Category: Psychoanalysis

1. Neurosis, understood as one of the three main clinical structures or diagnostic categories of Lacanian analysis, can itself be divided into three further structures, each of which is defined not simply in terms of different symptoms, but different subject positions. These subject positions, in turn, must be thought in terms of the fundamental fantasy, considered by Lacan as the staging of the position one takes with respect to an early, sexually charged and traumatising experience.

Freud already provides an account of trauma in his early thought, exploring the consequences of a kind of surplus or overload of sexual feeling in a specific incident in one’s childhood. If you are revolted by what occurred, you may become a hysteric; if you feel guilty, an obsessive. Sexual sensations of this sort exceed the pleasure principle, and give rise to what Freud calls ‘satisfaction’ and Lacan jouissance.

In these cases, the position of the subject is given in terms of a defense against the excessive pleasure in question, and is reflected in the fantasy that stages desire.

Since it is a defensive feature, it is no surprise that desire, awakening in this context, abhors sexual satisfaction. Fantasy, says Lacan, ‘provides the pleasure peculiar to desire’ – a pleasure in which fulfilment of various kinds is hallucinated rather than sought in the real world.

For Lacan, we often gain pleasure simply from imagining satisfaction. The drives are thereby reined in so that the pleasure of fantasy can be indulged. For their satisfaction would entail an overwhelming, excessive experience that would kill desire, smothering it, whereas fantasy allows desire to continue its play. As such, desire operates as a kind of defence, and the subject likewise, as it holds itself against jouissance.

2. We can distinguish hysteria from obsession, the two most important clinical subdivisions of neurosis at the level of fundamental fantasy.

The main source of satisfaction to the infant is the mother’s breast which, initially, is not considered by the infant as being separate from him or her. There is, at this point, no sense of self; subject is not divided from object, self from other; one experiences not separate entities but a continuum. Once the infant becomes aware of itself as separate from its mother, the breast is no longer thought of as being ‘possessed’ by him or her. Weaning involves separation, and the child loses the breast, the ‘object’ that provided it with pleasure. Thereafter, the child attempts to compensate itself for its loss.

The obsessive’s fundamental fantasy sees it attempting to overcome separation as he (obsessives are characteristically male) constitutes himself in terms of the relation to the breast. It becomes what Lacan calls the cause of his desire insofar as it seems to promise that wholeness or unity that was lost with separation. But the obsessive will not acknowledge that the breast is part of the mother – that it comes from an Other.

The hysteric’s fantasy sees separation overcome as the she (hysterics are typically female) constitutes herself in terms of the object the Other is missing – she is concerned not with the breast, then, but what she feels her mother has lost. Her loss is understood in terms of the mother’s loss of her, the child, considered as the object she was for her own mother. The child senses her mother to be incomplete because of her separation, and thereafter constitutes herself as the object that could make her mother whole or complete.

The hysteric, in Fink’s words (and I have been paraphrasing his work very closely here)

constitutes herself as the object that makes the Other desire, since as long as the Other desires, her position as object is assured: a space is guaranteed for her within the Other.

The hysteric, then, does not take the object for herself like the obsessive, but to become the object that fulfils the Other’s desire. She seeks to constitute herself as the object a for the Other, divining what the other desires by way of her. As Fink sums it up,

the obsessive attempts to overcome or reverse the effects of separation on the subject, whereas the hysteric attempts to overcome or reverse the effects of separation on the Other.

3. Lacan characterises the  fundamental question with which the neurotic is concerned is the question of being: ‘What am I?’ It is an answer to this question the child sought from its parents – ‘what do they want of me?’; ‘why did they have me?’, but the answers it received were characteristically disappointing (‘to be a good girl’; ‘because mummy and daddy loved each other …’), letting the question remain in its urgency. The child attempts to finds an answer to this question in its own way, by focusing on the inconsistencies in what its parents say and do.

Here we find the key to the neurotic’s fundamental fantasy: it is an attempt on the child’s part to constitute itself with respect to the desire of its parents.

The hysteric and the obsessive can be distinguished with respect to the questions they relate to being. The obsessive asks, ‘Am I dead or alive?’, being convinced that when he stops thinking he will also cease to exist. Lapsing into fantasy, musing, or gaps in thinking that might happen, for example, during the ‘little death’ of orgasm carry with them for the obsessive the threat that he might die; he loses what Fink calls his ‘conviction of being’.

Above all, the obsessive wants to remain an intact, independent ego – a conscious, thinking subject who struggles to bring to light thoughts and desires that concealed from his conscious awareness. He does not acknowledge the lack present in his psychic economy, nor his own dependence upon the Other, maintaining a fantasmic relationship with a cause of desire that is detached from the Other of which it is a part (the breast detached from the mother, and, thereafter from any particular woman).

The obsessive usually achieves sexual satisfaction from masturbation, or, if sexually involved with women, treats them as exchangable repositories of the object a, being interested in them only insofar as they embody the cause of his desire. In the case of a more permanent partner, the obsessive will transform her (assuming a heterosexual model of sexual relations) into a mother figure who provides maternal love and commanding filial duty. Alongside this Madonna, other, dangerous women will embody the object a for the obsessive; the cause of his desire lies elsewhere.

4. By contrast, the hysteric’s question is ‘Am I a Man or a Woman?’ How is this to be understood? She seeks to make herself the object of the Other’s desire (in heterosexual relationships, the male partner) in order to control that desire. The hysteric will typically attempt to leave the Other’s desire unsatisfied, granting her a permanent role as object. The hysteric would thus maintain herself as desire’s lack, as the object that can never be grasped by the Other.

Fink emphasises the hysteric also identifies with her male partner, desiring as though she were him. The hysteric, in his words, ‘desires if she were the Other’. Whence the hysteric’s question: is she the male Other with whom she identifies or the woman he desires?

At the same time, the hysteric seeks to keep her own desire unsatisfied, often deliberately depriving herself of what she wants (as Fink notes, the pleasure self-deprivation affords the hysteric is particularly evident in anorexia). This is not something of which she is unaware – she consciously desires to remain unsatisfied.

This can manifest itself by her keeping her male partner’s desire alive even by frustrating his desires. Lacan: ‘Desire is sustained [in the person who incarnates the Other for the hysteric] only by the lack of satisfaction [the hysteric] gives him by slipping away as object’. The hysteric thus arouses a desire in the Other and then frustrates his satisfying it.

She is often driven to do more than this, constructing elaborate love triangles involving her partner in which she is able to maintain herself as the master of his desire, its cause, even as she attempts to avoid being the person with whom he satisfies his desire.

5. Interestingly, the hysteric typically finds the Other’s sexual satisfaction distasteful, and carefully attempts to avoid being the object which sexual excites the Other. There is a fine distinction to be made: she wants to be the cause of his desire, but not of his jouissance. Even as she engages in sexual activity with a man, she will imagine to imagine that another woman, not she, is in bed with him – because, in thought at least, ‘she is not there’, emphasises Fink.

The hysteric, Fink notes, may well find sexual satisfaction with women (‘the Other sex for both men and women’), in masturbation, in eating, in drug or alcohol use, or in other activities. In relationship to her partner, however, she wants to keep sexual satisfaction and desire apart. It is not the goal of the analyst, Fink advises, to bring them together; as Lacan suggests, love, desire, and jouissance occupy structurally different levels; a problem may lie in the analysand’s sacrifice of desire and sexual excitement in favour of an idea such as ‘the perfect love’, but the analyst must treat the patient’s overall eros.

6. A pattern is emerging: both the hysteric and the obsessive may be seen to refuse joussance for the Other. The hysteric does not want to be the cause of the Other’s jouissance (even as she wants to be the cause of his desire). The obsessive seeks to annihilate the Other by masturbation or the treating his sexual partners as indifferent repositories for the ‘object a’.

Neurosis in general, Fink suggests, can be understood in part ‘as a strategy regarding jouissance – above all, the Other’s jouissance’. As he writes, ‘both the hysteric and the obsessive refuse to be the cause of the Other’s joussance’. And yet, says Fink, we must not be too quick in drawing this conclusion. Lacan suggests that the neurotic’s fundamental fantasy ‘takes on the transcendental function of ensuring the Other’s jouissance’.

How should we understand this apparent rehersal? The pages in which Fink explores this question are thorny and dense. He notes that the fundamental fantasy of the neurotic forms in response to the Other. It is in response to the Other as the symbolic father or as superego who seems to prohibit desire that joussance awakens.

Prohibition eroticises what it forbids – the symbolic father thus eroticises what falls outside the law. At the same time, however, there is a kind of threshold within fantasy, Fink explains, ‘beyond which it turns to horror’, and claims is familiar to us in dreams in which what we are pursuing seems to turn into something horrible. Desire finds itself unexpectedly drawn towards a kind of obscene jouissance (Zizek, of course, has written a great deal about this.)

This is linked, says Fink very quickly, to the superegoic injunction which, far from forbidding us to enjoy, actually commands it, in order to satisfy the sadistic Other within us. Such satisfaction does not unfold at the level of the ego – certainly we are seeking jouissance, but it is not, in this case, for ourselves, but for the Other.

Here, Fink’s account, tantalisingly and frustratingly, breaks off.

The general point seems to be that the subject’s position in the fundamental fantasy of the neurotic may seem to be one of refusal of the Other’s jouissance, but in fact forms in response to the Other, understood as the symbolic father or superego who lays down the law.

Our desire is always in accordance with the law, certainly, but an obscene jouissance can break out at any moment, causing desire to veer unexpectedly towards something that horrifies us. Is it in these moments that the neurotic understands how his or her jouissance is always in some sense for the Other?

Why do patients come to analysis in the first place? Sometimes they are overwhelmed by the power of a particular affect, be it depression, anxiety or guilt, without knowing why they feel this way. They may experience aches and pains dismissed by the medical profession as psychosomatic, or diagnosed as stress-related. Or they may be haunted by nonsensical but nonetheless frightening thoughts. In the case of neurotic patients, diagnosed thus through the important ‘preliminary conversations’ that take place face to face between analyst and patient, it is by understanding the role of repression that the missing cause of particular thoughts and affects can be discovered.

In psychosis there is, properly speaking, no unconscious at all, since the unconscious is the result of repression. In the neurotic, however, the motor force of repression leads, as Freud said, according to Fink (whose work I am paraphrasing here) ‘to a separate inscription or recording of a perception or a thought that once passed or flashed through one’s mind’. Repression happens through the acceptance or affirmation of a particular reality (a witnessed scene, for example) that is then pushed away. Whereas the psychotic excludes out the reality in question, never affirming or admitting it, the neurotic has always already accepted it, albeit attempting thereafter to push it out of his or her consciousness.

‘What is essential in repression … is not that affect is suppressed, but that it is displaced and misrecognisable’, writes Lacan. The analyst takes the patient’s symptoms as ‘proof’ of repression because, as Lacan says, ‘the repressed and the return of the repressed are one and the same’. The repressed idea is the same idea that reveals itself in unconscious formations such as bungled actions (‘accidentally’ staining a dining table) or particular slips.

The repressed can return as a ‘conversion symptom’ – that is, as it is expressed in the body, for example, in a convulsive movement of the arm or in the contents of one’s thoughts. Hysterics will typically experience rapidly changing physical symptoms of this kind. But the repressed can also return in the compulsive, disturbing thoughts that characterise obsession. .

But there can be no absolute distinction between hysteria and obsession in these terms since, in psychoanalysis body and mind exist in a single economy. For Lacan, it is one that expresses itself by means of linguistically expressed thoughts. ‘The first thing to say about the unconscious … is what Freud says about it: it consists of thoughts’, he writes. Even the body, he argues, is overwritten with signifiers – the symptom always takes the role of a language [langue], insofar as it expresses repression.

Fink gives the following example from Freud:

… Anna O. […] developed an occasional stiffening of her right arm, because it was that arm that refused to protect her father when she believed (in a ‘waking dream’) that he was being threatened by a snake. In other words, her physical, bodily symptom spoke of’ a relationship to her father and a possible death wish she had toward him that she was loath to admit to herself.

Thus conversion symptoms, which are extremely various, must be understood psychosomatically as they are part of a language through which the unconscious addresses us. The unconscious is a language, says Lacan, which, through analysis, the analysand must learn how to read.

Here, we might recall Freud, for whom dreams were symptoms which would permit of an interpretation that would uncover their true significance by clarifying the associative links which led to them. The manifest dream, that is, the way it is remembered and recounted by the patient, conceals the true, latent meaning of the dream because of the self-censoring desires of the supergo.

For Freud, it was necessary to understand the way in which the ostensible contents of the dream attest to the play of latent desires. This is what he called the dreamwork, that is, the way in which latent thoughts operated according to prelogical ways of thinking. In what Freud calls condensation, for example, latent dream thoughts are combined into a single manifest element. In displacement, an apparently innocuous detail in the dream can become highly significant, and vice versa. Plastic representation sees important people in the dreamer’s life being replaced through a stock of common symptoms (the king = the father, for example).

Crucially, the manifest and latent content of dreams are described by Freud as two different languages. For Lacan, the unconscious is a language; it always involves linguistic symbolisation. In this sense, repression concerns a perception or affect that has been symbolised in some way. The unconscious consists of thoughts that are expressed or formulated in words.

Note, then, that what is repressed, says Lacan, ‘is neither perception nor affect, but the thoughts pertaining to perceptions, the thoughts to which affect is attached‘. Repression works by actively severing affect and thought. Thus, affect can remain when the thought to which it is linked is repressed. This is often what is found in hysteria, where the affect persists when thought has been ‘forgotten’. In obsession, something similar may occur, where the thought – as it pertains, for example, to a childhood event – is available to consciousness, but the affect is not.

In both cases, the link between thought and affect, at the time of they were originally found together, has been broken. The analyst will attempt to allow the patient to transfer the missing affect onto the analytic relationship. It is by playing the part of the man or woman without qualities that the psychoanalyst can bring the patient to project the dissociated affect upon him or her, however negative this projection might be (the analyst as toreador).

This is how the repressed can be managed, allowing it to come forward as it is combined with other, related thoughts in the analytic session. The repressed will be revealed as such, in the analytic session, and be worked through by the analysand so that it no longer exerts a painful claim on their lives in the present.

Lacan’s list of clinical structures or diagnostic categories may seem small: psychosis, neurosis and perversion, neurosis being divided in turn into hysteria, obsession and phobia. It may also seem arbitrary: why are there not 4 fundamental structures, or 6 subdivisions of neurosis?

Of course, Lacan inherits his diagnostic categories from Freud, and there may be a sense that he is continuing to elaborate the key terms of a rich and productive legacy, in a manner someone who writes on a figure like Deleuze aims not simply to produce critical commentary on his work, but extend it into new domains.

Lacan, on this account, would be a kind of Freudian. But what of the groundedness of the terms inherited from Freud? As a philosopher, Deleuze provides arguments for the ideas and structures he puts forward: his work must be phenomenologically compelling, in the case of appeals to experience, and deductively so, in the case of appeals to the conditions of experience; it must also be logically consistent; it is incumbent on the philosopher to provide demonstrative and sometimes verifiable grounds for for his claims.

With Freud, however, so much depends upon clinical work, upon working with patients as an analyst and, of course, upon being analysed oneself. As such, much that is central to psychoanalysis must remain closed to those of us who have been neither analysand nor analyst. This is so even for those who have a sense of its enormous ambition – psychoanalysis, as Sinthome said somewhere, can be understood as a transcendental account of the symptom, exploring its conditions of possibility.

As such, the clinical structures Lacan identifies provide much more than a cursory mapping of particular symptoms encountered in analysis. He does not seek, for example, to continue to the multiplication of clinical categories Fink, commenting on Lacan, finds among American psychiatrists, psychoanalysts and psychologists: ‘depressive disorder’, ‘bipolar disorder’, ‘panic disorder’, ‘hyperactivity’, ‘hypnoid states’, etc. None of these categories is able to excavate the determining structures that account for the symptoms they map, being content merely to analyse each pattern of symptoms to its smallest constituents, and targeting it with drugs or specific therapeutic techniques.

Psychoanalysis does not take a symptom-by-symptom approach, since the same symptoms can actually be found in disparate kinds of people. Fink gives the following example:

A woman who is anorexic can legitimately be categorised as having an ‘eating disorder’, but then we already know this as soon as we are told she is anorexic. If, however, she is diagnosed as hysteric, we can begin to situate the role of her ‘eating disorder’ within the larger context of her psychical structure. This may allow us to see, for example, that the same role played by her anorexic in her teen years may have been played by vomiting when she was a child, shoplifting when she was in her early twenties, and high-stress, high-volume trading as a stockbroker in her later years.

Then the classificatory scheme to which Lacan appeals has the advantage of being able to understand what unifies those symptoms the patient manifests. The practice of psychoanalysis appeals to a transcendental account of symptoms that cuts across the specificities of their manifestation in particular patients.

This account cannot be presented detachedly in the manner of a philosophical treatise, since it depends upon clinical practice – upon the analyst’s experience as a practitioner who comes to the use of Lacanian diagnostic schema over a considerable period of time. Fink refers often to those analysts who are under his care; presumably, the analyst him- or herself will need to be watched over and guided. Over time, however, the schema will take on usefulness and significance for the practitioner, as he or she begins to intuit common features of patients in the same diagnostic category.

Here, the analyst must not be misled by the appearance of symptoms which overlap from structure to structure: obsession and hysteria can manifest themselves, for example, in compulsive rituals and somatic symptoms; hysterical traits like conversion can be found in obsessives and obsessive traits in hysterics. It is no surprise that Freud sought an absolutely definitive account of hysteria, since this would allow the analyst to lay bare the fundamental mechanisms that regulate the patient’s psychic economy. But Freud was unable to find one, leaving only provisional definitions of hysteria and obsession, which as Fink notes, are often internally inconsistent.

‘In his lifelong attempt to formalise and extend Freud’s work’, Fink writes, ‘Lacan provides the basis for a structural understanding of obsession and hysteria that Freud did not provide’. His account of the diagnostic schema is supposed to open up the key structures that account for symptoms; as such, he may be taken to have produced the transcendental structure Freud looked for, but was unable to produce. But this structure can reveal itself only to those who are analysts themselves, and have undergone a lengthy period of training.

1. In the posts on the analytic session so far, I have been following Fink’s account of the analysis of a typical neurotic. The analyst’s concern is to let the neurotic analysand wonder out loud about the significance of their unconscious formations. The analyst must create a space where this is possible, standing in as an opaque Other whose hears something in what the neurotic says that was not consciously intended.

In so doing, the analysand begins to understand that he or she is not always in charge of the meaning of what he or she says. In the psychotic, by contrast, this place is not available, since he or she has not progressed beyond the imaginary stage.

In the case of the neurotic, analysis will pass through imaginary to symbolic to real stages. In the first transition, the analyst’s desire can be understood as constituting a rupture in the symbolic order as it is constructed by the patient. But there has to be a symbolic to disrupt; in the psychotic, there is not.

What is lacking is a subject of meaning; the psychotic lacks a sense of self. In relation to the neurotic, the analyst must disrupt his or her meaning-making activity, which can often be conventional and impatient, opening him or her to the unconscious rather than focusing upon the ego; with the psychotic, however, the ego is what is lacking. If there is to be any chance of the analyst’s ‘hitting the real’ then there is a great deal of constructive work to be done in the analytic sessions.

The psychotic must be brought to that stage where the meaning-making activity of his or her psyche is engaged, and carefully steered away from the creation of that kind of delusional world as found in Schreber. The aim of analysis will be for the psychotic to find a place in a world where the questions as to who he or she is, and why his or her parents wanted a child at all – questions of origin and destination – can be addressed without prompting a ‘psychotic break’ of the sort Schreber underwent which saw him, comparatively late in life, construct a cosmology in which he could find his place.

2. For Lacan, there are three principal clinical structures of the psyche: neurosis, into which most ‘normal’ people fall, psychosis and perversion. This diagnostic schema is simple and absolute – there can be no borderline cases, but diagnosis itself can be a difficult affair: certain psychotic traits in an individual may not indicate he or she is a psychotic. The defining mechanisms of each structure are therefore crucial to identify, especially since their particularities will orientate the method of analysis.

In the case of the psychotic, something has gone wrong with what Lacan calls ‘The Name of the Father’, to which Fink prefers the expression ‘father function’ or ‘paternal function’. Here, Lacan is not referring to the function played by an individual’s flesh-and-blood father, but to a symbolic function. But what does this mean?

For Lacan, the child is aware of the mother’s desire as a threat; at the same time, wanting for the mother to occupy herself exclusively with him or her, obliterating the distinction between mother and child. The father keeps the child from this becoming one with its mother, protecting the child from the desire of the mother – understood as both the child’s desire for the mother and the mother’s desire.

In this sense, the father can be understood as protecting the child from a threat, but he does so through prohibition, as the one who lays down the law for both mother and child. The father does not need to be present in order to function as a father. ‘Just wait till your father gets home’, says the mother: here, the child is supposed to reflect upon what the father will do or say.

The paternal function can play a similar role even when the flesh-and-blood father has died. ‘What would your father have thought about that?’, says the mother to an errant child. Crucially, the paternal function works to appeal to another source of authority beyond the mother’s.

For Lacan, the paternal function can also fail, leading to a variety of observable consequences to the analyst. But evidence has to be carefully reflected upon and weighed up. Take hallucination, for example. For Freud, the child who wants satisfaction of some kind hallucinates an earlier experience of satisfaction – seeing (and tasting) food, for example, in wanting to assuage hunger. Such is what Freud calls primary-process thinking, and is present in other unconscious formations such as daydreaming and fantasising.

Hallucination also has a specific relationship to the psychotic, but it is also a feature of any of the forms of psychic organisation. Faced with what he or she may take to be an account of hallucination by the patient, the analyst must pause and consider the subjective nature of the experience.

Crucially, Fink underlines, even as he or she makes no claim as to the ‘reality’ of the hallucination, the psychotic is absolutely certain about the significance of what he or she sees. The psychotic may believe he or she was chosen to hear or see it – ‘God has chosen me as his messenger’; ‘They are trying to get me’. The neurotic, by contrast, doubts the significance of the hallucination. Fink:

The neurotic is unsure: maybe the person was there, maybe not; maybe the voices are coming from some outside source, maybe they are not; maybe what they say has some meaning, maybe not; the meaning seems to have something to do with the person, but perhaps he or she is misinterpreting it.

Then the hallucination is something from which the neurotic feels a certain distance. ‘God revealed himself to be, but am I to be his messenger?’ ‘What do they want with me?’ Fink goes so far as to suggest what the neurotic senses cannot really be considered as hallucinations:

a bona fide hallucination requires a sense of subjective certainty on the patient’s part, an attribution of external agency, and is related to the return from the outside of something that has been foreclosed.

3. A second example of observable consequences in the clinic that must be carefully reflected upon. For Lacan, we are all of us alienated by language. Growing up, we are taught language by others, allowing our thoughts and experiences to be shaped. At the same time, we might be aware that we are unable to use language to say what we mean; that, speaking or writing, we are unable to find a place in language and make it our own.

There are many ways of addressing this alienation: we might assume a particular accent, identifying with the privileged; on the other hand, we may rebel against a standard language, preferring a slang full of swear words. We may leave behind our mother tongue altogether, abandoning it as it reflects a hated political system.

Alienation, however, can never be quite overcome. Whereas the neurotic is able to ‘subjectify’ language, having the sense that speech and writing do his or her bidding, the psychotic has a sense of being possessed by language, as though words were coming from outside him or her, rather than doing his or her bidding.

This phenomenon is well attested in artists’ experience of inspiration. Invocations of the Muse may seem a bland poetical formula, but perhaps are ways of naming the way in which a certain kind of inspired language arrives from without. Of course, inspiration is not a simple receptivity, but depends upon an answering desire to suspend reason or wilful deliberation – a willingness, that is, to allow an empowering spirit into creative work, to render it productive.

The artist must embrace dispossession, acknowledging the authority of a possessing voice, but it is also necessary to assume responsibility for the work, to shape and realise what has been received so that it may inspire others in turn. Inspiration allows the artist to discover an enhanced fluency, a deeper level of expression.

In the twentieth century, the experience of inspiration is recast by Blanchot in terms of the experience of the outside (as Foucault calls it, the thought from outside (the thought of the outside, the outside as thought)): here, language is no longer ordered in accordance with what the human being is able to achieve, indeed, with the very measure of its so to speak ability to be able.

Language is encountered as precisely what forbids subjectification – as an impersonal streaming that offers not repose but restlessness. Coming from outside the world to which language normally answers by way of its capacity to refer, this experience or thought cannot be contained by the interior realm of the speaker or writer.

For Blanchot, it is language as the outside with which a certain literature engages, and which is reflected in a certain practice of literary criticism. The writer is now linked to an experience of depersonalisation and possession. Here, then, is an experience akin to that of the psychotic. But there is a crucial difference. The inspired writer, even the Blanchotian one, might be understood (except by Deleuze and Guattari) to be highly creative of metaphor. The psychotic, says Lacan, cannot create metaphors at all.

Reading Blanchot’s The Last Man, we find the narrator comparing the relationship to the eponymous figure to the function of a lock on a river, which changes the level of water relative to one another. Here is an original use of metaphor (but Deleuze and Guattari, I think, would call it a metamorphosis) of which the psychotic would not be capable.

Like the creative writer, the psychotic experiences language as dispossessing, but unlike him or her, the psychotic’s speech is not creative of new meanings through metaphor. The psychotic can only use other people’s metaphors, imitating the way they speak, but there is something about the essential structure of language that eludes them.

Why is this the case? Lacan’s answer is stark: because of the failure of the essential metaphor – the paternal metaphor. Recall the discussion of the relationship between the father and mother. The father, says Lacan, as name (The-Name-of-the-Father) cancels out the Mother (the Mother’s desire and the desire for the Mother); the paternal function, regardless of any particular act by one’s biological parent, forces the child to give up its proximity to the mother.

Here, there is a clear overlap with the castration complex: the child has been forced to give up its jouissance, but the father’s prohibition is also creative of desire. With the refusal of the mother, I now understand that it is the mother I lack; my desire is constituted by that prohibition that separates me from the pleasure I feel in proximity to my mother – the attention she pays me, the smell of her body, etc.

For both boys and girls, joussiance is born with the father’s (the paternal function’s) prohibition, although it is typically stronger for male children, with whom the father, for Lacan, feels rivalry. Fink writes, in a passage that reminds me of Bataille’s discussion in Theory of Religion of the emergence of the human being from the ‘first immensity’ of animal life:

… the child’s relationship with its mother is first given meaning by the father’s prohibition; that meaning is, we might say, the ‘first meaning’, and it establishes a solid connection between a sternly enunciated interdiction and an indeterminate longing for closeness (which is transformed into desire for the mother as a result of the prohibition).

The ‘first meaning’ in question is, for Lacan, brought into being all at once by the paternal metaphor. In the act of prohibition, ‘a link is established between language and meaning (reality as socially constructed), between signifier and signified, that will never break’.

This Lacan’s famous point de caption, variously translated as an ‘anchoring point’, a ‘quilting point’ or ‘button tie’, which refers to that stitch used to secure a button that stops the fabric moving round in the stuffing of a piece of furniture. The efficacy of this stitch in no way depends upon the rigid structure of a particular piece of furniture, and likewise, the paternal metaphor ties meaning to specific words without regard to reality considered in itself, that is, free from particular acts through which, for each individual, language and meaning are stitched together. Without this stitch, everything will come apart – language as a structure cannot be assimilated.

This is precisely the problem the psychotic faces. He or she cannot create new metaphors, to new meanings using the same old words because of the failure of the paternal metaphor. But he or she can resort to neologisms – these are one of the signatures of psychosis, according to Lacan.

Here is an example (although free from the neologisms that characterise psychotic speech) from Roger, the patient examined in the case study Fink includes in this chapter:

Words frighten me. I’ve always wanted to write, but couldn’t manage to put a word on a thing … It was as though the words slipped off things … So I thought that by studying the dictionary from A to Z and writing down the words I didn’t know, I would possess them all and could say whatever I wanted.

4. A third diagnostic sign of psychosis can be found in the predominance of imaginary relations in the psychotic. Analysis will typically carry the patient through the stages of the imaginary, the symbolic and the real. For the neurotic, it will quickly become clear that it is the symbolic Other that is their concern – the function of authority played by parents and authority figures. Feelings of inadequacy or guilt refer to a conflict at the level of what Freud would call the superego of the patient and Lacan the ego-ideal, that is, the way the patient is seen by others.

The psychotic, by contrast, remains at the stage of the imaginary, feeling a rivalrous relation to others not in terms of attempting to gain approval from an authority figure, but as they threaten to usurp his or her place. Persecution is one example of a rivalrous relations, and is the chief characteristic of paranoia (one of the psychoses).

This is because the patient has not acquired the Symbolic relation to language. Lacan: ‘It is insofar as [the patient] has not acquired … the [symbolic] Other [language with its underlying structure] that he encounters the purely imaginary other. This other negates him, literally kills him’. Words, for the psychotic, are literally things and have real power.

(Here once again there is a strong overlap between the experience of the psychotic, as described by Lacan, and the literary writer. For doesn’t poetry also involve an encounter with words as things – not, that is, as they fulfil the efficient functioning of the symbolic realm, allowing the circulation of language and meaning, but as they allow words to force themselves into our attention in terms of their rhythmical properties, their sonorousness?

Words, for the poet, are also things – even as, at the same time, the poet is obligated to allow words to mean, to signify. And we should also note the way in which Deleuze and Guattari’s account of language as performative, as interacting within larger assemblages, as accomplish incorporeal changes in the world, function as ‘mots de ordre’, as slogans or watchwords as incorporating features of the psychotic experience of language.)

5. For Lacan, the body, in neurosis (the state most of us occupy), is overwritten and codified by the symbolic. The ‘real’ of the body as biological organism is socialised and domesticated; jouissance is only at play in the erogenous zones. In Lacan’s terms, the codified body is dead, libido being alive or real in the zones in question.

Libido, jouissance is channelled in a manner entirely different to that of the psychotic, for whom only the imaginary structures and hierarchises its drives. As such, jouissance can return in a massive and unpredictable manner, the patient speaking like Judge Schreber of the ‘voluptuousness’ of the body, of indescribable ecstasy, or even of shooting pains with no discernible physical cause. This invasion of jouissance is the fourth sign that may lead the analyst to diagnose psychosis.

The paternal function not only determines the relationship to language in the subject, but also his or her relationship to morality, to conscience. Typically, the neurotic exhibits strong egoic and superegoic control over his or her drives. Lacking that function is the fifth sign of the psychotic, who feels little guilt about injuring others. For guilt is always linked to repression, and that to the paternal function.

A sixth sign in the male patient is a certain feminisation. Some fathers exhibit an ‘unbridled authoritarianism’, feeling rivalrous with their sons. ‘The imaginary is way, the symbolic peace’, writes Fink very nicely. The symbolic order depends upon a kind of pact – the paternal function decrees ‘your mother is taken, but you can have another woman’, or ‘spend the morning doing homework, and in the afternoon you can go out to play’.

By contrast, the unbridled father, stuck in the imaginary, does not curb what he demands of the son and can never be satisfied. The father is the monster in relation to whom the son can only feel rivalrous. The Oedipal triangle cannot form, and the child assumes a feminine position in relation to the imaginary father. It is this feminine position which emerges in what Lacan calls a ‘psychotic break’, in the collapse of the patient’s imaginary identifications.

Feminisation in psychosis [Fink writes] thus seems to be indicative not of a total absence of a real father in the child’s family, but of the (at least occasional) presence of a father who established only an imaginary relationship with his son, not a symbolic one. Interestingly enough, the psychotic may also describe himself in a feminine or passive relation to language itself, passively submitting to it, invaded by it, or possessed by it.

Thus Schreber’s account of the voluptuousness of his body will be couched in terms of a felt feminisation.

6. For Lacan, human desire is a question that is formed in language. Over the course of therapy, the psychoanalytic ‘talking cure’ sees changes in the neurotic, who discards ideas that seemed formerly to be intrinsic to their character, giving up prior ego identifications and so on. With the psychotic, such changes cannot be seen; there is no movement in his or thoughts. The same phrases are reiterated. As Fink writes, ‘There is no properly human desire in psychosis. Where the structure of language is missing, desire too is missing’. The psychotic does not know repression, and hence questioning and wondering are entirely absent. Unconscious formations, for the psychotic, indicate nothing.

Fink discusses a case study of a psychotic, Roger, who has been attending sessions for 2 years. He brings his analyst a huge quantity of meticulously kept accounts of his dreams, which he types up and memorises (such productivity, Fink notes, is very common in the psychotic).

Roger is allowed to recite his dreams for a long time, the therapist keeping his writings. But one day, the therapist offers an interpretation of what he hears: when Roger recites a dream in which he is in a gilded cage ‘strewn with roses, watched by the therapist’, the therapist suggests this may be an image of what is currently happening; as Fink writes, ‘perhaps he sees the world as if from within a gilded cage where everything is rosy and he is admired by his doctor’.

This interpretation triggers what Lacan call a psychotic break: the patient has become shockingly aware that there is more to his dreams than pretty images he can write down and remember. What has happened? The therapist has become the Other to the psychotic patient, thereby taking on a symbolic role for a patient who lacks a relationship to the symbolic.

Until this point, his relationship to Roger was merely dyadic; now it has become triadic, with the introduction of an ‘outside’. What happens next? With a psychotic patient like Roger, there is no subject who can respond to the Other – no button tie through which meaning is established by way of the paternal metaphor.

Roger begins to attribute a menacing meaning to all kinds of things that, prior to the therapist’s intervention, had no such meaning. A hammer inadvertently left in the therapist’s waiting room is suddenly understood by Roger to imply that the therapist thinks Roger has ‘a screw loose’. A question on the cover of a journal in the therapist’s waiting room, ‘Are students crazy?’ (announcing an article on discontent among college students), leads Roger to believe that that question is aimed directly at him, and that it is intended specifically for him.

Roger is becoming delusional which, if given its head will lead to the fully fledged construction of what Lacan calls a ‘delusional metaphor’ – a point from which the psychotic might remake the world. This is exactly what happened with Schreber, whose complex cosmology grants him a stable world of meanings in which he can give himself a place. Here, the capacity of meaning-making runs amok – Schreber creates a world of meanings, it is true, but it is one that intersects only partially with the world of others around him.

Fortunately, in Roger’s case, the analyst is at hand to prevent that fully fledged delusional process that follows a psychotic break, in which the psychotic attempts to explain why he or she is here, why they were wanted and so on. The psychotic needs to do so because he or she lacks that answers to these questions, however provisional and shaky they are, that issue from the experience of the desire of one’s parents or caregivers.

‘[A]s subjects, we are born of our parents’ desire, not of their bodies’, writes Fink. As such, the psychotic cannot be said to have quite be born. Then it is the analyst who must find a place in which the psychotic can fit as part of a world of meaning without giving way to delusional activity. The analyst must encourage the meaning-making that is part of the ego, producing a sense of self in a patient who otherwise lacks it.

I am continuing to paraphrase Fink’s book on Lacanian clinical practice.

1. In the process of being brought up, there are certain prohibitions placed on the child’s behaviour: eating and excretion are carefully managed, and autoerotic behaviour discouraged. Lacan calls castration the general loss of the possibility of the child’s immediate gratification. This loss, however, is transformed by the prohibition placed on the child’s behaviour such that it becomes jouissance; bodily pleasure is transformed into something enticing and erotic; the strength of the prohibition can be directly correlated with the erotic charge borne by the forbidden act.

Of course, at the time of its upbringing, the child has no choice but to accept the giving up of immediate gratification. But this relinquishment is equivocal: the jouissance sacrificed by the child plays a role in constituting the subject it becomes. In Fink’s words,

the subject constitutes him- or herself as a stance adopted with respect to that loss of jouissance. Object a can be understood as the object (now lost) which provided that jouissance, as a kind of rem(a)inder of that lost jouissance.

I desire, now, what I gave up, and it appears all the more attractive for the fact that it has vanished. This is not a desire among others, to placed on a par with other demands I might have, but plays a crucial role in determining who I am. As Fink puts it, the subject constitutes him or herself with respect to the loss of jouissance, and, indeed, in relation to those who brought about this loss: parents and caregivers in the subject’s early years. The ‘object a‘ can be understood more precisely as having its origin as what is left over from that forbidden jouissance.

2. The role of the fundamental fantasy for Lacan can now come into focus: in Fink’s words,

[it] stages the relationship between the subject and the lost object that provided this now prohibited satisfaction. Desire, as expressed in and propped up by the fundamental fantasy, is determined and conditioned by the satisfaction that has been prohibited and renounced.

As opposed to particular imaginary scenes or constructs, the fundamental fantasy stages the position of the subject and the missing object of jouissance. Lacan calls this the ‘subject position’ or the ‘position as subject’ of the analysand.

It is the fundamental fantasy that the analyst will attempt to uncover through analytic session. But this process cannot assume the fantasy in question is simply there unaltered, lying in wait. For the fundamental fantasy as it is constructed and reconstructed in the analytic session, says Fink. Sessions allow this fantasy to be ‘distilled’ out of that disparate fantasies which arise over the course of analysis, revealing itself as it has determined the stance the analysand takes towards what caused his or her behaviour.

This recalls Freud’s notion of the primal scene. In his case study of the ‘Wolf Man’, he explores the way in which traumatising scenes may sometimes only be interpretable as experiences long after the actual event. Freud wonders whether the 18 month old who observed his parent’s intercourse ‘could be in a position to take in the perceptions of such a complicated process and to preserve them so accurately in his unconscious’; nevertheless, he insists that what was traumatising in the observation of parental intercourse ‘was the conviction of the reality of castration’.

But he also wonders whether the primal scene need refer to an actually occurring event – a real act of witnessing. At the same time, he also appears confident that he has brought the mystery of the scene in this particular case study to a full elaboration, showing, as elsewhere, how any complex the psychoanalyst uncovers can be referred back to an older one, eventually pointing back to a lack that belongs to our originary history.

Our individual fantasies bear a structural similarity with other primal fantasies that recall this lack. And it is this structure that is important with respect to the primal scene, which otherwise could be dismissed as having to do with the patient’s retrospective construction (his or her cryptomnesia) rather than any actually occurring event.

Likewise, then, with the fundamental fantasy that the Lacanian psychoanalyist builds up over the course of analysis. Fundamental fantasies bear upon the experience of castration, differing from individual to individual, and from the way in which they allow themselves to be constructed in the analytic session only as they reflect a patient’s particular mode of jouissance.

3. Freud noted in frustration that analysis often came to an end when confronted with the ‘rock’ of castration: the patient can only be brought to the state of giving up of satisfaction made according to the desires of his or her caregiver. For Freud, analysis should push further. This is likewise Lacan’s aim, for whom running up against castration means the patient remains fixed or stuck by the giving up of jouissance to the caregiving Other.

How does this manifest itself? A patient who appears to be an obedient son to his parents, taking on a job in the family firm, marrying a woman from an approved family, etc., may still harbour a resentment towards his parents. As Fink puts it, ‘Every neurosis entails […] a resentful stance toward the Other’s satisfaction’. The neurotic (classified according to Lacan) views giving up his or her jouissance in terms of a reward that has never manifest itself.

For Lacan, the neurotic’s position does not need to wreck analysis upon the rock of castration. It is possible in his expression to traverse the fantasy via the encounter with the desire of the analyst. In so doing, the analysand’s fundamental fantasy can be reconfigured, and along with it, a new relation to the Other achieved.

This is how analysis might push further than castration. Whereas the neurotic is marked by resentment for what he or she has given up, and is therefore in a stance of resentment towards the Other’s desire, the patient who has traversed the fantasy is no longer stuck; the Other’s jouissance is no longer a frustration. No longer does the analysand seek recompense from his or her parents or caregivers for lost jouissance. By the end of the analysis, the analyst, who has come to occupy the position of the ‘object a‘, will likewise no longer be blamed for what the analysand has lost.

In another book, Fink explains traversing the fantasy as ‘the process by which the subject subjectifies trauma, takes the traumatic event upon him or herself, and assumes responsibility for that jouissance’. Like Nietzsche’s Zarathustra, one must will what has happened without resentment, subjectifying what may seem to have happened randomly or accidentally. Hasn’t child of the ‘Three Metamorphorses’ become its own cause?

4. Analysis ends with what Lacan calls ‘precipitation’, a reconfiguration of the fundamental fantasy. The analysand is now able to take responsibility towards his or her castration; the analyst as Other (and through him or her, parents and other caregivers) is no longer blamed for stealing jouissance from the patient. But something else occurs, too – all along, the analysand will have been aware of the analyst’s desire for him or her to continue the process of analysis. The end of analysis is not announced by the analyst, but by the analysand, over whom the analyst’s desire no longer has a hold. 

But this is not a simple breaking off, both parties shaking hands and agreeing on a job well done. There is danger, says Fink, in letting the analysis come to a peaceful end, since this can suggest acquiescence to the analyst as an authority figure. The analysand must be brought to the point where the analyst’s desires have no more hold upon him or her, but this requires the arduous work that analysis involves. Analysis will usually end only after a serious struggle.

More sketchy notes closely paraphrasing Fink’s book on Lacanian psychoanalysis in the clinic, following posts here and here.

1. Unconscious desire reveals itself in the analytic session through that associative process through which interpretations proferred by the analyst in response to the patient’s unconscious formations (slips of the tongue, botched actions, double entendres, etc.) Even as analysis involves a certain kind of pedagogy, it does not take the form of the analyst’s propounding a general theory of psychoanalysis to the analysand, or indeed, in the case of interpretation, fixing and determining the meaning of unconscious formations once and for all. Of course, the analyst must reach a diagnosis of the patient, identifying his or her symptom, but what is important in that give and take in the session is to let the patient gain confidence in an open-ended interpretational process in which he or she is a participant.

For Lacan, the analyst’s interpretations of the patient’s unconscious formations should aim at providing enigmatic statements that frustrate the desire of the analysand to work them out at the conscious level. The unconscious must be engaged as it presents itself to the analysand who has been taught to abandon the notion that there can be a single, unequivocal meaning which unconscious formations reflect. As such, the analyst’s interjections in the session must be polyvalent if he or she to avoid spoon-feeding the analysand, and creating a relationship of dependency, whereby he or she stands in relation to the analyst as a child to a parent, or a pupil to a teacher.

It is in this sense that Lacan calls analytic interpretation ‘oracular speech’. What matters is the way the analyst’s interpretations resonate (Fink’s word) with the patient. The analyst will play on the sound of words – ‘that word sounds like …’ and point out double entendres; scansion may be employed. This will be intermittently frustrating for the patient, but what matters each time is to find provocative ways of intervening in the session that sends the analysand back to the mystery of his or her own unconscious formations. It is essential the analyst resists standing in as an authority figure, maintain him- or herself as the abstract, formal Other to the patient in order that transference may reach the real.

2. What does Lacan mean by the real? It can be considered, says Fink as the connection or link between two thoughts that has succumbed to repression and must be restored. It can also be thought of in terms of traumatic events (usually sexual or involving people who have been libidinally invested by the subject) that have never been talked through.

As such, the real is what must be symbolised through analysis: it has to be spoken, put into signifiers. As Jacques-Alain Miller has put it, analysis provides the progressive ‘draining away’ of the real into the symbolic. Aiming at the real, interpretation helps the analyand put into words that which has led his or her desire to become fixated or stuck.

Interpretation can be said to hit the real, in Lacan’s expression, when it permits an encounter with what it was the analysand had been trying to formulate all along. For Lacan, it is the real that brings the analysand incessantly to the same subject or event, letting him or her feel stuck, something essentially not yet having been formulated.

Hitting the real means the interpretation has been able to symbolise something that has not yet been put into words – when the analyst says, to use an example from Fink’s clinical practice, ‘Your mother turned you against your father’, this reveals the cause of the analysand’s anger, which, now symbolised, restores the missing link in the patient’s thoughts and feelings.

In the example in question, the analysand, Fink says, had discussed her anger toward her mother in several sessions; more recently, the analysand’s love for her father, long repressed, had also emerged. Analysis allowed the two themes to be connected. In previous sessions, the analysand’s anger with her mother had been linked to various events, but the analyst’s interpretation, linking this anger to her repressed love for her father, can be said to hit the real as it symbolised the cause of her anger. And, having done so, the interpretation has prepared the way for working through that anger.

As Fink notes, the interpretation in question does not supply the meaning in an unequivocal way to the patient. The phrase, ‘Your mother turned you against your father’ can be understood in many ways; as Fink recalls, the analysand heard this statement not figuratively, as one might expect but as referring to the physical sense of being turned up against her father. She was able, as a result, to associate to other significant events in her life (and note this lovely expression: associate to).

Then the analyst’s interpretations must remain oracular – as Fink notes, ‘an interpretation plays off ambiguities in its very formulation’; the analyst should prefer to present formulations that are able to sound other words and names that have been important to the patient. As such, it prevents the analyst from simply feeding the analyst’s demand, maintaining the desire of the analyst as the Other.

3. Through the process of analysis, the analysand is supposed to begin to work out what is being addressed to him or her through the unconscious. The patient must learn to want to know, pondering unconsicous formations as they operate as what, for Lacan, is the cause of the analysand’s desire.

Cause, in this context, is to be understood in a very specific sense. In Fink’s example, an analysand fixates on women who are indifferent to him; here, the cause of his desire is not to be confused with his relationship to a particular woman, but rather upon being refused by women as such. Desire does not have a specific object as its correlate but seeks to incarnate what it looks for in that object. A particular woman, in this sense, is only the avatar of the cause of the analysand’s desire, to the extent that the cause can be subtracted from this woman or any other.

Crucially, for Lacan, desire as such has no object – the satisfaction the analysand in question might feel when a previously unobtainable women decides she wants a relationship with him may well kill his desire. What he desired was something unsatisfiable; after all, as Lacan says, human desire seeks to go on desiring, looking only to perpetuate itself.

Lacan’s expression for the cause of desire the ‘object a‘, which may take an infinite number of guises – the shape of someone’s hands, the timbre of a voice, for example (each time, I suppose, it is a part, rather than a whole that is in question; a fragment, a nugget). Over the course of the analysis, the analyst prompts the patient to want to discover something, to attempt to understand what his or her unconscious is saying.

By offering tentative, oracular interpretations of the patient’s unconscious formations, the analyst now becomes the cause of the analysand’s desire, the ‘object a‘ having been displaced onto him or her. Once this has happened, analysis can really begin in earnest, as it consists in ‘working through’ – in the work of transference.

3. Lacan calls the ‘fundamental fantasy’ that fixation of the analysand on the object a, the object cause. Fantasy, here, is understood to frame the way in which the subject imagines him or herself in relation to the cause. For Lacan, there is but one single fantasy, akin to Freud’s notion of a ‘primal scene’ that is fundamental to each analysand. A successful course of analysis will see the transposition of the analysand’s fundamental fantasy – but what does this involve?

For Lacan, our desire always involves others around us. Growing up, we are likely to have focused on whatever it is our caregivers spoke of wanting; our desire to this extent is aroused by the desire of parents and other caregivers. We often want what others around us want, modelling what we want on the desires of others. And we may unconsciously want to desire in the manner of others around us, to the extent that the desire of the Other may be said to cause our own desires. Our most intimate desires may well in fact be modelled on the desires of our parents or others who have been close to us.

A persistent danger over the course of analysis is that the analysand takes the Other’s desire to coincide with his or her own, installing the analyst in the position of parent or judge. This is why the analyst cannot rest in the symbolic stage of transference: he or she must embody desire as the ‘object a‘, and as such, avoid being pinned down by the patient.

By withholding a definitive interpretation of the analysand’s behaviour, the analyst becomes a difficult and problematic figure for the patient. What does he or she want? What is the nature of the analyst’s desire? The analysand will characteristically try to pin it down, to classify it, and thereby have done with what Lacan calls angoisse, angst. This is because the analysand finds the analyst’s desire unbearable, attempting to transform it into a specific, intelligible demand, in terms of which the analysand might then moderate his or her behaviour in a way pleasing to the analyst. This, of course, falls far short of what is required in analysis. The analyst’s desirousness must remain enigmatic, however difficult it is for the patient.

3. As we grow up, restrictions are placed on our behaviour: eating and excretion are carefully managed, and autoerotic behaviour discouraged. Lacan calls castration the loss of the possibility of immediate gratification. This loss, however, is transformed by the prohibition placed on the child’s behaviour such that it becomes jouissance. Bodily pleasure is transformed into something enticing and erotic; the strength of the prohibition can be directly correlated with the erotic charge borne by the forbidden act.

Of course, at the time of its upbringing, the child has no choice but to accept the giving up of immediate gratification. But this relinquishment is equivocal: the jouissance sacrificed by the child plays a role in constituting the subject it becomes. In Fink’s words,

the subject constitutes him- or herself as a stance adopted with respect to that loss of jouissance. Object a can be understood as the object (now lost) which provided that jouissance, as a kind of rem(a)inder of that lost jouissance.

I desire, now, what I gave up, and it appears all the more attractive for the fact that it is vanished. This is not a desire among others, but plays a crucial role in determining who I am. As Fink puts it, the subject constitutes him or herself with respect to the loss of jouissance, and, indeed, to those who brought about this loss: parents and caregivers in the subject’s early years. The ‘object a‘ can now be understood more precisely as having its origin as what is left over from that forbidden jouissance. It is a reminder of what was lost.

Freud noted in frustration that analysis often came to an end when confronted with the rock of castration: the patient can only be brought to the state of giving up of satisfaction made according to the desires of his or her caregiver. As Lacan might put it, this would mean the patient remains fixed or stuck by the giving up of jouissance to the caregiving Other.

How does this manifest itself? The neurotic may appear to be an obedient son to his parents, taking on a job in the family firm, marrying a woman from an approved family, etc., but may still harbour a resentment towards his parents. As Fink puts it, ‘Every neurosis entails […] a resentful stance toward the Other’s satisfaction’. The neurotic views giving up his or her jouissance in terms of a reward that has never manifest itself.

For Lacan, the neurotic’s position does not need to wreck analysis upon the rock of castration. It is possible in his expression to traverse the fantasy via the encounter with the desire of the analyst. In so doing, the analysand’s fundamental fantasy can be reconfigured, and along with it, a new relation to the Other achieved.

Whereas the neurotic is marked by resentment for what he or she has given up, and is therefore in a stance of resentment towards the Other’s desire, the patient who has traversed the fantasy is no longer stuck; the Other’s jouissance is no longer a frustration. No longer does the analysand seek recompense from his or her parents or caregivers for lost jouissance. By the end of the analysis, the analyst, who occupies the position of the ‘object a‘, will likewise no longer be blamed for what the analysand has lost.

4. Analysis ends with what Lacan calls ‘precipitation’, the completed transposition ot reconfiguration of the fundamental fantasy. The analysand is now able to take responsibility towards his or her castration; the analyst as Other, standing in for the analysand’s parents and other caregivers is no longer blamed for stealing jouissance from the patient.

Something else occurs, too – all along, the analysand will have been aware of the analyst’s desire for him or her to continue the process of analysis. The end of analysis is not announced by the analyst, but by the analysand, over whom the analyst’s desire no longer has a hold. 

But this is not a simple breaking off. As Fink stresses, if analysis comes to a peaceful end, this can suggest acquiescence to the analyst as an authority figure. The analysand must be brought to the point where the analyst’s desires have no more hold upon him or her, but this presumes the arduous work that analysis involves. As such, analysis will usually end only after a serious struggle.

More paraphrastic notes from Fink’s book on the clinical practice of Lacanian psychoanalysis.

1. A person usually comes to analysis in times of crisis, when their symptoms bring them into some kind of conflict with others around them, or intensify to the degree they become unendurable. It is when the satisfaction the symptoms provide begin to waver that they seek external help.

At the same time, there is a satisfaction in the very dissatisfaction to which the symptoms have led – a jouissance, to use Lacan’s words, in which pleasure is mixed with pain (there is pleasure in pain and pain in pleasure). Analysis is sought, Fink says, when jouissance breaks down – when the effects of the symptom, understood as the sole source of the person’s obtaining enjoyment, have become unendurable.

Initially at least, the patient may simply be looking merely for a way of retrieving that wavering source of jouissance, of seeking the quick fix they believe analysis might provide. As such, the patient – or analysand, to use Lacan’s word, the ‘-and’ ending implying that it is the patient who must be prepared to do the analytical work – is often unprepared for what analysis will call for. It is the analyst’s role to maintain the force of this calling, even against the analysand’s explicit wishes – for who would want give up the sole source of their enjoyment?

There must therefore be a discipline to the analysis, which the analyst must rigorously maintain without becoming, for all that, a disciplinary figure (a parent, a judge). It must be what Lacan calls the desire of the analyst to maintain the session, for the patient to talk, to fantasise, to associate. But what does this mean?

The analyst’s desire is focused solely on the process of analysis – it is not concerned wanting the best for the patient – for him or her to achieve career advancement, or to find a suitable life-partner. Desire, likewise, has nothing to do with what the analyst wants the patient to say, or the plans the analyst might have for the patient’s development. The analyst’s desire must remain enigmatic, free floating, holding back from prompting the analysand in any particular direction.

2. Initially, the analyst must broadly determine the kind of patient the analysand is by way of a mixture of direct questioning and allowing the patient to talk and associate, the clinical category into which the patient might fall. The analyst will also seek to crystallise the dissatisfaction of the patient into a particular psychosomatic symptom, leading the analysand to understand how his or her problems may be susceptible to a talking cure.

These ‘preliminary interviews’ may last for as long as a year, over which the analyst will begin to lose, for the patient, the sense of being an individual like any other. Slowly, the analyst becomes akin to an actor or a placeholder, and analysis can pass from a face to face meeting to one in which the analysand is put on the couch.

In these initial sessions, the analyst should offer only punctuations of the analysand’s speech, suggesting through specific interjections – emphasising particular words, interjecting a ‘huh!’ every now and again, and of course focusing on slips of the tongue, garbled speech and other ambiguities – how another account of what the patient is saying might be possible. This is not yet rigorously diagnostical work, but allows the patient to become aware that there is another layer of meanings to his or her unconscious formations. The patient, too, should become interested in his or her own slips of the tongue and double entendres as such formations.

The analyst, then, draws the patient’s attention to certain points at which unconscious desire surfaces, thereby allowing the patient to think about them and to associate to them. This may require the analyst carries out an interruption or scansion of the session, whereby the patient’s attention is focused upon what gives a clue to a hitherto unavowed source of jouissance. The analyst may call for the session may end on such a note, rather than letting the patient carry on speaking.

Above all, the analyst cannot let the patient chatter aimlessly, but must keep him or her off balance, for it is only when what they say becomes enigmatic to them – when they begin to place their faith in those moments in which the play of the unconscious reveals itself that their desire can be said to be engaged in analysis. Only, that is, when they begin to wonder about the significance of their slips, fantasies, dreams and garbled speech that analysis becomes as Lacan puts it ‘dialecticisable’. Now the patient has given up the impatient demand for a cure and has truly entered analysis.

Note here the active role of the analysand in the sessions: he or she is not looking to the analyst as a source of authority. It is the analysand’s unconscious that is, in Lacan’s phrase, the subject supposed to know in the sessions: at the same time, this subject is projected by the analysand onto the analyst, who agrees in his or her role as actor or placeholder to stand in for the unconscious. The analyst has become, in Lacan’s words, the Other – a blank and anonymous stand-in, a mirror or a projective screen for the analysand.

3. It is in terms of the analysand’s relationship to this stand-in that we can understand the role of Lacan’s notions of the imaginary, the symbolic and the real.

Initially, the analysand will have what Lacan calls an imaginary relationship to the analyst. What does this mean? The relationship is dominated by the self-image of the analysand and the image he or she has of the analyst. The imaginary stage, Fink notes, is marked by rivalry as the analysand measures him- or herself against the image of the analyst: who is better? who is inferior? The analyst must be careful not to respond to this imaginary relationship, maintaining his or her position until rivalry subsides.

The analysand will then characteristically move on to a symbolic relationship to the analyst, relating to him or her as to an authority figure who is able to deliver judgements of various kinds, whether approving or disapproving. To the analysand, the analyst cannot help but embody certain values by dint of the way he or she dresses, by his or her accent, by the decorative features of office in which the sessions take place and so on. But once again, despite this, the analyst must strive to become no one in particular, that is, Other with regard to the analysand, rejecting the interpretations of the patient in his or her transferences.

Freud came to call transference the developing relationship of the patient with the analyst over the course of a treatment. Specific kinds of transference characterise the imaginary and symbolic relationships to the analyst – rivalry (insofar as the analyst seems to be like him or her) and the desire to be judged (the analyst as Other, as judge or parent), respectively. But with respect to the real relationship, the analyst is understood to be the cause of the dreams, fantasies and slips of the analysand – that is, his or her unconscious formations. The analyst thereby becomes what for Lacan is a ‘real’ object for the analysand, which is to be indicated by the expression ‘object a‘.

In this position, the presence of the analyst becomes far more troubling for the patient under analysis, showing up in the unconscious formations themselves. The patient may now exhibit what is called negative transference with respect to the analyst. This is not to be avoided and may even be necessary: analysis, at this point, is not a pleasant process, since the analyst as Other must allow himself to stand in for people and events that the analysand must confront in the analytic session. For it is not enough for the analysand to merely talk through his or her issues with respect to those people and events; the analysand must also experience the affect they originally aroused (even if this affect was diffused and not experienced as such at the time of the events themselves).

Crucially, then, transference also involves a transfer of affect associated with those people and events in the past into the analytic sessions. Analysis depends upon the projection onto the analyst of those emotions felt towards the people and events in question. Only at this point, for Lacan, can analysis really progress. In Fink’s words, the analyst can now work ‘to reestablish connections between the content (thought and feeling) and the persons, situations, and relationships that initially gave rise to it’. The analyst can uncover the real of those connections as it is brought to signification by the analysand.

The analyst, then, must allow him or herself to stand in for people, events or relationships that were productive of what can be determined as the patient’s symptom. He or she must become Other to the patient to the extent the analyst can bear a kind of transference that might be called substitutive. The analysand, too, might be said to become Other for him or herself in talking and associating to particular polyvalent interpretations the analyst might proffer. A process that will lead to the unconscious (the patient’s Other, if I understand correctly) to be projected upon the analyst as Other.

Only in this way can analysis touch upon the real, as it understood as a connection or link between two events that has been repressed and can now be restored. Only now can the real, understood as trauma, be put into words, that is, symbolised, such that the an analytic cure to the distressing effects of the patient’s symptom might be found.

Some paraphrastic notes on Bruce Fink’s supremely clear book on Lacanian psychoanalysis as a clinical practice.

What is the role of the analyst in analytic sessions? To become Other to the patient, evincing neither approval nor disapproval, providing polyvalent interpretations of what the patient says intended not so much to provide the key to the patient’s symptoms as to prompt the patient to ponder his or her unconscious formations – those instances of garbled speech, slips and double entendres, botched actions, daydreams, sequences of thought and so on that are important as raw materials in analysis.

At the same time, the analyst will need to create and maintain a space in which the patient can talk, fantasise and associate – interpretative work, as it is carried out by analyst and analysand depends upon the constancy of the analyst’s desire that the patient continue with the sessions. The analyst’s desire bears exclusively on those sessions – on the analysis alone, and not, for example, for the patient to find a fulfilling job, meet a lifepartner and so on. It is in this way that the analyst’s desire is in Lacan’s words, purified – it bears upon the role the analyst must play with respect to the patient.

But why is it so important for the analysand to continue with the sessions? Because the patient will be resistant to what is demanded from analysis. Simply turning up in search of a cure for problems is insufficient, since the patient, according to Lacan, actively turns against wanting to know what his or her symptoms might be. It is this primary resistance, this will to know nothing that the analyst must overcome.

How? First of all, by emphasising the difference of the relationship to the analyst from any other relationship. There is a difference in level between analyst and analysand – clearly enough, theirs is not a reciprocal relationship; the patient is a patient, and will be required to speak, saying whatever comes to mind and doing so without unrestrainedly, fearing no censure.

As Fink puts it, there must be a pedagogical element in analysis if it is to begin to reveal unconscious formations that may then be used by the analyst to diagnose the patient’s symptom; the analyst is some sense a teacher. The patient is not there to be taught about the essentials of psychoanalysis, nor indeed for a high level intellectual discussion with the analyst. Likewise, the patient does not attend sessions simply to chat about his or her life, passing a pleasant hour reviewing the events of the past few days. The analyst is not the patient’s equal, entering into a relationship of reciprocity with the analysand, but nor is he or she an authority figure, who will tell the patient what to do.

Perhaps we might understand the relationship to the analyst as being one to a teacher who wants the analysand to to learn to read and interpret a difficult text not so much to provide a definitive interpretation of the text in question as to allow him or her to understand how interpretation itself, though active, is always provisional.

I think here of my own encounter with T.S. Eliot’s poems in an English class when I was 15 or so; what mattered for the teacher was not to provide a key to these poems, but to show how they elicited and escaped different frameworks of interpretation. What escaped, in a sense, was the poem itself as a poem.

In the analytic session, the ‘text’, if it can be called that, is not something that lies outside the patient in the manner of a poem, it is the unconscious that lies within the patient that must be brought to speech and heeded. (Of course,this distinction here between inside and outside is naive; the unconscious, as Lacan shows is not buried in the profounds of mind, but is socially produced; it depends upon the relation between subject and others; and the poem depends upon those intentional acts that place consciousness always outside itself.)

The analysand will need to attend to previously unnoticed behaviour – slips of the tongue, daydreams, idle fantasies and flights of thought, musing upon what they might mean without turning immediately to the analyst for a definitive interpretation. This kind of pondering is not intended to be theoretical; the interpretative work with which the patient may be engaged aims not so much as uncovering the secret of the basic structures of the psyche as allowing that they might be more than conscious interpretations of unconscious formations. Certainly it will be up to the analyst to diagonse the patient, but this is not, at the beginning of analysis, of immediate concern; the pedagogical phase of analysis is required before any real analytic work can begin.

One model for the early stages of analysis would be that of placing the pupil in front of a poem, and attempting to let him or her heed that poem in as it were its own terms (that is to say, as it resists various techniques of reading, various hermeneutical frameworks). It must be allowed to maintain its distance, even as this distance becomes that which draws a reading after it, awakening the desire to spend time with the poem, to tarry over it, without expecting an instant interpretation or message.

Like the poem, the unconscious is mysterious. And as in a literature class, the aim must be for that mystery to summon the reader, altering the way the reader reads, eliciting particular acts of reading, particular forays, but also calling forth the desire to read.

I remember my encounter with T.S. Eliot not only for the wonder of the poems themselves, but also in terms of what it opened for me: time to spend with other poems, with other books; time to be spent with an author’s oeuvre. And so too must the analysand learn to spend time with the unconscious, heeding it in its own terms (that is to say, in its ambiguities, its hesitations) and in the time it demands such that it can be made to speak.

What, then, is shared between analyst and analysand via the pedagogical element of analysis? A sense that to the patient’s unconscious there belongs a specific distance, which admits only of a particular kind of approach and in relation to which, analyst and analysand are collaborators. But collaborators who have a different perspective with respect to those formations which signal the unconscious: the patient must produce material for analysis and be ready to ponder its significance; the analyst by maintaining the necessity of the analysand’s continuing to attend sessions, and by withdrawing from any fixed interpretational role with respect to what it is the patient says.

In a sense, then, both patient and analyst must allow themselves to become other than who they usually are with respect to one another, the patient in order to let the unconscious reveal its play, and the analyst in order to produce those conditions that best allow for the emergence of unconscious formations. This is what the pedagogical element of analysis requires.