Lacanian Treatment - Psychoanalysis for Clinicians. first three chapters of a manuscript by Yehuda Israely

Lacanian Treatment - Psychoanalysis for Clinicians

first three chapters of a manuscript by Yehuda Israely, Ph.D.

Clinical Psychologist - Psychoanalyst

This part of the manuscript includes the back cover, table of content, introduction and two chapters (2 and 7). It is approximately 12,700 words in length. The full manuscript includes a preface and five more chapters that appear in the table of content and is s about 40,000 words long. The original book was published in Hebrew by Resling Publishers in Israel (2014). All non-Hebrew rights are reserved to the author. Translated to English by Mirjam Hadar.

Back cover

Secret wishes, forbidden pleasures and painful memories hide below consciousness’ false bottom. How do we decipher the desire and pleasure located between the words spoken in psychotherapeutic treatment, how can we identify and interpret them? This book, following the author’s previous work which focused mainly on Lacanian theory, is dedicated to the practice of psychological treatment. Given its general clarity, the book can also be useful to those who are not deeply versed in Lacanian thinking. 

How does one interpret symptoms, dreams and other expressions of the unconscious? What is transference, and how is it put to work in treatment? How do we work with anxiety, depression, suicidal tendencies and other types of distress?  What is the Lacanian approach to these things? How does diagnosis relate to how we orient the treatment? And, finally, what is the secret of termination of the treatment, which happens to coincide with the analyst’s training process? Though this book primarily addresses therapists (and not necessarily psychoanalysts), patients, as well, will recognize themselves, and find something of use, in these pages.

Dr Yehuda Israely is a clinical psychologist and psychoanalyst. He teaches at the “Tel Aviv Forum of the Lacanian Field”; is a member of the “School of Psychoanalysis of the Forums of the Lacanian Field” (EPFCL), and has a private clinic in Tel Aviv. Previous books: Hafilosofia vehapsichoanaliza shel Jacques Lacan [Jacques Lacan’s Philosophy and Psychoanalysis] (Modan, 2007); his book Mesopotamia – shtikat hakokhavim [Mesopotamia, the silence of the stars] (Am Oved, 2010), written in collaboration with Dor Raveh, was awarded the 2011 Geffen Prize. 

Contents

Acknowledgements

Preface

Introduction

1.     Ethical Foundations

2.     The Clinic as a Symbolic Space

3.     Transference

4.     Symptom

5.     Trauma, Anguish and Depression

6.     Clinical Structures as Subject Positions

7.     The End of Treatment

Introduction

Psychoanalytic knowledge, traditionally, is considered the psychoanalyst’s domain in his individual work with patients. But this knowledge is also valuable to practitionairs who are not necessarily psychoanalysts. This book offers a framework for thought and action drawing on the theory of Jacques Lacan, which may serve all those treating the psyche (whether they are psychotherapists, couple therapists, art therapists, or youth workers in a psychiatric unit). The Lacanian perspective restores attention to certain Freudian insights neglected by other schools of thought, while also proposing adjustments and innovations to some Freudian ideas. 

Lacanian treatment is first and foremost a craft of working with words. It was Freud who said that the very aim of psychoanalysis is to use words in solving problems caused by words. These are the words forming the cultural environment that have shaped the patient. In becoming interconnected they determine meanings and forms of pleasure that eventually come to structure his identity. Lacanian thought perceives the patient’s identity as a symbolic texture of words. The more fully the therapist subscribes to the notion that reality is a function of meanings and of words – that is, reality is symbolical rather than actual or natural, as positivist philosophy would have it, or as the patient will tend to believe at the early stages of therapy – the more will words work in the service of the treatment as the patient makes changes to his life.[1]

In the Lacanian perspective, a central component of the analyst’s training is the analysis he himself has undergone.  Interpretations heard as an analysand are assumed to have changed the meanings of words engraved on his psyche, thus changing the modes of desire and pleasure associated with these words.  Such exposure to the power of words spoken in early childhood and to the power of words spoken as part of interpretations in treatment is a precondition for the work with words he is to do as a therapist.

The treatment’s objectives and outcomes – reflected in the subject’s ability to take an analytic position – are situated in the ethical domain. Ethics addresses questions concerning the nature of the proper action and values to be pursued. A precondition to dealing with such issues is one’s formulation of the nature of reality. This is why the first chapter of this book discusses Lacanian psychoanalysis’ fundamental assumptions regarding reality, and the status of language in this reality, as well as the ethical values entailed by these philosophical assumptions. Lacan’s most basic assumption regarding reality is that reality is an assumption. The riddle which the psychoanalyst tries to solve is how the patient constructs his reality by way of an assumption that is both outcome of his symptom and validated by it. More simply put: What is the story which a person inhabits so as to maintain his desire and how does the symptom validate this story as a reality?

The clinical perspective deriving from Lacanian ethics considers pathology in terms of desire. If the philosophical premise is that reality is a symbolic construction, with the ethical implication that one must take responsibility for creating one’s reality, then the consequent clinical perspective examines psychical distress as a function of the desire (successful or not) behind the structuring of reality. Depression, for instance, can then be viewed as a condition marked by no desire and anxiety - in Lacanian terms anguish - as a condition of either unclear or repressed desire. Symptoms are unconscious representational modes of desire. In Lacanian ethics, the therapist again and again enquires into desire: Do you live according to the desire that inhabits you?[2] This is not an ethics that envisions normalcy, adaptation, choosing the golden mean, socialization, achievement or living up to others’ expectations. Nor does it seek serenity, ascesis or religiosity of any kind. Since there is no complete ‘free choice’ as any choice is subject to unconscious conditions, emphasis here, rather than on a person’s desire, is on the  –  often unconscious - desire within him, the desire that owns him. The objective of treatment is to elicit the patient’s internal agency of unconscious choice and to help him identify with it, enabling him eventually to say: “In view of the actions that flow from the unconscious – this is my will!” This agency is one of the meanings of the Lacanian notion of the subject of the unconscious.

This is why the psychoanalyst is alert to any signs of unconscious wishes in the patient’s speech. When the latter tells him he is late because he had a hard time leaving his computer game, the psychoanalyst will relate to his late coming as an expression of desire arising during play. Rather than conscious statements of the type “I wanted to arrive in time”, a person’s will is expressed in those parts of his speech were desire appears without conscious intention: “I had a hard time leaving the computer”.[3] While desire was embodied in the acting out of the late arrival, it was interpreted and formulated only in terms of the conversation about the reasons for this lateness.

The patient’s subject of the unconscious is extracted and identified too, moreover, by means of the role construction in the clinic. In the reality of the clinic, the psychoanalyst positions himself as object – wanted, loved, and object of the patient’s transference relations – with the aim to prompt the patient to take a subject position – loving, and with a will that takes possession of the therapeutic space.

This however should not lead us to ignore the fact that the psychoanalyst, too, is a desiring subject, and that this desire is inseparable from his ethical position and his analytic work. Hence the chapter dedicated to ethics also deals with the desire of the psychoanalyst. What desires however should inform and direct the psychoanalyst in his encounter with the patient? What desire can the psychoanalyst entertain if he occupies the object position in the relationship?  If treatment aims to draw out the subject and understand it, then how is the psychoanalyst, having undergone analysis himself, to position himself as object? This is a paradoxical desire: it is easier to determine what it isn’t than what it is. Society’s normative values, for instance, are not fundamentally the psychoanalyst’s desire.[4] Even the search for factual truth, which motivated Freud, doesn’t stimulate the psychoanalyst’s desire according to Lacan. The analytic object of desire is the use of the symbolic dimension, the medium of speech in treatment, for the sake of producing effects in the Real, that is, so as to achieve actual change in the patient’s modes of desire and jouissance.  This is a desire that recalls the poet’s wish to arouse feelings and effect changes in the world by means of words. It is a very specific and paradoxical desire to embody the object of desire. Functioning as object, the psychoanalyst stirs the patient to become subject and express his desires.

Chapter two looks at how the various elements of the ritual-symbolic space - including time, money, furniture, the handshake - are managed to support the treatment. Reference is made to the following questions: How does one set the first appointment? What’s especially important in the first meetings? How does one conduct oneself in the role of the one who is assumed to know, the one asked: “Tell me, what’s my problem?” How does one accept being abused, or admired and loved, without identifying with these roles? Other questions discussed are: What’s the point of free association in the treatment? How can one prompt it? And once the associations come, how to make sure they keep coming? How does one listen? To what? How does one ask questions? And how does one interpret?  What to do with a patient’s slips of the tongue? And what about one’s own? Is every mistake a Freudian mistake? Why use a couch? How to make the transition from chair to couch?  In Lacanian psychoanalysis it is the analyst who determines the length of each session through an act called cutting the session. Why should a session be cut? And how is this achieved? What are the theoretical objections to cutting sessions?

In addition, chapter two also deals with the psychoanalyst’s starting position. He does not expect the patient to copy him or identify with him, and he should take an ironical stance regarding his own prejudice (in other words: not to identify with his own preconceptions). He must moreover opt for an unjudgemental attitude where it concerns his patient’s impulses: he should not be shocked or put off by the things he hears. This is a position he can take, among other things, as a result of his own psychoanalysis where he has come to recognize all these impulses also inside himself.  Such a position of human solidarity, on the basis of recognizing one's own drives, is one of the key reasons why psychoanalysis is a crucial part of analytic training.

Chapter three deals with the transference. What is transference? How is it managed? What does the psychoanalyst do with the patient’s demands? What is one to do when the transference is positive? And what to do when the transference is negative? The basic assumption is that the engine of the transference, and the treatment, is the psychoanalyst’s showing the patient his desire as something for which the latter is responsible.

Further questions discussed in this chapter are: How to apply the theoretical principle according to which the psychoanalyst serves as object, or more specifically, as what Lacan called "the object that serves as the reason for desire"? How is the treatment to be conducted in such a manner that the psychoanalyst acts as a moving force driving the patient to act in his life? How to deal with the patient’s resistance to letting go of jouissance and to knowing his desire (i.e., the removal of repression)?[5] How is one to forge the transition from perceiving the subject’s symptoms as an outcome of his history (i.e., a biographical approach) to seeing them as a style enabling jouissance and desire (i.e., a structural approach)?

Chapter four approaches the question of the nature of the symptom, and of the difference between psychic and medical symptom. If for Descartes, existence was predicated on thought (“I think therefore I am”), for Lacan, it is predicated on desire (“I desire therefore I am”).  According to this view, the symptom is the subject’s unconscious way of maintaining desire, that is, to exist as a subject. Does this mean that “I suffer therefore I am”? Not quite. The suffering which Freud called “neurotic” originates in alienation from the symptom, as though it wasn’t part of the subject.  If however the subject identifies with his desire, which is maintained by the symptom, then his suffering from the symptom will decrease significantly. In treatment, some of the symptoms will cease, while the patient will identify with others. The chapter also discusses the role in psychoanalysis of the analytic symptom (a symptom perceived as being caused by the treatment or appearing in the course of the treatment, though it wasn’t what the patient complained of initially). Also discussed is the nature of the relations between symptom – as said, a way to exist as a desiring subject – and phantasm, which is a way to obtain pleasure.

Chapter five addresses common problems in psychoanalytic treatment, first of all anguish, a widespread psychic phenomenon for which Lacanian theory offers a unique clinical approach. Here the questions discussed are: How is one to extract desire and jouissance from the anguish in which they are enfolded, thus to reduce the attendant distress? How does one work with depression; with suicidal tendencies; with trauma? How to work with the unconscious materials arising from dreams or nightmares? How can one make sense of impulsive behaviors, and are they a message that needs deciphering?

Chapter six deals with diagnosis in relation to three clinical structures: psychosis, perversion, and neurosis – the latter of which is divided into an obsessive structure and a hysterical structure. Questions discussed are: How does each of these structures relate to the Oedipal complex? How do these structures serve as a strategy of desire for the subject? How does the psychoanalyst specifically attune his work and his presence to these diverse structures? How to conduct an effective diagnosis on the basis of the patient's attitude to issues like time, space, transference, the law, desire, and jouissance?

The final chapter, chapter seven, is dedicated to termination of the treatment. It proposes a distinction between psychoanalytically based psychotherapy and psychoanalysis. While the former’s main objective is the reduction of mental suffering, coming to an end when symptoms pass, the latter also offers an investigation of the unconscious, the impulses, the relations between history and personality – an investigation crucial to the psychoanalyst’s training.  Since psychoanalysis is not only a treatment method but also a training method for the psychoanalyst, the final chapter is simultaneously an introduction to the first chapter, which dealt with the psychoanalyst’s position. The question that marks termination of the analysis is: “Have you lived the desire that inhabits you?”

This book, unless otherwise stated, refers to work with neurotic patients. It deals only sporadically with work with psychotic patients, and even less with Lacan’s late thinking, which touches on work with Real jouissance,  beyond language, and which refers to Oedipus and the clinical structures as a Freudian myth that can be transcended.  These topics lend themselves less easily to discussion, certainly not for readers who are not very familiar with the basics, with Freud’s writings and with Lacan’s early writings. I hope this book casts light on questions concerning psychoanalytic practice; stirs readers’ desire to study psychoanalysis and makes its contribution to the conservation of the corpus of psychoanalytic knowledge.

Chapter II

The Clinic as a Symbolic Space

 The analytic space is a kind of theater composed of symbols. The more defined and consistent the set, the more unlike other spaces in his life, the easier it will be for the patient to get immersed in the treatment, to familiarize himself with its ‘local culture’ and move into free associations which, in their turn, are part of the symbolic-ritual process of analytical psychotherapy. Time, money, the way the clinic is furnished, the therapist’s typical intonation, contracts and agreements (regarding cancellations, for instance), how the patient enters the clinic, how they shake hands, how he moves toward the couch – these are what make up this process. So powerful is the reality of this symbolic domain that a patient may fail to recognize his therapist outside the symbolic domain of the clinic.

The therapist uses the symbolic setting of the clinic in order to advance healing according to the theoretical principles that guide him. These principles manifest themselves in each and every response to a phone call, to every practical reference to time, money, cancellations, late arrivals, referrals, gifts and the other pieces of the symbolic puzzle that constitutes the clinic. Obviously therapists may share theoretical principles yet reach totally different practical conclusions. And so the practical issues discussed in this chapter are only meaningful in the context of the theoretical insight that underlies them, and they should therefore be regarded as nothing more than illustrations of a praxis that is based on a theory. 

The First Telephone Conversation, Payment, Cancellations and Late Arrivals, Making Notes and Eye Contact

The first telephone conversation:

Usually the first contact between patient and therapist is via the telephone. It is a good idea to already use this opportunity to establish the patient as a desiring subject, by for instance asking questions like: “When would you like to meet?” and “Why do you seek treatment?” In this conversation moreover, the patient is likely to ask how much a session will cost. One may respond that payment is something that can be discussed on meeting as it depends, among other things, on the patient’s means.

Payment:

Money plays a critical symbolic role because payment is a constant reminder that the therapist is neither parent nor friend. If the patient brings into the therapeutic relationship social, romantic or familial expectations, it may be better to require payment after each session.  Formalists expect all their patients to pay at the end of each session. This also prevents compulsive patients from running up bills in order then to position themselves as compulsive debtors (and the therapist as a claimant), and keeps hysterical patients from positioning themselves as badly done by. (It is of course worth not to miss the opportunity to interpret the patient’s unconscious desire to be wanted or demanded, or to be loved and special, depending on what stage in the transference relations the therapy has reached.)

Questions of payment are part of the therapist’s freedom. So as not to fall victim to his own neuroses, it is advisable for the therapist to be free of concerns regarding payment and senses of exploitation or bitterness regarding the patient. It is moreover best for the therapist to be free to speak or to be silent as he wishes, or to terminate a session as he sees fit (this is elaborated below). The less preoccupied the therapist is by issues concerning payment or time management the better able will he be to abandon his position as subject, who experiences lack and desire, in order to surrender this place to the patient.

Cancellations and late arrivals:

Cancellations and changes in appointment times are crucially significant in therapy, both by offering material for interpretation and in so far as they affect the analytic space – which must be protected for the sake of the therapist’s freedom and the patient’s commitment. The common rule is that cancellations or changes in times must be announced at least 24 hours ahead, otherwise the patient will be charged. If a patient time and again cancels 25 hours in advance, the rule might be changed and the patient could be charged for a meeting as soon as he makes the appointment. Interpretation, here too, is advisable (and in accordance with other relevant indications relating to the treatment: “You want to figure out to what extent people are ready to put up with you and to accept the damage you cause”; “You want to be given a clear boundary to protect you against your own impulses”). 

In case of a misunderstanding about the time of the meeting, there’s no fundamental reason not to be lenient, once or twice, on the assumption that if this is not a matter of a symptom then it will surely not happen again. But where there are repeated cancellations or late arrivals, the therapist’s leniency will cause the symptom to worsen. Recurrent cancellations can be used to convey an ethical message about the difference between guilt and responsibility. If a patient expresses guilt toward the therapist for having cancelled a meeting, one may suggest he pay for the missed meeting in order to put an end to the guilt of which he complains. If a patient expresses reluctance to pay for a meeting one may interpret: “You rather pay me with the pain of guilt than with money?”; “Is guilt really cheaper?”; “Do you tend generally to stress guilt rather than taking responsibility for reparation?”; “By paying me in suffering, you seem to assume that people enjoy your suffering as if it was a sort of alternative payment – do you think of one who asks for money as a sadist?” and so on.

Late arrivals, too, may be significant, though not with a fit-for-all meaning. If a generic interpretation, nevertheless, is made, it tells more about the therapist’s symptom (interpreting every late coming as disrespectful, for instance, may disclose the therapist’s symptomatic positioning of himself as one who tends to be taken lightly). Lateness may be taken to express aggressiveness; avoiding a sense of emptiness or avoiding having to spend time in the waiting room because it is experienced as a humiliation; a request for signs of caring, or a challenge of the clock which represents death; lateness may also say something about the jouissance of the symptom (I couldn’t give up on just one more game on the computer”; “I drive like a madman when I’m late”). There’s an infinity of possible interpretations, and it is therefore important each time anew to check. A patient, for instance, who spent time in jail, is late in getting to the bus stop on his way to work, every morning; he then chases the bus and sometimes misses it. When asked how he felt when he caught the bus in time, he replied: “I was glad I managed to catch the bus, that I didn’t throw away another working day.” Here the interpretation may well be that he takes risks in order to feel that he ‘manages’ – given his sense of having missed out on things while being in jail.  Late arrival may thus be regarded as a form of acting out which deserves to be interpreted, both so it does not grow worse and in order to release the desire and the jouissance which it helps to maintain. As a rule, if the interpretation does not affect the lateness, it’s best to look for other meanings.

Making notes:

If the therapist makes notes in the course of the face-to-face session the patient may feel that he is not being heard. This then is likely to draw him out of the subject position, while it is the main objective of the treatment for him to take that position. If the patient lies on the couch, however, the therapist should write down what he says, not by way of recording but in order to read the patient’s speech as though it were a text, even as he is speaking. This reading of the patient’s words as text is one of the key ways of relating to the subject of the unconscious, the hypothetical entity behind his unconscious motives. It is more natural to hear things in terms of conscious conventions when listening to speech. Manifesting themselves in the patient’s tone and his conscious emphases, his conscious intentions will interfere with the therapist’s ability to read the text itself. Reading affords a better way into the unconscious connections in the patient’s speech. Much like there is a difference between listening to a poet reading from his writings and reading the same poems oneself, listening-reading in relation to the patient’s text without attending to his voice and persona exposes meanings of which the speaker himself was unaware. This type of listening-reading does not replace Freud’s notion of evenly hovering attention. “Reading” too must hover and not look for anything specific in such a way that connections will reveal themselves.

To illustrate, a patient who tends to be rejected by men mentioned going to the supermarket. The man she admires and is interested in said that "a super woman is almost a man". Bringing together these two statements serves as a basis for the interpretation: “A super-man will give you market value".

It is easier, moreover, to identify combinations of letters, motifs, or recurrent expressions when reading as the ear is used to ignore them. If a patient, for instance, frequently repeats “I don’t have” in diverse forms (“I don’t have money today”, “I don’t have anything to say”) it will be easier to pick up on the link between these statements and to ask: “What is it that you don’t have?”, while the question in the background is: “What desire can spring from the lack that is present in the statement ‘I don’t have’?”

There is a fundamental difference between relating to the patient’s text and to his body language, tics, changes in dress or hairstyle, which tends to position the patient as object and therefore is best avoided (even where the patient will be disappointed because we have failed to refer to his weight loss, for instance). Attention to words, by contrast, constitutes the patient as subject by remarking on the interconnections occurring in his text. Thus when the same word appeared in an ostensibly different context, pointing out this context is tantamount to pointing out the unconscious in action – or rather: the subject of the unconscious (the unconscious function of choice). As a result, the patient identifies less with the socially recognized figure and more with this mysterious unconscious factor that guides his choices, directs the text, and makes the connections between his words that emerged through interpretation.

First Sessions

No initial interview is held in Lacanian treatment, nor is there any structured examination of the patient’s mental status. Instead the patient is allowed to freely say what he wants, with minimum interference, right from the first meeting. A general prompt can be something like this question: “What brings you here?”; “What hurts?”; “What is it you want?”; “How can I help?” and information (about the patient’s childhood, earlier therapies, etc.) can be gathered as the free speech goes on. Still, the first session has some typical specific functions. It is recommended that the patient articulate a complaint or wish that made him come for treatment. Statements like “It’s mandatory if you want to study psychology”, or “My wife told me to come,” do not convey the patient’s wish. “I don’t want to lose my wife,” by contrast, does. The first session also offers an experience of analytic work, among other things because it proposes a different perspective for thinking about things, even if it concerns only a minor issue. Such a fresh perspective helps in establishing the transference. The first meeting is generally too soon to point out his own responsibility for his anguish to the patient: since he doesn’t yet understand the actions of the unconscious he cannot distinguish between guilt and responsibility. Still, a different angle on the facts can give hope for change.

How does one invite free association? Since repression exercises its censorship, unpaved roads have to be taken and hence it is important to tell the patient to say anything that comes to mind, without criticism and without filtering. There is an advantage, moreover, to letting the session evolve without any prior agenda: it leaves space for surprise, for breaching obstacles and for bypassing repression. If it is the patient’s task to say anything that comes to mind at a given moment, it is the therapist’s role to collect expressions of the unconscious: errors, slips of the tongue, recurrent motifs, jokes or parallels, and by means of them to point out unconscious desires. The relations between conscious and unconscious resemble those of a game of odds-and-evens between an adult and a child. Again and again the adult wins because he understands the child’s pattern. When the child understands that the adult reads his thoughts and anticipates his choices he can do nothing to reverse the situation because the adult will also know about that. The unconscious can be compared to an adult who sees the whole picture, and the conscious, here, can be likened to a child. The child may win at least part of the time if he doesn’t try to think and makes his choices by throwing a coin. In that case the adult won’t be able to predict the child’s actions. Speech in conditions of free association is like throwing a coin: it opens a possibility for new interpretation by skirting unconscious censorship.

Ego and Imaginary Identification in the Early Stages of Treatment

In the early stages of treatment, in the work with neurotic patients as well, room must be given to the ego by means of the therapist’s willingness to be the object of admiration or idealization, to be attributed magical, omnipotent knowledge – knowledge, in other words, that exceeds the professional (“You probably know what this dream means”; “I’m sure you know what I’m going to say”). This attribution of knowledge plays an important role in creating the foundations of the transference relations. The therapist, of course, should take care not to assume that he actually is in possession of such knowledge, that is, to fall into the trap of imaginary identification with his own ego.

As mentioned in the previous chapter, Lacan invented a myth describing the emergence of the ego, which he called the “mirror stage”. The young child who looks into the mirror erroneously concludes that he and his image are one and the same thing. He wants to believe this because this identity allows him to perceive himself as a clear-cut, integrated figure with an outline that covers up for his fragmentary experience. Turning to his parents, who are a great Other, representatives of the symbolic order, with the question “Is that me?” they answer him by supporting his imaginary identity: “Yes, that’s you!”[6]  One can recognize a repetition of the mirror stage in the idealizing relations with the therapist. The patient assumes that the therapist sees him as an integral figure and has the ability to define him and tell him who he is (at times, this appears as an explicit request: “Tell me if I’m normal!”). This assumption maintains the patient as an ego in the therapist’s perception. The ego grows weaker in the course of the treatment and its place is taken by the subject. While the former evolves on the basis of the body’s image in the mirror, the latter is a product of language. The subject is the unconsciously desiring one who is revealed through the desire made manifest by his words or actions.  This is why the subject is considered the agent of Freudian slips, exactly what shatters the ego-figure’s unity.

Ambiguity, as said, assists in this transition from belief in the ego’s unity to the emergence of the subject. From the perspective of the ego, ambiguity appears as ignorance or imperfection because it contradicts the myth of unity, of one meaning. As the treatment progresses it becomes clear that there is no correct meaning, that lack of clarity is inherent and that from the plurality of clashing meanings follows the emergence of the subject who will decide between them by taking a position (or the subject of the unconscious who exists given the fact that the position was already taken in the unconscious).

Analytic Listening and Encouraging Speech and Desire

Freud introduced the notion of “evenly suspended attention” or “hovering attention", which refers to the therapist refraining from attending to any specific meaning in the patient’s words.[7] Such listening acts like a net, ready to capture something when it comes but without knowing what. The therapist attends in order to be surprised. Even if his net doesn’t catch anything through an entire meeting, it’s important the therapist doesn’t force himself to speak. Quiet listening without intervention is extremely valuable. Moments of silence may occur which will be broken by the patient saying something he didn’t dare to say until then. This is why it is sometimes necessary to maintain a position of non-response to the patient’s expectations for dialogue and his demand to be released from his anguish for the sake of the treatment’s progress. Anguish is the price to be paid if one wishes to open the unconscious and overcome repressions.

In addition to the above, the therapist’s attention is fuelled by two key objectives: desire and jouissance. These are embodied in, among other things, the classic ‘suspects’ of the therapist’s listening: Freudian slips or parapraxes, failures in action, relationships that display unconscious oedipal relations, as well as repetitions in form or subject matter. Desire takes many shapes, from casual mentions of appetite to various modes of feeling, demand, expectation and deprivation. Jouissance, excitement beyond pleasure, has different manifestations too, including pain, shock and aversion.

In everyday listening our point of departure is that we are understood and that we in turn understand our interlocutors. In analytic psychotherapy we start with the opposite assumption. When the patient tells us about an experience that seems familiar to us we must not take it for granted that we understand either its causes or its nature. A woman patient of over eighty, for instance, before undergoing surgery talked about her fear of dying. In conversation an unexpected reason for her fear emerged: there was a secret she worried she was going to have to carry into her grave. The criterion for irregularities in a patient’s text that are worth consideration is not normalcy as the therapist thinks of it, but the text’s internal consistency. If the patient talks about someone angrily and the next time with guilt, it’s fitting to give pause.  The point here is not to urge the patient to make up his mind or to expose his lie but to face him with the contradiction in order to consider its nature. He may feel guilty, for instance, at the very fact of being angry for having to fulfill some unfeasible, nearly self-sacrificing ideal of kind heartedness. In the end, then, reflection on the contradiction evolves into reflection on the patient’s belief in any kind of ideal of which he isn’t really sure what he thinks.

Another form of inconsistency is when the narrative flow of the patient’s account is broken. Dropped parts may point at repression, as do statements of the kind: “No matter, that’s of no consequence”, whether they occur in the context of missing details or in relation to something the patient himself said. Another way of distancing what is being said which might point in the direction of repression is when a person changes either his accent or his language in mid-speech.

Another form of Lacanian listening is by privileging signifier over signified – a preference for surface listening over deep listening. The assumption is that the repressed rather than being buried somewhere deep down is there for all to see. But when it appears in a different context, in a different semantic context, one might very easily fail to see it. It’s like when a librarian is trying to hide a book in the library by hiding its filing card while the book is simply on the shelf. A patient told me her car was towed away from a spot at which there was a clear sign announcing that cars would be towed away.  She said: “I have no luck" (mazal is the Hebrew word she used, which means luck).” Thinking through the prism of ‘deep meaning’ one might have concluded she was irresponsible, or that this was a provocation intended to maneuver the therapist into the role of educator. But stress on the word mazal triggered associations. Mazal was the name of an aunt who had been like a mother to her. Remembering this aunt brought tears to her eyes. The signifier “I have no mazal” expressed a sense of being orphaned. Another patient told about an error she had made “inadvertently” (in Hebrew tom-lev). Her mistake was to have authorized payment of something that went to a boy suffering from a developmental disability, against the instructions of the organization for which she worked. The therapist reminded her that her own brother, who suffered from a developmental disability, was called Tom. Mazal and tom, in these cases, were spoken as words (rather than names) and had they been analyzed for their semantic meaning their emotional charge would not have been picked up. That is to say, it wasn’t the names that were repressed: only their context was, like in the case of the filing cards in the library.

Even when a patient uses a common expression which does not seem to invite identification of personal meanings, the therapist is free to look for them. When a young patient says “a real son of a bitch” (slang for something very good), the therapist may suggest to him that this is a violent or sexual expression. Though the patient may dismiss the therapist as anachronistic, subsequent associations will confirm or disprove the interpretation. Confirmation for an interpretation is not usually or necessarily forthcoming right away. Optimal confirmation derives from the unconscious, in the shape of a string of associations, recollection of a dream or physical phenomena like anguish (anxiety), a blush or a rise in body temperature.

The main objective of the therapist’s questions, like his listening, is to allow the patient to continue talking. Closed questions do not offer an opening for speech and associations. It does not matter, in any case, if he answers the question; in some sense it’s better if he answers the question he thinks he was asked, because this gives us a better notion of what preoccupies him.[8] The therapist’s merest reiteration, with or without a change in intonation, may be enough to bring on more associations. The movement of the signifiers in an association opens consciousness, sets desire into motion, facilitates its flow, and is therefore a goal in its own right. This is also why the therapist should stay close to the patient’s language, even if it isn’t usually his (i.e. the therapist’s).

Since it is the aim of the analysis to discriminate between the desiring subject and the other, the therapist must be alert to elements of suggestibility. Complex questions are likely to work suggestively, and the same is the case, in fact, for any addition of subject matter. Remarks like “You look tired,” or “Does this arouse sexual feelings?” may inadvertently plant seeds of tiredness or sexuality in the patient’s consciousness, as if they had been present before the remark. A typical illustration of suggestion is the mother’s interpretation-statement of her child’s wishes. If the child cries and the mother feeds him, she interprets him and thereby constitutes him as already hungry.

Interpretation

In the early years of psychoanalysis Freud found that interpretations explaining the Oedipal origins of symptoms removed the symptoms. This was a momentous discovery; patients suffering from paralysis got up and walked. But the potency of interpretation diminished over time.[9] Lacan explains that Oedipal interpretation’s initial freshness and unusualness were the source of its power. In time Freud’s notions concerning the Oedipus complex became a common cultural good, and hence the interpretation grew banal. Hence, though his work does rely on Oedipal interpretation, Lacan stresses that interpretation should be innovative and surprising in order to be effective. The more unexpected the angle from which things are approached, the more successful the interpretation will be in releasing desire from the symptom.

Lacan, as said, considers it an important part of the therapist’s role to edit the patient’s text – as editing subserves interpretation.[10] Editing, through paying attention to punctuation and emphasis in the text, forms a minimal level of elementary interpretation; it may include repetition of parts of words, trying to supply the endings of unfinished sentences and inserting coughs into the text. Such interventions take a part in determining the meaning of what is being said.

Biographical and structural interpretation:

Freud found the roots of neurosis in the patient’s biography; childhood events produce inner conflict which then expresses itself in symptoms. While adopting this approach, Lacan also goes beyond it. Symptoms, for him, constitute a symbolic structuring of the desire and jouissance in the patient’s present reality. Hence interpretation might either be biographical or structural. As long as the patient is not ready to assume responsibility for his desires, interpretation will tend to be biographical, more external, that is. As treatment progresses, the therapist will increasingly address the patient as responsible for his choices and he will enquire into how the latter uses the symptom for the sake of desire and jouissance. Obviously, these two modes of interpretation are often tightly interwoven. Often jouissance is prompted by biographical causes. Still, though we may agree that a certain symptom evolved under the influence of external factors, the question of why it continues remains unsolved. Emphasis in the structural approach is not on tracing the symptom back in time in order then to resolve it, but on identifying how it profits the patient, that is: how does the symptom maintain his desire and jouissance?

In the case of inhibitions, for instance, plain logic suggests that the child’s formative environment put a brake on his drives causing him to have become an inhibited adult, but one might paradoxically say that these inhibitions are the patient’s way of deriving jouissance from prohibition. Anal-retentive auto-erotic jouissance in relation to the law undergoes displacement, and desire is maintained by means of the inhibition which turns gratification into an impossibility.  Unconscious logic, here, acts like a proposition: “What I pursue cannot be realized and so I can count on it that my jouissance with this desire will not be destroyed by gratification.”

This is why an interpretation that seems aimed to get rid of the patient’s symptom will lead to anguish due to apprehensions about losing both the desire and the symptom. Similarly, getting rid of symptoms by means of external conditions that stop the symptom (like artificial feeding in the case of anorexia or closing the casino to the gambler) is likely to lead to depression, to the loss, that is of desire and jouissance. Interpretation, therefore, must be directed to the desire and jouissance enfolded in the symptom and not to the symptom’s existence as such. Then it will be possible to hold on to the desire and the jouissance of the symptom without recourse to the suffering.[11] But this is inexact because the symptom is a way of constructing desire, and desire does not exist without symptomatic structuring. Hence Lacan coined the notion of the sinthome which describes what is left of the structuring symptom which holds desire and jouissance, but having shed superfluous suffering.

Interpretation and Truth

Unicorns have one horn; the statement to the effect that they have two horns is false. The system ruled by the truth-falsehood dichotomy does not take into account that the unicorn simply doesn’t exist. The same is true for words: a word doesn’t represent something actual in the world. Rather it generates meaning and its truth is measured in relation to the inner consistency of a priori definitions. The unicorn is pre-defined as having one horn only, and truth is what agrees with a definition, not with a “thing”. This is why Lacan’s attitude to truth is as to a “fixed” game and as always partial.

It is by this logic that the Lacanian clinic is ordained to approach absolute truths with caution. A good interpretation is not considered (as Freud sometimes did) one that hits upon the truth, unveils a fact, but one that produces the effect of truth. This is the effect of a formulation that leads to relief from anguish. An opposite illustration of this is when one finds words to describe a traumatic experience - by definition an experience that cannot be put into words. Formulation by other symbolic means – for instance through art – can also have this effect. This very formulation, occurring as one talks to a listening person, has – from the psychotherapeutic perspective – an effect over and beyond removing repression. Even in the absence of an interpretation that decodes repressed materials, the fact that things have been formulated and received a response from outside, validates them as a statement.  It is therefore not only the analytic psychotherapist’s role to enable the patient’s words to be meaningful, but also to be their addressee and thus to transform them into a declaration. By affirming the patient realizes himself as a subject, as someone who determines who he is through speech. To return to the unicorn who has one horn, if we don’t consider truth positivistically as actual fact but as internal consistency, then the therapist’s interpretation can be seen as pointing out not facts but the patient’s unconscious interpretation. For instance an interpretation like: “One can tell from your response that you interpreted my lateness as contemptuous”, points at the patient’s meaning rather than offering new meaning. The therapist’s interpretation turns to the patient as subject of an unconscious that interprets and gives meaning. For instance, an adult female patient brought along drawings she made as a child and asked whether they showed the distress she experienced at the time. Rather than: “One can see from the drawings that you suffered”, the interpretation was:  “One can see from the drawings that you were trying to tell about your suffering” – the drawings reveal her effort to express something, to communicate her distress.  What was identified in the drawings – as in all of the patient’s expressions – rather than objective facts, was the existence of a subject trying to bring herself into existence through articulation.

The object of interpretation is always symbolic. The patient’s dress style, thus, is not relevant from the interpretive perspective, assuming that interpretation is based on the patient’s speech. When a patient, who is talking about a sense of being oppressed, wears a shirt carrying the word Freedom, then one can relate to his way of dressing as a mode of speech because he chose to wear a shirt with this print – but this case is an exception. Interpretations of behaviors, like weight increase or loss, that are not necessarily symbolic may play into the hands of people with neuroses by allowing them not to speak, that is: releasing them of the burden of subjecthood (e.g., where it concerns matters of weight: “If they understand about me without my having to speak up, then there’s no need for me to speak”). Such interpretations are differently superfluous in the case of psychotic patients whose status as subject is fragile. They may produce a feeling of persecution, a sense of not being respected as a subject and of being treated, instead, as an object. As mentioned in earlier chapters, a good interpretation is one that puts emphasis on ambiguity and requires the patient as subject to make up his mind. An ambiguous interpretation constitutes the patient as the one who is responsible for the interpretation he chooses. Accepting the lack of perfection inherent in the absence of one correct interpretation is tantamount to letting go of the fantasy of absolute jouissance. Anyhow, since it is in the nature of the signifying system never to reach closure, interpretations and speech will never fully be exhausted. Acceptance of this fact forms the completion of the analysis.

Dream Interpretation

According to Freud, and to Lacan after him, a dream always represents a wish. But how and by means of whom does the dream represent a wish?

"One day I had been explaining to her that dreams are fulfillments of wishes. Next day she brought me a dream in which she was travelling down with her mother-in-law to the place in the country where they were to spend their holidays together. Now I knew that she violently rebelled against the idea of spending the summer near her mother-in-law...now her dream had undone the solution she had wished for: was this not the sharpest possible contradiction of my theory...the dream showed that I was wrong. Thus it was her wish that I might be wrong and her dream showed this wish fulfilled."[12]

Freud brings this anecdote to demonstrate how a dream represents the wish as fulfilled if we are focused enough to recognize what the wish is. Freud recognizes that the wish is the hysterical wish to object to Freud and prove him wrong. Lacan interpreted it as the hysterical desire to reveal the lack in the Other who is in the role of the master.

The subject of the wish, therefore, is not the main actor of the dream, the ego that is, the protagonist of the dream who suffers the presence of the mother-in-law, but rather the screenwriter whose desire is responsible for concocting the dream, the identity of the one trying to prove Freud wrong. And so when interpreting the dream we shall look for the desire of the subject in the desire of the dream’s screenwriter, on the assumption that the very existence of the dream is already the fulfillment of a wish. The writer is willing to sacrifice the main actor (to make her suffer in the presence of her mother in law) in order to fulfill the wish (to prove Freud wrong).When a person dreams that his wallet was lost and that his attempts to find it resulted in failure we will assume that his wish was to be rid of his wallet. In free association, we shall look for the desire that this wish embodies: Avoid superiority and conflict? A hysterical desire to maintain desire by means of lack? A patient dreamt he rescued his fellow students at the college which was going up in flames. One could assume that the desire, the wish in this dream, is the heroism of rescuing cherished friends, but this is likely to be the ego’s desire, the desire of the dreamer as the protagonist of the dream. If we follow the rule that the subject’s desire is the desire of the dream’s scriptwriter, we shall ask the patient and ourselves: Why does he want the college to burn down? What fulfilled desire does the dream present? If, say, the patient is due to have a test which he is afraid he might fail, then if the college goes up in flames, his test will be cancelled. Unconscious desire is not averse to exact a high toll in achieving realization. In fact: the more extravagant the price, the better disguised is the desire. Similarly, a patient who went for a run every morning dreamt that she was forced to pass right through a house in the middle of a run, and of course it transpired she couldn’t get out. It would be a mistake to interpret the main actress’ frustration at being unable to get out of this labyrinth. This frustration only acts like a screen to the realized wish to stop running. As said, desire is embodied in the assumptions behind the dream narrative (the assumption that the morning-run was cancelled for reasons that have nothing to do with her). Desire may also occur outside the dream – like Freud’s patient’s desire to prove him wrong, or the desire, typical of nightmares, to wake up and discover it has only been a dream. In other cases, one may actually dream that one is dreaming. Often, this awareness of the dream being just that leads to immediate awakening – but this is not always the case. Freud regards dreaming about dreaming as a double defense.[13] If the appearance of the wish as a dream constitutes a defense that allows the patient to say “It’s just a dream,” then a dream within a dream is a double defense against knowing the wish. Another way of thinking about nightmares is that they are dreams in which the price of camouflaging the wish grows to the point of terror (the college burning down, for instance). By this logic, the more nightmarish the dream, the more repressed the wish. Nightmares, needless to say, also follow other types of logic, for instance the pleasure of the drive (for instance, the sadistic-pyromaniac impulse).

From a technical perspective, Freud suggested that once the patient has recounted the remembered dream, he be asked to repeat it. The therapist pays close attention to any details that did not appear in the first account but emerged in the second. These details, even if they may appear marginal, are considered important because they are likely to have been repressed. It is to these details we shall ask the patient to associate.[14]

As regards dream images, what must be deciphered is the verbal expression concealed in the image, not its meaning or the feeling it arouses.[15] Usually, feelings are the conscious response to the image, as the conscious mind understands the meaning of the image. A patient dreamt that his father was walking around with a music stand. This image aroused feelings of curiosity since his father had nothing to do with music. It could erroneously be concluded that curiosity about the father was the issue.  Later in the same session, however, the patient used the expression: “he took a stand”, and it transpired that this was the expression concealed in the music stand image. This is what Freud had in mind when he said that dream images must be deciphered as we decipher a rebus, a riddle in the form of shapes which represents expressions. When given due attention, the expression “he took a stand” caused the patient to be flooded by admiration for his father who stuck to his views, and by a sense of his own failure to meet this standard. The feeling realized-encoded by the dream was love: admiration for the father.

The theory and praxis of dream interpretation is also relevant for the interpretation of day dreams, stories, art, and the work produced in art therapy. It should be noted, however, that interpreting a work of art with a view to capturing the desire it enfolds is bound to put a clamp on creativity, much like the interpretation of jokes robs them of their humorous effect. Sometimes it is better not to analyze a work of art, which is an aim unto itself.

Moving to the Couch as an Act of Interpretation

Historically, the couch was introduced because Freud felt uneasy about constantly being under his patients’ gaze. The transition equally released the patient from eye contact which had also kept the encounter somewhat similar to any other friendly meeting. The couch affords both therapist and patient a freedom by not having to maintain a certain image. The therapist no longer needs to wear a certain expression (which obviously affects and is affected by his thoughts) or to be concerned about how he looks, and this helps him maintain his free floating, unfocused attention. As for the patient, the absence of eye contact also allows him to think of the therapist according to his unconscious fantasy (bored, angry, enjoying or forgiving). And so the couch is really a kind of laboratory, whose conditions allow for recognition that the patient’s assumptions regarding the therapist, and in general, are only just that: assumptions, whose origins are worth investigation.

Again, we should remember that only few therapies start off with analysis: most of them begin as psychotherapy, and the transition to the couch is neither obvious nor anticipated. The move is made as an act of interpretation.  And like any interpretation, it is grounded in things the patient has said and it indicates desire (to move to the couch, in this case). If the patient for instance says he’s tired; asks what the couch is for; mentions that it’s difficult being in the other’s eye; complains about being stuck in the intersubjective dimension (“I keep thinking about what you think about what I think”) – in all these cases one can suggest the patient’s request might be met by moving to the couch.

Cutting the Session as an Act of Interpretation

It may well be that the therapist’s practice of cutting the session is the most controversial issue in Lacanian psychoanalysis. There is a good reason for this: the cut is the very essence of the difference between the various types of post-Freudian analysis and Lacanian psychoanalysis. The common notion of the ‘short session’ is inaccurate for the cut may occur after twenty minutes or after forty. The point is that the end time of the session cannot be known in advance – neither to the therapist nor to the patient.

The most powerful interpretation the therapist has available, the one that opens the unconscious, releasing associations, new insights and positioning, is this act of cutting the session. One objective of the cut is to encourage thought between meetings. The patient’s thoughts about things he would like to discuss in the therapy are an important part of the therapy. In so far as it functions to trigger a process, the session’s main import lies in opening up thought and setting free association into motion, not in its duration. For this purpose, the point at which the session ends is critical due to the nature of speech, which may conceal no less than it reveals. Concealment, in the context of therapy, supports the patient’s avoidance of taking a position or keeping that position unclear. The cut, in other words, blocks the escape route of the patient’s defenses. Thus cutting a session with a depressive patient is likely to spark a demand, thereby revealing the manipulation which often lurks behind the depression and the desire that hides behind anger. When a patient says that it’s all useless, that therapy isn’t helping him, cutting the session at that point is likely to arouse his fury, showing that there are things he feels important enough to say.

In addition to deciding the patient’s last statement, cutting the session also serves as a broader type of interpretation.[16] The cut has an enigmatic effect and this entails an experience of desire: the therapist’s will arouses wonder and curiosity. The very mystery of the will of the person in the position of the big Other undermines any struggle arising in the face of this demand, exactly because the demand is unclear. Though the enigma may cause the patient to experience overwhelming anguish it is a necessary stage on the way from demand to desire. In the case of patients with neuroses, the enigma helps them to relax their rigid view of things (in the case of psychotic patients, however, it may dangerously encourage them to generate delusional explanations). The cut has the additional effect of prompting the patient to say what’s important to him and to decide what’s trivial. Neurotic patients will engage in chatter in an attempt to avoid their desire. This is why they often raise what really matters toward the end of the session, as if they were dropping the bomb right before they go. Knowing that time is limited and that no matter what, he will not be able to say everything, encourages the patient to express what’s really meaningful in a radical manner.  The patient starts with what is most pressing because the session may come to a close before he’s managed to mention it.

Lacan mentions another aspect of the cut, namely that it gets in the way of confabulation and the illusions of knowledge. It prevents speech from becoming based on the pleasure of speech for its own sake or on the phantasmic experience that we understand what we are saying – i.e., on an imaginary agreement.[17] Because the aim of therapy, in many ways, is to forego the gratification of jouissance in order to make place for desire, will and ambition which are fundamental to action, speech itself is bound to produce a jouissance that is an obstacle to action. People often come to therapy to get help in moving on to action: speech indeed brings us closer to the edge of the cliff of action but it is not part of the act of jumping. To get from speech to action, a quantum leap is necessary: the act will be done on condition that speech stops. Cutting the session facilitates this shift by putting a halt to the jouissance of speech which could substitute for action ad infinitum. No matter how much the patient would like to say more, the cut helps him recognize that not everything can be said, and that if he delays action in order to put it all into words, he will never do anything.

The cut reflects the psychoanalyst’s ethical commitment to the patient’s desire.  While in other types of therapy, the therapist, at the end of the pre-set fifty minutes collects the patient’s unconscious before the latter goes back into the world, the therapist in Lacanian therapy is obliged to be constantly alert to make the cut at the most opportune moment.  The compulsive-normative structure of the fifty-minute session is bound to exempt the therapist from taking a position and instead to bolster the patient’s faith in normalcy. In his everyday life, too, the patient probably makes decisions on the basis of arbitrary rules and norms. If the duration of the session is not determined by a norm – then by what is it determined? By the same thing we would like to guide all of our choices: desire. The position of the therapist when he makes the interpretation that cuts the session is a position regarding the patient’s unconscious desire. If the patient concludes a certain topic by saying: “That’s it!” the therapist cuts as though he interpreted: “When you say: ‘That’s it!’ it is your wish to end the session, and I respect your wish.”  The thought about the twenty minutes remaining until the end of the fifty-minute session is like a demand or a command which it is the therapy’s objective to undo. If in session that is based on fifty minutes it is the norm that rules, In a session who's duration is based on the patient's speech it is the word of the subject of the unconscious that rules. The Interpretation of the analyst has the following meaning: "You are your own and only master."

Chapter VII

The End of Treatment

As Lacan saw it, on reaching its conclusion analysis produces an analyst. This is not necessarily the case for therapies that are not defined as psychoanalysis. The metaphors for the analytic process and for its (mostly logical) end point which Lacan proposed are useful in guiding therapy even if it isn’t psychoanalysis.

Identification as Object

As mentioned already, the neurotic patient refuses to be an object. But in declining to be the object of jouissance of some persona on the imaginary plane (in order thus to avoid erasure of his subjecthood), he also makes it paradoxically difficult for himself to desire, that is, to be a subject, on the symbolic plane. Desire exists only as part of the structure of the symbolic chain, of the ideas and concepts that make up the social structure as it changes from one generation to the next. At the end of the analysis, therefore, the person will ideally identify as object of the symbolic order. At this juncture, subject and object, desire and jouissance, will have become one.

To put it differently, though it may transpire at the end of the therapy that the imaginary other does not really exist, this should not entail that he is superfluous, that he cannot be put to use. One may use a compass even if one does not intend to reach the furthest reaches of the North Pole, much like there’s no need for a scientific proof of the existence of God in order to pray to him. While the big Other is demanding and judgmental at the onset of the analysis, at its end he may be employed to set boundaries to jouissance and the production of desire. If, at the start of the analysis, the neurotic patient may pay his personal fitness trainer in order for him to make him work hard, feel that he is tormenting him and that he is working for the trainer, at the end of it he will understand that he pays him for his own good.

The psychoanalytic clinic is constructed in such a way that the psychoanalyst serves as a component supporting the structure of the patient’s subjecthood. Thus the analytic position involves positioning oneself as object (which is why a certain alleviation of neurosis is required in order to achieve taking one’s position as an analyst). The analyst, whose main wish is to offer treatment, takes position as object of the patient’s thoughts and desires. By maintaining silence he pushes the patient to speak; by occupying the position of object (who exits the patient’s life at the end of the treatment) he drives the patient into subject position.[18]

Lacan also points out that the identification as object of the symbolic structure opens up the possibility for a link with the eternal. He makes the distinction between the first death – the moment when word kills thing (concept substitutes for the real) and the second death, namely biological death. As identification with the signifier is possible, and the latter of course remains unaffected by biological death, Lacan argues that the signifier generated by the first death survives the second death. Symbolic immortalization survives biological death. This formulation by Lacan is a logical rendering of Freud’s myth of Totem and Taboo. Freud described the totemic system as a solution to the males’ turn against the alpha male, which would leave the tribe without a real leader. The role of the primordial father was attributed to a mythical-imaginary animal which could not be killed. An immortal symbol of leadership solved the problem of the leader’s actual death.

Usually the symbol that survives biological death is a memorial, a tomb, a person’s name, his symbolic function or some creation he left behind. This is neither religious faith nor mysticism: the fact is that symbols survive humans, and that identification with symbols, with the symbolic system, extends existence beyond temporal linearity.[19] Lacan referred to Antigona as one who acknowledged she had no existence as subject outside the structure of the order of the family. This explains her willingness to die in order to bury her brother and to survive second death.

Traversing the Phantasm, Discarding Identifications, and Identification with the Symptom

The phantasm is a particular type of fantasy. It is a myth of perfection which serves as a tool of jouissance. Symptoms are not directly related to the existence of the phantasm but to belief in it, to a failure of recognition of the fact that phantasm misleads. When he believes in phantasmatic perfection, the subject will need symptoms to undermine that perfection because the latter erases him as subject.  Recognition of the fact that the phantasm is a myth, which is achieved through a process Lacan calls “traversing the phantasm”, involves recognition that lack cannot be eliminated (and that myth only comes to support jouissance). Lacan, in order to represent acceptance of lack, borrows Freud’s notion of ‘castration’. Thus for a masochist traversing the phantasm will take the form of recognition of the fact that he structures reality so as to situate himself as a rejected object (or, in the case of hysteria, as being frustrated; or as a perfectionist in the case of compulsiveness) with the aim to hold on to his faith in perfection.  Traversing the phantasm renders the suffering of the symptom superfluous and allows the subject to use the symptom as a tool of desire. The symptom is a complaint only in comparison to the wholeness of the phantasm. For Lacan this process of accepting lack is a movement away from impotence (the thought that the lack could have been dealt with if it were not for the subject’s failure) to impossibility (the realization that lack is inevitable part of existence).  This shift results in a great sense of relief.  Once one recognizes the symbolic-imaginary, virtual nature of reality, as desire constructs it, the difference between this invented, ideal reality , with all its associated identifications, and the Real – which is impenetrable to change – becomes patent.

Fantasy allows for identification. For people with neuroses, too, the fantasy is a kind of delusion which gives the subject a function, allowing him to define and identify himself.  Some therapeutic approaches consider this identification an important objective, and patients often start their therapy by asking the therapist to tell them who they are. At the end of the process of analytical psychotherapy, the patient is no longer interested in self-definition: the attempt to reduce being so as to fit a definition also involves reducing desire. But desire is metonymic in nature and doesn’t fix on one image of identification. Considering identification as an object of a structure implies the continuous motion of desires which are never fixed in a stable unitary identity.  If the imaginary register enables the consolidation of a fictive identity, thus releasing the person from the chaos of the Real, though at the price of a congealed, frozen ego, free association helps the subject to position himself among signifiers in a way that gives him freedom of movement and disburdens him of the stagnation of imaginary self-definition.

This process, which Lacan calls ‘crossing of the plane of identification', involves the recognition that desire exists in us and that it, rather than our idealized self-perception, is what determines us.[20] Still, unlike Buddhists, Lacan concedes that despite the dangers of identification with it, the ego also is an important component of erotic jouissance. While in his early teaching, Lacan focused on the diverse modes of undoing the imaginary ego, in his later work he stressed the need for the combined activity of the three orders (the symbolic, the imaginary, and the real).[21]

Lacan also refers to identification with desire at the end of analysis as identification with the symptom.  Once the symbolic and imaginary dimensions of the symptom, i.e., whatever it conveys concerning the subject’s desire, have been interpreted and the symptomatic suffering has been alleviated, the symptom nevertheless always retains a germ of Real, a germ of jouissance which no amount of interpretation can resolve. Then what’s left to do is to stop treating this germ as a problem but to identify with it; what remains is to observe where our feet are taking us in order thus to understand where we want to go.[22]

Have You Acted in Accordance with the Desire that is In You?

At the conclusion of the seminar on the ethics of psychoanalysis, Lacan discusses life from the perspective of the following bottom-line question: 'Have you acted in conformity with the desire that is in you?'[23] Desire: that is to say – not wish, of which the self is the agent, and which, therefore, flows from the ego. Rather, desire as master, imposing itself on the subject (in the sense of the one who is being subjected to it; and hence the question formulates: the desire in you not the desire of you), but also desire which the subject has the power to subserve. The subject is the subject of the structure of the unconscious. Desire is its effect and simultaneously it drives and maintains the subject. Desire is not the same as the wish for goods, for acquisition; it is, quite on the contrary, the thing for which one is ready to forego worldly goods and property, for which one is willing to pay.[24] Hence the question about the desire inside the subject is asked in the context of the Day of Judgment, the bottom line. Does the act I choose to commit now follow the same direction as what I would like to prevail after my death? Does the act I choose to commit now follow the same direction as what may be chosen by one looking back at his choices on his deathbed?  These questions are, of course, posed under a certain constraint.  To what extent can we know what we, as future subjects on our deathbed, will want?

Though pharmacology and cognitive approaches today play the prime role in the amelioration of psychic suffering in the western world, psychoanalysis, in its various guises and its diverse practices and institutions, still endures. Strikingly, it still relates the treatment of the symptom to a life of desire and meaning rather than to a religious imperative or other normativities.  Humanity still benefits from the gift Freud offered when he discovered the unconscious. Still, words have a capacity to remove bodily pain as by an act of witchcraft, to spark desire where previously depression reigned, or to dispel anguish and replace it with yearning. Still, belief in something that exceeds us prevails: the unconscious which originates in us, for which we may humbly take responsibility without suffering guilt – humility that is a cure in and of itself. Still, there are those who ask: “Do you act according to the desire in you?” and who will listen patiently until the question evokes a “Yes”.

[1] I use a universalizing, inclusive masculine to refer to both genders.

[2] Lacan, J. (1992[1959]), The Seminar of Jacques Lacan, Book VII - The Ethics of Psychoanalysis, p. 60.

[3]Is the subject or the unconscious created or is it revealed? In a structuralist's perspective the distinction between creation and revelation disappears. In this perspective the analytic discourse structures the subject as the subject of the unconscious by assuming its existence. I will elaborate on this in the chapter dedicated to the graph of desire.

[4] Lacan, J. (1988 [1954], The Seminar of Jacques Lacan, Book II – The Ego in Freud’s Theory and in the Technique of Psychoanalysis, pp.222-223.

[5]"Enjoyment" would be the closest translation of Lacan’s term jouissance which however is generally preserved as is in English Lacanian texts.

[6] Lacan, J. (2002 [1958])”The Mirror Stage as Formative of the Function of the I as Revealed in Psychoanalytic Experience”, in Ecrits, pp. 77-78.

[7] Freud, S. (2001 [1912]) The Standard Edition, Vol 12. Recommendations to the Physicians Practicing Psycho-Analysis. London. Vintage. P.112.

[8] Fink, B. (2007) Fundamentals of Psychoanalytic Technique, New York: Norton, p.27.

[9] Lacan,J. (1988 (1954). The Seminars of Jacques  Lacan, Book II –The Ego in Freud’s Theory and in the Technique of Psychoanalysis pp.10-11.

[10] Lacan, J. (2002[1953], “The Function and Field of Speech and Language in Psychoanalysis”, in Ecrits, pp.209-10.

[11] Lacan, J. (1974), “Seminar XII –RSI” – Unpublished Manuscript translated by Cormac Gallagher, Session 2.

[12] Freud, S. (2001 [1900]) The Standard Edition, Vol 4. The Interpretation of Dreams. London. Vintage,  pp. 151-152.

[13] Freud, S. (2001 [1900]) The Standard Edition, Vol 4. The Interpretation of Dreams. London, Vintage, p. 338.

[14] Ibid., pp. 96-121.

[15] Ibid., p. 49.

[16] Fink, B.(2007), Fundamentals of Psychoanalytic Technique, p.47.

[17]Lacan, J. (1978[1963]), The Seminar of Jacques Lacan Book XI – The Four Fundamental Concepts of Psychoanalysis, p.250.

[18] Lacan relates this objectal position to the other jouissance – to the female position in matters of sexuality, or to the mystical position.

[19] Lacan, J. (1961(, “Seminar IX – Identification”, unpublished manuscript translated by Cormac Gallagher, session 26.

[20] Lacan, J. (1978 [1963]) The Seminar of Jacques Lacan, Book XI The Four Fundamental Concepts of Psychoanalysis. New York, London: Norton p.273

[21] Lacan, J. (1975), “Seminar XII –RSI”, Unpublished manuscript, translated by Cormac Gallagher, session  10.

[22] Soler, C. (2003), What Lacan Said About Women, pp. 250-252.

[23] Lacan, j. (1992 [1959]) The Seminar of Jacques Lacan, Book VII The Ethics of Psychoanalysis. New York, London. Norton p.314.

[24] Lacan, J. (1992 [1959], The Seminar of Jacques Lacan, Book VII – The Ethics of Psychoanalysis pp.310-323.