October 24, 2017, by criticalmoment
Lacan Study Group – Discussion Board
So it was decided in the Lacan Study Group that we would benefit from some sort of rolling blog or discussion forum to help us in engaging with Lacan’s third seminar on the psychoses. To that end, we are going to hijack this blog! It is hoped that everyone involved can post questions and comments but also share relevant links, whether to secondary literature or indeed cultural ‘texts’ (novels, films, art-works – whatever) that help to illuminate the concepts we’re engaging with. To get the ball rolling however, here are some notes on the three sessions we’ve had so far, compiled by myself and mainly Max (thanks Max for that). Apologies for the length of this – a no no in the blogosphere generally – but we can work in more manageable chunks once we settle into a rhythm.
All the best,
SESSION 1 – 09/10/17
An opening discussion of the complex relationship between psychoanalysis and psychiatry.
DSM categories into the 100s [265 in DSM V]; Lacanian psychoanalysis *simple* by comparison, but not descriptive of behaviour – it’s a structural diagnostic approach.
Lacan’s main differential diagnostic approach developed in the 1950s:
1.NEUROSIS (<<< repression)
- hysteria (a ‘dialect of obsession’, according to Lacan)
2. PERVERSION (<<< disavowal)
[Freud on sexuality – we begin as polymorphous, then something happens *socially* that produces ‘heterosexuality’ etc. Perverts not commonly in analysis – why bother? (maybe to unnerve analyst!) See Colin’s book with Diana Caine]
3. PSYCHOSIS (<<< foreclosure)
Only three diagnostic categories/structures, although perhaps ‘autism’ is another [See Jean-Claude Maleval’s book, if you read French]
Repression – there is registration at some point, which is then repressed. Foreclosure – more radical: no registration.
‘Ideogenesis of symptoms’: symptoms not just biological in origin, but ‘psychological/subjective’ – leads to key question: what is a subject? Fundamentally a biological being, or is there something about human experience that’s not reducible to that?
So then, onto Seminar III on psychosis… The Schreber case: a first-person account of a psychotic break and the construction of a delusion which Freud used for his analysis of the issue.
Bleuler credited with concept of ‘schizophrenia’.
‘Psychotic certainty’ = “like lead caught in the net” (Lacan). This refers to the rigidity of delusional convictions which do not lend themselves to dialecticization (so lead in the net means something heavy and unmoving in the net of signifiers).
SESSION 2 – 16/10/17
Because of the way Lacan opens the session, we went over again some of the things I said last week, namely, the idea that psychoanalytic treatment (rather than theorisation) of the psychoses is not a given. He makes a distinction between ‘question’ and ‘treatment’, suggesting that over the course of the seminar he will move towards the issue of treatment through an opening up of the question. In other words, don’t begin by thinking you know what it is! I also pointed out that ‘nosography’ is the detailed description of the presentation of illnesses which are then organised into diagnostic categories. This has very Victorian roots in a kind of positivist empiricism but also a taxonomic zeal. Lacan appreciates the close observation and the resulting rich phenomenology, but of course departs from most of the taxonomies.
We then followed his first diagnostic distinction internal to the psychoses: the schizophrenias on the one hand, the paranoias on the other. The former were getting a lot more attention, partly through Eugen Bleuler and his protégé, Carl Gustav Jung, at the Burgholzli clinic in Zurich, but Lacan notes Freud’s distance from these developments, and greater interest in the paranoias. I suggested this was because the paranoias are more obviously ‘symbolic’ in the sense that a delusional metaphor is made from a signifying scaffolding whereas in schizophrenia the more pressing issue is the integrity of the body and often very ‘real’ ways of regulating that. We then had a quick chat around Lacan’s claim that the unconscious is structured like a language.
We talked about Lacan’s reference to the signifier ‘madness’. I related this to contemporary reappropriations of the term madness within the so-called ‘survivor movement’, which deliberately counters the medical model behind psychiatric diagnoses to say something about the complexity of the experience.
We then followed Lacan’s brief sketch of the status of paranoia in Germany and particularly France. In Germany, almost all forms of insanity were referred to as paranoias. In France however, paranoia was interpreted in terms of characterology and was thus essentially a description of a personality type. We then had a discussion about the danger of diagnosing on the basis of behaviour (the temptation to label people we simply don’t like is lurking here of course). For Lacan, this approach is essentially psychologizing, since psychology often likes to deal with types. We then had a discussion about all the ways in which psychology has tended to offer its services to the state as a tool for the management of populations. Becky pointed out that its methods often boil down to surveys and Likert scale questions which produce a statisticalised version of subjectivity. Here, I confessed my own involvement with DSM and ICD 10 categories as an addiction therapist, pointing out that the numbers very often do lie! John pointed out how these numbers are linked to justifying funding so exert a real power. We also touched on CBT, as an approach the tends to peremptorily establish the criteria for ‘efficacy’ which will justify its legitimacy (e.g., ‘evidence-based practice’).
I said a few things about Lacan’s surprising admiration of de Clerambault who, on the face of it, looks like a paradigm of biological psychiatry. I briefly explained de Clerambault’s idea of ‘mental automatism’ as physiological motor phenomena generated by the body but manifesting as thoughts/speech completely outside the subject’s conscious intention. This has been one way to explain the supposedly erratic speech of psychotics or ‘hearing voices’. Lacan will re-read this idea as a linguistic phenomena, having to do with the insistence of the logic of the signifier, and thus a certain distance from the measure provided by the signified, or meaning. So mental automatism is useful in that it demonstrates that what de Clerambault calls ‘elementary phenomena’ do constitute a breach in intelligibility but the mistake would be to think that psychoanalysis aims to restore this meaning. On this point, we talked about the very widespread misinterpretation of psychoanalysis as a kind of hermeneutics which explains everything through sex or the Oedipus Complex (e.g., very bad versions of psychoanalytic lit. crit.). Psychoanalysis might ‘restore a sense’ but Lacan’s point is that it is not one that is given to understanding (this would always be imaginary). To give a far-too quick example: isolating a signifier that has been repressed isolates it precisely as a signifier, often with a kind of dumb jouissance lodged in it, rather than a signified that seems to mean something.
We ended, then, on the example Lacan gives of the child who wants to know whether the blow he has received is a pat or a slap (bottom of page 6). I suggested this was Lacan’s way of introducing the role of the signifier into a seemingly direct, physiological phenomenon (if pat, delight; if slap, tears). The signified is dependent on the signifier, not the other way around. This is Lacan’s way of taking his distance form the paper by Karl Jaspers on ‘Meaningful Connections’ and also by implication the distinction between explaining and understanding that Jaspers develops in his General Psychology. Jaspers thinks a kind of intuitive empathic understanding needs to be utilised in psychiatric work, especially with psychotic subjects. For Lacan, while admirable in some sort of humanist moralistic sense, this is ultimately a ‘pure mirage’ because understanding is imaginary, veiling the logic of the signifier behind that of the signified. As we said when we worked on the Direction of the Treatment, if you think you understand it’s probably because you aren’t listening anymore …
SESSION 3 – 23/10/17
Brief discussion around setting up some kind of online correlate of the study group, with the group agreeing that a blogroll, open to contributions from all, would be best (rather than a fully ‘interactive’ social media page).
Picking up from the bottom of page 6, Jasper’s concept of ‘understanding’ is critiqued via the key Lacanian concept of the symbolic (order), which disrupts any simple, linear account of ‘meaning transmission’; e.g., the blow issued to a child by the parent is not a simple/closed a—>b exchange, but a symbolic gesture, rooted in the symbolic order, and so provokes a question in/for the infant: what was meant by the blow? Was it a pat, slap, or something else? Even with something as apparently direct and biological as pain, there are myriad possible responses, because our responses as speaking beings are mediated through signifiers. Lacan is opposing the stimulus-response model at the heart of behavioural psychology. E.g., the child that falls but waits to see the expression on a parent’s face to determine how badly they are hurt.
This symbolic space, with all of its slippages, subtleties, ambiguities and questions, is the space of the subject. This opened up a discussion about trauma, and whether it resembles the stimulus-response model of behaviourism. The DSM implies it does, effectively producing lists of traumatic stimuli, but thanks to the role of the signifier (as in the pat/slap example) this can’t be done. Trauma has an unknowable core: Lacan has a neologism for this .. toumatisme (trou meaningly ‘hole’ in French).
Jasper’s concept of ‘understanding’, meanwhile, is the unattainable (‘ungraspable’) hoped-for product of a well-meaning but – for Lacan – useless idealism. If we think we understand psychotic patients, we cease to listen, assuming a consensus on what reality is. Jasper’s ‘general psychology’ is only illuminating insofar as it represents precisely what psychoanalysis is not; scientific ‘psychology’, for Lacan, is imaginary, insofar as it is profoundly disrupted by the ‘anomalies and paradoxes’ of human behaviour (as explored in analysis). The statistical subject of psychology emerges from averages, but no one is average …Lacan also takes his distance from the idea of ‘psychogenesis’ which has been very influential on other orientations in psychoanalysis (e.g., Kleinianism), where there are supposed overlaps with developmental psychology.
Such psychology presupposes certain universal features/truths about the human individual which, in Lacan’s view, stem from an inherited, Kantian-ish conception of the ‘unified personality’, transcendental cognition, the synthesised ego, etc. dating from the 18th Century; but Lacan doesn’t then go too far in the other direction, towards notions of supposedly ‘immediate experience’. Some aspects of existential psychology/psychoanalysis do this in appeals to authentic experience (Jasper’s was influential on Heidegger). For those involved in the group last year, the potential pitfalls of this approach were explored through the clinical case by Irvin Yalom. Lacan claims that Freudian analysis is more akin to sciences like physics in seeking to ‘get behind’ the immediate data of perception etc. E.g., Quantum physics or the findings of the Hadron collider at CERN. At this point in Lacan’s thinking, this would be common to structuralism too: there is an all-too knowable or understandable phenomenon which is ‘meaning’ and the apparent communication of that meaning, but underlying the very possibility of such meaningful communication is langue, a structure of differences that in itself means absolutely nothing. Josh made the links to the notion of entropy and how important that was in the information and communications revolution (Lacan, relatedly, drew a great deal on developments in cybernetics).
Psychoanalytic relation is artificial; analysis a ‘construction’ (Freud’s paper on ‘Constructions in Analysis), structured by this artificiality, rooted in speech/signifiers, not an assumed ‘pre-conceptual’ or ‘pre-linguistic’ experience/reality.
Finally, we had a brief discussion about Lacan’s remarks on the links between ethology (the study of animals, essentially) and psychology. A pertinent example here, of course, would be the famous dogs of Pavlov. In the paragraph at the top of page 9, which was where we stopped, Lacan is interested in the fact that there is indeed a role for the image and thus the imaginary in the animal kingdom, but for humans (and actually some other higher primates he doesn’t mention), this role is taken up in a symbolic order. E.g., there is lots of mimicry in nature, but not the ‘double-bluff’ which requires a symbolic system. This has a clinical relevance connected to Lacan’s assertion that ‘truth has the structure of fiction’.
Session 5 – 06/11/17
I said a few things about Freud’s 1925 paper ‘On Negation’, linking it also to the later paper ‘On Constructions in Analysis’, both of which deal with the already common criticism of psychoanalysis that it is a disempowering imposition of an often Oedipal interpretation that can’t be wrong (as in, because you deny that it’s about your mother, that only goes to show that it is about your mother).
Freud makes two important points: in this kind of situation, it is always the analysand that introduces the new element not the analyst, precisely in the form of a negation. So the more usual situation is the one in which the analysand says ‘I know you are going to say it’s about my mother, but it’s not’. Under conditions of free association, the question would always be, why mention the mother at all? Freud speculates that a repression can be partially addressed in the form of a negation. However, he also notes that there must be an initial ‘yes’ for this to then receive a ‘no’: in other words, it is because the mother is already present in the unconscious that she can appear under the sign of negation.
But what is Lacan doing with this short paper by Freud? He’s using it to unpack his differential diagnosis between psychosis and neurosis. So there are two types of Verneinung (negation):
- repression (verdrängung) where an initial bejahung or inscription is present, in which case we are dealing with neurosis and in symptoms, dreams and slips of the tongue we can see that “what is repressed returns in the symbolic”
- foreclosure (verwerfung) where that symbolic bejahung seems to be absent, in which case we are dealing with psychosis, and in elementary phenomena such as hallucinations we can see that “what is foreclosed from the symbolic returns in the real”
He then turns to one of Freud’s case studies to illustrate this point, the famous Wolf Man case. I pointed out that although Freud, in his haste to prove his theory of infantile neurosis, treated the Wolf Man as if he were a neurotic, the subsequent history of the patient suggests otherwise, not least because he spent the rest of his life seeking out psychoanalysts to complain about the way he had been used by psychoanalysis (a kind of solution in itself, I suggested). Lacan, then, presents him as a psychotic subject insofar as “any assumption of castration by an I has become impossible for him”.
For this reason, he focuses not on evidence of an infantile neurosis as Freud does, but rather on evidence of something like elementary phenomena, and he finds that in the hallucination the Wolf Man experienced of his almost severed finger. As a hallucination, this feels very real for him and he has precious few words about it, suggesting it is not symbolizable. Lacan then points out the similarities, especially at the level of content, between the neurotic return of the repressed, say in the form of intrusive obsessional thoughts on the one hand, and these hallucinatory experience which can take auditory form (i.e., ‘hearing voices’). This is a reminder that we should not diagnose on the basis on ‘semantic content’ along the lines of ‘what he is saying sounds a bit mad, not connected to ‘reality’’ etc. A more rigorous structural approach would want to locate these phenomena in their relation to the symbolic, the imaginary and the real orders. Lacan then begins to do with with his famous L-Schema which demonstrates the difference between the imaginary axis of ‘empty’ speech and the ‘full’ speech of the unconscious in the symbolic.
Further notes since we got on to session 2 of SIII
Lacan’s opening move is to suggest that paranoia once suffered from the same woolly imprecision as the vague term ‘madness’. Psychiatry approached it descriptively as an observable pattern of behaviours that could somehow be set apart as ‘abnormal’ when compared to a putatively knowable ‘normality’. In such an approach, one cannot help but judge people from the perspective of one’s own idea of normal.
Even when some conceptual precision was aimed at with the German psychiatrist Emil Kraeplin in 1899, Lacan disagrees with the resulting definition (“There isn’t a word of truth in it” he insists!). Because Kraeplin’s framework was essentially one biological psychiatry (his over-arching term ‘dementia praecox’ identifies psychosis as a brain-based cognitive decline), he defines paranoia in terms of 1) the ‘gradual development of internal [i.e., organic] causes’; 2) the production of ‘a stable delusional system it is impossible to disturb’; and yet 3) the preservation of ‘clarity and order in thought, will and action’.
Lacan contradicts Kraeplin point by point. To 1) he counters with his own idea of ‘fertile moments’ which can be sudden rather than progressive, and which also seem to be triggered by life circumstances rather than internal organic developments. I gave an example from my own practice, to show that when the real irrupts the signifier on the basis of which a delusion is then constructed is rarely accidental, having to do with the subject’s own history. To 2) he opposes the malleability of delusional systems which respond, often very creatively, to shifting contexts and circumstances (this is one of the reasons why the handling of the transference, especially with persecutory paranoias, can be extremely difficult: one can quickly switch position into that of the malevolent Other). In a rather obvious sense, a delusion that wasn’t flexible enough to make ‘sense’ of varied and variable phenomena would not be of much service. His response to 3) is more complex, precisely because he recognises it as the more entrenched problem within mainstream psychiatry.
Kraeplin’s reference to the preservation of ‘clarity and order in thought’ is another way of saying that psychotic subjects with developed delusional systems make a lot of ‘sense’ in a certain way. Their systems are internally consistent and indeed extremely logical. We believe we understand what they are saying, but we also (think we) know that it doesn’t correspond to reality (whatever that is? I think I called it our communal delusion at one point), and it’s mainly for this last reason that we are pretty sure they are ‘mad’. This position of judgement often parading as a benevolent ‘understanding’ for Lacan is simply not ethical. Lacan acknowledges that efforts have been made to subdivide the paranoias, such as those of his ‘master’ de Clérambault, who makes some distinctions between delusions of interpretation and litigious delusions etc. However, he is of the opinion that a proliferation of descriptive differences at the level of phenomenology are not the answer. Rather, he is advocating a structural approach to diagnosing paranoid psychosis: elementary phenomena should be taken as elementary not in the sense of first or originating, but as elements within a structure with its own logic.
To do this, the analyst has to move away from the trap of believing she ‘understands’ the patient’s intended ‘meaning’. Lacan points out that there may well be a perfectly ‘understandable’ kernel to a delusion (for example, that ‘the CIA are watching my house’) but this is not what is important (i.e., it would be a big mistake to get too involved in trying to disprove this idea that the CIA are watching my house, since I will probably decide very quickly that you are working for the CIA etc. – also, it may indeed be true, which from a Lacanian perspective wouldn’t stop it being delusional). What is crucial to notice in a delusion, then, is that this albeit sometimes ‘understandable’ kernel is “inaccessible, inert, and stagnant with respect to any dialectic”. What Lacan means here is simply that nothing anyone says will shift it, as if it is an S1 to which no S2 can be linked.