Un-Triggered Psychoses
in the New Forms of the Symptom
Massimo Recalcati
1. Un-Triggered Psychoses
The concept of un-triggered psychoses implies the obvious assumption of a disjunction between the temporality of psychosis and its triggering. In fact, the triggering as such reveals without doubt the existence of the subject’s psychotic structure. Yet, as we shall see, Lacan’s teaching on psychoses makes the distinction, already in his Seminar III, between the psychotic dimension of the subject and its actual triggering.
The concept of un-triggered psychoses (or unfettered psychoses, undeclared, compensated, closed, white, cold, not delirious psychoses) supposes a definition of a psychotic functioning in the subject without localizing the actual moment when the breakout of the psychosis occurs. As a matter of fact, if the triggering is the result of a specific event that opens up—precisely of triggering—the psychosis, then the category of un-triggered psychoses dispenses with the triggering and its typical clinical effects such as hallucinations and delirium. In particular the clinic of the so-called “new forms” of the symptom (toxicomania, drug addiction, anorexia, bulimia, depression) makes evident the incidence of closed psychoses, un-triggered, compensated, where these new organizations of jouissance, especially anorexia-bulimia and toxicomania, appear as the psychosis’ subjective modalities of closure and compensation. Through these modalities the subject defers the possibility of triggering or, as Lacan puts it, keeps himself on this side of the hole of psychosis, on the brink of psychosis but without falling into it.
The clinical category of un-triggered psychoses implies, in this perspective, two other fundamental categories: the imaginary compensation and substitution (suppléance), in the sense that both are shaped as specific forms of subjective soldering of the psychotic hole. In this sense compensation and substitution share the same function. However, from another point of view they stand differentiated, for if the stabilizing soldering takes place in the compensation through an imaginary identification of the narcissistic type with one’s fellow man, in the case of substitution we are dealing instead with the starting up of an authentic signifying operation of excessive jouissance. Thus, substitution is characterized as a subjective form of psychosis stabilization much more articulated than the imaginary compensation. In fact, Lacan introduced the concept of substitution in the 70s when he reflected on Joyce, whose work is considered to be the extraordinary paradigm of this concept.
2. The Origin of the Problem
One of the classic categories that can be detected as a significant theoretical precedent of un-triggered psychoses is the concept of “latent psychosis” formulated, among others, by Paul Federn. [1] A precursor in the psychoanalytic treatment of psychoses, Federn was one of the first analysts to rigorously study the case of psychotic decompensations in subjects apparently neurotic. In the 30s and 40s when he perceived that many analysts were then dealing with psychosis, he ironically noted that these analysts were those who previously had wrongly diagnosed their patients as neurotics. [2] At the same time, this error revealed an obstacle in the identification of the psychotic structure of the subject since neurosis functioned as a protection screen against psychosis itself. By way of this empirical method Federn finds—in his psychoanalytic practice—latent psychoses.
In his “Analysis of Psychosis”, Federn refers to the treatment of neurotics managed strictly following the classical rules of analysis (couch, free association, regression, etc.), that at a certain stage of the treatment, patients manifest some psychotic decompensation. From this clinical phenomenon, which could be called the phenomenon of “psychotic decompensations under transference,” Federn infers the possibility of structural psychoses under the guise of neurosis. Here, psychosis remains latent, whereas phenomenal neurosis is what makes itself visible, although its treatment could trigger the unmasking of psychosis itself. Therefore Federn detects in the subject a structural functioning of the psychotic kind darkened by a neurosis that, incidentally, suggests a sort of self-therapy performed by the subject vis-à-vis its psychosis. It is well understood then that analysis could become a factor in the triggering of psychoses if “diagnosis of psychosis is not given in due time.” [3]
Federn encounters the issue in the analytical experience:
In 1912 Professor Freud sent me a twenty year-old student in modern philology. She was a beautiful and intelligent girl whose obsessive state inhibited all her activity. Her neurosis got worse two years back due to a love disappointment. Her father was a schoolteacher honorable and fair, who understood neither his wife’s hysteria (she had divorced him) nor his daughter’s neurosis… The treatment was moving without any serious resistance. The patient was losing most of her obsessions too easily. In 1914 I had to leave Vienna and travel to New York, so I left the patient free to pursue her study. When I returned four months later, she greeted me with a gaze that was both proud and timorous; she confided that a great actor loved her and that the voice of Friedrich Nietzsche had spoken to her. [4]
In this case, the procedure of the analyst (with the ensuing undermining of the compensation guaranteed by the imaginary transference) functions as the determining element that triggers psychosis in the young patient. Putting aside the valuable remarks that Federn develops concerning these phenomena of psychotic decompensation under transference, [5] what we must isolate is the existence of psychosis that seem to be neurosis and that in certain conditions (in which Federn consciously includes psychoanalytic treatment though, contrary to Lacan, he does not postulate a theory that explains how the encounter with an analyst could dramatically affect the opportunity for the triggering of psychosis) could reveal, once the superficial neurosis is dissolved, psychosis as such.
3. The Matheme of Un-Triggered Psychosis
Jacques-Alain Miller has formalized the question of un-triggered psychosis with the following matheme: [6]
Let’s read the matheme starting from the bottom. We first find Po, which indicates in Lacan’s classic doctrine on psychosis, the foreclosure of the Name-of-the-Father. The signifier that regulates all signifiers (the Name-of-the-Father) has been excluded, has not been symbolically inscribed in the subject’s unconscious. Instead of this inscription, we find a hole: Po. The Name-of-the-Father is not operative, is unable to rule jouissance and articulate jouissance to the Law. Therefore, in psychosis, jouissance—not castration, not signification—returns investing the body of the subject (schizophrenia) or identifying itself with the locus of the Other and thus engendering phenomena where the Other pursues the subject (paranoia).
The exclusion of the fundamental signifier, the Name-of-the-Father, does not constitute a repression in the sense that the exclusion, the zero reduction of the Name-of-the-Father effected by foreclosure, is not homogeneous in relation to the exclusion brought about by repression. We should then consider two sorts of exclusions that are structurally different. There exists a profound difference between exclusion of the Name-of-the-Father from the unconscious of the subject and the exclusion of the repressed from the consciousness of the subject. Whereas in the latter what is excluded—the repressed—could cause a process of re-appropriation by the subject (it is what Freud defines as the purpose of the analytic treatment of neurosis), in the case of psychotic foreclosure exclusion prevents any possibility of subjective re-appropriation. In other words, what is at stake is totally inert and irreversible exclusion.
The first is a dialectical exclusion—what is excluded belongs to the essence of the subject—the second one is an exclusion devoid of dialectics—what is excluded does not belong to the subject because it has never been inscribed in it. This different status of exclusion in foreclosure and in repression also explains the diverse modalities of what is excluded. In repression what is excluded returns in the symbolic formations of the unconscious (dreams, symptoms, parapraxis, lapses…). In foreclosure there is no return of the excluded as symbolic formations, in foreclosure the excluded returns in the real. Whereas the symptom holds vis-à-vis the subject a status of extimacy (extimité), of interior-exterior or “foreign internal territory” as Freud noted, the elementary phenomena of psychosis (hallucination, delirium) get control of the subject by coming from the outside.
If we ascend to the second stage of the Jacques-Alain Miller matheme, we find the Name-of-the-Father. It signals the main effect of foreclosure: a failed symbolic inscription of the chief signifier of the Name-of-the-Father, that is the ineffectiveness of the Name-of-the Father—its efficacy, in the classical doctrine of “On a question preliminary to any possible treatment of psychosis”, is explained in the so-called paternal metaphor. The barred Name-of-the-Father means that in psychoses there has not been a paternal metaphor and, therefore, the desire of the mother has not been confined by the normative action of the Name-of-the-Father. Its effects reduce the subject to a real object of jouissance of the Other.
But the significant point in Miller’s matheme is not so much the connection between foreclosure and the ineffectiveness of the paternal metaphor but the function of the third stage, which enables the subject to fill the structural hole that inhabits him by way of an imaginary compensation (C) that precludes psychosis from appearing as such.
The connection between foreclosure—as the structural cause of psychosis—and the ineffectiveness of the Name-of-the-Father is not enough to produce the triggering of psychosis. The imaginary compensation takes here the place of the Name-of-the-Father in the sense that it is what ensures in the subject some stability. This compensation keeps psychosis closed off and guarantees the subject with a narcissistic support by way of identification with his fellow man.
4. Theory of the Imaginary Compensation and the Triggering of Psychosis
Why then foreclosure as structural cause of psychoses is not sufficient in itself to hasten the triggering of psychosis? We know that imaginary compensation could work as a bandage and keep psychosis “closed.” Is it perchance the theory Lacan develops in his Seminar III with his metaphor of the subject and the stool? [7] What gives stability to a stool is a point of support external to the two legs (that is the imaginary couple): a third leg that assures the stability of the other two. There is not a stool with two legs since the two does not allow an orderly distribution of weight. “Not every stool has four legs. There are some that stand upright on three. Here, though, there is no question of their lacking any, otherwise things go very badly indeed.” [8]
In psychoses, then, we assume the absence of the third leg, the symbolic leg. However, as noted by Miller in his matheme on un-triggered psychosis, the stool lacking the symbolic leg (the Name-of-the-Father) could find its balance anyway. This is precisely the function assigned by Lacan to the identifying compensation: a kind of imaginary prosthesis of the symbolic leg that produces the desired effect of stabilizing the situation of the subject-stool. In fact, the effect of this imaginary prosthesis is to invest the subject with an identity that substitutes the “absent Oedipus.” Likewise, if the imaginary compensation refers to the absence of Oedipus—that is to the absence of the paternal metaphor—the event is not sufficient to assure an effective symbolic triangulation. The subject remains as the prisoner of a specular relationship, his identity lacks an operative subjectivation since it is the product of a narcissistic identification with his fellow man located as an ideal I. Hence the rigid and massive character of this identification, which is not, as in hysteria, the identification to a trait; it is rather a mimetic identification, widespread, all-inclusive, which tends to reproduce entirely the object of identification.
In his Seminar III Lacan openly addresses the question of compensated psychoses in a chapter, aptly titled by Jacques-Alain Miller, “On Primordial Signifiers and the Lack of One.” [9] In particular, Lacan signals three fundamental aspects:
a). Katan defines as “prepsychosis” the situation of subjects living in a condition of pre-triggering, but without that the actual triggering as such occurring; this condition, labeled by classic psychiatry as “schizophrenic atmosphere,” is punctuated by a progressive disappearance of the symbolic (points of) references, instability, deep lack of equilibrium, confused stupor… For Lacan “prepsychosis is the feeling that the subject has come to the edge of the hole.” [10] The hole is the one that has been opened by the foreclosing absence of the Name-of-the Father.
b). What can keep the subject from falling into the hole is the imaginary compensation. “The subject will have to bear the weight of this real, primitive dispossession of the signifier” promoted by Verwerfung, “imaginary crutches enable the subject to compensate for the absence of the signifier.” [11]
c). Imaginary compensation tends to appear in a series. It is the series isolated by Helene Deutsch on so-called “personalities as if” and that Lacan defines as “a series of purely conformist identifications with characters who will give the subject the feeling of what one has to do to be a man.” [12]
The main feature of the identification that prevails in the imaginary compensation of the absent Oedipus is one of being an adhesive identification, whole, immediate, mimetic, not dialectical, not tertiary, in series: identification of the subject to a fellow creature located as an ideal I.
Winnicott’s hypothesis about the “false-Self” and Helen Deutsch’s study on “as if” personalities explain a great deal about the features of imaginary compensation. The “false-Self” and “personalities as if’ signal the dimension of the subject where the imaginary identification compensates for a fundamental emptiness of being by establishing a continuity of being—as Winnicott says—absolutely artificial, built on sand, since it actually lacks the symbolic support bestowed by the Name-of-the-Father.
Winnicott’s “false-Self” describes a “clinical state” characterized by a split between the subject’s being, the true-Self, and his social mask. The latter, which acts as a shelter and hiding place for the subject’s being, and therefore as mediation with respect to the demands of the external world, may get pathologically entangled to the point of causing an authentic and irreversible alienation of the subject. This alienation is “constituted with a base of complacency” in which the subject constructs a cohesion of himself that strives to remedy the absence in early infancy of a desire of the Other capable of symbolizing the existence of the subject as such. Once this primal particularization fails—what Winnicott describes as the effect of “holding,” of support and self-control exerted by “a sufficiently good mother”—all that remains for the subject the possibility of achieving an identity by way of multiplying mimetic identifications with the other, “showing himself complaisant to environmental demands.” Hence the main feature of false personalities: of experiencing life as surrounded by a halo of unreality, of futility, of emptiness and of non-existence. [13]
In her article “On personalities as if” (1934) Helene Deutsch shows how certain subjects, who appear as absolutely normal and exhibit a strong capacity for social adaptation—she compares it with a kind of “psychic mimesis”—in fact manifest a complete lack of subjective authenticity. It is like an actor endowed with great interpretative technique but with no ability to give life to the character he represents. This hollowed-out technique is the cocoon of the “as if” personality in which the object identification conceals the subject’s fundamental emptiness of being. To live and behave like the rest of us, to exhibit an adequate social adaptation, to present oneself as identifying with determined roles so that “any object could serve as a springboard to identification,” are some of the typical modalities of personalities “as if” that conceal the inner emptiness inhabiting them. [14]
At the moment of triggering, due to the irruption of an element heterogeneous to the imaginary coupling, the rigid identification to the specular other is smashed into pieces. In a patient of mine, for example, the triggering concurred with his sister’s pregnancy, which broke the specular identification that so far sustained him, by introducing into the imaginary coupling “brother-sister” a third element non-assimilable to the narcissistic-identificatory unity of the coupling. Moreover, his sister’s pregnancy confronted the subject with the fundamental signifier of paternity he lacks.
For the triggering of psychosis to be produced then, the existence of the structural cause of foreclosure is not enough. The absence of the signifier of the Name-of-the-Father is not enough. Lacan is quite clear when he states “for the psychosis to be triggered, the Name-of-the-Father, verworfen, foreclosed, that is to say, never having attained the place of the Other, must be called into symbolic opposition to the subject.” [15] What Lacan stresses here is that the condition of the triggering is produced by the intersection of two different causalities: a structural causality and a contingent causality. If the former is identified with foreclosure of the Name-of-the-Father, the latter appears as the encounter of the subject—“in symbolic opposition”—and this signifier—the Name-of-the-Father—that “has not attained the place of the Other.” In the terms of Seminar III, this means that the triggering takes place when “the subject, at a certain crossroads of his biographical history, is confronted by this lack that has always existed.” [16] This constitutes the theoretical core of the doctrine of the triggering that Lacan rigorously defines in the “Post-scriptum” of “On a question preliminary to any possible treatment of psychosis,” when he states that the encounter with an “A-father”—that is with the encounter in the real with the symbolic leg the subject-stool has always lacked—is what determines the triggering of psychosis. [17]
The structural cause must then intersect with a contingent cause. This intersection decides what Lacan terms, in his “On a question…” (1958), “the conditions of triggering.” Likewise, we should isolate a third element that characterizes the onset of psychosis, namely, the dissolution of the identificatory compensation that so far had sustained the narcissistic form in the subject. In Seminar III, The Psychoses, Lacan emphasizes the fact that the subject, at the onset of the triggering, is summoned by the Other to answer in “the first person,” prendre la parole, [18] that is to subjectivize, without the help of his specular companion, his own position vis-à-vis the symbolic Other. Imaginary compensation is what so far has protected the subject from this impossibility to respond by means of “a multitude of imaginary beings,” which however is revealed as devoid of any symbolic consistency. [19] In other words, we are dealing with a proliferation or numbness of the ideal I that is shaped as a way of mending before the structural deficiency of the Ideal I. Hence Basaglia’s reading of mental anorexia as a “coenestophrenic psychopathy,” in the sense that the abnormal development of a concern for one’s own thin-body (“the subject’s slavery to her own somatic development”) is framed as a facade that offers the subject with a moulding of her personality ensuring, although abnormally, her existence. [20]
In a case of mine, the triggering of psychosis occurred when the specular identificatory relationship with the twin sister was interrupted when she enrolled in a different school. At that moment the Other (represented by the new school) intruded separating the imaginary couple and forcing the sisters into different statuses. The girl developed psychotic angst as a first response to the dissimilar enrollment that left her alone to answer, in the first person, the call of the Other.
Here, we can conceive of the function of the twin couple as a subjective modality of organizing an imaginary compensation for the failed inscription of the Name-of-the-Father, to the double inscription enforced by the Other as an event destabilizing the adhesive identification with the fellow man, and the encounter with the symbolic Other (the new school) as the contingent cause that leads the subject beyond the edge of psychosis.
5. The Psychotic Dimension of Anorexia-Bulimia
Serge Cottet distinguishes between a clinic of lack and a clinic of emptiness. [21] The former refers to the lack, desire and the divided subject and is concerned with the clinic of neuroses; the latter refers to jouissance and emptiness and is concerned with the clinic of psychoses.
There is a classic doctrine on anorexia where Lacan includes it, indeed he chooses it as the paradigm of the clinic of the lack. In this perspective, the anorexic maneuver appears as oriented towards preserving the locus of lack in the Other and, therefore, in the subject. The clinic of anorexia as a clinic of lack allows Lacan to highlight the following:
a). The anorexic desire as “desire of nothing” makes evident the truth of the structure when it reveals that what lies at the heart of human desire is not an object—desire is never desire for an object—but nothingness as object, nothingness manifesting the inadequacy of every imaginary object in regard to the structurally metonymic inclination of human desire.
b). Anorexia shows the irreducibility of the field of need to the field of desire, for if need is the need for something, desire is desire for nothing, for Other thing, it is desire for Other, and precisely for that reason it cannot be reduced to need. In this sense, the hunger strike of the anorexic tries to evince the transcendence of desire in relation to the need in front of an Other (family, society) that, on the contrary, tends to crush the former onto the latter.
c). Anorexia reveals a structural affinity with hysteria because in both rejection—of the body, of nourishment—becomes a defense or a manifestation of the subject’s desire. So that the anorexic is prepared, in order for desire to survive, to give up—hysterically—jouissance, to annihilate the satisfaction of need.
d). The anorexic demand as demand for nothing clarifies the deep nature of the demand of love as intransitive demand. The demand of love is not a demand for something, but the demand for the sign of the Other’s lack, not the demand for the breasts but of the sign of love, as Lacan precisely points out in his Seminar IV, La relation d’objet. In anorexia the demand for love appears in its purest statute inasmuch as it is not a demand for something the Other possesses (nourishment, etc.) but for something the Other lacks, whereas anorexia’s bulimic drift shows how the absence of the sign of love—the “disappointment of the demand of love” as Lacan notes—sets the subject in motion towards its real compensation through the object that precisely fills up the bulimic.
This brief summary of Lacan’s classic doctrine on anorexia avoids considering the dimension of anorexia as psychotic instead of neurotic. We will here introduce two critical observations in order to introduce the rapport between anorexia-bulimia and psychosis.
Firstly, according to the clinic of anorexia we should distinguish between the descent of desire as desire for the Other and desire as desire for nothing. If hysteria highlights desire as the Other’s desire—in the sense that the hysterical subject acts with its own lack in order to bring about the lack in the Other—, anorexia, in its psychotic dimension, emphasizes desire as desire for nothing or, as Lacan puts it, as “appetite for death.” [22] Here the subject does not work on the lack to probe its value in the Other’s desire, but rather “nothingifies”, if we may say so, the lack itself by reducing it to a localized emptiness, to the stomach’s emptiness. The anorexic rejection allows the survival not of desire as such, but of a kind of pseudo lack. “Pseudo” because it ends the relationship with the desire of the Other in order to be united with a radical thrust of auto-mortification. The by-product of the disconnection between lack and desire is a kind of reduction—of ossification—of lack itself to a reified emptiness, not vitalized by phallic signification, not signified, not metaphorical. An emptiness that could decline into nirvanization of the subject—anorexia —, or as compulsive avidity—bulimia.
We are dealing with a new statute of nothingness. We are not dealing—as in Lacan’s classical doctrine —with nothingness as the object tending to the opening of the Other’s desire, with nothingness as the separating object, but with another nothingness, nothingness as pure nothingization of the subject, of nothingness as annihilation, nirvanic de-vitalization of the subject. In this sense the Lacanian definition of anorexic desire as appetite for death ends in the abyss, in what Freud signaled as the disjunctive drive between Eros and Thanatos, as the pure expression of the death drive. In Lacanian terms, we could argue that this “other nothingness” is not related to the Other—as in the classical doctrine—but to the Thing.
This new classification of nothingness also constitutes the logical principle of the capitalist discourse articulated by Lacan in 1972. [23] In this discourse “everything is consumed,” on one hand the lack of the subject is constantly recycled and covered by the consumption of the object, and on the other hand the lack of the subject is endlessly kept alive by way of the continuous offering of new objects of consumption. So that the recycling of the lost object leads to a progressive absorption of the lack in the demand. The age of the capitalist discourse is our age, working as background and determining the apparition of new forms of the symptom that manifest the pathological drift of the accentuation of the convulsive and infinite character of the demand. Anorexia and bulimia aid in simplifying the incidence of the capitalist discourse in the dimension of the clinic. Anorexia and bulimia make evident the transformation of the subjective lack into a pseudo de-objectivized lack, into an anatomized emptiness: pure real emptiness unrelated to desire.
6. The Principle of Nirvana
By way of returning to this Freudian category I am trying to connote a psychotic functioning in the anorexic subject—or, if you like, the psychotic dimension of anorexia—by returning to this Freudian category, without this implying the effective presence of elementary phenomena.
To Freud the clinic of neurosis arises from the conflict between the pleasure principle and the principle of reality, between the drive’s demand and the limits enforced by the program of Civilization. In this sense the Freudian clinic of neurosis fundamentally entails the dimension of the internal conflict of the subject. In the “Formulations on the Two Principles of Mental Functioning” (1911), Freud structures the relationship between the pleasure principle and the principle of reality as a genuine metaphorical substitution where, as noted by Jacques-Alain Miller, the principle of reality supersedes the pleasure principle. This substitution could be related to structuralism where culture prevails upon nature. [24] The Lacanian notion of original symbolization implies that for the subject to be inscribed in the field of reality something of the pleasure principle should be repressed. This first substitution can then be formalized as follows:
But the substitution of the pleasure principle is not without residues. Actually, Freud discerns a survival of the pleasure principle even when it seems to yield to the principle of reality. The survival of the pleasure principle points to the subject’s attachment to the dimension of jouissance as a structural attachment. The principle of reality imposes itself on the pleasure principle, that is the subject’s tendency to secure its own drive satisfaction; but not without leaving a remainder.
This typically Freudian issue reappears in the Lacanian field through Jacques-Alain Miller: he reminds us that in Lacan it is precisely the negativization of jouissance through the Other that produces the objet a as a residue of this negativization, as the expression, following Freud, of what in the pleasure principle refuses to submit to the principle of reality.
We write it as follows:
PP1 indicates the persistence of a fragment of the pleasure principle that is not symbolized, not castrated by the normative action of the principle of reality.
These two central formalizations bring into focus the clinic of the neurosis as being directed by the conflict between the pleasure principle and the principle of reality, by the effects of the subjective division produced thereby, and by the existence of a residue of the pleasure principle (in Lacanian terms, the objet a), which strives to be left outside the principle of reality, and which adopts a rather conflicted opposition to the said principle.
Specifically, in Beyond the Pleasure Principle, Freud will define the Jenseits Lustprinzip as that which exceeds the limits of the pleasure principle—by means of which the subject pursues pleasure as the locus of hedonistic satisfaction —, as the segment of the pleasure principle that rebels against the demands of the principle of reality. If “the” beyond of the pleasure principle is what resists to the symbolization compelled by the principle of reality, then it is not properly beyond the pleasure principle, but is the indicator of that which, belonging to the pleasure principle, has successfully resisted the substitution of the principle of reality. In other words, it is the residue of the universal metaphorization impelled by the Other. It is the residue of jouissance that flows over (for Freud in the guise of libidinal fixation) from this side of the metaphorical operation.
If we now introduce the principle of Nirvana we will realize that we are exceeding the clinic of neurosis. What does the principle of Nirvana deal with? Freud considers Nirvana as a narcotizing of the pleasure principle. [25] It is not then a metaphorization—the principle of Nirvana does not substitute the pleasure principle—but the oblivion of the pleasure principle or as Freud observes, the narcotizing of it. How should we understand this effect of narcotizing?
We can take literally the recurring statement of the anorexic subject: “I need to narcotize myself, I don’t have to feel anything.” The statement by itself is insufficient to signal the presence of psychosis, yet it indicates some sort of organization of the subject’s libidinal economy. Narcotizing, nirvanization, nothingness. Freud himself, in The Economic Problem of Masochism, reclaims the term from Barbara Low and Schopenhauer who, in turn, inherited it from Hindustani traditions where Nirvana appears as a state of absolute quietness, the suspension of life’s restlessness. In this state passions are extinguished and the subject achieves illumination and immobility, that is to say fulfillment in this life of the pure jouissance of nothingness (nulla), vis-à-vis this jouissance all human categories of satisfaction are revealed as imaginary vanity. To Freud the ascetic suppression of every sort of jouissance is also a variety of jouissance, jouissance of privation (lack), masochistic, jouissance characterized by the disjunction between the death drive and the life drive.
Let’s consider now a well-known procedure in anorexic-bulimic subjects, namely the verification by way of the vomit that the mass of food ingested equals the mass of food evacuated. Here the subject must check that nothing has been modified, that the internal equilibrium of the body has not been affected since any discrepancy—even very small—could spark a catastrophe. The calculation of calories, the systematic and theoretical sub-division of food, the exertions of the purification of the body, in brief, the progressive elimination of everything able to introduce the contingent dimension of alterity, signal the radical rejection of the Other and the return in the real of the instance of the pleasure principle. Actually, if the pleasure principle is set on realizing a well-balanced satisfaction, capable of not altering the mechanism’s internal inertia, its narcotizing implies a kind of crazy extremism of this tendency toward homeostasis.
In other words, when the pleasure principle is not articulated in agreement with the principle of reality—according to the metaphorical law of substitution—but instead returns directly to the real, with no symbolic mediation, the pleasure principle narcotizes itself in the principle of Nirvana.
In the clinic of anorexia, the principle of Nirvana, by narcotizing the pleasure principle, gets control of the principle of reality and becomes the standard and working method of the subject. This results in an authentic life-style, every-day practices, delirious lucubrations, all of them engaged in preserving the subject in its nirvanic unity, in its purest sameness, in its impassibility, away from the principle of alterity constituted by the Other. Jacques-Alain Miller defined the position of the toxicomaniac subject —who, like the anorexic-bulimic, links jouissance to an inhuman partner—as darkened by a fundamental anti-love. [26] The making of the toxicomaniac entails his own constitution—a self-making—precluding the Other. In this sense, he is “anti-love”, since love implies the reverse of the toxicomania logic, that is the impossibility of “self-making” precluding the lack of the Other. The psychotic tendency of toxicomania—as that of anorexia-bulimia—is here revealed in full: the being of the subject does without the being of the Other. The being of the subject is rather in opposition, rejecting the being of the Other. Hence Lacan theorizes in his Seminar III on the condition of the psychotic subject as marked by a radical exclusion of the Other.
7. Body and Un-Triggered Psychoses
Certain severe cases of anorexia-bulimia seem to indicate a psychotic functioning in the subject without a genuine triggering off and its resulting elementary phenomena. The absence of language disorders should not be considered, as such, a conclusive element in the diagnosis of psychosis. The peculiar mode in which the subject structures its rapport with the Other and with jouissance may enable us to diagnose psychosis even without the explicit existence of language disorders. Likewise, a series of phenomena affecting the body may be used as references that indicate the psychotic condition of the subject. In particular, I would like to refer to five examples that have recurred in my experience with anorexic-bulimic subjects with a psychotic structure.
The first evidence refers to the presence in the subject of a dimension of real, not symbolic, mortification. It involves what could be classically defined—and here again we follow Freud—as the drive disjunction between Eros and Thanatos. It finds its clinical expression as a dis-eroticization and a dis-vitalization of the body. Yet, we are not confronted with a rejection of the body that could signal a hysterical modality as a way to relate to the body. The real mortification of the body—or, if we like, its nirvanic dis-vitalization—rather than emphasizing the separation between desire and jouissance or the masochist jouissance of privation, underscores a kind of total abolition of desire prompted by the ascendancy—hors-discours—of the death drive.
In the clinic of neurosis the body is the locus of the Other, in the sense that it is the signifying treatment of the body that empties it of jouissance, which mortifies it, but at the same time it compensates the emptying out with the eroticization of the body itself. This eroticization is especially condensed, Freud remarks, in the border areas of the body: the so-called erogenous zones. The incorporation of the signifier determines the emergence of the alteration of the body: in effect, from body-organism, biological body, it becomes a drive body, a body made up by the signifiers of the Other. When alluding to the clinic of the emptiness, we are on the contrary dealing with the fact that the incorporation of the signifier has not taken place and, consequently, the body is not “altered” but is preserved as a One closed against the Other; it does not incorporate the signifier, it rather “disincorporates” itself from the signifier. The rejection of the signifying mortification implies an inadequacy of the body eroticization, since the requisite of eroticization is the subtraction of jouissance and thereby the definition of the erogenous zones as zones where the lost jouissance had left a kind of active memory around which revolves the work of the drives. In the non-psychotic functioning of the body the signifying mortification is kept in a vital dialectics with its own eroticization. In Freudian terms, it is what accounts for the thesis of the drive union between Eros and Thanatos. In Lacan, Thanatos is configured as the lethal action of the signifier on the subject, whereas Eros is reviewed through the function of the fantasme as that which converts the subtraction into the recovery of the lost jouissance.
In the clinic of psychosis, on the contrary, there is disunion between Eros and Thanatos. Mortification and eroticization split apart. The signs of aggressiveness, of hetero, of self-destruction, the passages à l’acte, the annulment of the vitality of the body, so frequent in extreme forms of anorexia, show the functioning of the disunion between the death drive and the life drive.
The second example deals with a kind of transformation of the lack into a hole in the body that is perceived by the subject as real. It is not the sensation of a hole in the stomach, it is rather of having a hole in the body, or better said, the feeling of the orifices of the body—for instance the buccal cavity, the anus—as opened up holes, that are imposed on the subject as living vortices. Thus, a bulimic patient of mine, ate in order to fill a real hole in his body, which otherwise would devour him. In this case, the bulimic blowout does not respond to the transgression and the imaginary phallicization of the food object, it rather tends to be configured as a practice leading to keep shut the symbolic hole in the subject’s structure. The dimension of having to eat in order to refill the hole of the body that is perceived as real recurs in the psychotic forms of anorexia-bulimia. The subject seems to transform the symbolic hole of foreclosure into a hole of the body that is felt as such, as absolutely real, with no signification. This is a precise evidence of the non-localization of jouissance in the erogenous zones, since phallic signification does not organize symbolically the set of drive objects (oral, anal, vocal and scopic).
The third example refers to the anaclitic use of the image of the other, that is to the continuous existence in the history of the subject of identifying adherences, of “imaginary couples” that function as narcissistic props. The recurrence of these imaginary compensations indicates a type of response in the subject when confronted with the foreclosing absence of the symbolic leg of the Name-of-the-Father. The body of the subject is entirely regulated by the body of the specular other until it attains authentic mimetic representations of this other. These twin couples lack any sort of symbolic triangulation; the subject adheres integrally, not to a specific feature, to the other’s image, as a traced copy, a specular copy. The direct takeover of the other upon the body of the subject, the massive identification, whole, not localized, the identifying mimesis signals both the emptiness of being that inhabits the psychotic subject and its attempt of fill it with the anaclitic use of the other’s ideal image. In these cases, it is easy to detect the irruption of the triggering off that coincides with the undoing of the imaginary couple, with its disintegration.
The fourth example alludes to the existence of practices or exertions upon the body; their intent is to introduce in the real the function of castration, since castration has not been symbolically achieved. These practices are recurrent in psychotic subjects “un-triggered,” who make use of anorexia-bulimia as a way to reach castration. The anorexic deprivation introduces in the real—for instance, as in the principle of Nirvana—a de-vitalization of the body, which sets in motion, in its own way, a kind of actuated castration of excessive jouissance, of jouissance that has not been isolated from the body by the signifier. In the case of bulimia, on the contrary, castration takes on the reality of vomiting or the abuse of laxatives as exertions that—methodically—allow the subject to exteriorize a malignant jouissance embedded in the body. In toxicomania, there is also a technique that seems to confer on the psychotic subject some control over jouissance, which otherwise would return to the body unmediated. It is worth mentioning the peculiar use that a psychotic patient of mine made of the syringe before she became toxico-addicted and later bulimic. She subjected her body to periodic cycles of injections of physiological solutions—not the substance of drugs—in order to literally “pierce” her body. Her piercing did not entail the addition of supplementary jouissance, but emptying her body of excessive jouissance, although the emptying occurred through injections and not by means of the signifier.
Finally, the fifth example is related to the existence in the patient’s history of ceaseless uprooting, of sudden change of plans, of transformations, of roaming, of trouble in establishing stable social links. This indicator could also appear as constant metamorphosis of the image as such (a typical phenomenon in hysteria too). We are dealing here with estrangement, disconnection, and dissociation of the subject vis-à-vis its relation to the Other, [27] where the subject progressively severs its social link with the Other and finds itself completely isolated. In this sense, anorexia-bulimia rather than connoting a specific discourse, points to its failure as the modality that maintains a viable connection between jouissance and the signifier. In other words, it is a kind of non-symbolic metonymy that, by continuously displacing the subject, corrodes any hope of a symbolic rooting of the subject itself.
8. Treatment of the Symbolic Hole: Imaginary Compensation, Delirious Metaphor and Substitution
Lacan identified distinct and attainable forms of jouissance. Here, his perspective, as Jacques-Alain Miller signaled, is Aristotelian: there are multiple ways for the substance of jouissance to decline, as for Aristotle there exist multiple ways to talk about the unity of being. The locus of the subject is then specified as invested with the need to treat the real of jouissance. In fact, what engages the subject with its structure is the rapport with the real of jouissance, the encounter with its own being of jouissance.
Lacan’s structuralism made clear enough that the essential condition for the treatment of jouissance is language. To inhabit the house of language means to inhabit a house not as owners but as guests. Language stipulates the terms to the subject’s being of jouissance, but jouissance does not entirely honor the activity of language. In fact, the return of jouissance upon the subject indicates that there is a certain jouissance, which the very negativizing activity of language is unable to exhaustively symbolize. Hence, the issue with the different “secondary modes”—if we consider language as the primary one—of treating the return of jouissance that, as such, do not define the position of the psychotic subject but that of the human subject as a being inhabited by language.
However, at this stage, we are able to introduce a general distinction: actually, there is a subjective treatment of jouissance not invalidated by the universality of language, which has recourse to symbolic castration and, therefore, makes use of the Oedipus as an underlying symbolic device to treat the real of jouissance. This is the praxis of neurosis. On the other hand, there are plural modalities dealing with the return of non-symbolized jouissance, which do not resort to the Oedipus. The psychotic subject is the chief embodiment of this issue, namely that of unraveling the real return of jouissance—that is, a workable treatment of it—without having recourse to the standard treatment of Oedipus.
What is, then, the typical treatment of jouissance in neurosis? Freud and Lacan’s answer is: the symptom. Indeed, it is the symptom that, in neurosis, is configured as the subjective treatment of jouissance. To Freud, this symptomatic treatment of jouissance implies a paradox. On one hand, the symptom indicates the aspect of jouissance forbidden as such by the Law of Oedipus, whereas, on the other, it points to the unconscious fulfillment of the drive satisfaction. Here, we perceive at work the structuring function of symbolic castration: the symptom is a product of symbolic castration since, as “compromise formation” (one of Freud’s classical definition), it forbids jouissance, disallowing it just because it centers this same interdiction on the fulfillment of the prohibited satisfaction. We will refer, as a quick example, to the function of the erogenous zone. Actually, the erogenous zone is constructed around the function of symbolic castration: the loss of the object—oral, anal, etc. —is sanctioned with castration and the loss, the subtraction, structures the erogenous zone as a pond, a cavity, an empty dot, which becomes the focus that organizes the motion of the drive and with the purpose—as Lacan magisterially shows in Seminar IX—of not closing upon the object, but of to repeatedly bordering the cavity created by the loss. Also, the subtraction of the prohibited object of jouissance becomes the precondition to achieve a supplementary jouissance capable of compensating the original loss of the object.
If we now analyze the functioning of the psychotic subject, we immediately realize the drive disorganization of the erogenous zones. This disorganization is the evidence of a deep de-erotization of the body. Think about the case where the patient perceived his own mouth as a real hole that had to be filled unlimitedly. Here, the stress is not on the extent of unconscious satisfaction, clandestine, which instead characterizes neurotic jouissance as transgressive in relation to the Law of Oedipus. In this case, there is no transgression of the Law, since the erogenous zone has not been localized as such because there is not an effective subtraction of jouissance—that is, an externalization of the loss object as the outcome of the symbolic effect of castration and, therefore, what is forced upon the subject is the hole of the body as real, as a sucking vortex. In another patient, this degradation of the symbolic hole to a real hole occurred in the form of an anguished sensation in which the limits of the body expanded; an unsustainable anguish, panic, which was relieved only by taking refuge in a closet where she recuperated, in some way, a limit to this real expansion of jouissance.
The psychotic triggering signals—contrary to neurosis’ Oedipal solution—the subject’s impossibility to treat, no matter how, the real of jouissance. At the triggering—once the barrier of imaginary compensation has been smashed—no subjective action can, in fact, be opposed to the return of jouissance.
As an “alternative” to the devastating effect of the triggering we can single out at least three procedures, which the psychotic subject could carry through for a non-Oedipal treatment (that is, he cannot resort to symbolic castration) of jouissance. They are: imaginary compensation, delirious metaphor and substitution.
We have already covered imaginary compensation. We will only mention the fact that it appears as a mode of closure of psychosis organized as the knotting between the imaginary and the real without the assistance of symbolic mediation. In compensation, the subject curbs and holds back the real of jouissance unregulated by symbolic castration by way of a massive identification to the specular other. Yet, at the same time, the subject is exposed to the contingent risk of the negative encounter that—when detonating the reciprocal adhesiveness of the imaginary couple—could trigger off the psychotic decompensation as such.
Delirious metaphor deals with an imaginary production that may take on the symbolic function of a metaphor, that is, the task of localizing, setting up, checking the invasion of jouissance the subject may endure. Temporally, the delirious metaphor presupposes the triggering, since it configures the way the subject reconstructs, mends the reality fragmented by the psychotic crisis. The delirious metaphor is the subject’s attempt to give a new meaning back to the world, a meaning that accounts for the triggering. For this reason, delirium is configured as a true subjective effort addressed to re-structuring the subject’s reality and its rapport with the Other.
Doubtless, far more engrossing for our reasoning is the notion of substitution that, as such, does not imply the triggering of psychosis, since substitution is characterized as the subjective mode that precludes the triggering. To Lacan, this is what happened to Joyce. [28] The element relating imaginary compensation and substitution consists in the fact that both are modalities that prevent the triggering and both keep the subject on this side of the hole of psychosis. However, whereas the former is wholly organized from the imaginary register—actually, imaginary compensation is a specular identification—the latter, on the contrary, entails a signifying task. As to the temporality of the triggering off, substitution appears as a subjective time “outside the triggering.” In principle substitution is opposed to the triggering. It signals an operation of “signification” of jouissance that, despite this very fact, occurs without having recourse to the standard Oedipal solution.
From a logical perspective, substitution implies a substitution. Something takes the place of another thing. Thus, it resembles the metaphor since both share the act of substitution along with its effect, which is to stabilize the signifying chain that likewise secures an anchoring point in the metaphoric condensation. More specifically, Lacan’s teaching leads us to discern between a generalized substitution and a restricted substitution. If the former responds to the impossibility for the human being to succeed in the sexual rapport, that is, to make and be One with the Other, resulting in love as substitution of precisely the structural impossibility of sexual rapport, the latter—restricted substitution—refers to the substitution of an absent signifier because of foreclosure—the Name-of-the-Father. This signifier is needed for the set of signifiers to keep an order of its own. [29]
The restricted configuration of substitution is what particularly affects the field of un-triggered psychoses.
The symbolic nature of substitution is first revealed in the fact that the subject—as Lacan argues regarding Joyce—makes a proper name for itself through it. The reference to the proper name touches the very nucleus of substitution when it differs from compensation. If in the latter the subject is narcissistically hooked to the specular image of the other, in substitution the subject is not bound to the being of the other, but rather sets in motion a kind of individuation in that it is precisely substitution which individuates the subject, differentiating its identity (the ego, as the late Lacan would say) from that of the others.
Secondly, the symbolic nature of substitution implies the production of a body of work. Evidently, the model of this body of work is not Joyce’s Ulysses (the “high” model, the one Lacan preferred), but may fully be achieved through more prosaic deeds. What counts is that these activities objectivize the task of the subject aimed at patching the split made by the foreclosing absence of the Name-of-the-Father. It is true in this sense that the Joyce’s case is exemplary because with him the “making of a name” absolutely coincides with the product, that is, with Joyce’s own body of work.
As for a clinical precedent of substitution that differs from Joyce’s “high” model, there is patient of mine—a psychotic young woman—who “under transference,” that is, during analytical treatment, set up a substitution organized around her subjective aptitude for painting, consisting in copying the work of the “great masters of contemporary art.” Becoming a “copyist” of the great masters allowed the subject to progressively attain an effective stabilization of her psychosis. The stabilization was not substantiated as in the past by an imaginary compensation, but by the utilization of the imaginary register—to make the copy—of the symbolic kind—to inscribe the Name-of-the-Father—that enabled the subject to forge a “proper name” for herself, socially accepted as being a “copyist.”
Notes
[1] Federn, Paul, Ego Psychology and the Psychoses, New York: Basic Books, 1961.
[2] ibid
[3] ibid
[4] ibid
[5] On the empirical attributes that a compensated psychosis under transference could assume, Federn wisely remarks “the acceptance and intuitive translation of symbols and comprehension of the own primary processes without resistance, immediate removal, even suddenly, of deep neurotic symptoms”.
[6] Miller, Jacques-Alain, “Della natura dei sembianti,” in La Psicoanalisi 13, Roma: Astrolabio, 1994, pp. 200-2.
[7] Lacan, Jacques, The Seminar of Jacques Lacan: Book III, The Psychoses, 1955-1956, New York: W.W. Norton, 1993.
[8] ibid, p. 203
[9] ibid, p. 196
[10] ibid, p. 202
[11] ibid, p. 205
[12] ibid, p. 205
[13] Winnicott, D.W., “La distorzione dell’io in rapporto al vero e falso Sé” and “Classificazione: esiste un contributo psicoanalitico alla classificazione psichiatrica?”, in Sviluppo affettivo e ambiente, Roma: Armando, 1970.
[14] Deutsch, Helene, “Some Forms of Emotional Disturbance and their Relationship to Schizophrenia,” in The Psychoanalytic Quarterly 11, 1942.
[15] Lacan, J., “On a question preliminary to any possible treatment of psychosis,” in Écrits: A Selection, New York: W.W. Norton, 1977, p. 217.
[16] Lacan, J., The Seminar of Jacques Lacan: Book III, The Psychoses, 1955-1956, New York: W.W. Norton, 1993, p. 203.
[17] “But how can the Name-of-the-Father be called by the subject to the only place in which it could have reached him and in which it has never been? Simply by a real father, not necessarily by the subject’s own father, but by an A-father. Again, this A-father must attain the place to which the subject was unable to call him before. It is enough that this A-father should be situated in a third position in some relation based on the imaginary dyad o-o’, that is to say, ego-object or reality-ideal, that interests the subject in the field of eroticized aggression that it induces.” Lacan, J., “On a question preliminary to any possible treatment of psychosis,” in Écrits: A Selection, New York: W.W. Norton, 1977.
[18] Lacan, J., The Seminar of Jacques Lacan: Book III, The Psychoses, 1955-1956, New York: W.W. Norton, 1993.
[19] ibid
[20] Basaglia, F., L’anoressia mentale è una nevrosi o una psicopatia?, Trieste, 1972.
[21] Cottet, Serge, “Gai Savoir et triste vérité,” in La Cause freudienne 35, 1997.
[22] Lacan, J., “Les complexes familiaux dans la formation de l’individu”, in Autres Écrits, Paris: Seuil, 2001.
[23]Lacan, J., “Del discorso psicoanalitico,” Milano, 05/12/1972, in Lacan in Italia, Milano: La Salamandra, 1978.
[24] Miller, J.-A., “Cause et consentement”, 05/05/1988, unpublished.
[25] Freud, Sigmund, The Economic Problem of Masochism, S.E. XIX, London: The Hogarth Press, 1986.
[26] Miller, J.-A. and Laurent, Eric, “L’Autre qui n’existe pas et ses comités d’action,” 11/20/1998.
[27] On the concept of disconnection or “dis-anchoring” (débrancher), see IRMA, La Conversazione di Arcachon. Casi rari: gli inclassificabilli nella clinica, Roma: Astrolabio, 1999.
[28] On Joyce’s case and its significance in the late Lacan, see A. Villa, “Il caso Joyce: osservazioni sul síntomo col ‘th,’” in Studi di psicoanalisi – Annali della Sezione Clinica di Milano, 1, Milano: La Vita Felice, 1999.
[29] Substitution is thus exerted upon the signifier of the Name-of-the-Father as the Other of the Other, that is, as the specific signifier that supports the set of signifiers. Lacan’s later teaching—when he stresses the inexistence of the Other of the Other, radicalizing the concept of structure, that is, emphasizing the fact that the structure itself is holed, that there is a structural hole inserted in the symbolic order as such—inevitably expands the notion of substitution beyond the scope of psychosis. Rather, substitution is acquires an universal value, since every human being is confronted with this non-symbolized real, with the impossibility of the existence of an unifying nucleus of the symbolic order.
translated by Jorge Jauregui