Difference between revisions of "Psychosis"

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=====Mental Illness=====
 
"[[Psychosis]]" is a term first used in '''[[psychiatry|clinical psychiatry]]''' to refer to '''mental illness''' ''in general''.
 
  
=====Neurosis=====
 
However, [[Freud]] theorizes a basic distinction between "'''[[neurosis]]'''" and "[[psychosis]]", according to which "[[psychosis]]" denotes only a ''more severe'' type of '''mental illness''' and "'''[[neurosis]]'''" denotes a ''less severe'' type.
 
  
=====Ego=====
 
He argues that both '''[[neurosis]]''' and [[psychosis]] originate in a conflict between the [[ego]] and other agencies of the [[psyche]]: '''[[neurosis]]''' results from a conflict between the [[ego]] and the [[id]], and [[psychosis]] results from a disturbance in which the [[ego]]'s relationship with the [[moebius strip|external world]].
 
  
=====Sigmund Freud=====
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=====See Also=====
[[Freud]] devoted relatively little attention to [[psychosis]], mainly because his theory of [[psychoanalysis]] was developed primarily with reference to [[neurosis]].
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{{See}}
 
 
=====Jacques Lacan=====
 
[[Lacan]], in contrast, began his career by working with [[psychosis|psychotics]] in [[Sainte-Anne_hospital|psychiatric hospitals]] before he became a [[psychoanalysis|psychoanalyst]].
 
 
 
[[Lacan]]'s interest in [[psychosis]] predates his interest 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}} ''[[Works of Jacques Lacan|De la psychose paranoiaque dans ses rapports avec la personalité]],'' Paris: Seuil, 1975 [1932]</ref>
 
 
 
[[Lacan]]'s discussions of [[psychosis]] are among the most significant and original aspects of his [[Jacques Lacan:Bibliography|work]].
 
 
 
=====Foreclosure and the Oedipus complex=====
 
 
 
[[Lacan]] draws on [[Freud]]'s remarks on the case of Daniel Paul Schreber, an appeal court judge who wrote an autobiographical account of his paranoid delusions, to elaborate the thesis that psychosis is triggered by the specific mechanism of [[foreclosure]].
 
 
 
A key [[signifier]] such as the phallus or the name-of-the-father is expelled or foreclosed froom the subject's symbolic world, and a hole is left in its place.
 
 
 
the foreclosed signifier is not integrated into the unconscious thanks to an act of repression, and therefore cannot return in the form of a neuortic signifier.
 
 
 
it sreturns, rather, in the real, usually in the form of persecutory hallucinations and delusions.
 
 
 
---
 
 
 
Unlike a patient suffering from a neurosis, the psychotic is not usually aware of the morbidity of his or her conditions, cnanot bettreated on a consensual absis and may therefore ahve to be committed to a psychiatric intitution.
 
 
 
 
 
---
 
 
 
[[Lacan]]'s most detailed discussion of [[psychosis]] appears in his [[seminar]] of 1955-6, entitled simply ''[[Seminar III|The Psychoses]]''.
 
 
 
 
 
[[Psychosis]] is defined as one of the three [[clinical structure]]s, one of which 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]]).
 
 
 
===Psychosis and Psychotic Phenomena===
 
In [[Lacan]]ian [[psychoanalysis]], it is important to distinguish between [[psychosis]] -- which is a ''[[clinical structure]]'' -- [[psychosis|psychotic phenomena]] -- such as [[delusions]] and [[hallucinations]].
 
 
 
Two conditions are required for [[psychosis|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 [[Name-of-the-Father|paternal signifier]] will ever lead to [[psychosis|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]].
 
 
 
=====Borromean Knot=====
 
In the 1970s [[Lacan]] 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|symptomatic formation]] which acts as a fourth ring holding the other three together.
 
 
 
===Psychosis and the Classical Method of Psychoanalytic Treament===
 
[[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]].
 
 
 
<blockquote>"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></blockquote>
 
 
 
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}} "[[Works of Sigmund Freud|On Beginning the Treatment]]," 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]].
 
 
 
===Psychosis and the Lacanian Method of Psychoanalytic Treament===
 
This does not mean that [[Lacan]]ian [[analyst]]s 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}} "[[Works of Jacques Lacan|D'une question préliminaire à tout traitement possible de la psychose]]," [1957-8b], in {{Ec}} pp. 531-83 ["On a Question Preliminary to Any Possible Treatment of Psychosis," trans. Alan Sheridan, in {{E}} pp. 226-80.</ref>
 
 
 
===Psychosis and the Symbolic Order===
 
[[Lacan]] rejects the approach of those who limit their analysis of [[psychosis]] to the [[imaginary order]].
 
 
 
<blockquote>"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></blockquote>
 
 
 
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 [[linguistics|linguistic phenomena]] in [[psychosis]]:
 
 
 
<blockquote>"The importance given to language phenomena in psychosis is for us the msot fruitful lesson of all."<ref>{{S3}} p. 144</ref></blockquote>
 
 
 
==Psychosis and Linguistic Phenomena==
 
The [[language|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 [[slip]]page of the [[signified]] under the [[signifier]], which is a disaster for [[signification]].
 
 
 
<blockquote>There is a continual "cascade 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></blockquote>
 
 
 
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>
 
 
 
<blockquote>"If the neurotic inhabits language, the psychotic is inhabited, possessed, by language."<ref>{{S3}} p. 250</ref></blockquote>
 
and elaborates a more specific theory of the origins of [[psychosis]]
 
 
 
==See Also==
 
 
* [[Foreclosure]]
 
* [[Foreclosure]]
 
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==References==
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Revision as of 07:54, 8 September 2006

French: psychose



See Also
References