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Psychosis

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{{Toppp}}psychose]]
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|| [[German]]: ''[[Psychose{{Bottom}}
"[[psychosisPsychosis]]" is a nosological [[category]] distinct from [[neurosis]] and [[perversion]]. (It is brought [[about]] by the [[Frforeclosure]]. ''of a primordial [[signifier]], the [[psychoseName-of-the-Father]]'').
In his seminar of 1955-56 ([[Seminar III|Seminar III, ''The Psychoses'']]), Lacan argues that there is a [[defense mechanism]] specific to [[psychosis]] on the grounds that the peculiarly invasive and devastating [[nature]] of psychotics' delusional systems and hallucinations indicates major [[structural]] differences between [[psychosis]] and [[neurosis]].
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The term [[psychosis]] is used in many ways, but in general refers to [[people]] [[suffering]] from so-called [[schizophrenia]], with [[hallucination]]s and [[delusion]]s; manic [[depression]]; various [[paranoia|paranoid states]]; and severe hypochondrial, [[obsessional neurosis|obsessional]], or [[narcissism|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]], [[hallucination]]s, and [[delusion]]s. 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:
 
# A [[particular]] relation to reality
# A special relation of the subject to his [[speech]];
# A particular structure of the subject
-->
==Sigmund Freud==
It is [[true]] that Freud had found that the [[discourse]] of the psychotic and the apparently bizarre and meaningless phenomena of psychosis could be deciphered and [[understood]], just as [[dreams]] can. Freud's [[analysis]] of the psychotic [[Schreber]]'s memoirs thus broke with contemporary approaches to psychosis, which regarded psychotics as beyond the limits of [[understanding]] (Freud, 1951).
The term However, as Lacan points out, the fact that the psychotic's discourse is just as interpretable as that of the neurotic leaves the two disorders at the same level and fails to account for the major differences between [[psychosisthem]] arose in , thus the [[psychiatrydistinction]] between the two remains to be explained. It is around this issue of the different mechanisms in psychosis and neurosis that Lacan's major contribution to the nineteenth century as a way study of designating mental illness in generalpsychosis revolves.
During Freud claims that in both neurosis and psychosis there is a [[withdrawal]] of investment, or [[object]]-[[Freudcathexis]]'s life, a basic distinction between from [[objects]] in the [[psychosisworld]] and . In the [[neurosiscase]] came to be generally acceptedof neurosis the object-cathexis is retained, according to which but is invested in fantasized objects in the neurotic's [[internal]] world. In the case of psychosisthe withdrawn cathexis is invested in the ego at the expense of all object-[[cathexes]] designated extreme forms of mental illness and , even in [[neurosisfantasy]] denoted less serious disorders.  This basic distinction between turning of [[neurosislibido]] upon the ego accounts for [[symptoms]] and such as [[psychosishypochondria]] was taken up and developed by megalomania. The delusional [[Freudsystem]] himself , the most striking feature of psychosis, arises in several papersa second [[stage]].<ref>Freudcharacterizes the [[construction]] of a delusional system as an attempt at recovery in which the psychotic re-establishes a new, 1924b often very intense, relation with the people and 1924e</ref>things in the world by way of a delusional [[formation]].
==Jacques Lacan==
===History===
[[Lacan]] discussed [[psychosis]] throughout his [[Jacques Lacan:Bibliography|work]]. His interest in [[psychosis]] predates his interest in [[psychoanalysis]]. [[Jacques Lacan]] studied [[psychosis]] for his doctoral research about a [[woman]] he calls "[[Aimee]]."<ref>{{1932}}</ref> Indeed it was his doctoral research, which concerned a [[psychotic]] [[woman]] whom [[Lacan]] calls [[Aimée]] that first led [[Lacan]] to [[psychoanalytic theory]].<ref>{{1932}}</ref> It is common to compare [[Lacan]]'s tortured and at [[times]] almost incomprehensible style of [[writing]] and speaking to the discourse of [[psychotic]] [[patient]]s. [[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 tenets of the [[Lacan]]ian approach to [[madness]].
===Clinical Structure===[[Psychosis]] is defined as one of the three [[Lacanclinical structure]]'s interest , 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 [[psychosisleft]] predates his nterest in the [[psychoanalysissymbolic order]]. Indeed it was his doctoral research, which concerned To [[speak]] of a psychotic woman whom [[Lacanlack|hole]] calls in the [[Aiméesymbolic order]] is not to say that first led the [[psychotic]] does not have an [[unconscious]]; on the contrary, in [[Lacanpsychosis]] to "the unconscious is [[psychoanalytic theorypresent]]but not functioning."<ref>{{LS3}} p.1932.208</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]]).
It is often remarked that ===The Psychotic Relation to Reality===In his articles on [[psychosis]] [[Freud]] noted the [[Lacanpsychotic]]'s debt altered relation to this [[patientreality]]. The 'imaginary [[external]] is reminiscent world' of a psychosis attempts to put itself in [[Freudplace]]of the 'external world's debt to his first . (In Lacanian [[neuroticterms]] , there are altered relations between [[patientthe Imaginary]]'s (who were also and Real Orders, in parallel with an alteration in [[femalethe Symbolic]]Order).
In other wordsstudying [[psychosis]] Lacan stated, whereas following [[Freud]], that "the problem lies not in the reality that is lost, but in that which takes its place."<ref>{{E}} p. 188-9</ref> Lacan emphasized the 'rent' or [[gap]] that appears in the relation of the psychotic subject to the world, and the nature of the 'patch's which the psychotic subject applies over this gap.<!-- ====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 approach 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 [[unconsciousabsence]] sis by way of the second condition, the [[psychotic]] [[structure]] will remain [[latent]]. It is thus conceivable that a [[subject]] may have a [[psychotic]] [[neurosisstructure]] and yet never develop [[delusions]] or [[experience]] [[hallucination]]s. When both conditions are fulfilled, the [[psychosis]]is "triggered off, " the latent [[psychosis]] becomes [Lacan[manifest]] in [[hallucination]]'s tortured and at times almsot incomprehensible style /or [[delusions]]. --><!-- ==[[Borromean Knot]]== --><!-- In the 1970s [[Lacan]] reformulates his approach to [[psychosis]] around the [[notion]] of writing the [[borromean knot]]. The three rings in the [[knot]] [[represent]] the three [[orders]]: the [[real]], the [[symbolic]] and speaking to the [[discourseimaginary]] of . 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 [[patientother]]sthree together.-->
Whatever one makes of such comparisons, it is clear that ===Schreber===In his [[seminar]] on [[psychosis]] ([[{{Y}}|1955-6]]) [[Lacan]] tackled [[Freud]]'s discussions case [[history]] of [[psychosisJudge Schreber]], a [[paranoid]] [[schizophrenic]] are among the most significant and original aspects who wrote a fascinating account of his workillnesss 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]]'s most detailed discussion follows [[Freud]] in arguing that while [[psychosis]] is of great interest for [[psychosispsychoanalytic theory]] appears in his , it is [[seminaroutside]] the field of 1955-6the classical method of [[psychoanalytic treatment]], entitled simply ''which is only appropriate for [[Seminar III|The Psychosesneurosis]]''; "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>
It <!-- 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 here 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 expounds 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 come 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 be point to the fundamental determining element of [[psychosis]], namely, the hole in the [[symbolic]] [[order]] caused by [[foreclosure]] and the main tents consequent "imprisonment" of the psychotic subject in the imaginary. It is also this emphasis on the [[symbolic order]] which leads [[Lacan]]ian approach to [[madnessvalue]] 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> -->
[[Psychosis]] is defined as one ===The Relation of the three [[clinical structure]]s, one Subject to his Speech===Lacan asserted that the failure to take account of hwihc is defined by the operation relation of the subject to his speech had resulted in a failure to [[foreclosureunderstand]]psychotic phenomena.
<!-- ====Language Disorders==== --><!-- 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 this operation[[{{Y}}|1956]], [[Lacan]] attributes these [[language]] disorders to the [[Namepsychotic]]'s [[lack]] of a sufficient [[number]] of ''[[points de capiton]]''. --of><!-the-FatherThe lack of sufficient ''[[points de capiton]] '' means that the psychotic experience is not integrated in the characterized by a constant [[symbolic order|symbolic universeslippage]] of the [[psychoticsignified]] (it under the signifier, which is "a disaster for [[foreclosedsignification]]; there is a continual ")cascade of reshapings of the signifier fromw hich the increasing disaster of the imaginary proceeds, with until the result that a hole level is left 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]] [[symbolic orderdimension]], 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> -->
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]] == References ==<div style="the unconscious is present but not functioning.font-size:11px"class="references-small"><refreferences/>{{S3}} p.208</refdiv>
The [[psychoticCategory:Jacques Lacan]] [[structureCategory:Terms]] thus results from a certain malfunction of the [[Oedipus complexCategory:Treatment]], a [[lackCategory:Concepts]] in the paternal function; more specifically, in [[psychosisCategory:Psychoanalysis]] the paternal funciton is reduced to the {{OK}}[[imageCategory:Practice]] of the [[fatherCategory:Subject]] (the [[symbolic]] is reduced to the [[imaginary]]).__NOTOC__
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