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{{ToppToppp}}psychose]]|-|| [[German]]: ''[[Psychose{{Bottom}}

The term "It is [[true]] that Freud had found that the [[discourse]] of the psychotic and the apparently bizarre and meaningless phenomena of psychosiscould be deciphered and [[understood]]" is used in , just as [[psychoanalysisdreams]] to describe a ''severe mental disordercan. Freud's [[analysis]] of the psychotic [[Schreber]]'s memoirs thus broke with contemporary approaches to psychosis, more serious than which regarded psychotics as beyond the limits of [[neurosisunderstanding]](Freud, characterized by disorganized thought processes1951). However, disorientation in time 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 space, hallucinationsfails 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 delusionsneurosis that Lacan's major contribution to the study of psychosis revolves.

ParanoiaFreud claims that in both neurosis and psychosis there is a [[withdrawal]] of investment, manic depressionor [[object]]-[[cathexis]], from [[objects]] in the [[world]]. In the [[case]] of neurosis the object-cathexis is retained, but is invested in fantasized objects in the neurotic's [[internal]] world. In the case of psychosis the withdrawn cathexis is invested in the ego at the expense of all object-[[cathexes]], even in [[fantasy]]. This turning of [[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 [[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 schizophrenia are all psychosesthings in the world by way of a delusional [[formation]].

[[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}} 1932.</ref>===History===[[Lacan]]'s most detailed discussion of discussed [[psychosis]] appears in throughout his [[seminar]] of 1955-6, entitled simply ''[[Seminar III|The Psychoses]]''. [[Psychosis]] is defined as one of the three [[clinical structure]]s, one of hwihc 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]]). ----- 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 the 1970s [[Jacques 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 [[sinthomeBibliography|symptomaatic formationwork]] which acts as a fourth ring holding the other three together. -------- [[Lacan]] follows [[Freud]] His interest in arguing that while [[psychosis]] is of great predates his 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 in [[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 [[Jacques 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 studied [[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 for his doctoral research about a technical procedure for working with [[psychosiswoman]], 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 imagianry 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.calls "<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 [[psychosisAimee]]: "the importance given to language phenomena in psychosis is for us the msot fruitful lesson of all."<ref>{{S31932}} p.144</ref> --- 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 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 "casscade 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 desribing 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>  --------- Of all the various forms of psychosis, it is [[paranoia]] that most interests Lacan, while schizophrenia and mani-depressive psychosis are rarely discussed.<ref>{{S3}} p.3-4</ref> Lacan follows Freud in maintaining a structural distinction between paranoia and schizophrenia. [[psychosis]] ([[psychose]])  The term [[psychosis]] arose in [[psychiatry]] in the nineteenth century as a way of designating mental illness in general.  During [[Freud]]'s life, a basic distinction between [[psychosis]] and [[neurosis]] came to be generally accepted, according to which [[psychosis]] designated extreme forms of mental illness and [[neurosis]] denoted less serious disorders.  This basic distinction between [[neurosis]] and [[psychosis]] was taken up and developed by [[Freud]] himself in several papers.<ref>Freud, 1924b and 1924e</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 '[[AimÈeAimée]]', that first led [[Lacan]] to [[psychoanalytic theory]].<ref>Lacan, {{1932}}</ref>  It has often been 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 first approach is via [[psychosis]].  It has also been common to compare [[Lacan]]'s tortured and at [[times ]] almost incomprehensible style of [[writing]] and [[speaking]] to the discourse of [[psychotic]] [[patient]]s.  "Whatever one are stabilized in the [[delusionLacan]]al [[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> Of all the various forms 's discussions of [[psychosis]], it is [[paranoia]] that are among the most interests [[Lacan]], while [[schizophrenia]] significant and manic-depressive original aspects of his [[psychosiswork]] are rarely discussed.<ref>{{S3}} p.3-4</ref>  [[Lacan]] follows 's most detailed [[Freuddiscussion]] in maintaining a structural distinction between of [[paranoiapsychosis]] and [[schizophrenia]]. Defined appears in clincal his [[psychiatryseminar]] as a serious mental illness affecting the whole of the personality. Unlike a patient suffering from [[neurosis]]1955-6, the entitled simply ''[[psychoticSeminar III|The Psychoses]] cannot be treated on a consensual basis and may therefore have to be committed to a psychiatric institution.  The word ''Psychose'' has been current since the 1840s, but was originally used to refer to any form of mental illness.<ref>Laplanche and Pontalis 1967</ref> The distinction between psychosis and neurosis was introduced and gradually refined in the course of the nineteenth century, and It is basic here that he expounds what come to psychoanalysis. In psychoanalysis, 'psychosis' is used to describe conditions such as hallucinatory confusion, paranoia and schizophrenia. Freud's theory of psychoanalysis was developed primarily with reference to neurosis. Lacan, in contrast, began his career by working with psychotics in psychiatric hospitals before he became a psychoanalyst (1932) and therefore elaborates a more specific theory of the origins of psychosis.  Contrasting neurosis snad psychosis, Freud argues that, whilst both conditions originate in a conflict between be the ego and other agencies main tenets of the psyche, psychosis results from a disturbance in the ego's relationship with the external world, neurosis from a conflict between the ego and the id. In psychosis the ego withdraws from some part or aspect of the rela world, either fialing to perceive it or being unaffected by its perceptiuon of it.. [[Lacan draws on Freud's comment and remarks on the case of Daniel Paul Schrebe, an appeal court judge who wrote an autobiographicla account of his paranoid delusions, ]]ian approach to elaborate the thesis that psychosis is trigged by the specific mechanism of [[foreclosuremadness]].<ref>Lacan 1957-8, 1981</ref> A key signifier or the name of the father is expelled or foreclosed fromt he subject's symbolic world and a hole or rent is left in its ploace. The foreclosed signifier is not integrated into the unconscious thanks to an act of repression,a nd therefore cannot return on the form of a neurotic signifier.

It returns===Clinical Structure===[[Psychosis]] is defined as one of the three [[clinical structure]]s, ratherone of which is defined by the operation of [[foreclosure]]. In this operation, the [[Name-of-the-Father]] is not integrated in the real[[symbolic order|symbolic universe]] of the [[psychotic]] (it is "[[foreclosed]]"), usually with the result that a [[hole]] is [[left]] in the form [[symbolic order]]. To [[speak]] of persecutory hallucinations and delusionsa [[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]]).

A mental condition whereby ===The Psychotic Relation to Reality===In his articles on [[psychosis]] [[Freud]] noted the patient completely loses touch [[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 realityan 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."<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' which the psychotic subject applies over this gap.<!-- ==Psychosis versus Neurosis==Psychotic Phenomena==== -->The term '<!-- 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]]== --><!-- In the 1970s [[Lacan]] reformulates his approach to [[psychosis]]' denotes an severe form around the [[notion]] of the [[borromean knot]]. The three rings in the [[knot]] [[represent]] the three [[orders]]: the [pathology|mental illness[real]], while 'the [[symbolic]] and the [[imaginary]]. While in [[neurosis]]' denotes less severe formsthese 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 [[Sigmund Freud]] elaborated 's case [[history]] of [[Judge Schreber]], a distinction between [[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]] and of this [[neurosisseminar]].<ref>Freud, 1924b and 1924e</ref>

<blockquote>"===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 [[Inoutside]] neurosis the ego suppresses part field of the id out classical method of allegiance [[psychoanalytic treatment]], which is only appropriate for [[neurosis]]; "to use the [[technique]] that [[Freud]] established outside the experience to reality, whereas in psychosis which it lets itself be carried away by was applied (i.e. neurosis) is as stupid as to toil at the oars when the ship is on the id and detached from a part of realitysand."<ref>5{{E}} p.202221</ref></blockquote>

==Psychosis <!-- 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. [[Jacques Lacan]] studied himself works with [[psychosispsychotic]] [[patient]] s but left very few comments on the technique he employed; rather than setting out a technical procedure for his doctoral research about a [[womanworking]] with [[psychosis]] , he calls 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]]; "[[Aimeenothing]] 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>{{1932S3}}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> -->

It is common ===The Relation of the Subject to compare his Speech===Lacan's style asserted that the failure to take account of writing and speaking to the discourse relation of the subject to his speech had resulted in a failure to [[understand]] psychotic patientsphenomena.

<!-- ====Language Disorders==== --><!-- The [[language]] phenomena most notable in [[psychosis]] are ''disorders'' of [[Psychosislanguage]] has many different forms: , 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 [[paranoiawords]]coined by the psychotic, or already existing words which the psychotic redefines).<ref>{{Ec}} p. 167</ref> In [[schizophrenia{{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 [[manic-depressionmetaphor]]."<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, 3-4the psychotic is inhabited, possessed, by language."<ref>{{S3}} p. 250</ref> -->