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"[[psychosis{{Toppp}}psychose]]" (|-|| [[FrGerman]]. : ''[[psychose]]'')Psychose{{Bottom}}

The term [[psychosis]] arose in [[psychiatry]] in However, as Lacan points out, the fact that the nineteenth century psychotic's discourse is just as interpretable as a way that of designating the neurotic leaves the two disorders at the same level and fails to account for the major differences between [[treatment|mental illnessthem]] in general.  During , thus the [[Freuddistinction]]'s life, a basic distinction between [[the two remains to be explained. It is around this issue of the different mechanisms in psychosis]] and [[neurosis]] came that Lacan's major contribution to be generally accepted, according to which [[the study of psychosis]] designated extreme forms of [[mental illness]] and [[neurosis]] denoted less serious disordersrevolves.

This basic distinction between Freud claims that in both neurosis and psychosis there is a [[withdrawal]] of investment, or [[neurosisobject]] and -[[psychosiscathexis]] was taken up and developed by , from [[Freudobjects]] himself in several papersthe [[world]].<ref>{{F}} p In the [[case]] of neurosis the object-cathexis is retained, but is invested in fantasized objects in the neurotic's [[internal]] world.1924bIn the case of psychosis the withdrawn cathexis is invested in the ego at the expense of all object-[[cathexes]], even in [[fantasy]]. "Neurosis This turning of [[libido]] upon the ego accounts for [[symptoms]] such as [[hypochondria]] and Psychosismegalomania." SE XIXThe delusional [[system]], the most striking feature of psychosis, arises in a second [[stage]]. p.149Freud characterizes the [[construction]] of a delusional system as an attempt at recovery in which the psychotic re-establishes a new, often very intense, relation with the people and things in the world by way of a delusional [[formation]].</ref>

[[Lacan]]'s interest in [[psychosis]] predates his nterest 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}} p.1932.</ref> It is often remarked that [[Lacan]]'s debt to this [[patient]] is reminiscent of [[Freud]]'s debt to his first [[neurotic]] [[patient]]'s (who were also [[female]]). In other words, whereas [[Freud]]'s first approach to the [[unconscious]] sis by way of [[neurosis]], [[Lacan]]'s tortured and at times almsot incomprehensible style of writing and speaking to the [[discourse]] of [[psychotic]] [[patient]]s. Whatever one makes of such comparisons, it is clear that [[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 tents of the [[Lacan]]ian approach to [[madness]].===Clinical Structure===[[Psychosis]] is defined as one of the three [[clinical structure]]s, one of hwihc 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 funciton function]] 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]].  ===Psychosis and the 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}} 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]]. ===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}} p.1957-8b</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 Psychotic Relation to Reality===In his articles on [[language|language phenomenapsychosis]] [[Freud]] most notable in noted the [[psychosispsychotic]] are 's altered relation to [[reality]]. The 'disorders'imaginary [[external]] world' of a psychosis attempts to put itself in [[languageplace]], and of the 'external world'. (In Lacanian [[Lacanterms]] argues that the , there are altered relations between [[presencethe Imaginary]] of such disorders is a necessary condition for a diagnosis of and Real Orders, in parallel with an alteration in [[psychosisthe Symbolic]]Order).<ref>{{S3}} p.92</ref>

Among 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 the psychoticsubject to the world, and the nature of the 'patch' which the psychotic subject applies over this gap.<!-- ====Psychotic Phenomena==== --><!-- In [[Lacan]]ian [[psychoanalysis]] it is important to distinguish between [[languagepsychosis]] disorders , which is a [[clinical structure]], and [[psychotic]] phenomena such as [[delusions]] and [[hallucinations]]. Two [[Lacanconditions]] draws attention are required for psychotic phenomena to are holophrases emerge: the [[subject]] must have a [[psychotic]] [[structure]], and the extensive use [[Name-of neologisms (which may -the-Father]] must be completely new words coined by "called into symbolic opposition to the subject."<ref>{{E}} p. 217</ref> In the [[psychoticabsence]]of the first condition, or already existing words which no confrontation with the paternal signifier will ever lead to psychotic phenomena; a [[psychoticneurotic]] redefines)can never "become psychotic."<ref>{{EcS3}} p.16715</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 1956the 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 [[Lacanneurosis]] attributes these three rings are linked together in a particular way, in [[languagepsychosis]] disorders to the they become disentangled. This [[psychotic]]'s disassociation may sometimes however be avoided by a [[sinthome|symptomaatic formation]] which [[lackacts]] of as a sufficient number of ''fourth ring holding the [[points de capitonother]]''three together.-->

The ===Schreber===In his [[lackseminar]] on [[psychosis]] ([[{{Y}}|1955-6]]) [[Lacan]] tackled [[Freud]] of sufficient ''s case [[points de capitonhistory]]'' means that the of [[psychoticJudge Schreber]] experience is characterized by , a constant [[slipparanoid]] [[schizophrenic]]page who wrote a fascinating account of the his illnesss entitled ''Memoirs of My Nervous [[signifiedIllness]] under '' (1903). Lacan's essay "On a question preliminary to any possible treatment of psychosis (1957-8)' enlarged on the signifier[[ideas]], which is a disaster for of this [[significationseminar]].

<blockquote>There ===Treatment===[[Freud]] was skeptical about the possibility of practising [[psychoanalysis]] with [[psychotic]] [[patients]]. [[Lacan]] follows [[Freud]] in arguing that while [[psychosis]] is a continual "cascade of reshapings great interest for [[psychoanalytic theory]], it is [[outside]] the field of the signifier fromw hich the increasing disaster classical method of [[psychoanalytic treatment]], which is only appropriate for [[neurosis]]; "to use the imaginary proceeds, until [[technique]] that [[Freud]] established outside the level experience to which it was applied (i.e. neurosis) is reached as stupid as to toil at which signifier and signified are stablized in the delusional metaphoroars when the ship is on the sand."<ref>{{E}} p.217221</ref></blockquote>

Another way <!-- Not only is the classical method of describing this [[psychoanalytic treatment]] inappropriate for [[psychotic]] [[subject]]s, but it is as "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 relationship between latent [[psychosis]].<ref>{{S3}} p. 15</ref> This is the subject [[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 signifier 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 most formal dimension[[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 its dimension as a pure signifierthe [[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.250144</ref> -->

This relationship ===The Relation of the subject Subject to his Speech===Lacan asserted that the [[signifier]] in its purely formal aspect constitutes "failure to take account of the nucleus relation of the subject to his speech had resulted in a failure to [[psychosisunderstand]]psychotic phenomena."<ref>{{S3}} p.250</ref>

<blockquote!-- ====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></blockquote-->

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