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"[[Psychosis]]" arises from a disturbance in the [[ego]]'s relationship with the [[moebius strip|external world]], [[neurosis]] from a conflict between the [[ego]] and the [[id]].
"[[Psychosis]]" is used to describe any ''severe'' form of '''mental illness'' characterized by symptoms, such as delusions or hallucinations, that indicate impaired contact with reality.
"[[Psychosis]]" is used to describe any ''severe'' form of '''mental illness'', in which the [[ego]] withdraws from some part or aspect of the [[pleasure principle|real world]].
==Sigmund Freud==
The term [[psychosis]] arose in [[psychiatry]] in the nineteenth century as a way of designating mental illness in general.
During [[Freud]]'s life, a basic distinction between [[psychosis]] and [[neurosis]] came to be generally accepted, according to which [[psychosis]] designated extreme forms of mental illness and [[neurosis]] denoted less serious disorders.
This basic distinction between [[neurosis]] and [[psychosis]] was taken up and developed by [[Freud]] himself in several papers.<ref>Freud, 1924b and 1924e</ref>
==Jacques Lacan==
[[Lacan]]'s interest in [[psychosis]] predates his nterest in [[psychoanalysis]].
Indeed it was his doctoral research, which concerned a psychotic woman whom [[Lacan]] calls [[Aimée]] that first led [[Lacan]] to [[psychoanalytic theory]].<ref>{{L}} p.1932.</ref>
It is often remarked that [[Lacan]]'s debt to this [[patient]] is reminiscent of [[Freud]]'s debt to his first [[neurotic]] [[patient]]'s (who were also [[female]]).
In other words, whereas [[Freud]]'s first approach to the [[unconscious]] sis by way of [[neurosis]], [[Lacan]]'s tortured and at times almsot incomprehensible style of writing and speaking to the [[discourse]] of [[psychotic]] [[patient]]s.
Whatever one makes of such comparisons, it is clear that [[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 ''[[Seminar III|The Psychoses]]''.
It is here that he expounds what come to be the main tents of the [[Lacan]]ian approach to [[madness]].
[[Psychosis]] is defined as one of the three [[clinical structure]]s, one of hwihc is defined by the operation of [[foreclosure]].
In this operation, the [[Name-of-the-Father]] is not integrated in the [[symbolic order|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."<ref>{{S3}} p.208</ref>
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 funciton is reduced to the [[image]] of the [[father]] (the [[symbolic]] is reduced to the [[imaginary]]).
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In [[Lacan]]ian [[psychoanalysis]] it is important to distinguish between [[psychosis]], which is a [[clinical structure]], and [[psychotic]] phenomena such as [[delusions]] and [[hallucinations]].
Two conditions are required for psychotic phenomena to emerge: the [[subject]] must have a [[psychotic]] [[structure]], and the [[Name-of-the-Father]] must be "called into symbolic opposition to the subject."<ref>{{E}} p.217</ref>
In the [[absence]] of the first condition, no confrontation with the paternal signifier will ever lead to psychotic phenomena; a [[neurotic]] can never "become psychotic."<ref>{{S3}} p.15</ref>
In the [[absence]] of the second condition, the [[psychotic]] [[structure]] will remain latent.
It is thus conceivable that a [[subject]] may have a [[psychotic]] [[structure]] and yet never develop [[delusions]] or experience [[hallucination]]s.
When both conditions are fulfilled, the [[psychosis]] is "triggered off," the latent [[psychosis]] becomes manifest in [[hallucination]]s and/or [[delusions]].
------
In the 1970s [[Lacan]] reformulates his approach to [[psychosis]] around the notion of the [[borromean knot]].
The three rings in the knot represent the three [[orders]]: the [[real]], the [[symbolic]] and the [[imaginary]].
While in [[neurosis]] these three rings are linked together in a particular way, in [[psychosis]] they become disentangled.
This [[psychotic]] disassociation may sometimes however be avoided by a [[sinthome|symptomaatic formation]] which acts as a fourth ring holding the other three together.
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[[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."<ref>{{E}} p.221</ref>
Not only is the classical method of [[psychoanalytic treatment]] inappropriate for [[psychotic]] [[subject]]s, but it is even contraindicated.
For example [[Lacan]] points out that the technique of [[psychoanalysis]], which involves the use of the couch and [[free association]], can easily trigger off a latent [[psychosis]].<ref>{{S3}} p.15</ref>
This is the reason why [[Lacan]]ian [[analyst]]s usually follow [[Freud]]'s recommendation to begin the [[treatment]] of a new [[patient]] with a series of face-to-face interviews.<ref>{{F}} p.1913c. [[SE]] XII. 123-4</ref>
Only when the [[analyst]] is reasonably sure that the [[patient]] is not [[psychotic]] will the [[patient]] be asked to lie down on the couch and [[free association|free associate]].
-----------
This does not mean that Lacanian analysts do not work with [[psychotic]] [[patient]]s.
On the contrary, much work has been done by [[Lacanian]] [[analyst]]s in the [[treatment]] of [[psychosis]].
However, the method of [[treatment]] differs substantially from that used with [[neurotic]] and [[perverse]] [[patient]]s.
[[Lacan]] himself works with [[psychotic]] [[patient]]s 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.<ref>{{L}} p.1957-8b</ref>
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Lacan rejects the approach of those who limit their analysis of psychosis to the imagianry order; "nothing is to be expected from the way psychosis is explored at the level of the imaginary, since the imaginary mechanism is what gives psychotic alienation its form, but not its dynamics."<ref>{{S3}} p.146</ref>
It is only by focusing on the symbolic order that Lacan is able to point to the fundamental determining element of psychosis, namely ,the hole in the symbolic order caused by foreclosure and the consequent "imprisonment" of the psychotic subject in the imaginary.
It is also this emphasis on the symbolic order which leads Lacan to value above all the linguistic phenomena in [[psychosis]]: "the importance given to language phenomena in psychosis is for us the msot fruitful lesson of all."<ref>{{S3}} p.144</ref>
---
The [[language]] phenomena most notable in [[psychosis]] are ''disorders'' of [[language]], and [[Lacan]] argues that the [[presence]] of such disorders is a necessary condition for a diagnosis of [[psychosis]].<ref>{{S3}} p.92</ref>
Among the psychotic language disorders which Lacan draws attention to are holophrases and the extensive use of neologisms (which may be completely new words coined by the psychotic, or already existing words which the psychotic redefines).<ref>{{Ec}} p.167</ref>
In 1956, Lacan attributes these language disorders to the psychotic's lack of a sufficient number of points de capiton.
The lack of sufficient points de capiton means that the psychotic experience is characterized by a constant slippage of the signified under the signifier, which is a disaster for [[signification]]; there is a continual "casscade of reshapings of the signifier fromw hich the increasing disaster of the imaginary proceeds, until the level is reached at which signifier and signified are stablized in the delusional metaphor."<ref>{E}} p.217</ref>
Another way of desribing this is as "a relationship between the subject and the signifier in its most formal dimension, in its dimension as a pure signifier."<ref>{{S3}} p.250</ref>
This relationship of the subject to the signifier in its purely formal aspect constitutes "the nucleus of psychosis."<ref>{{S3}} p.250</ref>
"If the neurotic inhabits language, the psychotic is inhabited, possessed, by language."<ref>{{S3}} p.250</ref>
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Of all the various forms of psychosis, it is [[paranoia]] that most interests Lacan, while schizophrenia and mani-depressive psychosis are rarely discussed.<ref>{{S3}} p.3-4</ref>
Lacan follows Freud in maintaining a structural distinction between paranoia and schizophrenia.
[[psychosis]] ([[psychose]])
The term [[psychosis]] arose in [[psychiatry]] in the nineteenth century as a way of designating mental illness in general.
During [[Freud]]'s life, a basic distinction between [[psychosis]] and [[neurosis]] came to be generally accepted, according to which [[psychosis]] designated extreme forms of mental illness and [[neurosis]] denoted less serious disorders.
This basic distinction between [[neurosis]] and [[psychosis]] was taken up and developed by [[Freud]] himself in several papers.<ref>Freud, 1924b and 1924e</ref>
[[Lacan]]'s interest in [[psychosis]] predates his interest in [[psychoanalysis]].
Indeed it was his doctoral research, which concerned a psychotic [[woman]] whom [[Lacan]] calls '[[AimÈe]]', that first led [[Lacan]] to [[psychoanalytic theory]].<ref>Lacan, 1932</ref>
It has often been remarked that [[Lacan]]'s debt to this [[patient]] is reminiscent of [[Freud]]'s debt to his first [[neurotic]] [[patient]]s (who were also [[female]]).
In other words, whereas [[Freud]]'s first approach to the [[unconscious]] is by way of [[neurosis]], [[Lacan]]'s first approach is via [[psychosis]].
It has also been common to compare [[Lacan]]'s tortured and at times almost incomprehensible style of [[writing]] and [[speaking]] to the discourse of [[psychotic]] [[patient]]s.
"Whatever one are stabilized in the [[delusion]]al [[metaphor]]."<ref>{{E}} p.217</ref>
Another way of describing this is as "a relationship between the subject and the signifier in its most formal dimension, in its dimension as a pure signifier."<ref>{{S3}} p.250</ref>
This relationship of the subject to the signifier in its purely formal aspect constitutes "the nucleus of psychosis."<ref>{{S3}} p. 250</ref>
"If the neurotic inhabits language, the psychotic is inhabited, possessed, by language."<ref>{{S3}} p.250</ref>
Of all the various forms of [[psychosis]], it is [[paranoia]] that most interests [[Lacan]], while [[schizophrenia]] and manic-depressive [[psychosis]] are rarely discussed.<ref>{{S3}} p.3-4</ref>
[[Lacan]] follows [[Freud]] in maintaining a structural distinction between [[paranoia]] and [[schizophrenia]].
Defined in clincal [[psychiatry]] as a serious mental illness affecting the whole of the personality.
Unlike a patient suffering from [[neurosis]], the [[psychotic]] cannot be treated on a consensual basis and may therefore have to be committed to a psychiatric institution.
The word ''Psychose'' has been current since the 1840s, but was originally used to refer to any form of mental illness.<ref>Laplanche and Pontalis 1967</ref>
The distinction between psychosis and neurosis was introduced and gradually refined in the course of the nineteenth century, and is basic to psychoanalysis.
In psychoanalysis, 'psychosis' is used to describe conditions such as hallucinatory confusion, paranoia and schizophrenia.
Freud's theory of psychoanalysis was developed primarily with reference to neurosis.
Lacan, in contrast, began his career by working with psychotics in
psychiatric hospitals before he became a psychoanalyst (1932) and therefore elaborates a more specific theory of the origins of psychosis.
Contrasting neurosis snad psychosis, Freud argues that, whilst both conditions originate in a conflict between the ego and other agencies of the psyche, psychosis results from a disturbance in the ego's relationship with the external world, neurosis from a conflict between the ego and the id.
In psychosis the ego withdraws from some part or aspect of the rela world, either fialing to perceive it or being unaffected by its perceptiuon of it..
Lacan draws on Freud's comment and remarks on the case of Daniel Paul Schrebe, an appeal court judge who wrote an autobiographicla account of his paranoid delusions, to elaborate the thesis that psychosis is trigged by the specific mechanism of [[foreclosure]].<ref>Lacan 1957-8, 1981</ref>
A key signifier or the name of the father is expelled or foreclosed fromt he subject's symbolic world and a hole or rent is left in its ploace.
The foreclosed signifier is not integrated into the unconscious thanks to an act of repression,a nd therefore cannot return on the form of a neurotic signifier.
It returns, rather, in the real, usually in the form of persecutory hallucinations and delusions.
A mental condition whereby the patient completely loses touch with reality.
==Psychosis versus Neurosis==
The term '[[psychosis]]' denotes an severe form of [[pathology|mental illness]], while '[[neurosis]]' denotes less severe forms.
[[Sigmund Freud]] elaborated a distinction between [[psychosis]] and [[neurosis]].<ref>Freud, 1924b and 1924e</ref>
<blockquote>"[In] neurosis the ego suppresses part of the id out of allegiance to reality, whereas in psychosis it lets itself be carried away by the id and detached from a part of reality."<ref>5.202</ref></blockquote>
==Psychosis and Lacan==
[[Jacques Lacan]] studied [[psychosis]] for his doctoral research about a [[woman]] he calls "[[Aimee]]."<ref>Lacan, 1932</ref>
It is common to compare Lacan's style of writing and speaking to the discourse of psychotic patients.
[[Psychosis]] has many different forms: [[paranoia]], [[schizophrenia]], and [[manic-depression]].<ref>S3, 3-4</ref>
== References ==
<references/>
[[Category:Lacan]]
[[Category:Terms]]
[[Category:Concepts]]
[[Category:Psychoanalysis]]
