Symptom

French: symptôme

The **Symptom** (French: *symptôme*; German: *Symptom*) is the foundational category of psychoanalytic theory and practice, marking the site where the subject's unconscious truth returns in a distorted, enigmatic form. Originating in the Freudian discovery of the "strangulated affect" and the "compromise formation," the concept underwent a radical metamorphosis in the teaching of Jacques Lacan: shifting from a symbolic "message" decipherable through metaphor to the late-Lacanian **sinthome**—a fourth ring in the Borromean knot that binds the registers of the Real, Symbolic, and Imaginary.

Unlike the medical sign, which serves as a semiotic indicator of an underlying disease, the psychoanalytic symptom is defined as an "interpenetration of the signifier and jouissance," functioning simultaneously as a pathological block and the subject’s singular mode of existence. In the clinical field, the symptom provides the differential basis for distinguishing between hysteria, obsession, and psychosis, while its "Real" dimension remains irreducible to interpretation.

Beyond the clinic, the symptom has been repositioned by contemporary political theorists such as Louis Althusser and Slavoj Žižek as a "social symptom" or "point of collapse". In this context, it represents the structural antagonism where the internal consistency of an ideological system fails, revealing the traumatic kernel that both sustains and subverts the social order.

Etymology and Linguistic Genealogy

The term **Symptom** originates from the Ancient Greek *symptōma* (which literally translates to "that which falls together," "concurrence," or "accident". This etymological root is derived from the prefix *syn-* ("together") and the verb *piptein* ("to fall"), suggesting a chance occurrence or a meeting of disparate elements. In the classical medical tradition, particularly within the Hippocratic corpus, a symptom was defined as any observable departure from normal bodily function—a coincidence of somatic signs that pointed a physician toward an underlying pathology or *nosos*. Within this framework, the symptom functioned as a semiotic indicator; it was a manifest sign that required expert interpretation to reveal a hidden organic disease. This hermeneutic structure established the symptom as a "signifier" for an underlying biological "signified," an epistemological model that psychoanalysis would eventually both inherit and radically subvert.

In his late teaching, specifically in *Seminar XXIII* (1975–1976), Jacques Lacan introduced a decisive linguistic rupture by reviving the archaic French spelling of the term: **Sinthome**. This spelling, which appears in the works of Rabelais, was utilized by Lacan to mark a transition away from the symptom as a decipherable message addressed to the **Big Other**. While the classical "symptom" is a metaphoric formation that can be dissolved through interpretation, the "sinthome" represents an irreducible kernel of **Jouissance**—a "letter in the Real" that does not seek to communicate a meaning. This etymological shift reflects a move from the symptom as a pathological "accident" to be eliminated, to the sinthome as a structural necessity that provides the subject with a singular mode of consistency and existence.

The Freudian Archetype

2.1 The Early Theory: Strangulated Affect (1895)

The foundational psychoanalytic conception of the symptom was articulated by Sigmund Freud and Josef Breuer in *Studies on Hysteria* (1895), where they defined it as a phenomenon of **conversion**. In this early model, a symptom arises when a traumatic psychical experience is barred from consciousness through **Repression**, leaving its associated "strangulated affect" without a path for discharge. This quota of affect (*Erregungssumme*) is subsequently diverted into somatic innervation, manifesting as a physical ailment such as paralysis or a tic. Freud famously concluded that "hysterics suffer mainly from reminiscences," meaning the symptom is a "mnemic symbol" of a repressed traumatic memory that persists in a coded, bodily form. The initial therapeutic goal was **abreaction**: the process of bringing the pathogenic memory to consciousness and allowing the trapped affect to find expression in words, which would theoretically cause the symptom to vanish.

2.2 The Symptom as Compromise Formation (1900–1905)

By the time of the *Dora* case (1905), Freud had refined the hydraulic model into a structural one, defining the symptom as a **compromise formation** (*Kompromissbildung*). In this view, the symptom is not merely a byproduct of repressed energy but a complex structure that simultaneously satisfies two opposing forces: the unconscious drive seeking fulfillment and the ego's defensive demand for repression. The symptom allows the subject to experience a disguised, distorted form of libidinal satisfaction while simultaneously providing a form of self-punishment for that very satisfaction. Freud further distinguished between the **primary gain** of the symptom—the internal psychic relief or unconscious satisfaction it provides—and the **secondary gain**, which refers to the external advantages the subject derives from being ill, such as attention or exemption from social duties. This dual satisfaction explains the symptom's inherent "inertia" and its resistance to even the most accurate interpretations.

2.3 The Structural and Economic Turn (1926)

In his mature work, *Inhibitions, Symptoms and Anxiety* (1926), Freud reconfigured the theory of symptom formation around the signal function of **Anxiety**. He reversed his earlier position, arguing that it is not repressed libido that creates anxiety, but rather the ego's perception of a "danger situation" that triggers "signal anxiety" to initiate defense. The symptom is thus a defensive product of the ego—a "lesser evil" designed to bind the traumatic energy and prevent a total psychic collapse. This positioning emphasizes the symptom's homeostatic function within the psychic economy, where it serves as a protective barrier against the breakthrough of overwhelming traumatic anxiety. By this stage, Freud recognized that the symptom is not just an obstacle to the subject's health but a vital, albeit painful, solution to a structural conflict that the subject cannot otherwise resolve.

Lacanian Periodization: Three Registers of the Symptom

3.1 The Symbolic Symptom (1950s): Message and Metaphor

In his early teaching, Jacques Lacan redefined the symptom through the lens of structural linguistics, famously asserting that "the unconscious is structured like a language". Within this framework, the symptom is not a biological malfunction but a **signifying formation**—a message addressed to the **Big Other** that has been "intercepted" by repression. Lacan formalized this by defining the symptom as a **metaphor**, utilizing Roman Jakobson’s linguistic categories to align Freudian "condensation" with the metaphoric process.

The symptom emerges when one signifier is substituted for another, producing a "metaphoric spark" that encapsulates the subject's repressed truth. Lacan expressed this through the general formula for metaphor:

$$ \frac{S}{S'} \cdot \frac{S'}{x} \rightarrow S(+)s $$

where S is the symptomatic signifier, S' is the repressed signifier, and s is the new signification produced by the substitution. In this period, the goal of analysis was strictly hermeneutic: by "putting the symptom into words" through **Full Speech**, the subject could integrate the repressed message into their symbolic history, theoretically causing the symptom to dissolve.

3.2 The Real Symptom (1960s-70s): Jouissance and the Objet a

By the late 1950s and early 1960s, particularly in *Seminar VII: The Ethics of Psychoanalysis*, Lacan began to emphasize that the symptom possesses a "Real" kernel that resists symbolic decipherment. He argued that the symptom is not merely a message to be read; it is also a source of **Jouissance**—an excessive, painful pleasure that persists even after its meaning has been interpreted. This shift recognized that the subject is often "attached" to their suffering because the symptom provides a unique mode of satisfaction that the symbolic order cannot offer.

Lacan eventually identified the symptom as the subject's way of organizing jouissance around the **Objet petit a**, the "object-cause" of desire. Unlike the symbolic symptom, which is "docile" to interpretation, the Real symptom is characterized by its **inertia**. It represents "the mystery of the speaking body," where the signifier is no longer just a carrier of meaning but is "incarnated" in the flesh, regulating the subject's drive-satisfaction.

3.3 The Sinthome (1975-76): Borromean Topology

The final major theoretical shift occurred in *Seminar XXIII*, where Lacan introduced the archaic spelling **Sinthome** to designate a new structural function. Using the **Borromean knot**—a configuration of three rings representing the Real, Symbolic, and Imaginary (RSI)—Lacan modeled the subject's psychical consistency. He proposed that in many subjects, particularly where the "paternal function" (the **Name-of-the-Father**) fails, the three registers are not naturally bound together and risk drifting apart into psychosis.

The sinthome acts as a "fourth ring" or a **suppletion** that artificially ties the RSI registers together, preventing a total psychical collapse. Lacan used the case of **James Joyce** to demonstrate how his writing functioned as a sinthome, providing him with a singular consistency that compensated for the lack of a functioning father. At this stage, the end of analysis is no longer the dissolution of the symptom, but **identification with the sinthome**: the subject assumes their symptom as the indispensable kernel of their being and their singular mode of existence.

Clinical Differential Diagnosis

The presentation and function of the symptom vary according to the subject's clinical structure:

- **Hysteria:** The hysterical symptom is essentially a **somatic question** addressed to the Other's desire, typically asking: "What am I?" or "What is a woman?". It respects an "imaginary anatomy" rather than physiological pathways, demonstrating how the body is subjected to the signifier. - **Obsessional Neurosis:** The symptom takes the form of compulsive rituals or intrusive thoughts designed to "cancel" the Other's desire and ward off a perceived catastrophe. The obsessional uses the symptom to maintain a distance from the Real of desire, often identifying with a "dead" or immortal position. - **Perversion:** In perverse structures, the symptom often manifests as a **fetish**—an object that disavows castration and fills the lack in the Other. Lacan eventually noted that the fetish functions analogously to a sinthome, serving as a prosthesis that makes sexual rapport seemingly possible. - **Psychosis:** Symptoms such as hallucinations result from **Foreclosure** (*Verwerfung*), where a signifier refused in the Symbolic reappears in the Real. However, "stabilizing" symptoms (like Joyce's literature) can act as a sinthome, providing a "social link" that prevents further fragmentation.

Contemporary Theory: Symptom, Ideology, Politics

5.1 Marx and the Invention of the Symptom

Lacan famously claimed that "Marx invented the symptom". In *The Sublime Object of Ideology*, **Slavoj Žižek** demonstrates that Marx’s analysis of the commodity-form is homologous to Freud's discovery of the symptom. Just as the symptom represents the "return of the repressed" in a coded form, **Commodity Fetishism** represents the return of social relations between people as "metaphysical" relations between things. In both cases, a structural failure or "antagonism" is masked by a manifest form that nevertheless betrays the truth of the system.

5.2 Ideology as Symptom

Žižek argues that ideology persists not through "false consciousness" (misunderstanding reality) but through a **symptomatic attachment** to rituals of enjoyment. This is termed **Cynical Reason**: "They know very well what they are doing, but still, they are doing it". Ideology functions like a symptom because it provides a "fantasy-frame" that masks the traumatic Real of social antagonism, allowing the subject to endure a contradictory reality.

5.3 The Proletariat as the Social Symptom

Following Laclau and Mouffe, the **Proletariat** is theorized as the "constitutive symptom" of capitalism. It is the "part of no part"—the element excluded from the social count whose very existence reveals the system's inherent impossibility and lack of totality. Political subjectivization occurs when this "excluded" element is elevated to a universal position, symptomatically exposing the truth of the entire social order.

See Also

- Jouissance - Objet petit a - Borromean Knot - Name-of-the-Father - Foreclosure - Identification with the Sinthome - The Sublime Object of Ideology

Bibliography

- Freud, S. (1895). Studies on Hysteria. SE 2. - Freud, S. (1926). Inhibitions, Symptoms and Anxiety. SE 20. - Lacan, J. (1966). Écrits. Paris: Seuil. - Lacan, J. (1975-76). The Seminar of Jacques Lacan, Book XXIII: The Sinthome. - Miller, J.-A. (1998). "The Six Paradigms of Jouissance." Lacanian Ink. - Žižek, S. (1989). The Sublime Object of Ideology. London: Verso.