Misconceptions about psychoanalysis. Part 1

It is time to clear up a few misconceptions about psychoanalysis. Culture, popular or otherwise, has changed. Once, in the film and literature of the mid-20th Century, psychotherapeutic treatment was depicted in largely psychoanalytic terms. A protagonist would speak of themselves in an intimate way, with a figure they trusted. The popular imagination has shifted since then, and consulting a psychologist is now marketed as a didactic experience, an implementation of technique, with little or no subjective element to the process. Continue reading

Obsessional Neurosis & Breaking Bad

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In psychoanalysis, the effect of language and of the Other is to produce a cut, a division in a subject. There are many ways in which this subjective division can be organised, and perhaps the most famous of these, in psychoanalysis, at least, is hysteria. Hysteria can be understood as a subset of neurosis, which is to say, it is an effect of primary repression. Freud, in the case of the Ratman, indicates that obsessional neurosis is a ‘dialect’ of hysteria, and Lacan develops this further, moving the obsessional away from the phenomenology of obsessions and compulsions, and toward a structural position. Here, I would like to outline some of the predominant features of this structural position using the series Breaking Bad. The protagonist of this series, Walter White is in many (though not all) ways an exemplary obsessional subject. Continue reading

The problem with diagnosis is not diagnosis, but discourse

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In the UK and elsewhere, there is a growing movement to abolish diagnosis in psychiatry and clinical psychiatry. Leading the movement are a group of clinical psychologists and a range of critics of mental health practice. I would like, once more, to revisit the question of diagnosis from a psychoanalytic perspective, in the hope that it may shed some light to those without an analytic approach. Continue reading

More on psychosis: Subjective structure and incompleteness

 

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I am not going to be exhaustive here. The aim is to present a little exegesis and a little analogy.The above chart – taken from Lacan’s Seminar X, on anxiety – may help to illustrate a couple of things at the very least, concerning the entry into subjecthood, and the separation of neurosis and psychosis. Continue reading

Paradigms across psychiatry, psychology and psychoanalysis

The dominant  paradigms within psychology and psychiatry, whilst far from being internally homogenous, nonetheless have more similarities than differences. Notwithstanding the division of labour between psychiatrists and psychologists in hospital settings (for instance), the two disciplines have a largely overlapping epistemic basis. Even psychology’s supposedly unique contributions – a body of knowledge about general, non-pathological psychological functioning – have been largely absorbed into psychiatry. Continue reading

Understanding Psychosis

The British Psychological Society has released a major report on psychosis, which pushes the debate on this topic further than anywhere else in mainstream psychology in the Anglophone world. The report calls for, among other things, listening to psychotics themselves; seeing psychotic experiences as ‘understandable’ responses to distress, on a continuum with ‘normal’ phenomena; a rethink of bioreductionism and the medical model more generally; advocacy of ‘formulation’ rather than diagnosis, and advocacy of patient rights more generally; and finally, the provision of psychotherapeutic treatments alongside pharmaceutical approaches. There are numerous online responses to this report already, some supportive, some hostile. I would like to offer a few words from a critical, psychoanalytic perspective. Continue reading

The Other, clinical and empirical: A review of Fonagy et al. on Affect regulation, mentalisation, and the development of the self

The following is taken from a presentation delivered late in 2011. Despite the age of the piece, I thought it worth sharing, as it touches on issues from more recent debates such as the nature of psychosis, the meaning of neuroscientific data, and the ethics of treatment. My views on certain matters below, such as phobia, or the nature of signification, have changed since then, but my views on Fonagy are more or less the same.

 
Anglophone psychology has long objected to the alleged individualism of Freud and
psychoanalysis. Psychoanalytic theory, they say, focuses on the intrapsychic, not the
intersubjective. Adler was one of the first to add a “social‟ element to psychodynamic
theory, positing a lack of “social interest‟ as the cause of every neurotic illness (Adler,
1928/1998). Later, a number of largely US-based psychoanalysts, led by Heinz Kohut,
championed an “intersubjective‟ or “relational‟ psychoanalysis. 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

Lost in Cognition

There is a tradition among certain psychoanalytic writers and schools, to decline any engagement with the world outside of analysis. In this tradition, psychoanalytic literature becomes a continual exegesis of the master(s), devoid of reference points to the world beyond. Thankfully, Eric Laurent and his colleagues are most definitely not of this tradition, as Laurent’s new book, Lost in Cognition, demonstrates amply. 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.