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After LacanReview - After Lacan
Clinical Practice and the Subject of the Unconscious
by Robert Hughes and Kareen Ror Malone (editors)
SUNY Press, 2002
Review by Adrian Johnston, Ph.D.
Sep 11th 2003 (Volume 7, Issue 37)

One of the most striking features of Lacanian psychoanalytic literature, as compared with the literature of other analytic schools, is its amazing dearth of clinical case studies.  Even vignettes about analysands are rarely to be found interspersed throughout Lacan-inspired texts.  Is this proof that Lacan is indeed guilty of having fabricated a theoretical framework so heavily intellectualized that its practical dimension, as the therapeutic stakes of the clinic, unduly suffers as a result?  Apart from a few notable exceptions, most Lacanian analysts remain silent about exactly what transpires inside the walls of their consulting rooms.  Rumors, rather than accurate reports, proliferate in response to this silence (especially as crystallized in the stories about how Lacan himself treated his patients).  After Lacan sets itself apart by virtue of containing copious amounts of contemporary clinical material, thus providing readers with a valuable glimpse into how a psychoanalytic approach informed by Lacan treats various kinds of psychical afflictions.  This collection of essays shows how a Lacanian clinic handles the sort of analysands landing on today's analytic couches (instead of, for example, rehashing once again Freud's century-old case studies).

The three contributors to this volume (Willy Apollon, Danielle Bergeron, and Lucie Cantin) are all members of the Montreal-based group GIFRIC (Groupe Interdisciplinaire Freudien de Recherches et d'Interventions Cliniques et Culturelles).  In Lacanian circles, GIFRIC is best known for its pioneering work with psychotics, and this collection outlines the core theoretical and therapeutic ideas behind their clinical strategies for psychotic patients.  Although, starting with Freud, there's been much debate about whether psychoanalysis can even treat psychosis at all--many believe that analysis isn't suited to handle the extreme end of the psychopathological spectrum--GIFRIC adamantly insists that a Lacan-informed analytic approach is capable of providing relief from painful psychotic symptoms.  One of the keys, the authors argue, is to undermine the psychotic's absolute certainty in his/her closed delusional system, to introduce a margin of doubt or suspicion into these anguished solipsistic worlds (Lacan contends that a hallmark of psychosis is the unusual degree of certainty such patients express in relation to their versions of un-reality).  And, they go on to maintain, psychoanalytic dream interpretation is especially effective at accomplishing this goal in treatment.  Confronting the delusion itself head on is unlikely to succeed, since the delusional patient is the authoritative expert in relation to the idiosyncratic web of irrefutable meanings expressed therein; everything confirms the delusion, and nothing could possibly contest or falsify it.  By contrast, psychotics, like everyone else, are capable of being perplexed by the manifest content of dreams, by experiencing bewilderment when faced by these strange and often confusing mental products.  Through dreams as a tangential angle of approach, the analyst can begin attempting to lead the psychotic analysand into questioning his/her pathological take on reality.  The psychotic can, in this way, gradually become a bit more comfortable accepting a degree of uncertainty, rather than insisting on a total and exhaustive interpretation of the world on the basis of a delusional system.  With the loosening of the delusion's grip through the erosion of the sense of certainty, the psychotic patients treated in GIFRIC's "388" clinic show improvements in their symptoms and report feeling better.  Such, in non-Lacanian parlance, is a rough outline of GIFRIC's contributions in this area.

However, the pieces assembled in this collection range over a number of psychoanalytic topics.  For instance, in the course of discussing psychosis, the authors elegantly summarize Lacan's recasting of the Freudian Oedipus complex as a mythical depiction of the drama in which the child is introduced to the mediation of its libidinal economy through the entry into both language and social structures (in which others and their desires must be negotiated with).  Similarly, they defend the more traditional Freudian-Lacanian Oedipal model against its feminist and post-modern critics.  The argument is made that the mother alone cannot be both the maternal nurturer as well as the paternal legislator simultaneously.  According to Lacan, in order to avoid laying the groundwork for later psychotic disturbances, the "paternal metaphor" must be brought to bear upon "the desire of the mother" (put all too simply, the child requires the reassurance that everyone in the family unit is answerable to a "rule of law" standing above each and every particular individual).  However, there are two main problems with a single parent trying to play both roles at once:  on the one hand, the question of what higher law governs the switching between the different parental positions/roles remains unanswered for the child, thus leaving him/her stuck with the same destabilizing anxieties as when faced with the enigma of an Other upon whom he/she is abjectly dependent;  on the other hand, a parent who pretends to "be everything" conveys the deceptive (and potentially disastrous) message to the child that it's possible to "have it all," to avoid the limitations and constraints imposed upon everyone by virtue of having to occupy a specific position in the socio-symbolic order.  In analytic terms, the figure of "super-mom" (a fantasy construct of certain "anti-Oedipal" feminist discourses) fails to provide the stabilizing benefits of the paternal third figure (loosely construed as Lacan's "Name-of-the-Father"), and risks encouraging a pathological denial of castration (in both the narrow Freudian sense as well as the broad Lacanian sense ŕ la "symbolic castration").  The authors also furnish the readers with illuminating discussions of other analytic disorders, such as hysteria, perversion, and obsessional neurosis.

The common Lacanian thread binding together this set of twelve essays has to do with the theme of jouissance as impossible.  The Oedipal path leading into the mediating matrix of social and linguistic networks--within this matrix, the individual's libidinal economy is subjected to numerous constraints and conditions barring the uninhibited working of the drives in pursuit of their gratifications--is a one-way street.  That is to say, once symbolic castration (qua the irreversible mediation of the libidinal economy by the symbolic order) has taken place, its effects cannot be undone.  The quasi-mythical "Real Thing" (as Lacan's das Ding), the pure, raw enjoyment supposedly lost to the drives during the course of Oedipalization, becomes a forever-inaccessible impossibility.  Different pathological structures represent various ways of dealing with this loss, with jouissance as something impossible.  For example, in chapters ten and eleven, Cantin analyzes both perversion and hysteria along these lines (the pervert denies castration by insisting that he/she knows the secret means of access to jouissance, while the hysteric avoids confronting the necessary impossibility of jouissance by simultaneously treating its loss as a painfully gratuitous contingency as well as looking for a "master" who can provide this always-already stolen enjoyment).  Thus, as Cantin observes, the pervert and the hysteric are apt to form a tightly bound couple, since the pervert offers him/her-self as the authority on jouissance (as the uncastrated One) ardently sought after by the hysteric.  According to GIFRIC, neurosis, perversion, and psychosis can all be effectively handled in analysis vis-ŕ-vis an approach which addresses them as distinct responses to the "trauma" of jouissance, to the painful truth that unfettered enjoyment (as a sort of blissful "state of nature") is, as Lacan puts it, "prohibited as such to the speaking being."

 Apollon is already well known in English-language Lacanian circles, having published a fair amount of work.  The two other contributors, Danielle Bergeron and Lucie Cantin, are less familiar names to American readers of Lacan-oriented literature.  However, the essays by both of them are clear, compelling, and insightful.  All three authors do an excellent job of demonstrating that Lacan's ideas are of great use in the concrete therapeutic field (rather than being nothing more than ornate academic abstractions).  Additionally, After Lacan is not just for Lacanians.  In their helpful editorial introduction, Robert Hughes and Kareen Ror Malone summarize this material in such a way that those unfamiliar with Lacan are offered an avenue of entry into the essays that follow.  Newcomers to Lacanian theory will find the glossary of key terms at the end of the introduction especially useful.  Overall, After Lacan is a much-needed and long-overdue survey of the clinical workings of a form of psychoanalysis inspired by Lacan.  Perhaps, hopefully, other Lacanian analysts will take their lead from GIFRIC and break a silence that has served only to stoke skepticism in the wider analytic community.  With more publications like this, Lacan might have a chance of exiting the confines of the North American ivory tower and catching on amongst clinicians here.


© 2003 Adrian Johnston


Adrian Johnston, Ph.D. holds a position as interdisciplinary research fellow in psychoanalysis at Emory.


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