– 20 –
Du détail pictural « non significatif » aux phénomènes élémentaires discrets : un bref parcours
François Sauvagnat
France
Lacan ne voulait pas d’autre préalable à la structure que les « types cliniques » de Charcot, illustrés, entre autres, par Freud, puis par Chaslin. Et de préciser[1]
qu’il existe un seul aspect du discours de l’hystérique – celui centré
sur le manque, et non pas sur l’objet – qui pouvait en transmettre la
logique.
qu’il existe un seul aspect du discours de l’hystérique – celui centré
sur le manque, et non pas sur l’objet – qui pouvait en transmettre la
logique.
Ce point a été,
entre autres, remobilisé par la notion de « psychose ordinaire », qui a
permis de raviver la notion, parfois oubliée, que les phénomènes
élémentaires psychotiques ne sont pas des « phénomènes repérables » qui
seraient « évidents », et qu’ils ont pu, dissimulés, travestis, dépister
les meilleurs. Rappelons-en quelques épisodes :
1) Le sentiment de désignation, die krankhafte Eigenbeziehung, que l’école de Breslau a établie comme phénomène élémentaire de la paranoia (C. Neisser 1892[2])
– est d’emblée présentée comme un phénomène caché, masqué par exemple
par une agitation, une réticence, des phénomènes hypocondriaques voire
une efflorescence de symptômes d’allure névrotique. Dans le cas de
l’homme aux loups, Freud témoigne à sa façon avec quelle facilité on
peut passer à côté alors que le nez est au milieu de la figure : avec le
rêve des loups qu’il hésite à qualifier de cette façon, alors qu’il
était tellement familier d’un autre syndrome paranoïaque qui en exhibait
la structure, le délire d’observation (Beobachtungswahn) de Meynert.
2) La non-fonction de l’objet a, que J. Lacan désigne dans le séminaire X[3] comme phénomène élémentaire de la psychose maniaco-dépressive, s’inspirant, non seulement de la fuite des idées (Ideenflucht) et du déraillement (Entgleisung)
des germanophones , mais également des différents aspects discrets
(certains affleurent avant décompensation) du « délire des négations »
de Cotard. Freud lui-même, avec le cas de Mme G, aura montré combien
facilement on peut se laisser aller à minimiser ce type de phénomène,
pourvu qu’il soit masqué, par exemple par des phénomènes d’allure
obsessionnelle.
3) Philippe Chaslin a bien montré
comment la discordance schizophrénique pouvait être particulièrement peu
repérable, dont parfois un simple geste bizarre, un décrochage verbal à
peine perceptible, pouvaient fournir la preuve. On sait à quel point
ses précieuses indications ont été historiquement maltraitées[4]… elles n’en ressurgissent pas moins dans des notations de Lacan : « discord au joint le plus profond de son être »[5]
à propos de Schreber, ou dans le laisser-tomber (schrebérien ou
joycien) – sans compter ce qu’il laissait présager de la problématique
borroméenne elle-même.
4) Le phénomène de Séglas, de la
pensée à peine proférée, — base des hallucinations psychiques de
Baillarger – à une profération autonomisée, xénopathique, télépathique,
en écho, jusqu’à l’impulsion verbale, exige également une autre sorte de
supposition de savoir, un autre type de « refus de comprendre », dont
Lacan fit un temps crédit à Clérambault. Phénomènes qui ne prennent
toute leur valeur qu’avec la notion, développée par Lacan, de
parasitisme langagier opposée à la doctrine chomskyenne du langage comme
organe.
5) Du côté des phénomènes
imaginaires, la tradition des recherches sur les différentes formes de
mythomanies et de mégalomanies a bien montré (Foville) à quel point les
manifestations pouvaient parfois être indépendantes d’autres vécus
délirants déclarés (notamment persécutifs ou hallucinatoires), la chose
devait se confirmer avec la mise en évidence du syndrome de Capgras et
de celui de Frégoli, sans parler du « signe du miroir », dont
Reboul-Lachaux a assuré la réputation de discrétion[6].
Il va de soi que
cette première esquisse de la notion de structure – le type clinique de
Charcot – a été profondément remaniée par Lacan. D’un paradigme
neurologique, il fallait tirer des mathèmes qui rendent compte des choix
paradoxaux, des « insondables décisions de l’être »
cette première esquisse de la notion de structure – le type clinique de
Charcot – a été profondément remaniée par Lacan. D’un paradigme
neurologique, il fallait tirer des mathèmes qui rendent compte des choix
paradoxaux, des « insondables décisions de l’être »
Extrait ( Texte complet ici)
[1] Lacan J Préface à la traduction allemande des Ecrits, in Autres Ecrits, Seuil 2005.
[2]
Sauvagnat F: Traduction et commentaire d’un article du psychiatre
allemand C. Neisser: “Discussions sur la paranoia”, in Psychose
naissante, psychose unique, sous la direction de H. Grivois, ed. Masson,
1991
Sauvagnat F: Traduction et commentaire d’un article du psychiatre
allemand C. Neisser: “Discussions sur la paranoia”, in Psychose
naissante, psychose unique, sous la direction de H. Grivois, ed. Masson,
1991
[3] Lacan J : Le séminaire X : L’angoisse, Paris Seuil, p 411.
[4]
Sauvagnat F:”A propos des conceptions françaises de la schizophrénie:
de la discordance à la problématique RSI”, in Synapse, Journal de
Psychiatrie et Système Nerveux Central, n°169, Octobre 2000, p.49-58
Sauvagnat F:”A propos des conceptions françaises de la schizophrénie:
de la discordance à la problématique RSI”, in Synapse, Journal de
Psychiatrie et Système Nerveux Central, n°169, Octobre 2000, p.49-58
[5] Lacan J. D’une question préliminaire à tout traitement de la psychose, in Ecrits Seuil 1966.
[6] Sauvagnat F:”Réflexions sur le statut de la mythomanie délirante», L’Evolution Psychiatrique, 68 (2003) p. 73-96.
– 19 –
Ordinary Psychosis and Melancholia
Natalie Wülfing
Great Britain
No other clinical picture
resembles more the features of subjectivity that have entered our common
discourse as “ordinary” – like sadness, depression, lethargy,
defeatism, etc. – than melancholia. In La Psychose Ordinaire, (La Convention d’Antibes, Seuil 2005),
one of the contributions turns around this question. Melancholia
resembles ‘normality’, and if we are speaking about what discreet signs
in Ordinary Psychosis we can illuminate, the discreetest, most difficult
to differentiate, of signs must be those of melancholia.
resembles more the features of subjectivity that have entered our common
discourse as “ordinary” – like sadness, depression, lethargy,
defeatism, etc. – than melancholia. In La Psychose Ordinaire, (La Convention d’Antibes, Seuil 2005),
one of the contributions turns around this question. Melancholia
resembles ‘normality’, and if we are speaking about what discreet signs
in Ordinary Psychosis we can illuminate, the discreetest, most difficult
to differentiate, of signs must be those of melancholia.
Let us bring out the central idea that Jacques-Alain Miller (in Psychoanalytical Notebooks 26, Ordinary Psychosis Revisited),
has singled out from amongst Lacan’s classic teaching, and relate it to
the question of the clinical picture of melancholia. The idea of “a
disturbance that occurred at the inmost juncture of the subject’s sense
of life” (Ecrits, p.466 [fr 558]), in a way, circumscribes the
melancholic’s position, in a structure stripped to a minimum. What is a
disturbance of the sense of life? It is the absence of something vital,
but the status of this something vital is the important psychoanalytic
contribution as such – for it is not an organic vitality, the vitality
of the organism, but the feeling of being alive that the Name of the
Father instils in the subject. In the absence of this function,
the signifier returns in the real – however in melancholia, it is not
the signifier, but jouissance – what is rejected in language – that
returns in the real. The foreclosure of the Name of the Father lays bare
the relationship to the Thing. (Laurent, Ornicar 47) It
is the being of the subject itself, as object, that turns against
itself. This marks its specificity and difference to the paranoid or
schizophrenic clinic.
What is this jouissance that
returns in the real? Eric Laurent refers to mania when he says “The
manic disorder can be grasped like a return in the real of the
mortification that language imposes on the living.” It means that in
melancholia and in mania as its counterpart, what is not mortified in
the Other, mortifies the subject. It returns in the real as a jouissance
linked to the being of waste. Lacan says it in a development
prior to any formula: “That [the meIancholic’s suicide] occurs so often
at the window, is not by chance. It marks a recourse to a structure that
is none other than a fantasy.” (Sem. X, p.336 [3.7.’63]) This recourse to a fantasy is not the neurotic fantasy, but the structure of being in the place of object a. It
is not the object of the cause of desire, but the object of exclusion,
the Thing, that the melancholic is always in danger of being identified
with. It marks “…[the] sudden moment at which the subject is brought
into relation with what he is as a.” (Sem X, p, 110 [16.1.’63])
In today’s world, where the
object is at the zenith of the social, what is rejected from language is
precisely returned into commerce, technology and addictive circuits
that surround us. It thus functions as a great generalisation, this
object a at the zenith. Does it mean that melancholia, and the precision
of the other psychiatric clinics of psychosis, are all disappearing
into this generalisation?
If it is possible, what are
the discreet signs of melancholia, that it is to isolate, to distinguish
them from other clinics of psychosis? There is always of course
the self-reproach, that Freud already singled out. “The self-tormenting
in melancholia, which is without doubt enjoyable, signifies [ ] a
satisfaction of trends of sadism and hate, which relate to an object,
and which have been turned round upon the subject’s own self.” (Mourning
and Melancholia, 1917)
The turning on itself is shown, by Freud, to be a consequence of the loss of ego: “Thus
the shadow of the object fell upon the ego, and the latter could
henceforth be judged by a special agency, as though it were an object,
the forsaken object. In this way an object-loss was transformed into an
ego-loss and the conflict between the ego and the loved person into a
cleavage between the critical activity of the ego and the ego as altered by identification.” (ibid)
The self reproach can also
appear in more discreet forms though, such as a heightened sensitivity
to the perceived criticism of others. This sensitivity is
sometimes part of a more perplexed relationship to language, when the
words of the other become difficult to assimilate and leave a residue in
which a whole day or several days are spent going over what was said
and what it might mean. Here the idea of language as parasitic, as
jouissance itself, refers us to the late Lacan. (Seminar XXIII, The
Sinthome) The parasite of language in the speaking being may play itself
out at the level of persecution (question of the Other), of
fragmentation (question of the body) or of a radical rejection (question
of being), to evoke the three ‘externalities’ that Jacques-Alain Miller
separated to distinguish between different psychotic substructures. (OP
Revisited, PN 26)
It seems to me that mourning
has disappeared from the melancholic clinical picture. What is left is
the radical impossibility of shifting the certainty that everything is
in vain. Nothing to be gained from the Other. Freud (somehow cruelly) in
fact thought that the melancholic had an uncharacteristic access to the
truth, in his self reproaches, which separated him from ordinary human
beings who did not have such lucidity. It would cast him as a non-dupe.
Thankfully, with Lacan, we think that the non-dupe errs…
– 18 –
The “Borderline” Issue
Alan Rowan
Great Britain
The idea that psychosis could be ordinary, lucid, latent or normal
and thus more or less compatible with everyday life was not such a
strange idea to many early pioneers of psychiatry. For example, Eugene
Bleuler spoke of latent schizophrenia as, “the most frequent form”
adding “these people hardly ever come for treatment”. However if they
do, one may discover Bleuler states, “concealed catatonic or paranoid
symptoms” behind what in everyday life may pass as minor oddness,
unusual moodiness or some discreet exaggerated behaviour or trait.
Moreover he noted how a subject might be well aware that others do not
share some of his beliefs and thus engage in what Bleuler termed “double
book-keeping” by simply concealing – despite a sense of inner
conviction -such thoughts from others, including of course their
psychiatrist or therapist.
and thus more or less compatible with everyday life was not such a
strange idea to many early pioneers of psychiatry. For example, Eugene
Bleuler spoke of latent schizophrenia as, “the most frequent form”
adding “these people hardly ever come for treatment”. However if they
do, one may discover Bleuler states, “concealed catatonic or paranoid
symptoms” behind what in everyday life may pass as minor oddness,
unusual moodiness or some discreet exaggerated behaviour or trait.
Moreover he noted how a subject might be well aware that others do not
share some of his beliefs and thus engage in what Bleuler termed “double
book-keeping” by simply concealing – despite a sense of inner
conviction -such thoughts from others, including of course their
psychiatrist or therapist.
For reasons that are no doubt complex but certainly entail the need,
as Foucault notes, to clearly segregate, socially discipline and treat
“madness”, rationality and social capacity were soon seen as
incompatible with psychosis, in stark contrast to De Clerambault’s idea
that, in some instances at least, the psychotic can be a master of
rational deduction. However, if subjective disturbances were in this way
to be subject to psychiatric classification it was not possible to do
away with forms of suffering that exceeded a neat categorisation of such
disturbances into (florid) psychosis and neurosis. Thus the concept of
the “borderline” emerged, first with Stern, and then more definitively
with Kernberg whereby, thereafter, it became incorporated into
psychiatric diagnosis as the “axis two” disorders of personality. Indeed
the question of how to understand and treat so-called borderline
disorders remains an on-going major theme within contemporary psychiatry
(Bateman& Fonagy), even as the diagnosis itself is considered
incoherent by many, given the extremely high levels of both internal and
external comorbidity for all axis two disorders (Zimmerman &
Mattia).
as Foucault notes, to clearly segregate, socially discipline and treat
“madness”, rationality and social capacity were soon seen as
incompatible with psychosis, in stark contrast to De Clerambault’s idea
that, in some instances at least, the psychotic can be a master of
rational deduction. However, if subjective disturbances were in this way
to be subject to psychiatric classification it was not possible to do
away with forms of suffering that exceeded a neat categorisation of such
disturbances into (florid) psychosis and neurosis. Thus the concept of
the “borderline” emerged, first with Stern, and then more definitively
with Kernberg whereby, thereafter, it became incorporated into
psychiatric diagnosis as the “axis two” disorders of personality. Indeed
the question of how to understand and treat so-called borderline
disorders remains an on-going major theme within contemporary psychiatry
(Bateman& Fonagy), even as the diagnosis itself is considered
incoherent by many, given the extremely high levels of both internal and
external comorbidity for all axis two disorders (Zimmerman &
Mattia).
This wider context thus represents one potential way to situate our
work programme on ordinary psychosis alongside the fact that for Lacan
there exists a “differential clinic” – meaning that the treatment of
repression/neurosis and psychosis necessitates a radical difference in
approach. Up to this point Lacanian analysts saw the majority of
“borderline patients” as having a psychotic structure and thus already
had a theory grounded way to approach treatment – in contrast to IPA
analysts – like Kernberg or Bateman, who struggled with pragmatic
adaptations (e.g. avoid regression, genetic interpretations etc.) to
so-called classical modes of interpretation. Today as we focus on this
clinic of “discreet signs”, where language treats jouissance, we are
thus confronted, as Laurent puts it, with the fact that: “What had been
established … as a radical distinction between madness as a result of
foreclosure and that which is not affected by foreclosure was now being
displaced. Between neurosis and psychosis, which hitherto stood apart
like two distinct continents, there emerged a passage of
generalisation”. What is foregrounded here is not just that the first
paternal metaphor of Lacan is one solution among others in terms of how
the subject “knots” the Real, Symbolic and Imaginary but that there is
no once and for all adequate solution that would do away with the
problems of jouissance in life – with the fact that the “body event”
always invariably exceeds its symbolic envelope. It is why today the end
of analysis focuses not on some final interpretation but on the
subject’s relation to his or her sinthome, on the isolation and
reduction of the subject’s “jouissance program” to a question of S1’s.
work programme on ordinary psychosis alongside the fact that for Lacan
there exists a “differential clinic” – meaning that the treatment of
repression/neurosis and psychosis necessitates a radical difference in
approach. Up to this point Lacanian analysts saw the majority of
“borderline patients” as having a psychotic structure and thus already
had a theory grounded way to approach treatment – in contrast to IPA
analysts – like Kernberg or Bateman, who struggled with pragmatic
adaptations (e.g. avoid regression, genetic interpretations etc.) to
so-called classical modes of interpretation. Today as we focus on this
clinic of “discreet signs”, where language treats jouissance, we are
thus confronted, as Laurent puts it, with the fact that: “What had been
established … as a radical distinction between madness as a result of
foreclosure and that which is not affected by foreclosure was now being
displaced. Between neurosis and psychosis, which hitherto stood apart
like two distinct continents, there emerged a passage of
generalisation”. What is foregrounded here is not just that the first
paternal metaphor of Lacan is one solution among others in terms of how
the subject “knots” the Real, Symbolic and Imaginary but that there is
no once and for all adequate solution that would do away with the
problems of jouissance in life – with the fact that the “body event”
always invariably exceeds its symbolic envelope. It is why today the end
of analysis focuses not on some final interpretation but on the
subject’s relation to his or her sinthome, on the isolation and
reduction of the subject’s “jouissance program” to a question of S1’s.
At the same time, as Miller notes, this “excluded third” of ordinary
psychosis is to be placed on the side of psychosis and thus
differentiated from the “very definite structure” of neurosis – in
Freudian terms the presence of an ego, superego and repressed
unconscious. When this structure exists problems of jouissance are
handled via this structure and in a way that allows the subject to
remain, one could say, a character in their story – if inevitably one
that will have its tragic dimension. It means that there is a binary
difference between those subjects where object a, as cause of desire, is governed by a fantasy construction which ties jouissance to the Other and where this tie is absent.
psychosis is to be placed on the side of psychosis and thus
differentiated from the “very definite structure” of neurosis – in
Freudian terms the presence of an ego, superego and repressed
unconscious. When this structure exists problems of jouissance are
handled via this structure and in a way that allows the subject to
remain, one could say, a character in their story – if inevitably one
that will have its tragic dimension. It means that there is a binary
difference between those subjects where object a, as cause of desire, is governed by a fantasy construction which ties jouissance to the Other and where this tie is absent.
In florid psychosis the subject proceeds by way of an often massive
delusional work something that in ordinary psychosis is avoided. Typical
indications from the so-called “borderline clinic” – paralyzing levels
of dread or anxiety, a lack of mutuality, the urgency of impulses, the
fear of annihilation with its arousal of aggression towards self or
others etc. all suggest difficulties that exceed the category of
neurosis. However, it is only via a clinic of “discreet signs” that go
beyond phenomenological descriptions that we may feel confident in
making a diagnosis. This points to a dimensions of our current work
program which has potentially significant contemporary relevance to both
psychiatry and the mental health field in general, with, it should be
said, interesting links to the (largely forgotten) history of both.
delusional work something that in ordinary psychosis is avoided. Typical
indications from the so-called “borderline clinic” – paralyzing levels
of dread or anxiety, a lack of mutuality, the urgency of impulses, the
fear of annihilation with its arousal of aggression towards self or
others etc. all suggest difficulties that exceed the category of
neurosis. However, it is only via a clinic of “discreet signs” that go
beyond phenomenological descriptions that we may feel confident in
making a diagnosis. This points to a dimensions of our current work
program which has potentially significant contemporary relevance to both
psychiatry and the mental health field in general, with, it should be
said, interesting links to the (largely forgotten) history of both.
Bateman, A. & Fonagy, P. (2004). Psychotherapy for
Borderline Personality Disorders: mentalization-based treatment. Oxford
University Press.
Bleuler, E. (1911). Dementia Praecox or the Group of Schizophrenias. International Universities Press, 1950.
De Clerambault, (1942). Oeuvres Psychiatrique. Universitaires de France.
Foucault, M. (1971). Madness and Civilization. Tavistock Press
Kernberg, O. (1967). Borderline Personality Organisation. Journal of the American Psychoanalytic Association, 15: 641-685.
Laurent, E. (2014). Lost in Cognition: Psychoanalysis and the Cognitive Sciences. Karnac Books, p. 4.
Miller, J-A. (2013). Ordinary Psychosis Revisited. Psychoanalytic Notebooks, Issue 26
Stern, A. (1938). Psychoanalytic investigation and therapy in borderline group of neuroses. Psychoanalytic Quarterly. 7: 467-489
Zimmerman, M.& Mattia, J. J. (1999). Axis 1 diagnostic
comorbidity and borderline personality disorder. Comprehensive
Psychiatry. 40: 245-252
– 17 –
To Diagnose: An Effort of Poetry
Gil Caroz
Belgium
Clinical Phenomenon or Diagnostic
Dispute?
Dispute?
During an afternoon of discussion
and debate with the CPCTs[1]
and related institutions in March 2015 (reported by Patricia Bosquin-Caroz and
published by FIPA), Jacques-Alain Miller underlined that diagnosis is no longer
applicable in a clinic that has taken note of the Lacanian notion that ‘all the
world is mad’. In this context, he added, diagnosis is no longer spoken, but is
understood. Elsewhere, what is brought to the fore is clinical questioning in
so far as it allows us to see the phenomenon, to specify it, and to describe it
succinctly. This concise description is of the order of a nomination.
and debate with the CPCTs[1]
and related institutions in March 2015 (reported by Patricia Bosquin-Caroz and
published by FIPA), Jacques-Alain Miller underlined that diagnosis is no longer
applicable in a clinic that has taken note of the Lacanian notion that ‘all the
world is mad’. In this context, he added, diagnosis is no longer spoken, but is
understood. Elsewhere, what is brought to the fore is clinical questioning in
so far as it allows us to see the phenomenon, to specify it, and to describe it
succinctly. This concise description is of the order of a nomination.
For those clinicians unable to give
up their knowledge of the catalogue of true psychiatry, as opposed to the DSM,
their competence to describe the clinical tableau will depend upon their talent
to speak well; clinicians who are able to name the phenomenon without effacing
either the subject (the patient) or the clinical relation between them. The
genius of Clérambault is here a source of inspiration. Speaking of the reports
which Clérambault compiled each day by the dozen, Paul Guiraud, (in his preface
to Clerambault’s Œuvre Psychiatrique), qualifies these as “certificates,
works of art as much as science”. In one or two pages, Clérambault knew “how to
flawlessly, seamlessly trace the personality of the patient, without recoiling
from the neologism that was always the genuine foundation. We can say that he
almost created a literary school, one that should be the school of all
administrations.”[2]
up their knowledge of the catalogue of true psychiatry, as opposed to the DSM,
their competence to describe the clinical tableau will depend upon their talent
to speak well; clinicians who are able to name the phenomenon without effacing
either the subject (the patient) or the clinical relation between them. The
genius of Clérambault is here a source of inspiration. Speaking of the reports
which Clérambault compiled each day by the dozen, Paul Guiraud, (in his preface
to Clerambault’s Œuvre Psychiatrique), qualifies these as “certificates,
works of art as much as science”. In one or two pages, Clérambault knew “how to
flawlessly, seamlessly trace the personality of the patient, without recoiling
from the neologism that was always the genuine foundation. We can say that he
almost created a literary school, one that should be the school of all
administrations.”[2]
In using the DSM5, you can content
yourself with noting the code 297.1 (F22) in order to indicate that the patient
suffers from Delusional Disorder. All that then remains is to specify
whether it is erotomaniac, grandiose, jealous, persecuted, somatic, or ‘mixed’.
In opposition to that, Clérambault’s literary descriptions in his short
‘certificates’ give a living consistency to the person described. It is not
only a clinical picture but also has a presence, a materiality, which is
seasoned by the patient’s words. Thus, you can believe that you can hear the
voice of Amélie, seamstress in a religious house, describing the strangeness of
the parasitic mental automatism that affects her. To quote her: “When one says
‘one’, one has the air of speaking of two people… There is something that
speaks when it wants to, and that stops when it no longer speaks.” Much later
Clérambault notes that “her eroticism is manifested in smiles and prolonged
blushing” or again that she “starts and stops from impulsive gestures. She says
out loud what she supposes we think.” The reader feels as if they participate
in the interview when they read Clérambault: “A part of her is getting tired at
the end of the examination and this inclines her not to reply, and another part
of her, which is favourable to us, is irritated by this, and she rebuffs the
former part out loud: “we want to answer; you leave; we can wait a little”
(ibid, p. 457-8). We think of L’amante anglaise by Marguerite Duras[3],
which allows us to put our finger on the psychotic reticence that forms the
basis of the staging of the link established between the author of the crime
and the person investigating it, who tries to identify the inexpressible hole
of her motivation. And then, when Clérambault writes, in his laconic fashion:
“In conclusion: Automatism. Erotism. Mysticism. Megalomania”, these words,
which belong to a universal classification, are transformed, in the case of
Amélie, into nominations of phenomena wholly particular to her.
yourself with noting the code 297.1 (F22) in order to indicate that the patient
suffers from Delusional Disorder. All that then remains is to specify
whether it is erotomaniac, grandiose, jealous, persecuted, somatic, or ‘mixed’.
In opposition to that, Clérambault’s literary descriptions in his short
‘certificates’ give a living consistency to the person described. It is not
only a clinical picture but also has a presence, a materiality, which is
seasoned by the patient’s words. Thus, you can believe that you can hear the
voice of Amélie, seamstress in a religious house, describing the strangeness of
the parasitic mental automatism that affects her. To quote her: “When one says
‘one’, one has the air of speaking of two people… There is something that
speaks when it wants to, and that stops when it no longer speaks.” Much later
Clérambault notes that “her eroticism is manifested in smiles and prolonged
blushing” or again that she “starts and stops from impulsive gestures. She says
out loud what she supposes we think.” The reader feels as if they participate
in the interview when they read Clérambault: “A part of her is getting tired at
the end of the examination and this inclines her not to reply, and another part
of her, which is favourable to us, is irritated by this, and she rebuffs the
former part out loud: “we want to answer; you leave; we can wait a little”
(ibid, p. 457-8). We think of L’amante anglaise by Marguerite Duras[3],
which allows us to put our finger on the psychotic reticence that forms the
basis of the staging of the link established between the author of the crime
and the person investigating it, who tries to identify the inexpressible hole
of her motivation. And then, when Clérambault writes, in his laconic fashion:
“In conclusion: Automatism. Erotism. Mysticism. Megalomania”, these words,
which belong to a universal classification, are transformed, in the case of
Amélie, into nominations of phenomena wholly particular to her.
The présentations de malades
given by Jacques Lacan testify to the teaching of Clérambault, who he regarded
as his sole master in psychiatry. Jacques-Alain Miller portrays how these
presentations remind us of Greek tragedy, except that the participants at the
presentation, simultaneously the chorus and the public, are waiting not for a
catharsis, but for a diagnosis that will be the last word on the patient.
given by Jacques Lacan testify to the teaching of Clérambault, who he regarded
as his sole master in psychiatry. Jacques-Alain Miller portrays how these
presentations remind us of Greek tragedy, except that the participants at the
presentation, simultaneously the chorus and the public, are waiting not for a
catharsis, but for a diagnosis that will be the last word on the patient.
Lacan dodges this expectation, he
makes a sidestep. He ends up affirming the diagnosis, but at the same time
suspends it and problematises it in order to lengthen the study. His reference
to classification is there in order to speak of the normality of the psychotic
subject who does not fail to recognise the Other in the mental automatism that
traverses him. For the rest, Lacan follows the Freudian thread of naming the
singular jouissance that is carried along by the psychiatric nomenclature. So,
Ernst Lanzer has entered into the history of psychoanalysis under the name of
the Rat Man rather than as a case of obsessional neurosis. And again, we
think of Sergei Konstantinovich Pankejeff as being the Wolf Man, before
considering him as a case of infantile neurosis (a diagnosis that has
since been contested).
makes a sidestep. He ends up affirming the diagnosis, but at the same time
suspends it and problematises it in order to lengthen the study. His reference
to classification is there in order to speak of the normality of the psychotic
subject who does not fail to recognise the Other in the mental automatism that
traverses him. For the rest, Lacan follows the Freudian thread of naming the
singular jouissance that is carried along by the psychiatric nomenclature. So,
Ernst Lanzer has entered into the history of psychoanalysis under the name of
the Rat Man rather than as a case of obsessional neurosis. And again, we
think of Sergei Konstantinovich Pankejeff as being the Wolf Man, before
considering him as a case of infantile neurosis (a diagnosis that has
since been contested).
Thus, psychoanalysis agrees with the
psychiatric nosography but tries to follow more closely not only the
personality but also the jouissance of the subject. The nomination of phenomena
requires a literary competence more than a scientific one, and there is nothing
better to shape and form this effort of nomination than the analytic experience
itself. To know how to name your own jouissance is a precondition to being able
to speak about that of another. To diagnose is to make an effort of poetry.
psychiatric nosography but tries to follow more closely not only the
personality but also the jouissance of the subject. The nomination of phenomena
requires a literary competence more than a scientific one, and there is nothing
better to shape and form this effort of nomination than the analytic experience
itself. To know how to name your own jouissance is a precondition to being able
to speak about that of another. To diagnose is to make an effort of poetry.
Translated by Janet Haney
Text published in The Hebdo Blog, No 64 (21 Feb 2016), dedicated to the
FIPA Study Days, 12 March 2016
[1] The Centres for
Psychoanalytical Consultation and Treatment (CPCTs) are one of the many forms
of the Federation of Institutions of Applied Psychoanalysis (FIPA), seehttp://www.causefreudienne.net/connexions/fipa/
[2] Clérambault, G., Œuvre
psychiatrique, PUF, Paris, 1942.
[3] Duras, M, L’amante anglaise, Transl. Barbara Bray,
Pantheon Books, New York, 1968.
– 16 –
Pour que les signes restent discrets
Dominique Holvoet
Dominique Holvoet
Belgique
La notion de
psychose ordinaire nous permet de fait le joint entre la psychose
extraordinaire, celle qui se lit à partir de la forclusion du
Nom-du-Père, et la dimension du délire généralisé qui relève de la
clinique qui se construit au XXIè siècle et dans laquelle le Nom-du-Père
n’est plus qu’un symptôme parmi d’autres possibles. Le Nom-du-Père est
mis en place par Lacan dans le Séminaire III comme un signifiant qui,
tel un anneau, « fait tenir tout ensemble »[1] alors que c’est au symptôme comme tel, rebaptisé sinthome, qu’est dévolu cette fonction dans le Séminaire XXIII.
psychose ordinaire nous permet de fait le joint entre la psychose
extraordinaire, celle qui se lit à partir de la forclusion du
Nom-du-Père, et la dimension du délire généralisé qui relève de la
clinique qui se construit au XXIè siècle et dans laquelle le Nom-du-Père
n’est plus qu’un symptôme parmi d’autres possibles. Le Nom-du-Père est
mis en place par Lacan dans le Séminaire III comme un signifiant qui,
tel un anneau, « fait tenir tout ensemble »[1] alors que c’est au symptôme comme tel, rebaptisé sinthome, qu’est dévolu cette fonction dans le Séminaire XXIII.
Ainsi
rencontrons-nous dans notre pratique bon nombre d’analysants pour
lesquels cette fonction-sinthome présente une fragilité particulière. Et
cette assertion pourrait d’ailleurs être élargie à l’ensemble des
sujets qui demande une analyse. Car c’est toujours vrai qu’un sujet
s’adresse au psychanalyste parce qu’il éprouve une certaine
discontinuité dans sa vie. La clinique de la psychose ordinaire requiert
de prendre toute la mesure de ces discontinuités afin d’en inférer la
fonction-sinthome qui nouait jusque-là les discontinuités successives.
La question reste donc toujours de savoir ce qui vient stabiliser la
langue dans tel cas, quel est le point de capiton qui préservait l’ordre
de la signifiance ou pour le dire dans les termes du Séminaire XXIII,
quelle écriture, quel mode de nouage est en jeu dans le rapport à la
parole de ce corps impacté par le langage ? Une petite délinquance, une
pratique addictive, un mode énonciatif singulier, une modalité inédite
de faire couple peuvent être les signes discrets d’une psychose
ordinaire, qui ne sont que les signes d’une sinthomatisation permettant
de faire tenir ensemble un édifice précaire.
Cet
édifice, c’est au dernier terme tout ce qui vient faire civilisation,
c’est-à-dire tout ce qui est en place de répondre aux perturbations, au
parasitage du langage comme tel sur le corps parlant. C’est en ce point
sans doute que ce qu’on appelle ici civilisation passe nécessairement
par l’art, particulièrement quand le programme de la civilisation
présente des ratés. Et c’est aussi en ce point que la psychanalyse
accompagne les corps parlant – tout le monde n’ayant pas vocation à
rejoindre l’artiste. Quoi qu’il en soit, pour l’un comme pour l’autre ce
sera « toujours à contre-courant que l’art [et la psychanalyse] essaie
d’opérer à nouveau son miracle »[2]
Car il y a en effet un malaise dans la civilisation qui est « ce
dérèglement par quoi une certaine fonction psychique, le surmoi, semble
trouver en elle-même sa propre aggravation, par une sorte de rupture des
freins qui assuraient sa juste incidence ». C’est dans cette parenthèse
que Lacan reprend d’une phrase le texte de Freud. Et il poursuit par
cette incise : « Il reste, à l’intérieur de ce dérèglement, à savoir
comment, au fond de la vie psychique, les tendances peuvent trouver leur
juste sublimation »[3]
Ce que Lacan nomme là la rupture de freins du Surmoi, c’est le
caractère d’intimation que comporte la voix, qui impose au sujet sa
signifiance. Car le problème n’est pas de mettre des mots sur les
choses, de faire récit, mais de ne pas être poussé, précipité à subir
les mots de l’Autre, révélation ineffable dont la densité de
signification fait effraction et brise alors l’ordinaire de la psychose
d’un parlêtre.
Eric Laurent, dans un entretien subtil avec François Ansermet et Pierre Magistreti en septembre 2011 (voir ici),
donnait l’axe de la clinique psychanalytique du XXIè siècle en
soutenant qu’à l’envers de ce que la vulgate veut bien retenir, la
psychanalyse n’est absolument pas une herméneutique. Il relevait que ce
qui caractérise l’existence du sujet est tramé d’un certain nombre de
discontinuités, de trous qui ne permettent justement pas d’établir une
continuité, un récit de vie.
Et
c’est pour cela que la psychanalyse n’est pas une herméneutique. Faire
une analyse, ce n’est pas faire le récit de sa vie. Au contraire
soutenait E. Laurent c’est « faire le récit de tout ce qui ne fait pas
récit, de tout ce qui fait trou, de tout ce qui fait obstacle à ce qu’on
puisse se retrouver soi-même, tous les moments où on s’est perdu de
vue »[4].
La clinique de la psychose extraordinaire nous a enseigné sur ces
moments de cristallisation où une écriture s’impose au sujet. Le
repérage des modes par lesquels un sujet tisse la trame sur le trou
permet d’éviter cette précipitation dans ce qu’on nomme une
hallucination, une lettre qui tout à coup fait sens, déclic, boum ! La
clinique de la psychose ordinaire tient à ce repérage des signes afin
qu’ils restent discrets.
[1] Lacan Jacques, Le Séminaire, Livre III, Les psychoses, Paris, Seuil, 1981, p. 359.
[2] Lacan Jacques, Le Séminaire, Livre VII, L’éthique de la psychanalyse, p. 170.
[3] Lacan Jacques, op.cit. p. 172
[4] Laurent Eric, Entretien avec les professeurs Magistretti et Ansermet pour la fondation Agalma, mise en ligne 28/11/2011 sur https://youtu.be/cCS9vRXIin4
