Treatment
Treatment in psychoanalysis refers to the practice of analysis, distinct from theoretical formulations. In the Lacanian tradition, it is not based on medical models but is seen as a symbolic and subjective process structured by language, desire, and the unconscious.
Distinction from Medical Models
Unlike psychiatry or clinical psychology, psychoanalytic treatment does not aim to restore normative functioning or eliminate symptoms. Instead, it engages the subject’s speech and desire within the symbolic structure of transference.
The goal is not ego-strengthening but traversing the fantasy organizing desire and confronting the truth of the unconscious subject position.
Aim of Treatment
For Jacques Lacan, treatment does not aim to "heal" the analysand in a conventional sense. Neurosis, psychosis, and perversion are structural modes of psychic organization, not pathologies to cure.
The aim of treatment is to allow the analysand to confront and assume their own subjective division—to come into relation with their desire and the structuring effects of the unconscious. This is sometimes described as the movement toward the end of analysis, where the analysand assumes the singularity of their symptom and relinquishes the fantasy of wholeness.
The Analytic Process
Psychoanalytic treatment progresses through three dialectical phases: beginning, middle, and end—each shaped by dynamics of speech, desire, and resistance.
Beginning: Entry into Analysis
The initial phase requires a formal pact formed through preliminary interviews, which:
- Convert complaints into a psychoanalytic symptom.
- Establish transference—the analyst's role in the analysand’s unconscious.
- Assess genuine demand for analysis and hypothesize clinical structure.
The analysand consents to the Fundamental Rule: speak freely, without censorship. This enables symbolic engagement with the Other.
Middle: Free Association and the Work of Speech
With the analyst out of view, speech—not visual interaction—is privileged. Through free association, the analysand produces chains of signifiers revealing unconscious formations.
Two tensions emerge:
- The drive toward truth (transference and the analysand’s desire to know);
- The resistance halting speech when faced with anxiety or jouissance.
The analyst intervenes structurally—punctuating, isolating signifiers—not interpretively.
End: Traversal of the Fantasy
The end of analysis is not marked by symptom elimination or behavioral change, but by a transformation in the subject’s relation to their desire and symptom. This may involve the traversal of fantasy—a moment where the analysand disidentifies from the imaginary narrative that structures their suffering.
At this point, the subject may come to assume responsibility for their position as divided and lacking, rather than seeking wholeness through the Other. The analyst, meanwhile, withdraws their presumed knowledge, dissolving transference.
Key Concepts
- Analysand: The subject of analysis, divided and constituted by speech.
- Analyst: Listens and intervenes structurally; holds the place of the subject supposed to know.
- Transference: Projection of unconscious desires onto the analyst.
- Resistance: Disruption in speech that reveals unconscious structure.
- Free Association: Speaking without censorship; central analytic method.
- Fundamental Rule: Command to speak freely; structural basis of analysis.
- Desire of the Analyst: Structural function sustaining the analysand’s speech.
- End of Analysis: Moment of assuming the truth of one's desire and symptom.
See Also
References