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None of the responses to the questions below claim to be medical, therapeutic, or spiritual advice, but psychoanalytic. Consequently, the list of questions below only addresses the symptom and mental causality within a Lacanian perspective, while seeking to distinguish its intervention from the current ambiance of a therapeutic, spiritual, or psychiatric treatment of mental disorders. Is there a difference between psychology and psychoanalysis?Institutionally, psychologists graduate from university graduate schools of psychology rather than medical schools and receive a Ph.D. rather than a M.D. After graduate school a psychologist can choose to get a supplementary degree in psychoanalysis, which if pursued rigorously conflicts with his/her university degree, for contrary to popular belief, psychoanalysis is not psychological. The reasons for the assimilation of psychoanalysis to psychology are as instructive as they are complex, and go a long way in revealing what it is in psychoanalysis that is currently being avoided. They explain why modern psychology textbooks represent psychoanalysis in a chapter of 'ab-normal psychology', as this is one means, among others, to trivialize problems of desire and the unconscious to that which deviates from the norm. But rather than take our word for it, why not read Freud himself?Actually, Individual Psychology has very little to do with psychoanalysis but, as a result of certain historical circumstances, leads a kind of parasitic existence at its expense. [S. Freud, New Introductory
Lectures On Psychoanalysis, XXII,1933 p.140] To enclose the Freudian interrogation within
the field of psychology is to lead it to what I call a psychogenetic delirium.
This psychogenesis can always be seen in its development each day, in the
way such psychoanalysts envisage the facts and objects that they have an
affair with.
What is the difference between psychoanalysis and psychiatry?Contrary to what many believe, Freud is not the father of modern
psychiatry. Indeed, one can
find him making statements that
imply the opposite: "Psychoanalysis
is not against psychiatry, but psychiatrists"
. Without claiming to resolve
the confusions in this format, it will
be enough if we simply clarify the problem. Psychiatry, born in the asylums of the 19th century, is a late cousin of psychology (the former is to body as the latter is to the soul). Its aim is to construct a normative view of madness around a scientific plan for society. Although its modalities have been many (biological psychiatry, neuropsychiatry, organic psychiatry, behavioral neurology, etc.) they all can be grounded on three main characteristics: (1) mental disorders are brain disorders (2) causes cannot be symbolic or effected by language and speech (3) psychiatry is based on scientific evidence. Psychoanalysis emerges in the 19th century when Freud puts all three
criteria into question by
introducing a 'talking cure' that
begins to speak to forms of psychic suffering
that had formerly been reduced
to silence and classified by psychiatrists
as organic illness. Today, most post-Freudian
psychoanalysts, especially Lacanian, would
continue in this direction in spite of the
recent return towards physical and biological
explications. In the United States psychoanalysis is most often assimilated
to a possible therapy for neurosis;
it is not usually extended to
the treatment of more serious mental illnesses
such as psychosis and schizophrenia,
which are thought to be the sole province
of the psychiatrists. This much said, modern psychoanalysis has found certain inroads into
such resistant cases through two antithetical approaches: one, following
the schools of American Ego-psychology and British Object
Relations, has sought to reinterpret
and extend psychoanalysis
into the medical clinic (or asylum)
and the psychiatric classifications;
the other, following the work of R.D. Laing,
David Cooper, etc., have sought to establish an
anti-psychiatry basing
the reality of mental illness on social and
cultural factors, thus, either dismissing
Freud altogether, or largely reading him as
a cultural theorist. Counter the pros and cons of the existentialist Anglo-American
schools, Jacques Lacan's structural 'return to Freud' had
the effect of deconstructing psychoanalysis in a way that
neither assimilated its theory and practice to psychiatry nor
rejected it in the name of anti-psychiatry. Instead, contemporary
Lacanian analysis achieved the work of Freud in
a different way: in a purely psychoanalytic theory that constructs
its practice and clinic in spite of the current sociological
assimilations and rejections. (see Clinic)
Although Lacanian psychoanalysis has had a grand
influence on the psychiatric and anti-psychiatric milieu in
France, it has just begun to make inroads into the United
States. Today, psychiatrists in the U.S. graduate from medical schools and
are fully qualified physicians.
Many psychiatrists have no
training in psychoanalysis or psychotherapy
and do not aim to interrogate the
symptom as something to be listened to or
constructed (as in psychoanalysis), but
only as something to be suppressed. As physicians,
psychiatrists have the right to prescribe
drugs, electroshock therapy, or treat people
against their will. In recent years some
groups have sought to make psychotropes
(drugs for the treatment of mental symptoms) more
available to the public by allowing psychologists
as well as medical doctors to prescribe them.
Currently, however, the law only allows a
psychiatrist, or indeed, a general practitioner,
to administer them. So why would Freud claim to go against psychiatrists, but not psychiatry
? One may well find reason
to state that Freud was not against
psychiatry, just as he was not against any
field of investigative research, but
was calling attention to the ill effects psychiatry
can produce on society, especially in the
generalization of its theories to the whole
of humanity and the investment in a society
of psy-experts. For examples of the total disregard of the differences between psychoanalysis and psychiatry witness most of the journalistic writing coming out of the L.A. Times. What is the difference between psychoanalysis and psychotherapy?Because the crucial distinction between psychoanalysis and psychotherapy
is more difficult to explain
than its differences with psychology
or psychiatry, it is all the more
necessary to take the time to disentangle
the threads. 1) Psychotherapy includes a very broad spectrum
of people who, in one way or another,
not necessarily psychoanalytically, talk to
people about their problems. At the minimum, this 'talk-therapy'
reduces to counseling or a type of care that
can be provided by a social worker or a qualified nurse;
at the maximum, it becomes a type of psychoanalytic
therapy – Psychodynamic Psychotherapy, Kleinian, Neo-Lacanian,
etc. – once the care relation between the
doctor and patient is formulated in terms of a subjective
transfer — a relation imitating
the passion of love — and practiced as a 'talking-cure'.
Contrary to the fashionable accounts, Freud is not the
founder of psychotherapy or psychodynamic psychotherapy: on the contary,
one often finds Freud not only admonishing the various 'off-shoots' of
psychodynamic psychotherapy as only a partial picture, but he shows quite
clearly how psychotherapy systematically results in an 'interminable
analysis' or a 'negative therapeutic reaction'. In a more modern presentation by J. Laplanche and
J.B. Pontalis, the authors have defined psychotherapy "under the
name of 'psychoanalytic therapy', as a form of psychotherapy that
is applied to the theoretical principles and techniques of psychoanalysis,
without realizing the conditions of a rigorous psychoanalytic cure"
(Vocabularie de la Psychanalyse; PUF, 1967 p.359). After reading
the responses to the questions on this site, it is hoped that the reader
will have found sufficient material to allow him or her to begin to make
the distinction. The more experienced reader will perhaps foregive us in
such a forum, if we only state the essentials without a detailled argument.
In regards to the field of Lacanian analysis, it must be asked further:
Do the current Neo-Lacanian best-sellers ever truly achieve an introduction
to Lacanian practice in the theory of psychoanalysis or do they repeat
a therapeutic caricature of Lacan as captured by the psychotherapist Granoff
some occurred 51 years ago ? (see:J. Lacan, W. Granoff, Perversion.
Psychodynamics and Therapy; Random House, 1956.).. The position of P.L.A.C.E. is, in taking seriously
not only the historical, but theoretical development,
that psychoanalysis has never been a branch of psychodynamic
therapy or psychotherapy. No doubt, if the reasons
for this difference were merely a question of doctrines, preferences,
and schools, then there would be no need to make it.
If on the contrary, this separation is fundamental
to a practice and theory of psychoanalysis, then it should be stated
simply. What follows only sketches an outline of why this
is so. In an another article on this web site (http://topoi.net/place6/thequestionbrief.html)
entitled: The Topological Turn – Constructing the Intension of
Psychoanalysis in Extension, we have begun to show how the
common distinction between psychotherapy and psychoanalysis can be reformulated
more precisely in terms of analysis in intension and analysis
in extension. For what concerns us in this initial probe, we will
begin with Freud and the habitual distinctions made in medicine. Firstly, a distinction between psychotherapy and psychoanalysis proper can be drawn by bringing out the significations of the word 'therapy' in the common medical acceptation of the term: if prognosis reads those symptoms that preceed the onset of illness, and diagnosis reads those which are concurrent to the illness, therapy reads those symptoms that follow the disease. At this common level, psychoanalytic psychotherapy becomes a medical branch of therapeutics and the transference is seen as a way of helping the patient speak about and resolve emotional problems that were supposedly caused by previous experiences (real or imagined). Needless to say, it is this coming 'after the fact' and treatment of mental disorders that distinguishes psychotherapy from psychoanalysis proper, as the former is left with merely managing a symptom and not addressing mental causality in its present and structural dimensions. Digression - The reader should be aware that
in the U.S – and elsewhere –
the confounding of psychoanalysis with psychodynamic
therapy is the rule, not the exception.
For instance, you will often find it wrongly stated
that "psychoanalysis is a branch of psychotherapy". One of
the reasons we have included this common questions
section on our site is to re-introduce terms
that have been understood too quickly and too well by
the average medias. For instance, a good example
of such misunderstanding can still be found in U.S.
news papers and academic journals; witness
the recent article in the New York Times (Feb. 14, 2006)
by Alix Spiegal: http://www.nytimes.com/2006/02/14/health/psychology/14psyc.html
which confounds psychoanalysis with psychodynamic therapy.
To be fair to the author though, each
new claim of progress - whether cognitive, neuro-suggestive, behavioural.
etc. - is in the embarassing situation
of committing a 'straw-man' argument by either
trying to refute or revamp something psychoanalysis
is not – psychodynamic therapy.
A properly psychoanalytic conception of the transference begins when it is no longer simply encountered in practice as an emotion, or used as a healing relation to the other, but is constructed in a theory of passions. Yet from the beginning, the transfer in the theory of psychoanalysis could not take its 'talking-cure' for granted, as it has always had to ask why it is so difficult to speak of and in love in the first place. What is that ignorance which speaks of love most faithfully, not merely in expressing one's emotions, but in the comedy and tragedy of mis-recognizing the consequences of one's speech and acts? Freudian psychoanalysis originally defined the transfer not as an emotion, but as a pathetic ambivalence (as the reversal of love and hate) resisting, and not aiding the psychoanalytic cure: "...it remains a mystery why in analysis the transference provides the strongest resistance to the cure, whereas in other forms of treatment we recognize it as the vehicle of the healing process, the necessary condition for its success" (Freud, Dynamics of the Transference, 1912). 2) By establishing a theory of the transfer, Freud founded its objective conception in a way that went beyond a subjective, emotive, and therapeutic use of love. As such, psychoanalysis began to propose not to therapize desire by using love as a remedy (as an AIDS support group might), whether it be through a dramatic rehearsal with a therapist or in the use of mountain retreats, but to disclose a passionate object relation which had previously been undecipherable, or at least, found resistant to the transfers of everyday life (those relations of fidelity presupposed of the subject in the communications of the group — the family, the workplace, society, etc.). This does not mean to say that today psychoanalysis invites one to construct this object as a fetish or by becoming more creative — it neither proposes its cure as a form of perversion nor artistic sublimation. On the contrary, it seeks to open up a place for the construction of an object whose reality goes systematically unrecognized in those dominant transfers whose traditional aim is to establish a relation of fidelity to others: art, politics, science, religion, sports, etc.. If the mistakes of psychotherapy have taught the psychoanalyst anything about the cure and transfer, it is about the necessity of constructing the object of passion as a psychic reality, beyond any form of pragmatism or utility, and yet not merely as dramatic forms of literature and art. It is on this condition, in the de-dramatization of the transfer and the construction of its object, that psychoanalysis initiates a progress in the well-being of the subject. (although it is well known that an intuitive recognition of this object lies at the heart of many films and narrative - see Alfred Hitchkock's MacGuffin Theory - many Freudian and neo-Lacanian commentaries have been content to leave their practice at the level of such intuitions/ see: Is analysis an Art of Interpretation?). 3) In order to explain the analytic symptom and its practice
one should begin with Freud:
"The theory of repression is the cornerstone on which the whole structure of psychoanalysis exists" (Freud, Standard Edition, XIV, p.16). Most psychotherapists view the cure as a way of getting rid of a symptom which has been caused by a repression. Get rid of the repression, it is commonly held, and the symptom falls away, thereby allowing the person to experience their emotions and life in a more satisfactory manner. Once this is assumed psychoanalytic therapy becomes the reenactment of a three-part drama: firstly, an inertia of small transfers - dreams, slips of the tongue, word-plays, forgetting, flirts, etc. — furnish the material of the scene, secondly, a larger transfer supposes the patient identifies with and projects her feelings onto the analyst in discussing this material. Lastly, the climax of the drama begins with an interpretive moment (most often offered by the analyst) that presumably reveals a specific lineage of mental connections that lead back to the source of the repression. If one is still trying to suggest this dramatic method maintains a relation to Freud's theory, then one states the cause was a trauma of a sexual nature, if not, then one suggests a myth or some real life shock. Again, the reader should be aware that nothing could be further from psychoanalysis than this psychotherapeutic misreading of its theory and practice: the question of psychoanalysis, its writing of the cure and repression lie elsewhere. To begin to get a tighter grip, one can simply read Freud: "Twenty-five years of intensive work have had as a consequence of assigning to psychoanalytic technique goals immediately different from those of the beginning. At the beginning, all the ambition of the medical analyst was to conjecture what was hiding in the unconscious of the sick person, and to reunite these elements in a whole and communicate them when it was proper. Psychoanalysis was above all an art of interpretation. But the psychotherapeutic task was not however resolved by this." (Freud, Beyond the Pleasure Principle, 1920). The originality of the psychoanalytic interrogation of the cure
consists, contrary to
the therapeutic and 'psychodynamic'
derivations, not
in lifting a repression (by
speculating on a hidden cause),
but in concentrating its focus on the
discovery of the mechanism of repression
itself: that is to say, in focusing
not on bringing out what is repressed
(blocked memories, emotions, pleasure)
but constructing what is repressing. Freud states: "The theory of repression became the cornerstone
of our understanding of the
neuroses. A different view had
now to be taken as the task of therapy.
Its aim was no longer to 'abreact' an
affect which had got on to the wrong lines but
to uncover repressions and replace them
by acts of judgement which might result either
in the assumption (annahme) or
in the rejecting (verwerfung) of what had
been formerly repudiated" (Freud, XX, p.30). (to be continued: The Lacanian notion of Repression
- A Topology of Repression). What is Lacanian Psychoanalysis?
The epitaph Lacanian Psychoanalysis began
in France
with the celebrated psychoanalyst Jacques
Lacan (1901-81). It is most widely recognized
by a return to Freud
and a linguistic axiom - "the unconscious
is structured like a language";
both situating a critique and reconstruction
of Freudian and post-Freudian psychoanalysis.
Habitually, contemporary psychoanalysis claims that
it goes beyond Freud, that is to say, that today it is possible
to read Freud in the tradition of psychoanalysis somewhat as a paleontologist
reads a fossil – as a quaint object that belongs to the folklore of the
past of psychology and psychotherapy. It is easy to understand this
movement, for in order to modernize psychoanalysis within the tradition,
what is most important is bypassed the moment Freud gets a makeover into
the human sciences (cognitive theory, neurophysiology, psycholinguistics,
etc.) and humanities (hermeneutics, lit-crit theory, philosophy, etc.). Without attempting to dis-entangle here such assimilations
and trivializations of Freud’s theory, it suffices to state that Lacan’s
return to Freud no longer reads Freud in the tradition,
but reads the tradition with the discoveries and concepts that Freud
invented. Of course, the Lacanian return to Freud proceeds
by a critique and testing of Freud's theory, but his theory can also be
used in a more extensive and primary way to critique the theories of the
generation of post and neo-Freudians who, in the effort to “keep up with
the times”, have understood too quickly and too well. The effects
of Lacan’s return to Freud has, therefore, produced a new generation
of psychoanalysts who have slowed things down and gone back to the basics:
no longer desiring to go beyond Freud in the latest fashion, as if
one ever really goes beyond any great writer from Euclid to
Marx, the Lacanian analyst of today goes further into what is impossible
to understand in his theory, or rather how such discoveries and inventions,
were systematically effaced and dissimulated not only by the post-Freudians,
but Freud himself into the tradition of the human sciences and humanities.
Although the heterogeneity of psychoanalysis is often homogenized by attempting to anchor its theory and practice down in already established academic fields and schools, Lacanian psychoanalysis establishes the stability of the theory in a more adequate manner: through the introduction of a topology. We have introduced elsewhere the importance of such a return to Freud -http://www.topoi.net/thequestionbrief.html . What we will do here, is comment on how the tradition of psychoanalysis, in its practical and clinical dimensions, can be read with Freud, since Lacan.
The unfortunate question remains, however, as to
why should one
have to 'mask' the real and its subject at the
level of a therapy to discover the truth that such
symptoms reveal ? Or further still, one should
ask whether the person or association to which
one addresses his or her questions would have a
theory and practice capable of reorienting a demand
for a therapy to a just theory and practice of psychoanalysis. In responding to these questions and the difficulty
of addressing the
symptom, Lacanian psychoanalysis
reopens a place for this 'other' orientation
to occur - through its sessions, seminars,
and work groups - without the need for the 'mask'
of a therapeutic intervention and not in an analysis
of 'others', but by an analysis of an
Other of thought, i.e., the unconscious. For more detailled information see: What is the
difference between
Psychoanalysis and Psychotherapy
? above and Clinic page: Question of
Psychoanalysis ] Is it true that a mental symptom is reducible to a neurological dysfunction or chemical imbalance of the brain?
There are two reponses to this question. One simple
and structural, though not necessarily easy. The
other, complex and thematic, which may give some different
points of entry by reference to problems faced in everyday life. We will begin with the simple response #1, then
#2 will bring out the complexity of the situation in reference to the various
rumours and technocratic aspirations. #1 Simple Answer: No, a physical dysfunction
- lesion, defective gene, chemical imbalance, etc. – is
not a necessary and sufficient condition for a mental symptom. Simple Explication: 'if someone has a lesion or a chemical imbalance of the brain, then there is a malfunction of the body' is true, but this does not mean, the converse statement 'if there is a malfunction of the body, then one has a lesion or chemical imbalance of the brain' is true. More simply still: if my arm is cut off, then I
can not move my hand, but just because I can not move
my hand, does not mean my arm is cut off. Said otherwise, having a problem of behaviour
or movement is a necessary condition of having
a physiological dysfunction (at the limit, the lesion/imbalance/defective
gene is itself a malfunction), but it is not sufficient:
it is always possible to have a finger that will not move,
and no lesion, chemical imbalance, or cut off arm. To
assume it is, commits a logical fallacy of affirming
the consequent. Moreover, to attempt to
justify the construction of a theory of the mental symptom
on the basis of mere lexical distinctions and 'half-truths'
–whether from commonsense, neurological postulates, or a diagnositic
code book – establishes the reference of a clinical intervention
ad hoc by avoiding an intrinsic interrogation
of the formation of the language and semantics (logic)
of a theory. Thus, confusing the technological problem
of the application and exactitude
of a theory to an external domain (the brain, mind, a gene,
culture, the family, etc.), with the scientific problem
of the interpretation and internal
rigor of a theory.
It is the contention of the researchers at P.L.A.C.E.
that by clarifying the logical argument above, each reader
can respond in a more adequate way to the question.
Consequently, by not avoiding the logical structure of the
argument, the reader can save alot of time by no longer having
to read the seasonal journalistic rumours and technocratic aspirations.
Just to give the reader an indication of the time saved,
they may wish to read the argument below that seeks to bring out
the argument in reference to different thematic versions currently
found in the United States. Though the argument is complicated
by reference to numerous examples, it may be of use in fleshing out
the skeletal presentation presented in #1 above. 2# Complex Response: Most psychoanalysts
will say, "No". Most psychiatrists
will say, "Yes". Complex Explanation and Examples: A case
in point: it can be asked if the sixth best
selling medicine in the US,
Zoloft, (3 billion dollars of sales in 2004)
owes more to its 'happy face' advertising,
than any scientific evidence
that the drug corrects abnormal serotonin
levels in the brain. Without examining the
current literature here, it is enough to
note that the hypothesis that was made in the
1960s that depression may be caused by low levels
of serotonin, is today still unverified.
Does this mean, however, that anti-depressants
such as Zoloft might still be proposed,
if not as a potential cure for depression, then
at least as an effective means to manage a symptom,
and that modern medicine has just not had the time
nor the means to verify its effects ? Or could
it mean, on a more disturbing level, that in the
market place of the psychotrope (modern drugs for
the treatment of mental illness) one can actually
be treated for illnesses one does not have ? For sufficient introduction into the controversies
surronding the subject, one could begin by watching the 60 Minutes Report
"What Killed Katey Riley ? Bipolar: A Dangerous Diagnosis
?" http://www.cbsnews.com/stories/2007/09/28/60minutes/main3308525.shtm
and Frontline's Medicating Kids at:
http://www.pbs.org/wgbh/pages/frontline/shows/medicating/.
Therein one will find a wide range of
viewpoints asking relevant questions, yet none providing
adequate reponses. Primarily, you will find three groups
formed around the problem of treatment: 1) those believing
in a natural and innate character of mental illness as
a developmental disorder (in this case ADHD: Attention Deficit-Hyperactive
Disorder) 2) those others believing in a cultural and acquired
character of a mental disability not necessarily attributable
to a medical illness, 3) those who stand somewhere in between.
Needless to say, neither the producers of the show nor
it field of experts go further than a reporting of the events.
Yet, one may well ask, at what point must we not accept that
all of our attention spans, whether normal or pathological, exhibit
a 'deficit' while so many questions are left unanswered. No doubt, group 1), largely represented by the drug
companies, medical doctors, psychiatrists, and
those in general who claim to be scientists, attempt
to convince people why psychotropes are
worth the risk of harmful side-effects and
often compare the use of drugs in the treatment
of subjective or mental symptoms to the common
household use of aspirin to relieve
headaches. In this respect, what seems to
be an unexplainable mental symptom (headache
pain, for example) can be removed by modifying
an underlying physical cause which corresponds
to its occurrence: remove the cause, and the effect
is supposed to disappear. Proceeding on these
assumptions, psychiatrists will draw attention
to the fact that although aspirin had been
prescribed as an effective pain suppressant
for decades, the physiological reasons why it worked
as a 'cure' for certain symptoms was not discovered
until technology improved in the 1960s. By analogy,
extending this paradigm to the field of the subjective
symptom - depression or anxiety, for example -, a positive
medicine can then state that if the cause of mental
illness has not yet been discovered, it is not
because there is none, but because, like in the case
of aspirin, a technological means has yet to be found
to isolate its physiological laws.
In this respect. a modern medical diagnosis is not
so much interested in 'causes' — as this smacks
of antiquated paradigms of empirical sciences —
but has an ideal: the determination
of the exact laws for an illness.
Yet, this search for an exact law of
experimental science
can not avoid the clinical dimension:
that such procedures still speak about
and refer through language in the theory of the
practicioner. Thus, opening the question
as to what extent there is a fidelity of language to
illness, sexuality, and death. No doubt, this clinical dimension of the symptom
is often shuttled over to group 2) posing problems of humanistic
medicine claiming to treat the 'whole' person (through alternative
therapies, homeopathy, magneticism, narratology, scientology,etc);
while such approaches remain either ignorant of or actively
hostile to experimental science. Our short intervention
in this forum adopts neither position as an effective response
to the subjective symptom. In fact, a psychoanalytic theory
and practice was born precisely in challenging the necessity
of a split between experimental research as natural science
and the clinic as mere cultural practice or the 'art' of medicine.
Left in this revolving door of explications, the
average reader/viewer usually falls somewhere
in the middle – in an approximative response which
eventually, in the urgency to do something, adopts a pragmatic
stance that 'what works for me' is what is good; while
the notion of an adequate and true theory of mental illness and
health is left out of reach. What follows can not hope to rectify or resolve these outstanding issues in an internet forum, but we can begin to introduce a way of formulating the problem that show how and where such resolutions can be found. We begin by bringing together what is normally kept apart by adopting positions 1),2), and 3) above. We begin by asking if procedures of experimental science as portrayed by group 1) are necessary, then what makes them sufficient, sound, or true? - without letting the response to such a question be dictated by cultural or pragmatic values of group 2). No doubt, in the urgence "to do something" many individuals have never had the time to consider the question of the truth of a theory beyond ad hoc consensus, belief in an expert, or reducing the rigor of a theory to an experimental and approximative testing of knowledge on others. Despite the progress that is made possible in the venerable tradition of physiologically based medicine and experimental science, there is a growing category of Other 'illnesses', habitually labelled as 'mental', that neither respond to its division of labor nor its methodology. Today, as difficult as it may be for those in a rush, it is necessary to investigate this Other that truth poses to a scientific theory as a preliminary to any possible treatment of others, while not letting this truth digress into mere pragmatic and aesthetic values. What is the psychoanalytic Sinthome ?
We will give here two responses one short and topological, the first
longer and discursive.
Therapeutically speaking, a symptom is often seen as something negative and unstable, while the individual is presumably stable and positive. Thus, a therapeutic action would consist in relieving the symptom, while a cure would actually seek to remove the cause, and therefore extinguish the symptom. Yet, today, if one can only speak of a physical or psycho- therapy, it is because no cure is available, only various techniques for the pacification and sedation of a symptom. By assuming the individual is inherently stable, psychotherapy presumes the individual's relation to desire is unstable to its object (through sexuality, money, drugs, and food, for instance), and only able to manifest itself symptomatically in terms of dissatisfaction. The task of therapy being, in the best of cases, the attempt to relieve the symptom by regulating a desire through the suggestive prescription of a substitute object with less harmful effects (gum for tobacco or art for sex, for example). Without denying the effectiveness of such techniques to bypass a symptom, at least for a while, an important opportunity in the interrogation of the cause of desire has been lost. For this reason psychoanalysis theorizes the symptom as posing a problem of its truth and therefore as something not to be avoided or merely pacified. To make progress into this dilemma, one can begin
in a more true
manner by observing
that it is not the ego that is by definition
stable and misrecognized, but desire.
Tending towards isolation whether in a group or alone, the fragile completeness
of the modern ego is only able to envisage a relation
to desire through economic and functional norms.
Thus, the ego – 'free but alone' – is revealed
as something inherently unstable. Indeed, the
relation to desire begins to acquire
an odd stability, even predicatability,
as the subject complains of sleeplessness,
stress, anxiety, loss or excess
of sexual desire and appetite, etc. Psychoanalytically
speaking, if it is desire that is
stable and the ego unstable, then the symptom
is nothing other than a certain alienated
or misrecognition of desire. The question
remains as to whether anyone would be there
to hear the symptom and to read this misrecognition
more positively — as a question of style
and a (mis)recognition of desire — without
leading the subject back into the 'accidental'
misrecognition of its ego posed as either the missed identifications
with the group or dysfunctioning of a
biological substance.
Second topological response:a question of style introduces the symptom as a certain plasticity and contingency of Figure and Form. In this forum we will only proceed informally leaving the reader to check the references of publications on this site for a more precise presentation. If a symptom is habitually introduced as 'my' symptom, it does not take long to recognize it is also someone else's symptom. At this psychotherapeutic level, one remains with the numerous complaints of the ego comparing itself to others. Thus, the claims "It is not me", but someone or something else who is the cause, a parent, spouse, or biological dysfunction . Lacanian analysis begins differently by introducing an analysis not of 'my', but the Symptom, or le Sinthome. 'My'
symptom is a function of chaining, while the Sinthomehas the structure of knotting. For example, caught in
the attempt to resolve 'my' symptoms, the ego doubles its trouble once
relief is invisaged as a form of chaining to others – joining a
club, artist commune, or sports team, finding a 'date', 'my' psychotherapist,
African safari, etc. Freud called this revolving door of chaining
the ego in a group neurosis and perversion. Lacanian analysis begins with a different public/private entry by going to the knot and
an analysis of the Sinthome. What is it to introduce
a question of style – a certain plasticity of the ego – so that it does not remain caught up in the charm of chaining to others, but literally introduces a construction ? That is to say, how can a style be constructed not simply charmed and grouped? How can the Sinthome be constructed with
another, so that this connection does not reduce to just another religion
(religare or 'linking together') or political rally ? Although the
response to such questions began with a Lacanian analysis of the Sinthome,
R. D. Laing had already posed the question informally:
The patterns delineated here have not yet been classified by Linnaeus of human bondage. They are all, perhaps strangely familiar. In these pages I have confined myself to laying out only some of those I actually have seen. Words that come to mind to name them are: knots, tangles, fankles, impasses, disjunctionis, whirligogs, binds. (Knots, R.D. Laing, 1969) (see article: Topological Dénouement
of the Cure: http://topoi.net/place6/topology.html) What are the credentials of a psychoanalyst ?Someone in the United States who intends to practice psychoanalytic
therapy,
or psychotherapy, must
become a doctor in a parallel field
from the university (sociology,
history, medicine, psychology, marketing,
etc.) and then complement these
studies in a higher degree program. In California,
if this person is not also a medical doctor
(M.D.), but has a doctorate (Ph.D.) in a parallel
field, they are called a Research Analyst.
In France, in the influence of Lacan, someone
can graduate directly from a masters
or doctorate program (D.E.A. or
Doctorate de l'Etat) with nothing but psychoanalytic courses that also extend to encompass philosophy, mathematics, linguistics, and logic (which are rarely included in a North American curriculum in psychoanalysis). Although the French university carries a more extensive curriculum in psychoanalysis than those currently in vigor in the U.S., it is equally insufficient for the production of psychoanalysis insofar as a transmission and training in psychoanalysis must proceed by means other than those commonly encountered in an 'academy' or 'school' environment. For this reason a training analysis is required to undergo an analysis sponsored by individualized analytic associations in order to be authorized as a psychoanalyst. Since Freud, psychoanalysis does not go against the university, but works in spite of it, for neither a university degree nor a therapeutic certificate suffice to guarantee the act of psychoanalysis. This is not in any way to discredit the university, but to say that it has had to adjust to Freud's psychoanalysis in much the same way the medieval university and its scholars had to adjust to the emerging new science of Descartes. The historian of science, no doubt having already wondered why the scientific revolution was never incorporated into the 17th century university, will not be surprised to discover the exterior politics that contemporary psychoanalysis maintains with the modern university. For this reason, a Lacanian psychoanalytic association aims to establish an organizational structure that makes the choice of an analyst credible beyond an academic convention. Who is a psychoanalyst ?To respond to this question, it is necessary to recognize two detours: 1) on one hand, the designation of a psychoanalyst is not regulated by federal or state law (CA), even an untrained person may use the title; 2) on the other hand, psychoanalysis, can be trivialized into forms of psychodynamic therapy that is regulated and credentialized by the state. A psychoanalyst should not be confused with either possibilty: just as one should not confuse a building inspector with an architect, one should not confuse institutional and juridicial questions with the conditions for the rigorous practice of a theory. For the two cautionary reasons of 1) and 2) above, one must be careful to not only verify the practitioner's theory-practice, but to not confuse such a verification with what it is to acquire a technical degree, a medical license, or psychology diploma. Without denying these possible assimilations, the session, clinic, and school of psychoanalysis is elsewhere. You are invited to the conferences, seminars, or to speak directly about any questions of disentangling these distinctions in contacting PLACE. The good news is that it is precisely because of these derivations that one can not – or should not – enter into the field as a consumer of a cure or a diploma. That is to say, when entering into the field of analysis, whether as a student or suffering individual, it is not a question of a division of labor between potential doctors or patients. Working in psychoanalysis is not the same question of getting a broken leg fixed where the doctor has all the knowledge and the patient is only a passive recepient of the act of an expert. On the contrary, it is this divide "I do not want to know ... let the expert figure it out" that is itself a part of the modern symptom. Here, then, in prefacing a response to the question of 'Who is a psychoanalyst?' by this detour through the cultural, professional, and institutional ambiance, it is most important to isolate the analytic 'act' within the theory of analysis itself. Lacan has proposed (Letter to the Italians) that the following two propositions are fundamental: A) the analyst only authorizes him/herself; B) there is no auto-analysis, it requires a collective authorization. These seemingly contradictory statements form the basis of isolating the structure of a psychoanalytic act within the theory and practice of psychoanalysis itself. See the School-Clinic page for further info. Does Lacanian analysis address substance abuse — alcoholism, eating disorders, drug addiction, etc.?Yes. It is the modern tendency to search for the place of its subject in segregative groups in order to efface an anxious and subjective division: I am an alcoholic, I am an anorexic, a drug addict, nymphomaniac, etc. and I go to Alcoholics Anonymous, Eater's Anonymous, X Anonymous, etc. Once this admission and identification with the anonymity of the group is achieved, usually by some form of empathy, then treatment habitually consists in a modification of behavior: a 'cure' resembling in this respect, what occurs when a hermit crab abandons his old shell and takes up the discarded shells of others. Without denying the possibility of success for such treatments, or the comfort perceived in giving the subject a sense of a home, one must examine what is lost in the process. Must a pulsional excess (a drive) be simply negated in the anonymity of a group identification — with the banality that this identity implies — or would it be more advantageous to elaborate case by case a singularity which deserves a Proper Name? Psychoanalysis responds by the latter: its intervention is non-segregative and does not rely on the mass identifications of group hypnosis (religious, scientific, peer, etc.), but permits the subject to maintain the singularity of their division and symptom in order to discover a reality of its place - a style. In this respect, the symptom is not an enemy of the subject, but something one is satisfied with (despite the complaints) which is functional (not dysfunctional) and to be listened to in spite of its seemingly nonsensical message (thus, not converted into the communicative norms of the group). menu Does the combined treatment of psychotherapy and psychiatry cure the patient of psychic suffering?No, but they can attempt to manage and calm a problem. Today,
in the urgency "to
do something",
the consumer of the cure is left abandonned
at the serene divide between
nature and culture: that it to say, left
divided between a psychiatric practice
aiming to reduce the singularity of
the suffering subject to the same biological
entity as any other John Doe, and a therapeutic
practice attempting to assimilate the subject
to the contents of a few cultural myths
and archetypes (the artists in us all, the inner-child,
etc.). Consequently, the habitual attempt
to treat mental causality either with
a medical drug (psychiatry) or speech reduced
to the power of suggestion (therapy),
has left many resigned to doing nothing or in
the disbelieve in any cure at all. Lacanian
psychoanalysis remains outside such imperatives
to calm and the divide of nature/culture by interrogating
the field of psychic reality differently.
For it not only separates the real of the
subject from its biology, but the symbolic of the
subject from culture, and, in this clearing, re-opens
the debate on a mental causality irreducible to
mental disorder or a deviation from the norm. (see Clinic) Do forms of spiritualism such as Yoga or Zen, or forms of adventure such as joining the Foreign Legion or Astral Projection, address the same symptom as psychoanalysis ?Although many disciplines, religions, paths, and adventures
ask excellent questions, the responses
- or nonresponses - given therein
are either not psychoanalytic or are only
so by ressemblance and themes. We
state this because it is obvious that what
is avoided in such comparisons is the question
of how one proposes to establish the identity
of psychoanalysis in the first place before any
correspondance can be made. In responding
more rigorously to such a question, then, it
is no longer possible to merely assume the identity
of psychoanalysis, while attempting to transfer contents
from one field to another as an interdisciplinary
research might. On the contrary, one must regulate
the question of identity and difference from the
beginning as a problem of structure, while determining
the conditions of its semantics as a problem intrinsic
to the singularity of an analysis. In
this respect, not only might a psychoanalytic
discourse have a happy relation
to Zen or Suffism, but perhaps more to the point, with
one's uncle Harry, a spouse, or an irrational fear of
Zerox. Yet, not to distinguish a discourse
of psychoanalysis from a theory
is not to distinguish an amalgamation of themes from a
truly structural problem of identity and difference.
(see Clinic Page: The Question of Psychoanalysis) How does Lacanian analysis address the question of mysticism ?Lacan himself posed the question of mysticism not only by referring to the occident - through Angelus Silesius, Meistre Eckhart, St. Theresa, etc. - but in reference to the oriental practice of Buddhism and Taoism. This much said, in recognizing that this domain cuts through the field of psychoanalysis, Lacan had taken enough precautions not to confuse the theory and practice of psychoanalysis with either. Unfortunately, it has become all too tempting for some to promote various blends of mysticism and 'New Agism' in the name of Lacanian scholarship and therapy. Yet, the question of the element of mysticism in analytic discourse - most notably in those schools following Jung - cannot be explored solely in terms of its relation to the paradigm of the 'mystic', but must include the question of what it is to 'step-back' from Western Philosophy, Religion, and Values, without adopting the spiritual attitudes or discourse of the mystic (to which Lacan attributes a hysterical structure** see below). Such was the basis of Freud's Meta-psychology. That the 'stepping back' of mysticism would find elements of Lacanian discourse aspiring to its mission, is perhaps not to be denied (over facile 'free-association' not withstanding). But what is more important to address is the moment a mystical discourse attempts to 'step back' from the tradition, often in flights of experience, the ineffable,and psuedo -rationality, Lacanian analysis begins to go 'deeper in': with a practice of the letter that is habitually assigned to the rationality of science and techniques. For since Freud, if psychoanalysis was able to put to rest many of those forms of spiritualism, magneticism, suggestology, crystal ballogy, etc. that had masqueraded in the 20th and 19th centuries as public therapies, it was by showing how the rationality of science, once taken down to its use of the letter, itself posed a revelation of the unconscious more bizarre - and more relevant to the cure – than the most mystical of reveries (which most often, as in the dictum of Wittgenstein, must leave what cannot be said to silence or to the ineffable, while forgetting the function of writing). Indeed, unlike various forms of spiritual belief, it becomes necessary in psychoanalysis to show precisely how it is possible that a discourse and theory functions beyond the 'belief' that actual participants invest in it. It is impossible to follow the development of contemporary Lacanian psychoanalysis without this dimension of its unconscious truth, for it introduces the clinic of psychosis while engaging some of the most crucial problems facing our modern civilizations. No doubt, this comparison deserves more attention than we can hope to achieve in this short paragraph. But these reasons alone are enough to show that although psychoanalysis may have certain 'associations' to various discourses, it can not conduct its theory or practice as the religious mystic or spiritual healer might: there is a world of difference between a practice of the cure envisaged as addressing these problems, and one that does not. [** one should note that Lacan did classify himself at one time as a 'perfect hysteric': that is to say, a hysteric without a love for the father, i.e., without an identification with the sinthome. ] Is psychoanalysis possible these days?Yes, but in failing to respond explicitly to the question
of what psychoanalysis
is, the entrance to contemporary
psychoanalysis often becomes
a revolving door. Either one engages
what one presumes to be psychoanalysis,
which then becomes impossible to practice;
or one engages in a possible practice —
psychotherapy or psychiatric assisted
psychoanalysis — whose theory is no longer
psychoanalytic. To step out of this cycle
psychoanalysis must not become simply
possible, but effective and actual. This requires
taking the time to orient oneself in responding
rigorously to the question of what
psychoanalysis is. (See left column of the Clinic
page.) Does psychoanalysis treat psychosomatic symptoms?[under construction]. menu Is psychoanalysis an art of interpretation?No. "Twenty-five years of intensive work have had as a consequence
of assigning to psychoanalytic
technique goals immediately
different from those of the beginning.
At the beginning, all the ambition
of the medical analyst was to conjecture
what was hiding in the unconscious
of the sick person, and to reunite these
elements in a whole and communicate them when
it was proper. Psychoanalysis was above
all an art of interpretation. But the
psychotherapeutic task was not however resolved
by this. A new approach
has come to light that consists in obtaining
from the ill person a confirmation
of a construction [...]" (S. Freud, Beyond the Pleasure Principle, 1920) "Psychoanalysis is not an art of interpretation, it is a construction.
Interpretation comes
to bear on a material element ( missed
acts, lapsus, etc.). Construction,
on the contrary, comes to
bear on the entire course of an existence,
most notably on the initial and determining
phases." (S. Freud, Constructions in Analysis, 1932) menu What is the Lacanian psychoanalytic clinic?"What is the psychoanalytic clinic? It is not complicated. It has a base — it is what one says in psychoanalysis. In principle one proposes to say no matter what, but not no matter where [pas de n'importe où — Lacan has also stated elsewhere 'not no matter how'] — in order for the saying [dire: infinite verb] to get into the 'analytic wind'.""I propose that the section entitled at Vincennes 'the psychoanalytic clinic' be a way of interrogating the psychoanalyst and to make him or her declare their reasons. [...] The psychoanalytic clinic must consist not only in interrogating analysis, but in interrogating the analysts, so that they render account themselves of the hazards of their practice, which justifies Freud having existed." (Jacques Lacan, Ouverature de la Section Clinique) How does P.L.A.C.E. propose to establish such a clinic ?In following the theory of Lacan and his topology, P.L.A.C.E. promotes neither a psychoanalysis of others nor a hospitable notion of the mental health clinic as a place to go when one has a mental disorder. On the contrary, at P.L.A.C.E. we construct the Lacanian psychoanalytic clinic otherwise: 1) firstly, as a place where one can not not have a mental order. That is to say, a mental symptom, far from being a disorder can be shown to exhibit a structure that is not necessarily a 'good' order, but just ordered. 2) secondly, there is no Lacanian clinic of others in the sense that the 'other' would be reduced to a sociological group of 'alter-egos' – the abnormal, disabled, or disenfranchised . No doubt, this sector cuts through the proper field of psychoanalysis, but the analytic act and the Lacanian notion of difference as Other is not there. In regards to the current situation in Lacanian analysis, whether in the U.S. or elsewhere, we also advise a certain caution in reading the current best-sellers on Lacanian analysis. For today many neo-Lacanians, in the 'urgence to do something', have attempted to reintroduce a treatment of disorders and a clinic of others while adopting the very therapeutic values that render a practice of Lacanian psychoanalysis and its topology inoperable. An introduction to a more precise reading can be already be found by noticing that in the quotation above Lacan had pointed towards the necessity of introducing a clinic of the analyst – and not at the place of patients or analysands. Is this an indication that a formation in the Lacanian psychoanalytic clinic merely affirms the old sayings: "Physician heal thyself!" or "Psychoanalysis is the illness that it tries to cure". Not quite, but they do provide a certain folkloric insight. This is because psychoanalysis is the one theory coming out of modern medicine whose practicioners have had the courage, at least among the nontherapists, to include the psychoanalyst as a symptom – more precisely a 'sinthome'– of his/her own clinic. Said otherwise, the impostures, immaturity, unscientificity, etc. usually attributed to the discourse of psychoanalysis by its detractors is not at all an epistemological problem of critiquing an illusion, but on a closer look is a clinical problem of constructing the psychoanalytic sinthome. As brief as this indication may be, it goes further than most to help to orient a reading of the Lacanian clinic beyond the current sociological and psychotherapeutic assimilations. For the fundamental problem of contemporary Lacanian psychoanalysis, is not whether psychoanalysis is scientific or not, or if it really does heal 'others', but how can psychoanalysis stabilize such a volatile field – how can it be judged, transmitted, etc. – so that it becomes a practice and theory that one does with an other, and not to another ? What does it mean that the psychoanalytic clinic would not be systematically assimilated to a sub-profession of social work, psychiatry, psychotherapy, psychology, or nursing? What does it mean when the problem of the Lacanian clinic is not one of isolating the place of other persons, but establishing a place of the Subject ? What is a theory of the clinic and the cure that would go beyond the therapeutic 'ball and mask' of the person ? Lacan's response to these questions was decisive: The ideology of contemporary psychoanalysis is a result of the failure to introduce an adequate topology. (D'un autre a' l'Autre, Seminar XVI) Without a topology the psychoanalyst can not begin to even isolate the symptom. (Ecrits) At P.L.A.C.E. we have worked with others to stabilize a practice of a psychoanalytic place in a way that is closer to the psychoanalytic practice of Freud and Lacan. In so doing, we have replaced the interminable epistemological and pendantic arguments between psychotherapeutic analysts and their detractors for a clinical argument on the topological construction of the sinthome. Today. the task of future and training analysts at P.L.A.C.E. is not merely to talk about Lacan's topology or claim it has no clinical use, but to show, on the contrary, just how it founds the psychoanalytic interpretation of the analytic sinthome. menu
In classical
euclidean geometry, two figures
are equivalent when one can
pass from one to the other by an isometry,
or if you want, when the signification
of the two representations is preserved
(a triangle is still called a triangle
in superimposing one on the other). In
topology - a theory of place or topos – the relation
of equivalency is more general, as it
is interested in figures that in passing
from one to the other vary quite a bit and
often loose their everyday signification.
For example, it is often said that a topologist
is someone who can not distinguish between
a doughnut and a coffee cup. |
Common Questions•What is the difference between Psychoanalysis and... •What is Lacanian psychoanalysis ? •What is the psychoanalytic Sinthome? •What are the credentials of a Psychoanalyst? • Can psychoanalysis be used in dealing with substance abuse — alcoholism, eating disorders, drug addiction, etc.? • Does the combined treatment of psychotherapy and psychiatry cure the patient of psychic suffering? •How does Lacanian analysis address the question of mysticism? • Is psychoanalysis possible these days? • Does psychoanalysis treat psychosomatic symptoms? • Is psychoanalysis an art of interpretation? • What is the Lacanian psychoanalytic clinic? • How is topology constructed in psychoanalysis? • Is psychoanalysis a science? • Is Freudian psychoanalysis a scientific theory of sexuality? • Does psychoanalysis, at least in its Freudian versions, reduce everything to sex? • What does psychoanalysis have to do with literature? |
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