Lacanian diagnostics

To understand the three main diagnostical categories - Neurosis, Psychosis and Perversion, we need to understand Lacanian Diagnostical principles. I will use texts written by Lacanian analysts combined with lively real-world analogies to support and portray the claims.

 

Lacanian diagnosis is the diagnosis in relation to the signifier, in relation to language. Psychoanalysis is a discourse, in the psychoanalytic situation, an analyst is listening to an analysand talking, interrupting when needed, or holding a normal dialogue when needed, whatever is being said in the room between the two individuals, consists of discourse. A signifier is the basic unit of language, an element of discourse, as amino acids are the basic units of protein. To understand what protein "is", we need to understand what it is made "of". Protein is made of amino acids, as language is made of signifiers. A signifier can be a letter or a word, even a gesture might be a signifier that signifies something. As speaking beings, we all relate to this field of signifiers, language is there with us all the time, and there are possible signifiers to be used in any situation available to you. This presupposes a relation between "you" as a speaking being and "the signifier", you two are bound together and that bond is the crucial moment within the Lacanian diagnostics. To understand and explain this relation to the signifier Jacques Lacan used structural linguistics, particularly drawing on the work of Ferdinand de Saussure and Roman Jakobson. The famous Lacanian dictum is "Unconscious is structured like a language", this statement emphasises the fact that the unconscious operates systematically through linguistic principles and differentiates this logical, linguistic view from other "Pseudo Freudian" perspectives in which the unconscious is seen as a black box in the aeroplanes, which holds the information in the dark room and that secret information comes out as catastrophic secrets or inhumane desires that had to be hidden. Ferdinand de Saussure proposed that a "sign" is a construct of a "signifier" and "signified". "Signifier" is a sound or word for example "table", and "signified" is the meaning or concept of that word. When someone says "table", you hear the word, the signifier which has been expressed and on top of that signifier you add an image, a meaning that this particular word brings into your mind. The word and its meaning is a "sign", where both the signifier and the signified are connected and at the same time split. A word and the meaning of the word are always split because depending on the context, the same word can bring different meanings and associations, as if the meaning itself is an imaginary construct. As speaking beings, who had to enter this realm of language and speech, we had to start relating to language, we had to learn how to use the linguistic system, which operates unconsciously. When you speak, you speak without trying to think how to speak, as if speech is being done by someone else through you, as if "the other" would be speaking through you. To summarise: you, as a subject, relate to language, to the signifier, through three possible mechanisms: Neurosis - (mechanism) repression, Psychosis - (mechanism) foreclosure or Perversion - (mechanism) disavowal. The primary mechanism of repression, foreclosure or disavowal relates to the fact of the splitting of the signifier itself between the signifier and the signified. A Lacanian method of diagnosis is based particularly on this structural relation to language, the signifier, while the signifier is itself split between signifier and signified. The structure of subjectivity starts through three structural positions of relation to the law (Neurosis, Psychosis, Perversion) and further develops into the split between the word and its meaning within the symbolic chain.

In order to make this make sense, let's delve into the literature and step by step follow the thread of Lacanian Diagnostics.

 

 

 

 

                                                                                           Analysis

 

In his book "A Clinical Introduction to Lacanian Psychoanalysis Theory and Technique" Bruce Fink explains these matters meticulously, he starts Chapter 6 (A Lacanian Approach to Diagnosis) with "The Lacanian approach bound to seem strange to those schooled in DSM-3 or DSM-4; it is in some ways far simpler, yet in other ways more discriminating than what passes for diagnosis in much of the contemporary psychological and psychiatric world" (Fink, 1997, p. 75). What we could extrapolate from this proposition is the fact that things might seem a bit different from the Lacanian point of view in comparison to the generally accepted, contemporary psychological view of today's world. Furthermore, Bruce suggests that "Lacanian diagnostic criteria are based primarily on Freud's work - a certain reading of and extension of notions found in Freud's work - and on work done by a handful of French and German psychiatrists (most notably Emil Kraeplin and Georges Gatian de Clerambault)" (Fink, 1997, p. 75). We see that Lacanian point of view was not based on thin air but on the thought process of Sigmund Freud, an Austrian Neurologist and the father of Psychoanalysis and many other thinkers such as Emil Kraeplin, a German Psychiatrist who lived in the late 19th and early 20th century and a French Psychiatrist Georges Gatian de Clerambault. And of course, Lacan's own work with psychotic patients within the psychiatric hospitals as he was a psychiatrist himself. Furthermore, to fully grasp the scope and width of Lacan's thought, many other thinkers within the fields of philosophy, mathematics, linguistics, anthropology and poetry should be mentioned here, but to follow the point I will avoid these for now and mention these in other texts.

Lacanian diagnostic criteria seem remarkably simple, it avoids piling up a growing number of diagnostical categories and criteria to distinguish separate disorders as in the version of the DSM and narrow it down to three main categories: neurosis, psychosis and perversion.

Bruce suggests "And unlike the categories developed in the DSM-IV, which provide little concrete direction for the psychotherapist regarding how to proceed with different categories of patients, Lacanian diagnoses find immediate application in guiding the practitioner's aims and in indicating the position the therapist must adopt in the transference" (Fink, 1997, p. 75). Here we can see the use value of the Lacanian diagnostic, it allows the therapist to understand in what structural position he or she should situate himself or herself in relation to the patient. In particular, Bruce Fink emphasises the need to understand this in order to approach patients correctly in terms of technique. Techniques used with neurotic patients are inapplicable and might lead to a disaster with a psychotic patient. Bruce writes "And not only are such techniques inapplicable - they may even prove dangerous, triggering a psychotic break" (Fink, 1997, p. 75). Here we can see the use value of the Lacanian diagnostic, it allows the therapist to understand in what structural position he or she should situate himself or herself in relation to the patient. In particular, Bruce Fink emphasises the need to understand this in order to approach patients correctly in terms of technique. Techniques used with neurotic patients are inapplicable and might lead to a disaster with a psychotic patient. Bruce writes "And not only are such techniques inapplicable - they may even prove dangerous, triggering a psychotic break" (Fink, 1997, p. 75). To further accentuate the importance of diagnosis and the emphasis on understanding the psychic structures, another great Lacanian writer, Professor and Psychoanalyst Dany Nobus could help us shed some light on this topic. In his book "Jacques Lacan and the Freudian Practice of Psychoanalysis", Dany wrote thus "Freud contended that ostensibly neurotic symptoms (such as elusive bodily pains and compulsive behaviours) should not be taken as unambiguous signs of an underlying neurotic illness, however conspicuous they may be. A psychosis can hide under the mask of neurosis, and the analyst should not be misled by the colours of the clinical guise" (Nobus, 2000, p. 8). Freud expressed the disguises that symptoms can take and by that, trick the analyst into making decisions too early, without enough evidence of the situation, even though the full amount of evidence needed for valuable diagnosis comes after the fact (after the treatment is over). Further Dany writes "Freud was adamant that the psychoanalytic process is unpredictable and that the analyst's initial diagnosis can always be disproved by the vicissitudes of the treatment, in which case analysts should be willing to change their minds about the patient's psychic economy" (Nobus, 2000, p. 8). This complicates matters even further because in some sense diagnosis is not final, it can morph and change during the treatment. By uncovering the buried layers of the patient's psyche, the analyst is receiving new information, more details could paint a different picture, as opposed to the one made at the beginning of the treatment. What becomes clear is that some sort of defining criteria is needed, which could be used as a compass for the analyst. This compass was truly a Lacanian project based on Freud's work, Jacques Lacan accentuated that he was a teacher of analysts. So, a Lacanian diagnosis is like a compass which allows the practitioner to situate himself or herself within the dynamics of the transference in the therapeutic relationship with the patient or as it was called by Lacan the "Analysand". Lacan used the term "analysand" instead of the term "patient" because he wanted to emphasise the "active" role of the person in analysis, the one who is actively engaged in analysing and doing the work is the analysand himself. If we look at the therapeutic settings assigned to people by the healthcare system, we see a clinic based on a couple of sessions which should get the person back on his or her feet and send them back to work (a short-fix scheme). In his book "What is Madness" Psychoanalyst and author Darian Leader wrote "We see this reflected in the mental health world, where treatment is often considered an almost mechanized technique to be applied to a passive patient, rather than as a joint collaborative work, where each party has responsibilities" (Leader, 2011, p. 4). Psychoanalysis in itself should not be seen as a capitalistic project of a contract between the "doctor" and the "patient", where the doctor gives a promise to the patient of "getting better", or a "cure in 10 sessions" in which the patient is a passive observer of the process and listens to the commands of the doctor. Furthermore, Darian writes "There is increasing pressure today to see mental health services as a kind of garage, where people are rehabilitated and sent back to their jobs - and perhaps to their families - as soon as possible" (Leader, 2011, p. 4). Further, Leader writes "The patient's specificity and life story are often airbrushed away. Where old psychiatry books were once filled with the reported speech of patients, today all one sees are statistics and pseudo-mathematical diagrams. Studies hardly ever mention what happens in unique cases, but present figures where the cases have been aggregated together. We never find out, for example, why one individual responded to some treatment and what exactly their response was; instead, we get the statistics of what percentage of what percentage of participants responded or failed to respond. The individual has vanished" (Leader, 2011, p. 4). Back to the text of Bruce Fink, he writes "Lacan attempts to systematize Freud's work on diagnostic categories, extending certain of Freud's terminological distinctions" (Fink, 1997, p. 76). This connects to the Lacanian proposition "return to Freud", Lacan proposed the need for the discipline of psychoanalysis to get back to the Freudian texts. His idea was to truly acknowledge the meaning and essence of what Freud was proposing in his writings. The movement of the post-Freudian analysts lost the essence of Freud's law, the meaning of speech and language disappeared, and the law of the father (Freud in this case) vanished because he was not around anymore, so, his children allowed themselves to morph their father's opinions and techniques into something else. Lacan followed his proposition of "return to Freud" in his famous seminars for almost 30 years. Fink further extrapolates the situation thus: "Freud himself separates neurosis from perversion by theorizing that whereas repression (Verdrängung) is characteristic of neurosis, the primary mechanism characteristic of perversion is disavowal (Verleugnung). Lacan points out that Freud employs another term - Verwerfung - to talk about a still more radical mechanism (though not in theoretical detail)" (Fink, 1997, p. 76). Interestingly, the first Freudian formulation of repression (Verdrängung) was made in his book Studies on Hysteria, (published in 1895). Freud introduced the concept of repression as “the cornerstone on which the whole structure of psychoanalysis rests”. Freud's thought of "repression - Verdrängung" is important from the standpoint of Lacanian diagnostics, this is the moment where Freud explains "our relation to the signifier" or "our relation to the law", "detrimental mechanism which will be one of the three pillars of psychic life" which Lacan will extrapolate later on within his thinking via the use of other disciplines such as linguistics. Further, Fink writes "This term is found in a number of contexts in Freud's work, and Lacan suggests (especially through a close reading of Freud's 1925 paper "Negation") that we understand it as the primary mechanism characteristic of psychosis; he translates it first as "rejection" and later as "foreclosure" (Fink, 1997, p. 76).

 

To summarise the three mechanisms: 

Neurosis - mechanism - repression (Verdrängung);

Psychosis - mechanism - foreclosure (Verwerfung);

Perversion - mechanism - disavowal (Verleugnung).

 

Bruce writes "Thus, the three main diagnostic categories adopted by Lacan are structural categories based on three fundamentally different mechanisms, or what we might call three fundamentally different forms of negation (Verneinung)" (Fink, 1997, p. 76). What does it mean? Let's begin with the term negation (Verneinung), what are we negating? Probably the most primitive Freudian answer would be "the reality principle". Freud in his text "Formulations on the Two Principles of Mental Functioning" ("Formulierungen über die zwei Prinzipien des psychischen Geschehens") discussed the pleasure principle and the reality principle. The pleasure principle is pretty much what life consists of, we constantly seek pleasure and run away from displeasure to seek pleasure. But sooner or later we have to meet "the reality principle", which shows us very clearly that it is impossible to seek pleasure all the time, that the world is not the way you think it is, but it is the way it is. The reality principle is like the stop sign for enjoyment. As babies, we are devouring pleasure machines, anxiety-pumping, narcissistic machines, that can not distinguish between what is possible and what is impossible, where pleasure starts and where it ends, a pure embodiment of demand. So, we live purely on "the pleasure principle", demanding love and food, while at the same time releasing the contents of our bowls without cringing, until there comes a day when we meet "the reality principle". This could be encompassed in the fact that we have to deal with "the law of the prohibition". The law comes as language, as the daddy's fist. At that point, the child is put into the position where "it" "a pre-linguistic being" has to relate to the law "of the speaking beings" in one way or another and the mechanism which determines our psychic structure is established via our relationship to the symbolic order. Mechanisms that determine our psychic reality are:

 

Neurosis - mechanism - repression (Verdrängung);

Psychosis - mechanism - foreclosure (Verwerfung);

Perversion - mechanism - disavowal (Verleugnung).

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Entrance into language? Entrance into the symbolic order? Law as language? What does it all mean? How come, entrance into language could be so important? A couple of examples might help.

Let's use another primitive analogy to accentuate the importance of the law and especially the entrance into the world of the law in Lacanian theory. Imagine a Christian cross, a cross has two parts, the shorter part which is horizontal and the longer part which is vertical. Imagine, on the left side of the horizontal line of the Cross a place for the "Mommy" and on the right side of the horizontal part of the Cross, the part for the "Babby", this line is a representation of the unity and connection between the mother and the child. The vertical part of the Cross is for the "Daddy", which in psychoanalytic terms would be represented as the bearer of the "phallus" and "the law". Daddy intervenes in the relationship between the mother and the child and says "No", Daddy is the prohibitor of enjoyment, the separator of the unity between the mother and the child, and the cause of the splitting of the atom. This precise moment of the intervention of the phallic law of the father is the moment when the child has to find a way how to deal with the loss of unity with the mother. Dealing with the trauma of the intervention of the law could be done in three ways of negation (Verneinung).

​

Neurosis - mechanism - repression (Verdrängung);

Psychosis - mechanism - foreclosure (Verwerfung);

Perversion - mechanism - disavowal (Verleugnung);

​

Negation by repressing (Verdrängung) the fact of the phallic intervention leads to neurosis, negation by foreclosure (Verwerfung) leads to psychosis, and negation by disavowal (Verleugnung) leads to perversion. Bruce Fink writes "Regardless of whether one accepts these mechanisms as fundamentally different and as defining three radically different categories, it should be clear that Lacan's project here is essentially Freudian in inspiration, and in direct continuity with Freud's efforts to discern the most basic differences among psychical structure" (Fink, 1997, p. 76). The main idea is the emphasis on three and only three existing mechanisms which determine our psychic reality. Further Fink writes "An important consequence of this structural approach is that there are three and only three principal structures. (There are, of course, various subcategories. For example, subcategories of neurosis are hysteria, obsession, and phobia - these are the three neuroses.)" (Fink, 1997, p. 77). Three general categories are determinant factors of our psychic reality, a three detrimental unconscious choices of functioning within the reality of the law: neurosis, psychosis and perversion. Out of these three main categories, a wider structure of subcategories develops which follows a logical path out of each main category separately. Derek Hook in his lectures on "Lacanian Diagnostics" explains these matters meticulously well, watching these lectures would be beneficial to an interested reader of this text.

As mentioned above by Fink, neurosis as one of the three main diagnostical categories is the basis of subcategories of hysteria and obsession. Furthermore, psychosis as one of the three main diagnostical categories is the basis for the subcategories of schizophrenia, paranoia and melancholia. Lastly, perversion as one of the three main diagnostical categories is the basis for the subcategories of fetishism, sadism, masochism and voyeurism.

 

Neurosis - mechanism - repression (Verdrängung); hysteria and obsession

Psychosis - mechanism - foreclosure (Verwerfung); schizophrenia, paranoia and melancholia.

Perversion - mechanism - disavowal (Verleugnung); fetishism, sadism, masochism and voyeurism.

 

Emphasis at this point would be to articulate the importance of situating the analysand within the particular structure. This is done NOT in the name of "shaming" or "violating a person's dignity" in any way shape or form, but in order to direct the treatment correctly. The correct diagnostic procedure is the first step in the line of treatment, it gives a topological map, that works like a compass for the analyst within the treatment settings. It allows the analyst to position herself or himself within the transference with the patient and conduct themselves accordingly.  

The whole Lacanian thesis of diagnostics is based on the primordial type of negation or a defence mechanism. To be a speaking being in this world, a being which speaks, you will encounter the law. The law which is the language invasively coming towards you, wrapped in the prohibition, like a candy wrapped in paper, like a gift of this world, a gift of speech. Your encounter with the law as language and the prohibition will inevitably elicit a defence mechanism (a non-elicited defence mechanism as in psychotic structure will be discussed in the part on psychosis). Three defence mechanisms as mentioned earlier (repression, disavowal, foreclosure) will be the determinant and detrimental factors of your subjective experience within this reality, the reality of speaking beings. The determinant factor of your encounter with the speaking world of the law will be the unconscious defence mechanism, a foundational operating setting of the bio-computer system. But, because it is "an unconscious defence mechanism", we can agree that the choice is not really "yours". Because "you" as "you" come into the speaking world only "after the fact" of encountering language as the law. That "after the fact" is the subject which encountered "the law" and has been produced and shaped by it. Stepping into the field of language, stepping into the world of speaking beings comes at a cost, the cost that we pay with our being. Our way of being in this world as speaking beings, living within the field of language, comes with the pressure of the law of language. The second analogy which will emphasise the importance of our entrance into language will be a bit more extreme: stepping into the world of language is like joining the mafia family, sounds crazy right? Stay with me, it will make sense eventually. In the world of "Cosa Nostra", the Mafia, in order to become "a new member of the family", "a made man", a new member of the family has to take the oath of silence and cut a piece of his flesh to elicit blood. On that elicitation of blood, the oath of silence is taken and a new member becomes an official member of the mafia family. What we are interested in, in this situation, is the underlying structure or principle of sacrifice. To enter the world of the mafia, to become a part of the family, you have to elicit some blood, you have to pay the price, you have to sacrifice a little bit of something "a pound of flesh". In the case of mafia ritual: your blood, in order to become "one of them". Similarly, to enter this world of speaking beings, we have to sacrifice a little bit of something as well. In the form of a symbolic sacrifice, that symbolic sacrifice is the cut of the law as language into our being. This cut of language onto our skin, like the blade of a knife or a pin, penetrating the skin in the mafia ritual, is what metaphorically cuts our being. It is, what elicits the defence mechanism, on which our subjective experience is built. So, all of us who "speak" belong to the "mafia family of the speaking beings", "a clan of speaking humans living within the field of language" which is probably one of the reasons why we and not the animals are running this world. The gift of language and speech is the gift that allowed us to communicate, pass on knowledge to new generations, build civilizations, and create and write poetry, literature and history. We are collectively unified by the gift of language and speech, but it came with a cost, the entrance into this family of speaking beings was traumatic. Our entrance into the family of speaking beings was a detrimental moment. A moment that left a mark, a mark which determined our subjective position, which determined our whole subjective experience by eliciting a fundamental mechanism through which we become the participants of the clan of speaking beings. Another example that could clarify and emphasise the importance of entrance into the world of speaking beings while portraying the trauma of becoming a speaking being is the movie "The Matrix". It is a film made by Lana Wachowski and Lilly Wachowski in 1999 which depicts a dystopian future in which the human race is trapped inside the Matrix. x. This program "Matrix" simulates reality for us human beings, while we are unknowingly sleeping in the special pods, surrounded by a GUI liquid. In our sleep, we are connected to the system by special metallic connections attached to our bodies which supply us with the dreaming content of our lives. While being fully asleep within the actual reality, in which intelligent machines, who created the simulation are using our bodies as batteries for their own survival and progression. There is a scene in the movie where the main character "Neo" played by Keanu Reeves meets the prophet "Morpheus" played by Laurence Fishburne, which gives him a choice, to take a blue pill and go back to sleep within the simulated reality of the machines, or to take a red pill and wake up in the real world, which is not simulated by the machines. "Neo" being a truth seeker chooses to take the red pill and go through the trauma of becoming a subject but in an inverse form. After taking the red pill Neo is seated in the chair by the Morpheus team and then Morpheus himself tells Neo that the pill is "part of the trace program, it is designed to disrupt your input-output carrier signals so we can pinpoint your location". After hearing Morpheus's explanation, Neo being an intellectual asks "What does it mean?". One of the Morpheus crew members named Cypher gives Neo a beautiful answer saying thus "It means buckle your seatbelt, Dorothy, 'cause Kansas, is going bye-bye". Cypher's answer is like saying in Lacanian terms, "Put your seatbelt on Dorothy, because you will go back into the pre-symbolic universe. You will inversely travel back through the moment of trauma and through the fantasmatic structure, back into the world which existed before you became a subject. Into the place and time prior to the entrance of the mafia clan of speaking beings".  After hearing Cypher's answer, Neo touches the huge mirror standing next to him and his fingers unexpectedly slightly penetrate the mirror, giving an illusion, as if the mirror is actually in liquid form. Highly surprised Neo takes the fingers out of the "liquid" mirror, which just a minute ago seemed like a normal mirror. Then, Neo notices a residue of the liquidish form of the mirror on his fingers, full of disbelief observing his fingers covered in "liquid mirror residue" Neo hears the famous line of words expressed to him by Morpheus, thus: "Have you ever had a dream Neo, that you are so sure it was real? What if you are unable to wake from that dream? How would you know the difference between the dream world and the real world?". Straight after hearing what Morpheus just said, Neo shockingly notices that the liquid residue from the mirror that engulfed his fingers is spreading and wrapping around his whole hand. At that particular moment of realisation of the absurdity of the situation, Neo says with astonishment  "This can't be...". Morpheus being a brilliant psychoanalyst interprets this by replying to Neo straight away by saying "Be what? Be real?". After the interpretation of Morpheus, the camera shows Neo going through a very bodily experience of seeing and feeling the liquidish residue that engulfed his finger after touching the mirror, spreading and travelling through his arm upwards to engulf his whole body. The camera shows us how the cold, metallic liquid is slowly engulfing his whole body. As if at the same time the metallic liquid residue of the mirror would be metaphorically deleting Neo from reality itself because Neo as a subject is disappearing. The contours of his body are being devoured by a cold liquid, which reflects the surroundings but is deleting him at the same time. His body is becoming a reflection of the world around him, Neo as particularity disappearing from this reality and becoming just a reflection of the universality of this fantasmatic reality. At that moment Neo expresses his bodily sensations and feelings by repeating "It is cold, it is cold!" twice. Watching that scene on your TV screen you can literally feel the cold liquid wrapping around Neo's body, it seems like a liquid silver would be truly devouring his flesh. Neo's facial expression reminds you of how you look at yourself from a third person's perspective while trying to slowly sit into a bath full of ice-cold water. Further, we see the same cold liquid wrapping around Neo's neck and travelling towards his face, engulfing his body, cold machinic silver liquid devouring his flesh. During that process, while the cold silver liquid is devouring Neo's flesh, Morpheus and the crew almost lose Neo because of the cardiac arrest. The process is so horrific that Neo's heart almost stops. At the end of this scene, the cold metallic liquid has wrapped half of Neo's face and is travelling towards his throat. Neo's mouth is wide open, and he is completely trapped in this experience. At that particular moment, just before the metallic liquid travels down Neo's throat to completely delete Neo from this reality, Morpheus's crew manages to locate Neo's coordinates within the Matrix and catches the subject. Neo's mouth is wide open, and he starts screaming. While he is screaming, the cold metallic liquid is travelling down his throat, changing his humanity which is expressed in screaming out of terror into a robotic, android scream. Neo's humanity completely disappears at that moment and is replaced with an android-like sound, during which Neo is saved from the illusion of the matrix. The next scene portrays the whole meaning of my example, it shows the cold structures of the symbolic matrix: Neo wakes up in a GUI cocoon filled with sticky liquid, with a bunch of hoses attached to his body and a huge hose shoved down his throat. He rips the hose out of his throat and for the first time gets a chance to inhale "real air", then he touches the back of his head and feels the main attachment connected to it. After touching the back of his head Neo gazes around himself and has a chance to observe a huge field of enormous phallic structures stretching from the bottoms of the ground straight upwards towards the heavens all around him.

These enormous structures are holding an incalculable amount of pods positioned circularly all around each structure, the same pods as the one in which Neo is still sitting, but filled with other humans, innocently sleeping and dreaming their lives away, giving their energy to the machines. At this particular moment, Neo as a superhero of humanity is given a chance to perceive the moment just before the entrance into language. The fields filled with other human beings trapped in the pods connected to the symbolic reality of the matrix could be interpreted as a chance for a "pre-symbolic", "pre-historic" entity, in this case, our superhero Neo, to perceive the "field of language" and in an inverse form go through the process of becoming a subject. The cold, flesh-eating metallic liquid which has engulfed Neo's body earlier, waking up in the field of pods filled with human beings innocently sleeping in their pods while giving their energy to the machines. This scene portrays a presymbolic entity encountering the cold world of language, the alien world, which alienates human "being" into a "symbolic identity". The field of pods, devouring human consciousness and supplying them with the dream of reality, is the cold expression of a newborn baby encountering the alien system which is language and the law itself. The Matrix gives us a clue about the feeling of the unrepresentable in the inverse form, the process is given to us backwards. Because we can only represent and interpret what has happened to us, only, if we travel backwards from the imaginary and the symbolic into the real and not the other way around. The Matrix sucks us back out of the imaginary and the symbolic, back into the real and shows us the weight, price and scale of the trauma which is our sacrifice for the entrance into the clan of speaking beings. But precisely because it works backwards, it supplies Neo with a chance and the capability to encounter the "pre-symbolic and pre-imaginary" moment while having the knowledge of the symbolic and imaginary.  It is a pre-symbolic and pre-imaginary encounter with the cold structure of language, with the cold structures of liquid metal which alienates our being and takes over. It alienates us from our being into the devouring, artificial structure of the world. It shows the cold structure of the world in which we function as machines, machines within the capitalist society. Human machines that completely forgotten their humanity. We can only function as human beings within the system through the symbolic and the imaginary veil by creating the phantasy of the world. Neo, gazing into the cold, symbolic structures of this world is the precise moment of encountering the splitting of the subject in an inverse form, the moment that splits the pre-symbolic entity. This splitting itself is the precise moment of birth of subjectivity, it is the precise moment at which psychosis, neurosis or perversion is inscribed. Being itself reacts and splits as a reaction to the touch of cold, liquid metal and the subject is born, born into the alien world. To make sense of the Matrix interpretation, we need to look back into René Descartes's philosophy. The first principle of Descartes's philosophy was cogito, ergo sum, usually translated into English as "I think, therefore I am". Descartes presupposed that he as an entity within this world exists only when he "thinks", he exists only within the process of his "thinking" and in the place where he thinks. Lacanian inversion of Renes principle would sound like this "I think, therefore, I am not", Lacan inverted Descartian understanding in order to bring the emphasis back towards "being". Lacan's inversion emphasises and exemplifies the split, the split between being and thinking. Thinking itself is already in the place of alienation because thinking is happening within the symbolic dimension. Descartes's presupposition of his existence was already based on the dimension of alienation, Descartes gave away "his existence as a being" to the alien world made of liquid metal. In his book "The Lacanian Subject Between Language and Jouissance" Bruce Fink writes thus: "While thus beginning with the punctual (or pointlike) Cartesian subject, that is, the fleeting coincidence of thinking and being, Lacan turns Descartes on his head: ego thinking is mere conscious rationalization (the ego's attempt to legitimate blunders and unintentional utterances by fabricating after-the-fact explanations which agree with the ideal self-image), and the being that would be diametrically opposed to the false being of the ego, but this is not ultimately the case" (Fink, 1995, p. 44). The matrix example, the example of Descartes's alienation into his thinking and forgetting his being, and the example of the cross portray our alienation. Furthermore, Bruce Fink writes "The very notion of splitting as produced by our alienation within language can serve as a diagnostical tool, enabling the clinician to distinguish, in certain cases, neurosis from psychosis" (Fink, 1995, p. 46).

As you, the reader, probably have noticed, there are no diagnostic criteria for normality. We have three structures:

 

Neurosis - mechanism - repression (Verdrängung); hysteria and obsession

Psychosis - mechanism - foreclosure (Verwerfung); schizophrenia, paranoia and melancholia.

Perversion - mechanism - disavowal (Verleugnung); fetishism, sadism, masochism and voyeurism.

 

"Neurosis, Psychosis, Perversion" and everyone inevitably lands somewhere in those three categories. Maybe somewhere down the line, in the future, a new mechanism will be discovered in addition to the three existing mechanisms (Repression, Foreclosure, Disavawol). Still, as for the present moment, we do not have a new mechanism. Imposition of the Law, its internalization and the residue that is left as a structural condition of subjectivity is what interests an analyst. Furthermore, Lacan was very categorical in regard to the liveliness of the underlying structures. This means that if a person internalises the law by foreclosing it and because of that becomes psychotic, that person cannot jump out of the wagon of psychosis into a new structure. Structures are rigid and inscribed for life, set in stone. If your entrance into language made you psychotic, neurotic or perverse, this is the structure within which you will function for the rest of your life. Sounds quite scary and rigid right? Authoritarian even?

In his book "A Clinical Introduction to Lacanian Psychoanalysis Theory and Technique" Bruce Fink writes in Chapter 7 on the "Consequence of the Failure of the Paternal Function", thus: "In Lacanian psychoanalysis, the paternal function is considered to be all or nothing: either a father (as noun, name, or "NO!") has been able to take on the symbolic function in question or he has not. There are no in-betweens" (Fink, 1997, p. 82). The statement seems quite clear, either the father managed to inscribe his "No!" within the child's psyche by neuroticising the child, or the child will become either psychotic or perverse. Furthermore, Bruce writes "Similarly, either the paternal function is operative by a certain age or it never will be. Lacanian psychoanalysis, though it purports to help the psychotic, cannot change the psychotic's structure: once a psychotic, always a psychotic. There is, of course, some question about the maximum age at which the paternal function can be instated - that is, the age beyond which one's psychical structure cannot be further modified. It seems likely that appropriately oriented analytic work with young children can, up to a certain point, bring about the establishment of the paternal function" (Fink, 1997, p. 82). The Fathers "No!" or a "Paternal metaphor" seems to be somewhat inscribable to a child through analytic work by an analyst or a general mental health practitioner, Lacan mentioned it in his Seminar IV: "The Object Relation" by suggesting that the process might be extended somewhere down the line to 6 years of age. The primordial relation to the law is already inscribed and it cannot be changed. But what can be changed, is some sort of intellectual comprehension of a person's relation to the law at the level of the intellect, but, not at the level of the structure. Furthermore, Bruce writes "In the case of adults, however, no amount of analytic or other work can, according to Lacan, change a psychotic structure. Such work can make certain psychotic traits recede from a patient's clinical picture, ward off further psychotic episodes, and allow the patient to carry on the life in the world; but there is no such thing as a "cure" for psychosis in the sense of a radical change in psychical structure (for example, transforming the psychotic into a neurotic) (Fink, 1997, p. 82). Once again we see the "particularity" of the Lacanian method, which allows the analyst to position himself or herself correctly and concretely. An indecision of structural category in which the "analysand" or "the patient" should be positioned from the perspective of the analyst, is an indecision within an analyst himself or herself and not within the analysand. Further, Bruce writes thus "This structural approach to psychosis also means that a patient who has a "psychotic break" at age thirty has always had a psychotic structure - it was simply "untriggered". The patient could, in theory, have been diagnosed as psychotic by the clinician long before an obvious break occurred - that is, long before the appearance of obvious psychotic phenomena" (Fink, 1997, p. 82). We see here the difference between "being mad" and "going mad" which Darina Leader discussed in his book "What is Madness". You can live your whole life within the psychical structure of psychosis as "being psychotic" and manage to go through life without psychosis being triggered. But, in other cases, psychosis can be triggered, and the Lacanian analyst knowing that fact of a patient's "psychotic" structure, because of his or her use of a very particular diagnostical criteria could be prepared to deal with this. In addition to dealing with a triggered "psychotic episode", analysts can work within the line of preventative measures, by making the therapy room a place where the "psychotic" person can find ways to live within this reality which could be highly triggering and dangerous with the help of the analyst. This is where the discussion of the technique in relation to neurosis and psychosis becomes important. By situating himself or herself within the transference, knowing the person's structure, allows the analyst to embody a non-invasiveness "message-sending secretary position" and avoid embodying the "representative of the law" which could be triggering and invasive.  Back to the three structures:

 

Neurosis - mechanism - repression (Verdrängung); hysteria and obsession.

Psychosis - mechanism - foreclosure (Verwerfung); schizophrenia, paranoia and melancholia.

Perversion - mechanism - disavowal (Verleugnung); fetishism, sadism, masochism and voyeurism.

What are the tools of the analyst? How do you arrive at the diagnosis? What are the paths that might be followed in relation to Lacan’s thought? 

In his YouTube lectures on Lacanian Diagnostics Derek Hook summarizes this process via three pathways:

                         Speech               Jouissance              The Other

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                                                                                Diagnosis via Speech 

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Speech - pathway via Speech. A term referring to the differentiation between different types of speech possible.

Jouissance - pathway via Jouissance. The term refers to enjoyment that exceeds the boundaries of the pleasure principle.

The Other - pathway via The Other. The term refers to the symbolic order as a placeholder and the governor of all the signifiers, rules, norms and structures that govern language and society.  While moving forward through the terminology of Lacanian Psychoanalysis, it becomes more complex. Let's work through the terminology first:

Speech - as being a performative action, an articulation via the system of language. As speaking beings, we speak and psychoanalysis is particularly interested in the speech of the subject. Not without the reason psychoanalysis was called "a talking cure", with emphasis on the action of "talking". Freud, as well as Lacan, talked about diagnosis via speech. Generally, speech is an interesting phenomenon, many things can be noticed while listening to someone speak while paying attention to the way they speak. Ways in which a person articulates certain words, mimicry on their face, especially during meaningful or meaningless words being spoken. Things such as the differentiation between Neurotic speech and Psychotic speech, and ways of enjoyment that could be heard and noticed via speech, further lead to understanding and comprehension of differently structured beings, being able to enjoy in different ways. Perverse enjoyment in "the other's pain" could be a signpost towards a perverse way of enjoyment. Even further down the line of diagnostics leads to the Lacanian understanding of sexuality and how this whole show of "speaking beings, living in the symbolic matrix" inevitably leads to the signifier, on which our being in the world of speaking beings is erected and based. Lacanian analysts pay particular attention to speech and language, you might ask, why is that? Specific differences can be distinguished between neurotic and psychotic speech, as well as neurotic and psychotic transference. In his book Jacques Lacan and the Freudian Practice of Psychoanalysis, Dany Nobus writes "Lacan indicated that in psychosis radical freedom of speech is paired with an absence of the spoken word, because the latter no longer addresses itself to somebody else: "the subject, one might say, is spoken rather than speaking". As Lacan had already underscored in 1946 discussion with Henri Ey, psychotic people are in a sense the most free individuals one can imagine, yet for this radical freedom they have to pay with their bodies and souls" (Nobus, 2000, p. 12). If we follow the Lacanian basics of neurotic inscription into the symbolic order of language because of the symbolic castration, then psychotic has a contrary scenario, being not inscribed in the symbolic order of language, as if the wall that should separate a word and its meaning was not erected. An example of the missing wall between signifiers and their signifieds could be: If a woman during dinner says "I am going to powder my nose" and walks away from the table. We can all fully comprehend that what she "means" is that she is going to the restroom.  Or maybe she politely decided to leave the dinner because some urgent matter had just come up at home and she did not want to express that publicly, so she used a diversion which would allow her to leave the dinner without explaining the extremities of the situation. Or maybe she was truly honest because it was a New Year's Eve party and she was truly going to powder her nose... Her saying "I am going to powder my nose" inevitably gives us a clear association and distinction between the words that have been said in this particular situation and the possible meanings of the spoken words. On the contrary, psychotic communication is more literal, it could be distinguished in particular because of the loss of separation between the words that have been said and the meaning of those words, as if the separation between the word and its meaning was not established (because of non-integration within symbolic order - psychosis). Dany further writes "For a psychotic person, nothing is unsure within what is being transmitted; sentences are unidimensional, a word does not carry any other meaning than that which is presented by the word itself" (Nobus, 2000, p. 12). Unidimensionality and certainty could be expressed next to each other in this case: a person is fully guaranteed that he is being followed by a red car. During his expression of concern regarding the red car, he is fully certain that the red car is truly following him. "This red car is following me everywhere, I know for a fact that this red car is following me everywhere". What we notice here is full certainty without the possibility of doubt. But, what if the person in question was truly persecuted by a "red car", last month or last year or maybe in his childhood? What about the residue that makes this experience real not because of psychosis but because of true fear that was instigated somewhere earlier in a person's life? This is a very clear argument, knowing more details about a person's background might be beneficial. But let's go further, what if "red cars" start to merge in combination with meaning and certainty? A person says "These red cars are signs, they mean that my grandmother is talking to me from another side, she is sending me messages via red cars". As if the signifier and signified merged and meaning is visible everywhere. Butterflies send messages to a person by dancing in special patterns or certain signs on the road start showing a secret direction to find the treasure hidden from everyone else. Darian Leader in his book What is Madness wrote "Where the signification established by the Oedipus complex is absent, the person is left at the mercy of too many meanings: this can at times result in literary and poetic dexterity, but often the person feels overwhelmed and invaded by meaning." (Leader, 2011, p. 100). As in my previous example of the Christian Cross and the separation between the mother and the child. The separation between the signifier and the signified is the symbolic castration, where the symbolic father principle cuts the unity between the mother and the child.

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