The full title of the doctoral thesis that signaled [[Jacques Lacan]]'s entry into [[psychiatry]] was [[De la psychose paranoïaque dans ses rapports avec la personnalité]] ('On paranoiac psychosis as it relates to the personality').
The work was dated September 7, 1932, when [[Lacan]] was thirty-one years old.
Readers of the work were uniformly impressed with the breadth of scientific learning that Lacan displayed.
To Georges Heuyer, who had doubts about the sheer quantity of bibliographical references, Lacan responded that he had, in fact, read them all.
Furthermore, Lacan claimed to have personally evaluated about forty cases.
And his familiarity with German texts clearly distinguished his scholarship from the chauvinism characteristic of the two great schools of psychiatry of the time.
The French school was his model because of the high quality of its observation and because of its elegance and precision.
But the Germans supplied Lacan with the doctrinal authority required by his goal of methodological synthesis.
"Then came Kraepelin" (Lacan, 1932, p. 23).
Emil Kraepelin succeeded in imposing differential diagnoses in the field of the psychoses, where previously the category of paranoia had been extended to every kind of delusion and cognitive disorder in a way clearly contradicted by observation, despite the fact that paranoia was defined very narrowly.
Lacan wrote in glowing terms of Johannes Lange, coauthor of the 1927 edition of Kraepelin's ]]Manual of Psychiatry]], whose study of eighty-one cases noted that classical paranoia was extremely rare, and assigned the curable cases to the category delineated by Kraepelin. As for "genuine paranoia," the question was whether it could be acute, whether remissions were possible. This was a question that Lacan asked from the outset (1932) and that would still preoccupy him twenty-five years later in "On a Question Prior to Any Possible Treatment of Psychosis" (1959/2004). For Lacan, the work of Robert Gaupp supplied an affirmative answer to this question. In short, Lacan endorsed Kraepelin's inclination toward a psychogenetic conception of paranoia, and what Lacan called "psychogeny" became a main theme of his thesis. Hence Lacan's harsh criticism of organicism, the constitutional theory, and the ideology of degeneracy—all then still prevalent in French psychiatry.
To stymie these tendencies, Lacan chose to speak of "personality." To solidify this notion, he drew upon Ernst Kretschmer, Pierre Janet, Karl Jaspers, and, finally, Eugen Bleuler. Bleuler and the Zurich school were Lacan's main route into psychoanalysis from the psychiatric study of the psychoses. Lacan sought to relate mental disturbances to personality, as Janet did, and, like Kretschmer, to explain them in terms of the individual's history and "experience" (Erlebnis) (1932, p. 92), with "its social and ethical stresses," rather than by evoking "congenital defects" (1932, p. 243). All this implied a "comprehensive" approach to psychotics consonant with the phenomenology of Jaspers. For this reason, Lacan enlisted the masters of psychiatry and psychopathology in support the open-minded approach to mental illness characteristic of his friends at the journal L'évolution psychiatrique.
Lacan argued that pathological manifestations in psychosis were "total vital responses," which, as "functions of the personality," maintained meaningful connections with the human community (1932, p. 247). In short, they were meaningful—a realization that defined the young Lacan's approach and influenced the choice of his inaugural case, that of "Aimée."
Aimée was a thirty-eight-year-old woman who, with "eyes filled with the fires of hate" (1932, p. 153), had tried to stab the celebrated actress Huguette Duflos.
