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Psychosis

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"[[psychosis{{Toppp}}psychose]]" (|-|| [[FrGerman]]. : ''[[psychose]]'')Psychose{{Bottom}}
[[Psychosis]] is a nosological [[category]] distinct from [[neurosis]] and [[perversion]]. It is brought [[about]] by the [[foreclosure]] of a primordial [[signifier]], the [[Name-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===[[LacanPsychosis]]'s interest in is defined as one of the three [[psychosisclinical structure]] predates his nterest in s, one of which is defined by the operation of [[psychoanalysisforeclosure]]. Indeed it was his doctoral research In this operation, which concerned a psychotic woman whom the [[LacanName-of-the-Father]] calls is not integrated in the [[Aiméesymbolic order|symbolic universe]] that first led of the [[Lacanpsychotic]] to (it is "[[psychoanalytic theoryforeclosed]].<ref>{{L}} p.1932.</ref> It is often remarked "), with the result that a [[Lacan]]'s debt to this [[patienthole]] is reminiscent of [[Freudleft]]'s debt to his first in the [[neuroticsymbolic order]] . To [[patientspeak]]'s (who were also of a [[femalelack|hole]]). In other words, whereas in the [[Freudsymbolic order]]'s first approach is not to say that the [[unconsciouspsychotic]] sis by way of does not have an [[neurosisunconscious]]; on the contrary, in [[Lacanpsychosis]]'s tortured and at times almsot incomprehensible style of writing and speaking to "the unconscious is [[discoursepresent]] of but not functioning."<ref>{{S3}} p. 208</ref> The [[psychotic]] [[patientstructure]]s. Whatever one makes thus results from a certain malfunction of such comparisons, it is clear that the [[LacanOedipus complex]]'s discussions of , a [[psychosislack]] are among in the most significant and original aspects of his work.--- [[Lacanpaternal function]]'s most detailed discussion of ; more specifically, in [[psychosis]] appears in his the [[seminarpaternal function]] of 1955-6, entitled simply ''[[Seminar III|The Psychoses]]''. It is here that he expounds what come reduced to be the main tents of the [[Lacanimage]]ian approach to of the [[madnessfather]]. [[Psychosis]] is defined as one of (the three [[clinical structuresymbolic]]s, one of hwihc is defined by reduced to the operation of [[foreclosureimaginary]]).
===The Psychotic Relation to Reality===In this operation, his articles on [[psychosis]] [[Freud]] noted the [[Name-of-the-Fatherpsychotic]]'s altered relation to [[reality]]. The 'imaginary [[external]] is not integrated world' of a psychosis attempts to put itself in the [[symbolic order|symbolic universeplace]] of the 'external world'. (In Lacanian [[psychoticterms]] (it is ", there are altered relations between [[foreclosedthe Imaginary]]")and Real Orders, in parallel with the result that a hole is left an alteration in the [[symbolic orderthe Symbolic]]Order).
To speak 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."<ref>{{E}} p. 188-9</ref> Lacan emphasized the 'rent' or [[gap]] that appears in the relation of a hole in the psychotic subject to the world, and the nature of the 'patch' which the psychotic subject applies over this gap.<!-- ====Psychotic Phenomena==== --><!-- In [[symbolic orderLacan]]ian [[psychoanalysis]] it is important to distinguish between [[psychosis]] , which is not a [[clinical structure]], and [[psychotic]] phenomena such as [[delusions]] and [[hallucinations]]. Two [[conditions]] are required for psychotic phenomena to say that emerge: the [[subject]] must have a [[psychotic]] does not have an [[unconsciousstructure]], and the [[Name-of-the-Father]] must be "called into symbolic opposition to the subject."<ref>{{E}} p. 217</ref> In the [[absence]]; on of the contraryfirst condition, in no confrontation with the paternal signifier will ever lead to psychotic phenomena; a [[psychosisneurotic]] can never "the unconscious is present but not functioningbecome psychotic."<ref>{{S3}} p.20815</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]] 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. -->
The ===Schreber===In his [[psychoticseminar]] on [[structurepsychosis]] ([[{{Y}}|1955-6]] thus results from a certain malfunction of the ) [[Lacan]] tackled [[Freud]]'s case [[Oedipus complexhistory]], a of [[lackJudge Schreber]] in the paternal function; more specifically, in a [[psychosisparanoid]] the paternal funciton is reduced to the [[imageschizophrenic]] who wrote a fascinating account of the his illnesss entitled ''Memoirs of My Nervous [[fatherIllness]] '' (1903). Lacan's essay "On a question preliminary to any possible treatment of psychosis (1957-8)' enlarged on the [[symbolicideas]] is reduced to the of this [[imaginaryseminar]]).
===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>
<!-- 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>
<!-- [[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> -->
===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 had resulted in a failure to [[understand]] 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 [[{{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 [[languge]] 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]].== References ==<refdiv style="font-size:11px" class="references-small">{{S3}} p.92<references/ref></div>
Among the psychotic language disorders which [[Category:Jacques 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>]][[Category:Terms]][[Category:Treatment]][[Category:Concepts]][[Category:Psychoanalysis]]{{EcOK}} p.167</ref>[[Category:Practice]][[Category:Subject]]__NOTOC__
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