Difference between revisions of "Psychosis"

From No Subject - Encyclopedia of Psychoanalysis
Jump to: navigation, search
Line 16: Line 16:
 
[[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 [[lack|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 function]] is reduced to the [[image]] of the [[father]] (the [[symbolic]] is reduced to the [[imaginary]]).
 
[[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 [[lack|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 function]] is reduced to the [[image]] of the [[father]] (the [[symbolic]] is reduced to the [[imaginary]]).
  
 
+
===The Psychotic Relation to Reality===
==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 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).
  
Line 24: Line 23:
 
<!-- ====Psychotic Phenomena==== -->
 
<!-- ====Psychotic Phenomena==== -->
 
<!-- 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 [[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]]. -->
 
 
<!-- ==Borromean Knot== -->
 
<!-- ==Borromean Knot== -->
 
<!-- 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. -->
 
<!-- 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. -->
  
==Schreber==
+
===Schreber===
In his [[seminar]] on [[psychosis]] ([[{{Y}}|1955-6]]) [[Lacan]] tackled [[Freud]]'s case history of [[Judge Schrber]], 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]].
+
In his [[seminar]] on [[psychosis]] ([[{{Y}}|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]].
  
 
+
===Treatment===
==Treatment==
+
[[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."<ref>{{E}} p. 221</ref>  
[[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."<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]]. -->
 
<!-- 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>
 
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>
 
 
 
<!-- [[Lacan]] rejects the approach of those who limit their analysis of [[psychosis]] to the [[imaginary 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> -->
 
<!-- [[Lacan]] rejects the approach of those who limit their analysis of [[psychosis]] to the [[imaginary 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> -->
  
Line 50: Line 42:
 
<!--  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 [[{{Y}}|1956]], [[Lacan]] attributes these [[language]] disorders to the [[psychotic]]'s [[lack]] of a sufficient number of ''[[points de capiton]]''. -->
 
<!--  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 [[{{Y}}|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 "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> 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> -->
 
<!-- 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 "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> 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> -->
 
 
== References ==
 
== References ==
 
<div style="font-size:11px" class="references-small">
 
<div style="font-size:11px" class="references-small">
Line 62: Line 53:
 
[[Category:Psychoanalysis]]
 
[[Category:Psychoanalysis]]
 
{{OK}}
 
{{OK}}
[[Category:Treatment]]
 
 
[[Category:Practice]]
 
[[Category:Practice]]
 
[[Category:Subject]]
 
[[Category:Subject]]
 
 
__NOTOC__
 
__NOTOC__

Revision as of 07:58, 12 November 2006

French: psychose
German: Psychose

The term psychosis is used in many ways, but in general refers to people suffering from so-called schizophrenia, with hallucinations and delusions; manic depression; various paranoid states; and severe hypochondrial, obsessional, or narcissistic states. The term "psychosis" is used in psychoanalysis to describe a severe mental disorder, more serious than neurosis, characterized by disorganized thought processes, disorientation in time and space, hallucinations, and delusions. Types of psychosis include paranoia, manic depression, megalomania, and schizophrenia. Psychosis has many different forms: paranoia, schizophrenia, and manic-depression. Common features are difficult to define exactly, but psychoanalytically speaking one can see three broad features in psychotic patients:

  1. A particular relation to reality
  2. A special relation of the subject to his speech;
  3. A particular structure of the subject

Jacques Lacan

History

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 comapre Lacan's totured 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 signiifncant 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 exponds 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.


Schreber

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.

Treatment

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 ahd resulted in a failure to understand psychotic phenomena.

References

  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