasileiro de Segurança Pública, 2024), records of deaths due to police interventions in 2023 estimate that 82.7% of those killed were black, 71.7% were aged between 12 and 29 years and 99.3% of them were male. It can be concluded that, in Brazil, those judged as “villains” and who, therefore, need to “get beaten up a lot” by the “heroes” are black boys (Amir) and young men. The aggressiveness represented in their play with superheroes then stages the harsh social situation in which the child himself is inserted, so that play begins to act as a resource for the expression of unconscious fantasies and for the elaboration of the difficulties experienced daily (Aires et al., 2021).
The classism inherent in the capitalist system, as well as racism, sexism and other forms of domination have at the core of their exploitation process the fostering of suffering in those oppressed subjects (Rosa, 2022). However, Lima and Lima (2020) rely on Freud to point out that human beings are incapable of admitting that the existing model of society is not capable of protecting and regulating all human bonds, so that the insufficiency of social institutions is denied and responsibility for one’s own suffering is projected onto the oppressed subject. In this sense, it is a social suffering (Aiello-Vaisberg, 2017) that is revealed through anguish, guilt, shame, humiliation and other feelings associated with inadequacy to the principles of the hegemonic discourse (Lima & Lima, 2020; Rosa, 2022).
The feeling of being impossible to overcome the social suffering generated by classism thus places oppressed subjects in a situation of helplessness, in which discomfort is inscribed in their subjectivities without there being any collective sharing (Lima & Lima, 2020). Suffering, therefore, begins to be censored by the subjects themselves, which is the result of an unconscious process of denial that seeks to anesthetize the anguish resulting from class violence. Silence is thus established as a defense mechanism against the horrors of capitalism (Lima & Lima, 2020; Rosa, 2022).
In connection with Brincando em Família, this silencing was perceived in Assaggi, who often preferred not to talk about mobilizing issues associated with her story and stated that she needed to develop a relationship of trust before being able to open up. However, overload, humiliation, guilt, shame, hatred and, above all, aggression, appear in the data reported about Assaggi and her family, revealing all the life negative aspects she struggles to contain.
Considering as a basis the bonds’ psychoanalysis to help understand the process described in this case, it is important to rescue the concept of “negative” addressed in detail in the theoretical works of psychoanalysts René Kaës and Pierre Benghozi (Benghoz, 2010; Kaës, 2005). The concept concerns the unconscious, enigmatic, repressed, silenced and unsymbolized psychic content: secrets, traumas, violence, humiliation, the unspeakable and the unspoken. For the authors, the negative functions as a family’s psychic heritage obtained through the process of transgenerational psychic transmission, so that the subjects of the group are heirs of the unelaborated subjective matter of their ancestors. The lack of elaboration leads to a repetition of patterns in the generations, so that the negative begins to be expressed through the production of group symptoms (Almeida, 2014; Costa, 2020; Leite & Campos, 2020; Scorsolini-Comin & Santos, 2016; Silveira et al., 2020).
From this general outlook, it is understood that class violence, to which Assaggi and his children are currently exposed and to which her ancestors have been exposed to in the past, results in the silencing attitude seen in adulthood. Such silencing, in turn, is a mirror of the negative transmitted in the intersubjective space of the family group. The transfer nature of the case studied is evident when Assaggi describes herself as an “explosive” person and states that her children “inherited” this characteristic. The generational character appears when the attendee reports the aggressiveness in the relationship with her mother, which is currently repeated in her relationship with Amir and which, in a certain way, the child also reproduces in his other relationships. Aggression is therefore seen as a family symptom whose roots are anchored in the silencing of social suffering.
Having already located the aggressiveness in the clinical case from the group/family and social dimensions, it is time to look at this symptom in Amir’s singularity. With the support of Winnicottian theory, it is possible to understand the complaint of aggression that affects the child as clinical manifestations of what the author called antisocial tendency. In the words of Winnicott (1967/1999), this tendency begins when the child realizes that “things were going well, but suddenly they start not going so well” and “a change occurs that alters the child’s entire life” (p. 82), which will trigger the phenomenon of deprivation.
It is noted that, in the story of Assaggi and Amir, the territorial separation between mother and son was the moment of change that may have generated environmental failures in the care of the child, so that acts of aggression and rebellion emerged as a claim for the affection that was diverted. However, it is important to remember that antisocial behavior is a call for help, an SOS, and does not necessarily have a psychopathological character (Vale et al., 2023). Amir is therefore not a sick child, but a child seeking support.
Following this path, something strongly noticed in Amir during his first day at Brincando em Família was his distrust of the space. According to the study by Vale et al. (2023), it is common for children who have suffered some degree of deprivation to show signs of distrust, arising from the fear of experiencing new failures in their care. In this way, trying to maintain a distance and not “giving in” emotionally to Brincando em Família right from the first contact works as a protection strategy, because, uncertain whether or not he could trust the program’s care, Amir needs to ensure that he will not go through the same emotional losses that he went through previously.
Levisky (2017) also addresses how Winnicott, in his work “Deprivation and Delinquency”, reflects on the delinquency practiced by young people in a context of helplessness in Europe after the Second World War. For the author, Brazil is going through a similar process, but the determinants of “deprivation and delinquency” would, in fact, be the violence, helplessness and lack of institutional support to which young Brazilians are subjected. If, within the family, there is a demand for special care from caregivers, it is clear that, by expanding the field of analysis to the social macrostructure, the antisocial tendency demands the assistance and support that were denied to the child by society. From this, there is a meeting point between the Winnicottian perspective on aggressive acts and the ideas already discussed in this investigation in relation to social suffering.
In this sense, Amir’s playing seen in Brincando em Família also gives clues about his social suffering. The questions about the value of objects, the requests to take toys home and the drawing of a house surrounded by the symbols of famous brands reveal the scarcity of material resources that affect the child, resulting from the low-income situation of his family. Hence, Amir’s aggressive behavior can be perceived as a protest not only against the deprivation suffered in his family relationship, but also against the unequal social context in which the child is inserted. Thus, his aggressiveness is also, a demand for care and support from social institutions. However, it should be noted, once again, that it is not poverty that produces “delinquency”, but rather social helplessness and the lack of dignified living conditions offered to young people (Levisky, 2017).
Another important point about the complaint of aggression in the clinical case is the episode of “stealing” a snack in a neighborhood market. To discuss what happened, we ought to recall something mentioned earlier in this study, in which the child’s satisfaction during the use of objects comes from the quality of the relationship that he establishes with the objects and not from the quality of the actual objects (Dias, 2000). In “Delinquency as a Sign of Hope”, Winnicott associates this premise with the antisocial behavior of stealing, in which the satisfaction of theft is not in obtaining the stolen item, but rather in realizing one’s ability to perform the stealing. From this perspective, it is understood that the act of stealing symbolizes Amir’s need to feel capable, strong and creative in order to find food – a need that seems to be important to him, since there are reports of times when his family went hungry. The child, then, does not want that food per se: he actually wants to recognize within himself the potential to obtain it (Winnicott, 1967/1999).
Furthermore, the Winnicottian understanding of emotional maturation emphasizes the importance of the environment in the child’s development process, which means that, even if human beings have a natural tendency towards development, they need to be inserted in a favorable, facilitating or sufficiently good environment (Bustamante & Oliveira, 2018; Oliveira & Bustamante, 2020; Vale et al., 2023). It is, therefore, an environment that is attentive to the children’s needs and capable of meeting their demands, in a way that provides experiences of development and well-being (Bustamante & Oliveira, 2023; Oliveira & Bustamante, 2020). When discussing specifically the care of children with aggressive behavior, Winnicott (1967/1999, p. 89) states that the psychotherapy space must be “foreseen” and “reliable” to be beneficial to the child development.
From this perspective, we understand that Brincando em Família operates as a “good enough” environment in caring for Amir and in managing his aggression complaint. This inference is exemplified when the program’s host repeatedly tells the child that he or she will not be able to take the toys home, but that he or she will be able to play with those same items, always at the same time, on the same day of the week and during the same care period. With this intervention, the psychotherapeutic setting becomes well defined and conveys predictability and allows the child to establish a relationship of trust with the space (Winnicott, 1967/1999). It is in this sense that, for the treatment of antisocial tendencies, Brincando em Família offers a safe and continuous environment (Aires et al., 2021), where care is stable and predictable, in which Amir knows that he can find again the care that was diverted from him in the past.
Another aspect that places Brincando em Família as a “good enough” environment is the survival of Amir’s aggressive manifestations, which means, in the words of Winnicott (1967/1999), being “indestructible in certain essential aspects” (p. 86). This occurs because the program has the characteristic of welcoming children’s spontaneous gestures (Aires et al., 2021; Bustamante & Oliveira, 2018), so that boundaries are set without punishment or retaliation. This condition becomes evident when Amir, cheating at dominoes, is noted for his behavior and the host intervenes calling his attention without assuming a coercive stance, such as removing him from the game or reporting him to his mother. We see then that Brincando em Família acts as a potential space to recognize, accept and integrate Amir’s manifestations, in which surviving aggressiveness brings possibilities for expression and elaboration of the child’s own complaint.
In their study, Vale et al. (2023) also warn that children who display antisocial tendencies may direct their anxieties and needs towards environments outside the family. Hence, other spaces where the child lives (such as school) also begin to suffer the impact of their aggressiveness. That said, it is understood that clinical work aimed at “complaints of aggression” also involves dialogue with the workers (in education, health, etc.) involved in caring for children and their families in different spaces and sectors. From this idea, the need emerges for care to be constructed through intersectorality and, therefore, with network articulations.
Network articulation is an important technology in Psychosocial Care (PC) that goes against the logic of sectorized and specialized care. In fact, it proposes as a basis, that professionals act actively and jointly, with cooperation between different areas of knowledge and with the transmission of resources towards comprehensive care for individuals with mental suffering and their families. Therefore, Network articulation’s main point is to provide spaces for dialogue between the different social policy services, in order to foster collective actions among those involved in the care work, whether they are professionals from different specialties or service managers (Avelar & Malfitano, 2020; Carlos & Gallassi, 2024; Pelinski & Bourguignon, 2019). It is through articulations and partnerships in intersectoral networks that PC will be able, according to public policies, to “ensure mechanisms for education, social protection, inclusion, promotion and guarantee of the children’s rights, adolescents and their family” (Fernandes et al., 2020, p. 730).
Networking was very important for the clinical development of the case reported in this study. The participation of the educator from Espaço Africanizar stands out in this process, as she not only referred the family to the organization Brincando em Família, but she was also present in most of the sessions. At various times, it was perceived how Africanizar played a supporting role (Figueiredo, 2007) – and, therefore, a caring role – in the family dynamics. The closeness between Assaggi and the educator allowed the attendee, through her involvement in the process, to be more comfortable in the services and, thus, her connection to the program was facilitated. By saying that she sees Brincando em Família as a space to receive help in educating her children “just like in Africanizar”, the adult reveals an expansion of the transferential bond, previously directed only to the social project and now extended in both directions. Thus, it is understood that Brincando em Família and Africanizing are considered partners in family care.
In this entire context of care, we ought to remember that, in Winnicottian psychopathology, emotional health is translated starting from an authentic and spontaneous position in relation to life, in which the subject acts in an emancipated manner and not subordinated to reality (Aiello-Vaisberg, 2017). To live in the world in a creative way is, therefore, a fundamental form of health, and playing comes to be understood as an indicator of mental health (Jucá & Mascarenhas, 2020). Thus, the creative space provided by playing sets the activity, in itself, as essentially therapeutic. Through play, children begin to build a relationship of trust with themselves and creativity with external reality, which fosters their emotional development as subjects (Winnicott, 1971/1975).
Playing assumes importance in the children’s connection with their reality to the extent that it is understood as an “intermediate” area, that is, one that simultaneously contemplates the subject’s external and internal reality. This is because, for Winnicott, playing is constructed from objects/phenomena that come from external reality, but which are used under a logic specific to the internal reality. In this way, the activity becomes revealing of the psychic contents of the person playing, a fact that allows the psychotherapist to work with unconscious material (Winnicott, 1971/1975). Thus, playing is seen as a significant path of expression and subjectivation for children, but is also an important driver of psychoanalytic clinical work (Jucá & Mascarenhas, 2020).
In Brincando em Família, playing was important in the caretaking of Amir. It was noticed that, in a space where he could freely exercise his creativity and develop unconscious fantasies, Amir was seen as an active, sociable, creative and not very aggressive subject. Playing allowed Amir to be known from another perspective and, hence, narratives about him could be developed beyond the “complaint of aggression”. Such narratives, when witnessed and mirrored (Figueiredo, 2007) by the program’s host, can influence a positive perception of the child about himself, which helps in his construction of the self and, consequently, in his development as a whole.
Conclusion
In this investigation, we sought to understand the relationship between complaints of aggression and the social suffering generated by classism within the scope of the Mental Health Program “Brincando em Família”. As a possibility of understanding the topic, aggression in childhood is seen as an expression of the child’s intrapsychic conflicts, so that such behaviors can be interpreted as an unconscious call for help. However, in dialogue with bonding and psychosocial dynamics, it is clear that aggressiveness can also be seen as a group symptom of a family that is inserted in a transgenerational web of social suffering intrinsic to capitalism.
Taking into account the need to construct intersectional narratives for this debate, the class marker was chosen as a central point of the discussions considering a gap perceived in the literature. It is recognized, however, that the social markers of gender and race were addressed tangentially in this research, but they are equally important for the analysis of the subjective phenomena addressed here. Therefore, it is essential that further studies delve deeper into the intersection among gender, race and class in child mental health care and their potential dialogues with the aggression theme.
Through the clinical case report, it was possible to identify subjective, group and social processes that influence the understanding of aggression complaints. In view of this, the discussion regarding the possibilities of welcoming children and families in situations of social vulnerability is expanded, in order to recognize and enhance sufficiently the good practices in caring for this audience. Partnerships in intersectoral networks are essential in this process, because in order to strengthen the field of children’s mental health, it is necessary to deal with professionals who work in caring for children and their families in the most diverse sectors.
In this sense, the discussions proposed here collaborate with other studies carried out in the psychoanalytic field that point to the idea that every psychic phenomenon is experienced from a social, cultural and historical reality. Therefore, it is not possible to think about subjectivity and its conflicts without them being associated with the problems of a given society. If psychological suffering is necessarily intertwined with social suffering, it is clear that all mental health care work must therefore be involved in social and political dimensions.
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Data availability
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