The Ethics of Psychoanalysis

 

The following is taken from one session in a series of introductory seminars as part of the Lacan Circle of Melbourne’s activities.

 

There is an interesting remark by Miller, in a paper from 2012 on the aims of psychoanalysis. ‘The psychoanalyst’s routine is therapeutic. His business is with the symptom that has to be cured.’ Psychoanalysts can put on airs, and ascribe lofty goals to their practice, but people come to consult with an analyst because something is causing them suffering. As Miller says, ‘If somebody goes to see a psychoanalyst for the sake of knowledge and not to get rid of a symptom it is not very certain that his demand can be received’.  So, whatever one may learn of oneself in the course of analysis, analytic praxis is not reducible to a quest for knowledge. Continue reading

Notes on mental health and neoliberalism

I recently read a couple of Foucault’s later lectures, namely Security, Territory, Population (1977-1978) and The Birth of Biopolitics (1978-1979). In this latter set of lectures, Foucault made a rare foray into contemporary economics, analysing various currents of neoliberalism (especially German and US varieties) and their relation to new forms of governmentality. I thought it beneficial, if only for me, to jot down a few notes on Foucault’s reconstruction of neoliberal thought, because I think it particularly pertinent in understanding contemporary knowledge and practice in mental health. I have a paper forthcoming in an academic journal on this topic, and perhaps after this post, I can move onto other things in 2016. Continue reading

Of ‘Psychopathic’ Children & Interventionist Clinicians

Brick2-5

Researchers in New South Wales are on the hunt for ‘psychopathic’ pre-schoolers. Apparently, they have created a ‘diagnostic tool’ in which young children are shown images, either ‘distressing’ or ‘neutral’, in order to classify the child as either ‘healthy’ or ‘callous’ on the basis of their responses. The 10% of children who were found to be ‘unemotional’ can be targeted for early intervention. Continue reading

On the Crisis of Reproducibility in Psychology

As we might expect, most results in psychology are not reproducible. As the authors who obtained these results say, ‘reproducibility is a defining feature of science’. From this, we could conclude, as have many in the field, that the answer is more experiments, tweaked statistics, metholodogical tinkering and the like. Or, we could make a point that is not so much epistemically radical as it is blatantly obvious, and that is that psychology is not a science at all. It does not resemble science except in the most superficial of respects. It isn’t just the failure of replication documented here, but the complete impossibility of findings in psychology ever being abstracted into formulae for precise prediction. Continue reading

Dismal Sciences: Anti-welfarism and Secondary Gain

polyp_cartoon_WTO_neoliberalism

There are a variety of contemporary ideological positions used to justify whittling down the welfare state, including market libertarianism, Reaganomics, Randism, Blairite ‘meritocracy’, and so forth. Some of these positions seek recourse to dubious economic ‘science’ (such as the Laffer Curve), whilst others are based on the distorted readings of Nietzsche or Darwin by adolescents. What all tend to have in common, however, is the notion that for the state to assist those in a position of weakness is, in essence, to encourage weakness. The rhetoric of neoliberalism does not pose attacks on the welfare state as the economic elites having won the class war and having their way with political economy, but rather, tries to argue that such attacks are for the benefit of the poor as well. These arguments, and the policies that they support, are often reviled as discredited nonsense, but they persist, nonetheless. Continue reading

Language and Diagnosis

 

The BPS has been tackling some important issues in mental health. In 2014, this involved publishing the ‘Understanding Psychosis’ report, and more recently, the BPS has published guidelines on ‘functional’ diagnostic nomenclature,  in which clinical conditions and treatments are articulated in non-medical language. In both cases, the BPS has identified an area of difficulty – perhaps even crisis – in mental health. Psychosis is poorly conceptualised and haphazardly treated. Diagnostic language in psychiatry was never ‘scientific’, and the farcical DSM-5 has eliminated any last vestige of credibility from these sorts of conceptual systems. There can be no doubt that the BPS has the best interests of what it calls ‘service users’ at heart when it attempts to tackle these problems and devise workable solutions to them. Continue reading

Paradigm Shifts after the Decline of the Medical Model

‘Neuroenhancement’ in its various forms, whether applied to cognitive tasks, or social functioning, looks initially like one more medical intervention. This, however, is misleading. For all of its flaws, the medical model is relatively simple and static. The idea is to identify pathology or malfunction, and to remedy it. Where the pathology in question is a positive symptom or syndrome, medical intervention is relatively free of controversy. Continue reading

The Problem with Randomised Controlled Trials (RCTs)

I have recently been debating the merits and problems of objective, quantitative research in mental health. (One of my interlocutors has posted a lengthy response here, arguing in favour of ‘objectivism’). RCTs are a methodological device introduced into mental health from general medicine. Whilst they are merely problematic in the latter, they are outright misleading in the former. Continue reading

Reductio ad traumatum

In 1933, two servant girls in Le Mans, France, Christine and Léa Papin, murdered two of their employers.(1) Madame Lancelin and her adult daughter were bludgeoned and knived repeatedly, to the point of unrecognisability. Each had their eyes gouged out. The Papin sisters had spent much of their young lives in institutional care. Their family had a history of incestuous abuse, and at least one of their relatives had died by suicide. Continue reading

Notes on Fantasy

 

The following are some brief notes of reflection on Freud’s 1908 paper on hysterical phantasy, delivered at a meeting on 16th August 2014:

 

  1. Speaking very broadly, in the early Lacan, there is an emphasis on desire and its interpretation. Later Lacan focuses on jouissance and knotting. (I have discussed some of this elsewhere). Fantasy is the bridge between them, and is theorised extensively between Seminars 10 to 14. The fantasy contains an element of desire or wish, but in later Lacan, also corresponds to Imaginary consistency, something which holds the world together for a subject. Freud’s insistence on the ‘bisexuality’ of (some) fantasy seems to me to merely suggest that a fantasy can contain multiple points of view.
  2. Fantasy is a formation of the unconscious, and can be interpreted as such, but not necessarily in quite the same way as dreams or parapraxes. Fantasy – especially in th form of worldview or ideology – has a hard time of surviving analysis and interpretation. Both Freud and Lacan are clear on the point that the fantasy precedes the symptom, even though this is the reverse order in which things are addressed in an actual analysis.
  3. There is a question about the nature of fantasy and enjoyment. Certain forms of jouissance – a self-administered addiction, for instance – is held by some analysts to be without fantasy, an example of pure narcissism. We can infer a distinction between a ‘discrete’ fantasy, of the sort discussed by Freud (where fantasy accompanies specific enjoyments, masturbation, etc) and a fundamental fantasy. To clarify – administering substances to oneself for jouissance may not require any discrete fantasy, perhaps, but may nonetheless fit within the coordinates of a fundamental fantasy (eg. of oral jouissance, identification with the ‘addict’, etc).
  4. Lacan significantly extends Freud’s theory of fantasy, in that ‘reality’ itself is fantasmatic (that is, consists by way of the imaginary). Again, this is somewhat different to Freud’s notion of discrete fantasies for specific wishes and enjoyments. Fundamental fantasy constitutes the coordinates within which a subject can manoeuvre. These are the unspoken assumptions that allow ‘reality’ to cohere.
  5. Following Freud’s logic, fantasy is diagnostic. The fantasy/delusion distinction allows one to differentiate between neurosis and psychosis. (Lacan’s work on fantasy also allows for a structural distinction regarding perversion, as evidence in Seminar 14, for instance). Beyond structure, however, an analysis of fantasy can show one’s trajectory within a set of subjective coordinates. To analyse things in this fashion is to move from general diagnostic categories to what is absolutely particular to a given subject.
  6. Fantasy – especially of a sexual nature – can be understood in terms of the later Lacan as that which covers over the lack of sexual rapport. By situating the subject relative to objet petit a, fantasy gives the subject an entry point into sexual enjoyment in the face of radical non-rapport. Or, to put it differently, if a subject could not derive enjoyment from a masturbatory fantasy, they may find it nearly impossible to obtain enjoyment from sex with a partner also. This is a Lacanian rather than a Freudian position.
  7. The failure of the fundamental fantasy – whether this is in the form of incompleteness, or inconsistency – is one of the causes of anxiety. When the imaginary and symbolic is ripped away, one is left with the gaping maw of the real. Specific, ‘discrete’ fantasies tend also to be accompanied by anxiety. It is generally easier for somebody to disclose their sexual acts than their sexual fantasies, since it is the latter which carry more subjective implication.