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Psychosis

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{{TopToppp}}psychose]]|-|| [[German]]: ''[[Psychose{{Bottom}}
The term [[Psychosis]] is originally used in a nosological [[psychiatrycategory]] distinct from [[neurosis]] and [[perversion]]. It is brought [[about]] by the [[foreclosure]] of a primordial [[signifier]], the term is originally used to describe any ''severe'' form [[Name-of '''mental illness''-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 [[Psychosisparticular]]" is a term originally used in '''relation to reality# A special relation of the subject to his [[psychiatry|clinical psychiatryspeech]]''' to refer to '''mental illness''' ''in general''.;# A particular structure of the subject-->\==Sigmund Freud==In It is [[psychoanalysistrue]] that Freud had found that the [[discourse]] of the psychotic and the apparently bizarre and meaningless phenomena of psychosis could be deciphered and [[understood]], however, "just as [[psychosisdreams]]" is often used to describe a can. Freud''severe'' form s [[analysis]] of the psychotic [[Schreber]]'''mental illness''s memoirs thus broke with contemporary approaches to psychosis, while "'''which regarded psychotics as beyond the limits of [[neurosisunderstanding]]'''" is used to describe ''less severe'' forms(Freud, 1951).
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 [[them]], thus the [[distinction]] 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 study of psychosis revolves.
Freud claims that in both neurosis and psychosis there is a [[withdrawal]] of investment, or [[object]]-[[cathexis]], from [[objects]] in the [[Freudworld]] developed a distinction between "'''. In the [[neurosiscase]]of neurosis the object-cathexis is retained, but is invested in fantasized objects in the neurotic'''" and "s [[psychosisinternal]]" which world. In the case of psychosis the withdrawn cathexis is basic to invested in the ego at the expense of all object-[[psychoanalysiscathexes]], according to which "even in [[psychosisfantasy]]" denotes a ''serious'' type . This turning of '''mental illness''' [[libido]] upon the ego accounts for [[symptoms]] such as [[hypochondria]] and "'''megalomania. The delusional [[system]], the most striking feature of psychosis, arises in a second [[stage]]. Freud characterizes the [[neurosisconstruction]]'''" of a delusional system as an attempt at recovery in which the psychotic re-establishes a ''less serious'' type new, often very intense, relation with the people and things in the world by way of '''mental illness'''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]].
=====Ego==Clinical Structure===[[FreudPsychosis]] 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]] argues in the [[symbolic order]] is not to say that both '''the [[neurosispsychotic]]''' and does not have an [[unconscious]]; on the contrary, in [[psychosis]] originate "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 a conflict between the [[egopaternal function]]; more specifically, in [[psychosis]] the [[paternal function]] is reduced to the [[image]] and other agencies of the [[psychefather]] (the [[symbolic]] is reduced to the [[imaginary]]).
"===The Psychotic Relation to Reality===In his articles on [[Psychosispsychosis]]" arises from a disturbance in [[Freud]] noted the [[egopsychotic]]'s relationship with the altered relation to [[reality]]. The 'imaginary [[moebius strip|external ]] world' of a psychosis attempts to put itself in [[place]], of the 'external world'. (In Lacanian [[neurosisterms]] from a conflict , there are altered relations between the [[egothe Imaginary]] and the Real Orders, in parallel with an alteration in [[idthe Symbolic]]Order).
"In studying [[psychosis]] Lacan stated, following [[PsychosisFreud]], that " the problem lies not in the reality that is used to describe any lost, but in that which takes its place."<ref>{{E}} p. 188-9</ref> Lacan emphasized the 'rent'severe'' form or [[gap]] that appears in the relation of the psychotic subject to the world, and the nature of the 'patch''mental illness'' characterized by symptomswhich 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 or ]] 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 indicate impaired contact with realitya [[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.-->
"===Schreber===In his [[seminar]] on [[psychosis]] ([[{{Y}}|1955-6]]) [[Lacan]] tackled [[PsychosisFreud]]" is used to describe any ''severes case [[history]] of [[Judge Schreber]], a [[paranoid]] [[schizophrenic]] who wrote a fascinating account of his illnesss entitled '' form Memoirs of My Nervous [[Illness]]''(1903). Lacan'mental illness's essay "On a question preliminary to any possible treatment of psychosis (1957-8)', in which enlarged on the [[egoideas]] withdraws from some part or aspect of the this [[pleasure principle|real worldseminar]].
===Treatment===[[Freud]] devoted relatively little attention to 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]], mainly because his theory it is [[outside]] the field of the classical method of [[psychoanalysispsychoanalytic treatment]], which is only appropriate for [[neurosis]] was developed primarily with reference ; "to use the [[technique]] that [[neurosisFreud]]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>
=====Jacques <!-- 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]], in contrast, began asserted that the failure to take account of the relation of the subject to his career by working with [[psychosis|psychotics]] speech had resulted in [[Sainte-Anne_hospital|psychiatric hospitals]] before he became a [[psychoanalysis|psychoanalyst]]''', and elaborates a more specific theory of the origins of failure to [[psychosisunderstand]]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> -->
   [[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> 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]] is by way of [[neurosis]], [[Lacan]]'s tortured and at times almsot incomprehensible style of [[Jacques Lacan:Bibliography|writing]] and [[speech|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 [[Jacques Lacan:Bibliography|work]].  =====Foreclosure and the Oedipus complex===References ==[[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]]. [[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 Phenomenadiv style===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 [[Namefont-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]]size: 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]],11px" 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]]. class===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. 226references-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.small"<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> ==See Also==* [[Foreclosure]] ==References==
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