Seminar III – The Psychoses

1955 – 1956

Chapter I - Introduction to the Question of the Psychoses

(All quotations refer to The Psychoses, The Seminar of Jacques Lacan, Edited by Jacques-Alain Miller, translated  with notes by Russell Grigg, Routledge: 1993)

It is worth starting our commentary on this first chapter of Seminar III, on the psychoses, by noting what might seem a strange aspect of Lacan’s approach to this subject: the major references for Lacan in this seminar are not to the leading psychiatrists of his day. There are only two references in this entire Seminar to Bleuler (p.4 and 135) and only a handful of references to Kraepelin, beginning from the second chapter rather than the first. Equally, only a few references are made to Clérambault, despite the fact that, in the Ecrits, Lacan names him as “my only master in psychiatry” (Ecrits, 65). Instead, as the space they are afforded in the index attests, Schreber’s Memoirs of my Nervous Illness and Freud’s study of Schreber through that text are the major references Lacan turns to in his approach to the psychoses.

Furthermore, we know from Lacan’s opening remarks that the topic he will address this year was initially advertised as the treatment of the psychosis, but Lacan tells his audience that the question of psychosis – that is, the fact that the notion must be put back into question – is where they will need to start from.

The first thing that Lacan draws our attention to is the fact that at the time he was speaking it was schizophrenia rather than paranoia that was attracting the interest of psychiatrists. Why does paranoia, he asks, have a “rather privileged position” (p.3) in Freud’s thought? Certainly there are approximately ten times as many references to paranoia in the index of the Standard Edition than there are references to schizophrenia, but a one-to-one comparison of the number of times Freud employs the two terms might be deceptive, given the alterations in the usage these terms undergo around the time that Freud writes the Schreber case study. However, Lacan notes that Freud insists on keeping a sharp distinction between paranoia and schizophrenia in the field of the psychoses, describing this distinction as “a necessary reference point for the intelligibility of everything we shall subsequently have to say” in the seminar (p.4). Therefore, it is worth making a brief interlude to summarise the place of these two classifications around the time of Freud’s writing.

Towards the end of the nineteenth century German psychiatry treated paranoia as “a very broad clinical type covering most forms of chronic delusional conditions” (Laplanche and Pontalis, The Language of Psychoanalysis, p.296), and this was a usage Freud himself initially employed. Kraepelin’s intervention in the 1890s was to separate dementia praecox (literally, premature dementia) on one hand from paranoia on the other. Shortly after, Bleuler proposed the term ‘schizophrenia’ to take the place of dementia praecox (on account of his belief that the illness was not premature), and included paranoia under the heading of the schizophrenias, as one of its types. Freud’s position in all this was to agree with Kraepelin in separating paranoia from dementia praecox, but to disagree with Bleuler in viewing paranoia as a sub-category of the schizophrenias. Freud also proposed the term ‘paraphrenias’ in place of ‘schizophrenia’. To summarise diagrammatically:

Paranoia


Freud’s recounts his justification for the use of these terms, his keenness to keep paranoia as a separate entity, and his divergences from Kraepelin and Bleuler in this respect, in the third section of the Schreber case (SE XII, p.75-76).

The French context is somewhat different, and in the opening few pages Lacan gives us a bit of background which can help us make things clearer. He contrasts the view put forward in his own doctoral thesis on paranoia in 1932 with that of his fellow French psychiatrist Georges Génil-Perrin six years earlier (Génil-Perrin, Les Paranoȉques, 1926). The latter refers to la constitution paranoiaque identifying five components to the paranoid personality – pride, mistrust, false judgement, inadaptability, and something referred to as bovarysme, a belief in which one is something he is not (cited in G.E. Berrios, The History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth Century, Cambridge University Press, 1996, p.435). Lacan’s doctoral dissertation does not mention Génil-Perrin by name, but as is customary for Lacan he therein attacks his ideas all the same. That attack is repeated here, with Lacan representing him as picturing paranoia as based on behavioural characteristics – a “characterological notion of anomaly of the personality” (p.5) – rather than on a structure or mechanism that might differentiate it from other psychoses. “A paranoiac – at least until the thesis of a certain Jacques Lacan attempted to stir up people’s minds… was a nasty person, an intolerant one, a bad-humoured type, proud, mistrustful, irritable, and who overestimated himself” (p.4). The focus on these characterological traits, according to Lacan, betrays the fact that this theory assumes a psychological genesis to paranoia.

In contrast, what de Clérambault’s employment of the strange term ‘mental automatism’ brings to the fore is the idea that psychotic phenomena in general have a fundamentally antideational [anideique] character. Mental automatism refers to the fact that, according to Clérambault, all categories and sub-categories of psychosis were automatic, autonomous of the subject’s psyche. “What this means”, says Lacan, “is that which doesn’t correspond to a train of thought” (p.6). More precisely, for Lacan de Clérambault’s approach avoids the temptation to psychologise the psychotic and to try to understand their delusional productions. We should not worry about having to understand psychotic delusions, because in doing so we run the risk of falling for the them. As Jacques-Alain Miller put it, in his recent discussion of the newly-proposed category of ‘ordinary psychosis’,

“Making sense is already delusional. And that is a very deeply held conviction of Lacan’s. In practice, when you understand what the patient says, you’re captured by his delusion, by his way of making sense. Your works as a clinician is not to understand what he says. It’s not to participate in his delusion. Your work as a clinician is to understand the particular way, the peculiar way he makes sense of things” (Jacques-Alain Miller, ‘Ordinary Psychosis Revisited’, Psychoanalytical Notebooks, Issue 19, July 2009).

Understanding entails a reduction to a specific theory of the psychosis, usually a psychological one, that obscures the inherent value of the psychotic productions themselves. If our efforts are focussed on understanding psychosis it is only so as to fit it in to our pre-existing world view, to attempt to jam a round peg into a square hole. As Lacan reminds his audience, it is not obligatory that if you hit a child he cries (p.6). This is a criticism which he briefly levels at Jaspers, and to which he contrasts “the value of a sustained discourse” (p.7): giving the patient the time to talk, to put their experiences in their own words, rather than trying to confer a sense on those words too hastily, leaving no possibility that you will be surprised or find out something new. He refers to suicide by way of example: contrary to popular assumption, suicide is more common in spring than autumn. Should we be so surprised at this, though? The fact that more people kill themselves in spring rather than in autumn “is neither more nor less understandable” (p.7): that is, we do not have to have the phenomenon proving or disproving something. “Surprise at there being more suicides in spring than autumn can only be based on this inconsistent mirage called the relation of understanding – as if there were anything that could ever be grasped in this order!” (p.7). Thus, Lacan is painting a picture in which these kinds of latent assumptions have been built up on top of one another to produce psychiatric theories of psychogenesis for the psychoses. For Lacan though, if we respect the individuality of each delusional formation, and allow the patient’s testimony to be our guide, it becomes apparent that there really is no such thing, that “the great secret of psychoanalysis is that there is no psychogenesis” (p.7).

This is really part of a wider critique of psychology, or psychologising explanations, that was a prominent theme in Seminar II. For Lacan, there is an insufficiency in psychologising conceptions – conceptions that rely on what goes on in the individual’s psyche – that make it impossible for us to view psychoanalysis – and the object of psychoanalysis – as the same, or part, of that psychology. If we fail to distinguish the two fields we run the risk of falling back onto what he calls “myths formed ages ago” (p.8): “The myth of the unity of the personality, the myth of synthesis, of superior and inferior functions, confusion about automatism….” (p8). Lacan gives us a definition of psychology that aligns it to ethology, that is, to behavioural patterns, rather than to the subject’s position in relation to the Other, which is key for psychoanalysis:

“… The psychological is, if we try to grasp it as firmly as possible, the ethological, that is, the whole of the biological individual’s behaviour in relation to his natural environment. There you have a legitimate definition of psychology” (p.7).

Psychoanalysis does not take a person’s behaviour as the grounds for making a diagnosis or an intervention; rather, psychoanalysis “brings resources into play that are beyond immediate experience and cannot be grasped in any tangible fashion” (p.8). This does not at all make psychoanalysis anti-empirical, however, because as Lacan points out, in physics “it’s not the property of colour as sense and differentiated by direct experience that holds our attention. It’s something which is behind this, and which conditions it” (p.8). We cannot take the phenomena that we are confronted with at face value and proceed to classify them into categories of neurosis, psychosis (and sub-categories of each) simply on the basis of the manifest symptomatology. In his study of the psychoses, Lacan is looking for a specific mechanism that would indicate a structural difference between the two.

What ‘other resources’ might we bring into play that would help us to do this? For psychoanalysis from Freud onwards, this is a) the transference and b) the injunction to free associate. It is, Lacan says, something artificial but that at the same time, “the analytic relation [is] constituted by what the subject recounts to the doctor and by what the doctor does with it. It’s by setting out from this initial mode of operation that everything gets worked out” (p.8). For Lacan himself however, this artificial resource is the tripartite distinction he establishes between the real, the imaginary and the symbolic, which he himself admits he is “forever harping on as so necessary to understanding anything at all about analytic experience” (p.8).

Here he divides the three orders into the “imaginary or real orders” on one side, and the symbolic on the other (p.9). Whilst the imaginary and real have the property of continuity, the symbolic is characterised by gaps between elements, “every element has value through being opposed to another” (p.9). What we find in psychosis is precisely this lack of a gap, a space that would separate elements – be they other people or inanimate objects – sufficiently enough to stop them becoming overbearing. It is a problem in the symbolic, the fact that something in that realm that would establish a difference and some kind of proximity between  elements is not operative. Lacan describes the effect in terms of the psychotic’s experience:

“Everything has become a sign for him. Not only is he spied upon, observed, watched over, not only do people speak to, point, look, and wink at him, but all this… invades the field of real, inanimate, non-human objects. Let us look at this a bit more closely. If he encounters a red car in the street – a car is not a natural object – it’s not for nothing, he will say, that it went past at that very moment” (p.9).

The example of the red car here is one that Lacan repeats later in this seminar as an example of what de Clérambault refers to by the name ‘elementary phenomena’ of psychosis, the experience the subject has at the onset of psychosis in which meaning is all of a sudden attached to some trivial or unimportant event – even if the subject does not know what this event means, he knows that this meaning refers to he himself in particular.

Lacan gives us three different ways in which we can interpret the meaning given by the psychotic to this ‘elementary phenomenon’. The first is that the red car is a perceptual disturbance (a physiological inability to differentiate colours); secondly, that the red has a definite meaning in the imaginary itself (hostility, anger or danger), as we find in the animal kingdom, for instance; and thirdly that the red car has a symbolic significance (like the way that in a game of cards red has a different value as opposed to black). Lacan says these show us how his three registers of the real, imaginary and symbolic are differentiated. However, it has to be said that when he returns to the example of the red car in the following session, he refers to these three possible interpretations as perceptive, imaginary and symbolic (p.21), and in the way he presents the alternatives here, only the interpretation he labels symbolic seems to live up to its name. Nevertheless, the point he is making is that if experiences are only processed with imaginary or real co-ordinates, without a symbolic order of references, they will appear hostile, threatening, and overbearing. Where we have the symbolic we also have gaps, some kind of organisation which separates things from one another, and this makes a contingent experience like seeing a red car pass in the street lose its malicious signification.

Lacan says that Freud’s approach to the Schreber case is even more pioneering than his approach to dreams, because of the fact that unlike dreams, which were commonly believed to be meaningful before the publication of the Traumdeutung, Freud’s break from his contemporaries on psychosis is more fundamental. However, he notes the fact that Freud nonetheless “leaves the fields of the psychoses and the neuroses both on the same level” (p.11). That is, he fails in doing exactly what Lacan is looking to do in his work: to make a structural distinction between the two, and moreover, one that is not based on a psychosexual aetiology. Freud deciphers the psychotic production in the same way as he does the neurotic’s. Delusion is therefore tacitly equated with the symptom.

We know that Freud never met with Schreber and produces his analysis only via the latter’s memoirs. Thus, we can say that he takes what Lacan calls his “printed discourse” (p.11) as the object of his commentary, and this puts us in the field of the symbolic. What is this discourse a discourse about? Lacan’s answer is that is about Schreber’s own body: “At what level does the sense translated by Freud unfold? From what are the naming elements of this discourse borrowed? Generally speaking the raw material is his own body” (p.11).

This might remind us of the kind of psychotic discourse that Freud characterises in the metapsychological paper on the unconscious as ‘organ speech’ (SE XIV, p.197-199). It is also noteworthy that unlike Lacan (who goes on to privilege Schreber’s encounter with the place of the symbolic father, the un-pere, when Schreber receives his rapid judicial promotion into a world of fathers, people much more senior than him), Freud’s interest is in Schreber’s hypnogogic thought  which has to do specifically with the body, and more specifically, with the eroticised body: “after all it really must be very nice to be a woman submitting to the act of copulation” (cited by Freud, SE XII, p.13).

Lacan tells us that the relation to one’s own body characterises the field of the imaginary and that whilst there is a difference between the way that the imaginary operates in humans compared to animals,  it has the general function of bringing about a relation to one’s own body that condenses on what becomes the erogenous zone:

“If there is anything in man that corresponds to the imaginary function as it operates in animals, it’s everything that, in a fundamental manner but one that is always barely graspable, relates him to the general form of his body at a point called an erogenous zone. Only analytic experience has been able to seize this relationship, always at the limit of the symbolic, at its mainspring” (p.11).

The establishment of the erogenous zone sits at a juncture between the imaginary and the symbolic. It is the hook onto which the whole imaginary relation – both of the subject to his own body, and to that of his semblables – hangs.

At the opening of the third section of this chapter, Lacan starts to explore where the difference in mechanism between psychosis and neurosis might lie. Whilst we know that Lacan formulates the foreclosure of the Name of the Father in psychosis as being the crucial difference here, we must remember that his audience are not yet aware of this, and that Lacan himself does not refer to foreclosure this early in the seminar. We must therefore use the discussion here to retrace the steps Lacan takes to arrive at the distinction between repression in neurosis and foreclosure in psychosis.

He begins by addressing the idea that the unconscious is out in the open, at the surface. Does it necessarily follow then that there is no unconscious in psychosis? If we think of the (topographical) unconscious as the sum of the repressed, and the return of the repressed as being evidence of a (dynamic) unconscious, then where repression is lacking – as Lacan comes to believe is the case in psychosis – there would surely be no unconscious (or at least, only a non-conscious, in the descriptive sense rather than in a dynamic sense). Lacan appears to agree with this, as he says later in this seminar that, “We also find in the very text of the delusion a truth that isn’t hidden, as it is in the neuroses, but made well and truly explicit and virtually theorised” (p.28), but his comments later in this chapter show that he is interested not in whether or not the unconscious is evident in psychosis, but why its contents do not appear to be repressed as such – why it appears that these elements lack the ‘return’ of the repressed we see in neurosis, and why psychosis therefore gives the impression that the unconscious is at the surface. Another way of raising this same problem would be to ask: if there is no repression of a truth that would animate psychical conflict, and which it would be the job of analysis to uncover , do we not then have to abandon any psychodynamic theory? To get out of this problem, we would have to identify a mechanism that was operative in psychosis which looked like repression, and had the same effect of giving what was unconscious an alien or unrecognised appearance to the conscious subject, but was at the same time somehow different.

Lacan approaches this in the following way:

“The question is not so much why this unconscious, which is articulated at ground level, remains excluded for the subject, not adopted by him – but why it appears in the real” (p.12).

Lacan reminds his audience of the address he invited Jean Hyppolite to make at Lacan’s seminar two years earlier on the subject of Freud’s short paper, ‘Negation’ (Seminar I, p.289, translated by John Forrester, Norton, 1988). What Lacan takes from this paper is the idea that repression is not enough to account for what is unconscious. The repressed and the return of the repressed are coextensive, two sides of the same coin. Later in this seminar he tells his audience that “… repression and the return of the repressed are one and the same thing, the front and back of a single process” (p.60). For example, in a Freudian slip, the repressed is evident in our speech. Even if we do not accept the words that we have used, nonetheless we have to admit that we have used them at that point in our discourse and not another; and that we might have used them at a time and in a context where they clearly say something about the thing we wanted to refer to, but in another, though significant, way. Repression however is a secondary phenomenon. At a more fundamental level “there must be admitted a primordial Bejahung, [(judgement of affirmation)] an admission in the sense of the symbolic, which can itself be wanting” (p.12). Lacan contrasts Freud’s German term Verwerfung with his Verneinung – a subtle difference that amounts to distinguishing a “phenomenon of exclusion” (p.12) from one of negation (the former corresponding to the term ‘foreclosure’). The difference lies, perhaps, in a question of degree, in that this exclusion is a far more radical rejection than simply a denial or negation.

However, it is important to note that, as Lacan presents it here, both negation and exclusion are after the fact. As he puts it, verwerfung entails that the subject “refuses access to his symbolic world to something that he has nevertheless experienced, which in this case is nothing other than the threat of castration” (p.12, my italics). The subject refuses to give castration a place amongst the other elements in his symbolic world. As Lacan’s neat expression has it, “Whatever is refused in the symbolic order, in the sense of verwerfung, reappears in the real” (p.13). Indeed, this maxim can be seen as an echo of a choice of words Freud employs when describing why Schreber’s psychosis cannot be conceived as simply a projection of latent homosexual feelings for Flechsig. Freud tells us that “It was incorrect to say that the perception which was suppressed internally is projected outwards; the truth is rather, as we now see, that what was abolished internally returns from without” (SE XII, p.71).

However, on this question of differentiating refusal from negation, a number of questions arise:

1. What agency makes this refusal? And, following from this: to what extent is this a choice of the subject?

2. Given that Lacan presents both as post-facto mechanisms, is the difference between verwerfung and verneingung just a question of degree? Is this the only thing that determines whether something is negated or whether it is radically excluded?

3. If so, why is it that the two mechanisms are so different – different enough to account for two different clinical structures (perversion and psychosis)?

Lacan’s way of addressing the negation or refusal question is to turn to Freud’s case of the Wold Man. Lacan states in no uncertain terms that he believes the Wolf Man to have had a psychotic structure (p.13), and although this was not triggered or made apparent whilst in analysis with Freud, Lacan finds clear evidence of the structure in a childhood hallucination recorded by Freud:

“When I was five years old, I was playing in the garden near my nurse, and was carving with my pocket-knife in the bark of one of the walnut-tress that comes into my dream as well. Suddenly, to my unspeakable terror, I noticed that I had cut through the little finger of my (right or left?) hand, so that it was only hanging on by its skin. I felt no pain, but great fear. I did not venture to say anything to my nurse, who was only a few paces distant, but I sank down on the nearest seat and sat there incapable of casting another glance at my finger. At last I calmed down, took a look at the finger, and saw that it was entirely uninjured” (SE XVII, p.85 – 86).

In relaying this example to his audience it is not the hallucination itself that interests Lacan. It is rather the fact that the Wolf Man did not mention it to his nurse, despite the fact that she was apparently in all other respects his confidante. This is for Lacan a sign that his experience was radically refused access to the symbolic:

“How significant is that suspension of all possible speech! - and precisely with the person he used to recount everything to” (p.13).

However, despite Lacan saying that “Freud’s text is free of ambiguity on this point” (p.13), this still does not make things clear. If we take a closer look at Freud’s comments before he describes this hallucination, it is clear at least that Freud himself says some ambiguous things about whether or not castration has been recognised. It is worth quoting the passage in question in its entirety:

“We are already acquainted with the attitude which our patient first adopted to the problem of castration. He rejected castration, and held to his theory of intercourse by the anus. When I speak of his having rejected it, the first meaning of the phrase is that he would have nothing to do with it, in the sense of having repressed it. This really involved no judgement upon the question of its existence, but it was the same as if it did not exist” (SE XVII, p.84).

It is this “in the sense of having repressed it” that Lacan quotes to show that something has been excluded from the symbolic, where the judgement of affirmation or Bejahung is missing: “The relation that Freud establishes between this phenomenon and this very special knowing nothing of the thing, even in the sense of the repressed expressed in this text translates as this – what is refused in the symbolic order re-emerges in the real” (p.13).  However, Freud goes on:

“Such an attitude, however, could not have been his final one, even at the time of his infantile neurosis. We find good subsequent evidence of his having recognised castration as a fact (SE XVII, p.85).

If we remember that Lacan is looking for a rejection of castration in psychosis – that he “refuses access to his symbolic world to something that he has nevertheless experienced, which in this case is nothing other than the threat of castration” (p.12) – then Freud’s remarks immediately above seem to contradict the assertion that castration has been rejected. To resume the quotation from Freud:

“In this connection, once again, he behaved in the manner which was so characteristic of him, but which makes it so difficult to give a clear account of his mental processes or to feel one’s way into them. First he resisted and then he yielded; but the second reaction did not do away with the first. In the end there were to be found in him two contrary currents side by side, of which one abominated the idea of castration, while the other was prepared to accept it and console itself with feminity [sic] as a compensation. But beyond any doubt a third current, the oldest and deepest, which did not as yet even raise the question of the reality of castration, was still capable of coming into activity” (SE XVII, p.85).

Freud seems to want to highlight to us the extremely ambivalent attitude that the Wolf Man has to castration. He accepts it, but still resists it, and therefore holds “two contrary currents side by side”: that castration is possible and that it is not. However, in a very ambiguous addition, Freud adds that at a more fundamental level he does not even raise castration as a question! It is in this final remark that we might find evidence of a foreclosure – the fact that, when confronted with it, he does not even ask himself whether it is possible for him. It is a more fundamental refusal than simply accepting or rejecting it – it is as if the topic itself is never given consideration.

Nevertheless, if we take the first two reactions that Freud cites – resistance followed by yielding, but in which the yielding does not supplant the resistance – we might read the Wolf Man more as a case of fetishism, as the mechanism that Freud tells us is at work in fetishism – disavowal, or verleugnung in German – seems most appropriate to what Freud is describing. This is how he presents the mechanism of fetishism in his 1927 paper on the subject:

“If we wanted to differentiate more sharply between the vicissitude of the idea as distinct from that of the affect, and reserve the word ‘Verdrangung’ [repression] for the affect, then the correct German word for the vicissitude of the idea would be ‘Verleugnung’. ’Scotomization’ seems to me particularly unsuitable, for it suggests that the perception is entirely wiped out, so that the result is the same as when a visual impression falls on the blind spot in the retina. In the situation we are considering, on the contrary, we see that the perception has persisted, and that a very energetic action has been undertaken to maintain the disavowal. It is not true that, after the child has made his observation of the woman, he has preserved unaltered his belief that women have a phallus. He has retained that belief, but he has also given it up.” (SE XXI, p.153 – 154).

Lacan’s answer to this suggestion of disavowal instead of foreclosure would be that what we see in psychosis is not simply one belief placed over the top of another in order to sustain the disavowal (such that we have two contradictory beliefs about castration still in place), but the reappearance in the real of what the subject has refused at a more original level. The Wolf Man’s psychotic structure would be pointed to by the fact that what has been refused returned from the real in the form of a hallucination.

But can we be so sure that this is a re-emergence from the real? Taking another perspective on the hallucination, could it not be argued that it represents exactly castration? Rather than being foreclosed, could we not say that, on the contrary, it is clear that the hallucinated (or, perhaps, imagined) amputation is a manifestation of castration itself, only manifested in the very way that we would expect it to be in a neurosis – transformed via a metonymic displacement from the penis to a suitable substitute - the finger?

For the time being however we can leave these questions aside on the grounds that we should not expect so much to be accounted for in the first session of this seminar. Indeed, it is worth pointing out that at this stage in the seminar Lacan does not use the word ‘foreclosure’ to translate Freud’s Verwerfung. Although we have seen that he references the German terms that Freud employs in order to make a distinction between mechanisms, Lacan speaks at this stage of two different forms of repression: “The origin of the neurotic repressed is not situated at the same level of history in the symbolic as that of the repressed involved in psychosis, even if there exists the closest of relations between their contents” (p.13).

Turning to verbal hallucinations, Lacan brings back us back to the version of the L schema, in which full speech can be plotted as lying on the dotted line which runs between S and A:

Schema L


What is demonstrated by this model is that all speech that is full speech cannot be transmitted directly to the Other, but must go via what Lacan calls the “detour” (p.14) of the small others, the imaginary ego-to-ego relations. This is why Lacan says that “the subject speaks to himself with his ego” (p.14). However, what we find with psychotics is a different relation to their own speech which may help us think about verbal hallucinations. In an assertion that is clearly contrary to any ego-psychology reasoning, Lacan says that it is the neurotic subject’s relation to his ego which is more unstable than that of the psychotic. Whereas the neurotic knows that he can never reconcile his own image with his speech, in psychosis we see “the subject completely identified either with his ego, with which he speaks, or with the ego assumed entirely along instrumental lines” (p.14). For example, we might think of the neurotic subject being a split or barred subject - $ - whereby a slip or error pointed out by an analyst as indicating another meaning might demonstrate a non-coincidence of the subject and his ego; however, a psychotic would have no such experience of the Otherness of their own words, or that they might convey a meaning which they are unaware of. The psychotic’s, subjectivity is absolutely identical with their ego, with their self-image. This is why Lacan suggests that it is not that the unconscious is out in the open for the psychotic, but that it returns in the real. However, when it does so as a verbal hallucination in particular, it takes the form of the ego, a voice from within addressing the psychotic and telling him something about himself:

“The moment the hallucination appears in the real, that is, accompanied by the sense of reality, which is the elementary phenomenon’s basic feature, the subject literally speaks with his ego, and it’s as if a third party, his lining, were speaking and commenting on his activity” (p.14).

Lacan explains that through the rest of this Seminar he will be employing the three registers of the real, imaginary and symbolic to account for psychotic phenomena, and that this will allow him to approach the theory of object relations, at that time dominant at least in the British school. In his closing remarks to his session, he makes an attack on object relations. He believes there to be a “misrecognition of the autonomy of the symbolic order” (p14 -15) on the part of the object relations school, and this has the effect of conflating the real and imaginary, ignoring the dimension of speech which is central to the practice of psychoanalysis. When the symbolic is appealed to in such a practice, it is answered from the imaginary, from fantasy. Such a practice makes “analysis the anteroom of madness” (p.15), he alleges, because in a way similar to the psychotic’s operation, there is something that resembles a foreclosure on the symbolic, a failure of the symbolic to overwrite the imaginary. Moreover, the failure to recognise this symbolic dimension means that, as with the ego psychologists that are Lacan’s favourite object of derision, the subject is seen as inseparable from the ego. This can have severe clinical consequences, Lacan believes. If the treatment is not handled with an eye to this symbolic level, it can trigger a rapid or persistent delusion “which consists in authenticating the imaginary, in substituting recognition on the imaginary level for recognition on the symbolic level” (p.15).

So to conclude our remarks on this first session: on the one side we have the question of diagnosis which relies not on the subject’s behaviour or temperament but on a particular mechanism which would separate psychosis from neurosis, and which Lacan attempts to find a reference to, however ambiguous, in Freud’s texts. On the other side, there is the question of the handling of the treatment of psychosis, as is evident by Lacan’s concern to point out where object relations theory might do well to make use of the distinction between the three registers. As we saw, Lacan opens this year of the seminar by saying that he wants to address not the treatment, but the question of the treatment of the psychoses, a fact that is reflected in the title given to the paper that emerges from this Seminar and is printed in the Ecrits – On A Question Prior To Any Possible Treatment of Psychosis. That is, Lacan is not simply aiming to propose a better technique for working within the established theoretical framework, but rather attempting to re-examine the theory of psychosis and propose something Freud never achieved – a structural distinction between the neuroses and the psychoses – through which questions of clinical technique could be asked afresh.

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