Psychosis

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French: psychose

The term psychosis is used in many ways, but in general refers to people suffering from so-called schizophrenia, with hallucinations and delusions; manic depression; various paranoid states; and severe hypochondrial, obsessional, or 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, hallucinations, and delusions. 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:

  1. A particular relation to reality
  2. A special relation of the subject to his speech;
  3. A particular structure of the subject

Jacques Lacan

History

Jacques Lacan's interest in psychosis predates his interest in psychoanalysis. Jacques Lacan studied psychosis for his doctoral research about a woman he calls "Aimee."[1] Indeed it was his doctoral research, which concerned a psychotic woman whom Lacan calls Aimée that first led Lacan to psychoanalytic theory.[2] It is common to comapre Lacan's totured and at times almost incomprehensible style of writing and speaking to the discourse of psychotic patients. Lacan's discussions of psychosis are among the most signiifncant and original aspects of his work. Lacan's most detailed discussion of psychosis appears in his seminar of 1955-6, entitled simply The Psychoses. It is here that he exponds what come to be the main tenets of the Lacanian approach to madness.

Clinical Structure

Psychosis is defined as one of the three clinical structures, one of which is defined by the operation of foreclosure. In this operation, the Name-of-the-Father is not integrated in the 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."[3] 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).


Schreber

In his seminar on psychosis (1955-6) Lacan tackled Freud's case history of Judge Schrber, a 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 of this seminar.


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."[4]


This does not mean that Lacanian analysts do not work with psychotic patients. On the contrary, much work has been done by Lacanian analysts in the treatment of psychosis. However, the method of treatment differs substantially from that used with neurotic and perverse patients. Lacan himself works with psychotic patients 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.[5]


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.[6] 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).[7] 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 "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."[8] 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."[9] This relationship of the subject to the signifier in its purely formal aspect constitutes "the nucleus of psychosis."[10] "If the neurotic inhabits language, the psychotic is inhabited, possessed, by language."[11]

References

  1. Lacan, Jacques. De la psychose paranoiaque dans ses rapports avec la personalité, Paris: Navarin, 1975. [1932].
  2. Lacan, Jacques. De la psychose paranoiaque dans ses rapports avec la personalité, Paris: Navarin, 1975. [1932].
  3. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p. 208
  4. Lacan, Jacques. Écrits: A Selection. Trans. Alan Sheridan. London: Tavistock Publications, 1977. p. 221
  5. Lacan, Jacques. p. 1957-8b
  6. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p. 92
  7. Lacan, Jacques. Écrits. Paris: Seuil, 1966. p. 167
  8. Lacan, Jacques. Écrits: A Selection. Trans. Alan Sheridan. London: Tavistock Publications, 1977. p. 217
  9. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p. 250
  10. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p.250
  11. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p. 250














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References



Index