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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 distinc-
tion between neurosis and psychosis was taken up and developed by Freud
himself in several papers (e.g. Freud, 1924b and 1924e).
Lacan's interest in psychosis predates his interest in psychoanalysis. Indeed
it was his doctoral research, which concerned a psychotic woman whom Lacan
calls 'AimÈe', that first led Lacan to psychoanalytic theory (see Lacan, 1932).
It has often been remarked that Lacan's debt to this patient is reminiscent of
Freud's debt to his first neurotic patients (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 patients. Whatever one
are stabilized in the delusional metaphor' (E, 217). 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' (S3, 250). This relationship of
the subject to the signifier in its purely formal aspect constitutes 'the nucleus of
psychosis' (S3, 250). 'If the neurotic inhabits language, the psychotic is
inhabited, possessed, by language' (S3, 250).
Of all the various forms of psychosis, it iS PARANOIA that most interests
Lacan, while schizophrenia and manic-depressive psychosis are rarely dis-
cussed (see S3, 3-4). Lacan follows Freud in maintaining a structural distinc-
tion between paranoia and schizophrenia.
Defined in clincal psychiatry as a serious mental illness affecting the whole of the personality.
Unlike a patient suffering from [[neurosis]], the psychotic cannot be treated on a consensual basis and may therefore have to be committed to a psychiatric institution.
