The Most Hysterical Psychoanalyst

This paper is an investigation into the prominence of hysteria in Lacan's work and the enduring significance of the diagnosis for contemporary practice. Beginning with Lacan's theory of neurosis, the importance of language, and symbolic functions, we will begin to understand why the hysterical symptom is the symptomatic structure par excellence. Lacan lauds hysteria as the neurosis in direct dialogue with a given historical moment, teaching the psychoanalyst where we are in the unfolding struggle between neurosis and civilization. He returned to the case of Dora throughout his twenty-eight years of teaching to refine his work. He even saw psychoanalysis as the progressive "hystericization" of the patient and depicted himself as an hysteric walking around on a stage, not knowing what he was saying, while attempting to teach the psychoanalysts. Lacan's reading of Dora seems to mark important shifts in his own life, from his beginning to write as a psychoanalyst, to being thrown out of the IPA, to struggling with his own school and the ensuing political eruptions in France in 1968. By tracking his elaboration of Dora we can witness the evolution of Lacan's work and how he uniquely positions the analyst in the transference.

Treating Psychosis Today: A Lacanian Take

This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.

It's About Time: Loewald, Lacan, and AprÈs-Coup in America

Martin Heidegger's thought deeply influenced both Hans Loewald and Jacques Lacan, the catalyst they seemed to have been waiting for. For Loewald, Heidegger's ontological centrality of time to Being-in-the-World would bridge to Freud's centrality of transference to the analytic process, thereby operationalizing transference as a prism of time. In revealing the interwoven correlatives of present-past-future, how they bootstrap one another phenomenologically, Loewald also revealed a spiral of recursive meaning (in essence, après-coup) that draws us into the future, "the something more" of existence. In parallel, through his recognition of the power of après-coup, Lacan rescued from obscurity Freud's profound conception of Nachträglichkeit, or the spiral and causal force of unfolding meaning. Lacan was now situated to bring après-coupin conjunction with Heidegger's Being-in-the-World, with time interwoven into all aspects of existence, thereby underpinning, too, language and the Symbolic Order. By reading Freud through Heidegger and then creating their brilliant syntheses, Loewald and Lacan, through their striking sameness and differences, illuminate the nature of the unconscious, of memory and meaning, of the spiral of time, and of existence itself.

The Reception of Lacanian Theory and Practice by American Psychoanalytic Training Programs

This paper explores the principal reasons for the exclusion of Lacanian ideas from psychoanalytic training institutes in the United States. The history of Lacan's role in the International Psychoanalytical Association, from which essentially he was expelled, occupies a central place in this story. Significant issues arose also from his practice style and technical innovations, whose rationale remains controversial today. Another major obstacle for the reception of his work is the theoretical framework of Lacanian analysis, so different from that of other schools. Inclusion of its unfamiliar vocabulary and concepts poses practical problems for training programs. At a more fundamental level, the strong antihumanist evolution of Lacan's thought runs contrary to the increasingly relational and intersubjective orientation of American psychoanalysis. The incompatibility between the disparate languages of a scientific theory aiming at objectivity and a phenomenology of personal intentionality and meaning greatly limits the possibilities for dialogue. The tension between these perspectives cannot be resolved, but a productive exchange between them is possible if they are accepted as valid and complementary ways of speaking about human behavior.

Uncanny Teletherapy: Working with Extimacy

Responses to the question of teletherapy have multiplied over the past decades, yet many therapists are grappling with the challenges and opportunities of teletherapy for the first time in the wake of the Covid-19 pandemic. For many clinicians, teletherapy was, at least initially, unfamiliar and unsettling. Much of the literature construes teletherapy as a degradation of an original-incapable of providing the intimacy achieved and maintained in two-bodies-in-a-room therapy-or as a good enough simulation. Both positions risk enshrining the consulting room as offering an unmediated scene of therapy. An alternative approach to the strangeness, distance, and mediations so prominent in the transition to teletherapy takes up a qualified sense of Freud's concept of the uncanny: the "minimal uncanny" and its reformulation in Lacanian theory as extimacy, a lens through which to explore intimacy and bodily proximity in the transition to teletherapy. Through the logic of extimacy, a theoretical view emerges that approaches teletherapy not as a poor substitute for real therapy, or a good enough substitute, but as an exemplary case of the therapeutic encounter.

People solve rebuses unwittingly-Both forward and backward: Empirical evidence for the mental effectiveness of the signifier

Introduction

Freud proposed that names of clinically salient objects or situations, such as for example a beetle (Käfer) in Mr. E's panic attack, refer through their phonological word form, and not through their meaning, to etiologically important events-here, "Que faire?" which summarizes the indecisiveness of Mr. E's mother concerning her marriage with Mr. E's father. Lacan formalized these ideas, attributing full-fledged mental effectiveness to the signifier, and summarized this as "the unconscious structured as a language". We tested one aspect of this theory, namely that there is an influence of the ambiguous phonological translation of the world upon our mental processing without us being aware of this influence.

Methods

For this, we used a rebus priming paradigm, including 14 French rebuses, composed of two images depicting common objects, such as paon /pã/ "peacock" and terre /tεr/ "earth," together forming the rebus panthère /pãtεr/ "panther." These images were followed by a target word semantically related to the rebus resolution, e.g., félin "feline," upon which the participants, unaware of the rebus principle, produced 6 written associations. A total of 1,458 participants were randomly assigned either to Experiment 1 in which they were shown the rebus images in either forward or in reverse order or to Experiment 2, in which they were shown only one of both rebus images, either the first or the last.

Results and discussion

The results show that the images induced inadvertent rebus priming in naïve participants. In other words, our results show that people solve rebuses unwittingly independent of stimulus order, thereby constituting empirical evidence for the mental effectiveness of the signifier.

Lacan and Culturalism: A Chronicle of an "Untimely" Resistance to Psychoanalysis

Although neither Sigmund Freud nor Jacques Lacan ever neglected the place of culture and the social field for the subject, they always opposed "culturalist" ideas, even when such ideas no longer used this label. It is important to examine what both of these figures said about culturalism, but it is just as pertinent to return to other criticisms of this movement, which developed in the United States during the last century, because at present this movement has returned covertly within French psychoanalysis. First, "culturalism" is neither a specifically American problem nor one that belongs to the past. Second, some decisive criticisms of this movement remain both germane and original: they are able to throw light on a theoretical current that, at least in France, now characterizes a dominant orientation of psychoanalytic work. Third, although Lacan himself foresaw it, the misuse of some of his notions has unexpectedly served as a Trojan horse that has enabled culturalism to return.

Viral Law: Life, Death, Difference, and Indifference from the Spanish Flu to Covid-19

What is viral law? In order to being my discussion, I note that the last two years have been extremely difficult to understand and that we, meaning those who have lived through the pandemic, have struggled to make sense. Thus, I make the argument that the virus has impacted upon not only the individual's ability to make sense in a world where every day routines have been upended, but also social and political structures that similarly rely on repetition to continue to function. According to this thesis, Covid-19 is more than simply a biological organism, but also a cultural virus that undermines the organisation of social, political, and economic systems and requires new ways of thinking about how we might move forward into a post-Covid world. In the name of beginning this project of making sense of Covid-19, I track back in history to the comparable reference point of the Spanish flu pandemic of 1918-1920 and, in particular, a reading of Freud's Beyond the Pleasure Principle, which the founder of psychoanalysis wrote in the shadow of the virus. In reading Freud's attempt to write a psychology of death in the context of this funereal period of history, I argue that he set out first, a mythological theory of viral law concerned with the death drive, before turning to second, a techno-scientific, biological theory of the same (viral) law characterised by microbial immortality. Beyond this exploration of Beyond the Pleasure Principle, in the third part of the article I turn to a reading of Lacan's interpretation of Freud's work, where viral law becomes a story of cybernetics and nihilistic mechanisation. Here, perfect mechanisation, and the endless oscillation between message and noise, looks a lot like living death. Finally, I take up Derrida's critique of Jacob's molecular biology and, by extension, Freud's theory of microbial immorality, that he thinks privileges an idea of repetitive sameness and opens up a space for cultural politics concerned with immunity against otherness. Derrida's key point here is that this biological fantasy ignores the reality of viral sex that enables evolution to happen. What this means is that the other, even in its microbial form, is ever present, and that we must recognise the importance of difference to the possibility of social, political, and economic change.

Psychodynamic Psychiatry in Argentina at a Crossroads

The authors provide an overview of the history of psychoanalysis and psychodynamic psychiatry in Argentina. They describe the evolving practice patterns of psychodynamic psychiatrists in this vibrant South American country, highlighting socio-political influences and challenges.

Sex and Prediction Error, Part 1: The Metapsychology of Jouissance

Jouissance is one of Jacques Lacan's most impenetrable concepts. Yet it is essential to Lacan's view of sex. The term is sometimes translated as "enjoyment," but this misses key features of the concept, notably its "traumatic," excessive character. This excess points to a structural negativity within the subject (i.e., the real), an original split that cannot be remedied. In this first of a series of three papers, it is proposed that "surplus prediction error"-as understood within contemporary neuropsychoanalysis-is a neural correlate for jouissance. In part 1, jouissance is explicated within Lacanian metapsychology, primarily in reference to Lacan's real and symbolic registers. Jouissance is an excess enjoyment, outside of the binding, representational capacities of language. The real is the negativity or antagonism within the symbolic, the limit of language and meaning, the point where jouissance emerges. To clarify the relationships among these terms, their positions are traced in some of Freud's major concepts, including drive, infantile sexuality, repetition, and the unconscious. A basic understanding of jouissance is necessary for the rest of this Lacanian neuropsychoanalytic project.

Sex and Prediction Error, Part 2: Jouissance and The Free Energy Principle in Neuropsychoanalysis

Jouissance refers to an excess enjoyment beyond (yet tied to) speech and representation. From the perspective of some Lacanian analysts, jouissance is precisely what testifies against any relationship to the brain-jouissance "slips" out of cognition. On the contrary, it is argued here that jouissance has a central place in contemporary neuropsychoanalysis. In part 1 of this series the metapsychology of jouissance was presented in relation to the real and symbolic registers. Here, in part 2, Mark Solms's neuropsychoanalytic model of Karl Friston's free energy principle is summarized. In this model, "predictions" aim to resolve prediction errors-most notably, those signaled by affective consciousness. "Surplus prediction error"-prediction error that arises at the point where the predictive model fails-is proposed to be a neural correlate of jouissance. This limit within prediction is analogous to the real as a structural negativity within the symbolic.

Sex and Prediction Error, Part 3: Provoking Prediction Error

In parts 1 and 2 of this Lacanian neuropsychoanalytic series, surplus prediction error was presented as a neural correlate of the Lacanian concept of jouissance. Affective consciousness (a key source of prediction error in the brain) impels the work of cognition, the predictive work of explaining what is foreign and surprising. Yet this arousal is the necessary bedrock of all consciousness. Although the brain's predictive model strives for homeostatic explanation of prediction error, jouissance "drives a hole" in the work of homeostasis. Some residual prediction error always remains. Lacanian clinical technique attends to this surplus and the failed predictions to which this jouissance "sticks." Rather than striving to eliminate prediction error, clinical practice seeks its metabolization. Analysis targets one's mode of jouissance to create a space for the subject to enjoy in some other way. This entails working with prediction error, not removing or tolerating it. Analysis aims to shake the very core of the subject by provoking prediction error-this drives clinical change. Brief clinical examples illustrate this view.

A discursive study of the reception of Lacanian ideas and their relation to Kleinianism (Uruguay, 1955-1982)

This research addresses the initial reception of Lacanian ideas in Uruguayan psychoanalysis. Lacanian ideas arrived in Uruguay in the 1960s in a context in which Kleinian thought prevailed. This paper studies the relation between Kleinianism and Lacanianism by analyzing discursive phenomena. The corpus used for this study was built from a variety of sources: theoretical-doctrinal papers, clinical cases, media publications, seminars transcripts, and institutional documents. The discursive materials presented here show the different controversies, crossroads, compromises, and demarcations that characterized the reception of Lacanian ideas in a context of Kleinian predominance.

Lacan on Trauma and Causality: A Psychoanalytic Critique of Post-Traumatic Stress/Growth

This article makes the case for the largely unacknowledged relevance of the thought of the French psychoanalyst, Jacques Lacan, for the emerging field of the medical and/or health humanities. From the 1930s all the way through to the late 1970s, Lacan was deeply concerned with the ethical and political consequences of then-dominant conceptions of the human in the 'psy' disciplines. His attempt to 'humanise' these disciplines involved an emphasis on humans as symbolic beings, inevitably entangled in the structures of speech and the 'logic of the signifier.' This article explores the implications of Lacan's linguistic framework for his understanding of trauma. It argues that the Lacanian concept of trauma offers a timely antidote to dominant psychiatric notions of trauma today, linked as they are to the questionable politics of 'Post-Traumatic Stress Disorder' and, more recently, of 'Post-Traumatic Growth.'

From the Imaginary to Theory of the Gaze in Lacan

To understand Lacan’s thinking process on vision, the entirety of his teaching must be taken into consideration. Until the 60s, the visual field is the imaginary, the constitutive principle of reality in its phenomenal giving to the experience of a subject. This register is the opposite of the field of the word with the L schema and, subsequently, as subordinated to the symbolic system according to the model of the optical schema of the inverted flower vase of Bouasse. It is only with the 1964 seminar that Lacan makes a daring turnaround through which the visual becomes a sign of the emergence of a real that is irreducible to both reality and the mediation of the subject of knowledge. The split that separates reality and the real is reproduced in Lacan within the visual field, which is, on the one hand, the cardinal principle of the consistency of the experience of reality (as imaginary), and on the other, it is an element of irreducibility to reality (as object gaze). This produces a cascade of consequences: first of all, the modification of the presentation of the mirror stage. Unlike the voice, which through prosody, tone, and volume, finds some strips with which anchor itself imaginatively to reality, the gaze, invisible and elusive, escapes the imaginary grasp. Captured in myths, it reveals its power and ability to annihilate—as in the myth of Medusa’s gaze—or to make people fall in love but only with a narcissistic love that leads inexorably to death as in the myth of Narcissus. The gaze is elusive because the subject is dependent on it in the field of desire. Like the voice, it is about the desire on which the subject is supported; it is one of the objects on which the phantom depends. In our opinion, thanks to this characteristic, the gaze object can make remote psychoanalytic treatment possible through easily accessible videoconferencing tools and, at the same time, create new conditions within it that should be carefully evaluated to understand its implications in the session itself.

Waiting for other people: a psychoanalytic interpretation of the time for action

Typical responses to a confrontation with failures in authority, or what Lacanians term 'the lack in the Other', involve attempts to shore it up. A patient undergoing psychoanalysis eventually faces the impossibility of doing this successfully; the Other will always be lacking. This creates a space through which she can reimagine how she might intervene in her suffering. Similarly, when coronavirus forces us to confront the brute fact of the lack in the Other at the socio-political level, we have the opportunity to discover a space for acting rather than continuing symptomatic behaviour that increasingly fails to work.

Apocalypse Now!: From Freud, Through Lacan, to Stiegler's Psychoanalytic 'Survival Project

The objective of this article is to explore the value of psychoanalysis in the early twenty-first century through reference to Freud, Lacan, and Stiegler's work on computational madness. In the first section of the article I consider the original objectives of psychoanalysis through reference to what I call Freud's 'normalisation project', before exploring the critique of this discourse concerned with the defence of oedipal law through a discussion of the post-modern 'individualisation project' set out by Deleuze and Guattari and others. Tracking the development of 'the individualisation project' in history, I consider its connections with the cybernetic theories of Wiener and Shannon in the psycho-cyber-utopianism of the 1990s, before moving on to consider the other side of the psychoanalytic-cybernetic interaction through a discussion of Jacques Lacan's rereading of Freud's Beyond the Pleasure Principle in the second section of the article. In reading Lacan's seminar on Freudian drive in terms of the cybernetic repression of death, I set up the conclusion to the article which involves a discussion of Bernard Stiegler's 'survival project' that relies on a recognition of the limit of death in order to produce human significance and oppose the madness of our contemporary computational reality.

Armed against Unhappiness: Psychoanalytic Grammars in Buenos Aires

Psychoanalysis has produced an ensemble of institutions, expertise, procedures, and practices for rendering the psychoanalytic subject legible and, through this, psychic life as an actionable site of intervention, dislocation, and struggle. This article examines how diverse psychoanalytic communities in Buenos Aires have produced unique grammars that influence how individuals articulate ideas about health and well-being. Descriptive, culturally specific, historically informed, and always provisional, this grammar is empirically grounded in lived experience. Through presenting several case studies, I flesh out how this grammar, as a deictic expression of/for the unconscious is deployed, reworked, and embodied in everyday interactions. I demonstrate how psychic life is enmeshed within social and political experience. In doing so, I consider how interpersonal, existential, environmental, social, and political contingencies shape divergent notions of well-being and structure desires of what it means to live "a good life."

The Half Embrace of Psychic Bisexuality

The discourse on psychic bisexuality is explored as it unfolds in Freud's writings, in contemporary papers by LGBTQ psychoanalysts, and in a volume of essays, Psychic Bisexuality, published in 2018 by a group of prominent French and British analysts (Perelberg 2018). The greater acceptance of nonnormative sexualities and genders is reshaping the discourse on bisexuality and gender in many corners of our profession, yet, as the Perelberg volume attests, that evolution is far from universal. A strain of unquestioned heteronormativity and cisgenderism is evident in Perelberg et al.'s description of the fundamentals of psychic life, a strain that has roots (via a certain one-sided reading of Lacan) in Freud's unresolved mourning of his inchoate homosexual self. A more embracing vision of bisexuality would seek to "hold," rather than enact, the grief and anxiety associated with the development of myriad diverse personal patterns.

"Psychoanalysis partagé": Winnicott, The Piggle, and the set-up of child analysis

Forty years after its publication in 1977, The Piggle has recently provoked new interest among researchers. Most notably, the real "Gabrielle" has shared her story with D. Luepnitz and the analytical community. Joining in this vibrant discussion, this paper aims at shedding new light on the case by focusing on The Piggle as a "set-up," namely on the heterogenous ensemble of discursive and non-discursive elements which determined the analytical process. This reconsideration, although grounded in a Lacanian framework, supposes opening a dialogue between the French and English-speaking literature on the case. Three issues are at stake. First the paper intends to uncover the logic at work in the cure, studying it from the perspective of the analyst and the child, but also from that of the parents. Second, this triple focus is key to a reconsideration of the set-up of psychoanalysis with children more generally-in so far as it questions the function of infantile neurosis and what Winnicott calls "psychoanalysis partagé." Third, it will look at the powerful effects of co-writing and co-publishing with the parents-considered as part of the set-up itself rather than exterior to the process of the cure-on the analytical outcome.

When Fathering Fails: Violence, Narcissism, and the Father Function in Ancient Tales and Clinical Analysis

Manifestations of failures in both symbolic and actual flesh-and-blood fathering reveal the inescapable role played by the father's unconscious transmissions in the ever present triadic matrix. Perelberg's crucial distinction between the murdered narcissistic father and the dead symbolic father suggests the problematic internalizations that fail to uphold the paternal law required for oedipal resolution. Three father-child narratives derived from classical literature and mythology are presented in order to elucidate significant unconscious paternal fantasies pertaining to lethal rivalry and neglect of the child's otherness. These narratives suggest how the father's insufficient management of rivalrous, envious, and murderously aggressive impulses-as well as narcissistic needs that fail to take into account the child's alterity-combine with the child's intrapsychic propensities to constrict triangular space and restrict development. Consequently, unavoidable father-child rivalries, absences, neglect, and desires often make it vital to recover the "missing" paternal function in analytic space. A clinical example illustrates the impact of this absence on the analyst's countertransference.

The Lacanian Concept of Cut in Light of Lacan's Interactions with Maud Mannoni

This article sets out to shed light on the Lacanian concept of cut (introduced in 1961–1962): it refers to the symbolic (i.e., linguistic) operation which produces the object a and thereby enables separation, through which the subject emerges. To that effect, we show how this concept benefitted from Lacan's interactions with Maud Mannoni (1923-1998), who focused on clinical situations where implementing a cut in the subject's environment is the only way to enable a separation between the child and the Other. Lacan first drew on Mannoni's clinical elaborations about the retarded child's alienation to the maternal fantasy: when the mother's unconscious doesn't leave room for the cut, it prevents the separation through which the child could become a subject. Lacan generalized this in the late 1960s: he broadened Mannoni's alienation to the maternal fantasy to characterize a type of child symptom, where children become their mother's non-separated, de-phallicized object a. Then, in the 1970s, Mannoni proposed an original theoretico-clinical setting to address the configurations where the object a isn't separated: in the splintered institution, the team follows on projects of activities (professional, personal, etc.) outside the institution voiced by children who haven't previously encountered the symbolic cut, by helping them realize these external projects. By thus acknowledging their attempts at establishing a cut and giving them consistency, the splintered institution helps them psychically elaborate separation.

The Mark, the Thing, and the Object: On What Commands Repetition in Freud and Lacan

In Logique du Fantasme, Lacan argues that the compulsion to repeat does not obey the same discharge logic as homeostatic processes. Repetition installs a realm that is categorically different from the one related to homeostatic pleasure seeking, a properly subjective one, one in which the mark "stands for," "takes the place of," what we have ventured to call "an event," and what only in the movement of return, in what Lacan calls a "thinking of repetition," confirms and ever reconfirms this point of no return, which is also a qualitative cut and a structural loss. The kind of "standing for" Lacan intends here with the concept of repetition is certainly not something like an image or a faithful description. No, what Lacan wishes to stress is that this mark is situated at another level, at another place, it is "entstellt," and as such, it is punctually impinging upon the bodily dynamics without rendering the event, without having an external meta-point of view, but cutting across registers according to a logics that is not the homeostatic memory logics. This paper elaborates on this distinction on the basis of a confrontation with what Freud says about the pleasure principle and its beyond in Beyond the Pleasure Principle, and also takes inspiration from Freud's Project for a Scientific Psychology. We argue that Lacan's theory of enjoyment takes up and generalizes what Freud was after in Beyond the Pleasure Principle with the Wiederholungszwang, and pushes Freud's thoughts to a more articulated point: to the point where a subject is considered to speak only when it has allowed the other, through discourse, to have impacted and cut into his bodily pleasure dynamics.

THE MISSING FATHER FUNCTION IN PSYCHOANALYTIC THEORY AND TECHNIQUE: THE ANALYST'S INTERNAL COUPLE AND MATURING INTIMACY

This paper argues that recovering the "missing" paternal function in analytic space is essential for the patient's achievement of mature object relations. Emerging from the helpless infant's contact with primary caregivers, mature intimacy rests on establishing healthy triadic functioning based on an infant-with-mother-and-father. Despite a maternocentric bias in contemporary clinical theory, the emergence of triangularity and the inclusion of the paternal third as a separating element is vital in the analytic dyad. Effective technique requires the analyst's balanced interplay between the paternal, investigative and the maternal, maximally receptive modes of functioning-the good enough analytic couple within the analyst-to serve as the separating element that procreatively fertilizes the capacity for intimacy with a differentiated other. A clinical example illustrates how treatment is limited when the paternal function is minimized within more collusive, unconsciously symbiotic dyads.

RECOVERING THE FATHER IN MIND AND FLESH: HISTORY, TRIADIC FUNCTIONING, AND DEVELOPMENTAL IMPLICATIONS

This paper aims to restore the father and paternal function to their rightful place alongside the mother and maternity in order to counter the prevailing matricentric, dyadic bias in psychoanalytic theory and technique. The author contends that both the symbolic and the actual, flesh-and-blood father are necessary to optimize his child's development. The paternal function inevitably operates in a triadic matrix; thirdness is always psychically in existence-with the father ever present in the mother's unconscious mind-and the paternal third is necessary to open up symbolic space. As an embodied other, the actual father, both as a separating agent and an attracting object, is called upon to recognize his child's otherness throughout the inescapable father-child rivalries, neglect, and desire.

The name of the Piggle: Reconsidering Winnicott's classic case in light of some conversations with the adult 'Gabrielle'

On the 40th anniversary of its publication, the author re-reads Winnicott's The Piggle - a case of 'on demand analysis' with a child suffering from psychotic night terrors - in light of new information about the patient. Conversations between the author and 'Gabrielle' explore two areas not regarded as priorities by Winnicott: the transgenerational transmission of pathology/trauma, and the ways that language, in general - and given names, in particular - organize individual subjectivity. The question raised is to what degree Winnicott - who described the treatment as "psychoanalysis partagé [shared]" due to the parents' involvement - thought of the pathology itself as 'shared.' The goal is not to supplant but to expand Winnicott's understanding of the case, borrowing insights from the work of Lacan and others.

Agents of the Father's law in a society of brothers: A philosophic and psychoanalytic perspective on legitimate use of violence

This paper explores subjective processes of "Agents of Law" - individuals who the state grants the authority to use violence - and the dissonance stemming from the contradictory demands posed on them as legitimate users of violence despite the societal taboo against violence. A conceptual model will be offered based on two theoretical legs, Lacanian psychoanalysis and political theories of legitimacy. Specifically, psychoanalytic ideas would serve to examine unconscious processes, subject position and various identifications related to the question of "self-legitimacy" of Agents of Law. A central link between psychoanalysis and political thought is found in the image of the father and in the triad ruler-God-Father, which calls for an oedipal analysis. A psychoanalytic reading of two philosophical schools that elaborated on the question of legitimacy will be presented, and yield two analytic poles of a model for the understanding of possible subject positions of agents of Law: identification with a "Living Father" vs. identification with a "Dead Father". The psychoanalytic reading will shed light on the limitations of the philosophical perspectives in reflecting on the various (im)possible psychological positions of agents of Law. Finally, then, it will be shown how psychoanalysis helps finding words to characterize different nuances in the coping of agents of Law with the contradictory demands posed on them in an age in which God is dead, the father was murdered and the king was beheaded.

Capitalist Discourse, Subjectivity and Lacanian Psychoanalysis

This paper studies how subjectivity in capitalist culture can be characterized. Building on Lacan's later seminars XVI, XVII, XVIII, and XIX, the author first outlines Lacan's general discourse theory, which includes four characteristic discourses: the discourse of the master, the discourse of the university, the discourse of the hysteric and the discourse of the analyst. Next, the author explores the subjectivity and the mode of dealing with jouissance and semblance, which is entailed in a fifth type of discourse, the capitalist discourse, discussed by Lacan (1972). Indeed, like the other discourses that Lacan discerns, the discourse of the capitalist can be thought of as a mode of dealing with the sexual non-rapport. It is argued that in the case of neurosis the discourse of the capitalist functions as an attempt to ignore the sexual non-rapport and the dimension of the unconscious. Psychosis, by contrast, is marked by an a priori exclusion from discourse. In that case, consumerist ways of relating to the other might offer a semblance, and thus the possibility of inventing a mode of relating to the other. Two clinical vignettes are presented to illustrate this perspective: one concerning the neurotic structure and one concerning the psychotic structure.

Freedom in the free world: The extimate becomes the law

My article takes Robert Burt's piece as a starting point to highlight how a lacanian analysis of law differs from the one Robert Burt (rightly) rejected and from the alternative psychotherapeutic scenario Burt develops. I focus on what I consider to be the novel characteristics of a lacanian analysis, particularly its insistence on the castration of the human subject by language, a castration that problematizes our understanding of "freedom" and "free speech", and, in turn, on Law's own castration. The gradual peeling away of the claims made on behalf of the subject by ego psychologists, enables us to arrive at what a lacanian analysis would ideally uncover, that is the subject's extimate core. I illustrate this with the film The Act of Killing, a documentary which displays not only the extimate core at the heart of the subject but the extimate as the Law itself. The encounter between law and psychoanalysis, I conclude, far from leading to mutual understanding, leads to the dissolution of the analysand's pretenses, and, in turn, to the withdrawal of psychoanalysis from the scene altogether.

An assessment of the existence and influence of psychoanalytic jurisprudence in the United States

In light of the ongoing controversy over the value of psychoanalysis generally, this article summarizes the standards for scientific expertise in law and concludes that the future of psychoanalytic jurisprudence does not lie in the courtroom. After a brief survey of the history of psychoanalytic jurisprudence in legal contexts and institutions, I identify a revival of psychoanalytic jurisprudence, including (i) its association, primarily as a social theory, with Critical Legal Studies (in the US context), and (ii) the influence of Jacques Lacan in the legal academy. The unifying themes in this critical methodology include the construction of the subject through the language and rituals of the law, the failure of mainstream jurisprudence to be sufficiently critical of the legal status quo, and the repression or denial of injustices in legal history. Paralleling that revival, I note that a field of scholarship employing traditional Freudian conceptions is also currently engaging interdisciplinary legal studies, intervening in law reform efforts (particularly in criminal law), and criticizing the background assumptions and conventions in contemporary judicial opinions. I conclude that psychoanalysis is both threatening to mainstream legal culture and a rich source of insights for contemporary studies of legal processes and institutions.

Conversion and the Real: The (Im)Possibility of Testimonial Representation

Although the spiritual vibration of conversion can be felt (by the curious outsider) through what conversion performers say in their testimonial discourse, what transforms the convert 'on stage' into a 'new being' and what is 'the real' (le réel) in conversion performance remain unclear. An important question in this connection is, What is 'real' in a conversion representation, both with respect to the convert's interaction with the audience and to the construction of social reality? Following Lacan's tripartite register of the imaginary, the symbolic, and the real, in this essay I argue that through testimonial discourse converts construct social reality as an answer to the impossibility of 'the real' in their performative discursive practice. In the first part, I question the constructed nature of testimonial representations-as well as some academic knowledge production that has governed conversion research in the last few decades-and how these representations encourage 'outsiders' to read the narrative repertoire as a negation or mirroring 'the real' of the conversion experience. In the second part, I apply Roland Barthes' analytic reflections on photography to conversion research, especially the notions of the studium (the common ground of cultural meanings) and the punctum (a personal experience that inspires private meaning). This brings me to a number of theorists (mostly never used in the field of religious conversion)-Jacques Lacan, Roland Barthes, and Slavoj Žižek-who are important to the perspective that is developed in this essay.

Reading Balint group work through Lacan's theory of the four discourses

In Balint groups, (para)medical professionals explore difficult interactions with patients by means of case presentations and discussions. As the process of Balint group work is not well understood, this article investigates Balint group meetings by making use of Lacan's theory of the four discourses. Five Balint group case presentations and their subsequent group discussion were studied, resulting in the observation of five crucial aspects of Balint group work. First, Balint group participants brought puzzlement to the group, which is indicative of the structural impossibility Lacan situates at the basis of all discourse (1). As for the group discussion, we emphasize 'hysterization' as a crucial process in Balint group work (2), the supporting role of the discourse of the analyst (3) and the centrality of discourse interactions (4). Finally, the potential transformation of the initial puzzlement is discussed (5). We conclude by putting forth the uniqueness of Balint group work as well as the potential usefulness of our analysis as a framework for Balint group leaders and professionals in charge of continuing medical education.

Culture, Truth, and Science After Lacan

Truth and knowledge are conceptually related and there is a way of construing both that implies that they cannot be solely derived from a description that restricts itself to a set of scientific facts. In the first section of this essay, I analyse truth as a relation between a praxis, ways of knowing, and the world. In the second section, I invoke the third thing-the objective reality on which we triangulate as knowing subjects for the purpose of complex scientific endeavours like medical science and clinical care. Such praxes develop robust methods of "keeping in touch" with disease and illness (like biomarkers). An analysis drawing on philosophical semantics motivates the needed (anti-scientistic) account of meaning and truth (and therefore knowledge) and underpins the following argument: (i) the formulation and dissemination of knowledge rests on language; (ii) language is selective in what it represents in any given situation; (iii) the praxes of a given (sub)culture are based on this selectivity; but (iv) human health and illness involve whole human beings in a human life-world; therefore, (v) medical knowledge should reflectively transcend, where required, biomedical science towards a more inclusive view. Parts three and four argue that a post-structuralist (Lacanian) account of the human subject can avoid both scientism and idealism or unconstrained relativism.

Metaphor in psychosis: on the possible convergence of Lacanian theory and neuro-scientific research

Starting from the theories of leading psychiatrists, like Kraepelin and de Clérambault, the French psychoanalyst Jacques Lacan (1901–1981) formulated an original theory of psychosis, focusing on the subject and on the structuring role of language. In particular, he postulated that language makes up the experience of subjectivity and that psychosis is marked by the absence of a crucial metaphorization process. Interestingly, in contemporary psychiatry there is growing empirical evidence that schizophrenia is characterized by abnormal interpretation of verbal and non-verbal information, with a great difficulty to put such information in the appropriate context. Neuro-scientific contributions have investigated this difficulty suggesting the possibility of interpreting schizophrenia as a semiotic disorder which makes the patients incapable of understanding the figurative meaning of the metaphoric speech, probably due to a dysfunction of certain right hemisphere areas, such as the right temporoparietal junction and the right superior/middle temporal gyrus. In this paper we first review the Lacanian theory of psychosis and neuro-scientific research in the field of symbolization and metaphoric speech. Next, we discuss possible convergences between both approaches, exploring how they might join and inspire one another. Clinical and neurophysiological research implications are discussed.

The subject in an uproar: a Lacanian perspective on panic disorder

From Jacques Lacan's theory of anxiety, principles are deduced for a Lacanian-oriented treatment of panic disorder. This Lacanian approach is related to Freud's theory of the actual neuroses, and is comparable in some ways with the approach taken in Panic-Focused Psychodynamic Psychotherapy (PFPP). The Lacanian conceptualization of panic retains the idea that both repressed material and unsymbolized mental states lie at its basis. People suffering from panic attacks are overwhelmed by signifiers, aspects of corporeal excitation, and/or existential questions that remain too Real. Psychoanalytic therapy aims to create a name for such Real elements. The three registers that Lacan situates at the basis of his psychoanalytic approach (the Symbolic, the Imaginary, and the Real) are discussed, as well as the treatment principles for conducting this clinical work. The case study of a young woman with panic disorder is presented to illustrate how a brief, Lacanian-oriented treatment (forty-eight sessions) progressed, and where the patient managed to both name and find a symbolic place for psychic experiences that were too Real. During this treatment, the patient overcame her avoidant-defensive mode of functioning and her persistent difficulties related to separation.

A metasynthesis of published case studies through Lacan's L-schema: Transference in perversion

Transference in perversion is characterized by specific problems such as a defiant and polemic attitude, erotic transference, projections, and aggression. Such transference poses particular problems in the treatment of perversion and might render analytical work with these patients impossible. The authors propose that Lacan's L-schema can contribute to separating productive from counterproductive aspects of transference as it distinguishes between an Imaginary and a Symbolic dimension in transference. In this meta-synthesis of 11 published case studies on sexual perversion, patterns of transference are analysed. On the Imaginary dimension, the authors found that patients with perversion tend to (un)consciously engage the analyst in a relationship characterized by identification, fusion and rivalry. On the Symbolic dimension, they found that perverse patients are able to question their motives, lapses, symptoms, and subjective identity. The thematic analysis revealed the importance of the position of the analyst in this work, which is described within the L-schema as being the representative of the otherness in the Other. Implications for clinical practice and recommendations for further research are outlined.

Anxiety and surplus in nursing practice: lessons from Lacan and Bataille

It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of 'surplus'. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients.

On the physiology of jouissance: interpreting the mesolimbic dopaminergic reward functions from a psychoanalytic perspective

Jouissance is a Lacanian concept, infamous for being impervious to understanding and which expresses the paradoxical satisfaction that a subject may derive from his symptom. On the basis of Freud’s “experience of satisfaction” we have proposed a first working definition of jouissance as the (benefit gained from) the motor tension underlying the action which was [once] adequate in bringing relief to the drive and, on the basis of their striking reciprocal resonances, we have proposed that central dopaminergic systems could embody the physiological architecture of Freud’s concept of the drive. We have then distinguished two constitutive axes to jouissance: one concerns the subject’s body and the other the subject’s history. Four distinctive aspects of these axes are discussed both from a metapsychological and from a neuroscience point of view. We conclude that jouissance could be described as an accumulation of body tension, fuelling for action, but continuously balancing between reward and anxiety, and both marking the physiology of the body with the history of its commemoration and arising from this inscription as a constant push to act and to repeat. Moreover, it seems that the mesolimbic accumbens dopaminergic pathway is a reasonable candidate for its underlying physiological architecture.

Jacques Lacan's theory of the subject as real, symbolic and imaginary: how can Lacanian theory be of help to mental health nursing practice?

This paper presents an outline of Lacan's theory of the human subject, in particular focusing on Lacan's concepts of the real, symbolic and imaginary registers, and how an understanding of these can inform change and practice in mental health nursing. Mental health nursing is under pressure to define itself as a practice distinct from other professions in the field, and to respond in new ways to promoting mental health to the individual and a wider public. Lacan's theory of the subject is of particular relevance to mental health nurses working with mental distress but has received little attention in mental health nursing literature. Six implications for practice are outlined in terms of: against normalization, the importance of the function of the symptom, what cannot be known, meaning as ever-changing, against empathy and against holistic ideas of the self.

Contemporary perspectives on Lacanian theories of psychosis

In contemporary Lacanian psychoanalysis, Verhaeghe's theory of actualpathology psychopathology in psychosis and the Millerian idea of "ordinary psychosis" provide diverging conceptual approaches to psychosis. In this paper, the two approaches to psychosis are examined with a particular emphasis on "mild psychosis" and compensatory mechanisms. Despite the shared focus on similar clinical phenomena, particularly body disturbances, these two theories provide different explanations of psychosis. Verhaeghe's theory of psychosis is a synthesis of Lacanian theory, Freud's idea of actual neurosis and psychoanalytic attachment concepts. Moreover, these ideas are situated in the "schizophrenia/paranoia dichotomy" an important heuristic device utilized in clinical practice with psychosis. In contrast, the Millerian field of ordinary psychosis aims to broaden the idea of psychosis by reviving the idea of "mild psychosis" and the different forms of stabilization possible in psychosis. Clinicians adapting the idea of ordinary psychosis aim to rethink pivotal Lacanian concepts-"untriggered" psychosis and stabilization-beyond the scope of the schizophrenia/paranoia dichotomy. Although the idea of ordinary psychosis requires further development, it promise greater utility than Verhaeghe's model, as it provides a broader and more nuanced approach to the complex vicissitudes of triggering and restitution in psychosis.

From sensorimotor inhibition to freudian repression: insights from psychosis applied to neurosis

First, three case studies are presented of psychotic patients having in common an inability to hold something down or out. In line with other theories on psychosis, we propose that a key change is at the efference copy system. Going back to Freud's mental apparatus, we propose that the messages of discharge of the motor neurons, mobilized to direct perception, also called "indications of reality," are equivalent to the modern efference copies. With this key, the reading of the cases is coherent with the psychodynamic understanding of psychosis, being a downplay of secondary processes, and consequently, a dominance of primary processes. Moreover, putting together the sensorimotor idea of a failure of efference copy-mediated inhibition with the psychoanalytic idea of a failing repression in psychosis, the hypothesis emerges that the attenuation enabled by the efference copy dynamics is, in some instances, the physiological instantiation of repression. Second, we applied this idea to the mental organization in neurosis. Indeed, the efference copy-mediated attenuation is thought to be the mechanism through which sustained activation of an intention, without reaching it - i.e., inhibition of an action - gives rise to mental imagery. Therefore, as inhibition is needed for any targeted action or for normal language understanding, acting in the world, or processing language, structurally induces mental imagery, constituting a subjective unconscious mental reality. Repression is a special instance of inhibition for emotionally threatening stimuli. These stimuli require stronger inhibition, leaving (the attenuation of) the motor intentions totally unanswered, in order to radically prevent execution which would lead to development of excess affect. This inhibition, then, yields a specific type of motor imagery, called "phantoms," which induce mental preoccupation, as well as symptoms which, especially through their form, refer to the repressed motor fragments.