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French: psychose
German: Psychose

Psychosis is a nosological category distinct from neurosis and perversion. It is brought about by the foreclosure of a primordial signifier, the Name-of-the-Father.

In his seminar of 1955-56 (Seminar III, The Psychoses), Lacan argues that there is a defense mechanism specific to psychosis on the grounds that the peculiarly invasive and devastating nature of psychotics' delusional systems and hallucinations indicates major structural differences between psychosis and neurosis.

Sigmund Freud

It is true that Freud had found that the discourse of the psychotic and the apparently bizarre and meaningless phenomena of psychosis could be deciphered and understood, just as dreams can. Freud's analysis of the psychotic Schreber's memoirs thus broke with contemporary approaches to psychosis, which regarded psychotics as beyond the limits of understanding (Freud, 1951).

However, as Lacan points out, the fact that the psychotic's discourse is just as interpretable as that of the neurotic leaves the two disorders at the same level and fails to account for the major differences between them, thus the distinction between the two remains to be explained. It is around this issue of the different mechanisms in psychosis and neurosis that Lacan's major contribution to the study of psychosis revolves.

Freud claims that in both neurosis and psychosis there is a withdrawal of investment, or object-cathexis, from objects in the world. In the case of neurosis the object-cathexis is retained, but is invested in fantasized objects in the neurotic's internal world. In the case of psychosis the withdrawn cathexis is invested in the ego at the expense of all object-cathexes, even in fantasy. This turning of libido upon the ego accounts for symptoms such as hypochondria and megalomania. The delusional system, the most striking feature of psychosis, arises in a second stage. Freud characterizes the construction of a delusional system as an attempt at recovery in which the psychotic re-establishes a new, often very intense, relation with the people and things in the world by way of a delusional formation.

Jacques Lacan


Lacan discussed psychosis throughout his work. His interest in psychosis predates his interest in psychoanalysis. Jacques Lacan studied psychosis for his doctoral research about a woman he calls "Aimee."[1] Indeed it was his doctoral research, which concerned a psychotic woman whom Lacan calls Aimée that first led Lacan to psychoanalytic theory.[2] It is common to compare Lacan's tortured and at times almost incomprehensible style of writing and speaking to the discourse of psychotic patients. Lacan's discussions of psychosis are among the most significant and original aspects of his work. Lacan's most detailed discussion of psychosis appears in his seminar of 1955-6, entitled simply The Psychoses. It is here that he expounds what come to be the main tenets of the Lacanian approach to madness.

Clinical Structure

Psychosis is defined as one of the three clinical structures, one of which is defined by the operation of foreclosure. In this operation, the Name-of-the-Father is not integrated in the symbolic universe of the psychotic (it is "foreclosed"), with the result that a hole is left in the symbolic order. To speak of a hole in the symbolic order is not to say that the psychotic does not have an unconscious; on the contrary, in psychosis "the unconscious is present but not functioning."[3] The psychotic structure thus results from a certain malfunction of the Oedipus complex, a lack in the paternal function; more specifically, in psychosis the paternal function is reduced to the image of the father (the symbolic is reduced to the imaginary).

The Psychotic Relation to Reality

In his articles on psychosis Freud noted the psychotic's altered relation to reality. The 'imaginary external world' of a psychosis attempts to put itself in place of the 'external world'. (In Lacanian terms, there are altered relations between the Imaginary and Real Orders, in parallel with an alteration in the Symbolic Order).

In studying psychosis Lacan stated, following Freud, that "the problem lies not in the reality that is lost, but in that which takes its place."[4] Lacan emphasized the 'rent' or gap that appears in the relation of the psychotic subject to the world, and the nature of the 'patch' which the psychotic subject applies over this gap.


In his seminar on psychosis (1955-6) Lacan tackled Freud's case history of Judge Schreber, a paranoid schizophrenic who wrote a fascinating account of his illnesss entitled Memoirs of My Nervous Illness (1903). Lacan's essay "On a question preliminary to any possible treatment of psychosis (1957-8)' enlarged on the ideas of this seminar.


Freud was skeptical about the possibility of practising psychoanalysis with psychotic patients. Lacan follows Freud in arguing that while psychosis is of great interest for psychoanalytic theory, it is outside the field of the classical method of psychoanalytic treatment, which is only appropriate for neurosis; "to use the technique that Freud established outside the experience to which it was applied (i.e. neurosis) is as stupid as to toil at the oars when the ship is on the sand."[5]

This does not mean that Lacanian analysts do not work with psychotic patients. On the contrary, much work has been done by Lacanian analysts in the treatment of psychosis. However, the method of treatment differs substantially from that used with neurotic and perverse patients. Lacan himself works with psychotic patients but left very few comments on the technique he employed; rather than setting out a technical procedure for working with psychosis, he limited himself to discussing the questions preliminary to any such work.[6]

The Relation of the Subject to his Speech

Lacan asserted that the failure to take account of the relation of the subject to his speech had resulted in a failure to understand psychotic phenomena.


  1. Lacan, Jacques. De la psychose paranoiaque dans ses rapports avec la personalité, Paris: Navarin, 1975. [1932].
  2. Lacan, Jacques. De la psychose paranoiaque dans ses rapports avec la personalité, Paris: Navarin, 1975. [1932].
  3. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p. 208
  4. Lacan, Jacques. Écrits: A Selection. Trans. Alan Sheridan. London: Tavistock Publications, 1977. p. 188-9
  5. Lacan, Jacques. Écrits: A Selection. Trans. Alan Sheridan. London: Tavistock Publications, 1977. p. 221
  6. Lacan, Jacques. p. 1957-8b