The Constitution of the Psychoanalytic Clinic: A History of its Structure and Power (Lines of the Symbolic Series)

THE CONSTITUTION OF THE PSYCHOANALYTIC CLINIC

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LINES OF THE SYMBOLIC SERIES

Edited by Ian Parker From the Conscious Interior to an Exterior Unconscious: Lacan, Discourse Analysis, and Social Psychology by David Pavón Cuéllar

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THE CONSTITUTION OF THE PSYCHOANALYTIC CLINIC A History of its Structure and Power

Christian Dunker

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First published in 2011 by Karnac Books Ltd 118 Finchley Road London NW3 5HT Copyright © 2011 by Christian Dunker

The right of Christian Dunker to be identified as the author of this work has been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data A C.I.P. for this book is available from the British Library ISBN-13: 978-1-85575-646-5 Typeset by Vikatan Publishing Solutions (P) Ltd., Chennai, India Printed in Great Britain www.karnacbooks.com

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CONTENTS

PREFACE

vii

ACKNOWLEDGEMENTS

ix

NOTE ON REFERENCES

xi

INTRODUCTION

xiii

CHAPTER ONE The doubt of Ulysses

1

CHAPTER TWO The return of Empedocles

17

CHAPTER THREE The act of Antigone

31

CHAPTER FOUR Rhetoric of space, rhetoric of time: paradox and interpretation

51

v

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CONTENTS

CHAPTER FIVE Taking care of oneself

93

CHAPTER SIX Montaigne, the most sceptical of the hysterics

139

CHAPTER SEVEN The meditation of Descartes

163

CHAPTER EIGHT The structure of psychoanalytic treatment

183

CHAPTER NINE Kant and the pathological

221

CHAPTER TEN The rebirth of the clinic as structure and as experience

245

CHAPTER ELEVEN Hegel: the real and its negative

295

CHAPTER TWELVE Logic and politics in psychoanalytic healing

345

CONCLUSION

365

REFERENCES

373

INDEX

393

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PREFACE

This book traces a history of psychoanalytic practice, of “the clinic” as a circumscribed social space in which one human being speaks to another and finds a way to speak such that what they say has something of the truth about it. This clinic operates now as counterpoint to a world run through with deceit, a world that seems to call upon each subject to deceive themselves and others in order to survive. But what Christian Dunker shows us is that the talking cure that took shape in the Western world accumulated its rationale from diverse sets of debates over the relation between language and truth. His exhaustive genealogy of what it means to speak well in this world ranges from ancient studies of rhetoric to medieval theological examination of the nature of the word to philosophical investigations into the nature of linguistic representation. The book tracks its way through the complex historically layered conditions of possibility for subjects to address each other in psychoanalytic space; it takes us a significant step forward in grasping how Freud and then Lacan could have been able to address an audience in Western culture and then throughout the world. And Dunker accomplishes something much more in this magisterial account, adding a psychoanalytic sensibility to the genealogy vii

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of psychoanalysis and thereby introducing another twist into what we think we know about speech and the subject. He brings to the history a crucial argument about the relation between “place”, “space”, and “position” in speech, and how psychoanalysis in the clinic must uncouple that relation between these three aspects if it is to avoid reducing the subject to its pathological forms. At this point, which for Dunker is where the best of Lacan connects with the best of Foucault, we realize that unravelling the relation between place, space, and position is what Dunker has been accomplishing in his historical study throughout the book. One might say that this is genealogy in reverse, for it succeeds in re-activating well-worn, imperfectly remembered and overlooked theories of language. Only now perhaps, after the event, is it possible for us to appreciate how pre-psychoanalytic theories of language were necessary to the formation of psychoanalysis itself. This book is an interpretation of that world of psychoanalysis that will change how we think and speak about it now. Psychoanalytic clinical and theoretical work circulates through multiple intersecting antagonistic symbolic universes. This series opens connections between different cultural sites in which Lacanian work has developed in distinctive ways, in forms of work that question the idea that there could be single correct reading and application. The Lines of the Symbolic series provides a reflexive reworking of psychoanalysis that translates Lacanian writing from around the world, steering a course between the temptations of a metalanguage and imaginary reduction, between the claim to provide a god’s eye view of psychoanalysis and the idea that psychoanalysis must everywhere be the same. And the elaboration of psychoanalysis in the symbolic here grounds its theory and practice in the history and politics of the work in a variety of interventions that touch the real. Ian Parker Manchester Psychoanalytic Matrix

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ACKNOWLEDGEMENTS

After advising masters and doctoral students for several years and after having been a candidate myself in similar situations, I now realize more clearly the decisive repercussions this type of work has on a person’s life. Working on an academic project represents not only a time when loved ones are deprived of our presence and we are deprived of theirs. There is also a subjective split that widens as the text gradually develops. There is a type of indirect and invisible dialogue with those around us: our family and friends, students and patients. There is a feeling of gratitude, along with the hope that they not only feel represented, but that they sense they are participating in a collective project. The cooperation of my two children, Mathias and Nathalia, not always particularly silent, was simply indispensable in helping me avoid the type of “self-preoccupation” into which a project like this can dangerously lead us. And there was the invaluable participation of my wife, Ana Cristina, who was always able to create a special gesture when it might have seemed most improbable during long nights of agendas, document printing and books being delved into. My dearest mother was also an important participant in the project, as she was the first to point out the road to letters and teach me the art of facing the confusion and ix

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despair necessary for creation. And there were my cherished students and advisees, especially Paulo, Ronaldo, Ana, Abenon, Cecília, and Leandro, who brought up central questions at unexpected moments, and Anna Turriani who helped me a lot with her “Sabre de Luz”. The working group on the writings of Jacques Lacan, first at São Marcos University and later at the University of São Paulo, was the first vehicle for this dissertation. I am therefore grateful to all those who participated in it over these last six years. I want also to express my thanks to the participants of the Forum of Psychoanalysis of the Lacanian Field, especially Dominique and Helô, for their encouragement on the research, as well as for a number of emergency translations. I also owe thanks to my colleagues at our office, Ana Laura, Michele, Conrado, Gui, and Bia, for the most productive serendipitous discussions I have ever experienced. Further gratitude goes to Ana and Micha for their reading and crucial indications in the text, as well as to Andressa, my essential schedule juggler. My dear friend Álvaro Faria has been the outside interlocutor closest to psychoanalysis that I know. I am also grateful to Vladimir Safatle, my dear friend and companion at philosophical-psychoanalytic workshops. He was tremendously helpful not only because of the great importance of his work for the development of mine, but also in terms of his genuine personal concern and interest in our dialogues. I owe the rediscovery of what it means to “miss someone” to Ian Parker and Erica Burman, who welcomed me to Manchester Metropolitan University and with whom I was able to discuss the first steps in this study. I am also grateful to my long-time colleagues at the Institute of Psychology of the University of São Paulo (IPUSP), especially Léia and Helena, for their patience and encouragement on this project. Finally, I cannot fail to mention the discussions I had with Contardo Calligaris and the constant presence of those who introduced me to the study of philosophy and psychoanalysis: Luis Cláudio Figueiredo and Luiz Carlos Nogueira. After all and everything I must express my profound gratitude to Terence Hill, who translate and discuss the English version of this text with me, with all his patience and Irish solidarity.

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NOTE ON REFERENCES

Most of Freud’s texts were quoted on the basis of Obras Completas de Sigmund Freud, Edição Amorrortu, Translation by José L. Etcheverry (1988), and compared with Sigmund Freud Studienausgabe, S. Fischer Verlag (1989), and with Sigmund Freud Standard Edition, translation by Jaime Salomão, Imago (1983). Some of the available books of Obras Psicológicas de Sigmund Freud, translation by Luiz Alberto Hans (2004) were also used. Both titles and passages quoted were translated into the Portuguese by the author. The following convention was adopted: OCSF-Vx: Obras Completas Sigmund Freud—Volume x. For texts by Lacan, Os Escritos, Edition of Jorge Zahar, translation by Vera Ribeiro (2004) was used, compared with Ecrits, Seuil (1990), and with Ecrits—A Selection, translation by Bruce Fink, Norton (1999). Also, Outros Escritos, Edition by Jorge Zahar, translation by Vera Ribeiro (2003) was used, compared with Autres Ecrits, Seuil (2001). The following reference scheme was used for the quotes: E: – Os Escritos OE: – Outros Escritos Sx: – Seminar Number x

xi

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INTRODUCTION

It is no surprise that no two historians, Nor any two clinicians, have had the same experience, And that endless discussions are frequent At a patient’s bedside. —Paul Veyne

In 1890 Freud wrote a short article for a medical manual on psychic treatment entitled Psychiche Bahandlung (Seelenbehandlung). By using parentheses in the title, Freud suggests a semantic similarity between psychic treatment, and treatment of the soul (Seele). The article is undoubtedly one of the founding texts of psychotherapy as we know it today, as something clearly distinct from “soul treatment”. It cannot be said that psychoanalysis as such had already been established as a method before 1896 (Freud, 1896a). By this time, however, Freud had been seeing patients and accompanying treatments for at least ten years. From Meynard’s work in psychiatry (1883) to his own experiments with cocaine (1884), from his studies with Charcot (1885) to his work at the Institute for Childhood Diseases (1886), and from the application of electrotherapy and hypnosis (1887) to the xiii

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clinical study on the aphasias (1891), there is, in the history of Freud’s formation, a combination of experiences of observation and experiences of psychic treatment.

The clinic Before becoming a psychoanalyst, Freud was a clinician and a psychotherapist. The term clinician refers here mainly to a professional painstakingly and methodically engaged in the observation, description and comparison of phenomena. The clinician is primarily a reader of the signs that constitute the field of his semiology and that organize a diagnosis. This connotation may sound strange in light of the fact that clinicians are also practitioners and that the use of the term clinician also refers to the family doctors of the past and to professional physicians whose natural habitat was at least their private offices and, before that, clients’ family homes, or even the street, rather than a hospital or university. This older and still pertinent meaning of the term “clinician”, or “clinical practice”, as the practice of healing, was used before the evolution of the modern clinical apparatus that appeared in the late eighteenth century. From that time on, knowledge deriving from experience, which had been relatively a-systematic and subject to rules of personal and idiosyncratic transmission, merged into a new form of rationality. In the sense that the term clinician is used today by modern medical science, those involved must subordinate their practice to the primacy of the accepted method in order to make the rules of scientific investigation correspond to the rules of how the treatment should be conducted. Clinicians must subordinate their intuition regarding the object to the universal description of the forms of becoming ill (diagnosis). In order to do this, he has to comply with a common code of descriptions (semiology). When we say that Freud was a clinician and a psychotherapist, we mean that he takes part, in a strategic place between medical disciplines, of this operation of conversion of the “clinic of earlier times” to the “modern clinic”. Psychotherapist, on the other hand, as the term has been used in different historical contexts, is a more generic designation and includes a diffuse field of curative practices that range from moral treatment to animal magnetism, from metalotherapy to practices of purification,

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including a variety of activities with religious, educational, and mystical undertones. At the turn of the nineteenth century in France, a psychotherapist was someone interested in the effectiveness of his or her action, this effectiveness being regulated by the subjective appraisal of the patient himself but, especially, by those surrounding the patient. Causal hypotheses and descriptions of symptoms are meaningful to the extent that they can contribute to these effects in terms of the patients’ consent and the enhancement of the therapist’s reputation as a healer. For a clinician, however, the patients’ subjective impressions about themselves are simply irrelevant if they are not included in the logic of the clinician’s semiology. A decree in France, dated 1803, sets down rules for legitimizing the practice of medicine, in order to distinguish physicians from charlatans and psychic healers. But the term “psychotherapy” was first used only in 1872, by Daniel Tuke, and popularized by Bernheim in a text of 1888, which Freud translated to the German (Roudinesco, 2005). There was, then, a gap between the social and legal legitimation of what was considered clinical, and the scientific and academic legitimation of psychotherapists. This gap expresses the difficulty in assimilating into the strictly clinical field, that which characterizes the effectiveness of psychotherapies, in other words, the importance of the personal authority of the psychotherapist over the patient. During the same period, an intense debate was going on in the field of political philosophy as to how legal authority is transferred to individuals and, inversely, how the authority of individuals can undermine instituted authority. Concurrently, political and theological notions, such as charisma, influence, magnetism, suggestion and personal relationship (rapport) were fundamental to the birth of psychotherapy. Benjamin Rush, founder of American psychiatry and a signatory to the Declaration of Independence of the USA, provides an excellent example of how psychotherapeutic strategies, since their beginnings, imply a tactic of power. Rush’s recommendations for meeting with a patient were the following: Look into [the patient’s] eyes until disconcerting him. There are keys in the eye. A second way to make him obey is through the voice. Next, one’s facial expression should be adjusted to the patient’s mental state and conduct. (Rush, 2006, p. 27)

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The gaze, the voice, and the facial expression are categories we often find when analysing the training dispensed by disciplinary regimes and in the tactics of power over bodies and over discourses. The importance of Freud’s learning from Charcot during the former’s period of formation at the School of Paris is often stressed. Charcot was, above all, a clinician. His concerns included, for example, the proof that hysteria could be found in men, the possibility of a differential diagnosis between hysteria and epilepsy, and a detailed description of the four phases of a hysterical attack (Charcot, 2003). Charcot’s use of hypnotism emphasized the possibility of simulating hysterical symptoms, not of curing them. His was a method of investigation, not of treatment, or cure. It thus becomes clear that Freud’s thinking was affected by both meanings of “clinician” described above. Charcot was a modern clinician because he employed the clinical method of investigation based on controlled inquiry, description, and intervention into the genesis and transformation of pathological phenomena. But Charcot was not a clinician in the older sense of the term. He worked in the university asylum-based system, and did not receive patients as a liberal professional. The French clinical tradition in psychology developed through its inheritance from Charcot’s teaching, and its greatest exponent was Pierre Janet. Attentive to the facts, Janet was a specialist in clinical descriptions and in describing psychopathological regularities. Following the iconographic tradition, which included the use of drawings and photography to capture the forms of presentation of hysteria, Janet dedicated himself to compiling clinical narratives. Janet formalized the clinical method he had seen in action at the hands of his teacher, Charcot. His efforts exemplify the context of the scientizing of medicine based on the conversion and submission of personal experience into impersonal universalization expressed by rules of action that can be conventionalized. Considered less important than his learning from Charcot are Freud’s brief forays, especially to southern France, where he set out to learn the techniques of hypnotism and meet figures such as Libeault and Bernheim. True “healers of souls”, they declared themselves able to relieve suffering through the power of personal relationship (rapport) and suggestion. Psychotherapy as a movement of popular expression and exposed to the constant

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criticism that they were charlatans, gave the term a pejorative tone, especially in France (Roudinesco, 2005). The figure of Anton Mesmer contributed to this impression, as he was a psychotherapist who based his programme of treatment, or healing, on animal magnetism, a fluidic energy that, according to him, issued from bodies and caused diseases. For example, Mesmer would set iron filings on a rotating table upon which lay beautiful ladies of European aristocracy, promoting veritable curing performances. Freud did not fail to pave his road of contact with other psychotherapists, such as Fliess (who, for some, was Freud’s own true analyst), Grodeck (the father of psychosomatics and the mentor of the concept of the Id), and Oskar Pfister (a Lutheran minister interested in the benefits that psychoanalysis could provide to education). It should be noted that, in the case of Fliess, the notion of psychotherapy included material practices, including nasal surgery, the organ seen as the source of the neuroses and as that which regulated them. The opposite occurred in the case of Grodeck. He held that his collective theatrical representations among patients could affect a great variety of organic and psychic diseases. For Pfister, psychoanalysis could renew what, in earlier times, was known as moral treatment. This period, during which one can describe Freud as a clinician and a psychotherapist and during which he wrote his key text on the treatment of the soul, was described by Freud himself, twenty-four years later, in the following words: It seems like a glorious heroic age. My “splendid isolation” was not without its advantages and charms. I did not have to read any publications, nor listen to any ill-informed opponents; I was not subject to influence from any quarter; there was nothing to hustle me. I learnt to restrain speculative tendencies and to follow the unforgotten advice of my master, Charcot: to look at the same things again until they themselves begin to speak. (Freud, 1914a, p. 21)

Freud’s emphasis on observation gives greater weight to clinical experience than to contact with psychotherapy, but his allusion to the non-existence of influences is fallacious. Freud was very strongly influenced by Fliess. One might understand, for example, that Freud

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avoided references to psychotherapy in this quotation, but this does not eliminate the text of 1890. The official title in the English Standard Edition is Psychical (or mental) treatment, thus translating Seele (soul) as mental. This title in German indicates, as we have seen, an ambiguity between soul (Seele) and psychic (Psychische). Both terms are preceded by the noun “treatment” (Behandlung). In English] the verb to treat can suggest the idea of arrangement, contract, or agreement between persons as in “treaty”. In German, the word Behandlung derives from Hand (hand) and refers to the notions of handling, managing, and caring for. But the idea of treatment of the soul does not have the magical and religious connotation that it has for us (Hanns, 1996, pp. 332–337). Treatment (Behandlung), the equivalent of the French traitment, is an expression that became consolidated in Freud’s text after an interesting oscillation. The word Behandlung seems to encompass two other recurrent terms, especially at the beginning of the work: Genesung (cure, guerisión) and Heilung (to heal, cure). But while Genesung basically indicates the results, the cure and the recovery of health, Behandlung and Heilung refer to the process and to the means of treatment. Behandlung suggests more active and specific intervention, as one would find in the work of caring for sheep. Heilung (similar to “healing” in English), on the other hand, indicates passivity, including the importance of the passage of time, as is the case in the curing of cheese and the manufacturing of red wine, which must wait for a time of “curing” until the process has been completed (Dunker, 2002). There is also an expression that appears rarely in Freud, located somewhere between the activity of Behandlung and the passivity of Heilung, namely, Sorge (care), which refers to minor interventions associated with special and continuous regimes of attention, such as in the art of gardening.1 An example would be when one is dealing with an injury: the injured place can be cleaned and a bandage (Behandlung) applied, but time is still needed until the injury or wound heals over (Genesung) and the organ has recovered (Heilung). During this entire process, as well as later, care (Sorge) is necessary. One can thus see how care (Sorge) implies not only the cure, but the curing experience deriving from its process.

1

I owe the discussion of these semantic subtleties to Dr. Nelson da Silva Jr.

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The cure The word “cure” has been set aside in favour of treatment, due to its direct and automatic association with medical connotations and with the idea of results. In addition, the notion of cure still bears with it the echoes of magical psychotherapeutic connotations that one finds in expressions such as “a water cure” or “a religious cure”. The notion of “treatment” contrasts with both that of “therapy” and that of “cure”. Countless times Freud mentions that his patients, before their psychoanalytic treatment, had been through a cure by rest or by electrotherapy. Electrotherapy, a popular technique at the turn of the twentieth century, was developed by Erb and studied by Freud, who proved its ineffectiveness. Rest cures descended from the old practice of sanatoriums, isolated places where patients could regain the strength they had lost in the tribulations of everyday life. As a result, there is a double sense in the refusal to accept the notion of cure in psychoanalysis. On the one hand, it sounds too clinical and medical and, on the other, it is dangerously close to the field of psychotherapy and, therefore, not clinical enough. I suspect, therefore, that the source of our uneasiness with the notions of cure and therapy is not the result of their being located in a more or less scientific sphere of discourse, but because of the connection the terms seem to have with the sphere of power. Both cure as the product of a medical technique and cure as the expression of a mystical epiphany lead us towards a position of power, which psychoanalysis must reject. In addition, psychotherapy is related to tactics of influence that, at least theoretically, psychoanalysis has overcome. However, this refusal of the word “cure” should not serve as a nominalist argument for avoiding the terms in which the problem is expressed from the point of view of the historical constitution of psychoanalysis. That is, it is not enough to declare a type of retreat from the political terrain to guarantee some extra-territoriality, the bases of which we are no longer obliged or inclined to present. This strategy would lead us, in analytical practice, to keep the problem of the influence an analyst exercises over the analysand as an unidentified factor. Inversely, this should also involve ignoring the influence the analysand exercises on his or her analyst. A method without ethics or ethics without a method? How can we distinguish between the type of influence found in a “cure” and that present in

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psychoanalytic psychotherapy? This topic was taken up by Freud in his article on Psychic treatment: Words are undoubtedly the main mediators of the influence that one man exerts over others. Words are good means for bringing about changes in the person who is being addressed. For this reason, it does not sound enigmatic to assert that the influence of the word can eliminate pathological phenomena, especially those that have their roots in states of the soul. (Freud, 1890, p. 123)

Here we have a topic that is dear to psychotherapists, the influence they can exercise over others. The topic of influence brings up an array of strategies, the sources of which would be difficult to unearth. This question involves the formulation of methods and procedures deriving from a broad and scattered variety of types of practical knowledge. Included here are the interpretation of dreams, miraculous cures, and those involving the soul, suggestion, medical rhetoric, religious counselling practices, spiritual direction, and confession, as well as the education of the soul. All of these practices have an equivalent in terms of the construction of political utopias and dystopias. To say that words are a source of influence is, then, an empty assertion if one cannot explain how this influence operates. Freud’s answer consists of a technical description of how hypnotism is practiced: One can hypnotize by maintaining a shiny object before the eyes, which are to be kept motionless for a few minutes, or by applying a pocket watch to the subject’s ear for a short period. Another, but similar, method is to wave one’s open hand before the person’s face and members from a short distance away. (Freud, 1890, p. 125)

If the first strategy of the text emphasizes the basis of the method, the second describes its technique. The method and the technique of treatment are constant objects of confusion. A technique is characterized by the reproducibility and effectiveness of its means. A method involves considerations on the purposes for which one proposes an action. However, the notion of method must travel a long road

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before it is to free itself from its ethical connotation. Only then can the clinic become the name of a method of investigation that will be the support for a method of treatment. In contrast, psychotherapy would seem to be the realm of techniques, and they too have their history. This moment in Freud’s personal history allows one to clearly isolate the two practices: the method is based on the word (“cure” by the word, that is, the “talking cure”), whereas the technique is still the technique of the gaze, which was present in hypnotism. Method and technique presume different modes of relationship with the patient. The method is a mediator, the technique is an instrument. Freud’s article continues by presenting the forms of suffering to which this combination of the method concerning the word and the technique of the gaze applies: Among these infirm persons, there is a group that stand out for the wealth and variety of their clinical conditions. They are unable to perform intellectual work because of headaches or difficulties in attention. Their eyes hurt when they read, their legs tire them when they walk, they feel vague pains or their limbs go numb. They contract digestive disorders in the form of unpleasant sensations, vomiting or gastric spasms, they become unable to evacuate without laxatives, they suffer from insomnia, etc. (Freud, 1890, p. 116)

In this description, allusions to the body and to the privation of liberty stand out. The body is a visible fact, but words are not. As the text asserts, for the gaze, pain is deaf, and here we move into the vast narrative field of what comprises the forms of suffering of the soul—a field of great historical variation, when one attempts to define the limits that classify something as a symptom. Every symptom expresses some form of discontent, but not all forms of discontent are symptoms. Major difficulties are involved in defining the borderlines between what a symptom is, what represents a mere sign or trace, and what is simply banal suffering, or the “pain of existence”. Symptoms require treatment (Behandlung), while discontent requires care (Sorge). A symptom can be cured (Genesung) but the subject can never “recover” (Heilung). To recover suggests returning to the state that existed before the cure, and this is impossible because

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every case involves a subject that has been through the process of cure. On the other hand, “to recover” also indicates a return or a re-appropriation of a place, and this is not entirely outside the intentions for the experience of a cure. When speaking of symptoms of the soul (or “mind”, as the term often used in English), the position of the one who is suffering must be taken into consideration, as well as the specific way this suffering is articulated with the person’s life in general, with the symbolic systems she or he takes part in, and with the discursive strategies that legitimate, recognize, and individualize that experience as a treatable setback, or injury. In the last resort, a symptom is a function of the one who designates it and how they designate it. The symptom therefore depends on who sanctions it. The clinician’s task, in this case, is to try to establish some degree of order and set up certain regularity in the course and appearance of the symptoms, separating them from discontent and leading them to their causes. There is no substantial separation between the descriptive account of the therapeutic tradition—which, in each historical period, attempts to systematize the discontent—and other forms of expression, such as literature, drama, demonological treatises, or popular observations. A chemist can go through the same procedures in her laboratory as a cook does in the kitchen, but the way chemistry is learned is quite different from the way someone learns culinary arts. Notwithstanding the varied descriptions that each one provides about what they do the reality of what goes on between the molecules of the substances is the same. The clinician is interested in producing a description that is solid enough to allow hypotheses to be drawn up and the effectiveness of certain procedures can be justified. Just as a chemist might know nothing about cooking, a clinician can be a very bad therapist. As we have seen, in Freud’s time, and in line with the vocabulary used here, a clinician presented himself as a specialist in methods of investigation, whereas a psychotherapist was defined by his mastery over the practice of healing. When Freud states, in the article we are discussing, that “only after studying the pathological can one understand the normal” (Freud, 1890, p. 118), he was laying down a sort of cornerstone for his clinical method. This approach situates the psychoanalytic method in a strategy that is opposite to that of moralistic, normative, or religious positions regarding the treatment

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of discontent. The presupposition of a type of harmonious, positive, and universal form of treatment makes it possible to compare and judge deviant, pathological, and particular forms of disease, or discontent, as accidents or contingencies that have changed the “normal” or “natural” course of a person’s health. For Freud, in contrast, the deviation is not the breakdown of some prior state to which one can return in practice (Heilung) and which one should theoretically seek from the beginning. The deviation is the very criterion of the method. This is exemplified in the order of the reasons given in which Freud posited the existence of the unconscious. First, he used the hypothesis of the unconscious to explain the genesis of hysterical symptoms and the resistance to recollection of the pathogenic factors involved (Freud & Breuer, 1893). Until then the unconscious had been an exclusive attribute of patients affected by psychoneuroses. Seven years later, Freud (1900) expanded the scope of this hypothesis, developed within the field of pathology, to include what might be called the “ordinary unconscious”, namely, dreams, jokes, and the psychopathology of everyday life. It is therefore a clinical method that is based on an original negativity about the subject’s being. There is a general psychological theory in psychoanalysis, which is universalist in aspiration, but that is constructed as a type of corollary or inference from pathology, and never deducted from normal mental psychic functioning. This brief examination of Freud’s seminal text on psychotherapy provides a starting point for understanding the constitution of psychoanalysis as clinical practice and as a form of psychotherapy. Countless objections and difficulties come up when one includes psychoanalysis in psychotherapy, and others arise when it is excluded. And there are many other arguments against the idea that psychoanalysis is related to the clinical tradition as it has been constituted in Western medicine, especially since the eighteenth century. But, in general, this double line of objections is backed up by a deeply foundationalist and legitimist historiography. This line of defence, interested as it is in underlining the extra-territoriality of psychoanalysis, given the original character of its form of treatment, is understandable in the academic sphere and in the context of the assertion of the permanence of psychoanalysis in culture. But it is also a reactive strategy. It prevents psychoanalysis from seeing its

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own historical constitution in a way that can re-invent its present. This does not mean the re-construction of the chain of psychological ideas that led to the notion of the unconscious, of sexuality, of childhood, or of repression. But it does mean that we try to reconstruct the logic that led psychoanalysis to set itself up as a unique form of clinical, healing and psychotherapeutic practice. Nor is the point to examine the conditions in culture or in society that made possible the invention of a treatment of the soul based on the word, but of specifying the historically problematic points that continue to be present in contemporary psychoanalytic practice. I want to avoid an epistemological type of examination of the status of any scientific or para-scientific incorporation of psychoanalysis. I am more interested in modes of subjectivization, in other words, the strategies of saying and not saying that psychoanalysis employs to carry out its policy of cure, of care and of treatment. The hypothesis that underlies this book is that the questions involved in the discursive practices that logically and historically constitute psychoanalytic treatment are, in the last resort, questions related to the idea of power. By power, I am referring to that power constituted by the word that influences, the power that is made and unmade foucaultian dispositif, its way of working, the power that legitimates, prescribes, and is affirmed in the forms of psychic suffering it identifies, as well as the power that is always problematized in the psychopathological axiom by which a symptom is a figure of the privation of freedom.

The practice The present study is located between, on the one hand, an archaeology of the types of knowledge that made possible the emergence of psychoanalysis and, on the other, a genealogy of its practice. The archaeological intention appears most strongly in the chapters dedicated to the formation of the apparatus for treatment and the hypothesis of a general structure of the clinic. Here the concern resides in the migration and compromise between concepts and surfaces of problems needed for the formation of psychopathology and for the subversion of the notion of treatment. The genealogical intention appears distributed in the triple dimension that Foucault (1986, p. 171) established for this concept: an historical ontology of

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ourselves in our relationships with the truth; our relationships with the field of power, which permit the constitution of subjects that act on others; and our relationships with morals, which examine the constitution of ethical subjects. Genealogy is a type of historical research that is opposed to the unity of a historical account and of a search for origins. Inversely, genealogy operates with the diversity and dispersion of chance happenings and of accidents in an attempt to de-subject historical knowledge and make it a figure of opposition and struggle against the order of discourse (Revel, 2005): “the contingency that made us what we are, the possibility of no longer being, doing or thinking what we are, what we do, and what we think” (Foucault, 1971, p. 26). I hold that the notion of genealogy presumes a specific use of the idea of “constitution”, which, moreover, is present in the triple connotation of the concept: constitution of a subject in relation to truth, to power, and to the other. Although the term constitution goes back to Kant and, therefore, to a somewhat essentialist understanding of categories and faculties that precede experience, its use by Foucault suggests the investigation of the historical character of these determinants. Foucault distances himself from structuralism when he admits of a relative divergence between the constitution of the subject, in texts such as The Hermeneutics of the Subject and History of Madness, and the formation of discourses, in books such as The Archaeology of Knowledge and The Order of Things. The constitution of the subject, which is the task of genealogy, thus fits in with the notion of formation, and this notion was often used by Foucault to study discourses according to a logic of opposition and compromise, and a tactic of domination of objects. Examining the formation of discourses is a task of archaeology. Genealogy and archaeology thus prove to be distinct but articulable methodological tasks. Constitution and formation are also opposed to the idea of construction, which seems to refer to the articulated exercise of the formation of objects with the constitution of subjects, with which it is correlative. To understand the functioning of a structure, such as the structure of treatment, the structure of the clinic or a structure in the psychopathological sense, it is therefore necessary to suppose a constitution and to connect this constitution to the logic of the formation of the discourses and practices that define a structure. Here the notion of construction comes in as a practice that implies a certain contingency and

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unpredictability in relation to structure. Using a modest analogy, we can say that constitution delimits a space where a subject is conceivable, formation organizes this space into places, and construction is distributed by the positions in relation to these places. This approximation suggests a certain affinity. In fact, it suggests the theoretical usefulness of a combined reading of the historical and philosophical notions of constitution, formation, and construction with the psychoanalytic notions of constitution of the subject, formation of a symptom, and construction of a fantasy (Dunker, 2002). The development of this hypothesis goes beyond the objectives of this book, which is dedicated to the analysis of the structure and constitution of the psychoanalytic clinic. However, the hypothesis shows up at numerous points in the text. For this reason, it might be convenient to explain it here in greater detail. The genealogical vectors of both truth and of ethics have received more or less systematic attention from psychoanalysis. It would therefore seem important to stress, together with these two currents, an examination of the relationships between cure, treatment, and clinic, on the one hand, and the sphere of power, on the other. It would be pointless to try to establish a definition of power foreign to the contexts and fragments treated, since the purpose of genealogy is to make this power-form visible. However, to keep this notion from becoming diluted in its most common meaning, related to the topic of domination, law, and the State, and consequently of force and violence, it would seem prudent to say a few words on the topic. Two types of knowledge are directly related to the question of power, namely, politics and war, and both carry a historically insistent reference to space. Ultimately, all of politics and all war have begun with some type of geography, an immanent theory of territory, of place and of position. It is no coincidence that political discussion in the West began with the notion of polis, developed within the idea of city and later, of territory. The first possession is the possession of space. Whether with respect to the domain of the body itself and its being able to move about, or whether with respect to the possession of the other, there is no reflection on freedom that does not contain some small theory of space and its occupation. We will therefore present a brief topology intrinsic to the reflection on power, in order to examine our problem. It has always seemed strange to me that Lacan’s most important, most systematic, and undoubtedly, most often read text on the

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psychoanalytic clinic bears the title of The Direction of the Treatment and the Principles of its Power (1958a). The English translations (by Bruce Fink) make a choice in terms of the problem mentioned above. The French text is Direction de la cure. The same holds true for Variantes de la cure type, translated as Variations on the Standard Treatment, in English (Lacan, 1955c). In both cases, the term used is cure (Heilung, or treatment) and not guerisón (cure as healing) or treatment (traitement) as is found in Du Traitement Possible de la Psychose (1958b). But if treatment sounds more palatable it is because the term cure conveys the idea of something important that should be recovered. From the master-slave dialectic to the criticism of the models of formation of analysts; from the notion of the psychoanalytic act to the theory of the four discourses; from the criticism of the primacy of the psychoanalytic technique over ethics to the theory of the end of analysis, there is a persistent reflection by Lacan on the dynamics of power involved in the analytic situation. This is not Lacan’s sole, nor even his most original, contribution to the specific scope of treatment, but I would like to believe that it is one of the lines least explored by the scholars of his work. We have become accustomed to recognize a separation between ethics and politics; to the point that it seems natural to us that where there is power, ethics is absent, and where there is ethics, there is no power. We are used to considering the analytic situation as a territory where the exercise of power is constitutively excluded. But this guarantee, by axiomatic decree, displays only a fragile and poorly discussed, if not an a-historical, conception of what power is. This keeps us from seeking strategies to deconstruct it and maintains the functioning of power out of sight and far from any type of resistance (Derrida, 1997). The connections and separations between clinic, cure, psychotherapy, psychoanalysis, and the problems involved in defining the method of psychoanalysis imply considering treatment in the context of its politics, its strategy, and its tactics. This is why any analysis of the constitution of the psychoanalytic clinic should undertake an archaeology that will take into account the heterogeneity and compatibility between these dimensions according to different modes of composition. It would thus be possible to infer from this constitution something like a structure of the psychoanalytic clinic, that is, certain relationships that are stable enough to allow one to grasp the full experience of a treatment. If the historical constitution of the

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psychoanalytic clinic leads us to the topic of power, the hypothesis about the structure of the psychoanalytic clinic will tell us about its possible strategies. We shall also see how the tactical sphere is thus doubly conditioned, but not reduced, to the former spheres. Therefore, the power that is being discussed here is not that of the State (interested in the security of the population), nor even that of associations (interested in disciplining a practice), and it is even less the power of mental health policies (interested in effectiveness). We are dealing with the power that confronts the subject with its desire and its destiny. This is not a treatise about the implications and consequences of psychoanalysis for political theory or for the understanding of social functioning; a field where the psychoanalytic study has advanced considerably. The present study has a much less ambitious scope in that its purpose is merely to discuss the practice and theory of treatment in the light of its history and of the history of the relationships between ethics and politics. One difficulty faced by those who undertake an archaeology of psychoanalysis is that of the very definition of its object. A definition that is overly focused on Freud’s writings has the inconvenience of leaving aside its numerous later developments, re-readings, and appropriations, without which the writings themselves could not to be studied, especially when one takes into account the clinical practices that are based on them. Inversely, an analysis aimed at approaching all possible variants of psychoanalytic discourse must concentrate on key concepts. For this reason, we have chosen to work within a range of topics and questions that are located between Freud and Lacan, seeking to maintain the distances and similarities that exist between the two authors. Generally, when one sets out to examine the historical constitution of a practice, one should leave aside the later interpretations that such a practice imposes on us. Otherwise, we would risk finding only what we introduced with our categories and organizing the history anachronistically, according to a confirmatory teleology. In addition, the thematic discussions and clinical implications of the topics that have come up interest us not only for their historiographic value, but also because they bring up questions about current practice itself, adding consequences to it and casting more light on certain problems of its formulation. This is why we conjugate the historical analysis of the constitution of the psychoanalytic clinic

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with discussions about aspects of its structure. We intend to show, at the end, that this relative opposition between the logic of a procedure and the historical origin of its components and conditions is not foreign to the problem at hand. To a certain extent, this is a point that separates the history of psychoanalysis, marked by the examination of the monuments that gave rise to it, from the archaeology of psychoanalysis, whose purpose is to analyze fragments that may question and reinvent the present. The dispersion and discontinuity between these fragments may be complemented by a reading of books and articles on the history of psychoanalysis (Roudinesco, 1988) and of psychotherapeutic practices in general (Jackson, 1999). In these texts, we will find excellent references to the historical epistemology of the concepts (Assoun, 1978), to the cultural implementation of psychoanalysis (Parker, 2006), to the origins of the method (Cazeto, 2001), and to the psychoanalytic psychopathology (Berrios, 1996). As I indicated above, this is a book about the historical evolution of the practices that characterize psychoanalysis, not only as a system of therapy, but also as a discourse and a form of knowledge. The concepts that interest us are, in fact, notions about the different fields with which psychoanalysis admits a practical affinity. Most of the texts that call foucaultian attention to this point end up concluding in favour of generically including them all. This, however, arouses objections from psychoanalysts (Mezan, 1988, pp. 184–217), who insist on the need for a more detailed and non-reductive examination of the question in its diverse branches and variations, when not an outright trans-historical break represented by its founders. To argue, through a generic judgement, that psychoanalysis is a practice of confession or that it depends fundamentally on the normative sexological discourse of the nineteenth century or on an absolute connection between sexuality and parenthood is to fail to perceive that all discursive practice prescribes forms of counter-power and that not all forms of resistance are homogeneous. To specify these zones of instability a little more clearly, we will appeal to the notion of narrative, a concept that is located between the unique linearity of speech and the particular surface of discourse. Power is always exercised through a specific articulation that brings together and compresses the domains of words and of narratives, according to a law of strict composition, which is discourse. It is therefore by

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studying the articulatory variations in the topology of narratives that we hope to find the points of constitution of the psychoanalytic clinic. The present study represents an attempt to chart the zones of instability, show how the assembly of the different discourses and apparatuses is not a totalitarian march towards a power machine without fissures. Without this, Foucault’s efforts would have been just another undertaking used in order to exclude others in the name of a given practice. Otherwise, his work, used as a critical reflection for psychoanalysts, would be useless.

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CHAPTER ONE

The doubt of Ulysses

These things never happened, but they will always exist. —Sallustius

U

lysses is alone on the battlefield, far from his comrades, and finds himself facing an army that is moving towards him. He wonders about his situation:

If I run away in fear it will be a disaster; if I am captured alone, it will be terrible. But why does my thymos tell me these things? I know that the bad (kakos) flee from the battlefield but the virtuous (arete) firmly resist. (Homer, 1950, p. 191)

This is a rare scene for a hero from the pages of Homer or Hesiodus, as it shows two different planes in perspective. The first plane is the objective action as the hero awaits an attack, continuing the horizontal nature of the narrative. But on the second plane there is a vertical conversation of the hero with himself, generated in his hesitation and surprise as he becomes aware of his thoughts. This process is 1

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unusual in Homer’s poetry, where the present generally does not open up to the past as something to be interiorized, but rather to the past as genealogy or as narrative that seeks to explain who the character is and why he is there. In sum, Ulysses’ doubt is expressed in the following question: Why do I wonder about what to do, since I know who I am? Faced with the question about how to act, Ulysses remembers a story that tells him of his lineage, his ties, and the commitments that explain who Ulysses is. His keenness and creativity come from his ability to unite what he is, what he was, and what he will be. This is why, in Homer’s narratives, there is only a first plane, uniformly illuminated and objective. In the Iliad as well, in the midst of the burning ships and the providential arrival of the Myrmidons, there is time for a comparison between the urgent situation and the life of the wolves, the genealogical order of the Myrmidons, as well as precise information about the lives of his rank-and-file men (Auerbach, 1989, p. 5). The heroes in the Old Testament are made of different stuff, in that they show overlapping vertical layers of meaning and conflict. There are perspectives in scaled depth, insinuating subjective and moral spatiality. The syntax is poor and skips over details, and the pre-suppositions of the narrative are left unexplained. The style is simple and allusive (Auerbach, 1988, p. 39). These characteristics are even more evident in the New Testament, with its heroes being defined by the type of transformations they are subject to. Saul of Tarsus, for example, is successively transformed, beginning with his conversion on the road to Damascus and continuing through to his arrest by the Romans and his life among the Greeks. He changes his name and, through his mastery of the languages and cultures of the places where he is captured, time and again he proves that his past can be overcome, that he need not always and solely define himself with reference to the community he comes from. The present is not exhausted by the past, but reconstituted by it. The symbolic coordinates that define a biblical subject can therefore be altered by a radical experience—as was the case of Saul, now Paul, and his conversion. The price this type of hero pays is that his reconstituted history remains full of disconnections, contradictions, allusions, and allegories. It is an undefined task of reconstruction of references, where plausibility is not based on accuracy, as it is in Homer. The reader must interpret, and his position as listener involves choosing

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meanings to complete the consistency of what has been narrated. The Greek hero is sculptured in the present and in the particularity of the experience that preceded him, including his lineage, his accidental connection with the gods, and his ties and commitments of submission and ancestry. The Judeo-Christian hero is moulded to make past and future converge with the present, and it is in this respect that he aspires to universality. He inhabits a universe that had a beginning and will therefore eventually come to an end. Contrary to Ulysses, who seems to live in circular time synchronic to the epics of the gods, the Old Testament heroes are inhabited by doubt and by a task: What should I do to be what I am? For this question to have an effect, the subject cannot pre-exist the event he declares: “There is neither Jew nor Greek; there is neither slave nor free, male nor female” (Paul of Tarsus—Epistle to the Galatians, 3.28 [Paul, 2000]). That is, the truth, as enunciation of the subject, declares a conviction that is not entirely assimilable by the law in its local particularity. The truth involves loyalty and process, not only occasional illumination. So, on the one hand, we have a subject exposed to a fluctuation of identity and, on the other, the law with no defined anthropomorphic support (Badiou, 1999, pp. 109–110). The thymos in Ulysses is a physical figure, a source of what moves or compels someone, the origin of anger and, indirectly, of all the passions. The thymos is a potential obstacle to what one expects of a Homeric hero, that is, that he permanently display congruence between being virtuous (arete) and being good (or skilful) (agathos) at something. Being skilful (agathos) implies the abilities and talents needed to join the means and ends of an action according to one’s place in the community. It means having the ability to act effectively and give proof of this. But being skilful at something is not the same thing as acting virtuously, just as having the resources is not the same thing as using them well. Besides being skilful (agathos) a Ulysses or an Achilles must also be virtuous (arete). Being virtuous has to do with the relationship between the agent and what the action is aimed at. Being skilful at, on the other hand, organizes the relationship between ends and means. The mythological heroes have their excellence guaranteed by a type of participation between the objective of their acts and the interests and decisions of the gods. The law of the gods (dike) is superimposed over the virtue (arete) of the heroes. This explains why Ulysses is surprised by his own hesitation.

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A warrior must fight; otherwise, he would not be a warrior, whose aim is to fight. He is what he is because he is in his place. And he has the resources he needs for fighting, especially courage and skill. Ulysses would rather lose while playing his role than win but leave his place. Another way to distinguish agathos from arete is in the field of one’s intentions. Let us take war, for example. In war one must attain certain intermediate objectives represented by tactical positions and strategic advantages during battles. Effects must be produced (fear and courage, for example), and one must also be effective in one’s actions (in the use of weapons, troops and local conditions). A person who shows agathos is able to act effectively and skilfully in this aspect of the war. However, we can also look at war from another point of view, that is, with respect to its ends. This involves arete, and it brings up important questions such as whether the war is just or unjust and whether the warriors are fighting virtuously or not. The Old Testament gives us a different version of this problem. The objective is given but it is essentially unknown to the characters. The means are also obscure, as can be seen in the Book of Job or the Song of Solomon. The biblical hero must trust and act without having all the knowledge he needs for this purpose. For him, virtue is always out of step with the law. This is why a Homeric hero never feels guilt, but he can suffer from terrible shame. The Greek hero is always in his time, identical to himself. In contrast, the Jewish-Christian hero is an exile in his own temporality. He seeks his time in successive experiences of change, crisis, and reformulation. In the process, the subject may “become another”. He can change his name, change countries, and change the genealogical and moral rules in which he was formed. As Lévinas (1997) showed, it was in the heart of the Judeo-Christian experience that the theme of alterity first appeared. The formula could be inverted to show that it was in the Greek cosmos that the first reflection on identity took place. The cultivation of identity must not be confused with modern individualism. It is above all a practical reflection on permanence, and this reflection requires conscious attention to the parity and consistency between the positions taken by an individual and the place this individual believes he belongs to, or wants to belong to. This is why the topic of identity is related to the type of change to

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which someone is subject in order to become what they are, in other words, arete. Inversely, the discussion of alterity involves an uncertainty about the relationships between the place where one is and the position they should assume or attain. The practice of agathos thus creates, redistributes, or leaves the relationships between places and positions undetermined.

Excellence and effectiveness The distinction between effectiveness (agathos) and excellence (arete) is at the root of any consideration of the principles of power in psychoanalytic treatment. If we see analysis as an interminable process that has the purpose of continuously deepening a relationship with the unconscious, a process of deciphering one’s own self, it can only be measured by criteria of excellence. But analysis can also be considered in the light of its effectiveness in removing symptoms and relieving mental suffering. In this case, psychoanalysis is a means to attain an end, a good method for removing specific symptoms. The opposition between excellence and effectiveness also emerges in a recurrent theme in the history of psychoanalysis. One only need recall a few incidents, such as the controversy between analysis of symptoms and analysis of character in the 1930s; the quarrel about analysable and unanalysable patients in the 1940s; and the opposition between standard analysis and its variations, in the 1950s. Today we come across those who defend the idea that there is an ethic in psychoanalysis, but it has a regulative role since, in the last resort, its basis is its method. And there are others who hold that psychoanalysis is an ethic because its method is at the service of an ethic in a constitutive sense. For example, analysis of character implies not only removing, reducing, or resolving conflicts and their compromises. It also effects changes “at the level of lifestyle and behaviour” (Ferenczi, 1927). Changes of this type are judged according to standards of evaluation that traditional effectiveness cannot provide, because the changes always have a negative aspect. This means they imply the removal of something that obstructs or limits the patient’s life. Contrary to a symptom, such as inhibition or anxiety, character is something that subjects are not likely to complain about. The same could

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be said of many disorders. The change here implies an account that approximates to the addition of something. The ethical tension would thus seem to have a double origin. On the one hand, psychotherapeutic pretensions, which are of Judeo-Christian inspiration, are based on personal relationships, direct authority, and positive benefit. On the other hand, we come across clinical pretensions, of Greco-Roman inspiration, which emphasize the relationships between means and ends and that are sustained by impersonal authority and negative benefit. If the Jew-Christian narrative sends one off on a search for satisfaction and grace, the GrecoRoman narrative invites us to avoid displeasure and glory. Inspired by Leonardo da Vinci’s categories of aesthetics, Freud (1905a) classified two types of treatment, those that operate per via de porre and those that operate per via di levare. In the via de porre, something is added, as in painting, hypnotism, and practices of suggestion. In these cases, it is supposed that the therapy will introduce something new to the subject, something that it does not have yet and that will be given to it as something with positive existence, enhancing it with more knowledge and, in the final analysis, providing it with a positive form of power. The opposite takes place in the case of via de levare, where something is removed or subtracted, as is the case with the art of sculpture: Analytic therapy, in contrast, does not aim at adding or introducing anything new, but rather at leaving something by removing another. And to this end it is concerned with the roots, in the pathological and the psychic interplays, of the pathogenic idea, the elimination of which is seen as the final goal. (Freud, 1905a, p. 250)

According to this definition, psychoanalysis is oriented primarily to a negative form of power, a power that is neither prescriptive nor restrictive, but aimed only at removing obstacles to the sovereignty of the subject. It does not engender a new form of freedom, but only does away with the privation to which the subject has been submitted. Freud’s criterion of the via de levare has the inconvenience of reducing psychoanalysis to its clinical dimension, thus holding back its psychotherapeutic pretension. It is closer to the Greco-Roman narrative of effectiveness than to the Jew-Christian narrative of excellence

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and its irreducible theme as to the final goal of the process. Reduced to this clinical dimension, there is a terminability of analysis, with clear and distinct criteria for concluding the process. From the point of view of a psychotherapeutic approach, in contrast, the notion of there being something that is “incurable”, or of an unredeemable nature, can only be seen as an intrinsic characteristic component of treatment. We have two different questions: How much a life could be healthy? and How much one could be happy with his or her own life? Freud’s analogy with Da Vinci’s aesthetics raises another problem: what is one to do with arts that are actually closer to psychoanalysis? Should they be called “arts of the word”? Is poetry and literature (arts of the written word) or the theatre and dance (arts of the spoken word) via de porre or via de levare? And what type of liberty could be expected in the sphere of discourse? Both the Greek and the Hebrew cultures are based on written forms of oral tradition, and in the passage from oral to written expression there is a transmutation of power attributed to the word. The words of poets and prophets change when they are put down in writing. A myth transmitted orally is transformed, but the changes it undergoes are set off by eyewitness accounts. The oral and the written word are inscribed in different ways through time. When a myth takes on a written form it becomes something else, mythology, a chronicle or, perhaps, history, and its connection with belief becomes exterior, optional, and questionable. Once written, a myth becomes part of a system of regulation, and is no longer a constitutive practice of social ties in a given community. Homer and Hesiodus compiled and translated the aedos and rhapsodos and poems somewhere around the eighth-century BC. Greek philosophy and Greek legal and political systems, which we associate with Plato and Aristotle, were consolidated only during the fifth century BC. The founding figure of Greek philosophy, Socrates, wrote nothing, his legacy having been organized by those who had heard his teachings. He is therefore a notable figure of transition from the oral to the written word. Countless practices of magical cures appeared in Greece during the period when the myths found their way into the written universe. Maenadism (divination based on dance) teurgy (based on the stars), oneiromancy (based on dreams), and the different forms of mantics (soothsaying, divination) provide a syncretic setting

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for the different types of cult from which they proceed (orphic, Dionysian, Pythagorean, etc.), forced into unification by the written compilation of the myths (Dodds, 2002). They can therefore be read as expressions of the de-stabilization of the Greek community during a historical period of transition and as a heterogeneous repertoire of tactics for effecting cures. Their very plural existence and the disparity of their particularities indicate the social decline of their function. They are forms of cure that locate the positive community not in the present, but in either the past or the future. The heroic narratives, be they Greek or Jew-Christian, as well as shamanism, can be used for therapeutic purposes. Separated from myths both by their having been given a written form of transmission and by the problematizing of the power associated with the word, these narrative genres imply therapeutics based on commitments with the community. The doubt of Ulysses arises when he finds himself separated from his army and his comrades, that is, when a contingency leads him to see himself as an individual facing a hostile horde of foreigners who may not recognize him as the great Ulysses, King of Ithaca. Isolation, exile, separation, a state of segregation, in the anthropological sense, are prototypes of the experience of interiorization and individualization (Dumont, 1985, p. 36). At this moment, Ulysses wonders how to act, but before considering the most suitable means and methods to get out of the situation, he engages in an exercise of remembering himself. This return to his commitment to the community, which is what really makes him what he is, comes before the keenness that he can, and must, make use of. A community organized around writing produces therapeutic practices that are a little different from those seen in oral communities. The account of Ulysses lets the individual members recognize themselves in this figure and consider their particular conditions for renewing their pact with the community. In societies organized by oral myths, this task is individualized in the figure of the shaman. Most of the literature on the history of psychotherapy, curing, healing, and the clinic, approach both the field of magical practices and the field of religious cures according to a standard of dual comparison based on rationality versus irrationality or on an opposition between the natural and the supernatural. In most cases, this produces a teleological history oriented towards justifying the present (Jackson, 1999, p. 13). Our criterion here will be of a different type. Regardless of ontology,

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the theory of causality or the type of rationality involved, we are of the opinion that a cure is an operation of language. Practices of language, on their various levels, should therefore be the guide for our archaeology, and not some pre-classification of the possible forms to which experience is supposed to conform. When Lévi-Strauss (1949b) compares the psychoanalyst to the modern shaman, he is considering that in both practices there is a type of re-balancing between social myths and the particular contingencies of the form of suffering that an individual is undergoing. Like the hero, the patient is a separate individual. Her place reflects a distinction that disconnects her from common life. The patient is someone who, voluntarily or involuntarily, is separated from a community of destiny and from the common meaning that its members share. The shaman acts as a type of mediator who reintegrates things through reconciliation between ritualistic acts and social narratives of reference. There are three types of shamanic cure: those where the shaman physically manipulates a sick organ or member and extracts or adds some causal element; those that carry out a struggle against harmful spirits; and those based on enchantments, songs, and prescriptions that entail no perceptible relationship of the sick individual to the cause of the suffering (Id., 1949a, p. 221). Against the thesis that places the origins of psychoanalytic practice in shamanistic magic is the criticism of the supposed ethnocentric generalization of shamanism (Hadot, 1995, p. 224), since, far from including the entire field of curative magic, the phenomenon seems to be restricted to America and Siberia. But one should not reduce shamanistic practice to its style. It operates, above all, through its structure. In any case, whether or not a healer is technically a shaman, he is characterized by offering the patient a language in which certain states that have not been formulated, or are not even formulable, can be expressed in some other way. It is here that similarities with psychoanalysis begin. In psychoanalysis, the patient’s “individual myth” and his or her neurosis are never completely formulated. They are “put into context”, experienced collectively, or shared in the transference, thus being intensely re-lived as they are named, in abreaction of the affects. But the homology proposed by Lévi-Strauss includes a detail that was not always noted by other critics and commentators on the topic. The relationship between psychoanalysis and shamanism is one of homology and inversion.

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The shaman emphasizes speech, the psychoanalyst emphasizes listening. The shaman deals with collective myth, the psychoanalyst, with individual myth. The patient identifies with the shaman, but establishes transference with the analyst. The shamanistic cure is sanctioned socially, whereas the psychoanalytic cure depends on the demands of each individual. The shaman is the agent of the cure, as he is able to read the signs of nature and interpret the source of their disparity with social expectations. He mobilizes a signifier of nature as a metaphoric replacement for the signifier of the enchantment (Lacan, 1965, p. 885). The psychoanalyst is also a reader, but of signs generated in free association, the warrant for which always depends on the patient himself. The analyst replaces the metaphoric articulation through which the symptom is presented with a metonymic articulation. Both therapeutic effects are explained by their symbolic effectiveness, but this effectiveness operates in different structures, and in both cases the structures are unconscious.

The case of Quesalid Whereas the term “effectiveness”, in this context, can be approximated to its Greek equivalent, agathos, might we then also speak of symbolic excellence (arete)? It is exactly this problem that Lévi-Strauss approaches in the article where he discusses the conditions under which someone becomes a shaman. He discusses the case of Quesalid, a Native Canadian who, moved by the desire to unravel and expose frauds exercised by shamans, began to frequent circles where magic was practiced. He was eventually invited to become a shaman, and thus learned the tricks and techniques of illusion proper to the craft. His first cure was an outstanding success that he himself credits to the simple fact that the patient “firmly believed in the dream he had about me” (Lévi-Strauss, 1949b, p. 203). But Quesalid—who remained convinced of the hoax represented by the magical cures— soon began to feel that some cures are more false than others. Visiting another tribe, he succeeded in curing a patient who had been resistant to the local shaman. Through an act of prestidigitation, he pulled a bloody worm from his own mouth and showed it to the public as proof that the evil had been removed. The local shaman had only spit into his own hands. In other words, Quesalid’s method was more impressive. Quesalid’s reputation spread to the point that

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he was summoned to a great duel with the most eminent shamans called in from other places. Again, the technique of the bloody worm triumphed over the incorporation of the invisible evil affected by his opponent, even though the opponent had included in his cure a trick in which his rattle appeared to be suspended in the air. The defeated and disgraced shaman thus saw his therapeutic system crumble. He then begged Quesalid to tell him his secret; was it a true malady, or was it invented? In exchange, the old healer explained his own theory of disease to Quesalid, whose doubt then had a counterpart in the hesitation of the old sorcerer. Quesalid continued in his career, remained silent about his secret trick, and continued to feel complete disdain for his profession. The old shaman eventually left in exile, went mad, and died. After many years of unmasking false shamans, Quesalid finally ran across a case where he could not be sure whether he was dealing with a true shaman or one more charlatan. This practitioner used suction, demanded no payment for cures, and never laughed. Granted that there are true shamans, he wondered whether he himself, Quesalid, was one of them? Quesalid’s doubt must be separated from his apparent scepticism. In the practical process of curing, all shamans re-enact the experience that made them such. This is why someone can become a shaman through a calling, through a stigma or by having gone through a successful shamanistic cure—exactly as a psychoanalyst has to go through an analysis before practicing it. But Quesalid’s example shows how this experience cannot be reduced to the incorporation of a theory of disease and cure, or to a mastery over a technique. Quesalid was a great sorcerer not because he cured the sick: he cured the sick because he had become a great sorcerer (Lévi-Strauss, 1949b, p. 208). His experience suggests that a shaman can cure without his believing in what he is doing, without his trusting in the myth that reintegrates the patient. This reasoning is partially false. It shows only that the effectiveness of the cure does not depend on belief in order to bear a type of interior knowledge into which the healer deposits an intentional truth (as myth). Belief can be looked at in another way, as a practice with respect to which personal interior conviction is a secondary effect. The first cause of the belief is the doing, and not the knowing. As Pascal said: “Kneel and pray—faith will come of its own accord”. This is consonant with the anthropological observation to the effect that

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there is a considerable and constant level of discrepancy between myths, on the one hand, as shared social narratives, and rites, on the other, as practices that are not direct and consistent counterparts of the myths. When practicing a healing rite, with all its correlate acts, Quesalid pragmatically believed, and this special type of belief, where the subjective implication in knowledge is suspended, was a source of the refinement of his excellence. Quesalid’s belief had a different function from that which operates in prayers for a cure. For faithful who pray for divine intercession, it is a matter of belief in something or in someone. For the user of a magical cure, the question is to believe in the shaman (Žižek, 2003, p. 110). That is, belief in something or someone is an indirect idealistic and transitive belief, while believing the shaman is a pragmatic and direct belief. The former exercises his practice with belief without faith, and the second, with faith without belief. For this reason, prayers are not considered part of magical cures, even though belief in transcendental entities is involved (Jackson, 1999, p. 19). Might not Quesalid’s doubt then be a decisive part of his symbolic excellence? A shamanistic cure always implies a complementary relationship between normal thinking, on the one hand, where a lack of meaning is possible and, on the other, pathological thinking, which is characterized by an excess of meaning. Magical thinking provides a new system of references where contradictory data can be integrated with one another. In other words, magical thinking does not solve the problem of the lack of meaning by using a more consistent vocabulary. It settles the contradictions in a new syntactic formalization. This explains the effectiveness of the second type of shamanism, where a language that is incomprehensible to the patient is used. In this sense, too strong a belief in one’s own vocabulary, in the effectiveness of the technique or in the legitimacy that the public confers on the healer (that is, Quesalid’s reputation) interferes with the symbolic excellence needed for the cure.

The place of truth and the position of the cause The doubt of Ulysses, the conversion of Paul, and Quesalid’s uncertainty express three modes of division of the subject or, in other words, three destinations for this division. In each case, the division is seen as knowledge separate from truth. In all three strategies the cure is

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defined as a process of reinstalling these effects of truth. The truth in Ulysses operates as aletheia, that is, as revelation, unveiling. Lethe refers to the mythical lake that made those who drank of its waters forget their own past. Adding the negative prefix [a], we have something like “unforgetting” or “disforgetting”. But forgetting, in itself, is already a negative term, as it conveys the idea of not remembering. Aletheia, therefore, refers to a mode of the truth that consists of a double negation, intrinsically associated with the relationship between past and present. The truth reveals what was already there in a type of return to itself, according to an ontology that connects the past to the present in a relationship of identity. In this respect, the truth, understood as position rather than as contents, returns to Ulysses when he remembers that he is the king of Ithaca, the great Greek warrior. The truth therefore explores especially the declarative dimension of language: the proposition, the sentence, and the choice. For the biblical heroes the Hebrew word for truth is emunah. That is, it presumes a personal reference related to the idea of trust and sincerity. The true God is the one who fulfils his promises and the false believer is the one who fails to comply with the covenant (Hegenberg, 1975, p. 13). In this narrative, therefore, the truth points to the future and to the performative dimension of language: the oath, the promise, the bet. It has already been noted that the difficult passage from propositional logic or verifiable functional logic—based on types of judgements and, especially, apophantic judgements—to modal logic, based on the notions of necessity, possibility, impossibility, and contingency, derives from minor differences in the real function of truth in each case (Tugenhat & Wolf, 1997, p. 38). The origin of this difference can be seen in the narratives we are examining. In our three figures there is a “separation of powers between the truth as cause and knowledge put into practice” (Lacan, 1965, p. 884). We saw how types of knowledge put into practice respond to the symbolic effectiveness of a treatment. We now introduce the idea that symbolic excellence connects with the position of the subject faced with the truth as cause. Lacan’s thesis is that, in magic, the truth takes on its role as efficient cause. That is, one condition for the transformation process is that its agent must coincide with its bodily support, so that the causal chain between nature and enchantment remains homogeneous. This can only take place through the repression (Verdrängung) of the subject.

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It is precisely this that is expressed in Quesalid’s doubt and in the split between his pragmatic belief in the magical sphere and his disbelief in the knowledge that justifies it. It is also through the physical acts he performs against his rivals that he becomes a superb healer. Now it is precisely this coincidence that is barred in Ulysses’ experience, in the tradition of logos and of science. His thymos is present as a source of disturbance and falsehood. He must free himself from this bodily substance in his process of anamnesis, and the truth reigns in him as a formal cause. For this purpose, a type of foreclosure (Verwerfung) of the subject has been set up. This is expressed by the way the subject deals with the very emergence of the question. Regardless of his fate or solution, Ulysses is surprised that it has come up. Theoretically, the doubt should not have been posited. Finally, in the sphere of religion, the division of powers between knowledge and truth is based on the final cause. Here, the relationship of the subject with the truth is asserted mainly by negation (Verneinung). When Paul denies the existence of Greeks and Romans, of men and women, he simultaneously stresses the universal objective of Christian belief. Thus, the process of transformation is described as the history of the negations of oneself, which are necessary for discovering the truth. It is important to stress that the notion of repression, used in the context of the fundamental defence that characterizes clinical structures, is usually associated with neurosis, while the idea of foreclosure is taken as being specific to psychotic defences. But in this context, these concepts are used to specify discourses rather than subjective positions. The approximation of science to psychosis, and magic to neurosis, is therefore inappropriate. These terms are not used here in their usual relationship with clinical structures. In the present context, they express modes of negation and a type of relationship where what has been negated still remains present and operates actively in the interior of what has been negated. In other words, they designate the type of truth and causality that has to remain concealed from the subject that speaks so that a certain piece of knowledge can allow power to be exercised. The categories are narrative strategies, not structural determinations. Homeric narrative, Judeo-Christian narrative, and shamanistic narrative suppose ethically distinct therapeutic solutions. Whereas Ulysses tries to re-establish the relationship between means and ends

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to recover his place, Paul tries to adjust the relationship between the agent and the receiver in order to recover his position, and Quesalid seeks a balance between the means and the agent of the cure. If we remember that, for the ancients, the field of ethics was defined by the relationship between the means, the ends, the agent, and the receiver of a given action, we are led to the conclusion that models of cure, considered in terms of their symbolic excellence, are also ethical positions. In this regard, the most likely hypothesis is that psychoanalysis is the heir of compromise therapies. In short, this means combining the three variants described above. But, contrary to these variants, the strategy for cure in psychoanalysis implies that it permanently leaves open the question of “who is speaking?” and, therefore, the question as to the source of the power in this speech. It should not be supposed that the subject comes to analysis as a tabula rasa in terms of therapeutic narratives. On the contrary, his complaint may well be expressed in relation to the narrative strategies through which his suffering can be formulated. His demand may also be a plea for the re-establishment of his effectiveness or excellence (Parker, 1999). According to Rieff (1990) compromise therapies base their method on the coercive strength of the symbolic system, which is able to re-unite the members of a community around a characteristic ideal. The feeling of well-being and health is defined by organic participation adjusted to the fate and origins of a community. In the final analysis, the community itself is the healer, through myths or narratives that it sanctions and through the intermediaries it chooses for this function. The therapist’s function is to make the individual re-commit herself to that community by making use of its symbolic integrating effect. Moral deviation and psychological conflict are thus the mimesis of social instability. The ideological trick here is that the integration carried out in this way does not change the social contradiction it proceeds from and even contributes to an intensification of that contradiction. Treatment that, in exchange for holding to the ideals of the community, the individual receives cure, care or a re-establishment of herself. It has been noted that the most common strategy of compromise therapies in modernity is to subordinate some of the traditional rules of conventional morality to the demands for personal achievement and hope (Taylor, 1994, p. 647). There is a type of politics of subjectivization involved here and, consequently, a strategy for stabilizing the calculation of happiness.

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This discursive and ritualistic renewal of compromises makes up the field of therapeutic belief. This belief involves an undefined chain of transformations, conversions, and proofs by which the individual returns to and refines her group identifications. Far from being merely an intimate and spontaneous feeling similar to conviction, belief is an operation aimed at suturing the open space between the oral and the written in an attempt to reduce, either discursively or through a confirming act, the distance between author and narrator. For psychoanalysis, however, there is no positive community with which the individual can be therapeutically fused. There are, at best, negative communities, that is, social ties based on the supposition of an intersubjective recognition that is never entirely possible and on the conflictive sharing of property and its use. In psychoanalysis there is also the critical work of de-stabilizing ideals and values expressed by the subject and intrinsically validated. Here, intrinsic validation is understood as the fact that such ideals and values are universal, therefore seen as desirable for all human beings, and to which the analysand should thus conform or adapt to. It is a practice based on a social configuration where an organic community tie is impossible and that involves an analysis of the different ways by which the failure of this tie occurs: educating, governing, making desire, and even psychoanalysing. There would then be no collective salvation or even permanent relief for the dialectic between hope and despair (Rieff, op. cit., p. 89). It is also supposed that the very demand for cure, salvation, or re-establishment, according to the paradigm of community integration, has its sources in the superego. That is, it is part of the origin of the problem, and not of the solution. This ties in with the fact that, in the analytic situation, the psychoanalyst puts himself in the place of a stranger. He is not a sacred personality, much less an exemplary model of conduct or someone invested with a magical participation in the world. His authority must be carefully separated from moral, religious, or magical legitimacy that could possibly be the basis of his action. On the contrary, his action is directed against the power that an identification of this type can confer on him. It is not an initiation, but a type of counter-initiation, the objective of which is to do away with the need for initiations (Rieff, 1990, p. 89). It is still an open question, therefore, as to what type of relation with the truth one could encounter that would justify the principles of the analyst’s power.

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CHAPTER TWO

The return of Empedocles

From land we see land, with water we see water, with the divine air we see air, with fire we see destroying fire; by love we see love and by sad hatred we see hatred. —Empedocles

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ometime around the fourth century BC certain discourses arose in Greece that was opposed to the Eleatic thinking from which Socratic-Platonic philosophy was born. One of the leading exponents of this opposing current was Empedocles of Argent (490–435 BC), a physician, politician, and dramatist. He proposed a system of thought that fitted better with his medical practice than the static metaphysics of being. That type of metaphysics was founded on the idea that everything that exists comprises a unity (logos), but it does not adapt well when one tries to think in terms of variations of this being, such as in the case of illness. In response, Empedocles and others developed a metaphysics of plurality, based, at one and 17

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the same time, on the accuracy of observation and on speculative solidity. Being is not a unit; it is divided into four principles (arche): earth, fire, water, and air. The cosmos is made of these principles in varying proportions and they are subject to cosmological regulation. In this sense, there are times when the strength of philia (friendship) prevails. It joins the different elements according to the law of “Like joins with like”. In other words, the portions of water join with more water, those of earth with more earth, and so forth, until the moment when the cosmos is divided into four entirely different and uniform regions. At this point a paradox emerges. The continuous action of the union of the same elements culminates in the maximum degree of separation of the principles one from another. This results in an inversion of the law of philia and in the beginning of a new era, now governed by neikos (the spirit of discord, or strife), whose approximate statement is: “Like separates from like”. The strength of neikos separates fire from fire, earth from earth, water from water, and air from air, bringing about an expanding movement of mixture between the elements to a maximum degree of dispersion. At this point a new inversion occurs, from neikos towards philia, and alternates indefinitely (Empédocles de Agrigento, 1973, pp. 219–253).

Empedocles between order and disorder A disease, or a disorder, is seen as an imbalance between these principles in an individual, and a cure is a return to the correct proportions, that is, a state that best replicates the prevailing strength at the moment: neikos or philia. For Empedocles, this return had a moral sense to it and it meant the freedom of the concealed self, which he called daimon, and not psyche (Dodds, 2002, p. 156). He held that physicians have the duty to discover which of the principles is in excess or is lacking. For this purpose, he would ask his patients about the moment when the disorder appeared, such as: “What were you wearing?” “What had you eaten?” “What was the weather like?”, or “What constellation was in the sky?” The objective of this investigation was to establish analogical relationships such as, “he was wearing red, and therefore there was too much fire”. The cure occurs by reintroducing the lacking element. For example, when the pneumatic principle is lacking, it is advisable to prescribe a diet based on poultry. Up to this point, we have a model of cure

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that is incorrect, although we must admit that it is consistent with its premises. But it is a model that has gained a certain amount of social recognition, especially after it showed its effectiveness when Empedocles managed to eradicate endemic malaria in the city of Selinonte. A clinical practice then arose that was largely based on the art of asking the right questions and organizing them according to an investigative strategy that would be consistent with causal principles. This practice, however, could not yet be considered specifically medical: Empedocles does not represent the new, but a type of older personality—the shaman who combines the still undifferentiated functions of the sorcerer, the poet and philosopher, the preacher, the healer and the counsellor. After Empedocles these functions became distinct and, from then on, philosophers were neither poets nor sorcerers. (Dodds, 2002, p. 150)

Empedocles’ method, which stresses diagnosis rather than prognosis, brings up a theoretical problem. His questions about the contingencies that surrounded the appearance of this disorder often prevented him from defining the exact moment it began. The disorder was confused with the patient’s life in general, and this life was intertwined with former lives, according to the Orphic and Pythagorean cults that influenced Empedocles. This may have been one of the reasons why he went on to specialize in techniques in recollection and memory. Probably under the influence of the Pythagorean School, he developed techniques of recal based on breathing and on the detailed reconstruction of events in daily life. Control of the diaphragm (prapides) allowed for communication and the possibility of separating memories from this and former lives (Hadot, 1995). Breathing (psyche) thus became the key to his curative doctrine, since it helped him settle the problem of memory. This done, he could then define the exact moment when the disorder began and, consequently, to identify the type of disproportion that was present between the elements involved. But Empedocles’ method still lacks a way to determine the moment of discontinuity between ordinary life and the pathology that has recently emerged, that is to say, between neikos and philia. Empedocles had to be able to explain not only his power to describe the disorder and explain its

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origin but also his reasons for acting on it, and he synchronized the moment of the action with the description of the disorder. Some say Empedocles went mad pondering over this problem. He felt he possessed magical powers, such as the ability to hold back the winds and, according to the legend, he threw himself into the crater of the volcano Aetna to prove he was a god. Is this aspect of the story irrelevant for the conception of treatment that Empedocles proposed? Besides having a good method for curing, why would the agent or executor of this method have to be him, someone different, someone called or anointed by the gods? Empedocles’ model of cure gives us a snapshot of the basic elements that structure our problem. First, there is a distribution between elements and principles that refer to the generic nature of being. Next, there is the specific manifestation of a disorder in this relationship, coordinated by the economy of lack and excess, and the manifestation must be recognized or interpreted by the reading of signs. Finally, there is a procedure for re-establishing and recomposing that characterizes the cure. This process has the objective of returning to the satisfactory proportion between the elements in the body and the proportion between the body and nature. This is the principle of isomoira (that is, the principles of proportion, or equality) (Jager, 1987, p. 787). This scheme characterizes the ancient models of cure in general. For Hippocrates of Kos (460–377 BC), there are four humours, different from the scheme proposed by Empedocles. Over a century later, Galen posited that pathological manifestations are limited to signs in the body. Gradually these different approaches led to the consensus that a disease is an episode of inversion of forces in a person. This position eventually gave rise to the notion of crisis and the great metaphor of disease as a process that finds its apex at the moment of struggle between sickness and health. A disorder, or a disease, therefore, was no longer conceived as a disproportion between man and the cosmos but as an imbalance that is interior to a given individual. The central idea in Empedocles, more so than in Hippocrates, is that a cure implies decision, choice, and pondering regarding the specific situation that is being faced. This position gave rise to the idea that a cure is basically an act practiced at an opportune moment, and it should last as short a time as possible. Hippocrates was against surgery and emphasized the continuity of the care that

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should be given. Empedocles, on the other hand, held that treatment should include interventions that would detect the discontinuity of illness. An act exposes its agent to a limitation, since it is impossible to have all the knowledge one needs to act. One does not have unlimited time nor all the desirable resources, nor can one discern with absolute certainty the quality of the ends and the merits of the means. Healing is a risky activity. Let us look at a historical example by looking at excerpts from Articles 215–218 of the Code of Hammurabi (2009), the earliest known legal text in the West: If a physician make a large incision with an operating knife and cure it, or if he opens a tumour (over the eye) with an operating knife, and saves the eye, he shall receive ten shekels in money … . If [he] kills him or … and cuts out the eye, his hands shall be cut off.

So we are in a situation of risk and we do not have all the knowledge we need to act, but we must act. Under these circumstances, one can certainly admire the courage of Babylonian physicians. They had only one chance. The model worked out by Empedocles and his pre-modern successors have in common that they see cures as grand narratives into which one must intervene in order to produce a return and an inversion of a process. This does not mean that a cure in itself is similar to narrating the past and articulating it consistently with the future. A cure does not have the purpose of transmitting knowledge, but of changing the state of a life, making it return to what it was before the onset of the event. A cure is not a narrative, but it has the structure of narrative. Other characteristics of narrative in a healing process are the presentation of an initial situation, a change in this situation, and an outcome, a re-establishment. The relationship between the initial position and the final position determines the type of transformation involved. The narrative also depends on the relationship between the narrator and the story that is being told, with its characters, scenery, and conflicts. One should not confuse the narrator, defined by his enunciative position and by the way he positions his listeners, with the author. Nor should one confuse the reader with one who listens to a narration, which is the place constructed by the articulations

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between narrative and discourse. What separates shamanistic cures and cures by narrative compromise from a specifically clinical strategy is the clear separation between the author of the cure and the narrator who describes its process. In the days of Empedocles, Greek culture seemed to be increasingly in doubt about its own myths, as it progressively displaced them from the condition of being factual truths to the status of feasible hypotheses or conjectures (Veyne, 1983). Moreover, the Latin term fictio means exactly “hypothesis”, that is, something that need be neither real nor true, but that can lead to effective action. The hypothetical method of investigation into the causes of a disease admits that the suppositions made by a physician can be contradicted by the narrative of the disease. This all leads back to the two questions left open by Empedocles’ model of cure. By asserting himself not only as an executor of healing techniques but also as a hero and a special person, Empedocles seeks to separate the author’s position from the narrator’s position. He does not tell the story of the struggles between instability and restoration as it was entrusted to him by tradition, as he might have witnessed personally or even according to the order of social legitimation prescribed by his times. He is not a messenger or a mediator of knowledge. He is its author. The authority of his discourse and his acts in relation to pathology is direct and personal, and not indirect or mediated. It would seem that a change in discourse in Greek society made it possible to formulate the method of investigation developed by Empedocles, and this leads us to the second question, which involves the role of the word used in the act of curing. It is a word that can be described as deontological. It prescribes how the patient should conduct her daily habits, her diet, her erotic life, her attitude towards time and space, and towards others. Deontology is a concept that we find in philosophy as well as in medicine and law, and refers to the theory of duty and underlying values, usually considered from the perspective of the agent of moral, therapeutic, or legal action. The birth of a word of this type brings up the question of the authority of an agent of cure. It is suggestive that Empedocles is also considered the father of rhetoric because this way of conceiving language presumes a certain awareness of the distance between speech and discourse and a methodical reflection on the source of their authority.

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Empedocles lived during a time that has often been characterized as one of transition from a social order based on myths to one based on logos di donai, that is, on the belief in rational explanations for acts and for the source of authority. The word arche does not belong to mythical vocabulary. It ambiguously designates the origin of a temporal series and primacy in social hierarchy (Vernant, 1989, p. 91). Myths exercise an anti-hierarchical as well as an anti-individualizing function (Clastres, 1988). Mythical narratives alternate two forms of temporality: repetition and breakdown (Leach, 1953, p. 193). These two temporal modes arise from the perception that certain natural phenomena are repeated and that changes in life are irreversible. In other words, there is a real that always returns to the same place and a real that appears as irreversible breakdown. On the one hand, there is cyclical time and, on the other, time as discontinuous. Ritual exchanges and systems of interrelated kinship are inscribed in the logic of cyclical temporality. Rites of passage, in which various stages of life are symbolically lived through, are examples of discontinuous temporality. We can then contrast Hippocratic medicine as a practice that emphasizes repetition and continuity with that of Empedocles, which concentrates on moments of breakdown and inversion. The authority of Empedocles’ word is not of the same type as that of a shaman, nor even as that we see today in compromise therapies. It is based neither on oracular laws nor on the authority of the family and the lineage to which one belongs. Empedocles was summoned to publicly justify his therapeutic approach, and was obliged to base himself on a difference that was foreign to his premises. According to his ideas, there is no hierarchical difference between elements or among principles. There is thus nothing that might bestow any privilege on the authority of his word. Moreover, in political terms Empedocles was a fervent defender of democracy and stood strongly against oligarchy. For him, obeying therapeutic rules whose authority emanates from the tradition guaranteed by the gods is completely different from obeying rules in situations of equality between subjects who are susceptible to persuasion.

The oath of Hippocrates Hippocrates decided to solve that problem in a very simple way. Maybe that is why he (and not Empedocles) is considered the father

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of medicine. Hippocrates invented a form of action that limited the authority of the healer at the same time that it set down the principles of his authority: the oath. An oath is a public and continuous act of language that establishes the passage and authority of the healer, inscribing him or her into a discourse. The oath, as well as other forms of performance, shortens the distance between the saying and what is said, thus allowing a passage from speech to discourse. The oath is to discourse what deixis is to speech. Deixis (to show) refers to that aspect of language that connects the subject of the message to the uttering, or the stating, of the message. Pronouns such as I, you, and him are deixis of person. Adverbs such as tomorrow, today, and yesterday are deixis of time, and adverbs such as there, here, and over there are deixis of place. In other words, their functions may vary in accord with the discourse. Deixis is the place where the subject of the enunciation is inscribed in the statement, whereas the oath is the act by which the subject of the enunciation is inscribed in a discourse. The Hippocratic Oath consists of ten points. The first two refer to the transmission of the art of medicine, an act that should be carried out free of charge. The relationship between master and apprentice should be similar to that which exists between parents and children. The next three points are of a moral nature: do no evil (even if asked to do so), abstain from injustice, and safeguard purity and innocence. The next three points deal with not taking advantage of the power that the healing situation confers: do not seduce women, slaves or young people; do not practice surgery; and do not use what you have heard or discovered in the situation of the cure for purposes foreign to the profession (secrecy and discretion). The final two points of the oath are a curious consideration on the oath itself: if the oath is complied with, may the physician have a happy life. If one acts in violation of the oath, the opposite should occur. The oath therefore treats of the transmission of knowledge, the limits of the power of those who exercise it, and the relationship between the physician and his or her own word. Most of the corpus hippocraticum deals with the relationship between doctor and patient. Hippocrates stresses the importance of observation and the regularity of the course of the illness and clinically gives more importance to prognosis than to diagnosis. The three true objectives that a doctor must keep in mind, therefore, are to relieve the patient’s suffering, reduce the gravity of the illness, and recognize and abstain from treating the

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untreatable (Adler, 2006, p. 22). For Hippocrates, the cure corresponds to dominating the time of the illness, and the physician is a type of assistant to nature, it being nature that precipitates both the illness and its cure. Fever, for example, indicates the beginning of the recovery process, the beginning of a cycle that is a type of natural tendency of the organism. The physician has the duty to watch over this cycle and protect its development (Lima, 2003, p. 45). Sickness is thus seen as a cycle similar to the seasons of the year. Hippocrates’ therapeutic principle is that opposites cure one another: one thing is the cure to its opposite (contraria contrariis curantur); a disease caused by overeating is cured by restricting the diet, a disease caused by the cold is cured by heat, diseases caused by overwork are cured by rest, and so forth. Contrary to Empedocles, who dealt with oppositions between quantitative principles (combining identity and difference), Hippocrates posits oppositions in qualitative terms (Jackson, 1999, p. 203). For Empedocles, cure operated by bringing about a return to the correct proportions. In Hippocrates, on the other hand, we find an approach that seeks to relieve, mitigate, and reduce suffering. His, therefore, is a project for care and re-establishment. An important distinction emerges here between suffering and symptom. Both Empedocles and Hippocrates are clearly aware that medicine must treat the illness through its symptoms and, at the same time, relieve the patient’s suffering, but these are relatively distinct tasks. For example, Erasistratus (330–255 BC), an Hippocratic physician, was once called to treat Prince Antiochus for a strange malady. The patient refused to eat, and spent his days in bed in profound sadness. He was unable to sleep and had gastrointestinal difficulties for months on end. Even when he managed to get to sleep, he remained anxious and had constant nightmares. The local doctors diagnosed dysfunction of the bilis negra, specifically, melancholia. Soon after Erisistratus arrived to treat the prince, he noted that the man’s difficulties showed strange oscillations. During the examination he noted that the patient’s countenance occasionally regained its cheer, and he noted that this improvement corresponded to times when the prince’s niece, Stratonice, was present. So the physician concluded that “the ailment was love, and not disease” (Id., 1986, p. 352). The difference between a set of symptoms and the suffering associated with them was decisive in separating the notion of treatment inspired by magical, religious, or clinical narrative therapy, from medical treatment.

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Suffering is cured with words, while symptoms are cured with changes in the patient’s living conditions. Illness has a predictable cycle, but suffering does not. The differences between Hippocrates and Empedocles must be understood in the context of a moment in time when medicine was part of the education (paideia) and culture of any Greek citizen. Medicine was not clearly seen as a method for curing disease, but rather as the knowledge needed for the practice of lifestyle. In this context, physical virtues, such as health, strength, and beauty, should be equated with the virtues of the soul, which include piety, bravery, moderation, and justice. Medicine was, above all, the field of the diet, but it also included physical exercise, what we would call lifestyle today. This would include the trivial choices of everyday life, such as what time to get up, to go to bed, what to eat and when, whether to exercise or not. One important aspect of this lifestyle was erotics, or aphrodisia. The use of pleasures was not based on the notion of restriction, but on the idea of temperance (sophrosine). That is, it depended on one’s ability to master one’s pleasures and exercise a relationship of sovereignty over them. The main point of this grammar resided in the opposition between activity and passivity, and not on the specific nature of one’s sexual object (Foucault, 1984b). In this light, one can conclude that Hippocratic medicine did not call for doing much to the patient. This would be to reinforce the passive condition, associated with the loss of liberty. It was through trust in the individual’s activity and in his or her strength to struggle to overcome the illness that this model of cure had its place in Greek society. Empedocles’ conception was not organized around the opposition between passivity and activity but around action aimed at the causes. This is why, at the same time, it fell under scrutiny regarding the role of power in healing processes. Hippocratic doctors acquire their authority at the moment they established their limits by taking an oath that inscribed them into a discourse. Doctors of the school of Empedocles, on the other hand, were confronted with the permanent problem as to the type of power involved in the cure.

Plato and the medicine of the soul Plato offers us another alternative model. He says that philosophy, as therapy for the soul, corresponds to a higher type of knowledge that

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is superior to and contains within itself other types of knowledge, including medicine. Medicine should serve as a model for true rhetoric. That is, it should serve as a technique whose purposes are determined by episteme. For Plato, a cure should always involve a mode of relationship with the truth, although this position is repudiated by Hippocrates and uncertain for Empedocles. A cure should involve body and soul. If both are ill, one should always begin with the soul and apply “fair words” to it (Jackson, 1999, p. 24). This weighting of philosophy over medicine means that the power of medicine derives from that of philosophy, with the hierarchy unfolding within medical activity itself. Doctors comply with three stages in the development of their knowledge, namely, practice, investigation, and the condition of being a cultured man. The relationship with the other person is entirely different in each case. A practical doctor is a doctor of slaves. Usually associated with a tyrant, he rushes from one patient to another distributing instructions but without speaking with them. An investigative doctor cures his patients and discusses with his fellow physicians in a regime of secrecy. A cultured doctor, on the other hand, not only cures. He speaks about the nature of the malady, about the bases for the cure and about the functioning of the physis in general. In this respect, there are a number of satires about this personage that combines the figure of the doctor with that of the teacher, as if his function were not to recover health but to turn his patients into doctors (Jager, 1987, p. 794). Some doctors were recognized as professionals (demiurgs) and others were designated as idiotes, that is, isolated, and not members of the state or human community. The school of Empedocles maintained a completely different approach in terms of the use of words in the healing process. The word was practiced in the process of dialogue. Therefore, it was not silent, as was the practice of curing slaves, nor was it restricted to discussion between physicians. Much less was the physician seen as one who teaches about disease. Empedocles was an idiotes (Jager, 1987, p. 788) and healed as one. The notion of philia breaks down here into a type of double requisite to which doctors should adhere, and combines philantropia (love of human beings in general) and philotechnia (love of the art of healing) (Jackson, 1986, op. cit., p. 40). In this respect psychoanalysis follows the therapeutic scheme proposed by Empedocles in that healing does not mean adding to

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one’s cultural formation, nor is it restricted to the elimination of a disease. It is like an investigation but without a theoretical objective. Its means are similar to those of rhetoric, but without rhetoric becoming a technique for living. However, the main similarity resides in the status of the word and of the relationship built up during the healing process. There are also similarities between psychoanalysis and Empedocles’ thinking in the way that practice is articulated with its theoretical explanation. There are two major principles in psychoanalysis, the life drive and the death drive, which operate in permanent intertwining and separation. There are heterogeneous elements in conflict according to an economy of exchanges and a describable topology. Finally, there is the permanent problem of the origin of the analyst’s authority. These similarities were alluded to by Freud (1937c) in the following words: In terms of name as well as in terms of function, the two fundamental principles of Empedocles are the equivalent of our two original drives (Urtriebe): Eros and Thanatos.

It is interesting to note that this reference to Empedocles is present in Freud’s last great text about analytic treatment, Analysis terminable and interminable. Freud compares Empedocles to Faustus, and expresses his fascination with the acute contradictions that the writings of Empedocles seem to bring together, especially the ambivalence between researcher (Forscher) and thinker (Denker) (Assoun, 1978, p. 147). Freud also admires the fact that Empedocles’ bases his positions on a pluralistic materialism which, at one and the same time, takes into consideration the importance of chance (tuche) while also trusting in causality. Like Empedocles, psychoanalysis emphasizes diagnosis rather than prognosis. Germane to this approach is the construction of diagnoses based on the art of asking questions, with an obvious effort to read the signs that make up the narrative of a patient’s life. These questions constitute not merely neutral anamneses of the facts, but inductors of a doubly fictional space, related to the analyst’s clinical hypotheses and to the structure of truth at stake for the patient. As in psychoanalysis, the history of the subject blends in with the history of the symptoms. The notion of illness is

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therefore inappropriate. Nonetheless, the problem of establishing discontinuities continues. The drama of Empedocles is not resolved through an appeasing oath that incorporates the analyst into a community of healers, even though the spirit of Hippocrates is surely welcome. It is simply that the position of the healing agent should be permanently questioned during the treatment. This brings up chronic difficulties that are only partially solvable, in terms of criteria for the formation, or training, of analysts. But it is here that the complex of imposture also comes in, the feeling of social marginality and the analyst’s horror towards his act. If, in our context, the idea of jumping into a volcano may sound a bit odd, this does not free analysts from the temptation to see themselves as gods. In any case, Lacan compared this seemingly fearless and mad act of Empedocles to the process of separation that characterizes the establishment of a new form of desire through the experience of psychoanalysis: A belonging neither to is called upon here to fill a nor to. Empedocles’ act, responding thereto, shows that a will [vouloir] is involved. The vel returns in the form of a velle. That is the end of the operation. (Lacan, 1964b)

Lacan plays with the opposition between the idea that, in separation, object a (petit objet a) is not, at the moment (ni a), and the idea that it also is not, by its nature (n’y a). The object a has two main forms of existence, both of which are negative: it has no image but indicates the lack of an image, in the sense that there is something that is not there. Object a is not an object, such as a substance or a phenomena. Object a is the failure of objectivation through image or representation, trough phenomena or essence, trough intellectual or sensible apreehension. In other words the lack that the object a represents is also a void, without the two coming together as a unit. A second opposition occurs between vel (a specific type of alternateness based on intersection) and velle (to want). Farther ahead, we will see the crucial place that this operation occupies in Lacan’s scheme of treatment. For the time being it is important to call attention to the affinity between Empedocles’ act and the type of problem related to the idea that the analyst is not authorized other than by himself (Rabinovich, 2000, pp. 125–145).

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So, what separates psychoanalysis from the perspective of Empedocles is not the structure of the rationality of his clinical approach, but the fact that its therapeutic action is not based even on a deontological type of word. It is certain that an analyst may sometimes make a deontological intervention, and there are good historical examples of this in Freud and Lacan, not to mention Ferenczi’s active technique, but it is not from obedience to these injunctions that one hopes for any progress during the curing process. We thus come to the conclusion that psychoanalysis cannot respond to an ethic of recomposition, typical of compromise therapies, Nor to a mixed clinical perspective like that we find in Empedocles cure-healing model, nor even the treatment-therapeutic model derived from Hippocrates, nor even the platonic method of the medicine of the soul. It must be admitted that there exists a relationship of opposition between the forms of power involved in psychoanalysis and in these other clinical and therapeutic approaches. This, however, does not authorize us to proclaim that there is any type of constitutive and specific negation of the form of power involved in such practices. That is, it is not sufficient to say that there is an opposition between compromise therapies and psychoanalysis, or between Hippocratic medicine and psychoanalysis, that would exempt analysis of these strategies of power. It must be shown how psychoanalytic discourse depends internally on the practices of negation or of counter-power derived from points of de-stabilization of the hegemonic therapies and their respective regimes of truth.

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CHAPTER THREE

The act of Antigone

Hold to your pretexts. As for me, I will give my brother a grave. —Antigone

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ntigone is the daughter of Oedipus, King of Thebes (Sófocles, 2000). Four children were born of his incestuous marriage to Jocasta: Polynices, Eteocles, Ismene, and Antigone. When Oedipus retreats to the desert, holding his own eyes towards the sun in punishment for the sin he has committed, Creon, brother of Jocasta, rises to the throne of Thebes. His act is contested by Polynices but supported by Eteocles. These two brothers struggle at the gates of the city and, when the fight is over, their bodies lie unburied. Creon decides that Eteocles should be buried with full honours, whereas Polynices should be condemned to the worst of all fates for any Greek man. He is to be left unburied. Consequently, not only is he to be forgotten; he is not even to be remembered; it will be as if he had never existed. Funeral rites marked a person’s inclusion into the symbolic Greek community and, without them, he 31

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or she became a symbolic outcast. We should recall that one of the ideals of Greek life was to have an early death and, if possible, on the battlefield. Only in this way could an individual be remembered forever by the community as a virtuous man or women. Creon’s edict corresponds dramatically to Oedipus’ own desire when he goes into exile in the desert. At that moment, Oedipus had said: "Me phunai" [It would have been better never to have existed]’. Creon threatens Polynices with his father’s desire. Antigone then decides to disobey Creon and bury Polynices. Ismene and Eteocles take sides with King Creon. Obliged to maintain his word, Creon orders that, in punishment, Antigone be buried alive. This situation results in an intricate network of alliances and appeals aimed at persuading Creon to go back on his decision. Ismene eventually decides to save her sister, risking the same fate for herself. Haemon, Creon’s son and Antigone’s fiancé, tries to dissuade his father, to spare the life of his beloved. Eurydice, Creon’s wife and mother of Haemon, tries to avoid the suffering of her son by interceding with her husband. The elders of Thebes, together with Tiresias, the soothsayer, ponder over the type of instability that might ensue from the punishment imposed on Polynices of being denied burial. When Creon realizes the unforeseen implications of his decision, he tries to go back on it, a situation that is always problematic in the case of a king’s word. But he vacillates too long and, before he can carry out the deeply symbolic act of "going back on his word’. Antigone unexpectedly holds firm; refusing the alternatives, she accepts the same fate as that of her brother Polynices to be deprived of funeral rites. Her fiancé, Haemon, commits suicide at her grave and, in consequence, her mother, Eurydice, also kills herself. Creon is the greatest loser. He sustained his word, from which he himself later backed down, but in the process he lost his niece, his son, and his wife, and a considerable portion of his authority as king. Antigone loses in a different way. She suffers the same fate she tried to avoid for her brother by being denied any funeral rites. Her act, aimed at asserting the laws of loyalty determined by kinship (oikos) against the laws of the polis, reformulated by men according to the contingencies of their acts, ends up destroying these same kinship relationships, dragging both Haemon and Eurydice to their deaths as well.

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This Greek tragedy brings together three strains of discourse. It is the aesthetic fulfilment of a social problem. Second, it is a discourse aimed at educating the public by reminding them of the symbolic narratives of the Greek community and positioning these narratives in a new situation of ethical contradictions. Finally, it also seeks to affect a cure for the passions (catharsis, in Greek) that attack individuals as well as communities. The countless historical forms by which the genre of tragedy has been understood contain the different solutions that can be found for the disparity between methods of curing or, we might say, healing, and the ethical principles that are related to them. Here we can see a new category emerging in our discussion, a type of spontaneous intermediary between the therapeutic principle (returning to a previous state) of recovering a lost situation of stability or harmony (integrative catharsis) on the one hand, and the clinical principle of observation and prescription (functional catharsis) on the other. We might call this third ethical principle of refusing power, which has an aesthetic dimension to it, the healing principle.

Tragedy To comply with its cathartic and educational function, the genre of tragedy must solve a number of formal aesthetic problems. It must subdivide the action into separate scenes, which all occur in a single place, necessarily sequential in time, expressed through dialogues that involve a maximum of three characters. From the point of view of the plot, a tragedy must break up the myth, isolate its essential fragments, and thus, in a certain sense, extract its structure. There is no time for long descriptions. The core of the action must carry more weight than the narrative (Snell, 2001, p. 100). The price paid for this formal requirement is that the protagonist, that is, the character who is experiencing the conflict (agon), begins to represent, rather than be, the hero. Before a narrative can be true, or real, it must first be plausible. At the centre of the dramatic action there is a type of judgement and evaluation regarding the hero’s act. This act is characterized by going beyond that which defines a man. In other words, heroes are people who separate themselves from the conditions that define them as members of the community and from the divine and human laws that membership demands. A hero’s fate is constructed

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by the integrative and disintegrative upheavals of this act. The tragic hero always commits an act of hubris, that is, an act that cannot be clearly and immediately located within the strategies of subjectivization expected or prescribed by the times the hero lives in. This act may be unknown to the hero, as was the case with Oedipus Rex, or it can be deliberate, such as in the case of Antigone. But besides these formal conditions that define the genre of tragedy, it is important to highlight the similarity between the incorporation of the word in psychoanalysis and in Greek tragedy. Something is needed that suggests a type of practical mimicry between the two discourses. All fields of art have contributed to psychoanalytic reflection, but the theatre seems to have provided an association that involves the very structure of treatment. The analysand brings with him his narrative and he not only relates it. He also plays it out in the transference, often without being aware of this fact. The problem for the analyst is to establish the place where he is put by this narrative, but he must also get out of this place, transform the meaning of the narrative, and sometimes change the discourse through which it is acted out. The word theatron means “place where one sees”, and this calls attention to a central problem during treatment, namely, the place one is listening from. Analyst and analysand are involved in an interplay that is organized on various levels by the positions of narrator-listener, actor-character, and author-audience. Here there are numerous figures of the other which the analyst must make use of. Just as Sophocles, Euripides, and Aeschylus had to condense long mythical narratives, analysands must condense their inexhaustible repertoire of memories, recollections, events, illusions, and promises that have made up their lives. They do this at every moment, according to the predominating conflict (agon) of the moment, placing other actors in different places, always subject to the unexpected reaction of the chorus, the orchestra, and the audience itself. The analysand must also deal with formal problems, even in free association, such as “What to put in the proscenium, or foreground”, “What to leave in the scene” and, finally, “What to do with the appearances from the other scene (andere Shauplatz) and the elements that come in from the obscene (literally, “that which is outside the scene”). As was the case with the dramatists of the fourth century BC, analytic treatment divides speech into segments that are

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discontinuous in time and that consist of acts, or sessions, whose structure is dialogic. Like the Greek actors and audience, the analysand also expects an effect, which is a cure as a realignment of his or her fate, or the methodical treatment of symptoms, or the therapy to relief suffering. The affinity in practice between psychoanalysis and the theatre that involves a mimesis, which Lacan called the anamorphic cylinder of the tragedy (1959–1960, p. 341), or the Moebius-like structure of the tragedy. At the level of their logical structure, tragedy and comedy are not as opposed as they may seem. The important factor is the reversion between hero, the supposed agent, and sovereign of his acts, and what Lacan, in reference to Antigone, calls “dejecta”, or waste matter, the residue of a story that cannot be entirely absorbed into the field of meaning. From the discursive point of view, the analyst is the countenance and place where jouissance happens (Id., 1969, p. 4). Lacan insists, however, that the analyst’s place is homologous not to that of the audience, nor even to that of the judges or the orchestra, but to that of the chorus. The chorus consisted of masked dancers and singers, a type of collective character that represented the polis and an expansion of the conflict beyond the individual sphere. The chorus marks the pauses between the acts, indicates its moments of transition, and can encourage reflection on a moral or social theme pertinent to the narrative. It can serve as a character dialoguing with the actors, it can take an active part in the action, it can even comment on the dramatic events taking place. It thus acts as both ideal spectator and as a voice responsible for moderating the discourses and economizing the affects (Nietzsche, 1992, pp. 56–62). At this point it might be worthwhile to recall the importance Lacan gives to the examination of tragedy as a theatrical genre. There is an important difference between tragedy as theatre and the tragic in general. There is the tragic meaning of the myth, just as there is a literature, a philosophy and a tradition of tragic thinking (where, for example, Lucretius, Pascal, and Nietzsche are inscribed). When Lacan points out that the ethics of psychoanalysis is tragic ethics (Lacan, 1959–1960, p. 375), this does not mean that psychoanalysis has a tragic view of the world, allied to Freudian pessimism or to the ethics of resignation and renunciation. It has already been shown that the idea of tragedy as fatalist narrative is a

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medieval Christian incorporation into the Greek meaning of tragedy (Williams, 2002, p. 36). It seems, on the contrary, that if one considers the genre of narrative, the ethics of psychoanalysis is not only tragic, but also comical. It inspires both the pathetic (such as apathy in view of the diversity of the forms of jouissance) and the enthousiastikos (as involvement decided in desire) (Lacan, 1959–1960, p. 298). This might be another way of looking at the curious combination of scepticism and hope that we find in Freud’s style of work (Marcuse, 2006). What is essential is that this experience of clash between hero and anti-hero does occur, between narrator and audience, between chorus and protagonist, and between author and actor of one’s own life. Aristotle called this effect catharsis.

Catharsis: functionality, integration, and disintegration Catharsis, or purification, is an effect obtained at the place where the audience sees and is situated by the drama. In the drama of Antigone, for example, a reconciliatory catharsis can be seen, if we feel, at the end, that Creon ceases to be a tyrant and becomes a prudent and wiser ruler. Ismene, in turn, is transformed from fearful subject into a strong defender of domestic laws. Reconciliation also takes place between the law of the polis, represented by Creon, and the law of the oikos, represented by Ismene. Reciprocally, for this change to take place, the old order must disappear, as is clear in Antigone’s total loyalty to family and in the bloodline succession from Creon to Haemon. The drama of the death of these characters functions as a type of lesson on excessive identification with the rules of conventional moral action, as if to invite the spectators to reflect more critically on their own forms of internalization of the law (Freitag, 1992, p. 23). This reading is compatible with what we call compromise therapies. An alternative interpretation might have it that Antigone stood up for her individual morality, decidedly refusing to be included in the ethical sphere either of personal family relationships (her love for Haemon was not all that strong), of economic relationships (she renounces a comfortable life as the future queen of Thebes), or political relationships (she confronts Creon’s law and, by extension, the city’s law). But her refusal proves that, in the end, she is right, because it functions as a permanent message that the laws of the

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polis can be unjust and unworthy, that a secure and comfortable life is not necessarily a happy life, and that personal and family loyalties can be insufficient to define the excellence of a life. This interpretation transforms what might be considered as Antigone’s precipitation and stubbornness into a gesture of freedom. Her act is not proof of some unrestricted loyalty to the laws of the family. On the contrary, it is a way to free herself from it once and for all. It is a type of negative catharsis (disintegrative catharsis) the purpose of which is to “purify” the desire for purification. Her hubris is invested with destabilizing excess for an act aimed at representing the inconsistency of symbolic systems in determining the subject. In other words, it is an act that indicates a lack in the symbolic order. Antigone shows us the exact point where different symbolic systems (kinship, politics, religious, or legal) become unable to join together into a harmonious whole, but rather constitute a system of contradictions. Ulysses is a figure who is always in his place (despite his being an inveterate voyager) and who acts according to conventional ethics (overcoming numerous trials), but Antigone is a figure without a place. She is the inhabitant of a negative community and her act is inscribed in post-conventional ethics. Her act is beyond the law (Safatle, 2003, pp. 189–234). The affect that dominates her, therefore, is not shame nor even guilt, but anxiety. This reading finds in Antigone an ethics of the real as na ethics of excelence (arete). A third interpretation of Antigone’s act would get around the ethical question, to the extent that she is neither the heroine of individualized morals nor a pretext for collective change. Antigone simply acted in a without much forethought. Instead of using her influence as a member of the royal family to have her trusted guards secretly bury Polynices according to the traditional rituals, she turned her conflict with Creon into a type of endless struggle for the “possession of reason”. Or she could have used her skills to convince Creon to treat her fiancé Haemon with condescendence. Finally, she refused to have a frank, open, or even seductive conversation with Creon in order to show him that his political interests could be affected by his drastic decision and that he could instead enter into an agreement by which he, as King of Thebes, “would look the other way” during some simple family funeral rites held for their brother Polynices. This solution would involve a type of relationship based on the simple ethics of effectiveness (agathos), but the survival of interests would

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imply indecorous arrangements from the point of view of the match between private vicious and public virtues. It would bring dramatization into the drama itself, as if the actors had begun to serve as parodies of their own characters. According to this solution, there would be neither integrative catharsis (reconciliation), nor desintegrative catharsis (negative catharsis), but a type of functional catharsis. These three strategies indicate different ways of relating to the law, and can be associated with different ways of looking at human desire. The first interpretation stresses a dialectizing of desire between the subject and the Other; the second stresses the limits of this dialectic, seeing it in a non-integrative way; the third interpretation focuses on a balancing of the calculation of jouissance. Each of these readings implies a policy of happiness and a specific distribution of power. The first policy (functional catharsis) accentuates the dimension of empathy and compassion, and has a therapeutic aspect (Jackson, 1999, p. 47). Its central concept is the notion of suffering. The second policy (disintegrative catharsis) stresses the dimension of curing and its central concept is truth. The third policy (integrative catharsis) is of clinical inspiration and here one must look at the plot to resolve the symptoms the policy brings up. The tragedy condenses these three different policies into a single metaphor. Catharsis becomes another designation for the dialectic between lack and excess in the field of political meaning. It has been said (Silva, 1998) that, originally, catharsis is a political concept that allows us to discern different models of subjectivity and different ways of dealing with “evil” in the field of social relationships. Plato, for example, would represent a closed model of subjectivity, illustrated, for example, by a circle with a dot at the centre. According to this model, catharsis expels evil. The impure must be ejected so that order remains in its harmonious purity. This is the policy of segregation. Aristotle, on the other hand, might represent a model of shared subjectivity where evil must be recognized as arising from deviations in the relationships between individuals. The evil can then be reintegrated. The image here is of two or more interpenetrating circles representing a politics of reconciliation. Vestiges of these two models of subjectivity can be seen in psychoanalysis. The first could be called the model of mental chemistry, of Platonic extraction. This model is present in the Freudian theory of representation and dominates all the metaphors that are organized around the notion of psychic apparatus, the

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topics, and the concepts derived from associationism. From the practical point of view, it appears in references to catharsis and to abreaction of the affects. The second model, which might be called a model of shared subjectivity, is of Aristotelian inspiration. It is present, for example, in notions such as identification, projection, and introjection (Gabby, 2002). Its practical reference, naturally, is the notion of transference and the strategies of possible exchanges and relationships between the subject and the other. There would seem to be yet a third model of subjectivity in psychoanalysis, which we get a glimpse of in a second reading of Antigone, a model that Silva (1998) has termed “open subjectivity”. What is involved here is a relationship that is not integrative, but rather productive with the past, a past that opens up to unpredictability. Concepts related to this third model include the theoretical questions of female sexuality, the death drive, masochism, and the technical question of construction. The first two models imply different approaches to suffering. In the first, the point is to sacrifice the other and, in the second, to sacrifice oneself. But in the third model there is yet a different formulation: I’m willing to sacrifice everything “except this!” “everything except the role of victim, except sacrificing myself. To free him/ herself from this role of “beautiful soul,” the subject must directly sacrifice the sacrifice itself. It is not enough to “sacrifice everything”. One must also renounce the subjective economy where sacrifice brings narcissistic jouissance”. (Žižek, 1991b, p. 96)

This would be an example of enunciation compatible with disintegrative catharsis. That is, it not only purifies, or integrates, but also dissolves the terms in which the question is posited. This has consequences for the community of meaning, where suffering is established and where the notions of both happiness and suffering are characterized.

Father function and the origin of authority Freud argued that the community of meaning which characterizes the symbolic transmission of desire is always reducible to

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the relationship with the father. Lacan added to this the idea that the father, in psychoanalysis, is a logical function and an effect of language. More precisely, the father is a metaphoric effect and an effect of writing. Aristotle defined metaphor as “the application of a foreign name through transference” (Aristóteles, 1999, p. 145). In this definition we find two terms that are important for the theoretical treatment that Lacan gives to the question: transference and another name. The idea that one signifier is replaced by another in a metaphor could lead us to the assertion that, before the metaphor, there is a name that is not other—a name that is identical to itself. This is true in the case of the letter and of the proper name. Every signifier is another regarding other signifiers, but also regarding itself, considering its diachronic insistence in discourse. The signifier is a position, not a word. Or, better said, it is a word in a position. When Ulysses remembers his name on the battlefield, when Hippocrates presents his oath or when Antigone asserts the name of her lineage, they transfer their ancestral identity to their current identity. But this is a narrative trick that obscures the basic fact that there is another name. The original name is already some other. From this arises the fact that Freud’s hypothesis of the primordial father (Urvater) is structurally mythical and not merely narratatively mythical. The anteriority of the Other is a logical, not a narrative fact. Other, in Greek, is allotrios, a word with a triple connotation. If we take the other in opposition to the same (idios), we are talking about the semantic field of belonging, usually used for personal or private matters, where “mine” is opposed to “extraneous”. If we take the other in opposition to oikeios, it is understood as foreign, or belonging to some other family. Finally, if we take allotrios in opposition to kyrios, we are referring to the field of legitimacy and authority (Azevedo, 2001). In psychoanalysis, the Name-of-the-Father can be considered a metaphor that, at the limit, designates the alterity represented by language. The structure precedes the subject at the level of speech (we learn to speak with the other—oikeios), at the level of discourse (which stipulates what can and what cannot be said—kyrios) and, at the level of the name (function of writing) which determines the assumption of language by someone—idios). The Name-of-the-Father is a crossroads from which, through transference, the father proceeds as the instance for forming ideals

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(Ego Ideal), as normative position (Superego), and as function of the phallic lack (castration). Therefore, there are only versions of the father, or Names-of-the-Father, which do not come together in a consistent universal. It should be noted that a name is not exactly a word, nor is it always equivalent to a signifier. A name, or the function of naming, has certain characteristics that connect it both to the system of speech and language and the system of writing. A name, for example, is not translated. It designates but does not mean anything or anyone. In its signifying dimension, the Name-of-the-Father operates as a fastener that imparts consistency and stability to phallic signification. However, in its dimension as name, it represents the hole, or the aperture, in the symbolic (Lacan, 1963c). This means that the symbolic order is not a consistent unity made up of some harmony between the different symbolic systems (oikos, idios, kyrios). This brief foray into the metapsychology of the paternal function is important if we are to separate the traditional reading of tragedy, especially of Oedipus Rex, which apprehends it solely as a family drama about the murder of the father, from a radical reflection on the limits of the law, the origin of authority in relation to human desire. This tragedy is a practical system of negativities intended to deal with the ethical bases of power in the family, in society, and in the State. It is therefore compatible with research on the foundation of power in analytic treatment. It was in this light that Foucault (1975a) showed that the tragedy of Oedipus contains a strategy of search for the truth, which is, at the same time, witness to Greek legal practices and the expression of the problematic situation that separates knowledge1 and power in the early classical period. Contrary to earlier practices, based on oaths and on the enunciation of the narrative (of the type “If I am

1 Translator’s note: French and Portuguese have two verbs corresponding to different connotations of the notion of “knowledge” in English. In all cases in this chapter, when using the verb “knowledge” we are referring to the sense given by the verbs saber (Portuguese) and savoir (French), and not to conhecer or conaissense. Saber, in Portuguese (savoir in French) corresponds to knowledge, in English. Saber (savoir) is close to the idea of knowing how, something that someone knows how to do, rather than some fact or piece of information the person may possess. Saber (savoir) indicates something that is not academic. Folklore, myths, and common sense, for example, transmit knowledege in the sense of saber (savoir). In contrast, schools of all levels, as well as researchers, in general, produce knowledge in the sense of conhecimento, information.

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Ulysses, then I tell the truth”), the test faced by Oedipus is oriented by the desire to know. The tragedy brings together two constitutive aspects of psychoanalytic practice: a type of method of investigation (compatible with that of Empedocles) with a critical reflection on power (compatible with tragic ethics). Oedipus, King of Thebes, consults the oracle at Delphi to understand what is causing the plague that is devastating his city. Apollo responds in reference to the presence of an impurity caused by the unpunished murder of the former king, Laius. The oracle states a truth, but notall, since it remains silent as to the name of the murderer. The soothsayer Tiresias is called in, and he clearly states, right in the second scene that “You promised to banish the murderer; I order you to comply with your promise and expel yourself”. Both the oracle and the diviner enunciate their sentence in the future, as prediction. We learn to recognize the notion of demand in this imperative enunciation, as it refers to a requirement of work and is uncertain and undecided for the subject himself. For Oedipus the demand compels him to bring up testimony from the past. This testimony begins with a first denial. Jocasta says Oedipus cannot be the criminal because she knows that Laius was killed by several men at the three-way crossroads. This part of the recollection, unknown to Oedipus, then passes from denial to proof, because this was exactly how Oedipus remembered having killed a man as he arrived at Thebes, and before his encounter with the sphinx. But this does not prove that Oedipus killed his father and, even less, that Jocasta, now his wife, is also his mother. Again, the moment of truth is seen to be incomplete. But now Oedipus’ relationships with reality are corrected. There remains a doubt as to who Oedipus really is, in terms both of his lineage and affiliation, as well as his being responsible for his acts. A slave from Corinth arrives at this point, bearing the news that Polibius has died. Oedipus weeps for his dead father, but is joyful because this is proof that he did not kill him, nor will he kill him, and this proves that the prophecy was wrong. Oedipus’ certainty is destroyed once again, this time by the slave who reports that Polibius is not Oedipus’ true father, but the plot is incomplete and the truth remains half-told. There is still need of proof that, as a small boy, Oedipus had been handed over by Jocasta into the care of a family in Corinth. This last element has come to light with the reappearance

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of the slave from Cithaeron who had run away after participating in the scheme to exile the boy, and now lives a modest and lonely life as a shepherd. The slave confirms that, as a child, Oedipus was given in adoption, and he thus has no further doubts. He imposes exile on himself in compliance with his promise. This strategy of investigation operates by dismembering the truth at each point, in its dialectic with knowledge. It uses the Greek technique of the symbol. That is, it begins with an object cut into two halves and confides each half to a different person. Each one can thus recognize himself or herself as the bearer of a message of truth, but no one has the whole truth. Each one is also authorized to recognize the other message bearer as a participant in the same symbol. This is a beautiful image to illustrate Lacan’s thesis that the subject receives his or her own message from the Other, but inverted. This technique appears clearly in Lacan’s first conception of treatment, where the process is divided into two phases: symbolizing the image and making it real. To symbolize the image means to recognize that there, where one finds an object that is presumably accessible by designation, there is, in fact, signification. Making the symbol real means transforming signification, as anonymous and impartial knowledge, into an intersubjective act. The dialectic between knowledge and truth occurs at many different levels in Oedipus Rex. First, there is the divine and prophetic discourse oriented to the future and marked by demand (Apollo and Tiresias). Then there is speech marked by the difficulty in intersubjective recognition. Is the dialogue between Oedipus and Jocasta carried out between two sovereigns, between husband and wife, or between son and mother? Finally, the words of the slaves come in, which are oriented by the testimony from the past and by the construction of a plausible fiction about the present. The temporal thread of the plot is similar to what Freud (1908e) described for formations of the unconscious. It is like the structure of the dream, which starts off with the future (the suspended desires of the previous day), returns to the past (repressed sexual and childhood desires), and is presented as performed in the present (oneiric hallucination). Just as the secret of the dream is in the manner by which it is constructed and not in its hidden contents, the secret of the tragedy is not given by the verdict, but by the circumstances related to the trials.

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One psychoanalytic way of looking at this tragedy is to see it as a type of master narrative of psychoanalysis. One of Lacan’s great contributions resides in his criticism of the Oedipalization of analysis, which closes the subject into an interminable return to the system of identifications and object choices implied by the Oedipus complex. In this case, like the character of Oedipus, the patient is deprived of the knowledge that determines him or her, and analysis can help this knowledge emerge through the effort to recall. Like the Greek system of trials the psychoanalytic method has its centre in the analysis of the resistances and defences that prevent analysands from recognizing the truth of their repressed desires. In this regard, treatment follows a strategy similar to what I described above as integrative catharsis, which appeases the strength of the superego by reconciling analysands with their primary figures and by changing their corresponding modes of relationship. This clinical programme, which is solidly Freudian, is based on an identification between the subject and the figure of Oedipus. In this case, the function of analysis is to take the patient to the end of this narrative. There are a number of problems involved in this way of looking at the tragedy. It takes tragedy only at the level of family (oikos), leaving aside the significant and highly problematic condition of the father, as both sovereign (kyrios) and a man (idios). From this results a type of overlapping between the symbolic system of the alliance with the symbolic system of sexuality and the identification of Oedipus as a character who does not know, or who does not know clearly enough, or even, who does not assume all the consequences of what he knows. But Lacan and Foucault take a different road. For them, Oedipus suffered no Oedipus complex since he did not wish his father’s death. Oedipus is not someone divested of knowledge. On the contrary, he knows too much. His hubris resides in an excessive approximation between his knowledge and his power. The title of the play is Oedipus Rex, not Oedipus the Incestuous or Oedipus the Parricide. Basileus, usually translated as “king”, actually means “tyrant”, that is, someone who has power but has no way of fully justifying it because he acquired it by force, by fear, or without the consent of the citizens. Tyranny as a political system was not condemned in the ancient world. On the contrary, the fear was that it might become

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instable. At the same time, it was considered necessary under certain circumstances. Just as the tyrant took power through his own merits, he could lose it. The tyrant always lives under the suspicion of false recognition, a doubt as to whether his subjects submit to his power without recognizing him. The tyrant is an important figure in the history of Western political imagination; he is someone seen as lonely, insecure, ignorant, and deeply unhappy. He suffers in the excess of jouissance with power. In Sophocles’ play Oedipus comes to power by being able to decipher the enigma raised by the Sphinx, which was: what walks on four feet in the morning, on two during the day and on three in the evening? The hero comes up with a strange reply. He points to himself. But, like all gestures, this one designates but does not name. Was man designated? Was it Oedipus himself? Oedipus as a name (swollen feet) or Oedipus as a person? Or else, was it the lineage he represents (Oedipus son of Polibius, etc.)? The sphinx jumps off the cliff since it receives its own message in an inverted form, and not necessarily because Oedipus gave the right answer. As often happens in clinical practice, Oedipus responded to an enigma with a quotation. A quotation makes a statement without determining its relationship with the enunciation, and this explains the broad array of allusions contained in Oedipus’ gesture. Oedipus’ drama is the drama of lost power. If he attained power through his own merits, he can also lose it for lack of skill or virtue. Differently from Ulysses, who can be certain of his place, Oedipus has only a position. He holds a type of knowledge, the knowledge generated by experience, the knowledge of how to find things, technical knowledge based on effectiveness, a type of “how-to-do-it” knowledge. Much attention has been given to how Oedipus’ name refers to feet, oedi means, the one who see, and pous means feet, swollen feet, and consequently, associates the hero with Laius (cripple) and Labdaco (he who walks with difficulty). This is one more indication of the primacy of oikos in the interpretation of the tragedy. The name Oedipus also alludes to oedi, which means both to have seen and to know. Oedipus’ knowledge is a lonely knowledge that has not been generated and constructed under the guarantee of the community. We might recall that Oedipus is, above all, a foreigner in Thebes. His knowledge is therefore that of someone who wants to see with his own eyes, and not believe in the words or testimony of

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others. Here we re-encounter the problem of the origin of symbolic excellence related to the authenticity of praxis. Thus, Oedipous “intend to show how, as is common in human history, the powerlessness to authentically sustain a praxis is reduced to the exercise of power” (Lacan, 1958a, p. 592).

Knowledge, power, and desire This exaggerated connection between knowledge and power corresponds exactly to what Lacan called phallus. The phallus is not the penis, but the symbolic and imaginary value attributed to it. As a unit of value of desire, it is necessarily a relational measure, a regulator between potency and impotence, between unity and fragmentation, between power and knowledge. This is why the phallic signifier is an unpronounceable signifier, as it represents the lack of signifier, the [-1], or even the unthinkable, its equivalence to –1 from the viewpoint of signification (Id., 1960b, p. 837). This is why the Oedipus complex, re-read by Lacan in his theory of the constitution of the subject, starts off with the notion of lack and ends up with the idea of the “circulation of the phallus”. The final discovery of the Oedipal child is that she or he is not the phallus, nor does the mother possess it, much less does the father. The Other also lacks the phallus and saying so is the function of the symbolic father. The phallus is a representative of the lack that operates through the dialectical circulation of desire. It inaugurates and coordinates the order of objects, powers, and types of knowledge that can be shared or exchanged (Id., 1962, pp. 11–24). But there are objects that cannot be exchanged, and do not easily participate in the circulation of goods and symbolic systems. The phallus is an effect of language, a signifying position, not an object or attribute that can be continuously possessed. As a consequence, the function must locate the phallus in the field of the Other, that is, in the field of language. But by unifying the different inscriptions of the father, the paternal function also unifies the dimensions of knowledge, power, and desire. This would put aside all of Lacan’s efforts at separating the father function not only from the function of “supposed-to-know” (transference to the master) but also from the function of the prescriptive and restrictive imperative of jouissance

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(the law of the superego) and finally from the function of the cause of desire (object a). An additional indication of this effort at distinction resides in Lacan’s assertion that the Other does not exist. This does not mean that the field of language, as incomplete universal, does not exist, but that the unification of the paternal inscriptions in this field is heterogeneous in its effects. In the final resort, Oedipus’ fear of losing this collusion—between knowing, being able to, and desiring— is the fear of losing what he does not have. And he begins to lose it as soon as he embarks on his investigation into the truth. So here we find ourselves in the malignant principle that can always be blindly directed. Specifically, this is the power to do good—no power has any other end—and this is why power has no end. But something else is at stake here. What is involved is truth, which is the only truth, that which refers to about the effects of truth. As soon as Oedipus went off in this direction, he immediately renounced power (Id., 1958a, p. 647). This reading has implications for the conception of treatment. Instead of re-telling the Oedipal narrative as a reconciliatory narrative, the treatment must explore the difficulties in the subjectivization of desire that arise from the overlapping of the effects of the paternal metaphor. As often happens in any process understood as analytic, the subject must be separated from his modes of alienation in the Other, in view of the symptomatic excess that results from bringing the otherness together as the conjunction of knowingbeing-able-desiring. That’s why disintegrative catharsis could help us to understand clinical topics such as the dissolution (Untergang) of the Oedipus complex, the dissolution (Lösung) of the transference, and traversing the fantasy. The authority of the master (power) is different from the father (knowledge) which is different from the authority of the Name-ofthe father (desire). Greek tragedy can be absorbed into the structure of psychoanalytic treatment, we can understand the importance of references to the theatre and their emphasis on action. We find in Antigone a type of model of the act as a problematic element located between ethics and the symbolic law. Here we learn that treatment also involves acts, decisions, and possibilities that are beyond normative reason, technical effectiveness, and conventional morals.

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In Oedipus Rex we can see a different model, which stresses the controversial relationships between power and knowledge. Here we learn that treatment involves a type of research and an economy of questions and answers located in a fictional field that does not exclude the truth. In fact, it is through the practice of this fiction, as both deductive and abductive hypothetical reasoning, and the possibility of lying and deceiving, that Oedipus unravels his plot. If, in psychoanalytic treatment, the word has all powers, these powers are not always homogeneous, nor is their relation to knowledge homogeneous. There is one know-how-to-do proper to investigative activity and another, similar to it, that involves the relationship with the act of speaking in the transference. Both appear articulated in the development of the treatment, but this does not mean that they are of the same nature. The first principle that commands the relationship to speech is the freedom of the word. In contrast, the second principle that regulates interpretation is that it should not go beyond its boundaries. The first principle is of the prescriptive type, the second, of the restrictive type. Psychoanalytical discourse is an heterogeneous dispositive of power, knowledge and desire. In this chapter we have discussed how Greek tragedy was absorbed into the structure of psychoanalytic treatment. We then brought up the importance of references to the theatre and its emphasis on action, presenting Antigone as a model of action and a problematic component located somewhere between ethics and the symbolic law. We saw that analytic treatment also involves acts, decisions, and expectations that go beyond normative reason, technical effectiveness and conventional morals. Besides these strategies (desintegrative, functional, and integrative catharses), we saw how different models of subjectivity enter into the discussion on how psychoanalysis has absorbed tragedy. On the basis of these models, we isolated a few preliminary observations on the theory of power and the heterogeneity of authority in psychoanalysis. There is, in Oedipus Rex, a controversial relationship between power, knowledge, and desire. In this respect, it was seen that treatment involves a type of research, or an economy of questions and answers located in a field that, although fictional, does not exclude the truth. In fact, it was through the practice of this fiction, with both deductive and abductive hypothetical reasoning and the possibility of lying, or deceiving, that Oedipus was able to lay bare his plot.

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This brings us to the domain of interpretation, where we can see the fundamental importance of the metaphor, the discourse and the Name-of-the-Father (as a fact of writing). We dismembered the different meanings contained in the figure of Oedipus (as father, tyrant, and man) and related them to distinct functions (knowledge, power, and desire). This gave rise to the problem of understanding how this triple partition is articulated in the different forms of practice that make up psychoanalysis. Late in his life Lacan seems to have clearly perceived this decomposition of the once indivisible paternal function. He consequently proposed the notion of sinthome as a “fourth knot” that would maintain the articulation between the three previous knots (Id., 1976). The Name-of-the-Father was thus assimilated, as a supplement, into the notion of sinthome. Without going into the details of this concept, it is interesting to note that it is based on the eminently clinical concept of symptom, but carries the spelling it had in French long before the birth of the modern clinic. Introducing the notion of sinthome corresponds to a return to countless expressions that are more closely related to the psychotherapeutic tradition than to the clinical tradition, including terms like personality, insanity, and even the idea that the woman is a sinthome for the man. Finally, the notion of sinthome is used to designate certain activities, such as writing, in the case of James Joyce the practice of loving (love letters—in both senses of the word “letter”), and as work. So, one might ask, is the sinthome an attempt to reunite the different policies of psychoanalytic treatment?

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CHAPTER FOUR

Rhetoric of space, rhetoric of time: paradox and interpretation

If you say what you like, you will hear what you don’t like. —Terence

G

orgias (487–380 BC), a disciple of Empedocles, has been considered to be hewho introduced rhetoric to Athens. Being a foreigner he was mindful of the great relativity of customs, the fragility of universal principles and the humanity of the gods. Gorgias was seen as a sceptic and a relativist who asserted, for example, that: “Nothing exists. Even if there is being we cannot know it, and even if we could know it, we could not communicate and explain it to others” (Barili, 1979, p. 15). As a practitioner of language and a specialist in defending and undoing positions, no matter what they might be, Gorgias lived from a tragic perspective, while also appreciating the comical side of life. If the real is lacerated by contradictions, human fate is uncertain and yet to be fashioned. Even though human fate can only be grasped symbolically in the structure of fiction and through oracular metaphors, we tend to forget the importance of language in the 51

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construction of this fate, or truth. Despite the old metaphor that fate consists of what has been written, our fate is lived out as something independent from the way we narrate it or tell others about it. Inventing a possible and fair position for man is a poetic task. If poetry is a desirable and positive illusion, sophistics is an extension of this project. Its correlative technique was termed psychagogy, that is, the art of leading the soul, and the study of the receptivity of the soul to music and to the rhythm of words. Psychagogy is often referred to as the precursor of the psychotherapies, as it involved transporting the soul by producing three effects, related to both means and ends: pistis (belief or conviction), agape (love or generosity), and elpis (hope or certainty). Through the conjunction of these three aspects, the word takes on a special type of power, making it able to “frighten away fear, banish pain, inspire joy and increase compassion” (Jackson, 1999, p. 100). The joint effect of these aspects and the correct conjunction between the geometry of places and the time proper to the word define the objective of rhetoric, which is persuasion. The two basic problems of rhetoric are related, then, to the temporality of language and the places through which the soul can be led. Propitious, discontinuous time where the word exerts all its power, is called kayros (opportunity, circumstance), and the space where topics, arguments, and proof develop constitutes topoi (place). Gorgias defined rhetoric as the art of speaking well, in the sense of one’s being a good speaker, and he considered rhetoric useful in two main areas: politics and therapeutics. Therapeutics was understood as including not only medicine, but poetry, ethics and, undoubtedly, catharsis (purification of the passions). Throughout history, rhetoric, like tragedy, has been seen by philosophers as a type of defendant on trial, accused of manipulating people so they will love knowledge rather than truth. Through its association with the sophists rhetoric was seen as an instrument of anti-philosophy (Cassin, 2005). In this sense, rhetoric has often been seen as a mere instrument of domination and of making the attainment of knowledge more difficult. The trial to which rhetoric has been summoned is based on the question as to whether it is a friend or a foe of philosophy. Like tragedy, rhetoric implies an aesthetic mediation between the practice of healing, on the one hand, and moral-pedagogical manoeuvres, on the other.

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Both “healing” and “manoeuvres” begin in the sphere of the spoken word and in situations of action. Rhetoric is the first Western example of any methodical reflection on language. It was the first field of knowledge to see language from the perspective of effectiveness, ignoring reflections based on metaphysical or ontological premises. In the sceptic tradition that followed it, rhetoric is a type of therapy that takes place through language, a practice of disillusionment towards the prejudices that would give precedence of being over language. Gorgias defined rhetoric in the following terms: Rhetoric is the art related to discourse which has its strength in the fact that it is a means of persuasion. In political discourse, as well as any other topic, it is an art that creates belief. It does not instruct. Its specific arguments refer mainly to the just and the unjust, the good and the evil, the beautiful and the ugly. (Plebe, 1978, p. 17)

The field of politics involves discourses that reach everyone regardless of the topic, starting at and returning to the common symbolic goods. This admits of a number of different readings, the most traditional of which is discourse (logos) aimed at that particular form of community called polis and all the topics that concern it. Here again we can note a number of similarities with psychoanalysis. For example, rhetoric sets up no restrictions in terms of topics, which is also the case for analysands’ speech. To proceed correctly to its arguments, a rhetorician must suspend his own judgement about what is just, good, and beautiful, as must the psychotherapist. Rhetoric only becomes necessary when power is indeterminate. Inversely, there is no rhetoric that does not bring up the discursive problem of power. It is exactly because it has historically been presented as pure technique, neutral from the viewpoint of its intentions, that rhetoric has historically been used for the most negative possible uses of power. Through rhetoric, politicians, religious, demagogues, publicity agents (and—why not?—psychotherapists) attempt to influence us to do and think differently from what we would do and think on our own, in “a state of freedom”.

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Let us now see how this theory of the contact and influence between minds provides a very partial portrait of rhetoric.

Persuasion, convincing, and conviction First, the notion of persuasion must be examined in detail, both because it can distinguish psychoanalysis from psychotherapy and because it involves the type of effect that one expects from interpretation. For Freud—contrary to Lacan’s view—interpretation ends when the analysand has a very specific experience. In Freud’s words (1915b, pp. 171–172): If we communicate to a patient a representation he has repressed in his own time, at some point in the past, and if we succeed in recovering it, this, in principle, changes nothing in his psychic state. … We will attain nothing more than a further blocking (Aliening) of the repressed representation. But now the patient has the same representation in a double form, in different places in his psychic apparatus. First he has the conscious recollection of the auditory trace of the representation we communicated and, in the second place, as we certainly know, he now bears in his interior the unconscious memory of what was experienced. Only when this latter memory becomes conscious have we been successful.

This experience, therefore, depends on the acceptance of the repressed, and it is symmetrical to the suspension (Aufhebung) of repression. Freud described in detail this process of acceptance in its different facets, such as negation, abreaction, working through, making conscious. At many different moments he uses political metaphors to designate this experience, such as the acceptance of a foreigner, recognition of citizenship, or recognition of conflict. The key to defining the annulment of the repressed though interpretation resides, however, in a change in the position of the subject, based on the knowledge that is recovered during this operation. In this case, Freud uses the term “acceptance”, which is not reduced to explicit assent or denial by the patient; it rather involves a state somewhere between conviction and belief. This state has the effect of changing the patient’s transferential relationship with the analyst. Further resistances come up at this

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point and in the transition from hearing to experiencing (Erlebnis) there is a transmutation of the therapeutic power of the word. It is also important to note in this passage the emergence of a counterpower on the analysand’s part, in that he or she must recognize the effectiveness of this knowledge (saber, savoir). Our problem can be introduced by the semantic peculiarity of the term as used by Freud to refer to interpretation (Deutung). This word alludes to the discovery of meanings in a text or in speech that are not evident, and is in contrast with the term Interpretieren, whose meaning is close to interpretation in the sense of translation: Deutungkunst (the art of interpretation) has the meaning of the “ability” or the “art” of handling and applying a technique in the purely technological sense of the term. In general, the way Freud uses the terms Deutungkunst (art of interpretation) and Deutungstechnik (technique of interpretation) is different from both divinatory art and from technology unrelated to the one who applies it. (Hanns, 1996, p. 291)

The difficulty in establishing Freud’s meaning of Deutung may well reside in the fact that it lies somewhere between the idea of translation and the transforming effect of the translation on the speaking subject. It is one thing to translate and another to judge what was translated. As Freud himself points out when clinically specifying his way of interpreting: The interpretation of a dream is divided into two stages: the stage in which it is translated (Übersetzung) and the stage where it is judged or evaluated (Deutung) is determined. (1923c, p. 117)

From the perspective of translation, then, one can imagine that interpretation is open to all meanings, even to absent meanings (meaningless). But from the perspective of the judgement it implies, its value is not indeterminate, even through some nonsensical signifier (Lacan, 1964a, p. 236). The absurdity we experience in dreams contains two different origins: the lack of a signified (ab-sense) in translation, and the lack of judgement of a signifier (non-sense). Freud seems to reserve the expression “interpretation” to refer to the resignification of specific points, as can often be seen with respect

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to dreams, minor slips of memory, lapses, and jokes. Less frequently, he uses the term to refer to symptoms, fantasies, and transferential manifestations, and in these cases, it usually supposes a combination of elements arising from interpretations as resignifications. The term Übersetzung, as used in the above excerpt, can be understood as “translation”, but also as “establishment”, in the sense used to assert that something has been established for someone or that a text has been established. But in this case it refers to being established in the sense that a conviction has been instated in this regard, but not imposed. This gave rise to the decision to translate Übersetzung as “conviction”. Conviction (Übersetzung) and persuasion (Überredung) are expressions that should be distinguished from one another, even though the Greek term for persuasion (petihous demiourgos) includes both conviction and suggestive convincing. Conviction is the subjective result of argumentation, whereas persuasion is the fruit of a subjective convincing that seeks to set up a relationship between judgements and acts. In the rhetoric of publicity, this is the difference between establishing a conviction that a product is good, and persuading the public to actually buy it. As can be easily noted, convincing another person (“con-vince” broken down as “to conquer jointly with”) involves an agonistic dimension compatible with “de-authorization” (Ablehnung). Besides conviction, the broadest category of persuasion includes another term found in Freud: Überlistung (the act of outwitting, or fooling). In this case, the subject is led to accept some knowledge without making it his own, close to the idea of suggestion, or of being moved. There is also an effect of persuasion seen in identification, in relation both to a leader towards the masses and a hysterical relationship with the desire of the other. Regressive identification is also included here, as a producer of symptoms. Identification is an inaccurate interpretation since it joins together two different processes: imaginary projection, as in Überlistung, and symbolic introjection, as in Übersetzung. The art of psychoanalytic interpretation, like rhetorical technique, starts off with the question: to whom is the discourse addressed? Who is its listener, audience, or receiver? The next aspect is to understand the circumstances of the enunciation, a problem for which three genres of rhetoric were established: the judicial, whose purpose

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is to defend or accuse; it is oriented to the past and to evaluating action already carried out; the deliberative, whose purpose is to counsel someone in favour of or against something; it is oriented to the future and to decision-making; finally, the epiditic genre, based on praise or censorship; it is addressed to the present (Mosca, 2001, p. 32). The classification of the genres of rhetoric might seem like a manual of anti-psychoanalysis, but it carefully lists the types of actions that analysts should avoid, basically, to defend or accuse, to counsel or dissuade, to praise or censor. The audience, on the other hand, is a topic systematically treated by Aristotle. His Book II of Rhetoric (Aristóteles, 2000) is a treatise on the different types of pathos that dominate the audience, such as fear, trust, embarrassment, compassion, indignation, envy, and emulation. Aristotle analyses the different types of character, where passions are regularly distributed according to pairs of opposites (cholera and calm, love and hate, fear and trust). Character exists when one considers these attitudes either by age (adult or elderly) or by social position. In fact, this classification of the affects and of the forms of character in complementary opposites was present ever since Hippocrates, and continued at least until the treatises on passion of the sixteenth and seventeenth centuries AD. It sees the rhetoric of curing, or healing, as rhetoric of temperance and the production of equidistance between two extremes. Each character thus defined requires a specific rhetorical strategy that it must adjust to. The rhetorician must recognize the character of his audience in order to infer what type of páthos will be predominant and to draw up his complementary discursive strategy. Páthos, in Greek, has four main meanings: happening, experience, suffering, and emotion. For Aristotle the notion contains the idea of the subject of an experience (pathe), of a source of activity (erga), and the willingness of the soul (hexes). From this angle, one can speak of a cure for suffering (material principle), in a distribution of páthos (katharsis), in a removal of páthos (apatheia), and a perception of páthos (aisthesis) (Peters, 1974, pp. 185–186). Here Freud’s recommendation that analysts should, above all, use the “neurotic currency” (1913b, p. 76) their patients propose to them’ is very close to the recommendation, from the rhetorical point of view, that the analyst find “the pathos that is most adequate to his or her audience”.

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The rhetorician should combine a diagnosis of the pathe related to the reading of the character of his listener with an assessment of the strength of his authority as speaker. This authority, so often used by Freud as a determinant of psychoanalytic treatment, derives from three aspects (Barthes, 2001a, p. 78): Phronesis: the quality of those who decide well, impartially weighing pros and cons according to a given symbolic effectiveness; Arete: the frankness, trust, and loyalty of those who express themselves according to symbolic excellence; and Eunoia: sympathetic and benevolent complicity with the audience. The power that circulates in a rhetorical relationship depends on the interplay of positions between the audience’s pathe and the orator’s ethe. Ethe can be approximated to the notion of style in psychoanalysis. At the beginning of Écrits Lacan repeats his classic statement to the effect that “The style is the man”. Style is a difficult notion to define, although it is easy to apply. Sometimes we say that a person has style, meaning, in terms of everyday psychology, personality, or class. These are notions that suggest that each person has something very personal that makes them who they are. More precisely, it means that we can recognize this someone, but the curious thing is that we do not know exactly how and why we do this. When we recognize a style, we have the impression that the person has some perceptible essence that makes her different and unique— identical to herself. But there is another important property in the notion of style. Today style is something we want to have for ourselves or to find in another. A person without style is someone common, someone who is vulgar or undifferentiated. This person is subordinated to signs, that is, to manners of being, speaking, dressing, and consuming that categorize him or her too rigidly. It is someone whose life style strikes us as unauthentic or fake. In other words, style is defined not only by one’s regular ways of obtaining jouissance but, essentially, by the one’s desire and the relationship one has with what he or she consumes. This way of understanding style is the complete opposite to Lacan’s approach: He uses a phrase by Buffon, which is not only that “Style is the man”, but that “Style is the man we are addressing”. Let us see how Freud’s considerations (1912b, p. 111) on his own therapeutic technique fit in here:

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I am obliged to expressly state that this technique proved to be the only adequate one for my individuality. I would not dare doubt that a medical personality of a different constitution might prefer some other attitude toward the infirm and the tasks that he or she performs to remedy them.

From this assertion and from the minimally normative tone of Freud’s so-called “articles on the psychoanalytic technique”, it is clear that he considered the specific procedures he developed for treatment as a set of compromises between the requirements of clinical discoveries, their theoretical consequences, and the particularities of each analyst’s style. This leads us to the conclusion that we have two opposing requirements: on the one hand, the analyst’s ethe, and, on the other, the analysand’s pathe. This sounds as if there is only one rhetoric going on during an analytic treatment, that of the analyst. But this is not the case. Certain analysts of discourse (Mahony, 1990, pp. 68–97) have suggested that, especially at the beginning of treatment, the rhetorical and persuasive discourse is on the side of the analysand. The analyst responds to this rhetoric with her dialectical discourse, and the treatment ends when the analysand assumes an aesthetic discourse. This is not the meaning of rhetoric we have in mind here, since one cannot dissociate rhetorical discourse from non-rhetorical discourse. At some level, all speech is organized by rhetoric. Ethe and pathe are therefore circulating positions, but they are not symmetrical. We saw above that an analyst should speak in his or her patient’s “neurotic language”, in the sense of a specific type of “exchange” that circulates in analytical treatment. This is quite obvious, and refers not only to language as idiom, or semantic universe, but, especially, to language as the rhetorical structure that the analysand proposes, that is, his style. Here we come to a crossroads. To what extent can one speak someone else’s language (in other words, how can one adjust to the receptivity of another’s character) to lead him or her to beyond where he or she, on their own, would otherwise be unable to go, or even want to go? Inversely, how can one know whether Freud’s expression a “medical personality” (quoted above) does not simply reflect a way of justifying the exercise of some power?

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It has been argued that all forms of domination begin by making others speak a language that is not their own. This is exemplified in colonization processes, as well as in the use of jargon and that discursively segregate different categories (Ferenczi, 1933, pp. 97–109). Noted how this condition begins with the violence inherent to the situation that is set up between adult and child. The child is forced to speak the language of the other. Let us set aside the question as to whether Ferenczi’s conclusions in this regard can be gotten around through gentler ways of dealing with children. Our concern here is to show how the recommendation, from rhetoric, which, shall we say, invites us to speak the other’s language, the patient’s language, is really an alternative of counter-power in the analytic situation. The systematization of rhetoric continues in Western culture along this path opened up by Aristotle, that is, under the idea that rhetoric does not produce valid knowledge nor is it a secure instrument for analysing the logical or dialectical truth of discourse. It thus became a servant of education, religion, politics, and even science. Rhetoric was thus considered a minor practice, a mere technique for speaking, and became a synonym for empty or deceiving words, or speech used to fool and to manipulate. The idea that words are pharmakos, that is, both poison that can kill and remedy that can heal, emerged from rhetoric. The absorption of rhetoric by philosophy owes much to the sophists, who, in exchange for payment, defended causes and presented ideas. This separation between the technique of speaking and the ethics of the one who is speaking gave birth to a potentially dangerous form of power. Perhaps as an inheritance from this reality, we see in Freud (1912a) a constant association between the technique of interpretation, reputed as easy to master, and the topic of transference, which he described as a much more complex clinical problem that is also more difficult to master. It can be said that the relationship between interpretation and the handling of the transference is similar to that experienced historically between rhetoric and dialectics (Dunker, 1996). In other words, rhetoric consists of a set of discursive tactics at the service of a strategy. But this strategy itself is carried out by handling the transference. Nothing would be more mistaken than to make an interpretation located outside time and outside the system of places built up in the transference. Nothing would be more incorrect than to interpret unless the time of the transference authorized us to

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do so. This has become consolidated in the clinical formula expressed by Lacan (1958a, p. 604): [One should work] according to a process that ranges from the correction of the subject’s relationships with the real to the development of the transference, and then to interpretation.

This way of organizing the types of intervention fits very well into the three types of argument into which rhetoric is usually classified (Perelman & Olbrechts-Tyteca, 1992, pp. 211–393): those that proceed on the basis of the structure of the real, those that emphasize the relationship between orator and audience, and quasi-logical arguments. These are also the three broad types of interpretation that psychoanalysis usually tends to focus on: interpretation of contents, interpretation of the transference, and interpretation of the resistance (Etchegoyen, 1987, pp. 237–245). Interpretation is thus triply conditioned by the subject’s position (character, in Aristotle), by the transference (rhetorical dynamis, in Aristotle), and by the discursive material it takes into account (places and arguments, in Aristotle). These factors involve enigmatic points that call for meaning. The object of an interpretation is, above all, a formation of the unconscious, such as a dream, a joke, a slip of the tongue or a symptom. Other examples might also be inhibitions, anxiety, déja recontè, déja vu, depersonalization, the feeling of the uncanny (unheimlich), and acting out. What distinguishes the notion of interpretation in Freud (but also in Marx and Nietszche) is that it is not an interpretation about objects, based on their similarities or analogies, or their affinity with other objects, but an interpretation of other interpretations (Khalil, 2004, pp. 217–230). For this reason, categories of interpretable objects in psychoanalysis end up being summarized in relation to a map of the borders of what constitutes something that can be interpreted in the patient’s own activity. By borders, we mean where interpretability dissolves into a type of reaction, where it becomes inaccessible to the subject himself, or where it goes beyond its own boundaries through a gesture or an act. One might object that, contrary to rhetorical discourses, analytic interpretations refer to very specific points, almost constituting parentheses in the analysand’s speech, it being the analysand who is the agent of the rhetorical discourse.

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But this would mean to ignore the fact that each interpretation, no matter how infinitesimal or silent it may be, constructs, sanctions, or changes a position in the transference, a position that authorizes further interpretation. This is why Lacan rejects interpretation of the transference. This would be equivalent to positing the possibility of metalanguage, that is, taking a position outside the transference that, according to some unlimited power, would authorize the interpretation of all the interpretations already made. Here is a problem for the politics of treatment that is homologous to that of the existence of rhetoric as purely neutral technique used by a subject without intentions. The attempt to exhaustively list objects of interpretation leads us to a further problem. To discuss it, we would have to suppose a separation in the discourse between places where the unconscious is present and places where it is absent. It cannot be said that there are areas where discourse is rhetorical and others where it is literal (in the sense of being non-rhetorical). For the same reason, one cannot state what is or is not a metaphor outside the circumstances of an enunciation. In short, there is no way to locate the unconscious by ostensibly designating it. The unconscious is in the subject’s entire discourse, without superficial or deep zones, without contents or containers. For Lacan the unconscious is a temporal structure comprising the Instant of the Glance, the Time for Comprehending, and the Moment of Concluding. It is also a topological network made up of relationships between space, place, and position. Finally, it is a causal instance, in terms of desire and of jouissance. It was in these terms that we discussed rhetorical apprehension of language, namely, the time of enunciation, the place of discourse, and the effect of persuasion. This does not mean that all discourse is and should be interpreted. On the contrary, the problem of rhetoric is to be able to recognize, above all, the moment, the place, and the effect of the intervention. It was noted above that rhetoric and psychoanalysis converge for apprehending language in terms of time, space, and choice (Metzger, 1995). Like the rhetorician, the psychoanalyst is concerned about the type of desire that emerges in his or her work. Like the rhetorician, the psychoanalyst is concerned with the way things are said, and he or she rectifies or ratifies what the analysand has said. But in what name do analysts authorize themselves to do so? What specific form

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does their desire take on, since it is conditioned by the demands of rhetoric? If a psychoanalyst is a rhetorician, his or her cause is a lost cause, the cause for truth. Lacan (1977, p. 123) stated that: The psychoanalyst is a rhetorician (rhêteur). To continue equivocating, I would say that he “rhectorifies” (rhêtifie), which implies that he rectifies (rectifie). The psychoanalyst is a rhetorician, meaning that he “retas”—a Latin word—or equivocates with “rhectorification” (rhêtification). If he tries to tell the truth, but this is not easy because great obstacles are set up against coming out with the truth.

Based on these preliminary similarities, we will now examine three aspects of interpretation in psychoanalysis in an effort to extract their implications for the topic of power in the sphere of psychoanalytic treatment. For this purpose, we will use the three main aspects into which the study of rhetoric has been divided over time: invention, arrangement, and elocution.

Inventio: The places of interpretation The art of inventing, deciding, or choosing what to say involves a number of topics, or arguments. For Aristotle, it is in the “Topic” (theory of places) that we find a formal and unvarying repertoire of arguments and figures of language that are continuously filled and used forming the discourse. Argument, in the rhetorical sense of the term, should be understood as a type of general norm that should be applied to each specific case. For example, the argument of waste consists in saying that once the initial sacrifice has been made, one must go all the way in order to avoid losing what had been invested up till then. As Perelman (Perelman & Olbrechts-Tyteca, 1992, p. 317) reminds us: The argument of waste consists of saying that once one has already begun a project, has accepted sacrifices that would be lost if one were to renounce the undertaking, it is best to move ahead in the same direction.

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In Le Guerrier Appliqué Paulhan (1930) writes: Siévre, wounded [in battle], simply and stoicly says: “What is necessary, is necessary”. “Even when there are good reasons to fight”, says Jacques Maast, “[the wound] would be more than enough for the thing to enter his head. … and the sacrifice, made and accepted, strengthens and enhances the reasons for combat. It urges one to continue on”.

This argument can be filled in, for example, with the particular case of a banker who continues to lend to an insolvent debtor, to avoid losing what he has already lent out, or by St. Theresa, who insisted on praying, even at times she was feeling burnt out. Otherwise, she would waste all her past efforts. There are common places (known to the entire community) and special places (better suited to a few persons, to a specialty or to a particular field of study or practice). The common and special places treated by rhetoric also include places found in dialectical or axiomatic demonstrations, such as logical places (definition, division, or genre), grammatical places (actions, subjects, and predicates) and nominal places (cognate words, etymologies, and figures) (Perelman & Olbrechts-Tyteca, 1992, p. 321). Common places admit to three general cases: the possible and the impossible, the existing and non-existing, the greatest and the least. Special places cannot be classified, as they depend on the scope of discursive restriction that one wishes to consider. As was seen above, psychoanalysis holds to an elementary condition that the discourse be based mainly on the special places determined by the patient. In Freud we find a practice of interpretation that oscillates between the importance of the specific places consequent to each patient’s singular associative story and the common places resulting from cultural realities. This is the case of the relationships between money and excrement, fire and sexual arousal, and symbols such as stairways and sexual intercourse. Let us look at this outline of universal symbolism that Freud became interested in through mythology, the history of religion and folklore from a rhetorical—rather than a metaphysical—perspective. It is not difficult to see how this involves only the development of certain common places. It is not related to a causal reason that determines the fixed signification of the terms (Forrester, 1983, pp. 118–127).

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But what determines rhetorical inventio is not the choice of places but the use of a specific type of argument known as an enthymeme. Its formal characteristic is that it is based on what is likely for the subject, not on what is immediately true or demonstrable. The category of likelihood includes two starting points for arguments: that which is possible (eikota) and that which is a sign (seimineia). An enthymeme is an elliptical syllogism where one or more premises or propositions are presumed, suppressed, or eliminated. Enthymemes and their variations, such as tautologies and commonplace expressions, rhetorically replicate logical arguments based on true contradictions, paradoxes, and “unlikelihoods” (Todorov, 1980, p. 232). Rhetorical reversion based on elision and change, as contained in the notion of enthymeme, fits Lacan’s description of interpretation in psychoanalysis since, when making an interpretation, an analyst construes: an everyday story as a moral apologue, a bombastic prosopopeia as a direct interjection, a simple lapse as a complex declaration, and a sigh in near silence as a lyrical statement (1953b, p. 342). Barthes (2001a, p. 60) saw in the practice of concision a special type of pleasure produced by an enthymeme. He gives the reader the satisfaction of concluding the presumed elements through his or her own efforts. Maximums, plays on words, sophisms and repetitions rhetorically use logical, grammatical, and nominal places. One can thus understand the types of interpretation proposed by Lacan (1973b, pp. 493–495) as logical, grammatical, and homophonic, without countering the thesis that interpretation in psychoanalysis contains an inventio related to the enthymeme. It is true that Freud made no systematic reflection on the modes and tactics of interpretation. But there is one text that holds an important place in the tradition of rhetorical studies involving the homologous problem of inventio, namely, his book entitled Jokes and their Relation to the Unconscious (1905a). The method used by Freud for understanding what is translated as a joke, or wit (Witz, in German)1 comprises an authentic rhetorical inventory. If interpretation must travel in an opposite direction along the path of the production of a given unconscious formation, by understanding the logic of the

1

Translator’s footnote: For a discussion on the problems of translating Witz into English, see “Editor’s Introduction” to Jokes and their Relation to the Unconscious, (Penguin Freud Library, Vol. 6, p. 35), a text also reproduced in the appropriate volume of the Standard Edition.

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formation of the joke, one can infer, by inversion, the path taken by the interpretation (Dunker, 1999). Freud sees jokes as “judgments [Urteilung—the original (ur) cut (teilung)] that play” (Op. cit., 1905a, p. 12), since “telling” a joke or “coming out” with something witty implies the production of something “meaningless that has meaning” (Freud, 1905a, p. 13). Its effect on the subject is always something that “disconcerts” and “gives insight”, something that has the intriguing property of fooling us, but for just a moment (Freud, 1905a, p. 14). Freud said that the soul of a joke is its brevity, its ability to condense meaning in the form of an unexpected comparison (Freud, 1905a, p. 15). For this reason, the production of a joke is very similar to interpretation. Both should stir up surprise and insight, and both are evaluated by their effects and imply the organization of meaning as counter-meaning. At several points in his text Freud uses the notion of Einfühlung, which could be translated as a shared feeling, as sympathy or as empathy. In its technical sense, the term is taken from Lipps and used to define not only the effect of a joke, but also the ethical community within which it functions. For Lipps, Einfühlung is a key notion to explain the functioning of psychotherapy, and this lets us to suppose that Freud’s book on jokes is not just a descriptive work on a special type of formation of the unconscious, but an investigation into the principles of interpretation in psychoanalytical treatment. In the first part of the book, Freud analyses the formal and subjective conditions for the construction of a joke: the different types of equivocation (by allusion, by metaphor, etc.) and the different types of tension of meaning, such as between the whole and the part, or between contents and container. Apparently, Freud did not have an organized repertoire of rhetorical categories, and this may explain his difficulties in classification. He divides jokes into two large groups according to their form of construction: those that are produced on the basis of verbal expressions and those that create their effects from plays on ideas. In the first case he is referring to jokes of words and, in the second, to jokes of thought. Jokes of words are further divided into two sub-groups according to the presence or absence of morphological deformations in the word involved. When Freud speaks of verbal expression, the connection with the idea of signifier is immediate. But there are other ways of looking at this notion: as a change in the acoustic images of words, as the relationship of the word with other

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grammatical components of the sentence and, as an inducer of logical relations that take place in jokes of thought. In short, there can be morphological, syntactic, and semantic variations of the signifier. The second part of Jokes and their Relation to the Unconscious is dedicated to the thesis that jokes fulfil repressed sexual desires. Freud attributed to jokes what he had discovered in terms of dreams. But, contrary to dreams, which suggest a private and idiosyncratic formation of meaning, jokes involve social processes. In this case, there must be relational conditions for jokes to be funny. Freud gives examples, such as the need for those present to belong to the same social class, have the same ethnic origin, be of the “same parish”, and even whether or not there are women present. The condition for the joke becomes ambiguous. On the one hand, it is an unpretentious paradox that results from a playful game with language. On the other, it is conditioned by specific social circumstances. These circumstances express the political volatility of jokes and, by extension, of interpretation. And it has been noted that jokes, humour, and irony are important tactics in practices of political resistance (Žižek, 2002). Humour is an effect that indicates a transition from one discourse to another, and can be a source of disturbance of the fantasy. Like blasphemy and cursing, humour indicates a possible, but not necessary, point of mutation from one discourse to another (Bassols & Gracia, 1994, pp. 185–200). But jokes also enable, reinforce, and propagate all types of segregation. This indeterminate character of jokes, which can serve either for segregation or for disturbance of an ideological fantasy, invites us to look at yet another aspect of interpretation. Besides addressing criteria of social and intersubjective figurability, interpretation should touch on the cause of desire and allude to the object. The pragmatic criterion for verifying a joke (laughter) leads us to infer, by its effects, the presence of the cause. Therefore, interpretation, like jokes, extracts the object in relation to the Other ($ → a) (Metzger, 1995, p. 97). This extraction takes place in two stages. First there is a displacement, a deformation, or a subtraction of the object, which shows up the inconsistency of the Other. But there is a second stage where neurotics try to suture the lack in the Other by any one of several possible strategies, such as by: Identifying this lack as the demand of their own castration; Identifying themselves with this lack, as in anxiety; Identifying itself with the signifier that represents this lack;

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and Identifying the Other with an object witch completes this lack, as in the fantasy. At this point, the needs of the superego and the fantasy can be recomposed. In other words, interpretation must always deal with its effect of alienation, which invites the subject to reaffirm his voluntary servitude, and with the effect of separation, which transforms the metaphor of the symptom (or its equivalent) into the metonymy of desire. The moment of the separation allows, but does not determine, a moment of choice. This moment of choice is when the analysand determines what discourse the interpretation will be articulated in, or whether he or she is dealing with an act. An act is defined as a break, or an interruption, and as a rearrangement of the symbolic order (and not only in the scope of discourse) of the interpretation by displacing or rotating the discourse. This discursive capturing of the interpretation makes it possible to understand the formation of the demand, especially in its aspect of collectivization. The simplest example of this effect is when we are in love with someone and tend to practice a type of ambiguity of signifiers that this someone addresses to us in order to confirm or deny our feelings. Such a floating signifier (Laclau, 2000, pp. 40–90) can then be managed by the seducer to orient the subject’s demands. So we have two new possible articulations of the rhetoric of interpretation. Either we are faced with the decomposition of the universality of the law, with the emergence of an exception, namely, an unconnected signifier that destabilizes the consistency of the Other. Or else we are up against a real contingency that shows singularity in its irreducible face as object a. This real contingency, expressed by the floating signifier, can be grasped in the form of alienation, reinforcing even further the consistency of the Other. From this it can be concluded that there is no need for the semantic paradox involved in an interpretation—and, by homology, in a joke—to also imply a logical paradox, which touches on the real and calls for a change in the position of the subject towards the object.

Dispositio: temporal structure of the analytic session Rhetorically, the arrangement of the elements in a discourse implies an understanding of the links between the parts of the discourse in

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the narrative. Classically, these parts are defined as: the introduction (exordium, proposition, and partition); the narration (confirming or refuting the argument); and the conclusion (peroration). This narrative (or argumentative) structure is compatible with the flow of the analytic session. That is, a session usually begins with the construction of a situation, around a master signifier (S1). This implies a network of places that should fulfil three conditions: presentation of characters, exhibition of the scenery, and configuration of the nature of the intrigue. The arrangement of the analytic session could then be read on the basis of its logical and temporal structure to the extent that we can show how this structure is not only a transcendent scheme of language assumed by a speaker, but also a rhetorical constant. This implies reading the three figures of logical time described by Lacan (1945) as rhetorical articulations. It is a difficult clinical task to determine just when a session can be considered as having begun. It is definitely not merely when the patient starts talking, because there are sessions that never start. They do not form the structure of a session. But this opening moment can only be described retroactively. That is, we only know that the first moment has ended when we go on to the second. Only when the session has finished can the first scansion be absorbed into the second, which can be said to be conclusive. What ends the opening of a session is the presence of an instant of looking, the “objective time of the initial intuition” (Lacan, 1945, p. 209). It is the moment for formulating the question, of precipitating a narrative vacillation. In rhetoric, this is the circumstance that defines the existence of a cause, also known as the quaestio (question). The cause as question involves the recognition of a contingency that is not immediately decidable. This contingency can be approached by way of a thesis (when one avoids the parameters of place and time) or by way of a hypothesis (when time and place is part of the formulation of the question) (Barthes, 2001a, pp. 85–87). But we cannot arrive at the second scansion without going through the first. From the logical point of view, it is only at the point of closing and concluding that one can infer, retrospectively, when it began, and presume the second scansion. But, from the rhetorical perspective, the end must be constructed by steps that make it possible. This idea is convergent with the thesis that “The handling of the transference is the handling of time in analysis” (Lacan, 1953a). But this

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ideal place does not correspond to the flow of a real session because one must act progressively in such a way that a point for ending the session becomes possible. A real session is understood as a temporal encounter between analyst and analysand. During this real session, the analyst must operate in a way that, at the end, it will take on its logical and necessary form. An approach is therefore needed whereby the real session and the logical session are brought together, and it is under this condition that one can say that an encounter between analyst and analysand has become a psychoanalytic session. Too many digressions or characterizations can make a session interminable precisely because it never began. We might recall the sophism analysed by Lacan (1945) of the three prisoners, each of whom has a black or a white paper disc attached to his back by the warden (there are two black and three white disks available for the warden to choose from). In the first situation (Situation I), a prisoner sees two black disks and concludes, immediately, that he is a white (Instant of the Glance). In the second situation (Situation II), he sees one black and one white disk and concludes, mediately, that if the prisoner with the black disk does not move, it is because he does not see two black disks on his colleagues, whereby he would conclude that his is white. Here, there is a temporal scansion and the subjective realization of the passage of time. This is the Time for Comprehending. In the third situation, the prisoner sees that the other two are whites. Obviously, none of them moves, but this immobility goes back to the previous case, and so each one starts to leave thinking of Situation II (one black and two whites). But when the prisoners note that all three start to move, each one then steps back. The newly acquired certainty is once again put in doubt because the prisoners are no longer sure that Situation II is really the case. Therefore, the common scansion of the movement leads to the recovery of the certainty, which is now indubitable, that Situation III is the case— where there are three whites—which means that all three men are to be set free. Just as an analysis begins with the subjective placement of the patient, a session begins when we can identify a question. This placement is confirmed by Lacan’s use of the term protasis (Lacan, 1945, p. 207).

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More than a formal hypothesis, a protasis represents an as yet undetermined matrix—let us call it the form of consequence that the linguists designate as protasis and apodosis. Being …, only then does one know that one is …

In this article of 1945 Lacan suggests several applications for his “logical time”: diplomacy, gambling, psychoanalytic handling, and mass phenomena. It is noteworthy that he makes no mention of any application in literature, which becomes even more problematic if we consider that the first version of that text appears in a magazine on art (Le Cahiers d´Art) and that the problem of the three prisoners was proposed to Lacan by André Weiss, who got it from Raymond Queneau. Queneau, a poet and mathematician, had been a colleague of Lacan at the famous seminars on Hegel given by Kojéve in the 1930s. Queneau and the group he later founded, the Oulipo (Motte, 1998) (an anagram in French for Workshop for Potential Literature), were interested in the possibilities of applying combinatory topology to the field of literary creation. Between the problems posited by the Oulipo was the mathematical study of narrative trees, that is, a way of establishing the logic of the possible or potential solutions to the relationship between sequence and transformation that would define a narrative according to its form of logic. One way of exercising this combinatory topology is at the level of signifiers, such as in lipograms. A lipogram is a where a given letter (or letters) of the alphabet does not (or do not) appear (Lionnais in Motte, 1998).2 Such combinatory writing can also be used in narrative blocks, as practiced by Italo Calvino, or in poetic verses, such as those by Queneau (Motte, 1998). From this historical detail, a line of continuity emerges between the text on logical time, the logic of the signifier, the rhetorical tradition in psychoanalysis, and the classification of the places of language. Finally, we might also recall that logical time is presented as a sophism, that is, a type of enthymeme applied to narrative blocks.

2 Also see: See Perec (a member of Oulipo): History of Lipogram, A Void, English translation of La Disparition, where the letter “e” never appears, and Les Revenentes. Liponyms, lipophonemes, and liposyllables are texts from which (respectively) a given word, phoneme or syllable is absent’ (Perec, 1969/1989).

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Considering these two arguments, let us go back to the importance of narrative rhetoric for the clinical use of logical time. In effect, the real nature of the problem proposed follows the traditional routine of rhetoric: Protasis: statement of the problem, the rules set down by the warden, the number of disks, freedom; Hypothesis: intersubjective situation between the three prisoners that obliges each of them to guess at the solution based only on what he sees in the behaviour of the other two; and Apodosis: the way out and the explanation of the solution. This does not mean that some problem is presented in every session of psychoanalysis and that some type of solution comes out of it, such as an integrative or conciliatory narrative. We have seen that strategy in analysis is characterized by the inversion and displacement of places and positions that determine the question. As in potential literature, the point is to isolate a logical form based on its lipograms (one cannot get to the third without going through the second, nor to the second without going through the first), rather than on the basis of an empirical situation. The different temporal positions can thus occur between sessions, during sessions, or between blocks of sessions. Everything depends on how one counts. Therefore, the definition of one position or another is an act of decision, and not of fitting a transcendental logic into an empirical exposition. For example, Lacan (1971a) describes the three moments in terms of three modes of enunciation of demand: the imaginary request, the symbolic offer, and the real refusal. In view of this closed circuit, which becomes real in the structure of the transference by alternating these positions, a type of temporal sophism is formed whose solution depends on an act and whose enunciation would be: “this is not it”. This act corresponds to the temporal form of object a. Another possible reading is by counting the logical time according to the writing of the fantasy (2 + a; 1 + a; 1 + a = 1/a). That is, logical time is a clinical instrument that depends for its use on the strategy adopted by the analyst, and does not always correspond to the end of the session. However, no matter how it is used it requires a type of standard forms of reading that can be the demand, the fantasy, or the subject, depending on the examples we approach, or that can be the discourse and the desire, as we mentioned above. These standard forms of reading can also include the narrative structure of the session.

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We thus move into the second moment in the dispositio in the analytic situation. This moment is marked by meditation and comprehension. In narrative terms it corresponds to the development of a plot, with the presentation of facts and descriptions. During this moment, positions laid down by the signifiers that represent and construct the initial situation are exposed to a process of resignification. Lacan says that “The unconscious needs time in order to be revealed” (1953b). How much time? We can say that it needs at least the time of the situation. That is, all sessions begin, logically and discursively, when one can introduce or detect a narrative imbalance. Narrative imbalance has exactly the same meaning that the technique of free association had for Freud. Before establishing it as his fundamental and general rule for patients as they talked in analysis, Freud used free association as an occasional and restricted technique. When a seemingly significant point came up as a patient talked, he would interrupt the flow of ideas or take advantage of a spontaneous pause by the analysand and intervene by asking for free association by saying something like “Tell me what comes to mind, but tell me now”. A number of authors have associated the second logical moment with the notion of knowledge. The idea of comprehension, as in the expression of time for comprehending, provides an intuitive basis for this association. Something more can be added to the reasons for this association by considering the rhetorical argument that holds that the development of the conflict is related to the effects of suspense, expectation, and doubt, which imply the need to produce knowledge, but knowledge that must remain in absentia if the conflict is to continue. Inversely, it is these moments of pause, ambiguity, and narrative indeterminacy that call for free-floating attention. They are the formations of resistance, understood here not only as breaks in the intentionality of signification, but as interruptions or breakdowns in the temporality of the narrative. Freud (1912a, p. 102) insisted that such pauses are usually indications that the patient is thinking about the analyst, but even if the resistance becomes evident in the sphere of the ego, this does not mean that it originates in the egoic dimension. There are other resistances that proceed from the superego, the id, or repression. For Lacan (1954a, pp. 159–171) the important thing is that these pauses be seen as facts of discourse. Resistance appears in the discourse, and its emergence in the ego is an effect. Resistance is not

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censorship, and this brings up a problem. In its most important meaning, “discourse” is defined as an apparatus,3 based on the compelling need to say something. Taken in this light, discourse cannot resist; it can only repeat. Speech, on the other hand, is a category where resistance is the result of the interaction between the subject and the ego. We therefore need an intermediate level between discourse, strictly speaking, and speech, in order to locate this effect of language. My hypothesis is that this intermediate level is the narrative. When an analyst is the audience to the narration, he or she has a slightly different function than when he or she is a reader. When an analyst is the audience, she or he can intervene in the narrative by changing its rhythm and speed, in short, its time. By saying “go ahead”, for example, the analyst presumes that what came before in the narrative has been absorbed. The analyst can express this by an interjection, by the mere indication of her or his presence, or by silence, when consent is expected. The time of the narrative is not defined by the length of the intervention but by the logical temporality of the acts it consists of. The third moment of the session should therefore introduce a second narrative scansion. The first scansion retroactively determines the beginning of the session and destabilizes the narrative by changing the position of the listener to the narration. As we saw, it precipitates a protactic signifier in the position of alterity in relation to the initial concentric position between the narrator and the agent of the discourse. We also saw that, through free association, the development of the narrative intrigue is oriented to the indeterminacy of knowledge (the quaestio). The second scansion, which opens the third moment of the session, should thrust the subject into an act that has the structure of a trial.

3 As Foucault himself explains: “What I’m trying to point out with this term [apparatus, dispositif in French] is, first, a thoroughly heterogenous ensemble consisting of discourses, institutions, architectural forms, regulatory decisions, laws, administrative measures, scientific statements, philosophical, moral, and philanthropic propositions—in short, the said as much as the unsaid. Such are the elements of the apparatus. The apparatus itself is the system of relations that can be established among these elements”. http://foucaultblog.wordpress.com/2007/04/01/what-isthe-dispositif/). This site has more to say on Foucault’s concept of apparatus.

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And it cannot be doubted that a judgement is a proposition in the indicative mood, such as: “I’m a white” or “I’m a black” (Lacan, 1954a, p. 207). Now we can distinguish, in rhetorical terms, the second moment of the session: it is the retroaction from the subjunctive mood (apodesis: if … then) to the first infinitive mood (prothasis: it is known that). “This movement could be called the opening cut of the session. This is the logical beginning of the session, the passage from an encounter between analyst and analysand to a session of psychoanalysis. But this does not determine whether it will be an ending session or an unending session. Concluding the real session by empirically interrupting the encounter is not the same as concluding the session logically. Some sessions will never happen because they never begin, but other sessions never end because the subject never concludes them. The subject keeps waiting for a closing cut, one that never comes. This is why we can say that the whole structure of the analytic session is in the cut. The best way of saying this is that the cut should interrupt or change the narrator’s initial position, even if this is done with simple silence. That is, the act that one expects from the cut is a questioning, by the narrator, of his own sovereignty, a fall from his position of agent of the discourse in a way that a new position takes its place.

Elocutio: figure and logic of the conflict Elocutio refers to that part of rhetoric that includes the analysis and classification of the figures or tropes. Originally, elocutio encompassed all the conditions needed for concrete speech, including grammar, pronunciation, diction, projection of the voice, and the poetic aspect of the words used. In other words, it involves all the indicators of the relationships between the agent of the speech and this agent’s speech acts. But by constituting the reservoir of figures and techniques that beautify language and transport and change meaning, elocutio eventually became a common synonym for rhetoric. The field of elocutio, also translated as “enunciation”, admits to a type of hierarchy in the use of language. On the one hand, there is a use that is literal, pure, referential or denotative, where language is “naked”. On the other,

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there is an impure, poetic, and connotative metaphoric use, where language is “dressed up and decorated” (Barthes, 2001a, p. 90). The way that one considers the distance between these two modes of language, including the admission of their existence, determines the type of understanding one will have of symbolization. There is no conception of treatment that deserves the name of psychoanalytic that does not explicitly or implicitly have a position regarding the distance between these two uses of language. A consensus has built up since Freud’s time that a cure necessarily or sufficiently takes place through some type of symbolization. It may give special emphasis to an economic approach, where one tries to give pre-reflexive, intuitive, pre-positional intensities to the dimension of word and representation, as is the case with the cathartic method. Or symbolization can stress the topical plane when the intention is to foster bonds (Bindungen) and inscriptions between different psychic places, as occurs in the elaborative method (Ducharbeiten). One might also see symbolization as a re-articulation of a conflict, either in the relationship between the levels of language or in the fact that the conflict itself is a symbolization of the real. For Lacan the symbolization that takes place in analytic treatment is the symbolization of desire. For him, there is also a complementary or alternative operation with symbolization, which he calls subjectivization. The clinical mechanisms for symbolization can all be reduced to metaphors, since the central metapsychological instrument for constituting the neurotic structure is the paternal metaphor. But, contrary to the tradition of elocutio, according to which the metaphor should be considered a connotative instrument, for Lacan it is also, and above all else, denotation. That is, it shows us not only the accessory ornament of language, but shows that this ornament is its skeleton. When Lacan says that “All designation is metaphoric” (1971a), he inverts the traditional relationships between the layers of meaning of language, making the metaphor not only an instrument of displacement of meaning, but also one of creation of meaning. This brings up an immediate problem. If language has the structure of metaphor and, then necessarily also metonymy, it would no longer make sense to distinguish between the symbolic organization of thought and the production of metaphors in clinical protocols of treatment. In the last resort, the only remaining clinical strategies are those that refer to the economic translation of quantitative excess

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(jouissance) and the topical re-articulation between the positions (subjectivization). In this direction, Lacan would seem to have abolished Freud’s most constant reference to the nature of symptoms, namely, that they are the symbolic expression of conflicts. The theory of generalized metaphorization thus leads us to the immanence of the conflict, which is polarized only in operations of inversion between the metaphor of the symptom in the metonymy of desire, and vice-versa. This led to a conception of treatment whose cutting edge is the acceptance of, or submission to, the symbolic. In another sense, not only neurotics, but perverse and psychotic individuals as well, are subjects that, with their symptoms and correlate practices, resist the transcendental functioning of the law, specifically the symbolic law as equivalent to the law of language. Laplanche (1992, pp. 215–263) as well as some pragmatists and thinkers who base themselves on critical hermeneutics (Freire Costa, 1994, pp. 9–60), are opposed to Lacan’s algebraic and formal understanding of the metaphor and his consequent failure to equate metaphor with processes of symbolization, which involves cognition as well as affects and the body. Farther ahead we will see how this conception is historically related to the first rhetorical considerations regarding the metaphor. But this position does not seem to be the only possible understanding of Lacan’s conception of metaphor. Safatle (2006, p. 104) showed that, beyond the metaphor as a procedure for selecting elements present in the diachronic (or metonymic) axis of language, there is the notion of metaphor as a way of relating to creation not only in terms of creating new meanings, but of creating new forms of being. This is what authorizes Lacan (1957b, p. 532) to “connect the metaphor with the question of being”. But the conventional reading of the theory of the metaphor in Lacan neglects the fact that this is not only a strategy for the symbolic negation of one signifier by another, but also a strategy for the symbolic negation (in another sense) that formalizes the real conflict. Summarized into steps, we might say that the metaphor is a trope of substitution, substitution is carried out on the basis of similarity, similarity can only be established through distinctions, distinctions involve choices, choices require oppositions and exclusions, and exclusion is a process of negation (Chaitin, 1996, p. 35). The metaphor therefore involves two levels in terms of the double negativity. On the one hand there is negation as the effect of a reduction in

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signification, which introduces pure signifiers without the denotative strength that could free the desire held back by the symptom. On the other hand, there is negation as the effect of real meaning. Here the negation corresponds to the annulment of the facticity of the reference. But this negation of the reference does not have the world of immediate perception as its object. There is no negation of the Real, as it presents itself, because its presentation is already an assertion (Bejahung). This is only the negation of an imaginary object, a construction, which identifies the object with the image of the object. This is why, in the end, the object is naturalized or literalized in its meaning. The first type of metaphorical negation simply disguises this construction. The word as death of the thing expresses a type of symbolization that denies any parity between the transcendence of desire and imaginary empirical objects. This imaginary position, however, the position of the ego, is the place from which all truth is enunciated (Lacan, 1975a). While this form of negation is located between the imaginary and the symbolic and presumes a constative use of language, the second form of negation is to be found between the symbolic and the real, and presumes a performative use of language. While a failure of the first type of metaphoric negation gives rise to the symptom, a failure of the second type gives rise to a degradation from the metaphoric to the metonymic and, therefore, to subjectivities of desire. Desire has a metonymic structure but it has two phases: first we have aphanisis (when the subject is absent), then we have fading (when the subject is present). Let us take as an example Lacan’s analysis of a fragment from the Case of the Rat Man. In the text on this case, Freud described a childhood episode where the patient addressed his father angrily and the father reprimanded him, and the boy cried out, “You napkin! You lamp!” Lacan argues that what is least important in this metaphorization of the father is the meaning of the signs involved (napkin and lamp). They seem to have been chosen only because such objects were in sight at the moment. The essential point is the presence of the relationship of substitution involved in the metaphor, which lets the boy name his father as what he is not. Two modes of negation stand out in this metaphorization. First, the patient makes the naming an act of designating the father as what he is not. That is, he negates him and, through this negation, confirms him in his place as other: napkin, lamp. This strategy solidifies

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the conflict, names its elements and expresses the forces between the opponents. On another level, however, the negation applies to the entire situation of conflict, making the real conflict pass on to the order of a sexual conflict. The father may have reprehended him for having bitten someone and, for this reason, the naming of the father also organizes the writing of the drives. This mode of the drive could be described as destructive and anal-sadistic, as the expression of a specific object relation or as a point of fixation for the fantasy. These readings may have their clinical usefulness, but they tend to overshadow the fact that this act of naming is not just the translation of a conflict, which then becomes symbolically represented. It is an act of inscription of the conflict on the body and this introduces another type of symbolization, regulated by a system of writing (Dunker, 2004, pp. 85–100). In the first case the metaphor is an inductor of knowledge, in the second it is the writing of the truth as inadequacy (Safatle, 2006, p. 107). Writing refers here to the field of the letter, which is the fundamental operator in this type of negation or formalization, in contrast to the signifier, which is the fundamental operator of the first mode of negation. Now we have the bases to re-examine the elocutio and see it as the field of the conflict and, consequently, interpretation as a system between listening-speaking and writing-reading. Lacan (1970, p. 428) also discusses interpretation based on the Midrash. The Midrash is a Jewish method of interpretation of the Torah based on the supposition that a written text reigns sovereign and on a belief in the literal character of its meaning. In other words, it is a method for restricting, or even eliminating the reader’s interference in deciphering the text so that it resists “intentional” interpretations, in the sense of translation, as discussed above. One suggestive detail is that, on rare occasions, the rabbi is authorized to interpolate the text. According to Ischmael, one type of interpolation is known as the method of Ceres, or method of castration. This procedure is authorized, when the text is obviously irrational (through some contradiction between two different passages) or, when there is an outright contradiction between the written law and the oral tradition of a given period. This can be understood in terms of the social context in which the method of the Midrash was developed. One of the groups of

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the ancient Hebrew community, the Sadducees, had the privilege of interpreting the Torah. They corresponded to the caste of the kings and judges who had genealogically inherited the power. They therefore took it upon themselves to both interpret the law and execute it, and they did so according to their own political conveniences, using and articulating texts as instruments for solving conflicts. The Pharisees rose up against this position, and developed the Midrash, claiming that a sacred text has a meaning that prevails over the interests of those who are socially responsible for interpreting it. The Pharisees belonged to the middle and liberal social strata, and were able to introduce the Midrash as a technique of interpretation to the extent that they gradually took on a more active part in organizing political power. This process was especially notable during the periods of Babylonian and Roman occupation, which meant the loss of autonomy by the Sadducees. It should be noted that two other groups were also instrumental in constituting the Midrash: the Essenes, a group that distanced themselves from collective urban life, which they considered impure and corrupt (especially in view of the alliance between the Sadducees and the Pharisees), and, the Zealots, a warlike group interested in using the scriptures to justify armed resistance against Roman oppression. The historical figure of Jesus is clearly composed to give strength to this conflict of interpretations. He is presented as a king (Sadducees) who came to free his people (Zealots) and renew the law (Pharisees), but his kingdom is of another world (Essenes). Just as the method of Ceres was aimed at reconciling the tension between oral and written traditions in Jewish hermeneutics, it also became the core of Christian patristic hermeneutics. One can see how social antagonism fully restored the techniques for interpreting written texts and this meant the return of the tension between the written and oral traditions. The figure of Jesus clearly functions as a metaphor that articulates these different signifying chains, and this is why the bodily destiny of Jesus is so important. In addition, this allegorization produces a unification of the names of the father, reducing the heterogeneity referred to above. The Christian strategy for containing the variations of readings to which a text is subject consisted basically of dividing the text into levels of meaning and limiting access to these levels according to a simultaneously social and hermeneutic hierarchy. For example,

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one can distinguish the different meanings of a text according to the Christian hermeneutic established by Origen into three levels. Literal meaning: the text is sovereign; it can be perceived as inconsistent and self-contradictory, but these properties do not emanate from the text but from the readers’ incapacity to interpret it. This incapacity is explained by the disparity between the permanence of writing and the impermanence of oral tradition and cultural change. Psychic or moral meaning: the lacunas in the meaning of a text are filled in with the discursive conditions that define its ideal audience. Contradictions in a text are settled by the subject’s moral or psychic affinity, according to a type of “contact between minds” or, one might say, by emulation. The psychic meaning emerges, therefore, by absorbing the literal meaning into the oral. The third level is the Mystical or spiritual meaning: lack of meaning in a text is attributed to a lack of knowledge and experience that would make it understandable. The subject must undergo a change that would be the key for grasping its meaning. In this case, the literal meaning prevails over the oral expression of the meaning. In his discussion on the similarities between interpretation and the Midrash, Lacan leads us to believe that interpretation should be of an eminently literal nature. However, the Midrash is a method for reading texts, not for interpreting oral discourses, which is, theoretically at least, the case in free association. This objection can be answered by resorting to the notion of structure of writing and structure of speech, but this brings us back to an earlier difficulty. The temporal of writing is different from the temporality of speech and cannot be reduced to it. With writing one can go back, read again, skip over certain passages, erase, and edit, but these operations are not as possible in the domain of speech. It is like comparing the theatre to cinema, or painting to poetry. They are not merely two different modes of expression; they are two different experiences. Freud (1925, pp. 239–248) compared these two systems in his text on the Mystic writing pad. This toy, usually called a “magic writing pad” today, consists of a sheet of transparent plastic, a second sheet of gray plastic, and a wax base. One writes on the top, transparent, sheet, which is analogous to consciousness, but no marks are left on it, and it can thus be re-used immediately. The middle sheet of gray plastic temporarily retains the impression made by the marks from the wax. This is like the pre-conscious memory, which is constantly

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renewed. The wax base, however, is continually re-used, but traces of different acts of writing remain imprinted in it, similar to what happens with the unconscious. In psychoanalytic interpretation, one works with both the evanescent temporality of speech and the temporality sedimented in the traces. The double meaning of a metaphor points to the double key of the choice (which is real) and of places (which are symbolic) compressed into the tactic of interpretation (which is imaginary). The idea that an interpretation should capture the “semantic resonances of the word” (Lacan, 1953b, p. 238) must therefore be adjusted to a mode of production of meaning that is not entirely in the realm of writing, nor is it completely in the realm of speech. Lacan (1972, p. 104) tried to specify his notion of meaning (Bedeutung) more clearly in 1972 by locating it in the symbolic, but only in one of its regions. In Lacan’s view, meaning is subject to certain limits; its field is crossed through by other domains, like fjords. Death, symptom, phallic jouissance [J Φ], and object a are four aspects of the symbolic that, by their exteriority, limit, or put boundaries around, the field of meaning. With this model, Lacan tried to show that a symptom is not reduced by expanding its meaning but by delimiting its boundaries, that is, by formalizing points where meaning turns into meaningless (either ab-sense or nonsense). An interpretation can remove a symptom through any one of three different operations. By introducing a new meaning, which is opposed to the refusal of repressed content, as in counter-sense (logic of opposition); Freud (1907b) points out that the preoccupations about the cleanliness seen in obsessive neurotics is related to the sense of feeling “sexually dirty” and here we see the logic of opposition; By removing a former meaning and changing its formal aspects, as in non-sense (logic of inversion); Freud (1918b) told the Wolf Man that the “Espe” in his dream was not a problem of translation from “Vespe” but a reference to himself. The sound “Espe” could be read as the initials “S.P.” (Serguei Pankejeff, the Wolf Man’s own name); here Freud is inverting the principles of hearing and of reading words; By confronting the lack of meaning (Sin) with edges of meaning (Bedeutung), as in ab-sense (logic of contradiction); in his dream about Irma’s injection Freud (1900) saw the formula of trimethylamine; this term is an allusion to repressed sexual content (opposition) and includes three groups of persons who insist on the

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dream, since the formula indicates three carbons (inversion between reading and hearing); but if one considers trimethyline as a chemical component of sexuality (Bedeutung) and as social component of human relations (Sinn), it is a way of positing the contradiction in or the ab-sense of sexuality.

Interpretation in structure of a paradox In 1953 Lacan discussed the idea that interpretation should capture the semantic resonances of the word and, to illustrate these resonances, he took the word dhvani, as it is used in India. This term does not proceed from the theory of interpretation given in the Midrash or in patristic studies, but from a homologous category in Indian rhetoric. In 1938, Dumal, a dissident from surrealism, published a text about Indian poetics that discusses the role of the semantic resonances of words, dividing the possible meanings of Indian poetics into three types: the literal meaning (that found in a dictionary, for example); the figurative or metaphoric meaning (the connotation); and the suggested meaning. The first two categories are allied to the hermeneutics of Origen. But the third type involves a kind of meaning that circulates in silence. It stresses the resonance of a word, its musicality and its power to corrupt the specific code of a language. According to Dumal, “it is something that depends on the circumstances; it happens at a specific place and a specific moment”. Suggested meaning implies a plus of meaning, a “more of meaning”, which the Indians call dhvani. It is a type of meaning that depends on the time of its enunciation. It is performative and cannot be retained beyond its happening. However, there are writing techniques that let one know whether, at any given moment, a dhvani has taken place, without one knowing how or through what means. Lacan’s initial interest in Indian rhetoric is in line with his later studies on Chinese writing. This interest is usually understood in the context of his broadening notion of language (1971b), which led him to recognize that there is relative autonomy in any given language between systems of writing and systems of speech. Certain Oriental languages can be quite useful for studying this topic because in many of them there is no direct correlation between speaking and writing.

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However, to judge from the texts that Lacan used as references, it may be that his interest also included the search for an alternative model for analysing action and strategy. The Western tradition of reflecting on action in the context of war and politics, where the notion of strategy developed, emphasized, from Aristotle to Clausewitz (Clausewitz, 1996), a type of thinking based on models. Strategy is a science that is expressed in a type of geometry of movement between eidos and telos of action (Jullien, 1994, p. 13). This implies a predominance of strategy over tactics and a method based on the average probability of analogous cases. The Chinese theory of strategy arose from a context different from the speech used in Greece in the sense that it was regularly addressed to the numerous and indeterminate members of the polis who had been brought together to make a decision. It was born from personal discourse directed to the emperor by those interested in obtaining benefits and becoming influential. As a consequence, their fundamental notions were those of situation and configuration. Chinese rhetorical strategy might be summarized as letting the situation act to one’s favour. Planning is less important than evaluating the potential of the configurations of a situation. The sovereignty of space is replaced by the primacy of time. The best image for understanding the notion of situation is not that of place or position, but that of water, which moves and conforms to the surfaces over which it flows. This indicates the importance of detecting antagonisms before they take shape in such a way that the battle is decided before it begins (Jullien, 1994, p. 165). In other words, strategy is intended to make the other act, to include him in a situation, to induce him into a given arrangement. In the words of Jullien (1994, p. 185): [I]t is a treatise on anti-rhetoric. Instead of teaching to persuade the other to see the correctness, or at least the interest, of our advice, it teaches us to influence him in such a way that, before any advice has been given, he is spontaneously led to follow our intention.

This is rhetoric of inducing reactions rather than of calculating them. It is not rhetoric addressed to him who speaks as the agent of a discourse. Rather, it involves getting the other person to speak and by asking the right questions to get him to tell the truth. This handling

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of contraries, aimed at making the other reveal his situation, is exercised by someone who presents himself as someone without qualities (Jullien, 1994, p. 220). His position is never that of a sovereign master, but of one who conforms to the real of the situation. We thus find in Chinese rhetoric a counter-example to Greek narrative rhetoric. This discussion thus shows us that the problem of influence and power is also present in figures of discourse that are quite different from those we are used to. It is therefore crucial to distinguish this type of suggestion, of which little is said concerning its contents, from the type that is merely metaphoric and is transmitted in the form of a discourse to which the subject is expected to submit. Many critics of psychoanalytic treatment (Spence, 1992) agree in their accusation that this type of treatment tends to subjugate the analysand to a master narrative whose contents, or structure, have already been pre-defined and to which the analysand should convert. The notion of “master narrative” was introduced and developed by Jameson (1992), who extracted from psychoanalysis the important distinction between the narrative and the act of narration, the act being a symbolic form of touching and transforming the true social antagonism. Jameson’s argument is based on an important distinction between metaphor and allegory. That is, the practice of ideological domination makes use of two fundamental linguistic strategies: the use and understanding of the metaphor as an instrument of psychological influence (a contact and influence between minds) and the combination between metaphors in a network of allegories. We have seen that the theories about the hierarchy of meaning and its correlative methods of interpretation are clearly related to holding onto and exercising power. We also saw that these conceptions contain strategies to articulate oral discourse with writing, for political purposes. The question is to determine whether psychoanalysis, as a practice that involves rhetorical aspects and as a theory about the production of meaning, might not involve a similar strategy. Our analysis of the notion of metaphor refutes the first objection, but this does not eliminate the hypothesis that, in discursive terms, psychoanalysis is indeed immersed in a type of negative theology (Dunker, 2006a). Negative theology—also known as Via Negativa, or apophatic theology—is a theology that attempts to describe God by negation,

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to speak of God only in terms of what may not be said about him. In brief, the attempt is to acquire an express knowledge of God by describing what he is not (apophasis), rather than by describing what he is. The apophatic tradition is often allied with approaches through mysticism, by focusing on spontaneous or cultivated individual experiences of the divine reality beyond the realm of ordinary perception. Such experiences are often unmediated by the structures of traditional organized religion or learned thought and behaviour. In negative theology, it is accepted that the divine is ineffable. It is an abstract experience that can only be recognized; that is, human beings cannot describe the essence of God. Therefore, all descriptions, if attempted, will be ultimately false. In addition, conceptualization should be avoided; in effect, such a line of thinking eludes definition by definition: neither existence nor nonexistence as we understand it applies to God, i.e., God is beyond existing or not existing. One cannot say that God exists in the usual sense of the term; nor can one say that God is nonexistent. Even though the via negativa essentially rejects theological understanding as a path to God, some have sought to make it an intellectual exercise by describing God only in terms of what God is not. One problem noted with this approach is that there seems to be no fixed basis on deciding what God is not (Pondé, 2003, pp. 74–92). Based on the Midrash, let us see how the allegorical method and its strategy for producing meaning operate neutralizing paradox. The allegory is at the centre of a method of interpretation developed by Philon of Alexandria (25 BC–50 AD). Essentially this method, based on knowledge from outside a text, was aimed at removing its elements deemed as irrational. The allegorical method is based on a special type of logical implication known as material implication or Philonic implication. According to Philon, a declarative proposition (if … then) is perfect if, and only if, it did not start off with a truth and end up with a falsehood. That is, the truth value of the conclusion depended only on the truth values of the propositions, and not on the logical relations among them (W. Kneale & M. Kneale, 1962, p. 133). There are two well-known historical applications of this method: to the epic texts of Homer and Hesiodus, injecting Platonic-Aristotelian philosophy into them, and to Christology, which established the meaning of the Bible in a way to make the Old Testament express a prophetic and anticipatory intention in view of the New Testament.

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For example, in the poetic book of the Old Testament known as the Song of Solomon there is a passage where the king holds the breasts of Sulamit in his hands. It is a strongly erotic scene, and one of the reasons why this passage was included in the Christian canon was through allegorical strategy. For those who apply the allegorical method, the breasts of Sulamit are not what they seem to be. Their textual comparison with two tender bunches of grapes was not enough to conceal the truth, so Sulamit’s breasts were later compared to Jesus Christ and Holy Mother the Church. By holding them in his hands, Solomon symbolizes the inseparable unity between them. Theological questions aside, the allegorical method proceeds exactly as an interpretation that retrospectively creates the very conditions for its position of meaning. An allegory is a stable metaphor able to function as a pole of attraction and catalyst for other metaphors, such as the bunches of grapes in the above example. The allegory, more than the metaphor in itself, is what emerges when one considers a metaphor as an analogy produced by “contact between minds”, in the words of Perelman (Lacan, 1961b, p. 903), or as a possible proportion between two signs, as the surrealists might state. We are now able to delineate a form of understanding the suggestion, which is important for the practices of influence we see as psychotherapeutic extensions of compromise narratives. It is important to note that Philon of Alexandria developed his allegorical conception in the context of the School of Therapists, in Alexandria. It is also understandable that he was the first to systematize the therapeutic value of reading (bibliotherapy). Fliess’ cosmic nasal theory is an example of the allegorical method. Fliess, who, in the opinion of Anzieu (1975), was Freud’s analyst, bases his theorization on two matricial signifieds: the male and female “substances”, upon which the universe is organized. The place where these two substances originate can be condensed into a single part of the body, the nose. Nasal bleeding therefore represents menstruation, nasal congestion represents pregnancy and sexual arousal, the two nostrils refer to the two sexes, and so forth. This association between menstruation and the nose was a case of overinterpretation (Eco, 1993, pp. 27–52), whose most important characteristic is that it cannot be refuted (heads I win, tails you lose). We read this paranoiac tendency not only in its hyper-interpretation of the allegory but also as a refusal to admit the existence of

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meaninglessness. A paranoiac universe is essentially one where everything has meaning, where there is no room for non-meaning, which is what is introduced by the second metaphoric negation. Curiously, such a universe is not pacified, it is in permanent conflict. Let us compare this interpretative strategy with a clinical fragment analysed by Freud (1927), namely, the Glanz auf die Nase, the “shine on the nose” that determined the love choices of a certain male patient of his. In his case, the choice of a love object, something usually conflictive and uncertain, became stabilized in a trait, a certain shine on a woman’s nose, which conditioned and even determined his choice of object. Although the “shine” may seem to be a good description for the patient, he felt it was insufficient. He could have said: “It’s an indescribable shine. I can recognise it but I can’t name it. But this uncertainty doesn’t bother me”. But the problem was solved by paying attention to a metaphorical anomaly: Glanz (“shine”, in German is close to glance in English). The patient had been raised by an English nanny, an experience that may have at least partially configured the subject’s drive. It is important to note in this case, however, that the shine on the nose is not allegorical, as was the case of Fliess and his theory about the nose. The shine is a trace from the writing of the drive. It does not expand the field of meaning, it rather deflates it by organizing its economy of jouissance. We have three operations involved here: a replacement of language, a replacement of signifier, and a replacement of writing system. Allouch (1994) stressed the importance of the differences between translation, transcription, and transliteration for the theory of the metaphor and, consequently, for the practice of interpretation. Translation operates to preserve the meaning between different languages. In the case of psychoanalysis, this is exemplified in the idea of translating the manifest material into its latent meaning. It is this interpretative scheme that allowed Freud (1909) to explore the polysemy of the signifier Ratten, in his Case of the Rat Man. As the treatment advanced, Ratten was translated as rats (Raten), in the phobic symptom, but also as debt (Ratten) in the relationship with the father and, secondarily, as children (that are little and aggressive, like rats), and by excrement (in the language of the anal drive). In transcription one supposes variations in the production of meaning and takes into account a language’s different modes of

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expression and its conditions of figurability, especially from spoken language into written language. For example, Raten and Ratten have exactly the same sound, but they are written differently. Freud uses the term “transcription” to refer to the different forms of association and dissociation between word representation and thing representation. In this case, there is a transcription of traces (Zug) into signs (Zeichen). Another example: in his article entitled The Unconscious Freud (1915b) discusses the different uses of the term “Aughenverdrehen”. Literally, it means “eye-turner” while metaphorically it means “someone who is very seductive”. This metaphor could appear in a number of different clinical situations. In hysteria it could engender an ocular conversion, for example, while, in psychosis, it might give the idea of someone actually turning his or her eyes. In this latter situation, it is as if there is no transcription from the literal to the metaphoric or as if the action took place without loss of meaning. An allegory thus ignores, or abolishes, the distinction between speech and writing (as different systems) when producing meaning and, consequently, the difference between translation, transcription, and transliteration. Transliteration is the passage from one system of writing to another. Most glossographic languages, that is, those based on the representation of speech, can admit to variations according to the associative principle, be it by morphemes (the case of Chinese), segments of speech (as in the Semitic languages), syllables (in the case of linear B languages), or phonemes (as in most Western languages). These examples serve to emphasize that one should not confuse graphemes, or letters, derived from a system of writing, with signifiers, which have their origin in a system comprising speech and language. Freud (1913a, p. 180) stressed that, in psychoanalysis, one should also take into account the mode of transliterative listening, as he indicated in the following observation: Although we may think that the means of representation in dreams are mainly visual images, and not words, we shall see that it is even more appropriate to compare dreams to a system of writing than to a language. In reality, the interpretation of dreams is totally analogous to the deciphering of ancient pictographic writing, such as Egyptian hieroglyphics. In both cases there are certain elements that are not meant to be interpreted

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(or read, as may be the case). They rather have the intention of serving as “determinative”, that is, they establish the meaning of some other element.

The process of transliteration was also mentioned by Freud (1900) when discussing the dream of Alexander the Great. Alexander was laying siege to the city of Tyre and hesitated about whether to attack it or not. One night he dreamed of a satyr dancing on a shield. The soothsayers interpreted the dream through the semantic dissociation of “Satyr” into “Sá tyre”, literally meaning “The city of Tyre is yours”. The signifier Satyr, a mythological being that is half-man and half-goat, is replaced by both translation and transcription (another arrangement of signifiers) and by transliteration (a different arrangement of letters). These differences between three separate processes take us back to the topic of conflict. In the section on inventio, above, we saw that Freud makes a distinction between jokes of words and jokes of thought. In the part on dispositio we saw how the logical structure of an analytic session depends on the distinction between judgement and act. Our discussion on elocutio led to the importance of the heterogeneity between speech and writing. In each of these sections we explored two different types of paradox, which, however, have been blended together in the practice of interpretation: the semantic paradox and the logical paradox. Semantic paradox belong to speech and depends on a certain theory of truth. Logic paradox belong to writing and depends on a certain theory of real. The semantic paradox, pertains, par excellence, to rhetoric, as can be seen in a short apologue on the origins of rhetoric itself. In this apologue, Tisias travels to southern Italy to take classes in rhetoric from Corax. After a time the master, considering the teaching concluded, asks Tisias to pay up, and the disciple answers: If, in fact, I have become a rhetorician, I can convince you that I should not have to pay. But if I can’t persuade you that I shouldn’t pay, this shows that I’m not a good rhetorician. So in either case I shouldn’t pay you.

Where the axiomatic seeks for a solution to a problem, the rhetorical is satisfied with an effect of language that undermines the alternatives contained in a discourse. In the apologue referred to above,

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the conclusions of the teaching and the payment are simultaneously denied and asserted. If Tisias paid for the teaching he received, he would be denying that it had been concluded. But the only way to conclude it was to prove that he should not pay. This is a semantic paradox because its key is the enthymeme that defines a rhetorician exclusively as “someone who is able to persuade the other”. The rhetorical figure that summarizes the idea of semantic paradox is the oxymoron. An oxymoron is an opposition between a term and the qualification that is given it, or between two qualities attributed to a single term, or between the simultaneous denial and assertion of the same fact or concept (Plebe, 1978). The Greek expression “to oxymoron” refers, literally, to the “acutely mad”. The oxymoron is the essence of semantic contradiction whose variants are the paradox and the antithesis. Oxymoron is a semantic approximation of opposites. A detail from the case of the Rat Man might be used to show how an analytic interpretation is a tributary of the figure of the oxymoron. The patient resorted to an oxymoron as a protective formula in order to be free of certain libidinous and masturbatory thoughts that occurred to him regarding a certain woman. To avoid thinking them, he would repeat to himself the word glejisamen, a neologism he himself constructed in the following way: “g”—Gisela (the desired lady); “gl”—glucklich (happy); “e”—Ernst Lanzer (the name of the Rat Man); “ji”—jezt und immer (now and forever); “s”—a letter whose meaning is unknown to the patient; “amen”—amen (so be it). This supposedly protective formula contains the woman’s very name and transcribes each set of phonemes through a signifier. It also translates the arrangement of signifiers into a protective signification, as a way to negate his masturbatory desire. The meaning of the entire neologism, would therefore be: “Gisela and Ernst happy now and forever, amen”. It is at this point that the interpretation made by Freud subverts the meaning of the sentence as he hears in glejisamen, the termination samen, literally, “semen”. For his interpretation, Freud took into account exactly the extra letter (the “s”), whose meaning was unknown to the subject in the operation of transliteration. It became clear that the protective formula brought about exactly what it was meant to avoid, the union of Gisela and semen through masturbation. If we now look at the rhetorical pathway of the protective formula, we see that it goes from antithesis to oxymoron. An “anti-thesis” is made up of two opposing assertions that cannot both be true at the same time, and an oxymoron brings together the terms of the opposition

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into a self-contradictory formation. This difference between the two terms can be clarified by the fact that an antithesis supposes a system of speech whose elementary form is a sentence, or proposition. The oxymoron needs only a system of writing whose elementary form is a trace or element. For example, if I say “A is a circle” and then say that “A is a square”, there is an antithesis between the propositions. However, if I consider the existence of a square circle, there is an oxymoron. Both engender forms of meaning, but at opposite points on the symbolic field. In other words, interpretation in psychoanalysis can be looked at in their various rhetorical aspects. The direct and indirect evidence of this approximation between analysis and rhetoric go back to the history of rhetoric in its various contexts. But no matter how closely we may seek in the formal aspects of rhetoric something that prescribes and justifies its use, we will find nothing more than a technique of language. No matter how complex or how strong the relationship between psychoanalysis and rhetoric may be, it cannot be more than a technical affinity the purposes of which seem to go beyond its own scope. Rhetoric would then seem to be a type of skill that is necessary but not sufficient for psychoanalytic practice. It clearly illustrates the psychotherapeutic aspects of psychoanalysis, including the risks involved in articulating it with discursive strategies of domination.

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CHAPTER FIVE

Taking care of oneself

Give up on your pain before it gives up on you. —Seneca

Cura sui So far we have examined a number of specific aspects of Homer’s epics, of Judeo-Christian texts and of myths surrounding holistic modes of social organization. In the process we have isolated a number of healing strategies based on integration and disintegration of meaning (tragedy), community bonds (shamanism, narrative commitment), techniques of speech influence (rhetoric), diagnosis and prognosis (medicine). Tragedy adds centrality and dimension to conflict in the narrative strategy of recomposition. Here the conflict no longer involves separation between worlds but the recognition of conflict in the immanence of this world in its legal, social, and epistemic present. It is in this context that integrative and disintegrative tactics of harmonization can be associated with catharsis.

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This new type of relationship between law and truth creates a surface of problems concerning the unification of knowledge-power with desire. Now, we can name this discourse articulation as the therapeutic surface. We can see the matrix of another surface in Empedocles, Hippocrates and Philosophical medicine of the soul, namely, the clinical surface. It is characterized mainly by the abstraction of a causal sequence and by the questioning of the issue of authority in the curing, or healing, process. We can see the matrix of another surface in Empedocles and Hippocrates, namely, the clinical surface. It is characterized mainly by the abstraction of a causal sequence and by the questioning of the issue of authority in the curing, or healing, process. Now we are going to introduce a third surface around the idea of cure (cura). There are three aspects to be considered here. The first aspect is in reference to the noun cure in French, corresponding to Kur in German and cura in Latin and Portuguese. It alludes not only to a magical or religious experience of having been freed from a disease. Curing, or healing, often refers to a process in time, which includes the narrative of the process itself. It is not a religious word but an ethical disposition. Curing includes the attitude of taking care of (Sorge in German). In this work we are assuming that a healing process, as the result of taking care of oneself, represents one of three the main practical traditions in the roots of psychoanalysis. Here we will consider the concept of curing, or healing, both in its broad sense of a magical-religious process (as in shamanism) and in its specific reference to lay practices leading back to the Hellenistic period (as in medicine of the soul, tragedy and the Latin cura sui).1 The second aspect brings in another problem in terms of English, which is the use of the term heal or healing, in the sense of recovering and its corresponding verb “to heal”—close to Guérison in French and Heilung in German and allied to reestabelecimento in Portuguese, but with certain subtle differences. “Healing” sound as a recovering process. It is related to the idea of going back or returning to a previous state. We include both magical curing, or healing, and the idea of therapy (considered as a set of techniques). As we will see, the current

1

Translator’s note: The differences between the English verbs to cure and to heal are so subtle that we have opted to consider them synonymous in translating these verbs.

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opposition between cure and heal, in the sense that, in general, we cure a disease and we heal a person, corresponds to a kind of inversion of meaning. Originally, the Greek-Latin idea of curing indicates a whole personal transformation, and the Christian idea of healing indicates the survival of the soul, according to the soteriologist tradition. So, we usually cure a person and heal a disease. But both curing and healing can be considered as types of recovering (Heilung). The third semantically relevant dimension of practices that are part of the roots of psychoanalysis is represented by the terms: treatment (Behandlung in German) and therapy. In our view, treatment depends on the idea of method and is a perspective that arose in the since seventeenth century, in modernity, and was finally established as a major reference in medicine only towards the end of the eighteenth century. Here we can integrate the notions of health (Genesung) and the presupposition of the clinic as a structure. Both the psychotherapeutic surface and the clinical surface face a systematic difficulty in integrating the symbolic excellence of their agents with the symbolic effectiveness of their practices. If the topic of excellence leads us to a discussion of the forms of power, that of effectiveness leads us to question the status of the truth. We can posit that psychoanalysis has a tactical affinity with rhetoric, that is, with the clinical approach of Empedocles, and that there is a strategic affinity with catharsis (integrative and disintegrative), although both these affinities are questionable in their scope and quality. But this supposition neither guarantees, nor even suggests, any political affinity of psychoanalysis with either of these two constitutive matrices. To argue that psychoanalysis has some similarity with the action of ancient physicians, the experience of tragedy, rhetoric, or the dialectical relation of Socratic inspiration (Cottet, 1989) merely situates elements on the plane of what Foucault (1969) called “enunciative modalities”, concepts, and strategies. But these elements are not enough to analyse the politics of a discourse. To characterize the formation of a discourse one must specify an object and show how it complies with specific and regular rules of composition, even if they are different from one another. No one of these practices is commensurable with the object of psychoanalysis. We saw that both tragedy and rhetoric, as well as the clinic of Empedocles, can be considered intermediate formations between the regime of myth (before the eighth century BC) and the nascent

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Socratic and Platonic philosophy (after the fifth century BC). Following the great apex of Plato’s Academy and Aristotle’s Lyceum, during the transition period to incipient Christianity, a number of schools proper to the Hellenic world arose. This period of dissemination of Greek culture and the development of the Roman Empire saw the rise of countless movements where philosophy was privileged not as the transmission of theoretical knowledge but as a practice of life (Hadot, 1995). The contemplative form of life was only one of these ways of life, and its opposition to the active life (vita activa), marked by being busy, occupied, and restless, was not immediate. It was only after a conflict between discourses that the experience of freedom became a theoretical way of life (Arendt, 1983, pp. 20–26). The discursive format of the practices involved in the active life was not always characterized by a discourse about any specific object of knowledge but, at times, by a discourse with a subject that aspires to transform his life. This practice was found among the Stoics, epicureans, sceptics, and cynics, who differed from one another through different and dispersed systematizations. The practice was oriented to the relationships between the subject and the truth. But this truth was not about the heavens and the stars, about the order of the cosmos or even about ethics or religion in general. It was about the conditions under which a subject can enunciate and practice a way of life. A way of life or, to use a more modern term, a life style, is not only a set of dispositions, tastes, and circumstances. It also includes the main contradictions between one person and another, as well as differences that individuals may bear within themselves. A way of life includes the power persons can have over themselves (and its limits), including power over their destiny, their choices and even over their bodies. In short, a way of life is fidelity to the truth that is an effect of these contradictions. This is what Foucault (1981–1982) was referring to with his expression “the care of the self”, termed epimeleia heatutou by the Greeks and cura sui by the Romans.2 The Delphic precept of know thyself (gnothi seauton) has often been invoked as a maxim for the therapeutic situation. This maxim, far from indicating an interiorized search for oneself, was originally 2

Translator’s note: Although The English title to Foucault’s book is “the care of the self”, we have preferred here generally to translate the concept as “Taking care of oneself”.

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a recommendation of prudence that encompassed a three-fold meaning: to avoid excesses (hubris), not to undertake more than is possible, and carefully examine the questions proposed to the oracle and to life. In Socratic philosophy this appeal to prudence (sophrosine) is based on a more generic recommendation: take care of thyself. That is, before and individual came know herself, she must take care of herself, be occupied with herself. To care for, or to occupy oneself with, correspond to the verb therapeuein, from which the term therapy was derived. It means both medical care for the soul and the service that someone renders to his or her master, the care one takes for one’s house, and even the cult dedicated to a divinity. The idea of therapy as treatment refers to action that is discontinuous in time and exercised whenever necessary and in response to a specific demand. In contrast, the notion of care expresses an attitude of continuous attention to oneself, a permanent orientation. This conditions the measures by which we undergo change (Foucault, 1981–1982, p. 15) and transfiguration that pass beyond the specific difficulties and obligations of everyday life. The immediate object of caring for oneself is the subject, but its final purpose is the city, meaning the social and everyday relationships with others. There is a relationship of precedence involved here: taking care of oneself is a condition for taking care of others. As Epictetus (Foucault, 1981–1982, p. 563) once said: Do not seek to determine what you are on the basis of the system of rights and obligations that distinguish us and situate us in relation to others. Rather ask yourself about what you are and then infer what should be done in general or in one circumstance or other, but always in accord with the functions you must exercise.

This recommendation by Epictetus shows us the type of inversion of perspective present in taking care of oneself. The subject should not be seen as a separate agent removed or isolated from the world, but as an organized entity that establishes a starting point for ethical action according to its own functions but not inferred from a system of rights and obligations. Taking care of oneself must be separated from the more generic notion of loving care (caritas) developed by Christianity and akin to the more recent expression in banalized English “tender loving care”. The notion of loving care implies a type of

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self-observation that has the objective of deciphering oneself. It can be seen in political and theological treatises as the basic image to indicate the analogy between men being governed by God, and caritas, clearly a form of kingly love. Hellenic care consists of loving care (eros) and care between equals (agape), which rulers should have towards their subjects (Campanella, 1973). Caritas therefore emphasizes knowing oneself in order to master oneself and to be known in order to be cared for, and it concludes with self-renunciation. The specific character of Hellenic caretaking is completely different. Hellenic care is difficult to pin down when one realizes that its horizon is truth in the sphere of the subject’s being, here and now. The position of the Hellenics is that taking care of oneself is unrelated to the world of work. It does not involve the production of some object nor of any technique inherent to work. Nor does it necessarily entail aesthetic or religious activity, much less, contemplative or theoretical activity, although it may include them to the extent that they are considered activities in the world. There are four spheres, or domains, that lead to a critical discussion of the Greek universe, in four domains where freedom could be so approached: health of the body, relationships with one’s wife, relationships with the same sex and, relationships with access to the truth (Fonseca, 2003, p. 105). Historically, there were three stages in the evolution of taking care of oneself: the Socratic-Platonic stage, its most outstanding reference being Plato’s Dialogue Alcibiades (fifth century BC); the Hellenic stage, where taking care of oneself expanded into a culture of the self, during the period of Imperial Rome (second century BC to third century AD); and, finally, the Fourth and Fifth Centuries AD, when this practice was eventually absorbed by Christian asceticism, which ended up subordinating taking care of oneself to the primacy of self-knowledge. In Plato’s Dialogue we find the character of Alcibiades, the same Alcibiades who was enthralled with Socrates in The Symposium (Platão, 1973) and whom Lacan (1960a) took for his re-reading of the structure of the transference in terms of the love of knowledge (agalma). But the situation in the dialogue entitled Alcibiades (Platão, 1985) diverges from that found in The Symposium. In the dialog, the once young warrior is older and is entering the critical age when the loves of youth are left behind and ambition is felt for political

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life. Alcibiades is interested not only in enjoying the benefits of his relationships and living peacefully with his family and other citizens. He wants to change his status by getting involved in the political action of governing others. But Socrates explains to him that the exercise of power must be preceded by caring for oneself. Without the experience of caring for oneself, something that Alcibiades obviously understands nothing, power flows over into excess or becomes corrupt and tyrannical. It is not that Alcibiades lacks formation (paideia), political experience or virtue (wisdom, temperance, courage, and justice). He lacks care for himself. How can he care for others, in the sense of being the sovereign of a city, without knowing how to take care of himself? Alcibiades is led by Socrates’ irony to recognize his ignorance through the following question: What is this self he must be concerned with and must take care of? Ignorance, constantly renewed throughout life, is like an obstinate passion that reigns over caring for oneself. This dialogue is actually aporetic, where the real issue is not raised. It is therefore impossible to get an exact idea of what caring means for Plato. But there is no doubt that he began a period during which self-knowledge absorbed, reduced, and dominated self-care. There is no need here to move from the question of ethics—that is, to how one should take care of oneself?—to the epistemic question: What is this object called the soul, the self, the ego? Note that we are not asking here who this specific soul, self, or ego is. The problem is that ignorance about taking care of oneself cannot be equated with ignorance about oneself. In the discussion on taking care of oneself, a number of techniques, practices, and devices will be re-read and transformed, all on the basis of personal relationships and dialogue. Caring for oneself is a lifelong activity, but it begins and is transmitted basically in a finite relationship. One possible image of this process is a series of encounters of varying duration between a master and his disciple. During these encounters, specific problematic situations are examined, such as whether to take on a job or position, get married, eat some specific type of food, move to another city, be disinherited by one’s father, develop friendships and relationships, deal with the illness of a loved one, engage in sex and, in short, deal with any matter that might be a source of positive or negative encounters in everyday life. Taking care of oneself is impossible without the active and continuous

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participation of another. As Galen said, man loves himself too much to free himself alone. If difficulties arise in the sphere of human relationships, it is not outside of them that they will be resolved. The other, who is support and condition for instating care for oneself, has an ambiguous status. Sometimes the other is a friend and at other times a regular advisor, teacher, or doctor of the soul. This other may practice any of a number of techniques, including purification (catharsis), concentration, and dispersion of the soul, solitude, and trials. As in the Medical School of Epidaurus, there is also the practice of taking substances in the attempt to induce certain types of dreams, examining them by recalling acts and circumstances that have made up one’s life, and questioning of decisions made in the past. Some techniques aim at focusing one’s attention and reducing dispersive curiosity, while others are meant to reduce attention and let it roam in other directions. There are also techniques of memory that call to mind the minor choices in everyday life so that the representations they involve in the subject can be examined. The work of separating and evaluating the knowledge needed to care for oneself includes knowledge of an ethopoetic nature, that is, knowledge that leads to autarqueia (depending on oneself) and to contenti (contentment with oneself). It is also important to distinguish these practices from enkrateia, that is, with mastery over oneself. We recognize this impulse, this need, to master oneself in the figure of Ulysses. For example, he has his sailors tie him to the mast and orders them to place wax in their own ears when the ship nears the cliffs inhabited by the mermaids. This is a beautiful metaphor of the proportionality between mastery over oneself and mastery over others. But in the sphere of caring for oneself, too much concern with self-mastery is interpreted as a symptom of the lack of such care. It is not that mastery rules out care. It is rather that the relationship between greed, effort, and the exercise of power indicates a lack of a relationship of care, suggesting that care has been displaced to a relationship of education or control among people. We see here two expressions of a political nature used to specify caring for oneself. The relationship of power over oneself is symmetrical but not proportional to the relationship of one’s power over others. The supposed relationship in the mastery over oneself is therefore the starting point for dominating the other or for

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being dominated by the other. Here is one example of this type of meta-hypothesis in Foucault’s work—a hypothesis that is found in The Hermeneutics of the Subject (1981–1982, p. 306), our reference text for the question in a broader project: There is no other first and final point of resistance to political power except in one’s relationship with oneself. The interest of strategies of power in techniques related to the self, therefore, is not accessory or complementary, but constitutive. Foucault’s works on the history of sexuality, the history of madness, juridical forms, and forms of governability are thus, at one and the same time, texts of historical criticism and fragments of the genealogy of political ontology of the psychoanalytic clinic. The soul as subject, rather than the soul as an essential substance, is the agent of a type of care that holds a metaphoric relationship with other forms of care, such as the care a physician dedicates to his patients, that a head of a family has towards his household (economy, oikos) or that lovers give their beloved (eros). Differently from a physician, the father of a family or a teacher, a caregiver takes care of the care that someone can provide for him/herself. This does not rule out erotic or dietary aspects, or the social relationships people have in their lives, but the relationship is indirect. Caring for oneself does not entail neglecting others. On the contrary, it sees care for the other based on the way one cares for oneself. Let us look at a concrete example from Epictetus (Platão, 1985, p. 330). The father of a family becomes desperate when his daughter falls seriously ill. Seeing that his own state is anything but helpful, he leaves the daughter in the hands of the family and goes to the school of Epictetus to ask for his advice. The philosopher tells the father that, despite the legitimate love he feels for his daughter, he committed an error. So moved by his daughter’s illness and unable to cope, he is taking very little care of himself. Overcome with concern, the father is failing to care for himself in order to care for his daughter. He has failed to examine the representations that occurred to his spirit, which prevent him from acting on the situation. It is interesting to note that this type of behaviour might seem a little selfish. But for Epictetus it was exactly by not being mindful enough of himself and by trying to take care of his daughter before taking of himself that he could not really care for her or, at least help her take care of herself. The general rule, then, is that one must take care of

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oneself in order to care for others. If we start off by caring for the other, there is no way out. Caring for oneself has two distinct sets of roots: one tradition that tries to include it and submit it to self-knowledge as a preliminary and propedeutic condition for knowledge in general, and another tradition where caring for oneself becomes separated from the objective of epistemology and becomes part of a technique for living. This is why these strategies can be analysed with relative indifference to the contents of their theoretical objectives, whether such objectives be the epicurists’ pursuit of pleasure, the Stoics’ correctness, the sceptics’ doubt, or the cynics’ suspension. The mere transversal presence of caring for oneself in these different traditions argues in favour of this. The meaning of the term technique (techne) must therefore be clarified. Technique, in this context, should not be understood as an automatic, repetitious, anonymous, and transmissible activity in the form of impersonal knowledge. Techne means made by man, as opposed to poiesis, which means made by nature or created by God. The most common metaphors for taking care of oneself derive from the art (techne) of navigation and refer basically to a form of knowing how (savoir faire) similar to that needed to pilot a boat or ship. A navigator must know his own position, but he must also be attentive to signs of the circumstances, such as the wind, the tides, reefs, and cliffs. In the experience of piloting one must be able to be alone and to separate oneself from the obligations, needs, and debts that make up everyday life. It is therefore considered a practice that one learns through one’s own experience. The voyage expresses the idea of sovereignty over oneself and reflexive selfappropriation of the directions taken. There is an affinity between healing, or curing, and governing, managing, or directing that can be seen throughout the history of caring for oneself as a metaphor essentially related to time. The time absorbed by caring for oneself includes kayros, which is the time needed for word and act to converge into happening. But there is also the time the Greeks call hora, that is, the stage of existence where taking care of oneself is not only desirable, as it is at any time in life, but necessary as well. It is the time between formation (paideia), and the time for participating in politics, marked by reflection on old age, which is still in the future, and by remembering (anamnesis). For people to take care of themselves, they must be

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freed from their process of growing up (their childhood) and from any desire to dominate others (politics). As Seneca wrote: “I hope you hold a generous disregard for everything that your parents desired for you in abundance”. (Letter of Seneca for Lucilio, in Foucault, 1981–1982, p. 118). These words of Seneca show how a type of freedom is involved in taking care of oneself with respect to both the past and the future. As I mentioned above, the practice of caring for oneself was developed in a heterogeneous way and consisted of more than a single format. At the school (Stoa) of Epictetus, a sort of service was offered that might involve longer or shorter stays there with occasional periods of return. The cynics provided public often erratic practices on the occasion of fortuitous encounters at celebrations and ceremonies or on the street corners of the city. The group of “therapists” organized around Philon of Alexandria were involved in more closed experiences involving ascetic restrictions and obligations more commonly seen in initiation ceremonies. Finally, for Seneca, the late Stoics and the epicurists, it consisted of experiences had in social environments similar to friendship that involved encounters and exchanges of correspondence, as well as encouragement to write. There is consensus, however, that, as caring for oneself became more organized, as its practical criteria became professionalized and as the schools adopted increasingly complex forms of organization, caring for oneself tended to disappear or be transformed into other practices. This was due to the infiltration of forms of power that corrupted the very essence of caring for oneself. A dissolutive selfcontradiction emerges when taking care of the other becomes more important than taking care of oneself. A curious similarity can be seen here between these heterogeneous forms of organization concerning care for oneself and the apparently equivalent solutions that have been developed more recently for transmitting psychoanalysis, namely, personalism, groupism, and institutionalism. This trend should serve as a historical warning for us, since taking care of oneself turns into something else when it becomes professional and when those in charge of its practice focus their attention primarily on politics as a network of personally and institutionally organized interests. When the persons involved in a school or an organized group dedicated to taking care of others occupy themselves intensely in a political career, by becoming

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famous or powerful, they contradict the main purpose of their intent to take care of others.

Time, truth, and discourse There is another serious tension between taking care of oneself and practicing medicine or therapy, and it has not always been noted by historians (Jackson, 1999, p. 23). We are talking here about three different but closely related traditions. First, there is therapeutic practice (recovering). In this tradition, the aim is for the individual to recover, or return to a previous state, in the sense of re-establishing an earlier condition of harmony, a correct balance between elements or a reconciliation with the natural order of things. The criterion of efficacy is based on the mitigation of suffering. The second is ancient clinical medical practice (treatment). Here we see the combination between observing diseases, making efforts to separate and classify them, and acting on their causes. Here, the criterion of efficacy is based on the ability to make diagnose and prognose of the process. Health and disease are considered different points in a normal cyclical process of repetition. There is nothing either new or old to remove or to introduce. Third, there is taking care of oneself (curing, healing). In the tradition of taking care of oneself, a cure consists of the establishment of a different state of the soul, meaning that, after being healed, the individual becomes someone different from what he or she was before (the person may decide to become a shaman, for example). Healing brings the idea of moving towards something new and curing implies the idea of removing something old. Here the criterion is the excellence of being, or the “discontent” in civilization (Unbehagen), as Freud called it.3

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N.T. While his works were being translated into English, Freud suggested to James Strachey the title Man’s Discomfort in Civilisation, but they finally agreed on Civilisation and its Discontents. Besides the problem of translating the German word Kultur into English (Civilization), we have the question of translating Unbehagen. Literally, this noun refers to a state of being, not some discomfort or discontent. It would be well to recall that the book’s original title in German, given by Freud himself, was Das Unglück in der Kultur, which means unhappiness or misery.

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It so happens that in the tradition of caring for oneself, being cured, or being healed, implies a return to a previous state, as is the case in therapeutic tradition. But there is a change in one’s relationship to suffering, as there is in a therapeutic cure, since such previous state never existed. It was created by the practice of caring. This is why taking care of oneself consists of a radically new experience. This previous and, at the same time, new, state is a type of fiction that is especially sustained in the experience of self-appropriation. The Stoics, for example, sought to experience a state so individual that it could be understood as always having been part of the subject, such as childhood or an earlier moment in life. This distinction between care of self, therapy, and clinical practice is important because it sustains a network of metaphors and allegories between suffering, disease, and discontent. Psychotherapy, as Lacan (1973c, p. 516) noted, is an impracticable project if its objective is to attain the ideal of some medical healing, or curing, because it is impossible “to go back to an earlier state”. It will always be a life whose history includes this return. In the medical sense of the term, therefore, disease is conceived as a metaphor of the suffering (pathos) that is confronted in the cure of the soul. Psychotherapy confuses suffering, we have to recognize with symptoms, we have to treat, with pathos we have to take care of. This implies neither a general psychosomatic allegory nor an anachronistic dissociation between soul and body. To treat the metaphor of disease is not the same thing as to treat the disease. Even though the symptoms involved in taking care of oneself are real, the structure of its process is metaphoric, and this can only be conceived of in the light of a materialistic theory of the metaphor (a voyage, a play, a war), as envisioned by the notion of incorporeal in the stoic philosophy of language. This metaphor of suffering as disease was broadened by the Hellenistic schools, which even described five stages in this metaphoric complex comprising suffering-passion-disease (Foucault, op. cit., p. 405): the proclivias, or constitution; the pathos strictly speaking, marked by the appearance of a disorder (affectus); the hexis, which corresponds to the assimilation of a disorder to the point that the subject thinks that by caring for this disorder it is caring for itself; the arrostema, a type of permanent state of disease where the disorder is no longer felt as such; and the kakia, when the passion dominates the

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subject completely and becomes actively imposed on those around it. These five stages are distinguished depending on whether the care is directed to the soul (therapeutike) or to the body (iatrike). The relationship between the conventional medicine of Hippocrates, Asclepius, and Empedocles is therefore not to be confused with the philosophical medicine of caring for oneself. Between these two views of medicine, the division is not between those who take care of the body and those who are occupied with curing the soul. For all the different schools, taking care of oneself included taking care of the body (sexuality, dietary exercises, aesthetic experiences). At issue here is the relationship the subject has with its body, and not direct care for the body. This includes both the body as agent of an action and body as affected by a disease. Therefore, the issue is not always the body assailed by an illness, which is but one of the possible circumstances. There is also the body, for example, that ages, that tires, that seeks pleasure, and that puts up with restrictions. This is the body as the first “property” any individual has, the body seen as an economy of jouissance and erotic ars. Another crucial distinction involves the way people go about caring for themselves. Such caring is not a universal obligation or an ethical or deontological law to which everyone must submit. Taking care of oneself is and must remain a choice to be made by the subject. Not because, in principle, anyone can be excluded from caring for her/himself, but because in practice very few sum up the courage and persistence that this implies. So the admittedly lost sovereignty when we go to a doctor and to whom we must submit, and the preservation of our sovereignty when we care for ourselves are two different things. In caring for oneself, the basic idea is that the subject can also be the agent of his own treatment. At this point treatment gradually became a broader concept that has two aspects: healing (in the sense of disposition to become healthy), and therapy (in the sense of particular acts to overcome suffering). This distinction was the historical result of the growing trust in scientific medicine and in the sovereignty of treatment over other forms of dealing with suffering, for being cured or healed, for recovering. This has made caring for oneself the object of criticism, since the choice may seem to represent a privilege, a luxury available only to an elite. But closer examination refutes this idea. It is most likely that caring for oneself was disseminated as a type of broad cultural

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practice, especially during the first and second centuries AD, even among the poorer strata of society in compromise formations with religious sects and practices. But at the opposite extreme, caring for oneself is socially associated with dedicating oneself regularly to some salutary activity. This might represent not only study, but experimentation and attention to aspects that take on greater importance, due to increased aesthetic or cognitive pleasure. It also implies the presence of at least some theoretical study and creative idleness. The practice arose in the middle classes with networks of friendship that were intertwined with institutional and family relationships during this period (Foucault, op. cit., p. 142). As we saw above, two conditions were factors in the eventual elimination of the system of transmitting the practice of taking care of oneself. On the one hand, society gradually became closed into impermeable and sectarian groups, which resulted in self-segregation. On the other hand, some groups eventually assumed very restrictive positions of social class. The hetero-segregation seen among the affluent also contributed to the disappearance of caring for oneself. This historical opposition between taking care of oneself and segregation is an additional argument against those who associate the practice with dissociation from the social field (the anchorites, for example) or with individualistic isolation. Excessive identification with a charismatic leader, with a group, or with an institution are clear signs of deviation from taking care of oneself. There was a type of mastery involved in taking care of oneself. The master, or guide, was versed in tradition (the heroes and their epics), the knowledge of competence (knowing-how-to-do) and the maieutic knowledge of investigation and discovery practiced in dialogue (rethorics). The condition for this complex of types of knowledge was Ignorance and the disposition to methodic observation (medicine). This is consistent to the extent that taking care of oneself is also to free oneself from the forms of care that others force onto us. Seen in this light, the presence of a master is based on systematic and ongoing criticism of the bases of one’s power transmitted in a real relationship. A master should actively ignore of what positive knowledge the disciple should make use of to care for himself. Taking care of oneself therefore leads the individual from the position of non-subject (in the sense of being the object of the care given by another) to the status of subject in an experience it had never had

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before, at any point in its life, and that it would tend not to come across through its own efforts. A master is a mediator in the relationship of the individual with its constitution as subject (Foucault, op. cit., p. 160). Before this transforming experience of subjectivization, the individual left its own is characterized especially as a stultus, literally, “someone who does not think”. Stulti are people who are at the mercy of contingencies. Lost in time and in the plurality of the outside world, they do not think about old age and, especially, do not see how people can live for purposes they themselves determine. This leads them to feel left out, to whom could apply the adage: “For someone who doesn’t know where to go, all winds seem to blow in the wrong direction”. Their will is not free and is without memory. They want something and, at the same time, want the opposite; they want glory, but if they attain it, they complain about all the fuss and hullabaloo. Their beings as subjects cannot become autonomous (discriminatio) because the self and the will seem to be disconnected from or unfaithful to one another. For having examined only one aspect of a desired object, they become disappointed when they attain it. This type of state can be treated by caring for oneself. The horizon for such a treatment is free, absolute, and endless wanting (Foucault, op. cit., p. 164). Stulti like Alcibiades, are not lacking in knowledge since they can be educated (educare), but they need someone to pull them out, to make them come out (educere). By exclusion, it is becoming clear that the master’s function in care for oneself should be exercised by philosophers. But, in this case, a philosopher is an agent of direct practice with others, and not teachers of some generic or universal discourse about knowledge, virtue, or beauty. Taking care of oneself involves three clearly different activities: governing, educating, and healing. They are distinct, but related as inter- and intra-limited practices. They are distinct, but this light, the figure of the philosopher is similar to that of the rhetorician and the physician, who are also specialists in the ways one can influence others through discourse or through action. The crucial difference is that caregivers, contrary to educational, philosophers or political rhetoricians, must not exercise power over others. No such direct opposition is possible in the relationships between taking care of oneself, and rhetoric. Since caring takes place in a relationship of speech, and speech involves a certain degree of influence, it must be made clear just which aspects of rhetoric

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are pertinent to care and how they can be used. And there is one particular mode of discourse that the caregiver should use whenever possible: parrhesia (to speak frankly). Parrhesia, or libertas occupies a very important place in the organization of all the practices involved in taking care of oneself. It is the art of speaking freely, the art of openness and sincerity (truth telling). The invitation to tell the truth is easily confused with the practice of confession, but it is not the same thing. In confession there is an obligation to tell, and to tell the truth, in order to attain salvation or the clemency of gods or judges. Taking care of oneself more closely involves a trial through which one passes voluntarily. It does not aim at truth in general, much less at another’s indulgence, but rather at exploring one’s ability to tell the truth about oneself, to make oneself the subject of a truth. Here we find a third meaning of truth, which is different from both aletheia and emunah, which were discussed above. This third meaning is veritas, and corresponds to the truth in the sense of saying precisely. The term is derived from verum, which refers to an exact report without omissions and narrated with integrity. Whereas aletheia is related to the present and emunah to the future, veritas refers to the past and to narration (Hegenberg, 1975, p. 14). It is thus related to the dimension of witness, but not witness in the sense used in the legal sphere, where it is also found, but to truth that witnesses the subject’s conversation with itself and establishes a conviction. In this context a caregiver can be described as a friend of the truth, someone who inspires personal trust (emunah), a teacher dedicated to a true relationship with the word (veritas) or, a master concerned with the discovery or invention of a new way of life (aletheia).

Frankness and free talking Parrhesia is the moral quality required for this undertaking. At the beginning, it is the caregiver who has parrhesia, and not the disciple, since the disciple must attain it through her own efforts at taking care of herself. It was not used all the time. It rather constituted the caregiver’s skill and art of being frank at the right time. Despite their similarities, we should not include parrhesia directly into the psychoanalytic notion of free association. First, because parrhesia is the first attribute of one who conducts the caring, and not the one who is being cared for. Second, because free association includes the

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intentional attitude of sincerity as well as the possibility of lying, deceiving, or misleading. Parrhesia is closer to the generic attitude that Freud suggests to analysts of talking frankly about delicate subjects such as sexuality, money, and power. In practicing parrhesia, one should avoid two opposing deviations: flattery and anger. Anger implies abuse of power and lack of control over oneself, and appears when the subject becomes aware that he does not have the power he thought he had. Flattery, as its exact opposite, is the abuse of power practiced by a subordinate who makes the superior believe he is more powerful than he really is. In acting contrary to parrhesia, both show that this virtue implies the ability to be alone, something that is impossible for angry or subservient persons. By speaking frankly one encourages neither the continuity of the other’s discourse nor his silence, as is the case with flattery and anger. Nor does this attitude presume dependence related to economic, political, or family ties. The commitment to taking care of oneself and to the regime of truth that is proper to it makes this sort of speech represent free speech. This does not mean that there is total opposition between rhetoric and parrhesia. Rhetoric is defined by the contents it is dealing with and by its audience. Similarly, in care of self, the question is to realize the right time (kayros) and the right way to say things (lexis) whereby the subject can recognize itself and take in something of what was said. Parrhesia therefore depends on the right moment, when speech makes something happen. Here we can see the practical roots of stoicism in the philosophy of language related to the notion of “incorporeal”. These positions, so often underscored by Lacan (1970), are attempts to justify that, even though everything that exists is body, there are nonetheless (incorporeal) effects of language that can be understood in their negativity and universality. This is the second aspect of language, which the Stoics called phasis, in opposition to lexis (Id., 1961a). In rhetoric, parrhesia means the right time for a topic to be treated freely. Both philosophical and medical parrhesia imply an attitude of generosity and benevolence by those who practice it. Nevertheless, this simple and direct style of saying things should lead the subject to work in some way. The rules of speaking frankly are: to say what one thinks and think what one says, to show things more than to show oneself. To direct the discourse towards what is useful and effective, rather than simply to what is pleasant. To pay attention

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to the enunciation and, to be tactically obedient to the resources of rhetoric (Focault, op. cit., p. 488). The cynics were also opposed to deceitful speech, which is often a characteristic of the rhetorical use of language. The cynics did not comprise any defined group or circle. They rather tended to bring together errant and marginal people who had no clearly defined social positions, family ties, or places in the system of production. Asceticism was a condition for their lives because their main intent was to question and decry social inertia by showing up its hypocrisy. This rejection was consonant with their criticism of the typical image that characterized professional philosophers. They would have nothing to do with well-trimmed beards or nice clothes. In fact, the ancients associated the cynics with going about in ragged clothing and being misfits to civilized life in general. Literally, the term cynic is related to the Latin word for dog (kine). In other words, they were seen as people who lived a free errant life, but also as a group that welcomed others and was welcomed in turn, as demanded by the rules of hospitality and loyalty expected between friends. For this reason, the cynics were considered the first anti-philosophers. The spread of poetry and sculpture dedicated to the god Priapus has been attributed to the cynics and epicurists. Statues of Priapus, with their remarkable phallic members, were often placed in gardens, at points symbolically located between the house and the city, and had the function of provoking laughter by criticizing abundance and excess, and extolling humility (Oliva Neto, 2006). Among the Stoics the exercise of frank speech served to oust those who approach care for the self with overly defined interests. Epictetus complained of those who came to him for utilitarian purposes, and saw himself as a counsellor of existence, not a mentor, friend, or spiritual director. Seneca, who was counsellor to many well-known figures, also did not wish his activities in the area of caring for the self to be confused with his role as a professional philosopher or teacher. Frank speech prevailed for Epictetus, whereas Seneca admitted the tactical use of flattery and the art of manipulating impressions.

From taking care of oneself to the culture of the self This difference gradually waned during the Hellenic-Roman period as service to the soul gradually became a professional activity.

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The decline of parrhesia as the rule for taking care of oneself is related to the progressive disengagement between catharsis and politics. For Plato one must care for oneself to better care for others and thus be happy, but in Neo-Platonism, taking care of oneself develops into a catharsis that leaves aside its political commitments and strives towards individual purification. The bonds of purpose, reciprocity, and reminiscence between the political and the cathartic planes were progressively dissolved into exaltation of the self that was eventually expressed in two practical offshoots of taking care of oneself: the art of existing and the technique of living (Foucault, op. cit., p. 219). In this movement the cura sui (cure of oneself) gradually ceases to be a permanent activity related to excellence and care, and begins concentrating the objective, or product, of the process. The culture of the self, which was established as a condition for the emergence of Christianity, is one of the spaces where taking care of oneself became professional, giving rise to a displacement and a social distribution of the different techniques that were once united in a single ethical scope based on the relationship between the subject and the truth. The culture of the self should be understood as a hierarchically structured set of values propounded as universal, but access to it is restricted, and depends on the degree of excellence of the interpreter. Here we re-encounter the double movement of a hierarchy of meaning (literal, moral, and spiritual) where the exegesis of writing replaces the relationship of speaking. The culture of the self implemented under Latin-Christian influence prescribes values that are articulated with a set of rules and conduct, effort and sacrifices that are justified in a socially valid, stable, and theoretically transmittable system of knowledge (Foucault, op. cit., p. 221). The emergence of the culture of the self brought with it elements that were originally foreign to caring for oneself, such as the notion of salvation and the problem of the soul’s immortality. With the rise of the doctrine of the immortality of the soul, for example, preparation became preparation for an afterlife, rather than for this life. Conversion ceased to be conversion to oneself (occupying oneself with oneself is to turn one’s gaze on oneself) and became conversion to the other. Here the notion of happiness as separate from the notion of contentment came in. Happiness, which was associated with salvation, came about through ataraxia (absence of disquiet) and through autarcia (mastery over oneself and one’s destiny) and thus goes back

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to the original Greek theme of self-determination. Enkrateia, on the other hand, has to do with control over one’s emotions. It refers, in other words, to the idea of self-control. Concepts once related to the mutual connotation of care and politics became depoliticized. Into this space of disconnection between caring for oneself and politics a progressive recognition of an intermediate ethics came in, the ethics of friendship. The best space to care for oneself was not seen as a closed group nor a space of errancy, but one of friendship, understood as suspension of and isolation from the sphere of interests. The opposition between taking care of oneself and taking care of others, which seems so natural to us, proceeds from the understanding that separates caring from politics, and desire from interest in public and private spaces. A good counter-example of this can be seen in the way the Epicurists saw friendship. Epicurus (Foucault, op. cit., p. 238) put it like this: Neither he who is always seeking material aid from his friends nor he who never considers such aid is a true friend; for one engages in petty trade, taking a favour instead of gratitude, and the other deprives himself of hope for the future.

This derives from the fact that the task of taking care of oneself is to develop the subject as someone. That is, to care for oneself, an individual must be one among others, rather than someone who is privileged or solidly installed in a special space or distinguished social position. It must be kept in mind that this principle was proposed by the Roman Emperor Marcus Aurelius and followed by Julius Caesar. It is in friendship, more than in any other form of sociability, that this uniqueness between different individuals and differences between individuals can best be treated. As I mentioned briefly above, taking care of oneself implies going through an experience of conversion. Three connotations are involved in this notion of conversion: the moral, the religious, and the political. For Plato, conversion (epistrophe) means going beyond appearances, returning to oneself, and becoming involved in reminiscence, that is, in a methodical process of remembering essential ideas, which are the source and origin of knowledge. For a Platonist conversion supposes another world that is independent of us and to which one must submit according to the principles of contemplative life (theoria).

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For the Hellenistic philosophy of taking care of oneself, this return, this conversion, is turned towards the world in its immanence and towards the subject in its active life. This involves a degree of freedom from what we do not master in our current relationships. Seneca said that those who are new to caring for themselves should turn a full circle. This gesture of turning around was traditionally performed at the moment when a master freed a slave. The symbolism of the gesture expresses a type of immanent and internal freedom to social ties. Conversion, from the Platonic-Christian point of view, was seen as a very important moment, where a change took place in the subject (trans-subjectivization) and he would enter into a new order. Such a conversion is considered Platonic-Christian because it was related to neo-Platonism, which developed in Alexandria in the early centuries of the Christian Era. For the Hellenics, on the other hand, conversion entailed a long process of self-subjectivization. The subject of care of oneself changes his positions towards life; he does not invent another life in another world. Christian conversion is characterized by repentance, remorse, and expiation (Christian metanoia). It is prepared for through an exegesis of oneself whereby the subject observes its acts and thoughts and then judges and is punished for them in order to renounce the world. Freed of its political meaning, Christian conversion thus favours a climate of interiorized guilt. With conversion to taking care of oneself, in contrast, one seeks to look into oneself and then enter the world by assuming one’s acts in life, and this leads to a climate of freedom. Both these forms of conversion are similar in the importance they give to looking at oneself, but they differ in the objective of what follows this looking. The difference can be attributed to the absorption of mythical elements contained in Platonic discourse. The myth of Er, about the journeys of a soul, described in The Republic, is an example. For the Hellenics this mythical component seems absent or is not strategically important. One must go beyond both the fear of the gods (and, by extension, fear of one’s fate) and the fear of the contingencies that define human experience, especially death. Conversion, in caring for oneself, takes on the position of an intermediary between Platonism and Christianity, in that it is a conversion to oneself (Foucault, op. cit., p. 289). As taking care of oneself declined into culture of the self, it had a different fate in store for conversion: aesthetization. Making life an

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especially beautiful endeavour and cultivating oneself as a work of art represent an extension of original Hellenistic ideas. This can be partially attributed to the high regard that was held for old age as a stage of maximum consummation of life, expressed in the form of a life that is worth being told about. This was the impulse for the birth of the genres of biography and autobiography. Such a narration refers to life that serves as example and that also includes the very act of narrating it. This flows from the cultivation, especially by the Stoics, of writing about oneself. Diaries, personal notes, and letters thus made up a corpus of practices and first-hand accounts through which we can understand the late functioning of caring for oneself. The types of practices involved in taking care of oneself can be classified as shown below. These variations will be discussed in detail in the pages that follow:

A. Ascesis

(a) Exercises of the body

(1) Dietetics (2) Erotica

(b) Disciplines of the soul

(1) Gymnastics (2) Attitudes

B. Meditation

(a) Premeditation on evil (b) Meditation on death (c) Examination of conscience (d) Concentration and dilation of the soul (e) Looking closely and looking from afar

C. Memory

(a) Remembering (b) Examination of dreams (c) Consolation

D. Method

(a) Observing nature (b) Examining the present (c) Pondering the future (d) Avocatio

Figure 1. Practices involved in taking care of one self.

Ascesis We have examined the general principles of caring for oneself, with its contrasts and compromises with medicine of the soul, with rhetoric, and with philosophical and religious discourses. We will

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now go into a more detailed breakdown of its specific practices, which are divided into two major groups: ascesis (askesis) and meditation (melecte) (Hadot, 1991). Meditation could include two further subgroups (method and memory). For some schools theses two subgroups are then differentiatedfrom meditation as such. Ascesis is subdivided into the practice of physical exercise (gymnazein), such as abstinence, diets, and erotics, and the practice of certain mental, attitudinal, and disciplinary experiences. The following are between the different forms of ascesis: Platonic (resignation to the pleasures of the senses), cynical (bearing hunger and injury to achieve independence and to practice denunciation), stoic (correcting judgements to avoid attachment to objects), pyrronic (indifference towards things), and epicurist (limiting desire as a way to attain pure pleasure). Pythagoric ascesis brought together a number of restrictive practices of a dietary and erotological nature related to the use of the word. Christian ascesis, in contrast, stressed the formation of a strict code of obedience along with renunciation in terms of conduct and attitudes. For the Stoics, cynics, and epicurists, ascesis had an entirely different nature, since one of its central questions was how to know to what extent and on what grounds a person should submit to the law. Obedience should be examined like any other servile attitude. In this case, ascesis implied a number of exercises whose purpose was to prepare and advise the subject as to the importance of contingency in human life and, at the same time, assert the subject’s mastery over it. Ascesis gradually built up a collection of experiences, discourses, and convictions whose main characteristic was that they could be easily remembered and were therefore useful when needed to face everyday events. This collection was meant to serve as a type of aid that was so thoroughly absorbed that it would spontaneously come to mind. Also in the context of Hellenistic ascesis a number of reflections on listening, reading, writing, and speaking were developed, and dreams and sleep were examined as a specific part of self-examination. This examination included observation of the body as a place for intensifying pleasure and pain. It also included analysis of the attitudes, habits, and language of others. In some cases, these practices should be developed into types of discipline. Discipline refers to a set of behaviour patterns that must be controlled and that, in the final countdown, will seem to the persons as “not having been reflected on”. They are simply embodied as automatic responses. An attitude

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is a kind of approach to a problem; discipline is a reaction to a problem. Special importance is given to the way things should be said (lexis). This is not a technique, as in medicine or oratory, which is also attentive to ways of speaking and listening. The purpose here is to attain equilibrium between two aspects of listening: the logical (logos) and that in which one is affected by words (pathetikos). To practice listening, the mastery of silence is especially recommended, that is, one should avoid immediately converting what one has heard into discourse or discuss every point of what was said, but rather maintain a physical posture of serenity. This means entering into active and meaningful silence, and here one can see the importance of the rule that the ability to speak depends on the ability to listen. Also, one must master the art of distributing one’s attention and know how to separate what is strictly rhetoric from the eroticization induced by the skill of the one who is speaking. The observance of these two practices leads to a type of memory by which one can concentrate the value of the words that are uttered at the same time that one distances oneself from their effect of dispersion in conversation. In ascesis we find a set of practices that constitute a psychotherapeutic surface. It should be noted that, in them, special attention is paid to corporeality and, especially, to sexual encounter. Under this topic, the main points are the frequency and the moment, and not the specific qualities of the object or the type of contact. This is because the problem of the relationship between mastery over oneself and taking care of oneself is to be found in their intensity (Foucault, 1984c, pp. 88–110). The distinction between physical and attitudinal exercises is much less important than the emphasis on the interiorization of the conflict and on self-observation. A curious similarity thus emerges between ascesis and the discipline of listening, which are frequently discussed with respect to psychoanalytic practice. This similarity seems even more intriguing if we remember that, at the bottom line, ascesis is an heir to the ancient tradition of catharsis.

Meditation The second group of practices related to taking care of oneself involve the notion of meditation, and relate caring for oneself to the clinical tradition. In some cases taking care of oneself includes ascesis but in other cases these two notions are in opposition, or in

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hierarchy first you practice preparatory ascecis, and then you are allowed to move into the taking care of oneself as a cura sui. Separated from ascesis, self-care can be divided into three sub-groups each is orientated to a specific temporality: meditation on the present, recollection of the past (memory), and method towards the future. In view of considerations to be presented farther ahead, it is important to recall that in the field of curing and caring, the method is one practice between others, and not the central theme of any and all practices. The method refers to a type of prognosis of the future and of predictions. There is thus a merely relative opposition between the three broad modalities of reflexive Western thought—memory, method, and meditation—since they are species of the same genus. We can align these practices to the meanings of the truth examined above, respectively: veritas (method), aletheia (meditation), and emunah (memory). But there is yet another opposition, that between the surface to which method belongs, and the surface from which technique arises (ascesis). For the Stoics the core of meditation was the examination of conscience based on the question of “Did you act according to your desire?” This is precisely the same formulation that Lacan (1959–1960, pp. 373–390) used to index the ethics of psychoanalysis and separate it from utilitarian, transcendental, or naturalist ethics. Stoic ethics is usually understood as an ethics of impassivity, which teaches its followers to desire less in order to suffer less. But if we concentrate only on taking care of oneself, we can see that, along with the above approach, there is also an invitation to the unconditional subjectivization of desire. The most important form of meditation is known as meditation on death. Seen as a model for facing the worst of servitudes, servitude to conservation to oneself, the meditation on death leads the subject to experimentally assume its condition of finiteness. From there it can re-evaluate its position in the system of obligations and rewards or debts to itself. Like the contemplation of nature (another genus of meditation), the meditation on death leads us see things “from above”, where human relationships become a spectacle. “I want to be lifted up into the clouds, and from on high I will see men roaming about by chance and trembling, for lack of reason, as they reflect on the idea of death” (Ovídio, 1986, p. 123).

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This brings up an opposition that left its mark on the idea of healing, or curing, until the nineteenth century. Specifically, there are three paradigmatic places where recovery (Heilung) should occur, namely: contact with nature, travel, and theatre. Whether in the form of a garden, an atrium or a simple stroll, it is presumed that being in contact with nature has curative properties because it makes the subject feel within himself. These properties should therefore be alternated with experiences of separation from oneself, of being outside oneself, as is experienced at the theatre, in travel, or in observation of nature (Foucault, 1973–1974, pp. 25–48). To see from on high includes placing ourselves in the world and relativizing our petty passions, vices, and virtues as we realize the inseparable character that exists between the splendours and the misery of the world. Therefore, to meditate on death does not mean to think about death as a speculative topic but to practice an exercise that puts the subject in the infinitely fleeting moment that constitutes the present, before which nothing else exists and after which everything is uncertain, as if we imagined ourselves in the place of someone who is dying, that is, someone who is living out his or her final days. Other variation of meditation is premeditation on calamities. The mediator imagines himself in the position where the worst misfortunes that anyone could imagine have already taken place. He brings to the immediate present the worst conceivable things, and undergoes type of trial in which someone is faced with the “Anything but this” that commands his life. The premeditation on evils is a type of trial or confrontation with a nightmare in such a way that it can be faced and gone beyond. Here again, taking care of oneself does not introduce any technique that is not already an exaggeration, or a controlled reduction of the individual’s own activities. A state of diffuse dread and apprehension regarding the future, and the corresponding anticipation of the worst, are already a part of the subject’s normal life. But they are present without sufficient radicalness and this leads to a sort of game of shadows by which one form of fear prevents the subject from clearly seeing the other, and so forth. Another variation in the practice of meditation is examination of consciousness, in the sense of paying attention to what freely comes to mind. The aim of the examiner of consciousness is to create distance and separation. Involved in everyday routine and demands from the world people forget themselves, they forget themselves

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as experience of the present. This means conscience which exists outside the self, in concerns about the future or in regrets from the past. Examination of consciousness is not only direct attention to the representations, ideas, or feelings that happened in consciousness but the expectation to realize the position from where consciousness obtains these experiences. The recurrent image here is about a disoriented man, who is so worried about where he is going, or where he comes from, that he forgets to ask where he is. If meditation on death brings the soul back to the present in a strategy of self-approximation, the examiner of consciousness introduces the distance that is imperceptible to the soul. If Seneca is a reference for meditation on death, which operates by distance from and approximation to the soul, Marcus Aurelius developed a practice that points in the opposite direction, namely, the concentration and dispersion of the soul. In this case, the meditators examine in detail the impact and value of the utterly minor events that take place in their everyday lives. They observe the thoughts that spontaneously occur to the spirit, examine their wonderment at tiny perceptions and feelings, name the things around them that go unnoticed, and let the memories related to these impressions come to the surface. All this serves to “dilate the soul”, thus freeing the subject of its servitude to everyday perspectives. Dilation of the soul should be practiced jointly and in alternation with moments of concentration of the soul, such as taking an object apart, redescribing an event bit by bit, or talking about apparently important happenings in a depreciating or ironic way. The objective of exercises like these is to effect a de-composition of the identity of the representations that plague or fascinate us. Compressing and dilating the soul are complementary experiences that make the subject, as reason, alternate with the subject, as point, by dismembering and decomposing the unity of meaning that dominates us or that we want to dominate. In the final instance, the Stulti wanted to dominate what they could not, and they thus let themselves be controlled by what can dominate them. As a counterpart to dilating and compressing the soul we have the opposite strategy, which consists of placing a kind of “counterfocus” on experience. For example, let us take a problematic situation that one might face in actual life. It becomes obsessive and occupies the soul day and night. The solution to this kind of loss

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of oneself (alienation) consists in considering the situation from the point of view of eternity, or “looking down from above”. Let us look at this situation from on high, from the sky, as the Stoics said. Such a view will show up other situations that are similar, or even worse than those that surround the subject in his own personal life, the life of his neighbours, and so forth. The opposite strategy is called “looking closely”. Here we have a minor but persistent problem, which does not occupy our full attention so it increases in magnitude as the consciousness is disperse and do not pay attention directly to it. The idea of looking closely is like focusing a lens on the situation so we can see its details and prepare a possible solution.

Memory The third group of practices related to taking care of oneself joins experiences and memory. Reflection on memory is, at one and the same time, an attitude that consists of a criticism of the state of preoccupation, understood as being lost or confused and looks ahead to the future. To concentrate on the present, a practice the Stoics and Epicurists valued greatly, means to disconnect from ourselves in both the past and future. Memory, on the other hand, is a way to re-encounter the present and, based on it, to face the future. The idea here is to go to the past in order to leave it and bring something of it up to the present. Remembering is seen here as an effort that is needed in order to forget. According to Epicurus: If one understands eternity not as having infinite temporal duration, but as being atemporal, then he who lives in the present lives eternally.

Another way to deal with memory is by examining dreams. Its similarity with psychoanalysis is clear in rare backing from certain Freudian texts. The first part of The Interpretation of Dreams (1900), for example, consists of a brief but accurate rundown on the questions brought up by caring for oneself in relation to dreams, namely, a dream’s relationship with one’s life when awake (a dream should not be interpreted as a whole, but bit-by-bit); the relationships between dreams and memory (including the idea that a dream is

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a type of prophetic memory); the internal and external stimuli that prompted the dream (for the Hellenics there were many different ways to incite a dream); the place of corporeality (including the erotic value of dreams); the forgetting of dreams (the Hellenics developed techniques for remembering dreams); and finally, the clinical value of dreams in their relationship to mental disorders. To sum up, a number of different aspects regarding dreams were at the core of the experience of caring for oneself, including the idea that dreams have meanings, that these meanings can be deciphered and that they refer to the dreamer’s current life, even if the connection is not immediately clear (examination of consciousness comes from this perception). However, in his references to the conception of dreams in the ancient world, and even in his admiration for Artmidorus of Daldis, Freud seems to be completely unaware of the place that the practice of the examination of dreams had in the ancients’ system of cure, as represented by caring for oneself (Lobo, 2004, p. 131). The practice of memory in taking care of oneself also applies to personal events that occurred in the past, specifically the loss of or separation from loved ones. This gave rise to a narrative genre often cultivated during the Middle Ages, namely, consolation. In his Consolatio Philosophiae, Boethius (1998) an exponent of this genre, describes the last moments of a man condemned to death. The confusion and dread related to death are dissolved as, at the end, the oneiric figure of a beautiful woman, known as The Visitor, turns out to be a grand allegory for the truth. When Boethius becomes able to contemplate her, he also encounters “the face of his true physician”. The Consolatio narrates this situation, which Lacan (1959–1960, pp. 327–341) called “between two deaths”, where a man who had been a philosophy teacher is unjustly condemned and has all his demands implacably suspended. The technique of “consolation” consists of interventions that unbalance the two basic attitudes towards calamity, indifference, and exaggerated emotion (Jackson, 1999, p. 169). In other words, faced with indifference, one should attempt to stir up some emotion and, faced with affection, to encourage greater indifference. This process of alternation continues from one pole to the other until the calamity is both deeply felt and seen with indifference. Consolation is included between the practices aimed at maximum tensioning between two meanings of subject: the subject as indeterminate reason and the subject as point, or position. The subject as indeterminate reason is positioned in the penumbra of the

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world and operates in a space of separation, or distance, where it has all possible time. For this very reason, the choice becomes impossible. In contrast, the subject as point, or position, operates in the temporality of an irreversible instant where it must make a choice, or simply decide for one solution or another. In the words of Foucault (1973–1974, p. 347): We show you the world not so that you can choose, like souls of Plato could choose their fate. We show you the world for you to understand that you have no choice and that nothing can be chosen unless you choose the rest. There is only one world, a single possible world, and it is to this world that we are connected. The only choice is not: what life do you choose, what character do you attribute to yourself, do you want to be good or bad? The only moment of choice given to the soul, at the moment when it is at the threshold of life and is about to be born into this world, is: “Decide whether you want to come in or go out. In other words, whether or not, you want to live”.

In Ad Marciam, de Consolatione Seneca (2007, pp. 156–181) addresses a discourse of consolation to a mother who has lost her son. The author’s strategy is to present two pathways to grieving. In the first he describes the attitude of Octavia, who, after the death of her son Marcelo, spends the rest of her own life in the state she was in on the day of the funeral. She rejects her other son, wears mourning garments, and spends the remaining years of her existence devoted to the crystallized memory of her lost child. Livia, in a similar situation, acts in a completely different way. She seems able to bury her son Drusos and, together with him, the suffering she went through in losing him. She never ceases to utter her dead son’s name, and her memories of him remain with her in both her public and private lives. The reader can see that Seneca seems to perceive the difference between the pathological mourning and melancholia, of Octavia, on the one hand, and the supposedly normal grieving of Livia (Silva, 2007, pp. 146–155). His narrative strategy differs from both the Judeo-Christian lineage and the typically Greek way of seeing things. Instead of ostensively declaring what attitude Marcia should take, Seneca says it is a matter of choice that has to be made when a subject is before the cruellest fate that can befall him.

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Method The fourth group of practices involved in taking care of oneself is the practice of the method that has to do with working through both one’s certainty and one’s decisions. These two dimensions make up the horizon of the truth, on which the entire experience of caring for oneself is based. The method involves choosing a fixed point to which one can return and from which one can project a systematization of oneself. Just as meditation on death is opposed to the distension and concentration of the soul, the method is opposed to experiences of memory and examination of consciousness. The purpose of the method is to establish an order for the future by taking on commitments and making considerations as to its contingencies. Included here is the possibility of these being unpredictable events, surprises, and avocatio, which is the hope for pleasures in the future, as was commonly practiced by the Epicurists. If you are not prepared for pleasure, as if you are not prepared for displeasure, you are an easy victim of its natural oscillation in life. On the other hand, the oscillation between pleasure and pain is a part of pleasure itself. Avocatio is a practice oriented to intensifying pleasure by dilating its expectation, but it is also a strategy for not getting lost in pleasure. A person who does not establish some economy of pleasure-displeasure for himself is liable to be dominated by its oscillation. So this fixation does not correspond to any sort of goal plan, but to an exercise of interaction and obtaining of pleasure along the paths of fantasy and imagination. The distension or concentration of the pleasure obtained from a job, a period of waiting and preparation can qualify and intensify it. The reflexive form of the method became more popular to the extent that it became increasingly important to conceive of caring for oneself as a method of individual education. With the dilution of taking care of oneself into a culture of the self, the method became an increasingly important and respected practice. Its importance grew as the figure of the caregiver evolved in to that of the physician-counsellor. Responsible for helping clients make reasonable choices and decide on actions that do not depend entirely on themselves, the method gradually became separated from caring for oneself until it became autonomous self-discipline. So we start with the method as one practice among others in the ethical experience of taking care of oneself. In the course of history method became a less ethical disposition

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and cognitive discipline of oneself. After all, method imposed itself as the most important practice as care was replaced with discipline. The authority to develop the experience of truth in a form of life was displaced to method, but this migration represents the victory of the ascetic pole of cura sui over the care pole (meditation, method and memory) of cura sui. By means of this evolution method changes its meaning from a logic of discovery and transformation of oneself to being a logic of verification and discipline of oneself. As we will see later this idea of method orientates experiences of discovery and inventing the prototype of the psychoanalytical idea of method. On the whole, the exercises involved in the various types of caring for the self represent a new moment in the way that conflicts can be organized. In tragedy, conflict is seen as an ethical proof between gods and humans with respect to truth and destiny. In rhetoric conflict is displaced to the aesthetical relationship of speech and persuasion among mortals with no free place for truth. In caring for oneself truth is not the pacification of conflict or its cause, but the space where truth and freedom is possible. It is an ethical and an aesthetic conflict since it represents tension with the other and dissonance with oneself. In other words, care of oneself is the first practice of the soul that recognizes itself as a political practice. Taking care of oneself is moulded in the empty space left by the city, the law and religion in terms of how people should lead their lives. It explores a dimension of freedom that is located somewhere between the smaller community—family and friends—and institutionalized relationships in the sense of politics and forms of production. As we saw, this space was gradually replaced by the techniques of moral, religious, and legal life that marked the Middle Ages and the rise of Christianity (Foucault, 1973–1974, p. 543). In the process there was the historical emergence of the figure of director of conscience for themselves and, inversely, the places where this freedom had been exercised were extrapolated in public discourses. It can thus be seen that, for the second time (after tragedy), care for oneself represented the place where this tension between social places and political positions was to be found.

Socrates and the cure of Alcebiades The hypothesis that practices known as taking care of oneself involve a type of relationship with sovereignty and power that were

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later seen in psychoanalysis could be refuted because there are no direct references in Freud to back it up, Lacan was the author who most systematically searched for references to practices in the Ancient World. In fact, Lacan (1958a) repeatedly alluded to philosophical and religious ascesis as contrary to psychoanalysis, but he did place analysis in the context of tragic ethics. The argument that ascesis and meditation are different currents of the same system of practices is not sufficient to settle the question. It might also be argued that Lacan failed to note the relevance of practices of taking care of oneself in their specific historical aspects and their unique ethics. He died a year before Foucault published his pioneer studies (Gros in Foucault, 1981–1982, p. 629), in this field and it is not very likely that he had contact with Hadot’s work (1995). The Hellenistic sources available to him for this question may have been the work of Festugière (1950, p. 70), who incorporated the practices of the Stoics and philosophical ascesis into religious ascesis, and the studies by Brochard (1887) on Greek scepticism, quoted verbatim in his seminar on the Object of Psychoanalysis. But when Deleuze (1969/1974) began stressing the importance of the Stoics, especially with respect to their conception of language, Lacan reacted immediately. His texts from the late 1960s and early 1970s contain a great number of references to the Stoics, especially to texts referring more directly to the topic of psychoanalytic treatment. Such texts include On psychoanalysis and its relations to reality (1968a, pp. 350–358) and The error of the subject supposed-to-know (1968b, pp. 329–341). But the strongest argument in favour of the integration of taking care of oneself into the archaeology of psychoanalytic practice is to be found in the use Lacan makes of the figure of Socrates. There are three stages in this approach. In the first stage (Lacan, 1960a, p. 159), Socrates is presented as the greatest figure of pure desire and of the position of the one who is loved (erastes). As such, Socrates inspires the love of wisdom. Socrates is described as: “a miserable man but, in this regard, the divinity granted me a gift: the power to rapidly recognise a lover as well as a loved one” (Apud. Goldmischmit, 1970, p. 75). On the basis of Socrates’ practical knowledge of the things of Eros, he intervenes at the Symposium, redirecting to Agathon the love that Alcibiades expresses for him. Alcibiades, being unaware of the function of the object as the cause of desire (agalma), does not know

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why he loves Socrates. Love, the most pathological of all normal phenomena, is different from desire, just as truth is distinct from knowledge. Since, according to Socrates, love is love of knowledge, one could aspire to a purer form of this knowledge, which is truth itself. It so happens, however, that the truth of this knowledge is not something concrete, but a void object. Lacan (1969a, p. 381) put it like this: What Socrates knows, and that the analyst should at least have a hint of, is that, at the level of the objet petit a [object a], this question has nothing to do with the question of access to an ideal. Love can only get close to, but never enters, the field of being. ... This is the mourning around which the analyst’s desire revolves.

Here Socrates’ desire appears very similar to the notion of parrhesia. As Lacan (1969a, p. 186) said: I would even say that the better the analyst has been analysed, the more easily he will be frankly loving or frankly feel a state of aversion, of repulsion, regarding the most elementary modes of relationships between bodies, with reference to his analysands.

Lacan’s second group of references to Socrates uses a very different approach. The question is no longer the analyst’s desire as pure desire, but a desire to attain the absolute difference. Here the figure of Socrates migrates to the idea of atopia.4 Atopia means a lack of place, a situation of drifting and refusing the place of either lover or beloved. In this sense, the analyst’s desire holds fast to the separation between object a and the ego ideal. The analyst’s desire represents the mourning of his own transference, his narcissism, and his castration.

4

Atopia comes from the Greek word atopos, which means “that which has no set place, that which resists classification. Topos means both place and discourse. In Greek dictionaries, the word atopia is articulated semantically with “something extraordinary”, a “rarity”, “something new”, “strange”, “unusual combination of sounds and words” (in rhetoric). Roland Barthes, one of the few to use the word atopos in his writings, does so to qualify not only what escapes description and definition, but what “is always unpredictable originality”.

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A similarity emerges here between the analyst’s desire and the slave’s desire, and no longer in relation to the desire of the supposed master, who, through irony and maieutics, gives birth to wisdom in the other. Here one can note an allusion to taking care of oneself when Lacan (1964a, p. 241) asks: How can one see anything but a first outline of the technique of discernment of the transference in the fact that Socrates answers him, not what he told him when he was a youth—concern yourself with your soul–but words more appropriate to a mature man—concern yourself with your desire.

This change accentuates the reference to truth as a process of enunciation of desire and looks at the transference not from the perspective of its presence, that is, in its form as loving, but from the perspective of its dissolution, conceived as traversing the identifications and the mourning that is correlative to these identifications. In the third group of references Lacan separates the figure of Socrates from that of the analyst. In this context Socrates is associated with the hysteric’s discourse, always questioning the law and demanding a master. Lacan sees Socrates as an excellent example of the function of the countenance in psychoanalysis, the countenance that is expressed in Socrates’ irony as a way of having the analysand produce knowledge. This change can be attributed to the idea that, in placing himself or herself as object (agalma), the analyst would have to be defined not only by his or her desire, but also by his or her jouissance (Cottet, 1989, pp. 174–176). To get around this problem, Socrates is taken out of the position of representative of the desire of the analyst and instated as the expression of the hysteric’s discourse, truth of which is the jouissance of oneself as object. That is, everything takes place as if Socrates’ desire were inconveniently related to the desire to know. So Lacan has to make a detour to re-evaluate, separate, and relativize the reference to Socrates’ function in both the transference and the treatment. But this relationship between desire and knowledge is a problem only if we take Plato’s Socrates as our reference. As we saw above, things take place very differently if one is dealing with the Hellenistic Socrates or with the Socrates portrayed by Aristophanes (as a comical rather

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than a tragic figure). By identifying the tradition of caring for oneself with philosophical ascesis, Lacan reduces the problem into a simple opposition between integrative and disintegrative dialectics, and this leads him to overlook the archaeological importance of Socrates. In the Alcebiades cure we can see three lacanian Socrates. The loving histerical searcher of knowledge, which helps us to understand transference around the agalma. The desiring rhetorical master of difference, which helps us to understand the desire of the analyst. The tragic caregiver of the soul, which refuses to use its power over others, and helps us to understand the politics of the cure. One should not see taking care of oneself merely as a practice of life or a technique for being happy, to use a expression of Freud’s. It is the first form of action and evolution of the conflict that articulates the surface we call psychotherapeutic with the surface called clinical. One would have to return once again to Lacan’s treatment of the affinity between Socrates’ desire and the analyst’s desire, taking into account that Socrates is a central metaphor for both the Platonic tradition of self-knowledge and the Hellenic tradition of taking care of oneself.

Therapy, treatment, and cure But to say that psychoanalysis constitutes a discursive formation as such is going a bit too far. Foucault’s effort can be read as an attempt to affect an archaeology of psychoanalysis. Foucault shows how it participates in other discursive formations, such as the silencing of madness (Foucault, 1961), the psychiatric order (Id., 1973–1974), and disciplining of sexuality (Id., 1984b), and the apparatus (dispositif ) of confession (Id., 1976), all of which are themes he touches on in this area. Nonetheless, Foucault presents Freud as a founder of discursivity (Id., 1970) and a participant in a hermeneutics of suspicion (Id., 1975b). He suggests that, in spite of all, there seems to be something irreducible in the psychoanalytic experience in terms of the discursive formation delimited by the two surfaces we are describing. If psychoanalysis is really seen as a double refusal, of both the psychotherapeutic and the clinical traditions (considered as powerforms), this does not in itself free us from considering the specifically negative conception of power that is contained in this refusal. Analysis is both psychotherapy and a clinical practice, but that is not all.

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It can also be seen as a form of curing, or healing, derived from the cura sui discussed above. That is, the separation between ethics and politics becomes much less clear when one considers that the matrix for this division can be found in the ancient tradition of taking care of oneself. The foucaultian position that there is no starting point or finish line of resistance to political power except for one’s relationship to oneself does not mean political exteriority. Nor is this benevolent or malevolent neutrality, nor anything necessarily related to confession or psychologized interiorization. As was seen above, Alcibiades’ request is explicitly related to his move into politics. The problem of placing the concept of treatment somewhere in the midst of philosophy, anthropology, and psychoanalysis is that one can neither reject nor espouse it, as if it consisted solely of an extension of philosophical curing, or healing. One must find the right strategy to refuse to exercise power without reducing the tension between ethics and politics that power expresses. It should be noted that both the clinical and the therapeutic perspectives arise from a dissociation from and a renunciation of examining its articulation with politics, whether through a reduction in the ethical aspects of psychoanalysis or through a reduction in its technique. For this reason, these perspectives are easily absorbed by articulations of the power to which they are subordinated. This is not the case in either the sphere of the cure or of caring for oneself. Here the discussion of power and domination is intrinsic, which means neither technique nor strategy to exercise power over someone else. Power and sexuality cannot be excluded from human relationships, nor can freedom be conceived without a theory of power and truth. But, as we saw in the tradition of cura sui, without a theory of power. But, as we saw in the tradition of cura sui, this relation on power proceeds from a certain experience of desire, with drives and with the other. Cura sui means an experience that induces resistance to the main and hegemonic form of power. We can see it as a liberating experience. Caring for oneself belongs to the field of praxis, as defined by the inseparable ties between agent, means, ends, and the other to whom the action is addressed. For Aristotle, praxis is comprised two types of knowledge; the ethical and the political, the former being oriented to the well-being of the individual and the latter to collective wellbeing. The political field is defined by the notion of conflict, which is organized and governed by the rules defining the field of politics.

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In other words, a political conflict must be settled politically, and the rules by which the political field can be approached (for matters concerning law, war, diplomacy, and the economy) are drawn up politically. A pragmatic and performative dimension can thus be seen in the definition of the field of politics. Defining the space of politics is in itself an act that establishes, at one and the same time, a position in this space and its correlated positions. Political is the original space where we cannot advocate a metalanguage or a universe of discourse, or the existence of the Other of the Other. As Lacan said: “metaphysics is done to fill the whole of politics.” This also applies to the case of the ethics of caring for (healing and curing). Not all of ethics is constitutively based on conflict, but all politics is. From this point of view, psychoanalysis is characterized either as: an ethics that admits to the constitutive nature of conflict (and, in this case, it follows the general principle that governs politics) or, an ethics for which conflict has a derived value. This appears implicitly in Lacan when, throughout his work, he discusses desire based on the dialectical relationship between master and slave. In this discussion, he is referring to a relationship that is defined by power and conflict between the forms of desire that the situation itself engenders. It is a relationship where power is in a divergent and suspect relationship to knowledge. Since desire is the effect of this divergence, it is related to the positional notion of recognition. As well as we have n ethics of the real, we have to postulate a politics of the truth in psychoanalysis. But Lacan’s work contains yet another line of thinking to deal with the problem. It is the possibility that the Real precedes the sexual, with the sexual sphere being a type of primary defence against the Real. In contrast to sexuality, which is defined in its constitution, formation and construction as a field of conflict, the Real is an external cause and a condition for the possibility of conflict. As a paradox for thinking and for experience, the Real does not cease to not inscribe itself. It is a condition of possibility for all possible conflict. In the alternative defined above, that the Real precedes the sexual we can see the truth as a theme that demarcates the second. Historically, politics and truth come together only on the basis of a theology or a metaphysics. Both alternatives end up leaving aside the being of the subject. In both theology and metaphysics the being of the subject in its factity and experience is absorbed as a particular case

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of Being in general. One thus loses the perspective where the true act of saying is a singular experience for the subject. The question of the being of the subject and of the effects of the return of the truth on the subject are rooted in the tradition that Foucault calls spirituality, which is the spirituality of neither theology nor metaphysics, but that of taking care of oneself. In our times, this type of practice has two heirs: psychoanalysis and Marxism. As Foucault (1981–1982, p. 40) himself put it: All the interest and force of Lacan’s analyses lie exactly here: I believe that Lacan was the only one after Freud to want to recentralise the question of psychoanalysis precisely on this question of the relationships between the subject and truth. ... He tried to pose a question that, historically, has been specifically spiritual, namely, the question of the price the subject has to pay and the question of the effect that the fact that he has told, that he can tell and did tell the truth about himself, has on the subject.

A question that remains open in this matter is whether psychoanalysis can deal with these effects on the level of knowledge, since, by definition, caring for oneself cannot be described in these terms. That is, the problem is to determine whether psychoanalytic theory and the formalization of the clinic that defines it can or cannot truly deal with the counter-power factor inherent to the activity where the clinic emerges and where the efficiency of therapy must be respected. In fact, the practice of taking care of oneself is situated in the political field, but as a somewhat negative element, as a resistance against which the practice sets up the only possible regime of sovereignty, the sovereignty over others. Since psychoanalysis is an experience of curing, a method for clinical treatment, as well as a technique of therapy as a process of recovery, we can conclude that the truth is indifferent to the source of its effectiveness. Technique and method are conditions of modern science, which, by definition, have abolished the problem of the truth and the particular experience to attain it. As we have seen, this was not the case in the ancient world. Inversely, if psychoanalysis shares problems and strategies with compromise narratives and therapeutic techniques, it does so by taking advantage of the

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points of destabilization of the truth in these domains of knowledge. The two arguments would seem to converge in the idea that the truth is a completely contingent (or even unnecessary) category in psychoanalysis. But the truth negated in the sphere of the clinic is not the same truth that is negated in the sphere of psychotherapy. They are distinct causal positions. One difficulty in conceiving of the historical constitution of psychoanalysis is that it has its own particular approach for the question of the truth. As Foucault (1981–1982, p. 223) wrote: Not very many people in recent years, in the Twentieth Century, have brought up the question of the truth. Not many people have wondered: what happens to the subject of the truth? ... As for me, I see only two, Heidegger and Lacan.

At this point we can introduce the horizon of the truth present in taking care of oneself. Truth, in this context, does not refer to an act of prospective knowledge with which someone takes power over an object and its corresponding idea. Truth operates here as a position and a moment, in other words as an “effect of truth”, not as a substance or a content. So we must distinguish the truth as an act of saying, from the formal way of saying (elocutio), and from saying something about the truth (as a metalanguage). This is an important point: the subject must change in order for the truth to be said because the truth appears as a possible name for the cause of this contingent transformation. In this practical sense, the truth is the effect of the effort at transformation and, as such, is never sought for directly as an end in itself, as it is by the professional philosopher. It does not have its own deontological or substantial value. Rather, it remains in the place of formal cause, which can only be grasped through its effects. I insist: in this context we are not talking about truth as a form of knowledge (episteme), as the Gnostics and Neo-Platonists sought, in other words, a type of knowledge that is generalizable enough and resistant enough over time that it could be stored away and transmitted, with aspirations to universality. For Platonism, the truth is a chapter in the history of the love philosophy has for knowledge, a history that is full of conditions, rules, methods, and requirements that are intrinsic and extrinsic to the act of knowing. For the Hellenics,

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specifically in the context of the practice of taking care of oneself, the truth is immanent and inseparable from the experience of change in the subject in its active life and its discourse. To quote Foucault (1981–1982, p. 24) once again: The modern age of the relationships between subject and truth will begin the day we postulate that the subject, as he is, is capable of truth, but that the truth, as it is, is incapable of saving the subject.

That is, since the seventeenth century, the truth has been an attribute of the proper use of reason. As such, it is universal and indifferent to the acts that constitute a subject as capable of the truth. This is what Lacan (1969b) calls foreclosure of the subject in the discourse of science. This dimension of the truth is usually opposed to the prevailing theological and finalistic dimension seen in the Middle Ages. As we have seen, the domain of the truth in psychoanalysis is opposed to both of these conceptions, and calls for a different starting point. This discussion is related to a certain cultural atopia that makes it difficult for academic territories to assimilate psychoanalysis. It is not a science, but has a problematic relationship with it. It is not art, but its experience would be unthinkable without art. It is not religion, but it can be made into one (Gellner, 1985). This location in the negative as to what psychoanalysis is not, appears, for example, in Freud’s discussion (1926b) on lay analysis (Laienanalise). In that text, the adjective lay has three connotations. It is: contrary to the idea that psychoanalysis is a branch of the medical profession (lay as not professional), contrary to the position that it is a system of beliefs (lay as not to religious) and, contrary to the argument that it is a specific way of obtaining knowledge (lay as common knowledge). The difficulty in situating the originality of the analytic experience has led to questionable reductions motivated by the tendency to incorporate what is new into what is already known, neutralizing or derogating its potential for resistance and criticism. So we have the hypothesis that there is a starting point in the space of taking care of oneself where the notion of the truth, as related to the subject, is depleted of its epistemological or moral potential (in

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the sense of pre-constituted knowledge about action). In addition, this hypothesis shows that, in this space, the truth is potentially immunized against its effects of oppression and domination. If both hypotheses are seen to be true, this is a point in favour of the political ontology of clinical practices, including that of psychoanalysis, even though this does not imply the exercise of power as domination over the other. The examination of the pre-modern configurations of the strategies of treatment of the soul can be organized into three different but articulated forms of practices.

Cure (Healing)

Therapy (Recovery)

Clinic (Treatment)

Figure 2. Surfaces of treatment, therapy, and cure.

The first surface formed between the cure and the clinic comprises a broad spectrum of practices and compromises based on self-transformation as an effort at enunciating one’s own truth according to the stronger or weaker presence of an ethics of excellence. Here the excluded constitutive perspective is represented by therapy. On the second surface, along the line extending from clinic to therapy, the question of the truth is suppressed and, in its place, the effects of transformation based on the ethics of effectiveness come into play. Here the notion of symptom plays a central role. Cure is excluded from this surface and acts as a constitutive outside

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cause. In fact, this surface does not need the concept of truth to be sustained. The third surface runs from therapy to cure. Here we find practices that are more clearly aligned with a political strategy and to which they are easily subordinated. Here, the notion of suffering is central. It can be seen here how this articulation between the truth of the symptom, the Real of the suffering and the pathos in existence, question that Lacan (1965, p. 825) addressed to analysts regarding their relationship to their work: Let me ask you, you analysts, a question, yes or no: does what you do have the meaning of asserting that the truth of neurotic suffering is having the truth as its cause?

Each of these surfaces is open to a number of different discursive articulations. That is, they are not exactly discourses, but narratives and schemes of interpretation and reading. They are strategies and tactics that find their termination and their visibility to the extent that their bidimensionality opens out to a space of multiple dimensions. For example, a cure as an emerging project in the sphere of taking care of oneself admits of one articulation with Platonic philosophy, another with the Hellenistic schools, and a third with Christianity. Rhetoric admits of extreme variations even if we classify it in the field of general hermeneutics, or even in theology or in mass social health medicine. We can thus describe the distribution and occupation of these surfaces by the practices we have examined. On each surface we find a point of internal torsion. On the surface that runs from the clinic to therapy we find a segment that extends from the shamanism of Empedocles to the medicine of Hippocrates. It is an interior cut that is related to social inscription and to the system for transmitting of a given practice. On the surface that runs from therapy to care of oneself we have a system of transition that consists of tragedy, which unfolds both in the practices associated with political catharsis and in its dilution into compromise strategies and reconciliation between hegemonic narratives in terms of politics of subjectivization of the suffering. On the surface that goes from care of oneself to clinic we can trace the broad movement of absorption of practices of taking care

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Care of oneself ( pathos)

Shamanism

Parrhesia

Integrative Catharsis

Disintegrative Catharsis

Narrative Compromise

Excellence - Efficacy

Ascesis

Meditation

Technique of oneself

Culture of oneself

Therapy

Clinic

(suffering)

(symptom)

Functional Catharsis

Rhetoric

Method

Plato´s medicine of Soul

Empedocles

Hippocrates

Figure 3. Distribution of historical practices. of oneself (cura sui), as disintegrative catharsis, until this movement gave rise to a technology of confession and knowledge of oneself. I speak of surfaces rather than of lines, because I feel that it is in the mutual limitations and in the compromises between one strategy and another that we can characterize each of them. In fact, we speak of constitution and not merely genealogy because each surface is formed both by internal negation, defined by its point of torsion (formation), and by what it must suppress in order to exist as such, this suppression consisting of external negation (constitution). In other words, the medicine of Hippocrates negates Empedocles’ strategy at the first level of its constitution, but both suppress the idea of cure in order to be stabilized. We can thus refute this point that was rejected in its very origin and go back to Freud’s categories. In this scheme we find a constitutive relationship between modes of experience (cure, clinic and therapy) and the procedures and practices of treatment, care, and re-establishment. The point of torsion inside each surface finds an external determination that overweighs its internal contradiction. We saw how this was revealed in the exclusion of the notion of cure in psychoanalysis, in detriment to the notion of treatment. Now it is possible to understand

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Cure or Care as a Process (Kur or Sorge)

Recovery as a State (Heilung)

Cure as a Product (Genesung)

Therapy as a Healing (Psychoterapie)

Clinic as a Discipline (Forshung)

Treatment as a Procedure (Behandlung)

Figure 4. Surfaces and Freudian categories. this exclusion as a constitutive element that, for example, places the discussion of power as really a discussion that is foreign to the specifically clinical-therapeutic surface. It is foreign but of constitutive value, just as rhetoric holds a constitutive but foreign relationship to politics. Analogously, the discussion about cure as a finished result of therapeutic action or as a process of permanent attention is, in its origin, foreign to the cure-clinic surface, but it determines the constitutive torsion of this surface. Even if we examine the notion of recovery we see that it proceeds from the clinical pole and crosses the surface of cure-therapy, injecting into it, for example, the questionable idea of a return to a prior state. In each case we find a type of practice that is treated in a field that is foreign to it. This is the basis of political impasses of the notion of treatment (Behandlung), impasses of the ethics of effectiveness contained in the notion of care (Genesung) and impasses in the ethics of excellence contained in the notion of recovery (Heilung).

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CHAPTER SIX

Montaigne, the most sceptical of the hysterics

We have in philosophy a very pleasant remedy because, through other ways we feel well-being only after we are healed. Philosophy does us good and heals us at the same time. —Montaigne

Kings and cures Louis XIII was crowned King of France in 1610, and he himself modified part of the traditional liturgy of the crowning ceremony. For at least four hundred years each French king had begun his reign with a pilgrimage to the small abbey of Corbeny, where he would pray before the remains of St. Marcoul. By being anointed and sanctioned through the saint’s intercession, the king received the power to heal the sick. This tradition went all the way back to Clovis, the founder of the Merovingian Dynasty in the fifth century. Clovis received the gift of healing in a dream and passed it on to his direct descendents, but not without the religious sanction that turned the

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potential to heal into the power to heal. Traditionally, upon leaving the monastery, the king would touch a few victims of scrofula, a type of inflammation of the lymph glands in the neck region, caused by the tuberculosis bacillus. But the cure was not immediate: to validate it the person had to fast for nine days and then drink some of the water in which the king had washed after touching the sick. Kings of different countries competed with one another, each nation having its own specialty: the English Kings cured epilepsy with the help of magical cramp rings. The kings of Hungary were specialized in jaundice and the French specialized in scrofula. Medieval medicine was unable to clearly diagnose scrofula, and probably included in it a number of diseases of the neck and face, usually of deforming or disfiguring types (Bloch, 2005, pp. 51–52). Numerous cures were attributed to St. Marcoul, but it was through the phonetic association of his name with the neck (cou) that he became the miracle worker for scrofula victims. In other words, it was not at all through any actual historical relationship with the French royalty that St. Marcoul became one of its patron saints. The point is that, since the French king had received the power to cure scrofula, a saint with the same gift had to be given great social importance and admiration. As for the longevity of the belief in the power of kings and their allied saints to heal, it was only in the Fifteenth and Sixteenth Centuries that these two historical lines were joined in a new form of legitimate power. It was during this period that theatrical healing performances began, along with the distribution of coins to the participants, enormous and popular pilgrimages to Corbeny (Bloch, 2005, pp. 194–200) and the mythical reconstruction of St. Marcoul, its patron. From then on it became necessary to send a certificate of the cure signed by the local pastor or by a local judge formally confirming the authenticity of the cure. The kings ordered investigations to determine whether, in fact, the only agents entitled to heal were saints, kings, and born healers. Here a strange warrant was involved. Among the different types of healing, one specific type earned considerable visibility and legitimacy, namely, the seventh son born to one and the same Christian couple (Bloch, 2005, pp. 206–208). So there is a duplication of the principle of genealogical transmission of the power to heal persons and cure diseases, which duplication does not compete with, but rather strengthens, the dignity of royal

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healing. Kings receive this power from their natural ancestors, just as witch doctors do by virtue of their position as sons since Hippocrates. Kings care for their subjects as a father cares for his children and a doctor for his patients. The charisma to heal was thus defined by combining human and divine powers. Cures performed by the king were the expression of his supreme political power, as Louis XIII (1610–1643) propounded. The formula used by Louis XIV (1643–1715), “The king toucheth thee, the Lord healeth thee”, was presented as an immemorial saying. The ability to heal made kings supernatural individuals and provided them with the symbolic excellence to affect cures. There were kings who touched their sick every day, others, once a week, and some even in battle campaigns abroad. They all effected cures on feast days like Easter and Christmas. Charles II of England (1660–1684) became extremely popular among his subjects for having worked an impressive total of one hundred thousand cures during his fifteen years on the throne, (Bloch, 2005, p. 248) without concern for class or origin. To deny the divine character of regal healing was to put the legitimacy of the kings’ power into doubt (Bloch, 2005, p. 105). Although the reference in this context is to the denial of the divine character of curing, there is, at the same time, a suggestion of its efficacy. Medical and ecclesiastical manuals recognized the excellence and effectiveness of healing by kings, as one well-known book on the matter stated it. There were discussions concerning the exact moment at which a king received his miraculous powers: whether it was when he rose to the throne or when he was anointed with the sacred oils, or even when he worked his first cure. The allegory of healing was part of absolutist religion, and consisted basically of the alternating and ambiguous articulation between different orders of the legitimation of power. In Ceneu’s words: The majesty of the kings of France cannot be said to be fully lay, and there are a number of proofs for this. First there was the holy anointment, which comes from heaven itself. Then there is the celestial privilege of healing scrofula, through the intercession of St. Marcoul. In other words, there are royal rights, especially royal spiritual rights. (Apud Bloch, op. cit., 234)

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The decline of royal miracle-working is at the centre of the political controversies over the divine right to power. This can be seen in the gradual changes introduced into the words spoken by the kings when they touched scrofula victims. In the seventeenth century, the expression evolved from “the king healeth thee”, to “the lord healeth thee” (Dieu te guérit). In the eighteenth century, we find the expression “May the Lord heal thee” (Dieu te guérisse). In the last ceremony of curing, practiced by Charles X of France, in 1825, however, the expression was “The king touches thee, may God heal thee” (Bloch, 2005, pp. 260–263). It is in this context that this popular saying was assimilated by medicine and even used by Freud. In this latter’s words: That coldness of feelings required of the psychoanalyst is justified because it creates for both parties the most advantageous conditions: for the physician, the most desirable care for his own emotional life; for the patient, the greatest possible degree of help that we can provide. One ancient surgeon took up the motto of, “Je le pansai, Dieu lê guérit” (I treated him, God healed him). The analyst should be satisfied with something similar to that (Freud, 1912b, pp. 114–115).

Fourteen centuries went by between Clovis and Charles X of France, and for this entire period kings always practiced cures. But it was only in the sixteenth century that regal healing became a crucial political factor. One important aspect to be kept in mind is that the myth of healing must be distinguished from the manner of healing. In fact, the effectiveness of cures and healing even depended on the personal sanctity of each particular king, with episodes of conversion (such as that of the Byzantine Emperor Constantine), miracles, and alliances. The myth expresses the submission of a king to celestial power. The modern apparatus or dispositif of healing by kings connects a type of mandatory conversion (the coronation) to a ritual of submission of the subjects to the king. Between myth and dispositif there is an inversion of functions. By way of this construction, the king represented a type of paradigm of conversion. His crowning was at one and the same time an investiture of political power and a legitimation of this same power in the religious sphere. The physician-kings therefore dialogued both with the natural knowledge of medicine and with

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popular belief. For the seventeenth-century Italian naturalists and the eighteenth-century German scholars, royal healing represented the main point of resistance to the laicisation of medical knowledge. It was the last type of miracle to be discarded in the formation of the natural sciences. Let us examine in a little more detail then, this combination of narrative strategies that sustained the belief in miraculous healing during the sixteenth century by discussing its two basic aspects, conversion and reform of oneself. After the Hellenic period, the word therapy appeared once again in the work of St. Augustine (354–430 AD) to designate the path along which pagans could be converted to Christianity. His famous Confessions is a philosophical, moral, and autobiographical text at the service of this strategy of conversion. There we can detect the argument that the best rhetoric to convert the other is based on one’s own account of conversion. It is the source and testimony (veritas) from which one draws the personal authority of experience. It is this auctoritas that confers on the pontiff the highest dignity, in contrast to the king, who has a different form of power: the temporal potestas. According to the doctrine of the two swords, inspired on Augustine, there is a sort of conjugated proportionality of powers: the sovereignty of the pope in ecclesiastical matters is proportional to the sovereignty of the king regarding his subjects. This thesis is put into effect by the conversion of the king (expressed in the ritual of his coronation), an event that symbolically expresses his submission to the auctoritas and the transfer of part of his power to the pope (Chatelet, 2000, pp. 31–32). St. Augustine described how his disorderly and sordid past was full of uncertainty, but was eventually transformed by the experience of grace and beatitude. There was a bright ray of light based on which everything became different. There is a new radical beginning, a rebirth. The contingency of this event justifies, but does not determine, the sacrifices and discipline of the consequent asceticism. St. Augustine provides a point of identification and support so that converts can adjust their calculation of jouissance (Dunker, 2002), meaning the right proportions of pleasure and sacrifice between this life and life hereafter. In the Christian tradition, renunciation and sacrifice become models of the relationship to oneself in the present. This is not only because the renunciation and sacrifice will be transformed into jouissance at the last judgement, but also because,

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in themselves, they correspond to an economy of guilt and expiation that are redundant in this new way of life. The allegory of healing is everywhere. In Augustine’s words (Agostinho, 1973, p. 15): He who, at your invitation, has answered the call and avoided falls—who now reads in me, when I recall and confess—should not laugh at my having been cured of my illness by That physician. Through Him, he was given the gift of not falling into the same illness, or, better said, he was granted the gift of not falling so gravely ill. Therefore, love Him even more.

The conversion of Augustine Conversion has the effect of encouraging love and the practice of recollection and self-examination. So here we have a first ramification of the psychotherapeutic tradition, namely, therapy based on discursive conversion. This imply a compromise narrative (which would bring things back to the harmony they were in before), but rather a cut or a break (which does away with the past and begins something new). Here, jouissance, in the form of beatitude and grace (salvation), takes the place of truth. The bonds between this individual and his or her community are not re-established (as they are in compromise narrative). Rather, the larger community is broken down into small communities, each one organized by a different model of destiny. Conversion is the ritual of being admitted into this kind of new community. In Augustine’s words (Augostinho, 1973, p. 123):

Put yourself in a special place among those who abominate this type of conduct; like the doctors in Sophocles, who “purge bitter bile with bitter medicine”, you show indignation and exasperation to stand up to your passions and temper. This is illogical. … Do not imagine that it is your responsibility to correct them, or that this is an easy task. But if you use them in accord with what they are, for the same reasons that physicians use forceps or surgical tweezers, strengthening yourself with the calm and moderation required by the situation, the pleasure you feel from your wise conduct will be greater than your exasperation at the cruelty and depravity of others.

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Here again we find the allegory of healing, but the strategy is guided not by a fervent change in position, but rather by the gradual substitution of attitudes guided by the example of the ancients and those who lived reputable lives. Therefore, the narrative substitution carried out by this rhetoric does not call for interiorization, nor does it replace renunciation and sacrifice with loving gratification, but rather with work and war. This involves continuous action, or moral reform, over oneself, and is a solution that stresses the displacement of jouissance to the sphere of production and domination. This appears in Augustine’s considerations on language, which was extensively commented on by Lacan. The symbol creates a new order of being in the relationships between individuals, according to a special type of temporality of the truth (Lacan, 1953a, p. 271).

Imitation and submission in Parallel Lives of Plutarch A second ramification of the therapeutic surface can be derived from the ancient tradition dedicated to the biography of prominent men. Contrary to Augustine, the narrative strategy of this extension is based not on identification with the experience of conversion, but of being subjected to the legitimate but impersonal authority that emanates from the life of the person being written about. The lives of Christ, the apostles, and other saints serve as examples, since they are, at one and the same time, model and inspiration for a type of moral imitation. For Plutarch (125 AD) and for followers of the Greek-Roman religious and legal tradition that succeeded him, discursive substitution was related to the law and obedience to it. Plutarch, a neo-platonic philosopher and politician, lived at a time when Rome was becoming cosmopolitan by absorbing a broad variety of customs, languages, and traditions. In this context of intense cultural relativism, he pondered over the criteria that would let us recognize a virtuous life, a life that would be worth living. In the process, he discussed prosaic topics such as the consumption of meat, the comparison between diseases of the soul and diseases of the body, the ways in which one should deal with one’s enemies, and the practice of lending money. He took part in the literary genre of consolation, discussed superstitions and the differences among beliefs, and the education of children, along with a broad range of other anthropological topics. But Plutarch’s great contribution was

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his invention of the technique of comparing lives, expressed in his work Parallel Lives (Id., 1923). In this book, Greek and Roman personalities are placed side-by-side. The main idea is that the recurrence of themes and of ways of deciding on virtues and vices allows one to classify a life in accord with its principal aspects. For example, Theseus and Romulus, Dion and Brutus, Alcebiades and Coriolanus, although separated by centuries, lived parallel lives. They are lives that are repeated and examples for other lives. This resource is not exactly a novelty, considering the lives of Jesus and the saints, are used by Christianity. The novelty here is that, beyond this discursive substitution, after the identification has been made clear, there is the need to submit to this life that, in a certain sense, has already been lived. There is an authority of those who have lived over those who are now living. We can conceive of a relationship of mutuality between Augustine’s strategy of conversion and crisis, and Plutarch’s strategy of reproduction. Plutarch’s model of parallels was later used by Origen (265–340 AD), for whom martyrdom and suffering were the fundamental model of one’s relationship with the truth (Leloup, 2003, pp. 37–49). One should recall here the association between suffering and temporal existence. This strategy consists of placing a master signifier in the position of agent, confronting the other in the place of the slave that produces. The position of the subject is displaced and, in the final analysis, it is the truth of auctoritas. In the end, one extracts a specific jouissance on the side of the practitioner, based on sacrifice and renunciation. In Plutarch’s strategy, we thus find the structure of what Lacan called the master’s discourse. We see here the appropriateness of the distinction between ancient master and modern master (Lacan, 1969b, pp. 27–37). The modern master places an a-semantic self-referential signifier in the place of the agent of the discourse. In contrast, the ancient master puts in this place the question of the subject, as we saw in the case of caring for oneself. If the life of Cicero is, in fact, a new edition of the life of the Greek poet Demosthenes, what life did Cicero imitate? If there are parallel lives there are infinite other lives in the past and in the indeterminate future that they conjure into being. The ancient masters, such as the interior master described by Augustine, have names in the place of agents, whereas modern masters have only signifier without meaning. Both demand

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some knowledge of the other: the savoir-faire of slaves, the Latinos’ way of knowing how to live, the savoir-crier of people healed by a king. Both the ancient and the modern masters have a subject hidden in the place of truth, which is aimed at producing an object. This discourse is marked by a specific paradox: it addresses the other as knowledge (living knowledge, a way of living) in order to treat it as an object, and reaps profits or social recognition in return. But who cares about the recognition of a slave? Who wants recognition from one we do not recognize? With Augustine’s strategy we come across another supposition. In the place of the agent of the discourse there is knowledge (S2). Augustine, one of the most prominent doctors of the Early Christian Church, questions the other as an object (a pagan), thus producing a subject converted by auctoritas (Dunker, 2005, pp. 137–160). Naturally, the truth of this discourse is a new master signifier represented by beatitude. Here we can see a version of what Lacan called the university discourse. This discourse contains a specific paradox: the other it addresses must be treated as an object in order to produce a subject. This is the generic paradox of education. This discourse is a regression from the master’s discourse, that is, it turns the impossibility of there being knowledge without a subject (effect of the master’s discourse) into the powerlessness to reduce a subject to the absolute signifier (university discourse). In other words, the university discourse brings the elements back to their former positions, according to the signifiers of the prescribed and retained demands, in accord with the definition of regression (Lacan, 1958b). This return, as a return to oneself, or as a return to a previous state (psychotherapy) is what we saw characterize conversion in Augustine’s terms. We can Conversion

Submission

(university discourse)

(master’s discourse)



  





knowledge-experience  pagan beatitude

 conversion

exemplary-life  wisdom authority

 sacrifice

Figure 1. Discourses of conversion and submission: Augustine and Plutarch.

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therefore represent the two narrative strategies, conversion and imitation, in terms of the discourses they take part in. In the construction of the myth of royal healing, the hagiographic discourse—which constructs, for example, the figure of St. Marcoul as a historical figure related to the genealogical line of kings—vies with the discourse of conversion represented in the crowning ceremony. This allows each king to act not only in the register of propagating the conversion and healing of people, but also in the register of his unquestionable authority to cure diseases. Here we have absolutist religion, and it was contemporary with the vast campaigns for Christianizing the New World and the re-conversion of Catholics who had been seduced by the Protestant Reformation. This undertaking was completely different from the Crusades, for example, which associated re-conquest with a discourse of territorial and spiritual submission and occupation by Christianity. The Crusades were not associated with any discourse of evangelization or conversion.

Montaigne: questioning the self The alternation of discourse between conversion and submission, reproduces the two great procedures that the West produced to locate truth in the scope of sexuality (Foucault, 1976, p. 61): the ars erotica, which has to do with the university discourse, and scientia sexualis, related to the master’s discourse. Ars erótica is based on the experience of knowledge (as a way of life or a lifestyle) and scientia sexualis, as knowledge and power over the body and its manifestations. Until the sixteenth century the confession of sins had no value for producing the truth, and served only for priests to decide the type and degree of penance that should be imposed (Winter, 2006, p. 52). The faithful confessed their sins once a year and this could result in the payment of a fee to assure their salvation, or in lifelong penance (sometimes referred to as “satisfaction”) necessary for reconciliation. Confession was voluntary and deliberate (Foucault, 1974–1975, p. 218). It was considered an act of bravery, a collective act within the community. Between the sixteenth and eighteenth centuries confession gradually became a mechanism whereby where the juridical and religious realms came together, as well as the moral and medical realms. This process concentrated sexuality in the female body, in sex education for children, widespread access to reproduction control, and the

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psychiatrization of perverse pleasures. Therefore, the key point for the formation of the clinical figures and interplay of discourses that are at the root of psychoanalysis is based on this evolution in the practice of confession since the sixteenth century and the Protestant Reformation. As Foucault (1984a, p. 70) described it: All Christians were obliged to unceasingly confess everything that happened to them. They had to open themselves to someone who had the responsibility to guide their conscience. This exhaustive confession was somehow intended to produce a truth that was known to neither the pastor nor the subject it self.

This new form of confession connects the narrative concerning the flesh with the figure of the confessor. The flesh is the subjectivity of the body. It is not the description of its acts or the judgement of its excesses, but the exploration of unknown intentionalities, the deciphering of voluptuousness, the narration of concupiscence. Two conditions govern the relationship between the subject and the confessor: exclusiveness and exhaustiveness—tell everything, but only to your confessor, who will, in turn, guarantee complete secrecy. Penitence is displaced from a public act to the experience of contrition, shame, and expiation. A moral physiology is born of the flesh (Id., 1974–75, p. 245), whose apex are the writings of the Marquis de Sade. This transformation in the status of confession is closely related to the interest in techniques for interrogating the penitent and deciphering his or her narrative. The model for this process was The Manual of the Inquisitors, written in 1376 by Nicholas Eymerich, and revised and expanded in 1578. It describes the tricks used by heretics who must be neutralized by the inquisitor in order to extract the truth. The heretic’s ruses include that of: answering ambiguously, answer by introducing a contradiction, invert the question, feign surprise, change the words of the question, twist the inquisitor’s intention, justify oneself, feign physical debility, simulate dementia and, give airs of sanctity (Eymerich, 1961, pp. 119–122). Suspicion and accusation are sufficient conditions to warrant torture, and they are confirmed by the defendant’s speech. In other words, there is a technology for listening aimed at extracting a confession based on the premise that the penitent has something to ignore, resist, or hide. This new way of conceiving confession marked the end of a certain balance that had been in place between the two forms of

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confession: confession of sins and confession of the faith (Jackson, 1999, p. 145). They were practiced in a type of cycle of alternation in that each one asserted and guaranteed the truth of the other. Their separation was an indication that confession, taken as a whole, had become progressively separated from the question of the truth. It degenerated from its condition of a privileged act designed to bring about change in the subject, and became a long, continuous and, especially, intra-subjective practice. Its position among practices of healing (in the tradition of care of the soul) and of therapy thus disintegrated. In the sixteenth century, the social phenomena of witchcraft and possession emerged as true symptoms of the practice of confession. A witch (Foucault, 1974–1975, p. 260) was usually a woman living on the outskirts of a village, sometimes near the forest. She represented the position of the pagan in Augustinian strategy. In contrast, a woman possessed by the devil lived at the centre of town or in a convent, and represented the position where Plutarch’s example is recalled. Possessed women were women whose parallel lives dominate actual life. Submitted to the strict discipline of a convent, a woman “possessed by the devil” could reflect a desire for a different possible life. A possessed woman would confess spontaneously and excessively, going far beyond the limits of secrecy and exclusiveness. Witches, on the other hand, confessed less and resisted, as they were accomplices to the devil. While the possessed woman indicated the emergence of the foreign within the familiar, the witch represents the emergence of the familiar in the foreign. The collusion between these two figures gave rise to the clinical topic of spasms, convulsions, and motor crises as significant signs of madness. Confession should not be understood as a discourse in the psychoanalytic sense of the term, but as an operation of alternation between two different discourses. In this context, confession operates at two moments: the moment of quotation and the moment of enigma. At the moment of quotation the point is to make a statement without an enunciation by describing concupiscent acts and narrating one’s everyday life. The opposite is the case with enigma: the idea here is to make an enunciation without a statement. This is the art of the confessor, who adds doubt and investigation into the flesh where before there had only been the body. Quotation is a tactic proper to the university discourse, while enigma is a tactic of

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the master’s discourse. The order is reversed in the second part of confession. Once an enunciation without a statement—which consists of the penitent’s shame and contrition—has been extracted, a statement without an enunciation is made, and this statement consists of penance and practices of purification. One thus moves from a judgement regarding the flesh to putting sexuality in the place of truth. Confession might be described as this perpetual back-and-forth movement between the university discourse and the master’s discourse. Conversion

Submission

(University discourse)

(Master’s discourse)



  





body



flesh



flesh



judgment

expiation



contrition



sexuality



repentance

Figure 2. Discourses of conversion and submission: the witch and the possessed. Besides the narrative of submission and the narrative of conversion, we must add a vast network of discourses and narratives that have come to the fore since the sixteenth century. They constitute what Foucault (Foucault, 1974–1975, p. 270) calls the point of inversion and resistance to the wave of Christianization, inquisition, and reformation. Among these movements of resistance to Christianization are witchcraft and diabolic possession: witchcraft is an external resistance against the colonizing advance of Christianity, and possession is an internal symptom of the disciplinary advance of this same Christianity. One especially meaningful example of this third strategy is found in the life and work of Michel de Montaigne (1533–1592). At the age of 37 and suffering from kidney stones, Montaigne moved to his rural estate, where he dedicated the rest of his life to writing. He invented a new literary form, the essay, and established a new narrative theme: “I am the subject of my book”. The essay blends common sense, sophisticated literature, experience and description,

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and is committed to freedom rather than to authority. But the crucial movement we find in Montaigne is not only in his openness to writing about himself, but in his curious way of combining it with a specific narrative position, the position of self-irony. In taking this position, Montaigne goes back to one of the currents of caring for oneself, specifically, scepticism, especially the current that began with Pyhrrus (318–272 BC). Therapeutic scepticism rejects the critical and merely negative objective of philosophy. It rather seeks to describe our ordinary life within the limits of experience. This makes sceptical therapeutics a critic of traditional therapeutics. Sceptical therapeutics is aimed at doing away with all integrative aspirations, be they metaphysical or cathartic, whether based on conversion or on narrative compromise. Sceptical therapeutics is clearly on the clinical side of strategies for curing, and inspires what Montaigne called the anatomy of the soul, that is, a discourse that methodologically suspends aspirations to the exclusiveness, necessity, and universality proper to the philosophical discourse, and replaces them with the plurality, contingency, and singularity that make up experience. This expresses the close affinity that exists between the notions of clinic and of experience. Psychoanalysis is a dialectic, in the sense of what Montaigne called the “art de conférer” (Lacan, 1953a, p. 317). This would seem to imply a renunciation of any theorization at all. The sceptic is not one who disparages the truth, since this would be to admit to the existence of falsehood. The sceptic is rather a person who keeps on searching for the truth, even while she asserts that this is impossible. A sceptic must abandon all aspiration to a “general and abstract ego” because this would presuppose that it is possible to know such an entity. He replaces that belief with the mere perception that there is no such thing as a personal self that is indissolubly connected to the body (Smith, 2005, pp. 49–88). Correlatively, the followers of Sixtus Empiricus are characterized as believers in a philosophy of the recognition of the world and of the common knowledge (in the sense of shared knowledge) that is present in it (Porchat Pereira, 1993, p. 112). It is surprising that Foucault dedicated so little attention to the sceptics in his analysis of caring for oneself, because the separation between knowing oneself and taking care of oneself is clear in the sceptics.

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Surprisingly, it is this sceptical attitude—in other words, a Pyhrronian attitude—that, according to Lacan (1963a), psychoanalysis demands of anyone who comes to be analysed. Some authors seem to see in this assertion a connection with the concept of suspension of judgement, action and criticism, as practiced in free association and, correlatively, in free-floating attention. But the question is more structural than deontological. The position of the real truth is not the truth of an ancient life (in Plutarch’s strategy), or the truth of a new life (in Augustinian strategy). It is the truth about which we can have no knowledge. Neurotics do not take to this idea easily. This emptiness of the “knowledge of the truth” is immediately occupied by jouissance (Ferreyra, 2004, p. 18). As neurotics might say: “It doesn’t matter if I don’t know anything because at least the Other knows”. When a lack of knowledge appears in the Other, neurotics interpret this as a kind of trickery. They think the Other is joking with them, in other words, this Other is having jouissance over them. As Lacan put it: “Now I offer you my jouissance; let’s see if you can get jouissance out of this. Make me a masochist who falls in love with your anxiety”. This is an enunciation to follow the analysand’s taking of a Pyhrronic position (Lacan, op. cit.). Montaigne could be considered a legitimate heir and representative of the meditative current of Hellenistic care of oneself. His practice is quite similar to that of Marcus Aurelius, especially in the idea that meditation is a way of controlling the internal discourse (De Santi, 2003, p. 166). He seeks an art of living that cultivates his independence and keeps him far from the protection of institutions and contracts (Willemart, 1999, pp. 56–59), according to the formula “Lend not yourself to others and give only to yourself”. But we find in this turning to oneself both a retreat from the world and an orientation towards this world. In this conversion (in the sense of taking care of the soul), the self is reduced to an enunciative position and not to a starting point for knowledge. In this regard, Montaigne wrote (1973b, p. 455): “I have nothing to say about myself, solidly, simply and wholly, without confusion and mixture”. It is the experience of fragmentation and mixture, rather than self-identity that makes up the raw material of his writings. On the surface where Augustine and Plutarch meet one can see a privilege given to reading, while, in Montaigne, this privilege is given to writing about oneself. In his Essays (1973a) Montaigne presents a semiology of the states of the

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soul (such as fear, loneliness, sadness, aging, anger, and cruelty), a diagnosis of human intentionality (the uncertainty of judgements, the chance of the passions, the insanity of reason, the presence of indolence, vanity and selfishness as motivations). One can also note the continued presence of rhetoric, no longer dedicated to the study and classification of the forms of discourse, but to the examination of the practice of conversation in everyday life (business, names, trivia, something that was denied, lies, the art of conversing, etc.). From the therapeutic point of view, there is but a single overall direction: to make philosophy is to learn to die. Therefore, Montaigne’s narrative has all the characteristics that are seen in the hysteric’s discourse: the divided subject as the agent of the discourse, questioning of the law as a symptom (Lacan, 1969b, p. 41), the production of knowledge that escapes appropriation by the one who has produced it and the formation of an object in the place of truth (death). We can separate these discursive aspects from Montaigne’s potentially hysterical lifestyle in the personal sense, in his belle indifference to world, his tendency to consider life as a theatre, his defiance of the law, and his taste for liberty. It now becomes easier to understand why the sceptical position must be present at the beginning of psychoanalytic treatment: it is the indicator of the hysteric’s discourse (Lacan, 1969b, p. 31). Montaigne’s conversion might also have been closely related not only to his kidney stones, but also to the friendship he built up with Étiene de la Boétie. The political execution of this young friend played a very important role in Montaigne’s decision to retire from world and dedicate his live to writing about himself. We find in La Boétie a number of the basic topics treated by

Writing about oneself (Hysteric’s discourse)  



question

 law

death

 knowledge-mixture

Figure 3. Montaigne: Writing about oneself.

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Montaigne, such as voluntary servitude, friendship as refusal of servitude, freedom as an unfortunate encounter that we try to protect ourselves from, criticism of the One as an instance of the justification of power and, of course, meditation on death. La Boétie (1999, p. 16) began his most famous text with the allegory of healing, with the following: Doctors are no doubt right in warning us not to touch incurable wounds; and I am presumably taking chances in preaching as I do to a people which has long lost all sensitivity and, no longer conscious of its infirmity, is plainly suffering from mortal illness. Let us therefore understand by logic, if we can, how it happens that this obstinate willingness to submit has become so deeply rooted in a nation that the very love of liberty seems no longer natural.

Montaigne’s moral anatomy is simultaneously an ironic criticism of self-deceit and of willingness to harbour the illusions one sees among men, on the one hand, as well as a study of their paradoxes, on the other. How can so many submit to so few? How can we explain why people so easily give up their freedom? Why has domination stood for so long and in so many places? La Boétie’s answer to these questions is surprising for their simplicity: servitude is what it is because it derives from human desire. There is a desire for servitude, a desire that imposes itself and makes people forget about desire. In this state of things, friendship is the only expression of freedom from servitude. Augustine, Plutarch, and Montaigne show three different ways of understanding the subject and three main points on the respective surfaces of three traditions, the therapeutic, the clinical and the tradition of the cure of the soul. Augustine, Plutarch and, more explicitly, Montaigne himself, were concerned with the question of: How did I become what I am? Therefore, the subject need not be thought of as a state, or even as a condition, but as activity, as the work of this question. It is precisely in this sense that we can understand Freud’s maxim on psychoanalytic treatment: Wo Es war, soll Ich werden (Where Id was, there Ego shall be). We can speculate over three different readings for this maxim. For the Augustinian surface of therapy, soll Ich werden is about

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natural duty (sollen). For Plutarch, the clinical surface of the soll Ich werden is a question of who I (Ich) am, and who I (Es) were. For the surface of curing and healing based on Montaigne, the question “sollen werden” is about being yourself (Ich werden). But just what is a question? The appearance of the first universities in the late middle ages was accompanied by a new type of rhetorical genre known as quaestio (question, issue, or cause). It was a pedagogical practice, a method of learning, based on the alternation of objections, expositions, and refutations. A topic was chosen and the quaestio was debated. For the first time, a great number of bachelors and masters were allowed to participate in the verbal disputes so characteristic of the construction of medieval knowledge (Libera, 1989, p. 26). The procedure of the quaestio supposes not only an exposition, but a contradiction and a conclusion as well. The order and form taken on by the exposition came together into a discourse that, in the end, leads the participants to the moment of the verdict. It is in this context that the quaestio is both a type of preparation for knowledge and an act of its achievement. Quaestio comes from the Latin verb quarere, which means to want, to seek, to look for. Perhaps this connotation is preserved in the logical sense of the term question.1 A question, in this sense, is a linguistic act that consists of enunciating something that denotes, either through its intonation, its grammatical form or its punctuation, that someone is asking someone else to complete the enunciation (Lalande, 1997). This type of “question”, therefore, is not a request for an answer. It is rather the material cause of a network of such questions. This cause is the designation of a lack in knowledge and an indeterminacy of its occupation. “For there to be a question, the being must have two names: void and penumbra” (Badiou, 2002, p. 128). A question performatively and recursively opens up a field of possible questions that call for answers, as was seen above in the discursive definition of the field of politics and ethics. We can define a question as issue as a journey taken by a truth, starting off with an event, a choice or a possibility, the condition of which is the presence

1

TN—this is question in the sense of an issue, rather than in the sense of a question that is asked in order to obtain a concrete answer.

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of an undecidable situation. This possibility produces a subject that must face the indiscernible character of its choice and the reasons, causes, and motives that led it to the act that incites it to the work of knowing. There are, then, four phases of a question in this sense: First the phase of growing up a question. Here we addressed the Other, and are affected by a place from where emerges a lack in the knowledge. This lack produces a demand that has to be located in a specific symbolic system. The conversion, represented by the Augustinian tradition is a main example of the process of questioning a specific symbolic order. Here the question insists, is itself recurrent. A fidelity to the question occurs. Second, the phase of investigation and testing. Here the question is exposed for some kind of proof, it has to produce something to be recognizable, in a group of people, among a live, among a time and place. The clinical procedure of comparison parallel lives exemplifies this phase. There are signs, great events, canonical or acute experiences that are grasped together. Third, the examination of the extent of its truth. Here the question has to deal with the knowledge it produces and with the change it induces. As in Montaigne self-examination we have to name the experience without losing it (Id., 1994, p. 45). We have to separate this particular experience from others. Fourth, the return of the question to his agent. Here we recognize that the question could not be judged as a universal transmissible experience. Here we recognize that the question is in fact the recurrences, the proofs, and its nominations that turn the agent into the author of this question. The difference between Route 1 and Route 2 is the presence or absence of an agent of the discourse. Foucault (1977b, pp. 251–253) defined discourse as a strategy without a strategist, this definition being perfectly in line with Lacan’s notion of discourse. The route that includes the agent reveals the figure of the strategist: the one in whose name the power is being exercised. But this visibility is occasional, and theoretically unnecessary. Discourse operates very well without visibility, which proves the pertinence of the category of semblance. The route that includes the question as issue is the route that necessarily introduces the passage through the place of the semblance. In the case of absolutist discourse, the semblance is occupied by the king while, in the case of the discourse of conversion,

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it is occupied by the saint. In the hysteric’s discourse—since this discourse is, in fact, a counter-discourse—the agent must be visible. The term question spread as of the fifteenth century and began to designate the subject, topic and point under discussion, and, the fact that this topic had not yet been settled. Every issue is an effort, a route, to which one may or may not remain faithful. It therefore expresses the situation where those who are discussing the topic are unable to come to a consensus or a reconciliation of theses. The English word subject and the French word sujet thus both ambiguously mean subject as topic and subject as the person who speaks about a subject/topic. In its meaning as topic, theme or object, question comes from the ancient Greek word hypokeimenon, that is, the logical or material sub-stratum that subsists in a transformation (Peters, 1974, p. 114). Hypokeimenon connects knowledge to the network of suppositions that it cannot fully explain but that appear as pre-suppositions for a position or choice. Lacan recognizes in hypokeimenon as an antecedent to his conception of subject. In Aristotle the term hypokeimenon is related to the linguistic, logical, and metaphysical sphere. The subject is what remains after a transformation. It is what underlies, what remains supposed (subposed) in a linguistic operation or a logical inference. The introduction of the category of hypokeimenon into Lacan’s theory of the 1970s represented a self-critical reversal of an earlier conception he had held of subject, where subject had been identified with the place of the shifter [in English in the original] (Lacan, 1960b, p. 814) (which represents the person, time, and space of the enunciation in the statement). There was nothing of the Real in the subject. The subject was identified only with the topological categories of space, place, and position (the position of the signifier in the unconscious) or with the logical categories of time (instant, time, and moment). His introduction of the reference to hypokeimenon maintains the connection with this grammar of denials. Lacan must extract from it a new type of negation, a real negation. He sees hypokeimenon as a variable that must be distinguished from ousia (substance). This difference does not mean an opposition between subject and object, but an opposition between necessity and contingency. In other words, the difference designates the real of the subject as a contingency, and not as a necessity (Pierre-Cristophe, 2001, pp. 238–239).

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This particular property of the term question, as issue, designates, in three stages: 1. The knowledge posited in the act, as in savoir-faire, savoir-vivan. Here the question is the process, as we might say in a legal context. Here the subject is represented by the line of time. 2. A sub-posed2 subject beyond the real effect, or the revelation of what is supposed by a particular position. Here it can be said that the act creates its own sub-positions. Here the subject is represented by the bar of negation. 3. The topic of the being of the subject in the sphere of the enunciation, a type of subjective-effect of the question. Here the subject is represented by a point of evanescence. Sceptical irony, together with the work of the question, the servitude imposed by desire, the fragmentation of demands and criticism of the One are convergent elements for what Lacan called the hysteric’s discourse (discourse histèrique). In this discourse the divided subject is seen as agent. Since this agent is a mere residue of the accumulated positions, it is also said that this agent is a semblance. It calls up, in the other, a signifier that is presented as sufficient, of its own accord, to legitimate the law. We can thus understand why Lacan calls the analysand’s initial position Pyrrhonian while, at the same time, asserting that the hysteric’s discourse is the only one that is in fact analysable. Montaigne was the first to recognize the structural dimension of the fact that human desire is the Other’s desire, that is, the desire for the Other’s desire. And he did this through an anthropological analysis of human relationships that finds parallels in many other sixteenth-century authors. These writers saw human relationships in a number of different ways, such as wise madness or crazy madness (Erasmus of Rotterdam), power as intrinsic violence and technique without natural justification (Machiavelli), the crucial role of recognition and illusion (Shakespeare and Cervantes), and life as theatre and representation (Calderon de la Barca). The hysteric’s discourse produces knowledge, but knowledge that is

2

Following the Latin subjectum, that which is cast underneath (sub) in a given movement.

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repressed in the sense that it is not appropriated by the subject in a way that could resolve its subjective division. This knowledge is powerless; it is brought in by a position “outside the world”. It is a position complementary to that of the narrator proposed by Montaigne’s irony. The powerlessness of the hysteric’s discourse is expressed not by failure, but by a relative indifference to power. This powerlessness protects the place of truth against its being occupied by an object. This “lack of object” has led scholars of Montaigne’s work to recognize his importance for psychoanalysis (De Santi, 2003, pp. 69–166). He presents a melancholic and critical practice that is a condition for the self to take on forms it never had before. The word essay comes from exagium, which means “to weigh”, but it can also mean experimentation or tasting. In an essay one can analyse the appearances and constitution of the subject. Lacan (1964a, p. 212) said once that: Montaigne is truly the one who focused not on scepticism but on all living movement of the subject’s aphanasis. This is where his fecundity lies; it is where he is an eternal guide who goes beyond everything that could represent the moment, to be defined, of a turn in history.

But, the crucial point in this description is the fact that Montaigne and the discursive strategy in which he is included introduce in an unprecedented way the scope of the discourse whose agent is a divided subject that apprehends itself in its very disappearance (aphanasis). Another form of the quaestio could be included here, for example, that by St. Theresa of Avila (1515–1582). Her writings express the polyphony of a de-centred subjectivity and the radical experience of the fragment (Figueiredo, 1992, pp. 68–81). She insists on the limits of representing oneself and in the ways of naming experience in the sense of a radical, individual, and irreducible breakdown of methodical replication: I saw that [the angel] had in his hand a long golden dart, and at the end of the point I thought there was a little fire; and I conceived that he thrust it several times through my heart in such a manner that it passed through my very insides; and when he drew it out, it seemed it pulled my insides out with it, and left

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me wholly inflamed with a great love of God. The pain was so great that I moaned, and the smoothness produced by this pain was so excessive that my soul desired that it might never end, nor could I be content with anything but the presence of God. It is not physical pain, it is spiritual, but the body also participates, and sometimes greatly. It is such sweet contact between the soul and God that I beg of Him to grant this experience to anyone who thinks I am lying. (Apud Borges Nunes, 2001)

One can note the presence of oxymorons (spiritual vs. physical, sweet vs. burning pain, etc.), the rhetoric of qualities, and Theresa’s subtle irony of desiring this marvellous experience for those who doubt her. This division, represented by aphanasis, can be detected in the narrative, in the various paradoxes used to refer to the self, knowing what this self, this oneself, is, was a secondary matter, here it becomes a quaestio. Let us look at an example. This “selfness” (Ricoeur, 1997)—self-preoccupation and selfcentredness—indicates the fact that I am one through time, in uninterrupted and permanent continuity. I am a combination of predicates that objectify me and in which I alienate myself by comparison. When they do not ask me, I know what I am, but when they ask me (interpellation) I no longer know what I am. But knowing what I am does not explain to me when I am. To know when I am I must know what type of relationship I have with the word I utter (convocation). So to know when I am I have to know when I am lying and when I am telling the truth. This leads me to a different encounter with that which insists with me: to describe, report, prescribe, and remember. In short, this means to find in language the proper time that designates me. Here there is no way to treat the quaestio without recognizing that I only apprehend who I am when I am speaking outside of where I am. When I know what I desire I don’t know who I am, and when I know who I am, I no longer know what I desire (Lacan, 1948, pp. 37–58). Augustine’s and Plutarch’s strategy are represented here. This leads to the third question discussed on Montaigne’s discursive surface: Where am I? Here I put into question my haecceity, or “me-ness”, that which makes me this unique and confusing mixture between identity and difference. I think where I am not, I am where I do not think (Lacan, 1957b, p. 521). We thus see that, as in the process of the quaestio, the various ways

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of negating the truth come together. The quaestio appears as the possible lie in the field of veritas, as error and falsehood in the field of aletheia, and as infidelity and deceit in the field of emunah. So we can reorganize the relationships between the therapeutic, the clinical and the curing/healing. Healing/Curing Surface Therapeutic Surface

Clinical Surface

Montaigne

Augustine

Plutarch

Writing of the self

Conversion

Submission

Quaestio

Kings’ Healing Persons and Curing Diseases

Hysteric’s discourse

Discourse of the University

Discourse of the Master

Figure 4. Surfaces and discourses.

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CHAPTER SEVEN

The meditation of Descartes

To heal, sometimes, to help, often, to console, always. —Seventeenth-century French saying

W

e have seen that the discursive strategies inspired on St. Augustine and Plutarch developed a line of psychotherapy based on conversion and submission and that Montaigne is a point set somewhat off this line and represents a complex of reflections closer to the idea of healing, or curing. After him, Descartes (1596–1650) goes on to construct a uniform surface between the line and the excluded point. Montaigne’s doubt is a sceptical doubt. Descartes responds to Montaigne by converting this doubt, which was a type of anthropological attitude and an exercise reformulated from the quaestio, into a criterion for finding new types of evidence based on clarity and distinction. Descartes realized that the organization of medieval knowledge, based on constituted authorities, was sustainable only in a closed order of the world (the cosmos). He was also aware that 163

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the discoveries in astronomy and mathematics of his day brought on a new form of knowledge that was compatible with the infinitude of the universe. He therefore had to find a solid and indubitable point that would define this new order (mathesis) of knowledge, which was to become the modern form of knowledge. In the light of our considerations on practices of caring for oneself, one should take into account Descartes’s conviction as to the notion of method. The Discourse on Method and the Meditations (Descartes, 1973a, 1973b) both refer to the family of practices we saw on the surface that extends from the clinical pole, on the one hand, to healing (therapy) and care for oneself, on the other. Meditation, method, and memory were practices recommended for enunciating the truth, but were not ways to guarantee any generalized knowledge. It is therefore clear that Descartes was dealing with a doubt that one practices especially against constituted authority and against trust in tradition and education as safe sources of knowledge. Descartes’ task was to turn the quaestio into a path that leads from the particular to the universal. Descartes studied at the Jesuits’ school of La Flèche, known for its rigour in mathematics and for its importance as a centre of formation. At the time, Jesuit spirituality was becoming prominent as a clear example of new developments in Hellenic asceticism, based on Christianity, where we re-encounter the discipline of self-examination, self-correction, and mastery over oneself. Discursively, the Jesuit tradition had already been defined as a strategy of disambiguation, that is, of purifying of meaning and formalizing the spirit of the text (whether legal or biblical), the origins of which go back to Canon Law (Haroche, 1992). In sociological terms, the Jesuits are often taken as representatives of the aspirations of modernity in terms of the legislative and discriminating reason that characterizes the civilizing tradition in psychology. The origin of Jesuit practices are found in the family of activities based on asceticism as exercises. The circuit described in the preceding chapter, that operates between knowledge-form and power-form of conversion could be taken to characterize the work of Ignatius of Loyola. He developed a programme of calculated construction of an identity, and not merely of the dissolution and re-appropriation of identity (Figueiredo, 1992, pp. 67–103) through rules for feeling, eating, reading, and understanding. There are even rules and objectives for self-flagellation.

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The first [rule is] to make up for past sins; the second is to master oneself, that is, to oblige sensuality to obey reason …; and the third is to ask God for some grace or gift (Loyola, 1992, p. 66). Everything is based on a type of general rule of disambiguation, which is a strategy for facing the dread of the indeterminacy and uncertainty caused by doubting the senses (Bauman, 1999). It can be seen that these traits of a narrative based on the reform of self in Descartes’ geometric and ascetic inspiration are in perfect line with the biographical rhetoric found in St. Augustine’s method of exposition and proof. Descartes, in Discourse on Method and Meditations, explores an important resource for our purposes here. They are texts written in French and in the first person, and in them the author begins by describing his experiences in the form of a first-hand account and then later by presenting them in a geometric mode. We have become used to seeing in Descartes a type of patriarch of modern science, a de-humanizer of human experience, the enthusiast for reason divested of subjectivity and dissociated from the body. He is considered the patriarch of a time without patriarchs, the spirit of an epoch. But one can go back to his experience as an attempt to separate and transform both the practices of Roman stoicism and the spiritual exercises of Christianity. That is, we can identify Descartes both as the last representative of the old practices of caring for oneself and the first representative of the modern way of conceiving subjective experience. As soon as my age allowed me to get out from under the subjection of my superiors, I completely abandoned the study of letters. And, deciding not to seek another science that could be found in myself or in the great book of the world, I spent the rest of my youth travelling, visiting courts and armies, and living with people of diverse temperaments and conditions. (Descartes, 1973b, p. 41)

The first pages of Discourse on Method, written originally as an introduction to the treatises on dioptrics, geometry and meteors, tell about Descartes’ encounters with many different kinds of knowledge, such as the contradictions between the various teachers and other authorities in his childhood, the great variety of opinions from one group to another and the different customs among peoples. He shows

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great admiration for the certainty produced by the knowledge of mathematics and, even though he aspires to the same type of universality and certainty proper to mathematical knowledge, he nonetheless speaks of an experience that is primarily his own: “My aim here is not to teach the method that each one should follow in order to conduct his reason well, but only to show how I made efforts at conducting mine” (Descartes, 1973, p. 38). He describes in a very personal way the path he took in constructing the method, a path characterized by the strong desire to know. Above all else, the method consists of decision and discipline of the will. More than carrying out a general reform of knowledge, Descartes is interested in reforming himself. The will, and not the intellect, is the sole active aspect of the spirit in search of truth (Teixeira, 1990, p. 241). How can one convert the shapeless, dubious, and poorly grounded knowledge that is handed down to us from both tradition and our senses into another type of knowledge, that is, a type of knowledge defined by the method, by certainty, and whose aim is to restore universality? We saw that caring for oneself implies a practice of healing, of which meditation is but one particular case. But caring for oneself is not a method; it is a set of techniques articulated by an ethic. This is why it is significant that Descartes based the modern notion of method precisely on a text entitled Meditations. So let us look at the stages in the history of the conversion of knowledge (savoir—knowing how) into knowledge (connaissance— knowing about) in a way that will show how this transformation implies a theory of the constitution of the subject and how this constitution requires a specific way of treating the soul. Here we see a combination of two practices: care of oneself and, treatment as a method. The result is treatment of the soul. We are aware of Lacan’s long and complex discussions on Descartes’ notion of subject and their implications for the relationships between psychoanalysis and science, but we will not concentrate on this topic here. We might recall, nevertheless, that it is in Descartes that Lacan best characterizes the emergence of the subject of science, also referred to as the subject of psychoanalysis. This correspondence is usually read in the context of Lacan’s epistemological proposition to establish psychoanalysis as a paradoxical science or to configure it in the space opened up by the impasses of its constitution (Milner, 1996), based

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on its undeclared metaphysical compromises and on the foreclosure of the subject derived from modern science. Lacan apparently picked up this strategy from Koyré (2006), who studied the relationships between ancient and modern science and also introduced the importance of the mathematization of space and the function of paradoxes in modern science. Koyré criticized the traditional conception that science evolves by the accumulation of observation and description of facts in a progressive continuity of knowledge. For him as well as for the French critical epistemological historiographers (notably Bachelard, Cavaillès, Foucault, and Althusser), the evolution of science seems to operate through discontinuity, breaks, and leaps derived from changes in the basic conceptions of the how of knowing. But here a problem emerges: modern science is Cartesian in a very restricted sense. It was not Descartes’ theory of the circulation of the blood that prevailed, but Harvey’s; it was not Descartes’ theory of the movement of the planets that triumphed, but Kepler’s; and it was not Descartes’ conception of the universe (undefined but not infinite) that proved to be correct, but that of Bolzano and Cantor. One might also recall his psychological conception of the communication between the soul and the body through the pineal gland and his philosophical objections of Spinoza and Leibniz. To summarize, Descartes seems to have had a congenital problem between his manner of conceiving knowledge and his manner of practicing knowledge. He brought up a key problem—the implication of the subject in knowledge—but was unaware of its most immediate consequence, namely, that it is the structure of the Other that precedes and constitutes the subject, and not the contrary. So, to infer that the subject of psychoanalysis is the subject of science and that this is also the Cartesian subject does not tell us whether we are talking about the subject in the theory or in the practice of science. Despite Lacan’s vacillating interest in the epistemological status of psychoanalysis, I am interested in seeing how Lacan used the experience of Descartes’ cogito to frame what might be called the structure of psychoanalytic treatment, which Freud (1923b), in fact, defined as a method of treatment, a method of investigation, and a doctrine of knowledge. In Descartes’ investigations into the new science, there is a change in the status of the relationship between the subject and the truth. From Descartes on, the being of the subject need not go through

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any experience or even through any preparation to encounter the conditions for verifying the truth. The subject is capable of the truth, a priori and is only accessorily ethical: “I can be immoral and can nonetheless know the truth” (Foucault, 1985).

Meditation and method The Meditations begin with an exercise of doubt—a doubt as to the false opinions we have all received since childhood and to the meanings that deceive us. This includes doubt as to the possession of the body and to existence itself. But in this context there are two central situations of individuals who are excluded from the practice of doubt and, by extension, from the kinds of evidence that result from it: those who are mad and those who dream. Here the contrast between these two exceptions has been given very little importance. Descartes (1973b) characterizes a madman as one who imagines himself endowed with a “body of glass” and who sees no difference between objective reality and reason. We could say that dreamers express the opposite experience, of perceiving themselves as having a “soul of glass”. They cannot perceive nor even distinguish subjective reality from reason. In Descartes’ words (1973b, p. 94): “I am astonished to see so clearly that there are no conclusive indications by which one can clearly distinguish being awake and being asleep”. The term Descartes uses, a “soul of glass” seems to describe a translucent substance that is incapable of reflection, self-appropriation or ispseity (ipso meaning self in Latin). What he is talking about is a substance and therefore endowed with sameness (same being idem in Latin). One can imagine the difficulties in having a body of glass. Looking into a mirror, we would receive the image behind the ego. For example, the mother might hold the child in such a way that it could not say “That’s me, or that’s myself ” (ipso meaning self). The child might say something like, “That’s the other me”. But, a repetition of the event would lead us to recognize in each recurrent image the same formation, and this formation would indeed let us say “That’s the same as me”, even though it is not “me or me myself ” (ipso). Here we might recall one of Foucault’s controversial arguments (1961). Descartes represents the point of transition from the madman as the subject of a tragic experience to the madman as the object of critical consciousness. Descartes’ position on this topic ushered

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in the process whereby madness was silenced, shut in, and made invisible by successive layers of discourse: moral, legal, medical, psychiatric, and even psychoanalytic. Ever since Descartes established this position, madness could no longer speak for itself. It had always to appear through a representative of its unreason. The madman ceased to occupy a feared and respected social position that would indicate an agent of some knowledge, as was the case in the ancient world and the middle ages, and became a representative of the negative of reason and an effigy of the great evil that came in to replace leprosy. This process was contemporaneous with the emergence of the modern state and its disciplinary strategies of control, discipline, and punishment. The hypothesis is clear: the constitution of madness as an object was contemporary to changes in the forms of power and their consequent relationship with the various regimes of truth. It is in this context that the silencing of madness also meant the erasure of a specific mode of relationship between the subject and the truth. Descartes thus establishes the condition for any possible treatment of the soul in modernity. The fundamental displacement to be considered here is not from the soul to the spirit, the mind, consciousness, subject, or personality. The key displacement takes place when we pass from the notions of curing (or healing) and therapy, to the notion of treatment. Descartes’ equivalent for this operation can be found in the idea that became the title of another of his books: Rules for the Direction of the Spirit (2005). Treatment comes in as a notion that is intrinsically related to that of method. The price we pay for this development is that we forget that the very context to which the notion of method applies here reduces and underlies both the notion of healing and the notion of therapy. The psychoanalytic method was established when Freud brought together and articulated the advances made in the sphere of the psychotherapy of hysteria (Freud & Breuer, 1893) with his hypotheses as to the functioning and interpretation of dreams (Freud, 1900). Dream and madness were thus brought together once again in a method of treatment. Freud thus had to re-define the status of knowledge and truth, now condensed into the notion of symptom, by both basing himself on and separating himself from Descartes. It thus became decisive in the analytic situation to show that psychoanalysis is not simply a version of the silencing carried out by psychiatry. It had to be made clear that the analyst should not act

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as a subject and that his or her authority proceeds from a type of transference of the credit that one gives to fiction as the hypothesis in an experiment. In this case, it is the fiction of a subject, a fiction that is pertinent to the knowledge that the situation produces (Derrida, 1994, pp. 81–82). As was seen above, the doubt was not only about the nature and origin of knowledge, but also about the state of the individual subject, its body, and its consciousness. Against this uncertainty one can see the hypothesis of there being certain forms of knowledge, such as arithmetic and geometry, where there can be no doubt. For example, there can be no doubt that a pentagon always has five sides and not six. But even this knowledge is doubtable if one conjectures that such ideas could have been introduced by a deceiving genius. Descartes (1973b, p. 96) wrote that: So I will suppose that there is no true God who is the sovereign source of truth. There is a certain malignant genius, as clever and deceitful as he is powerful, who exerted all of his efforts to fool me.

This movement of generalization of the first attitude of doubt and its radicalization in hyperbolic form corresponds to a very astute response to the position taken by the sceptics. There is a displacement in this movement by which Descartes abandons the sphere of ethics, where the theses of scepticism were first set down, and a migration to the terrain of a theory of the subject necessary for knowledge in general. This displacement leaves a type of wake behind it, with which Descartes begins his Discourse on Method, termed provisional morals, a concept that has been the target of controversies and objections, but is at the origin of this great experience of Cartesian method exercise as treatment of the soul. Descartes never went back to provisional morals in their fundamentals, but they imply obedience to the laws and customs of his country. In Meditations (1973b, p. 51) he wrote that: [I] always seek more to overcome myself than to seek fortune, change my own desires rather than the order of the world and in, general, accept the belief that nothing is entirely in our power except our thoughts.

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We see in these provisional morals (in fact, provisionality and precariousness were to leave their mark on the organization of modern ethics) the traits of both caring for oneself in its stoic and sceptical forms and, even more so, of the idea that the only possible power is power over oneself. One can see how recollection, an act that precedes the explanation of the method, implies a transformation of desire. Descartes notes that the attitude of doubting is an intellective doubt. When we doubt we are thinking. I can doubt my senses, my memory, and my imagination. I can even doubt my very existence, but I cannot doubt that, as I am doubting, I am doubting, and that to doubt is an act of thinking. No matter how totally some evil genius may be fooling me about the contents of my thoughts, he cannot fool me as to the fact that I am thinking. That is, he cannot fool me about the activity of thinking, even as I think: “We must thus conclude and see as constant that this proposition, I am, therefore I exist, is necessarily true every time I say it or conceive it in my spirit” (Descartes, 1973b, p. 100).

Subject: universality, negativity and existence The dramatic detail is that this first proof, this first clear and distinct idea that resists the criterion of doubt, is only true when I say it. “I am, therefore, I exist, this is for sure, but for how long?” In other words, the subject’s first problem thus constituted is that it, the subject itself, is evanescent and is dependent on an act of enunciation whose contents refer to that act itself. The solution, which generates an additional point of discussion with psychoanalysis, is to refer this thinking substance (res cogitans) to the act of thinking (cogito) and separated from the thing being thought about (cogitato). Here we re-encounter the three positions of hypokeimenon. It is said that the essence of the one who thinks is thinking itself, thus encompassing act and power in the same entity. It should be noted that, up till this point, there has been a separation between certainty and error, which are psychological attributes of the subject and attributes of thinking, in contrast to evidence and falsehood, which are logical attributes of thinking. Descartes’ quaestio posits certainty as a condition for the truth, and not the contrary. A second step is needed for this certainty to become truth through the intervention of a guarantee.

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The problem is thus reduced to how to sustain the subject through time. God might be fooling me and he might nevertheless exist (in the act of thinking), but I cannot posit that my thinking is itself true for this reason. Only my thinking is true at the moment it is uttered, but neither my thought nor the object being thought about are true. Descartes is thus obliged to refute the hypothesis of a deceiving God. As of his Third Meditation he shows how the existence of God is necessary. God exists, and is characterized by infinitude. At this juncture, the subject, heretofore characterized by finiteness, can be extended in time, thus guaranteeing the truth of the thinking and the knowledge thus produced. Therefore, transference occurs between God and the subject, transference from infinitude to finiteness, from universality to particularity, and from discontinuous existence to continuous existence. It is a transference that affects and defines the properties of knowledge thus established. God is the supposed of all posited knowledge, and the subject becomes substance in this transposition. Lacan takes up this topic in his theory of the Other. In the order they are presented in Descartes’ meditation, the constitution of the subject comes before the theory of the Other, but the Other comes before the subject in the logical solution of the problem. The order of the reasons is not equivalent to the order of the ideas. Three lines of demonstration are present here. The first line (universality) is that we must suppose the existence of three types of ideas, namely, innate (born with the subject), adventitious (formed by combining and deducing ideas), and factitious (conjectured without presupposing their existence). The idea of the self is innate, as is the idea of God, because we do not produce these ideas by fiction nor can we add to or subtract anything from them (as one can do with factitious ideas). The cogito is also not an adventitious idea, because it does not result from a sensorial experience concerning anything particular. The main attribute inferred by this deduction based on the typology of ideas is that innate ideas are also universal. They do not result from finite thinking in time, but from infinite thinking. The second line (negativity) is that, one must suppose the distinction between finite and imperfect thinking, on the one hand, and infinite and perfect thinking, on the other. Perfection is defined as the absence of lack. Therefore, error does not result from negation, considered lack.

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It rather results from the privation of knowledge derived from the finiteness of thinking (Descartes, 1973b, p. 124). This privation appears in the two sources of error, according to Descartes: precipitation and prejudice. Precipitation occurs because the subject does not have all the time it needs to break down (analyse), recompose (synthesize) and enumerate the order of the ideas. The finiteness of time, therefore, brings about precipitation, and it is here that error emerges. Damage or what we might call prejudice (pre-judice), derives from the absence of examining and breaking down (analysing) the ideas we come in contact with. We thus assume that what is confusing and indistinct is actually clear and distinct. Prejudice (pre-judice) and caution arise from the anticipation of thought and, therefore, from its temporality. These sources of error are basically associated with the incorrect use of free will. They constitute betrayal of the method. It should be noted how, in his article on logical time, Lacan (1945) associates prejudice with the first logical form of the subject, and associates prejudice with precipitation as a necessary part of the final conclusion. The thesis on logical time thus appears as an alternative solution and a dialogue with Cartesian temporality. Lacan seems to propose another relationship between time and reason, not a new time nor a new reason. The third line of approaching the subject must consider the problem of existence and the essence of something are only separate on the level of ideas, and the separation results from the division mentioned above between infinitude-perfection and finitenessimperfection. Here the argument proceeds from mathematics and geometry. For example, the essence and the existence of a triangle differ only to the extent that they are two different thoughts. Essence and existence cannot be distinct in the triangle that exists outside my thought (Descartes, 1973b, p. 131). Thought can only be separated from extension on the plane of existence. These three perspectives, universality in contrast to particularity, negation in contrast to positivity, and existence in contrast to essence, are decisive for Lacan’s theory of the subject. In Descartes these three themes are inter-related in a network of arguments that go back to St. Anselm’s proof of the existence of God. We saw that the existence of God is a condition for producing knowledge, but we have not yet examined how Descartes proves the existence of God. Briefly, Descartes’ argument can be summarized in the following sequence: let us consider the idea of God as having no substance.

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This idea corresponds only to a conjecture and a synonym for the idea of perfection. We might say “God = perfection” in the same sense that one asserts, for example, that “x = perfection”. But if we admit of this equivalence we are led to admit that the idea of perfection implies the concept of absence of lack. Nothing can be perfect if it has the slightest failing or negativity. If the idea of God corresponds to the idea of perfection, and if the idea of perfection does not admit of negativity, then God cannot be merely an idea divested of existence. In this case, there would be the lack of something, namely, the attribute of existing. An idea that is only an idea, without a corresponding existence is an imperfect idea. If God is defined as a perfect idea, he cannot be deprived of any attribute whatsoever, much less the attribute of existence. If God is equivalent to perfection, he cannot fail to exist. Therefore, God exists, and not merely a conjecture that lacks existence. Extending from this argument, there is the idea that evil is a privation of good. If evil is a lack without its own existence or substance, then God not only exists; he is necessarily good. Otherwise he would be divested of something, namely, of the attribute of goodness. Note that the argument cannot be inverted: God is not divested of the attribute of evil, because evil is not an attribute. It is only a lack of good. If he is necessarily good, then he is not a deceiver. With this, one can eliminate the conjecture of the malignant being that disturbed the subject’s temporal consistency. The cogito thus ceases to be a specific instant circumscribed to its own enunciation, or utterance, and takes on its guarantee of truth and permanent evidence in time. That is, based on the Other (in this case, represented by God); one can extract a given guarantee for knowledge. To know, it Is not necessary to re-enunciate, each time, that I think, therefore I am. It suffices to remember this when the occasion demands. Here we re-encounter the circumstances by which a determined enunciation (when the occasion so demands) positions the emergence of the subject. The path taken by the cogito is there, but it operates as a supposition that has not been enunciated. It remains as saying something that does not need to be translated into something said. Now it is the subject that functions as supposed, guaranteeing the correctness of the knowledge produced. The scheme is relatively simple: the subject guarantees knowledge and God guarantees the subject. If the cogito is the first evidence that constitutes the subject,

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the proof of the existence of God is the evidence that constitutes the Other as a guarantee of the subject’s knowledge. Here the reading of Lacan introduces a double subversion. The first aspect is with respect to the subject; the separation between thinking and existing is not sutured by the intervention of the Other. The second is the division between knowledge and truth, and it is not restored by contact between human and divine reason and temporality. The subject, as divided by the disparity between enunciated and enunciation, occurs as the negative function of thinking: I think where I am not, I am where I do not think. This negative function is demonstrated by the extensive revision of the status of desire in its relation with language and appears in many different ways throughout Lacan’s work. He refers, for example, to the negativity of the structural forms of defence (repression, foreclosure, refusal), the negativity of the modes of inscription of the subject in language (trace, letter, signifier), and the negativity of the subject’s existential positions (alienation, separation). This does not reduce the unconscious to a figure of irrationality or to pre-reflexive affect, but it situates the problem of the relations between unconscious thinking and this point where the subject that thinks seems not to exist. That is, the I do not think is not a synonym for there is no thinking in my being, but that there is thinking that is not carried out by the self. The ego (moi, myself, oneself) is the place where the subject thinks and where it deposits what is thought. The subject is a position that maintains a negative relationship (I do not think, I am not) with its modes of objectification. The subject is a position witch subverts the place from where it appears. So it can be seen how Lacan retains the process of constitution of the Cartesian subject by separating the first evidence (I think, therefore I am) from the second evidence (God exists). All attributes of the quaestio that lead Descartes to the first evidence are conserved in the meaning that Lacan gives to the subject, including its occasional character, its division by doubt, its lack of contents, its immanence to the act, and its positional value related to enunciation. There is therefore a criticism of Descartes’ second evidence, but not of his first. We can certainly find versions of the notion of the Other in Lacan that are similar to a deceiving God but this would mean admitting this God’s existence, which is not the case. The most constant figure

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here is that of a deceived God (Baas & Zaloszyc, 1999, p. 57). The problem revolves around the theme of negativity, which we saw to be essential in St. Anselm’s proof. The three fundamental attributes of God are treated in a text devoted to a “negative proof” in which the universality of the Other is transformed into a fragmented universality (the signifier of the lack in the Other), the existence of the Other is reverted into an ex-sistence (the Other does not exist), and perfection is attached to a special type of object, characterized by its negativity (the object a). Therefore, what is denied the subject after this breakdown of Descartes by Lacan is its reflexivity. There is a type of object that is not specular and that prevents the subject from apprehending itself as itself. Instead of some conjunction between one’s (subject) self (Other) (one’s self being equivalent to oneself), proposed by the Cartesian transference, Lacan posits a disjunction between the one(‘s) (subject) and the self (other object). It should be noted how this was present in Freud’s earliest intuitions about the unconscious: the symptom is a way of remembering (a mnemic symbol) where one does not remember that it is a recollection. Fantasy is a type of imagination that cannot imagine itself as such. Transference is a type of imagination that cannot perceive itself as such.

Logic of transference The generic non-existence of the body, the speaking being, (parlètre) and the living being does not result from the I am not, but only the insufficient or excessively sexuated character of this body. The generic non-existence of reason or of the knowledge that the notion of unconscious comes to install does not result from the I do not think, but only the desiring dimension present in the symptoms. Therefore, there are two modes or two phases of the subject with respect to desire: the ego as subject, which is seen in the alienation to the signifier and the subject as ego, which is expressed in the form of the unthinkable (Baas & Zaloszyc, 1999, p. 45). So we come to the Cartesian core of all psychoanalytic psychopathology. The clinical forms of psychosis, perversion and neurosis (considered or not as structures), are strategies to recompose the Other and make it the source and origin of authority, the legitimacy of knowledge, and the condition for all possible desire. These forms are thus not foreign to the process of constituting the subject as universal or as figures of

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unreason, as Descartes would have it. They are rather the subject’s modes of being and un-being. But besides these clinical forms and their strategies of desire, there is another division of being, which can be seen in existence by strategies of jouissance and the extraction of pleasure from the Other. Here it is not the face of the subject that matters, but that of the subject as object in its fantasy. So Lacan reads Descartes by applying this type of negative key to deal with the relationships between universality and existence. Specifically, the coextensive connection between subject and thought (I think, I am; or, we might say, I think therefore I exist) must be replaced with a disjunctive conjunction (I think or I am; I think or I exist). This conjunction “or” has two different meanings. It can mean both the inclusive “or”, which brings together alternative elements, and the exclusive “or”, which implies that the choice of one alternative rules out the other. For Lacan it was important to come to a third meaning for the term “or”, namely, a meaning that contained, at one and the same time, the strength of the logical need for the exclusive “or” (if I choose A, I necessarily fail to choose B) and the strength of the logical contingency of the inclusive “or” (if I choose A, I contingently choose B). For example, we can understand an abrupt demand for a choice such as “your money or your life”, in the exclusive sense (I choose the money, therefore, I necessarily lose my life), as well as in an inclusive sense (I choose my life, but without money, it is only a partial life, since a life without money is not a full life). Therefore my choice introduced a contingency in what was chosen that was not there before the choice came up. The third possibility, the “or” that in the Latin “Romance languages” is called vel, implies choosing, in life, the loss of the money. It is the choice by which the negative element in the intersection between A and B. Lacan called this type of choice a forced choice, and it conditions the logical operation of the separation. This brief commentary is important for understanding why, when Lacan tried to formalize the process taken in psychoanalytic treatment on the basis of the notion of analytic act, he uses Descartes’ categories of thinking and existing, and applies to them the key of negativity, as well as referring to the tension between universal and particular. He has two objectives here. First, to show that the division of the subject between enunciated and enunciation is covered over by another division, located between knowledge and truth, which proceeds from the Other. Second, Lacan is concerned with

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showing that the relationship of the subject with the Other need not be a relationship of inclusion, as it is in Descartes, because it can also be seen as a relationship of exception. Let us look at these two arguments in detail, since an epistemic position regarding the possibility of scientifically formalizing psychoanalytic treatment depends on them, as does any political dimension implied indirectly by the idea of the sovereignty of the Other. (I)

contrary syllogisms

(II)

↑

↑

subaltern syllogisms

subaltern syllogisms

↓

↓

(IV)

sub-contrary syllogisms

(III)

Figure 1. Aristotelian group of syllogisms. These four classes of propositions can be categorized into four different groups of relationships, called syllogisms. We can now look at Descartes’ evidence, a subject thinks, as a proposition. For Descartes, evidence is not primarily a proposition, but it can become one through intervention by the Other which takes the subject out of and beyond its enunciative act. Let us now look at Aristotle’s four classes of propositions. The four classes of proposition are: I) all subjects think

- affirmative universal (the case of science)

II) no subject thinks or, all subjects do not think

- negative universal (the case of dreams)

III) some subject does not think

- negative particular (case of a madman)

IV) some subject thinks

- affirmative particular (case of the cogito, I think)

Figure 2. Cartesian classes of propositions. There is a relationship of contradiction between classes (II) and (IV), and between classes (I) and (III). We are distributing the logical

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relationships according to a single predicate, namely, to think. But let us imagine that we are faced with a situation involving a combinatory of two predicates: to think and to exist. We want to infer the position of the subject (all subjects, no subject, some subject, one subject) on the basis of this combinatory. “All” and “some” refers to quantity, and “one” and “no” to existential. The opposition between the universal and the particular is quantitative (lexis), and the opposition between the affirmative and the negative is quantitative (phasis). We can now apply this combinatory (of logical conditions between the propositions) to a real situation, by means of a table divided into four possible cases, according to the following scheme: The four possible cases for combining “to think” and “to exist”

(Case 1) To think

(Case 4)

(Case 2) To think and to exist

(Case 3) To exist

Figure 3. Peirce combinatory applied to thing and existence.

Considerations a. Theoretically, Cases 1 and 4 correspond to the affirmative universal (all subjects think, therefore, some subject thinks). The particular is included in the universal (Case 1) and it excludes the existence of thinking in negation (Case 4). If all subjects think (Case 1), then no subject does not think (Case 4). But there is a problem here, since nothing can guarantee that all subjects think, or even that there is at least one subject that thinks. From this we can derive the logic of the “not-all”, which Lacan uses to read feminine sexuality. This does not mean that there is a part of the subject which does not think, but that a “not-all” (pas-tout) subject thinks. The correct idea is that “all subjects think, but the “not-all” (of any given) subject exists”. Here, existence must be

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divided in two different ideas: being an element () and belonging to or a part, of (). b. Cases 2 and 3 correspond to the negative universal (no subject thinks, therefore, some subject does not think). The negation of the universal implies the negation of the particular. Here the negation of the universal means the affirmation of the particular. All thinking implies existence (Case 2), but not all existence implies thinking (Case 3). Here we have the issue of alternative double binds, which are the inclusive choice (coming together) and the exclusive choice (intersection), which we examined above when differentiating between: if I choose A, I necessarily fail to choose B [exclusivity] if I choose A, I contingently also choose B, [inclusivity] and if I choose A, I lose B (the “or” that the Latins called vel). c. Cases 1 and 2 correspond to the affirmative particular (some subject thinks, therefore, some subject does not think). The affirmation of the particularity of thinking (Case 1) implies that thinking is not the only attribute of subjects. For example, a subject can both think and exist (Case 2). Lacan’s idea of existing “not without” thinking is based on this interpretation of Descartes’ subject as the subject of science. It is also based on the conclusion that psychoanalysis is “not without” the subject of science. “Not without” is a type of negative condition, as can be seen in Lacan’s formula that “anxiety is not without an object”, which is not the same as to say that “anxiety has an object”. d. Cases 3 and 4 correspond to the negative particular (III) (some subject does not think, therefore, some subject thinks). This affirmation that some subject does not think does not exclude the possibility that the subject exists. But we are led to conclude that some subjects think by negating that “some subject does not think” (if some subject does not think, then some subject does think, then exist at least one subject who think). But this does not follow because in Case 4 there is neither thinking nor existence. However, the proposition that every subject thinks is true even in Case 4, where there is no subject, either thinking or existing. Here the Lacanian idea of the subject as “minus one” comes in. This place of not existing and not thinking, in relation to the other cases, indicates the proper place of the subject, “in reason since Freud”. Case 4 is a statement with no value of existence but it is nevertheless true as universal, since the subject of the unconscious

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cannot verify its own existence separately from the Other, and the subject must first be considered as universal. Let us synthesize the main idea with an example. It is as if to say that there are no green Martians on Mars (negation) and then conclude that there are Martians of other colours, such as blue, red, or purple. This is a true proposition that refers to a non-existent object (Case 4). Inversely, it can be affirmed that all Martians are green (Case 1). That is, through this double inference we come to the idea that there can be universals that do not have existence, and similarly presume particular existences that are not included in universals. The second consequence is that the clear opposition between subject and not-subject is different from the opposition between thinking and existing. That is, the relationship to oneself (“to be or not to be”) is not symmetrical with the relationship between one’s predicates, or qualities (to be tall or to be short). In order to construct a predicate another predicate must be negated. Not existing implies thinking, provided that one does not also negate the subject. Therefore, thought is an exception to the set consisting of existence that stands before the backdrop of not-subject. Here one goes back to the function of the intersection between inclusive and exclusive forms of alternative and there is yet the possibility of “vel”. The universal is grounded on this possibility of an exception, and should not be thought of as a saturated totality. The idea of God as infinite and universal, in which the thinking subject is necessarily included as a particular and finite case, is thus refuted. Madness and dreams now return as the two paradigms of the subject of the unconscious. We thus see how the course of the quaestio exemplified in Montaigne is inverted by Descartes and reversed once again by Lacan. But in these reversals one does not return to the same previous state. Now there is a new distension of the surface that joins healing and treatment, as a method-oriented procedure. It should be recalled that the experience of the cogito and the formulation of the principles of first philosophy in Descartes correspond to the metaphysical roots of the tree of knowledge. Its trunk is physics and it has three branches: morals, mechanics, and medicine. We saw that morals remain in a stationary stage in Descartes’ work; that mechanics emerges as the main example of the application of the geometric method, and that medicine remains as the sphere of the application

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of Cartesian metaphysics. It is known that Descartes worked on a treatise on medicine, but he never outlined more than a few descriptions about the circulation of blood and some considerations on the formation of the human foetus. Despite the fact that he never finished it we know that Descartes had some expectations for this project, including the establishment of a practice that would be sufficiently methodical regarding the treatment of diseases. In his opinion, it would be better to take one’s own good sense into account than to consult professional doctors; such was the state of dispersion and lack of bases of seventeenth-century medicine (Cottingham, 1995, p. 109). This methodical, well-grounded and perfectly transmissible form of healing is the modern form of the notion of treatment. So let us now look and see how this notion of treatment applies to psychoanalysis.

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CHAPTER EIGHT

The structure of psychoanalytic treatment

What do analysands come looking for in analysis? The only thing there is for them to find is, par excellence, The trope of tropes, which can be called their fate. —Lacan

W

e saw that Descartes joins two different types of concept on a single surface. On the one hand, there are strategies of conversion and submission that derive from the therapeutic lineage and, on the other, meditative scepticism, a notion that is related to the theme of healing according to Montaigne. As of Descartes it became possible, under the aegis of a new notion of method, to separate therapy and healing, on the one hand, from the very modern notion of treatment, on the other. Treatment implies finitude, order, and transformation related to causes. In a method, one practices a discipline of the will and a purification of the subject that one needs “to rightly conduct one’s own reason and seek the truth in science”, in the subtitle to Descartes’ central work. The method consists of a discourse and a practice that connect the

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exercise of one’s own reason to the exercise of private domains through universal reason. We also saw that Discourse on Method is presented as the preface and introduction to three specifically scientific texts. According to the order of reasons, everything happens as if, after a long consideration on the possibility, origin, and form of knowledge, we were finally in a safe and solid position to practice knowledge. This is the origin of the idea, consolidated by the university discourse, that the practice of the method is preceded by an exposition of its motives in the form of a discourse. This does not happen in the order of matters. First, Descartes discusses a specific form of knowing by carefully studying Galileo’s astronomy, and then goes on to formulate and systematize its principles. This specific form of knowing refers mainly to geometry and astronomy, two sciences of space. The central thesis here is that a void is not only physically impossible; it is also essentially impossible. For Descartes, space is not an entity distinct from the matter that fills it up (Koyré, 2006, pp. 91–92). The task of grasping space varies according to the central notion of dimension, a point where the measurable becomes separated from the measured. The existence of three dimensions suggests that there is nothing of real in the multiplicity of the object. This existence is only an effect of the subject’s seeing things from a specific position, or a specific angle (Guenancia, 1986, p. 24). In this sense, Descartes is preceded by the discovery of the rules of functioning of perspective in the theory of optics and in sixteenth-century painting. The apprehension of space conceived as matter does not take place discursively because the discursive mode only grasps dimensions. Apprehension of space takes place through a type of abstraction that transports valid relationships of finite objects to relationships in infinite situations. Such abstraction consists of mathematical writing, and the existence of paradoxes and contradictions in it attests to the disparity between the finite, in discursive reasoning, and the infinite, in mathematical reasoning. This had already been seen by Nicholas of Cusa (2002) (1401–1462), who proposed the methodological notion of learned ignorance, (docta ignorantia) a type of knowledge that consists of knowing one’s limits as a way to apprehend this disparity. Cusa also posited the theory of two truths (discursive and mathematical) as Cusa’s conceptual complement to learned ignorance (Koyré, 1987, op. cit., pp. 12–13). The theory of the two truths

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marks the separation—decisive for modernity—between, on the one hand, the truth dependent on the enunciation and on the conditions of the subject that enunciates them, and, on the other, the truth as propositional function, whose value can be calculated logically. So we can separate the practice of the geometric method, from which the truth is potentially excluded, from the considerations that base and generalize this method, the Discourse on Method, where the truth is still a pertinent category.

Method of treatment and science The discourse on method and the practice of the method are two different things, the latter being a retroaction on the former. Every practical method must be able to be referred to the generic bases of the Discourse on Method. As was seen above, this discourse, as well as the cogito, once enunciated, has no need to be remade. It only needs to be remembered. This circuit continues functional in most sciences, which, in the construction of their knowledge, only verify whether their practical methods confer with the conditions imposed by the Discourse on Method. The fact that there are many different forms of this Discourse on Method (empiricist, pragmatist, rationalistic, etc.) is indifferent. It is also irrelevant if we take into account “harder” theories of knowledge, such as those of Carnap and Popper (1982), or if we hold steadfastly to “lighter” epistemologies, such as those developed by Kuhn (1988) and Feyerabend. Despite their disagreements in terms of the meaning of discourse, whether mathematical writing and formal empirical statements, in the first case, or consensus and social field of production of paradigms, in the second case, the conditionality between practical methods and discourse of reference remains constant. The only really important difference here is that each of these strategies leads to different ways of articulating knowledge and power. Now let us imagine a science with its own practical methods, which have the pretension of being a science of the subject. Whether this be psychoanalysis, concrete psychology, or phenomenology, it should not only retrace the history of the memory of the Discourse on Method, but remade it as an experience. The alternative seems crystal clear: either we trust in the method according to its modern meaning, and transform the subject into an object of knowledge like

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any other object, or else we choose the subject and, in this case, we are dealing with a type of knowledge and a discourse that have no claim to be called scientific. It is a forced choice: the subject or the method. I do not intend to reduce the complex relationships that exist between psychoanalysis and science to this simple alternative, in the sense that one must choose once and for all between science or not-science, between grounding based on the subject or based on object. Psychoanalysis is located exactly where this alternative is most problematic and perhaps even paradoxical. Modern science is defined by reliance on the method and the basic condition for the method is that it is more constructed for the object than for the subject. We can therefore postulate that the object is an effect of the method. Here our foray into Cartesian theory allows us to bring up three difficulties in placing psychoanalysis in the field of the sciences, but also three difficulties in placing psychoanalysis outside the field of science. The first point concerns self-referentiality and the existence of the object. Any object that can be known and can therefore be represented must admit to an ontological identity with respect to itself. This is the main argument found in the monistic and materialistic conceptions of knowledge. Koyré’s thesis is that this representation, especially considered as mathematical formalization, is what determines the object in its scientificity. His evaluation of Galileo’s and Newton’s work suggests that it was not accumulated empirical data that spontaneously engendered a change in the type of knowledge and gave rise to the birth of modern physics or astronomy. It was rather the formalization that anticipated the existence of the object as such. It was in this context that the identity of existence, in terms of the object, was determined before the concept that determined it. Descartes’ undertaking can be characterized as a reaction to the subjective substance described extensively in Montaigne as a substance different from itself. In the interior of this heterogeneous substance Descartes finds a nucleus of identity and permanence represented by reason. This is why the expression “I think, therefore I exist” is central, and not “I think, therefore I desire” or “I think, therefore I speak”. In the interior of the substance different from itself (subjectivity), there is a substance identical to itself (subject). But, can

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this relation be inverted? The problem consists in knowing whether existence, as attribute, is a type of adjective that denotes itself or not. In other words, is the existence of the object in question in psychoanalysis a case of heterology? According to Greeling’s paradox an adjective is heterological when it does not denote itself. For example, the adjective “long” is heterological because it is not long. The adjective “French” is heterological because it is not a French word but an English word. The adjective “monosyllabic” is heterological because it is not monosyllabic, but pentasyllabic. In contrast, the adjective “short” is autological, and not heterological because it denotes itself, more specifically, the word “short” is a short word. The word “English” is not heterological (it is autological) because it does in fact belong to the English language. The adjective “pentasyllabic” is not heterological because it indeed comprises five syllables (Quine, 1996, p. 19). Greeling’s paradox is one example of a paradox related to the inclusion of a category into itself. Other cases of the same type are Epimenedes” paradox (he once said: “Cretans, always liars”, even though he himself was a Cretan), and Russell’s or Zermelo’s paradox (the set of all sets that are members of themselves both belong to and do not belong to themselves) (Branquinho, Murcho, & Gomes, 2005, p. 578). The purpose of referring here to Greeling’s paradox is that it is a logical-linguistic paradox and not an exclusively logical question. But we can imagine versions of Greeling’s paradox that apply to verbs, nouns, adjectives, and so forth. Getting back to Descartes, is the word “exist” in “I think, therefore I exist” heterological? Is the declaration of “existence” necessary and sufficient to describe existence? This is the same case as the application of the rule to the adjective “heterological” itself. Is it heterological or not? The answer is simple: it is heterological if and only if it does not denote itself, that is, if and only it is not heterological. It is heterological if it is not heterological. In Cartesian terms, the “existence” of the subject exists only if it does not exist. Its existence depends on the declaration or on the wager, as Pascal seemed to suggest against Descartes. This is what Lacan called the foreclosure of the subject by science: the subject is ejected so that it can be constituted as existing. By excluding the declarative subject in the first person singular, “I think”, and not “we think” or “it is thought”, that the reality and existence of objects that are thought of becomes apprehensible. This argument is extended to the generic question

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of the relationships of psychoanalysis with science. Its method is scientific if and only if it is not scientific. But it can also be said that it is not scientific if and only it is scientific. However, this argument is restricted to Lacan’s position, which holds that the subject of science is the Cartesian subject. The second Cartesian problem inherent to the question of the scientificity of psychoanalysis involves the universality of the subject that it considers and the knowledge that derives from this fact, namely, the universality of an experience and the transmissibility of knowledge. It should be noted that the universality of the subject depends on two attributes: language and division (Spaltung) (Dor, 1993, p. 131). Therefore, the problem of existence, by which the division of the subject is demonstrated, can now be universalized not through the figure of thinking, but through the figure of language, and this conclusion corroborates the demonstration presented above. The second problem arises from the fact that language and the division of the subject are universal in different senses. Lacan contests the logic of including the classes into one another and inverts the usual hierarchy between universality and particularity (Pierre-Cristophe, 2001, p. 233). In the first case, one could argue for the scientificity of psychoanalysis in the sense that it is inscribed as based on the sciences of language and, especially, on logic. From this perspective, the efforts at formalization of its concepts are in line with the necessary epistemological requirement formulated by Koyré. But the division of the subject is only apprehensible in terms of speech and not in terms of language, meaning speech in the first person, according to the method of free association. This is the unique division that is found in each subject, and it is of interest to the method of treatment. In this sense, psychoanalysis deals with experiences whose reproduction and particularization are possible, such as through its psychopathology. But these experiences nevertheless require a concession to the fundamental demand of its method. Therefore, both forms by which one can ascertain the criterion of universality are incommensurable. Once again, psychoanalysis is inscribed in the field of science at the same time that it de-stabilizes its universality. The third problematic figure in the relationships between psychoanalysis and science is negativity. Both in its concepts and in its clinical practice, psychoanalysis seems to refuse the criterion of

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positivity of knowledge, which is necessary in order to establish itself as knowledge. However, it contains a critical theory on the incidence of knowledge about the subject. This is a function of its alienation and reification according to the form of an object for itself. One must not confuse this counter-experience, represented by knowledge at the level of subjective experience, with knowledge strictly speaking, as a transmissible knowledge-form by science through culture. It is thus a characteristic of this knowledge-form that the notion of the truth has denied it. Science abdicates the truth to engender a type of knowledge, which is unfinished and prospective by definition. This is the main criterion used by Freud (1915) to distinguish metapsychology from metaphysics. But this negation of the truth, even as a position that is empty of contents, is important to disconnect science from any normative contents, which is the object of ethics and technique. However, for psychoanalysis and for the subjective experience that is dealt with in treatment, this position of the truth matters. Even though Descartes calls attention to this separation between knowledge and truth, this does not imply that a science of the subject need not deal with the forms of return from this position of the truth (Freire, 1996, p. 41). This scientific knowledge has to be knowledge about the efficient cause. The notion of force in physics, the idea of life in biology, and the conception of language in the social sciences define different types of efficiency and have to do with the relations of the subject with specific forms of object that functions as cause. In this case, once again we find psychoanalysis as a field built up in the wake of science. Here we see how up-to-date Politzer’s criticism was (Politzer, 1998). Any form of psychology that wishes to be considered critical must give up trying to convert the subject who, by means of such a psychology, should dedicate himself to being a reproducer of the psychological discourse of the healing agent. Any form of treatment meant to deal with the subjectivity must start off by renouncing all authority based on the conventional meanings of constituted signifieds. Healing requires an ontology in the first person. One is always dealing with this individual subject who speaks, works, and goes about life. Even when this subject places itself as, or is taken for, a particular case of a given class, category, or set, the analyst is not thereby authorized to consider these categories as real. The analyst

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suspends this supposition regarding a substance apprehensible by anyone, in favour of ontology in the first person. In other words, the centre of the treatment of the subject is the analysis and liberation from the forms of objectification, alienation, and acts that are carried out in spite of the suspension practiced by the clinician and as a function of the singularity of her or his method. We might also say that, together with the analyst, the analysand reconstitutes the same unification between knowledge, power, and desire that is seen in the analysand’s more or less regular ways of constituting objects. He or she not only remembers, but also practices his or her own Discourse on Method. One of the best-known definitions of psychoanalysis, given by Freud himself (1964, p. 131), states that it is the name of: 1. A procedure for the investigation of mental processes that are almost inaccessible in any other way; 2. A method (based upon that investigation) for the treatment of neurotic disorders; 3. A collection of psychological information obtained along those lines, which is gradually being accumulated into a new scientific discipline. There is a clear hierarchy of the spheres of knowledge in this definition. First, and fundamental, is the procedure of investigation. Second is the method of treatment and, third, bringing together the method of treatment and the method of investigation, appears the field of science. But this order does not reflect the historical development of psychoanalysis. Above all else, Freud was a scientist. He had dissected eels in a laboratory, described cerebral functioning and drew up hypotheses about the clinical use of cocaine. From his clinical experience as a physician (which he said he hated), he derived his therapeutic interest in treating hysteria. Only after that did Freud set down the rules for the method of psychoanalytic treatment and a method of investigation. This is in line with the inversion between the order of matters dealt with and the order of reasons that we saw in Descartes. Before formulating a discourse on the psychoanalytic method, Freud practiced a method of treatment and he simultaneously developed a method of investigation. Here one could argue that the anteriority of the method of treatment is

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historical and contrasts with the logical anteriority of the method of investigation. The problematic connection between method of treatment and method of investigation shows up the epistemological peculiarity of psychoanalysis. It is, at one and the same time, a form of discursivity and a science, without one aspect being guaranteed by the other. It is not only from the perspective of the analysand that one expects a discourse in the first person. The analyst must also authorize her or himself; the analyst must become included in the function of authorship that determines her or his practice. So experience, analysis itself, is a condition for the analyst’s practice, and this experience is not mere training or mere anonymous acquisition of skills. However, it is not so certain that psychoanalysis as a method of investigation requires that those who engage in it must have been through the experience of having been analysed. There have been countless important studies that seek to exercise the method of psychoanalytic investigation and that were nonetheless not carried out by psychoanalysts. In this case, it seems that there is a compromise with the particularization and not with the singularization of experience, and this makes possible a special type of consideration of the scientificity of psychoanalysis in this case. As Granger (1994, p. 113) wrote: Although it is radical, the only obstacle seems to me to be the individual reality of events and beings. Scientific knowledge is exercised fully when one can neutralise this individuation without seriously changing its object, as occurs in natural sciences in general.

It should be noted that the process of “neutralizing” this individualization requires a criterion that will “in no way seriously alter its object”, and this criterion could not come from the method of “neutralization” itself. It does not result only from the sphere produced by this type of “scientificity” of psychoanalysis, but from the discursivity where the function of authorship is not eliminable. To quote Foucault (1970, pp. 66–67): Re-examination of Galileo’s texts may very well change the knowledge we have of the history of mechanics, but it can

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never change mechanics itself. In contrast, a re-examination of Freud’s texts changes psychoanalysis …, especially the opposition I tried to delineate between a (discursive) establishment and a scientific foundation. It is not always easy to decide if we are dealing with one or the other, and nothing can prove that there are two incompatible procedures present here.

What is fundamental here is exactly the importance of the function of author for founding a discursivity. This is the case for both Freud and psychoanalysis. The function of author is a particular case of the subject-function (Foucault, 1970, p. 70). But in the case of discursivities, the relationship between what is said and who says it is important. Several questions are permanently posited, such as the question of authenticity, of who can appropriate the discourse and what places are reserved for other possible subjects. In other words, the political dimension in the sphere of discursivity is constitutive because it depends on a non-anonymous network of recognition and transmission. In contrast, the political dimension in the sphere of science is regulative (or at least presented as such), because it depends on an anonymous network of recognition and transmission. However, what should we understand by procedure of investigation, in the definition presented by Freud? It is possible that this expression refers to the studies on the interpretation of dreams, the psychopathology of everyday life, and jokes, for example. But, here Freud may also be referring to much of the descriptive material found in Three Essays on the Theory of Sexuality, in the articles on the psychology of love life, and a specific part of the studies on literature, culture and society. It is important not to confuse here the idea of the procedure of investigation with the notion of applied psychoanalysis. Application, whether it be pertinent or not, refers to the object, not to the method. The type of psychoanalytic observation that Freud practices in this type of text simply ignores clear rules that make up the method of treatment (aspects such as transference, free association, symptoms, and interpretation). The method of investigation sustains the temporality of writing. The method of treatment has its own rules proper to the oral universe of speech, and its sources are heterogeneous. Jokes and their Relation to the Unconscious is in line with the tradition of rhetoric. The Interpretation of Dreams is inscribed in the language of care for

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oneself. The Psychopathology of Everyday Life is another possible name for Montaigne’s moral anatomy. Finally, the studies on sexuality and the bonds instituted by civilization are based on a type of anthropological investigation with a narrative foundation. Due to its heterogeneity and characteristics, the method of investigation should not be confused with the method of treatment, but serve as its basis. Freud’s position that, in psychoanalysis, investigation and treatment cannot be separated should not lead us to the conclusion that they are the same thing. When one interprets a dream in analysis according to the principles related to a method of investigation, one is not practicing the same type of investigation as when one is writing a book about dreams, even if it contains self-writing. This would be to turn patients into psychologists of themselves, which is completely different from turning patients into analysts of their own experience. But the relationship between method of treatment and method of investigation is not one of subservience or priority, but of mutual practical and theoretical usefulness. The connection is not incidental, but intrinsic. Here we can see Lacan’s thesis (1967b, pp. 261–263) to the effect that what is common to both psychoanalysis in extension (method of investigation) and psychoanalysis in intension (method of treatment) is the transference. Psychoanalysis in extension is guided by three essential themes: identification (imaginary), the Oedipus complex (symbolic), and segregation (real) and they all converge directly to an analysis of the positive strategies of power. Psychoanalysis in intension, on the other hand, is defined by the fact that it forms operators for practice, and corresponds to the experience of treatment. Here the theme of power is negative. Due to the heterogeneity of its sources, its variety of means and the distinction between its principles, the method of investigation is an open structure. It communicates directly with other discourses and other strategies of power and investigation. In contrast, the method of treatment is a closed structure. This does not mean that it always continues the same through time or that it contains some quality of identity that would allow reference to a true or legitimate psychoanalysis, in contrast to unjustified derivations and copies. The question is how to be sure that all the versions and variants of the method are related to a single structure. This hypothesis makes it clear that the method of treatment cannot be defined by the nature

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and skills of clinical procedures, the modes of interpretation, the numerous ways of dealing with the transference or the fact of carrying out a diagnosis. Any method could be defined by three types of rules: the constitutive, the regulative, and the constructive. Only the constitutive rules define the structure of the method. Let us now take a look at Freud’s analogy between the psychoanalytic method and the game of chess. There are certain rules that pragmatically define the structure of the game, such as the number and movement of the pieces, the opening positions, and the conditions for ending the game. We can alter these rules, but if we do, we are not playing chess anymore. We are playing some other game that may or may not belong to the same general group. These rules have the value of separating one game from another, and they are therefore constitutive. But there are a number of other rules in chess without which it would be insipid. This group consists of strategies, such as the importance of occupying the centre at the beginning, the combined use of pieces, and the logic of the exchanges and reduction in the number of pieces during the game. They guide its development and let one of the opponents win. These rules are regulative because they control the effectiveness of the game. Finally, there are the more or less regular situations that the players must confront in countless strategic contexts, traditional openings, expected ends (king and rook, against pawn and king, for example). Here we find constructive rules that have tactical value. One could study these situations separately and reflect on the best way to act in each case. Included among the constructive rules are the elements that make it possible to effectively play the game, such as the size of the pieces, the dimensions of the board, and the use of a clock. Also present would be the etiquette that one is expected to follow (a piece touched and a piece moved) and the time taken for each move. It has been said that the psychoanalytic experience could be described as analogous to a game (Rona, 2003). This distinction can be found similarly in the categories used by Lacan to define psychoanalytic treatment. As he once wrote (1958a, p. 596): Let us see why analysts are less free in their strategies than in their tactics. And analysts are even less free in that which dominates both strategy and tactics, namely, in their policies, where

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they would do better placing themselves in their lack of being than in their being.

The difficult point here is to define a method of treatment in the sense of politics. The fact that greater tactical freedom (the type, mode, and frequency of interventions) is limited by strategic freedom (management of the transference and the diagnosis) does not mean that politics are a perfect equivalent to a method. Politics implies that one will take the ends into account, but strategy implies only that one will consider means and objectives. As was seen above, ends are not objectives. However, the introduction of political categories, derived from Gramsci, closely follows Freud’s rhetoric to define the method of psychoanalytic treatment. As Freud (1923, p. 231) wrote: The psychoanalytic procedure is distinct from all suggestive, persuasive and other types of methods because it does not aim at suffocating any psychic phenomenon by means of authority. … The inevitable suggestive influx from the physician is guided in psychoanalysis by the task, which is the patient’s responsibility, of overcoming his or her resistances. In other words, to carry out the work of treatment. … The emergence of resistances protects the patient from any deceiving effects of the influx of suggestions.

Healing becomes treatment when the notion of method is used as one of its central and essential components. In the ancient world, method was merely one among several points along the road that began with care for oneself. In contrast, in modernity, the method commands the healing. Whatever in the healing process is not according to the demands of the method is rejected and considered part of the diffuse fields of religion, art, or metaphysics. In other words, it is politics, represented in the example by the dimension of authority or by resistance, which, by contrast, defines psychoanalysis and distinguishes it from other strategies or tactics of treatment. This is why Lacan’s statement that the analyst is less free in his politics means that there is something constitutive between the space of psychoanalysis and the space of politics. In the same way, psychoanalysis is defined in politics as conflict (between desire and defence, for example). This conflict is treated by the means and ends

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that the true participants in this space define for themselves, as places that they occupy in the “space of the free association of words” (the transference, for example). But even during the process of this conflict each participant’s positions of desire changes in relation to those of the other, as the other is recognized at each instant (sexual, repressed, and infantile, for example). Here we have a type of homology between space, place, and position between psychoanalysis and politics. We are now in a position to present one possible version of the structure of the method of psychoanalytic treatment in order to locate its points of political, strategic, and tactical incidence. Descriptively, the psychoanalytic experience involves a number of stages, such as the preliminary interviews, the entrance into analysis, the interpretation of symptoms, the overcoming of resistances, the construction of the fantasy, and the end of treatment. A diachronic separation of this type has the inconvenience of reducing treatment to a set of events lined up in time, which corresponds to succession only in the experience of treatment. In contrast, a model intended to encompass the simultaneousness of pathways, the variety of interpretations, the modes of transference, and the solutions of symptoms in an analytic treatment would have to respond to such a level of generality that its practical usefulness would be very small. Finally, if we began considering its politics or its ethics in the questions of method, such an extremely complex and heterogeneous mixture would be produced that its value for clarifying anything would be inadequate, to say the least. Unfortunately, this is the state we have become accustomed to in manuals on treatment and the direction of the healing process (Fink, 1997; Nobus, 2000), which consist, in this context, of the best of theoretical production by analysts on specific topics, such as the beginning (Leguil, 1993) or end (Pommier, 2003) of analysis, transference and interpretation, regular symptoms, structures, and clinical cases. In this regard, the notion of psychoanalytic act is particularly useful for examining this problem. Psychoanalytic act admits of a triple meaning: the entire treatment, that is, the passage from analysand to analyst; certain operations that are immanent to it, such as the act of beginning an analysis (1967a, p. 4); and a type of clinical intervention, such as an interpretation, a construction, the management of transference, and anxiety (Pommier, 2003, p. 65). An act is a gesture with simultaneous ethical-political (political act), methodological

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(doing something) and technical (an intervention) connotations. According to its definition, as stated by Lacan: [An analytic act] consists of an intervention by the analyst during treatment, as it constitutes the setting of psychic work and has the effect of a crossing, a traversing. (Chemama, 1995, p. 18).

This definition also allows for the triple definition referred to above. It clearly refers to the specific idea of a type of intervention by the analyst that immediately addresses something more generic, a type of permanent activity, the setting for psychic work. On the basis of this second meaning, we could say that analytic act refers to the conditions that make analysis possible. Outside of the “management of the transference there is no analytic act”, as Lacan (op. cit., p. 46) said. There is also a third meaning, namely, that psychoanalysis “has an effect of traversing”. The temptation would be to place here the notion of traversing the fantasy, but I believe that would tend to be somewhat reductive. Analysis is indeed a traversing, a crossing, but not only of the fantasy. There is a traversing of the transference (its dissolution), a traversing of anxiety (a reduction to its crystalline form) and a traversing from analysand to analyst (passage). Here the analogy with the theme of travel and maritime navigation, as seen in the sphere of caring for oneself, is inviting. A journey needs luggage and preparations, routes and planning (setting), and it also demands a decision as to where it will begin and end (effects of traversing). A journey can mean moments of major or minor change in general, a change in direction and the solution of problems (intervention). But these things are not independent from one another. A change in route may involve a re-decision to travel or a desire to go through with the trip or turn back. Inversely, taking a trip in strict compliance with a sequence of isolated operations would take the enjoyment out of it. Another possible comparison is with any type of artist. Each stroke of a painting bears the brand of the artist’s own style and is part of the overall painting consisting of the finished canvas. But the creation of a painting is not merely the methodical application of a plan conceived in the preliminary studies or first designs. The whole is transformed by the progress of the colours and the unexpected irruptions in perspective or form. If we ask, then, what the act of the

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painter really is, we would have to say that it is, at one and the same time, the finished canvas and certain modifications that we recognize in retrospect as having been decisive for the composition of the painting. Between the act as process and the act as procedure, we can note that there is a relationship of mutual negation. Allegories such as sculptures, journeys, or games of chess, all used more than once by Freud to refer to psychoanalytic treatment, represent a problem for the formation of universal models, since only rarely do such events allow one to represent the logic that goes along with the notion of act or experience. This is because, in general, formal or conceptual writing ends up reducing the temporality of the experience to a spatialized temporality. Held down into relationships of conditionality and reversibility, the time proper to the psychoanalytic experience loses its full representation. Curiously, and contrary to Descartes, when time is geometrized, it loses its real dimension. Lacan was not the first to conceive of the method of treatment as an act. In the 1920s, Ferenczi developed an extension of the classical technique, which he called the active technique. He referred to it in the following terms: “One must create a concept and a technical term for something that has always been used in fact, even without being formulated [One must] deliberately employ it” (Ferenczi, 1921). Ferenczi’s active technique was based on a particular structure of treatment, divided into two phases. Based on Freud he wrote that (Ferenczi, 1921, p. 111): During the first phase of the treatment all possible libido is directed away from the symptoms and toward the transference. This phase implies no any active support within the analyst’s reach. Here Ferenczi is referring to a psychoanalytic suggestion that “uses transference to let the patient become personally convinced (Übesetzung) of the unconscious reasons for his suffering”.

The second phase of the treatment involves making the libido, (in transference), move away from this object, and find new destinations. Ferenczi starts off with exceptions to this rule. His main exception is anxiety hysteria, where the clinical management for solving the phobia requires the analyst to take certain unpleasant measures (injunctions) and renounce certain pleasant measures (interdictions).

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There is a generalization of this specific aspect, since Ferenczi holds that the tactical use of the active technique can be used in relation to unconscious motions to “convert them into acts in the analyst’s presence” (Ferenczi, 1921, p. 124). In other words, Ferenczi’s active technique is not only a procedure for removing of symptoms and inhibitions and aimed at direct therapeutic ambition or at an increase in the strategic scope of the procedure, but a way to produce new discursive material for treatment. For this reason, the active technique is recommended for the second phase of treatment, especially for liquidating the transference, but not for the first phase, where its use would be equivalent to wild psychoanalysis (Id., 1925, p. 366). It is a tactical aid and should never replace traditional treatment. In this respect, the active technique is quite different from hypnotic suggestion and from merely proposing tasks for the analysand to carry out. In fact, it encourages repetition in the transference without becoming an exercise of power at the same time. As Lacan (1967a, p. 117) put it: The analyst is the one who moves around in broad zone into which he is often called by the patient to intervene as act and not only to the extent that I can occasionally be called upon to take part, to take sides, to be on the patient’s side in relation to someone close (or anyone else), or even simply by carrying out this type of act (in effect, it is a good thing that it is an act]) that consists of an intervention through approval or, on the contrary, of giving advice. This is precisely what the structure of psychoanalysis leaves open.

Ferenczi continued with his clinical experiments until he came to the idea of mutual analysis, with inversion of roles between analysand and analyst. Lacan seems to note that, in injunctions and interdictions postulated by the active technique, there was not only a tactical and strategic innovation, but a political dimension as well. To defend this form of clinical procedure, pre-supposed by the practice of the cut in sessions of variable length, Lacan was obliged to set down clearly defined limits between the notion of act with respect to categories that were close to it, such as countertransference, slips of the tongue, symptomatic acts, acting out, and passage to the act.

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We are now in a position to present the structure of the treatment in view of the idea of an act.

First moment in psychoanalytic treatment: the emergence of the subject of the unconscious For months and months he had told Lacan about his love for X. He talked about her, about his relationship with her, about their life in common, and its ups and downs. Everything had been analysed to the full, including the reason for his choice, that the choice had to do with her name, etc. Now he sums it all up: he has decided to marry her. He comes into the session and says: “I’m getting married next week”, and, to this bit of news Lacan asks: “Who to?” (Allouch, 1992, p. 27). The intervention “Who to?” simultaneously recovers three dimensions. It has the value of an interpretation, as it indicates the unconscious knowledge involved in the choice. It is also a way to manage the transference, to put the demand for concordance under suspicion. In addition, it represents a value of indication of the object by introducing onto it a specific form of negativity. These concurrent dimensions in interventions have an order for entering at the beginning of treatment: the subjective rectification conditions the transference and this, in turn, conditions the interpretation (Lacan, 1958a, p. 604). During the preliminary interviews, with which analysis begins, the same tactical and strategic rules of the method of treatment are in effect, but the regime of exception is of a political order. It has not yet been decided whether there will be an analysis. Certain conditions based on the symptomatic, diagnostic, and transferential functions (Quinet, 1991) of these interviews must be complied with for this to occur. The symptomatic function refers to the possibility of implicating the subject in the real that constitutes his or her discomfort. The diagnostic function refers to the type of alienation that is established between the subject and his or her symptoms. Finally, the transferential function indicates how this alienation is carried out with respect to the treatment and, in particular, to the analyst. We see that it is not the function of suffering that constitutes a criterion for analysis, but the split in knowledge and the position of the subject towards this fracture in the self-supposed everyday unity of the subject. The transference is an indication of

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installation of the treatment in the clinical area and the replacement of the function of suffering with the function of the symptom. These three operations that occur at the beginning of the treatment can be written with the help of the mathematical structure known as the Klein group, perhaps the simplest case of algebraic structures: “An algebraic structure is a set consisting of any elements at all, but between which one or more rules of composition or (a synonym) operations are defined” (Barbut, 1996/16, pp. 145–170). These rules of composition, in the case of the Klein group are: the existence of a neutral element, an associative operation, an inversion operation, and a permutation operation. Lacan constantly uses the Klein Group, expressing the essence of both expositive strategy based on topology, on the one hand, and modal logic, on the other. The logic of the signifier (the button tie) (Lacan, 1955b, pp. 13–68), the structure of the relationship of speech (Lambda scheme) (Id., 1954a), the structure of the subject (graph of desire) (Id., 1960b, pp. 807–842), the relationships of the subject with the object a (logic of the fantasy) (Id., 1966a), and especially, the theory of the four discourses (Id., 1969b) are all varying schemes and uses of the Klein group. A Klein group admits of an algebraic expression and a geometric expression, which may or may not contain a specific semantic character. The systems of kinship described by (1)

(3)

(2)

(4)

Figure 1. Group of Klein.

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Lévi-Strauss are examples of structures of this type, as well as are certain formal languages described by Russell and Tarski, cognitive structures described by Piaget, and even the logical sequences of IQ tests, such as the Raven Test. Let us look at one example of a Klein group based on the Raven Test: So we have two elements, namely, triangles and tetrahedrons, combined with two properties, coloured and non-coloured. There are two basic forms of transformation: of colour and of form. If the same operation is repeated, the system returns to its initial form. For example: a. b. c. d. e.

Initial position: triangle Operation: “change in form” Result: square One more “change in form” Result: triangle

Repetition as opposition or passage to the contrary, makes it possible to extract the neutral element. When there is addition, “0” is the neutral element; when there is multiplication, “1” is the neutral element. It can be said that there is a relationship of opposition between (1) and (2). But if we go through steps (2) to (4), there is a change in colour. This operation must be distinct from the first, and is known as an inversion, but only if we consider it in the context of the system that first established the relationship of opposition. Finally, if we go through steps (1), (2), and (4) there is an operation of inversion and opposition, known as an operation of transposition, or permutation (Barbut, 1996/16, pp. 145–170). It is said that a collection of elements forms a group in relation to a given operation if: the collection is closed under the operation, the collection contains an element of identity with the operation, for each element in the collection there is an inverse element in relation to the operation, and the operation is associative. The elements can be numbers (as in arithmetic), points (as in geometry), changes (as in algebra or geometry), or anything else. The operation can be arithmetic (as in addition or multiplication), geometric (as a rotation around a point or axis), or any other rule for combining two elements of a set (such as two transformations) in a way that will form a third element of the set (Boyer, 2002, p. 379).

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It so happens that the entire Klein group is a closed and involutive structure. This means that it can always return, according to a finite set of elements and places, to a previous state of the system through the organized repetition of the operations that are prescribed in it. As we saw, this involutive property (the return to a previous state) cannot be applied to the analytic experience, even though this is a part of its metapsychology in the figure of the death drive. This objection led Lacan to work not with a perfect Klein Group, but with two Klein subgroups, or two monoids. This is in line with the idea that treatment takes place in two phases and makes more acute the examination of the type of transformativity that takes place between one phase and the other. The monoid that expresses the first moment in analysis is constructed on the basis of an interpretation that brings together Freud’s well-known expression about treatment (Wo Es war, soll Ich werden) (where the id was, there the ego should be) and the categories extracted from Descartes’ cogito, but read from a negative perspective. Therefore, the first position of the subject that enters into analysis corresponds to a particular type of division: either I do not think or I am not. This is a pyrrhonic position, scepticism for Montaigne and the origin of the quaestio. It is what Freud called the common neurotic state, characterized by the draining of the libido into unconscious conflicts, by neurotic anxiety and by the ups and downs of narcissism. The alternative conjunction “or” represents here the function of the cause of anxiety, opposition, and imaginary disagreements proper to narcissism. In this state, there is a disparity between the subjectivization of desire (I do not recognize myself there where I do not think—unconscious) and the subject’s preferred way of obtaining satisfaction (I do not recognize myself where I obtain

(I) (operation of alienation) (2) I do not think ↓

←

(1) Either I do not think or I am not ↓

(operation of the transference)

(operation of the truth)

(3) I do not think and I am not

(4) I am not

Figure 2. First moment of psychoanalytical treatment.

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satisfaction—id). In other words, the Wo Es war (where the id was) does not imply the soll Ich werden (I, the ego, should come in as a subject). This position, which the preliminary interviews have the objective of ascertaining, admits of three possible transformations, according to the properties of the Klein group. The first operation, that of alienation (I do not think) is a correlate to Descartes’ second evidence, which adds to the subject’s finitude and precariousness, limited to the act of enunciating the cogito, which is the security and guarantee of the infinitude and existence of the Other. Here we find both the alienation that characterizes the symptom (alienation to the desire of the Other, stifled word, metaphor for the Name-of-the-Father) and the alienation that characterizes narcissism – here Lacan used the expression false self. In his view, there is also a form of alienation that is typical of anxiety. To the extent that it is not without object, its proper form of alienation implies the production of a screen object. This form of alienation also expresses the aphanisis of the subject, present in the second moment of the fantasy. We might recall that, according to Freud (1919e), to which Lacan returned countless times, the first moment of the fantasy (A child is being beaten) and the third moment (I see my father beating a child) are separated by a second moment (I am the child my father is beating) that remains unconscious and must be the object of a construction in analysis. This second moment is concealed exactly because the subject sees herself or himself in it. Therefore, the aphanisis of the subject in the fantasy is the radical way by which the subject alienates itself as an object from which the three other modes of alienation (symptom, anxiety, and narcissism) are derived. Here we re-encounter the Cartesian surface that integrates, on the one hand, the point represented by Montaigne’s quaestio, with the strategies of conversion and submission, on the other. In other words, this point consists of the closed circulation between the hysteric’s discourse and the master’s discourse. In this case, we can see a specific type of negation, an indeterminate negation that opposes but does not recognize what is negated, as we find in Descartes’ first process of doubt. The second operation (I do not think and I am not) corresponds to the work done in and by the transference. It can be said that there is an articulation of the transference in the subject’s modes of alienation. This conditions, but does not define, the transference

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that can be used in psychoanalytic treatment. This transference must be carried out like a transference neurosis. In other words, each point of the original alienation in the Other finds a simile that reproduces and brings up anew the subject’s relationship with unconscious knowledge. We saw that, in Descartes, knowledge is transferred through a triple movement of position, supposition, and post-position. In Lacan, transference has a similar structure: the subject supposed to know. This subject supposed to know is an operation of transference (knowledge), of transposition (of the subject), and of transfer (of a supposition). All three of these aspects are involved in the Lacanian concept of transference. It should be recalled that both transfer and metaphor (meta-phorein) indicate movement, moving from one place to another. The concept of transference can thus be understood in several different ways: 1. as the subject that is supposed upon knowing, in the sense that anonymous and indeterminate knowledge of the unconscious calls for an explicit subject, a “sub-posted”, “sub-placed”, supposed subject. 2. as the subject that is supposed or presumed as knowing, in the sense that, from the beginning, it is aware of a process, but that the subject only reveals himself as being aware of a process at the end of the process. This is Hegel’s Selbstbewusstsein (selfknowledge) as a subject that remains as a conjecture or a hypothesis that is subliminal (sub-jectum) to the knowing process. This is the indeterminate subject of science (it is known that …). 3. as the subject that is supposed to knowing, in the sense he is divided between knowledge and truth, or in the sense that a signifier represents a subject to another signifier. Lacan emphasizes the movements of inversion, such as inversion between the development of the truth and dialectical intervention, inversion between the need to repeat and the repetition of need, inversion of demand to desire, or inversion between the torus of the subject and the torus of the Other. In this process of transference of knowledge there are also relationships of opposition by which transfer is seen as resistance, whether in love, in imaginary disagreement or, especially, in identification. Here transference appears as a form of alienation. Resistance is a property of the discourse, and not of the ego,

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exactly because it is the discourse that establishes the relationships of opposition. This is why resistance is, above all, resistance by the analyst, since it indicates that the discourse positions the analyst as direct and symmetrical negation of the position of the subject’s ego. Besides inversion and opposition, the grammar of transference can also mean a process of transposition, meaning the simultaneous negation of both simple negation (opposition) and determinate negation (inversion). Here transference appears as an apparatus of subjectivity. These variations of negation indicate how the transference in psychoanalysis is neither repetition, nor even a simple duplication of the past or stagnation of the stable modes of production of objects, but also the creation of something new. The “sexual reality of the unconscious put into act” is also an encounter with the real (Lacan, 1964a). The passage from a symptom as complaint to an analytic symptom introduces something extra into the symptom. This transportation of the modes of alienation from the subject to the Other creates an overlapping between unconscious and subject supposed to know, namely, the transference neurosis. Its orientation gradually decants the analyst to the position of object, with which the analysand identifies in his or her fantasy ($ <> a). If alienation was characterized as a specific form of negation (associative negation), this act of transferring is a negation and an assertion of the act of transference and it is correlative to Descartes’ process of constructing a place to guarantee knowledge. The third operation underway during the first logical moment of analysis refers to the truth. This is the passage from the either I do not think or I am not, to the I am not. But, curiously, this operation is blocked because it corresponds to a state of transference without analysis. It is available to the analysand under the form of either a passage to the act or of acting out and, at this point it corresponds only to making the transference more actual, in the here and now, without interpretation.1 This is what Freud describes in the form of interruptions in the treatment brought about by immediate and precipitated repetition of the symptom in the transference. This is close to the idea, found in caring for oneself, that the subject needs an experience that enables

1

Translator’s note: In the sense of “at the present time”, rather than “actual” in its usual meaning of “in fact”.

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him or her to enounce the truth, and this is the only way that such an enunciation becomes possible. Therefore, the operation of the method, in this case, is limited to maintaining the place of the truth “safe”, insisting on the prolonging of its incompleteness, and expanding free association and the extension of the symptoms. To guarantee the place of the truth as an empty place also implies emptying it of the identifications and objects of anxiety, which tend to make the truth a semblance.

Second moment in psychoanalytic treatment: mutation in the transference Allouch (1992, p. 49) once described the following situation: A Jesuit is in analysis with Lacan, being one of the first generation of Lacan’s students. One day, in a session, this analysand formulates his intention to leave the Jesuits and get married. Lacan does all he can to persuade him to change his mind. Lacan says that the superego in marriage would be worse than that in the Church. The result was that the analysand went ahead with his decision, but now he was certain that he took it alone.

The Socratic phase of transference implies a displacement of the love for an object to the love for knowledge. Love is a fundamental affect for understanding the transference, not only because it allows the subject to realize that there is transference going on, but also because the subject himself thus gives the transference a certain degree of “reality”. This is why the grammar of transference contains the same forms of negation as do the contrasts that define the grammar of love, to wit, according to Freud (1915a): a. loving vs. being loved b. loving vs. hating c. loving vs. indifference Not only is love subject to a simple inversion (from loving to being loved). It also admits of an interversion (from love into hate) and an opposition (from love into indifference). Opposition is

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an indeterminate negation whose enunciation is: “This is not it”. Here the negation falls on the verb to be, ruling out or excluding (Ausstossung) a bit of the real that takes shape in the form of imaginary projection or of symbolic introjection. Inversion (Verkehrung) is determined by a negation that falls on a signifier in a metaphoric or metonymic way, allowing what is negated to be symbolically conserved without this fact being recognized. The passage to the contrary (Umschlagen) is also a determinate negation but, in this case, the act-ualization of meaning destroys, or undoes, the meaning. This can be seen in what Lacan called the nonsensical aspect of the signifier. For example, in a session the analyst said: “Let us continue with that”. And continue means “stay here and continue the session”, and continue means “we do not continue today”, “the session is over”. This is what is meant with the idea that a signifier represents a subject to another signifier. S1 → S2  The first signifier (S1) is in the place of supposition and the second signifier (S2) is in the place of the posited. The subject () is below the bar, which indicates negation. So the subject must be in ellipsis in order to be transported from Place to Place. When this happens, the place of S2 becomes that of S1, and so forth. We find the same logical scheme in the matheme of the transference. S → Sq s (S1, S2 … Sn). Here a signifier in the analysand’s (S) associative chain is articulated with any signifier of the analyst (Sq). The subject is represented here by the signified(s). In this case, position 1, or the signifier (S), is replaced by position 2 (the signifier of the analyst), with a double effect: not only does the subject move to a different position; a kind of discourse also occurs, a system of replacements, which we call free association (S1, S2 … Sn). It should be noted that the subject is separated from this series by the presence of parentheses. The parentheses may indicate that there is also a relationship of implication between subject(s) and speech (S1, S2 … Sn).

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This undefined re-application is illustrated by the Fibonacci series: a=1 1+1 1+1 n… Or: 0, 1, 1, 2, 3, 5, 8, 13, 21, 34 … n As can be noted, it is a series in which any given element is the sum of the two preceding elements. Modalities of intervention referring to the transference behave in a way similar to the transformative relationships specified by the Klein group (opposition, inversion, transposition). This explains why the position of the transference is what authorizes interpretation and act. The interpretation introduces a new form of negation. For example, where the subject was once retained in an indeterminate negation, he makes it pass on to a determined negation. And where he was alienated in the form of a simple inversion, interpretation introduces a passage to the contrary. At the same time, this takes place by the passage from alienation to transference and by the maintenance of the restriction against operating with the truth. But this work corresponds only to the Klein group’s first monoid. It is of special importance here to understand how this inversion in the orientation of the vectors of the Klein group (alienation, transference, and truth) takes place without, at the same time, being in fact an inversion in the sense of an involutive route. There thus is a mutation in the operational regime of the transference that is not of the same nature as interpretation or other interventions aimed neither at de-alienation, nor even of the same order as the interventions that are aimed at strengthening the place of the truth or bringing as yet uninscribed modes of alienation of the subject into the transference. There is a mutation that is inscribed in the logical scheme itself of the subject supposed to know. But when we note the centrality of the notion of subject supposed to know as a final position for the topic of the transference in Lacan, we can see that his presentation ignores elements related to the drive. We see that the strategy of the transference replicates the grammar of the drives, but this does not mean that we have integrated the notion of object into the subject supposed to know. The subject supposed to know seems to be able to explain the installation of the transference neurosis, at the price of completely excluding the drive.

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The problem is even more serious if we note that, up to this point, all of Lacan’s formulations on the transference associated it directly with the logic of the drives. Examples of this concept are: 1. The equation in analysis involving an unknown, referred to as agalma, a hypothesis as to how drives are concealed (Lacan, 1964a); 2. The aspect of analysis whereby it separates drives from fantasy (Lacan, 1966a); 3. The management of the transference, which implies separation between object and ideal (Lacan, 1964a); 4. The analyst’s desire, to the extent that it returns to the drive what had formerly been a demand (Lacan, 1967a). This would allow one to posit the hypothesis that there is a point of mutation in the transference, equivalent to a type of median point in analysis, consisting of a transition from the first moment to the second moment, according to Freud. This is the point of inversion of the transference vector and of the Klein semi-group, which represents, at the same time, the end of the first phase of the analysis and the first steps in its termination.

Third logical moment in psychoanalytic treatment: separation from object a Patient:

“It might be that, now, in the last resort, sometimes I am just happy. But can I say what happened [when I was] with you?” Lacan: “That is precisely it. How to say it?” P: “But you said that the objective was not happiness”. L: “I never said that”. (La Sagna, 1992, p. 51)

The second logical moment in treatment must introduce a change in the transference that will explain the idea that the psychoanalytic act reduces the subject supposed to know to the object a (Lacan, 1967a, p. 115). We saw that this represents a type of act of magic because there is no reference to the object in the definition of subject supposed to know. So how it can be reduced to something that was not there? This is the course of the third logical moment in psychoanalytic treatment. The solution to this impasse takes us to one of the dimensions of alienation, which, by clinical thesis, encompasses and condenses

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all the others. This is the dimension of fantasy. The idea that the transference catalyses and spurs on the modes of alienation of the subject has led us to posit a certain isomorphism between the forms of negation practiced in alienation and in transference. An analytic symptom is a miniature of a complaint-symptom and of a demand, not only because it reduces its extension, but also because it contains, in a simpler way, through symbolic reduction, the practice of negation involved in it. This transportation, which identifies the subject supposed to know for the unconscious, is especially difficult to occur in the case of fantasy. This is due to the fact that fantasy, contrary to symptom, narcissism or anxiety, cannot be entirely subjectified. It is true that all dreams have a navel, which is the real core of jouissance in each symptom, and that narcissism and anxiety are reduced to an object form and a form of objectality. The destiny of what Lacan called pure desire is to bring about this reduction. In other words, pure desire is a form of desire that is increasingly separated from empirical objects and from the forms of identity attached to images or from the signifier that fixates them to the object. First, there are two limit signifiers for this process: the phallus and the Name-of-the-Father. Here analysis involves a strategy of purification of desire that is associated with the process by which the subject becomes real in his division. Later, Lacan replaced this idea of pure desire by the idea of a desire to establish the pure difference. Even so, this strategy has its limits. There must be a point that is virtually inexhaustible but by which the discursive work of the treatment finds a finite horizon of symbolization. Here Lacan begins to show interest in other forms of symbolization that allow him to unite the universality of the phallus and the Name-of-the-Father to the subject’s existential experience. There are a number of hypotheses for this problem, and all of them are related to the mode of symbolization related to writing. There are several examples of the attempt to introduce some other form of symbolization (which could also be termed formalization) into the psychoanalytic method. Among such examples are the unary trace as a real basis of symbolic identification, the letter as materiality of jouissance in the symptom, each subject’s proper name as unspeakable and, especially, Borromean writing.

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Here the similarity to Descartes is unmistakable. This other type of symbolization—writing or formalization—corresponds to the topic that we saw Descartes inherit from Nicholas of Cusa, namely, the topic of the paradox or discrepancy between what is discursive and what is mathematizable. The passion not to know (passion de l´ignorance) connects ethically the discursive order with the logical order. If the Name-of-the-Father and the phallus are figures of what Descartes called thinking substance (res cogitans), and if, within thinking, they indicate the finitude of thinking, there must be an equivalent inside existence that also represents the finitude of extension and of temporality in thinking. This problem is not raised in Descartes because, on this point, the non-deceiving God who guarantees that this finitude is solely finitude of reason in the subject, and not finitude of reason. Just as the Name-of-the-Father and the phallus are structures that characterize a type of failed universality, the object a is a structure that indicates a failed existence. Much of the difficulty in keeping up with Lacan’s statements, which are blatantly discrepant during this period of his work, are due to his efforts at integrating a general theory of negativity with these two self-contradictions: a universal indexer that is not a universal (the phallus and the Name-of-the-Father) and an indexer of existence that is not an existence (object a and unary trace). Therefore “this a is neither inside nor outside, and is neither real nor illusory” (Lacan, 1967a, p. 73). Regardless of the solution one may want to choose, the issue for our discussion on the method of treatment is that this theoretical problem finds its clinical expression in the topic of the fantasy. (II)

(2) I do not think

(3) I do not think and I am not

(re-alienation)

(analytic act)

↑

(1) I am not and I do not think (a ) →

(4) I am not (operation of the truth)

Figure 3. Third moment of psychoanalytical treatment.

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In other words, in the experience of treatment, the point is to build up and traverse a type of logical model (construction of the fantasy) and a subjective experience (traversing of the fantasy) that can give clinical expression to the theoretical notion of formalization. Here Lacan’s Cartesianism is obvious. The description of this conjecture corresponds to the second monoid of the Klein group. In the monoid that represents the first logical moment in treatment we saw a combination of symbolization of relationships of exclusion and negation between Wo Es war (where the Id was) and soll Ich werden (the subject must emerge as existence). But in the third logical moment in the treatment this combination is expanded in a way to include other procedures besides symbolization. Acting, formalizing, writing, and knotting are examples of such clinical tactics. Reducing supposed knowledge to the object a has to do with the forms of act by which the subject chooses alienation. If the first alienation was constitutive of the subject’s mode of being, the re-choice will not be a return to a prior state. It should be a return that negates the route taken. This can be done in one of two ways: passage to the act and acting out. Passage to the act is a category in French psychiatry that usually refers to violent or transgressive actions where the subject inflicts damage on another or on him-or herself, as in suicide. Lacan displaces this specific meaning to a more generic dimension whereby, in a passage to the act, the subject simply tries to find a new beginning, discover a new way of being where “the subject will find his presence renewed” (Lacan, 1967a, p. 58). Here we come across echoes of the tradition of conversion as a return to oneself and as the foundation of a new order of being in the subject. Here the footsteps that led to conversion are erased. The notion of experience is lost, since these footsteps from the past become mere narrative ingredients that explain the dimensions and orientation of the transformation. But, in terms of this beginning, Lacan made a number of assertions that would seem to imply that analysis introduces a radical type of new beginning for a subject’s life, which might be described as the dazzling light of the end of analysis, the transcendent beatitude, the holiness of analysts (St. Thomas of Aquinas), etc. In Lacan’s words (Lacan, 1967a, p. 64): The psychoanalytic act refers to a form of wrapping, a structure that, in some way, suspends everything that, until then,

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had been instituted, formulated or produced as a statute of act, to its own law.

The other way of re-choosing alienation is acting out, which is defined as transference that has not been interpreted (Id., 1962). One should not oppose transference as associative, recollective, and symbolic power, on the one hand to acting as the simple negation of remembering, according to the simple definition of Recalling, Repeating and Working Through, on the other (Freud, 1914b). Acting out (agieren) is a type of symbol that is not recognized as such. It is a imaginarized symbol. It is interpretable in a sense different from the other formations of the unconscious since it requires a type of rectification of the relationships of the subject with the real. In acting out the subject acts as the ironic gaze that narrates not only a scene, but also shows how it was constructed, thus including the position of the subject that looks. Acting out is like involuntary irony that makes the subject act out the scene of his or her fantasy without distinguishing the characters from the audience. The fact that the analyst is positioned in the place of the audience is a way of forcing the transference, which takes the analyst out of the place of the choir and forces her or him to identify with the audience or the judges of the theatre. This is why acting out always has a comic enunciation, just as passage to the act has a tragic enunciation. Both are forms of re-choices because they negate the choice that is made in transference. Based on the inversion of the monoids that give structure to the method of treatment is represented by the product of the reversion of the subject supposed to know into object a. Here the return is not to the product result of the alienation (I do not think), but to the initial place of division of the subject (either I do not think or I am not). But we should remember that this is a non-involutive system and, therefore, that this division is not the same as it was at the beginning of analysis. The difference is that the division is part of the process through a specific form of negation, a determined negation, which conserves what was negated at the same time that it either writes, formalizes, or knots it. This would make Aufhebung a fourth type of negation able to affect the relationship, examined above. a. opposition or indeterminate negation (Verneinung) b. inversion or passage to the contrary (Umschlagen)

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c. transposition or interversion (Verkehrung) d. sublation (Aufhebung) discursive contradiction and ontological paradox, negation of the other three forms of negation. Sublation is able to block movements of opposition, inversion, and passage to the contrary proper to the processes of making the real imaginary and the imaginary, symbolic. The fourth type of negation is seen in the effectiveness of an act, the analytic act. Just as the beginning of the analysis consists of an act carried out by the analyst, the end is an act by the analysand. It is an act of passing from analysand to analyst. It also “defines of the beginning” (initium, apke) (Lacan, 1967a, p. 78), such as traditional symbolic act of the emperor handling the plow, commemorations for the beginning of spring, passage rites, the expression, “In the beginning was the Word” (John, 1.1), and the statement by the German romantic poet Goethe, that, “In the beginning is action” all characterize this form of beginning. Through its paradoxical properties, the psychoanalytic act is, essentially, a discourse without words. Here we re-encounter the notion of symbolic excellence, which we used as an operator to understand ancient healing practices. The excellence of the act is different from the effectiveness of doing. Another property of the fact that the reversion of transference into object a is equivalent to the knot between formalization and discourse is the thesis that there is no subject in the act. This is understandable because, if the position of subject results from the dimensionality conferred by the inscription of the phallus in the field of the Other, and if the act is a consequence of a type of negation of the infinite consistency of the Other, there is no way to conceive of the position of subject. That the subject is abolished or in aphanisis does not mean that, at this point, the Being of the subject does not exist. This position is reinstalled by the effects of the act, by its being read in retrospect (nachträglich). Finally, we arrive at the third possible operation at the third logical of analytic treatment, which involves the possibility of passing through the place of the truth. This movement located somewhere between I am not and I do not think, on the one hand and I am not, on the other corresponds to the notion of traversing the fantasy. Here we are in the order of experience and formalization. The fundamental

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operator here is the concept of separation. Separation between the object a and the phallus (-), which conditions the tension between discursive contradiction and logical paradox (each of which is an object of specific constructions). Two lines open up here. First, there are a number of movements related to the experience of being a subject as lack (Lacan, 1967a, p. 98). Second, a separation occurs between the drive and the fantasy. In the first line, the truth is seen as an enunciative place of specific and temporary occupation, which is a residue of the operation of deflating knowledge. It is a place that is not without knowledge, but it proceeds precisely from a radical separation between knowledge and truth. Where the id was (Wo Es war)—since being (war) has been separated from the id—, the subject should enter in (soll Ich werden) as loss (-). The experience of lack in the being of the subject is correlative to the experience of the signifier of the lack in the Other [s ()]. This is Descartes’ theme of universality. The second line represents the traversing of the fantasy and the truth operation as separation and operation of the truth, we face the problem of jouissance. The fantasy is a subjective device that releases desire to attain pleasure and it thus commands the subject’s entire economy of jouissance. On this point, Lacan’s position is clear: sexuality is not the field from which the subject’s truth is extracted, due to the “irreducibility of sexual intercourse to any true interaction” (Lacan, 1967a, p. 38). The notion of experience can be seen as intimately related to the healing process. This healing process constitutes, in the strongest sense of the term, an experience. We can locate, in the more original and generic idea of experience, the modern emergence of the idea that having an experience is a process of making something real. The method represents an ideal condition for producing real objects. Finally, we can include the even more specific idea of act in the production, or formation, of reality, this concept encompassing acts of desire, of language and of work, for example. In other words, having an experience implies the production of a “state of reality”, and reality, seen from this perspective, contains specific acts carried out by the subject. This perception led Lacan into a long period of showing that there is no relationship between the sexes. There are numerous reasons for this. There is a great difference between the modes of

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jouissance in men and women, a separation between the phallus and object a, that is, a disproportion between the object a and Other. For our purposes that the important thing is to underscore that this discussion is carried out entirely in the domain of existence (there is no relationship between the sexes). In this regard, the truth is still a safe place, an opening in the woods, strengthened by the semblances about the relationship between the sexes, in other words, the truth represents the different modes by which it fails to exist.

From the psychoanalytic act to the discourse of the psychoanalyst So we come to the end of this very synthetic exposition on the structure of the psychoanalytic method. Our objective has not been to examine all the aspects involved in the notion of treatment, but to show how it might be seen radically as a structure. In other words, based on a very limited number of defined places and operations one can extract a combination that joins the constitutive reason of all possible strategies and tactics of treatment. The fact that this structure might possibly be described in other terms with better conceptual quality or clinical precision is basically irrelevant to the central idea that treatment can be conceived as discourse and logical path. This is confirmed in Lacan’s evolution to the concept of analytic act, in other words, the concept of analytic discourse. In his seminar XVI, The Other Side of Psychoanalysis, Lacan (1969a) once again presents a Klein group (with modifications) to shape this discourse, as follows:

Places

Elements

Agent

Other

S1 = master signifier

Truth

Production

S2 = knowledge

Analytic Discourse  



 = subject a = object a

Figure 4. Analytic discourse.

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Here we re-encounter the analyst as agent of the act-discourse and the analysand as subject. The master signifier in the place of production includes what, above, was called the operation of alienation. The signifier of knowledge in the place of the truth re-edits the operation of separation. The vectors introduce the notions of impossibility and impotence, which, in the past were represented by the existence of movements vetoed within the system. The bar both unites and separates the topic of the grammar of negations, which includes but is not limited to its earlier use in Lacan’s work as designation of the operation of metaphor and repression. Another variant of the systematization of psychoanalytic treatment based on the Klein group is in topological representation. Here Lacan works with four elementary structures: the torus, the Moebius strip, the cross cap, and the Klein bottle. Each of these figures corresponds to a type of relationship between torsion and cut between surfaces. Treatment can thus be described as the area for initial circulation for the torus of demand until it develops into a Moebius strip, which indicates the relationships between transference and ideal. A double cut is made in this figure eight inside the sphere where the strip is fixed separates the object a (Id., 1973b, pp. 448–497). This cut functions like a type of disk that completes the spherical surface of the Other. This frees the subject from the illusion created by its fantasy, the structure of which represents the outside connection between the two torii. This short description is only an indication that, in the last resort, all operations are convertible to transformative groups: the Moebius strip is equivalent to a surface + a torsion; the two toruses are two Moebius strips that fit in together, and so forth. The cut, for example, corresponds to separation, the junction corresponds to alienation, and torsion corresponds to transference. The combination of the figures is thus reduced to the topology between elements and operations. From the seminar on identification until the end of his teaching, Lacan (1961a) systematically dedicated parts of his seminars to the development of topological structures. This evolution from the notion of analytic act to that of analytic discourse is usually understood as a step ahead in formalization and clarity. The seminar on the analytic act was unfinished due to the manifestations in Paris in May 1968. Therefore, the idea that one model of formalization will complete the next is intuitively attractive, but something gets lost in the passage from the notion of act to the

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notion of discourse. The idea of act flows from the tradition related to a healing process whereas that of discourse derives from the surface related to clinical and therapeutic work. It is also a fact that after 1973, for the last eight years of his life, Lacan radicalized even further his work on formalization by introducing a new type of writing based on the topology of the knots and on the special importance of the notion of dimension (dit-mension): real, symbolic, and imaginary. At this point he radicalized even further the notion of symptom, but, strangely, he later used this notion in a sphere closer to healing than to the clinic. The sinthome, a variant Lacan posited to carry out this reversion, is more a way of life than a specific formation that formalizes suffering in proper symptoms. Despite the countless clinical elaborations and conceptual changes Lacan made during this period of his work, they introduce no new model for understanding the structure of psychoanalytic treatment. They are efforts aimed at settling this central and problematic core represented by the disparity between the discursive and the logical level of psychoanalytic experience, succinctly presented here, in their various ways of being present. Now the distinction between the three aspects becomes more important. They are, namely psychoanalysis as clinical treatment (because it is defined as a method), psychoanalysis as a healing experience (because it is defined in relation to truth) and psychoanalysis as psychotherapeutic technology of discourse. This difference tends to be discarded in current hybrid references to clinical experience as a type of equivalent to the method of treatment, and the method is often reduced to a technical device. As was seen above, the notion of position, from which the idea of device is derived, is central for understanding this formalization of the method of treatment. A device is an articulated set of places, positions, and operations that refer to concepts and facts of experience and whereby a network of strategies and tactics can be seen. According to Foucault (1977b, p. 224), a device is: A decidedly heterogeneous set that encompasses discourses, institutions, architectural organisations, regulating decisions, laws, administrative measures, scientific statements, and philosophical, moral and philanthropic propositions. In short, it includes the said and the unsaid … A device is the network that can be established among these elements.

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However, a device is subordinated to a way of conceiving space. We saw here the close affinity between the practice of the geometric method in Descartes and the derivation of it made by Lacan—a derivation that is in line with primitive concepts as well as with the nature of the questions posited by Descartes. However, both the object of a critical inversion (the problem of the Other) and the introduction to a logic of negativity are absent in Descartes (I do not think, I am not). One could intuit that the formalization of the method of treatment is conditioned by the conception that one has of space, and in this way explain the reasons for Lacan’s final forays in this direction. But this would be to presume a degree of isomorphism between clinical treatment and therapy. The idea is simpler: space is a category not only of geometry and topology, but also of geography and politics. To define its scope is a historical task, and this takes us back to the constitution of the space of the clinic, of which the methods of treatment are possible surfaces. We saw that the model of structure of treatment posited by Lacan consists of a search for conceiving this surface as a closed surface and, nonetheless, consisting of a cut that is central to the reversion, as yet uncharted, of the subject supposed to know into object a. If we understand how the concept of act (Lacan. 1967) belongs to the surface of the healing (cure), we can understand how the conception os psychoanalytical discourse (Lacan, 1969a) belongs to the therapeutic surface, and the concept of method of treatment (Lacan, 1936) belongs to clinical surface, as well as the importance to keep them separated.

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CHAPTER NINE

Kant and the pathological

This is practical, not pathological love. It is love seated in the will, and not in propensities toward feeling. It is located in principles of action and not those of debilitating compassion, and it is this love alone that can be classified. —Kant

I

mmanuel Kant (1724–1804) lived a long and interesting life. Born in Königsberg to a family of humble origins, he was encouraged by his mother to study the classics. At the university he studied mathematics, the history of philosophy, and, especially, Newtonian physics. Following the death of his father, he took on a job as a private teacher for aristocratic families in Eastern Prussia for nine years. In 1755 he became a professor at the University of Königsberg, where he continued for the rest of his life. Kant’s everyday life can be described in great detail. He rose at exactly five o’clock every morning, be it summer or winter. He then dressed and got ready for his day. He would have some tea and the smoke his pipe as he made plans for his day. He then proceeded to a large amphitheatre-like classroom where he gave his classes. 221

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Later he would answer his correspondence. When he announced that it was 12:45, the cook would bring him lunch, consisting of soup followed by tonic water. After lunch he would take a daily walk along the exact same route and according to the same schedule. Legend has it that others could set their clocks and watches by the moment Kant walked by on his stroll and that he only changed his schedule for that walk twice in his life, one of them to receive a letter from Rousseau about the events of the French Revolution. After he returned from his stroll he would read and write until dusk. He then meditated on what he had read while gazing at the tower of Lobernich. After the lamps had been lit he resumed his reading until 9:45 p.m. At 10:00 he would go about undoing any thoughts that might disturb his sleep, and then go to his bedroom where Lampe, his valet, would help him get ready for bed. He developed a very precise way of wrapping himself up in bed. With an agile movement he would vault obliquely into his lair. “Next he drew one corner of the bedclothes under his left shoulder, and passing it below his back, brought it round so as to rest under his right shoulder. Fourthly, by a particular tour d’adress, he treated the other corner in the same way, and finally contrived to roll it around his whole person”. … “Accordingly, when packed up for the night in the way I have described, he would frequently ejaculate to himself (as he used to tell us at dinner)” (De Quincey, 1989, p. 138).

Kant developed a rational method of living based on dietary, hygienic, and moral precepts, as well as on detailed examinations of how one should act in every situation presented by existence. He disciplined himself in a manner that he himself had developed, based on the free use of his reason. When his not so faithful valet Lampe was discovered pilfering money, after 38 years with Kant, the master painfully dismissed him and wrote the following words in his own personal diary: “The name of Lampe should never again be remembered”. This is a curious sophism: Kant meticulously wrote down in his diary the tasks and precepts he wanted to remember. By writing down that Lampe’s name should not be remembered he condemned himself to remember what he supposedly wanted to forget. His propensity for anti-nomies of this type was also evident with respect to women:

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When I was able to need a wife I couldn’t support one. When I was able to support one, I no longer needed one. (Goulyga, 1981, pp. 65–69)

It is interesting to note that minor contradictions like these did not go unnoticed by this hero of Königsberg. Any change in his daily routine, such as delays in the arrival of his coffee, could cause the following type of dialog: If it was said “Dear Professor, the coffee will be brought up in a moment”. ““Will” be!” he would say, “but there’s the rub, that it only “will” be”. […] If another cried out “The coffee is coming immediately. He would retort, “Yes. And so is the next hour: and, by the way, it’s about that long that I have waited for it.” Then he would collect himself with a stoical air, and say: “Well, one can die after all: it is but dying; and in the next world, thank God! there is no drinking of coffee, and consequently no waiting for it”. (De Quincey, op. cit, p. 130)

In spite of this type of episode, Kant was not an unpleasant or intolerant person, but cheerful, generous, and very interested in other people. The high point of his day-by-day life was the dinners he offered on days announced beforehand. He never brought together for these events fewer than five persons or more than eight, with about equal distribution in terms of age and background. Kant would politely co-ordinate the discussions and entertain his dinner guests, and he gave great importance to the conversations, especially at his Tischgesellschaft (society of the table). He made efforts in his private life, his political opinions, and his institutional relationships (with university students and editors) to be consistent with the principles of his philosophy. Kant was entirely consistent with his own word. Without ever leaving the vicinity of the little town of Königsberg, Kant nonetheless considered himself a citizen of the world. He lived an ordinary life without children, marriage, or women. He was neither rich nor poor, neither happy nor unhappy, and he felt he was living the greatest and most moving of adventures conceived by man: the adventure of freedom.

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Faust, Don Quixote, Robinson Crusoe, and Don Juan are the most common narrative references when one thinks of the type of subjectivity that characterized modernity. Each of these heroes, each one very different from the others, expressed the same form of monomania. They were exclusively and selfishly interested in their personal enterprises and they defined themselves and had others define them by what they had autonomously decided to do or to be. Above all else they are losers. They were unable to turn what they strived for into reality (Watt, 1997, pp. 233–236). They survive in mere posthumous existences devoid of happenings, like brazilian Machado de Assis’s character Brás Cubas. They are narratives that admit of a conservative moral reading, the enunciation of which might be: See what happens to those who turn their backs on cosmic solidarity of life, on their native community and on the collective meaning of the conventionality of signifieds (Watt, 1997, 236). Don Quixote’s hallucinatory madness, Don Juan’s erotomania, Faust’s melancholia, and Crusoe’s megalomania should therefore be aligned with Kant’s obsessional neurosis. But contrary to our other heroes, besides his ambition for selfdetermination, Kant had the interest of a clinician. He intended to cure reason of its excesses, establish its limits, describe its functioning and, in short, to show how the insanity of heroes can be purified and transformed in a way that will justify a new form of interaction between freedom and determination. Much has been done to show Kant’s theoretical importance for psychoanalysis. Freud’s epistemology and his way of conceiving knowledge and science have their main reference in Kant. The identification between the superego and categorical imperative shows his importance regarding morals. The categories of judgement are basic for understanding the logic of negation. Kant’s notion of sublime is a key for Freud’s own notion of sublimation. But the direct use Freud makes of Kant is quite precarious. For example, Freud’s identification between the superego and the categorical imperative is simply an error in reading and a complete lack of understanding of the concept. The categorical imperative is a transcendental structure and functions as a condition for universal possibility and, a priori, for any moral act. It operates a priori through practical rules or maxims that orient our actions, and only if these maxims can be raised to universal law.

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To love one’s neighbour as oneself, to act by taking others as ends in themselves, and never as means; to behave with benevolence or loyalty, and all similar examples are only this, examples, or maxims. But the Critique of Practical Reason (Kant, 1788) is a way of founding moral action outside the regime of the examples presented by customs or outside the models or ideals that organize them. Examples provided by the life of memorable persons can be condensed into maxims or rules of action and, as such, they can regulate habits, as identifications as we saw in Augustine, Plutarch and Montaigne. But habits only offer us the basis for synthetic, a posteriori, judgements. In other words, they result from sensitive experience, relativity, and diversity. Here writers tend to distinguish between ethics and morals, ethics being the field of reflection and foundation for morals. Just as one can behave immorally but according to civil law, one can act immorally in the sense of behaving against customs but in accord with ethical law. It is in this context that certain theoreticians of ethics distinguish between conventional and post-conventional morals (Tugenhat, 1996, pp. 161–176). The basis for moral law, if one wishes a basis, should not be found only a posteriori, but on an analytical level. In other words, it should be a priori and a condition for experience. In this context, then, the basis is enunciated for the subject as pure duty (sollen) in a type of judgement that is neither hypothetical (principle and consequence) nor disjunctive (logical oppositions), but categorical. The categorical imperative is a judgement of relationship that involves the connection between a subject and a predicate in such a way as to bring them together in sensitive diversity unified by apperception. Judgements thus determine the constitution of objects and the unity of consciousness (Pascal, 1985). Categorical imperative, therefore, is not a metaphysical entity, but a synthetic a priori judgement. It is a special case. Synthetic judgements are usually a posteriori and result from experience, but here we have a judgement that is synthetic because it takes sensitive experience, expressed in a maxim, as its predicate. It is also a priori, since it takes freedom as its subject. The categorical imperative takes place by expelling the pathological, the object of pleasure, which replaces the well-being of the senses (Gute) with the supreme moral good (Wohl). The pathological is therefore a synonym for the presence of sensitivity, diversity, and particularity in the sphere of reasons, causes, or motives for our ethical action. Through

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the categorical imperative it is not only possible, but necessary, to desire law. The association between the superego and the categorical imperative is a constant in Freud. The superego is used to illustrate the functioning of the censorship in dreams (Freud, 1900, p. 567), reappears as having its origin in the taboo of incest (Id., 1913b, p. 31) and clearly explains the origin of authority. As Freud wrote (1923a, p. 49): “Just as the child is compelled to obey its parents, in the same way, the ego submits to the categorical imperative of the superego”. Despite appearances, Freud’s superego derogates almost all of these characteristics. It has an empirical genesis based on identification (the Oedipus complex), an anthropological justification (Totem and Taboo), is expressed in perceptive levels such as the voice and the gaze, is not outside pleasure and satisfaction, and a pathological object as its basis. The Freudian subject does not obey the law because of a desire for law, but out of love for the images that sustain him and lead him to be loved through the ideals that these same images provide. Through the superego the subject becomes a pathological object for the Other. This notion has spread through Freudian theory by typifying the effects of the action of the superego in the form of erogenous masochism, female masochism, and moral masochism. In addition, the purest expression of the superego is not only the self-observing consciousness, but the voice. A voice without words and without statements is, at one and the same time, the negative basis and the place of negativity in the heart of ethics (Agamben, 2006, p. 58). This form of voice is one of Freud’s arguments for refuting the universality of the spatial-temporal form of sensitivity (Freud, 1920, pp. 23–27). For Kant this would indicate the presence of the pathological. But the final argument against identification between superego and categorical imperative is the clinical argument, according to which the more the subject complies with the intransitive moral demand, the more does his superego demand. It oppresses and brings about guilt feelings, and not a sublime appeasement of consciousness, as Kant would have it. This does not mean that Kant is right, but only that Freud did not use the notion correctly. Freud may be much more helpful for understanding how enunciative strength of the categorical imperative, read from an anthropological point of view, is at the service of voluntary servitude and of the subject’s strategies

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of alienation. … or worse (Lacan, 1971a) in the name of a universal and categorical principle applied to and directly overlapping the empirical circumstances (Fingermann & Dias, 2005). When Eichmann was confronted with the accusations of his Nazi practices at his trial in Jerusalem, his response was consistent and crystalline: “I am a Kantian and I followed the categorical imperative that is necessary for a universal State (Arendt, 1989). We could imagine that Antigone, when faced with Creon’s decree, might also appeal to the categorical imperative. In this case, she would be seen as a proto-fascist character thus, derogating Lacan’s analysis of the act of pure desire. Like a Stalinist hero who abolished himself to prove the universal laws of history, Antigone, in the unconditionally of her act, would find not desire, but the law. It has been shown how the extension of the categorical imperative, in its equivalence with aesthetic judgements and its corruption into an anthropological equivalent, explains the formation of communities of taste and a type of aesthetic religion based on the breakdown of the universality of the subject (Lebrun, 1993, pp. 511–527). Nietszche (1991, pp. 63–73) also noted that the formalism in the categorical imperative makes it a principle of cruelty, end and consecration of Christian ascesis. To sum up, things are bad with Kant and worse without him. In Lacan the relationship is a little different. There is not only displacement and reconfiguration of themes, concepts, and categories, but open debate with Kantian philosophy. There is a systematic self-critique that might be declared with and against Kant where a number of propositions must be worked on: a. re-create transcendental aesthetics (topology). Transcendental aesthetics is part of Critique of Pure Reason, where Kant discusses the conditions for possible existence of knowledge based on the senses (time and space). For Lacan it should be re-written, since the notion of space that Kant considered universal is that which is derived from Newton. But the so-called non-Euclidian geometries, as well as the various topologies, show that space can be conceived of in other ways. A homologous argument can be brought forth regarding time. b. revise the General Theory of Negativity, from Hegel to Kant, thus enhancing Kant’s notion of negative grandeur (object a). Negative grandeur is a way of reintroducing the problem of the reality of

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negation. Negative grandeur has two elements in simultaneous absence and presence, outside the logic of contradiction. Lacan sets out to renovate the understanding of negativity by introducing an object that is, at one and the same time, existent and not representable, and that can only be inscribed in the symbolic through negative strategies (repetition, subtraction, or deformation). c. show how the categorical imperative is completed with Sade’s naturalistic imperative (fantasy) and, d. introduce a paradoxical nucleus in the categories of unity, negation, causality, and existence (theory of desire and jouissance). But the greatest importance of Kant’s thinking for Lacan is in the strategic place that Kant occupies as a turning point in Lacan’s own work. Taking into account the extremely limited value of this type of division, we can say that there is a Kantian Lacan until 1960, and a counter-Kantian, or post-Kantian, Lacan after 1960. We will closely examine this problem according to the reading proposed by Safatle (2003, p. 189). Lacan’s seminar on ethics and its adjacent texts, from the early 1960s, can be read as a period of displaced self-criticism that marks a turning point in Lacan’s thinking. Instead of directly facing the impasses into which his theory of the constitution of objects had led him, Lacan re-discusses his own position, putting Kant in his own (Lacan’s) place and criticizing Kant from there. Everything happens as if Lacan realized that the protocols of symbolization and subjectivization that had guided his conception of treatment until then had led to a practical application of Kantianism. Some important commentators show us how this takes place through a type of transcendental doctrine of the subject (paternal metaphor) based on a transcendental aesthetics of desire (the theory of the signifier) and a transcendental logic of the Other (the law) (Santuário, 2004). Other studies (Simanke, 2002) allow us to see how this infiltration of Kant into Lacan appears both in a theory of the empirical genesis of the ego (the mirror stage) when it emerges from a combination of a structuralist anthropology (Lévi-Strauss, 1949a, 1962) with a dialectical anthropology (Kojéve, 1947). We would stress at this point that what is going on in all these cases is the use of a criticism of practical reason (therefore, ethics) as a field of trials for a theory of intersubjectivity.

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Up till this point in Lacan’s work, desire, which cannot appear through empirical objects, should be recognized in its transcendental structure, as overdetermined by the Other. Desire can thus be disconnected from the teleology of its demands. This is what Lacan called submission to the symbolic. The direction of the treatment leads to the production of pure desire through the realization that its basis on the Other is lack (castration), either through the phallus or through the Name-of-the-Father or through the law. But pure desire continues to be subordinated to the dialectic of recognition (Baas, 2001). Here a new problem comes up: in the relationship with the structure, in other words, with the Other, there is no reciprocal intersubjectivity, but rather asymmetry, as we saw in our examination of Descartes’ theses. The problem gets more complex if we conceive that the Other, defined as the place of language, is another absolute, equivalent to the transcendental categories of understanding (Verstand). One solution is to argue that, in order to maintain an untotalizable relationship with the Other we must identify with the lack in the Other, and not with the Other in itself (Stavrakakis, 1999, p. 139). But this is still a very precarious solution because this kind of negativity, which is based on the notion of the signifier of the lack in the Other, has no anthropological or immanent reference. This leaves us on the transcendental level, through which a few ideas of regulation exist, such as God, soul, and world, and they correspond to the place where the lack in the Other implies a guarantee of the subject. It would be well to note that, for Lacan, this place is occupied by death precisely to settle the problem. Death is, at one and the same time, a figure of negativity and of universal condition. It has an ontological and anthropological dimension. But when one takes death as a determinant of the possibility of taking pleasure from the law, many different clinical impasses come up. How can one distinguish the fulfilment of this negativity of desire without mistaking it for the desire for castration that moves hysteria? How is one to separate this experience, also called the second death, the real-ization of a masochistic fantasy? Finally, how is one to introduce a discontinuity between pure desire and the moral law, which arises from the superego, since, at the end of analysis, such a lack of distinction could lead the subject to make itself the pure executor of the law, as Sade suggested?

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The issue here is the status of the place of the (universal or particular) Other and the status of the (necessary or contingent) position of the subject in the fantasy. Kant’s theory fails to recognize that the form of an act does not guarantee its meaning. In other words, it is possible to practice perversion while strictly obeying the law at the same time. If the superego, as formulated by Freud, is defined by observation, judgement, and punishment, it can make use of the same processes to function as a machine that automatically converts narcissism into masochism. In other words, it does not act only as a restriction of jouissance by activating the negation of the drives that are incompatible with the ego. It also impels towards jouissance, transforming the ego into an object of the satisfaction of the superego, reintroducing jouissance at the very core of law. The transcendence of Kant’s categorical imperative, according to which there is pure duty (sollen) that provides the foundation for moral action, enters into conflict with the immanence of the object that may be involved in this duty. In the last resort, there is a pathological level in Kant’s morals, which is transferred to psychoanalysis through the figure of the superego. The situation becomes dramatic when we realize how this duty (sollen) operates in the very categorical imperative that commands analytic treatment: Wo Es war, soll Ich werden. As long as this duty (sollen) was in pleasant and austere resonance with Kant’s morals, things went very well. Psychoanalysis was one more mechanism in the modern project of clarification (Aufklärung) at the service of the construction of a superego at one and the same time critical and benevolent. But when one realizes how the categorical imperative has its face of terror and oppression, we see ourselves as authentic representatives of the superegoic strategies of conversion, purification (pure desire?), ascesis, and confession that Foucault so correctly criticized in his archaeology of psychoanalysis. “That the subject may arise” (soll Ich werden) can become the superegoic maxim of clinical application that, in the universality of his theory, Freud justifies oppression of the subject. This led Lacan to his double intention to: show the constitutive lack of the Other, and conjecture that an act can go beyond alienation to the object that sutures this lack: the traversing of the fantasy. This means radicalizing the presence of the pathological in the heart of analytic practice and implies inventing a new form of perversion.

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This position is characterized by a disparity between the object located in the Other and the object located in the fantasy. This object, then, is conceived as being irreducibly opaque to symbolization. To recognize that moral action always involves some interest in jouissance is insufficient to reconfigure the clinical project of psychoanalysis. In fact, this is an outcome of the questioning that characterized the first stage of Lacanian ethics, which was basically: “Did you act in accord with your desire?” If the subject can answer the question affirmatively, this shows only that he knows something about his fantasy. At the same time, however, he stays anchored to this position. He continues to act in accord with a heteronomy. In a certain sense, the Other is still in the Other’s place. But a negative answer is not a good solution either, because it makes evident only the common neurotic state based on guilt, transgression, and the sovereignty of the Other. The alternative is to find an act that not only makes an ethical position and the recognition of the place of ethics emerge. In addition, however, it is what constitutes the very space of ethics in its radical impossibility of being totalized. This has a number of implications for the fields of erotica, aesthetics, and politics in psychoanalysis. In this case, the notion of act becomes a central category. But to argue that there is a real basis for ethics brings up a problem as to what implication this will have for an ontology. Here formalization and mathematization tend to give importance to the notion of discourse. The problem can be summarized in the fact that ethics has always been the field of duty and of what is possible, in view of the concept of freedom. When one wants to establish a field of duty in the sphere of being, what is usually attained is a metaphysics with clear ideological implications. This is the easiest way to move from contingency to necessity, from the way things could be to the way they must be. The modern solution, with the rare exceptions of the positions of Spinoza and Sartre (Chauí, 1981, pp. 10–98), has been to get around the problem of ethics through an anthropology or a theory of the conventionality of meaning. Lacan’s idea of an ethic of the real must therefore be clarified. In this respect Zupancˇicˇ (2000, p. 235) wrote that: The heart of all ethics is something that “is not ethical” in itself (nor is it “non-ethical”)—in other words, it has nothing to do with the register of ethics. This “something” goes by various

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names—although here we limit ourselves to two: for Lacan it is “the Real” and for Badiou, it is “the event”.

However, the objective of our foray is not to map out the points of contact between psychoanalysis and Kant’s theory. We are more interested in the value that Kant’s problematic has for the historical constitution of the psychoanalytic clinic. We saw that Kantian transcendental idealism is strongly based on a notion of interest to this question: the pathological. We also saw how Kant establishes practical reason by avoiding the pathological. The pathological is not simply the empirical, but the extrapolation of the limits of the empirical, and it also has an equivalent in the area of understanding. Intuition without concepts is blind, understanding without intuition is empty. Kant’s task as a clinician of reason was to try to set down the limits within which this synthetic relationship is established a priori. This is done through the three great questions he set out to answer: What can I know? What should I do? And what am I allowed to expect? In other words, it is a matter of the conditions necessary for all possible knowledge, ethical (including aesthetic) action, or judgement. Historically, two strategies of knowledge have tried to give a destination to this obstacle, to think change, applying Kantian philosophy. The first strategy is inspired on anthropology, in fact, more precisely on ethnology. It seeks to re-encounter Kant’s universal in a culturalistic way by recognizing the great diversity of symbolic and intersubjective human expression and by presupposing a homology by which all such expression refers to the same formal problems. The second strategy is psychological in nature and seeks to establish the Kantian universal in the form of cognitive structures that are constant and regular as a function of their common origin, or even as a function of some innate basis. Both strategies duplicate Kant in order to encounter the positive version of human pathology. In this way, the elementary conditions for a new way of apprehending the pathological and instituting space for a criticism of clinical reason are set down. We find support for this idea once again in Foucault (1960). He argues that Kant’s Anthropology from the Pragmatic Point of View (2006), a compilation of the twenty years of classes given by Kant on the subject, and usually considered a minor work, corresponds

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to a type of fourth criticism and, therefore, of a fourth fundamental question, namely, “What is man?” We will see that Foucault’s reading of this text allows one to understand the birth of the humanities, on the one hand, and of the medical clinic, on the other, according to a strategy of turning Kant’s criticism into a positive force. There is also space in this text for the existence of a negative relationship between criticism and the specific ways of dealing with the pathological. This might be the door to the clinical space explored by both psychoanalysis and phenomenology. It has been shown that Rousseau (Starobinnski, 1991), the Scottish moralists (Macintire, 1991), and even Hegel (Honneth, 2003) can also be read as theoreticians of negative anthropology. Kant’s Anthropology examines the concrete ways of observing oneself. Its starting point is a topic that was common to the political philosophy of the late eighteenth century, namely, how can it be justified that one individual may possess another. A number of anomalous circumstances of the notion of ownership might be pertinent here such as a man who acquires, or takes, a wife; a couple who have children; a family that takes on domestic help; or a company that buys slaves. There is a certain legal vacuum in all of these cases. If the legal field deals with the enjoyment of property and with its use and abuse, it is subverted by these special cases. The relationship of domination in these cases is not based on ownership or sovereignty. The vacuum was noticed by the libertines, especially Sade (1988), and this gave rise to the complementary categorical imperative: “I have the right to get pleasure from, to enjoy, your body. You can mention anyone and I will exercise this right with nothing to hold me back from finding pleasure in the exertions that give me pleasure to satiate”. In thesis, the expression “You can mention anyone” indicates universality. Judgement is of the categorical type and also expresses an imperative that connects moral action to freedom in the form of a synthetic and a priori judgement. To sum up, and as others have already pointed out (Adorno & Horkheimer, 1944/1895, pp. 81–113), Kant should be read with Sade (Lacan, 1963b, pp. 776–842). Also in Sade we saw this clinical furore of exhaustively describing and classifying the possible forms, cases, and ways of applying this law. In this vacuum between right and morals arises the problem of the symmetry between a person-to-person relationship and a person-to-thing

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relationship. For example, Kant argues that a man has the right to be jealous of his wife, and not being jealous would indicate that she has been reduced to interchangeable merchandise. A man’s right to be jealous is a sign of his recognition of the wife’s freedom. The first demand of the wife’s freedom is to escape from the jealousy, thus proving that she is more than a thing. On the other side of the coin the wife will thus have the right to flirt, which is an intermediate point between civil law, which made the woman her husband’s property, and the moral law, which recognizes every person as a subject of freedom (Foucault, op. cit., p. 14). This type of analysis comes quite close to a number of Lacan’s positions as to the dialectic of the transference and of intersubjective recognition. These positions represent a radical break with the efforts of the anthropological current in medicine until the early nineteenth century, to adjust an illness or disorder to some form of the metaphysics of evil. The key category of Kant’s analysis is not evil, but freedom. The connection between ethical virtue and health becomes arbitrary. Inversely, the forms of the pathological had to be re-described as a function of their specific mode of privation of freedom. As seen in the brief discussion on Kant’s life at the beginning of this chapter, there is a certain degree of co-participation by both philosophy and medicine in the construction of the everyday art of being healthy. This is possible only because philosophical precepts and medical prescriptions complement one another. Medicine presents a negative universal by eliminating disease. Philosophy, on the other hand, consists of a positive universal that defines the rules for staying healthy. This explains the growing importance of self-conservation, egoism, and self-love in authors of that period. Inversely, medicine’s main problem is how to define the rules for accelerating and inhibiting movement. The paradigmatic symptom for this conception of disease is the spasm, which brings acceleration and inhibition together into a single happening. There are two clinical situations that show this discursive complex comprising philosophical medicine within the limits of reason: hypochondria and melancholia, and each of them represents a paradox for the general law of self-conservation. Hypochondria reflects excess and exorbitance in this new way of caring for oneself, whereas melancholia illustrates the lack, or absence, of the principle of self-conservation.

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But the theory of the spasm seems to positivize the two aspects of Kant’s philosophy of the subject, namely: receptivity, present under the condition of the possibility of having sensitive intuition (time and space), and spontaneity, present under the conditions of the possibility of forming intelligible concepts (mode, relationship, quantity, and quality). The spontaneous and passive syntheses of the body can thus be resumed by voluntary acts of the spirit (Foucault, op. cit., p. 16). The positive and negative migration of the categories found in Kant’s three criticisms provides a first theory of the three mental faculties: the faculty of understanding (Verstand), feelings of pleasure and displeasure (Wohl), and appetite, or desire (Pathologich). Here the conceptual matrix emerges that makes psychiatry and psychology possible as sciences of the workings of the mental faculties, such as memory, attention, perception, thought, and so forth. These faculties anticipate, organize, and condition the psychopathological descriptions of the classical clinic. Here there is place for neither a rational nor an empirical psychology. There is a place for a theory of the constitution of the subject. But the object of anthropology is not the soul (Seele) nor even the spirit (Geist), but Gemut (a noun in German that encompasses notions such as heart, mind, and even temper). In other words, the object of Kant’s Anthropology is not what is or what should be, but what one does with oneself between what one is and what one should be. This corresponds to Rousseau’s notion of perfectibility, which, in turn, corresponds to the idea of excellence (arete) of the ancient Greeks. We can now rename the theme of the relationship between people and things as the expression of a radical difference between power (können) and duty (sollen). Anthropology is possible only because people do not behave—at least not always—according to the categorical imperative. In anthropology we find the study of the failure of the categorical imperative, not of its success. Anthropology, then, is primarily the study of non-being, of disparity, and of the incongruence of oneself to oneself and of oneself to the other. This is the negative nature of the regime of truth that corresponds to an anthropological approach. But since this anthropology refers mainly to a way of speaking about men and women, describing their impasses, and portraying their limitations, it might be more exact to speak of ethnology, or ethnography.

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The subject is an a priori from the perspective of the possibility of knowledge, but it is an object from the point of view of existence. What, in this object, represents the subject takes place through a negative function: “not me, not yet pure me, too much me”. The passivity we found in the categories of sensitivity is never really passive when one is dealing with anthropology. This originariness does not mean what came first chronologically, but an effect of the synthesis of the subject that declares, a posteriori, that it was already there (Foucault, op. cit., p. 24). There are many German terms in the area of criticism that are preceded by the suffix -Ur, which indicates the original as foundational, but in anthropology there are more terms preceded by the suffix -ver. This -ver indicates negation or intensification and it is exactly the kind of experience that was described by the stoics, the cynics, and the sceptics when discussing care of oneself. It is also what we find in the notion of return, as used by Empedocles. It is a return to what has not yet gone. In this case, the truth is simultaneous with the experience of the loss of truth. Another important development of anthropology is the separation between phenomenon (Erscheinung) and appearance (Schein). A phenomenon is an object of knowledge whereas appearance is the environment of intersubjectivity. Specifically, it is the intent to transform what belongs to the order of appearance into a phenomenon, and this intent is carried out by the emergence of a characterology, or by a physiognomy, sciences based on the inference of interior traits based on outside appearances. Only in this case can empirical psychology be classified in anthropology (Foucault, op. cit., p. 27). Before Kant, anthropology took as its reference not the logic of appearance, but the world and the ways by which a subject is affected in the movement whereby it becomes an object for itself. In other words, anthropology studies the generic and more or less regular figures of alienation. Here we are a long way from caring for oneself as an activity of occupation and attention; we are still immersed in the impasses of the knowledge of oneself as a pathological vocation of being. The world as totality is beyond any predication and constitutes a concrete system of inclusion. Contrary to the universe, which is everything possible, the world is everything that exists and a system of the necessary. We find here a new figure for the Other. If, in Descartes, the Other was equivalent to the logical properties of God (infinitude, perfection, thought), in Kant the Other

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is equivalent to the world, since Kant includes human beings in it. There are three fundamental concepts for understanding this experience of the loss of self: the source (Quellen), the domain (Umfang) and the boundaries, or borders (Grenze). The source indicates the alienation to knowledge, since, to a certain extent, everything that is given to me is already stipulated by the anteriority of the Other. Domination refers to the alienation by power that regulates my freedom and conditions its exercise to a pre-installed authority. The boundary, in turn, refers to the helplessness of this situation in which one cannot appeal to the transcendental use of the idea. As Foucault (Foucault, op. cit., p. 33) put it: The issue of anthropology has no independent contents; it explicitly repeats the first three questions (to know, to do, to wait), but repeats by displacing the tripartition more or less lent to the distinction of the faculties.

This repetition also implies a change in vocabulary. Whereas criticism must build up a well-defined set of terms, which might be called “conceptography” (Begriefschrift), as Frege called it, without error or ambiguity, anthropology implies the use of ordinary life, everyday speech, discourse of reporting, examples and advices from common sense. Its domain and context are the field of culture (Kunst) where there is freedom as the exercise of arbitrariness and negation (Foucault, op. cit., p. 36). This knowledge about people’s likes and dislikes, their concepts and their inclinations, is always open to new examples and narratives. In other words, we find in Kantian anthropology a form of description, classification, and analysis based entirely on the specific cultural use of language. Its true ground is much closer to linguistics than to psychology or anthropology, as we understand these terms today (Foucault, op. cit., p. 41). This has suggestive consequences when one considers that it is part of Kant’s article Anthropology from the Pragmatic Point of View, a series of short essays on mental diseases and disorders. It consists, on the one hand, of more or less consolidated categories in the medicine of the times, such as amentia, dementia, derangement, and insanity and, on the other, everyday descriptions such as simpleton, stoop, dope, and dandy (Kant, 1798, pp. 102–114). These are words from the common language that make up the substance of

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the matter examined. We also find this type of term in Freud. For example, hysterical conversion takes place on the basis of the everyday representation of certain parts of the body. Dreams have a decipherable meaning, as they do according to common understanding, and there even exists a psychopathology of everyday life. The importance Lacan gives to the signifier, as it is effectively uttered by the patient, goes in the same direction. As Lacan’s work evolves we can see his concern in building up a psychopathology based on the logic of appearances. The greater importance given to, notions such as veil (with which Lacan defines perversion), semblant (by which he reads jouissance), and masked (by which he defines hysteria) are indications of this effort. In Kant’s anthropology all this involves a clarification of language in its relationship to the intense meaning of the term experience (Erfahrung). This German word comes from fahren, “to travel”, “to wander” or “to take a trip”. Ambiguously, it refers to both the process and its results in an oscillation similar to what one finds in the terms to cure and to heal. How can I tell others about a trip I took? I can tell them about my experiences (Erlebnis), the intense moments, and the unexpected impressions. I can present logs or diaries or call in witnesses, but the mere description of my having gone somewhere and how I occupied my time do not make my trip a true experience. The important thing is to know whether there was experience, to know how the trip changed me, how I am different after it from what I was before, in other words, how I see myself from outside, based on where I am not, as the prefix “ex” suggests, for example, in the word “ex-perience”. Through this process, we resignify our own lifestyle. But there were also places where I wandered about, where I experienced uncertainty, proof, and attempts to do things, according to the root “peri”, as in the word “experience”. From this perspective, experience is neither empirical nor a phenomenon. It is not immediate information from consciousness, or the controlled presentation of objects (as in scientific experiments). Experience is always a process in the subject that involves the construction of an object, the constitution of a subject, and the formulation of a story. In this regard, Lacan compares psychoanalysis to mystical ascesis, to compliance with the rules of the moralists, to initiatory discoveries, and an artist’s relationship with a work he or she has produced. In Beyond the Pleasure Principle the conditions are put down as to what “can be

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called analytic experience”, that is, the law of no omissions, the law of no systematization, and the law of free association (Lacan, 1936, p. 85). As indicated above, the reduced model of this type of analysis of the word in Kant is called Tischgesellschaft, the “society of the banqueters”. There is a subtle continuity in a conversation around a table, so that the participants’ freedom to formulate their opinions and comments, to insist or to change the subject, is not seen by the others as imposition or coercion. This notion arose in the sixteenth century (Elias, 1994, pp. 95–109) as minor ethics, in other words, of etiquette, as a way to regulate human sociability. Here again we see the importance of the ethics of friendship, so highly valued in the sphere of caring for oneself. People are citizens of the world not because they use their powers of reasoning correctly or because of the categorical imperative, but simply because they speak. Their scope, therefore, is neither mastery over the universal nor over the singular. Their scope is the private sphere. What are repeated are regularities, plays on words, as well as intersubjective relations, strategies of pleasure and displeasure, paradigmatic examples, and cases. Anthropology is located between the metaphysical privilege attributed to the study of the soul and medicine’s technical mastery over the organism. Anthropology lies between the study of the fundamentals of culture (Kultur) and of civilization (Zivilisation), between public and private space. When psychoanalysts insist on the importance of distinguishing between the organic of the body and the psychic of the soul, they are attempting to demarcate the boundaries of their origin in Kantian anthropology (Granze). This anthropological demarcation should not be confused with one’s holding to a Cartesian type of ontology delimited by the relationship of extensive substance (body) to thinking substance (cogito). Anthropological demarcation depends on how one speaks, describes, or refers to the body or the soul. It does not presumably establish the level of existence of something beyond the practice where this something is socially inserted. And when psychiatrists place themselves between the legal order and neurophysiological processes, they occupy this space in a different way. Finally, when scholars in the humanities enter into this space with anti-nomies between liberty and determination—demarcating their specific triangle comprises of life (function and norm), language

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(meaning and system), and work (conflict and rule)—a different strategy of occupation is at issue (Foucault, 1966). Kant’s book Anthropology occupies a very strange place in his writings, related to one of the most decisive encounters of his philosophical formation. In 1766 he published a pamphlet entitled Dreams of a Visionary Explained by Dreams of Metaphysics, which resulted from his reading the book Arcana Coelestia (Heavenly Secrets), by the Swedish mystic, poet, and inventor Emanuel Swedenborg (1688–1772). This book describes Swedenborg’s spiritual experiences, his visions of heaven and hell, his gift of being able to speak with angels and spirits, his direct and personal encounter with the Lord, telepathy, the influence of other worlds on ours, the curiosity of the spirits about the souls of men, and other related topics. Until then, Kant had written about simple topics of natural history (such as the ageing of the earth, the theory of the winds, the Lisbon earthquake, and the nature of fire), logic (the theory of the syllogism and negative grandeurs) and, especially, metaphysics (the demonstration of the existence of God). His contact with Swedenborg was very disturbing and frightening for him and made him wonder how the development of metaphysics could lead to the same point as a hallucinated revelation. What separates metaphysics from well-organized madness? If Hume woke Kant up from his dogmatic sleep, it was Swedenborg who woke him from his metaphysical nightmare. From then on he had to establish the conditions and limits of the exercise of reason, beyond which it would be nothing more than false reason or insane reason. Metaphysics also had to be re-founded and the possibility of a deceiving God had to be eliminated once again. Two years went by between the pamphlet on the Swedish visionary and An Essay on the Maladies of the Head (Kant, 1764)1 a title that is faithful to the explicative method in anthropology. David-Ménard (1996, p. 98) clearly shows how the topics arising from Kant’s encounter with madness, consequence of his reading of Swedenborg, are broken down in Kantian philosophy. These topics include critical philosophy as a science of the limits of reason, the separation between the sensitive and the supra-sensitive, the new conception

1

The title in German uses the word Kopf, which actually means “head”, and not mind, or spirit. This title thus follows the explicative method of anthropology.

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of modalities, the theory of negativity, and the re-application of the sceptical method. The theory of modalities plays a decisive role in the great reduction and quaternary logical organization that Kant made of Aristotle’s categories and Kant’s duplication of them through the theory of judgements, (Caygill, 2000, p. 53). As can be seen, negation appears twice on this chart, first as an a priori category of understanding (ontological negation) and then as a form of judgement (propositional negation). In this transition Kant presents the concept that, what is not-impossible is not necessarily possible. Here we again see Lacan’s important theme of the disparity between the universal and the existential. Non-universality does not necessarily imply the negation of existence, and non-existence does not necessarily imply the negation of universality. According to Kant’s theory, the two first categories or judgements find their synthesis in the third category or judgement. For example, the unity of plurality gives us totality, the particularity of universality gives us singularity, and so forth. Consequently, there are two forms of negation: real conflict and dialectical conflict. Real conflict holds to the logic of existence and appearance, whereas dialectical conflict holds to the domain of the universal and of judgements. The disparity between these two forms of the negative must be reduced to a minimum in the activity of knowledge or in correct moral action, but disparity shows up in the experience studied by anthropology and diversity defines the field of the pathological (David-Ménard, op. cit., pp. 223–239). If negation is the element that affects the transfer from real conflict to contradiction, there will always be a certain unsuitability between the object and the objective, which is what we find dispersed in Anthropology (David-Ménard, op. cit., p. 266). This unsuitability, in its different forms of the failure of alienation, is considered pathological, and the fact that these forms cannot be integrated lays the groundwork for implementing the clinic. Up until now we have been suggesting that there is a constitutive connection between the space set up by Kant’s anthropology, on the one hand, and psychoanalytic clinical work, on the other. There is a thematic similarity, a negative duplication, with the function of criticism. The importance of language and experience is therefore clear, as well as the threshold between power and duty. But, the most distinctive trait of this similarity is in the

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type of relationship that exists between the knowledge obtained from the clinic, which is, above all, descriptive knowledge, and the psychoanalyst’s aspiration, which is to act on the pathological in some way, and transform it. Therefore, the pathological should be placed in the broad space of pathos (cure and healing), as the suffering should be placed in the smaller field of therapy and the symptom should be located at the even smaller field of clinic. Our foray through Kant has led us to define the field of pathology as broader then the field of medicine. A number of aspects, derived from the discrepancy between what one is and what one should be, configure not only what is political, but what is ethical and social as well. These aspects include social suffering, ethical suffering related to the symbolic relationship with the law, the anxiety of determination, and the anxiety of indeterminacy. This field, defined as the field of pathology, includes specifications or strategies of location and positive positioning of what is pathological. One of these strategies is the clinic, in the sense that emerged during the eighteenth century. This sense includes clinical practices that have come down to us since the Ancient World (diagnosis, therapy, prognosis, and epidemiology). However, it was only after Kant that such practices could be organized as a type of structured treatment of the pathological. From then on, clinical work can be presented as a method dissociated from and independent of the much broader field of pathology. We find in Lacan (1963a, p. 6) as well a relationship of completion between the historical birth of the clinic and the experience of treatment, as he stated in the following words: Because it is impossible to conceive of either experience as such or of how the structure of the modern neurotic, which, even though you may not know it, is coextensive with the subject of the clinic, to the extent that its clinical and therapeutic status is given by psychoanalysis. Psychoanalytic praxis is literally the complement of the symptom. … And it is by apprehending a certain way of questioning neurotic suffering that the symptomatology is completed in the treatment.

It should be noted how this quotation contains a relationship of alternation between experience and structure, and how this

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alternation is repeated between the clinical and the therapeutic statuses. This is in line with the idea that there is a co-extension between the clinic and the completion of the symptom in praxis. The symptom, as it is established in this experience known as the clinic, is an incomplete symptom, both by its particularity and by its intersubjective nature. This is fundamental for unbalancing the reification of the symptom in a universally aspired descriptive order. It is “commonplace” knowledge, distinct from knowledge and reason, which are dependent on a narrative and on the practices of caring for oneself. To quote Lacan (1975b, p. 554) once again: [T]he question begins with the position that there are types of symptom. There is a clinic. But, please note, it is prior to analytic discourse and, if this discourse brings it some light, this is secure, but it is not certain.

This statement can be read in two ways. It is in line with the idea that the symptoms with which psychoanalysis is concerned were somehow described by the clinical, medical, or psychiatric tradition that preceded it. But it also implies a relationship of anteriority between the experience of the clinic and the discourse of psychoanalysis. One of the objectives of this examination of the formation of the space of the pathological is to show that the clinic should not be understood exclusively a science method, but also as method of experience. The condition of the experience is not reality, nor is it merely the ethical distance between being and duty, nor even the separation between duty and power. It is the conflict, disparity, and contradiction that characterize the occupation of this space of pathological, which has a political ontology, with positive or negative politics.

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CHAPTER TEN

The rebirth of the clinic as structure and as experience

Certainly I am not favourable to abandoning innocuous methods of treatment. For many cases they are sufficient and, when all is said and done, human society has no more use for furor sanandi than for any other fanaticism. —Freud

The birth of the eighteenth-century medical clinic The formation of the modern clinic in the late eighteenth and early nineteenth centuries consisted of a composite of very heterogeneous practices, discourses, and mechanisms. In fact, it did not develop around a common object, specifically, the body and its diseases, but on the basis of demands whose roots of social legitimization derive from legal, moral, and religious systems, on the one hand, and, on the other, empirical, institutional, and theoretical aspects of medical knowledge. In essence, the modern clinical method results from the

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encounter of three very traditional figures: the surgeon (practitioner, witch doctor, psychic healer, itinerant barber-surgeon of the lower classes), the physician (researcher in anatomy, theoretician of the workings of the body, medical doctor for upper-class families) and the professor (philosopher, anthropologist, and anatomist of the soul). Surgeons base their practice on the effectiveness of their interventions, while physicians base their diagnoses on descriptions of organic facts. Surgeons base their experience on a certain number of different cases, while physicians look for experiments that can be replicated in an infinity of similar situations. The modern clinic arose when the system reduced this diversity to a single and sovereign policy, bio-politics. This meant that methodical experimenting began prevailing over the value of broad and diverse experience. Under this new system, experience became a part of experimenting, the part related to the controlled observation and description of phenomena. In the other hand the medical professor was a key figure to integrate this practice to a social medical care politics. Medicine, since its new beginning is social medicine, and the care of populations (epidemiology) was its main problem. Modern clinical practice also arose from the merger of two physical spaces, the hospital and the university. The division between specialists in methods of treatment, on the one hand, and intellectuals interested in methods of investigation, on the other, clearly makes evident the double origin of the modern clinic. As we saw above, semiological, diagnostic, and prognostic practices have been in existence since the time of Hippocrates in Ancient Greece. In contrast, the theoretical question of aethiology, transmission and evolution of diseases was renewed at the dawn of modernity. In the eighteenth century a type of synchronization arose that brought different components of the clinic together into a structure. The objective of the present chapter is to describe this structure, which will be termed the classical clinic. The term classical clinic is used here in the same sense that Foucault used the expression classical period, to designate the establishment, since the seventeenth century, of insanity, or madness, as an object of discourse. Milner (1996) used the same meaning when he referred to Lacanian classicism with respect to the aspirations of universality, formalization, and appeal to science in the first Lacan.

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Clinical practice in modernity, also includes all those medical practices based on the weight of the body and its secretions as well as on the different astrological systems combined with practices of healing in modernity and acts of healing practiced by absolutist kings. Treatment based on bleedings and purgations, and even, to a certain extent, Newtonian concepts, such as gravity and magnetism, in association with ancient theories of the elements, characterize modern medicine. To avoid this difficulty, I intend here to reserve the expression classical clinic to designate the formation, in modernity, of the structure of (modern) clinical practice as we know it still today. As we saw above, three groups were involved in the historical evolution of medicine today, namely, specialists in methods of treatment, and intellectuals interested in methods of investigation. The merger of these three lines took place concurrently with other changes in the status of medicine as a whole and the engagement of professors in political implications of diseases. Above all else, the birth of the classical clinic was a milestone in the history of social medicine (Foucault, 1974, pp. 179–198). It represented an enormous state-controlled undertaking that started in early eighteenth-century Prussia and gradually spread to the rest of Europe. It included birth control policies, vital statistics, epidemics and endemics, and an unprecedented system of normalization of medical practice that included even companies and universities. This system of normalizing the work of physicians mirrored the successful model of organizing a professional army, where Prussia was also a pioneer. The project was also applied to the relationships between doctors and their patients, so we can see the emergence of employed physicians, a trend that implied the subsequent administrative control of the profession, through the work of a medical police for mapping and controlling areas related to the movement of persons and their belongings. The metaphor of movement, or of traffic, extended to the planning and distribution of hospital resources, as well of the water and the air. In other words, it was not yet medicine for persons and bodies, but rather a question of environmental resources and health. This circumstance meant that it was first exercised on the poor, whose condition was intrinsically associated with unhealthy environments, poor hygiene, and high population density. In short, social medicine was an enterprise of engineering for the population.

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This programme was responsible for the increasing numbers of patients in hospitals, and their presence demanded new strategies of power for administering and controlling them. Dealing with an epidemic was the work of police-doctors, treating mental patients was a medical and legal matter, and the treating of women and of children was seen as a medical-moral situation. This new form of power was based on the authority transferred by the State for dominating the body and individualizing subjects. A new form of power, known as “biopower”, has now replaced sovereign power as the hegemonic form today. The relationship between these two forms of power is analogous to the relationship between the cures practiced by the absolutist kings and the treatment afforded by the more recent social medicine. Medicine ceased to be merely a corpus of techniques and types of knowledge needed for curing or healing, and now determined that the ideal man was the healthy man (Id., 1963, p. 39). The clinic, on the contrary, was interested only in the deviant and in the phenomenalization of appearances that constitute the field of the pathological. As Canguilhem (1990, p. 188) showed we can confront an ontological conception of the pathological, taken as a qualified opposite to health, with a positivist conception derived from the pathological in a quantitatively normal state. If disease is seen as an evil, successful treatment implies recovery. During the period when Kant was writing about Swedenborg’s delusions, the social representation of medicine involved a number of techniques for improving life and conserving health, many of which were seen as competing with one another. The point of theoretical unification was still the synthesis of Hippocratic medicine taught by Galen (130–220) in the second century. This model of pathology was based on three types of disease: of specific organs, of tissues, and of humours. One of the most curious aspects of this conception was related to the functioning of the heart. Galen’s conception posited that the blood flowed through invisible pores from the right ventricle to the left, where it was filled with pneuma and heat. The pores comprised the rete mirabile, which Galen claimed to have discovered in his dissections, but this structure was never again seen in a human body. All indications are that Galen had dissected only pigs, where such a cardiac structure can be found. The most surprising fact is that, ever since Vesalius (1515–1558) and Harvey (1578–1657), it had

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been known both theoretically and empirically that Galen’s theory of circulation was incorrect and that a better conception was available (Lima, 2003). Even so, this factual knowledge failed to affect the logic of therapeutic action and the diagnostic reasoning behind it. In 1764, for example, Meckel was still studying the changes in the encephalon both in mania and tuberculosis by the rational method of weighing equal volumes of the encephalic mass of his patients. The main instrument used for treating patients and carrying out medical research was the scale, rather than the stethoscope (Foucault, op. cit.: XI). This is understandable when we recall that these practices were based on a theory of the elements and of the material differences between the elements in producing disease. The idea of proportion had a concrete denotation in the mass and tissues of the body. The social prestige and actual effectiveness of curing and healing diseases by barber-surgeons was therefore not that different from what was achieved by scholars in universities. This was the beginning of a process related to the ancient idea of clinic, which was never included in the practice and “conceptography” of the medicine inspired by Galen since the second century C.E. In contrast to Islamic medicine, conventional Western medicine was dedicated to the wealthy classes, and was clearly dependent on the rhetorical discourse of philosophy. A decisive change in the structure of knowledge brought about a new mentality in the mid-eighteenth century whereby the first question asked of a patient was no longer “What do you have?” but “Where does it hurt?” (Foucault, op. cit.: XVIII). Ancient medicine had assimilated into its healing process the knowledge that the subject himself had about his own disorder but, since the seventeenth century, this knowledge was gradually replaced by a relationship with an individual who described, but did not conjecture or suppose anything about the ailment. With the passage from the clinic of the ancient world to the classical clinic that took place during the eighteenth century, the agonistic and rhetorical relationship between types of knowledge ceased to exist. The gaze occupied a central position in this new apparatus (Foucault, 1963, p. 121). It was a purified gaze, regulated and administered by several different operations in which it was only a mirror endowed with memory.

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According to Wyngarden and Smith (1985, p. 16): The instrument for measuring was personal and unique. Subjective evaluation reduced precision. Who can quantify nausea or the severity of pain? Symptoms can be forgotten, suppressed or amplified when filtered through the screen of the personality.

In the above quote, extracted from a well-known reference book on clinical practice in medicine, we see how the patient’s personality and the clinician’s subjectivity appear as wellsprings of inaccuracy. The personality is seen as a screen, a filter, which bypasses and relativizes, and makes any pure limits or translucent access to what is really of interest more difficult. The mere idea that a physician has a personality is the effect of his social individualization. Evaluation, as an act that includes signs, symptoms, and descriptions provided by the patient, is purely subjective, because the clinician should interpret and ponder over the patient’s various statements in a way that can be reduced to a single entity. Even today, clinical assessment is the first step in any consultation with a medical doctor. The process starts off with a generic script designed to elicit observations (examination of systems) and note changes seen (by observation) or described (in anamnesis). There is, then, a type of perpetual oscillation between the gaze that observes and the gaze that judges. This is the link between the historical affinity of clinical practice and visually comparative descriptions, since lack of or delay in clinical judgement is always related to an incomplete description. As Foucault (1973–1974, p. 232) wrote in this context: The clinic is a presentation of the patient in a performance where the interrogation of the patient serves as instruction for students and where the physician acts on two levels, examining the patient and teaching the students. The physician is thus, at one and the same time, the one who cares for the patient and the one who utters the words of the master.

Clinical practice implies bending over at the patient’s bedside and interpreting the important signs in his body. In other words, a certain gaze must be applied to this body and, from the gaze, a complex set of operations are derived.

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Long before this methodological form was established, the term cline, which is the origin of the word clinic, had attained philosophical dignity in the writings of Lucretius (98–55 BCE). This scholar was an Epicurean immersed in practices of caring for oneself so clinamen designated a declination or an original deviation of atoms, representing the central core of his conception of chance as the general principle of his physics. For Epicurus the term clinamen was important because it assured the existence of freedom and morals. But for Lucretius this same notion took on a broader connotation, justifying a radically materialistic but non-deterministic theory of nature. Non-deterministic materialism, based on the idea of a fundamental deviation as the source and origin of an entire system, does not imply, for Lucretius, any form of irrationality, but of a logical inclusion of chance. The necessary inclusion of chance (tuche) within determination made it possible for him to postulate that diseases had material causes—invisible living organisms that penetrated people’s bodies through accidental circumstances of their lives, causing disease. This is exactly the same compromise between need and chance that we have come across since the classical clinic to the present day. This compromise can be clearly seen in the notion of case (casus), in other words, that which falls, that which happens as quaestio and contingency. The notion of clinamen brings together two important connotations: bending towards the patient, coming close in order to look at them and respect their condition, and grasping the logic of the deviation, perceiving declinations and intellectively linking chance with need. The look that organized the clinic that emerged during the eighteenth century gives geometric form and constructs figures in space that we exemplified by using Kant’s anthropology. In other words, it methodically transformed what seemed to be appearance into cognoscible signs and phenomena. As Sydeham ([1784] apud Foucault, 1973–1974, p. 4) wrote: He who writes the history of diseases must pay attention to the clear and natural phenomena of diseases, no matter how uninteresting they may seem. In this, one should imitate artists who, when painting a portrait, are careful to include signs and the most minor of details.

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Disease therefore has a history and a geography with striking moments that consist of instantaneous portraits that must be recognized. Disease is not contained in a closed space of pre-defined possibilities, but open to undefined redescriptions. The idea that disease is like a picture in movement enables us to establish analogies of degree and distance between forms, contrasts, and intensities of colour. There is then identification of the rationality of the process, the integration of the causes. From this results a possible comparison between genuses, families, and species of diseases. Here there is a gaze that is more qualitative than quantitative. There is the insistent presence of metaphorical terms in clinical discourse, such as acute pain, spasms, or dry coughs. Let us go back to the fundamental operations of the clinical gaze, which are divided into procedures that classify (taxonomy) and procedures that organize (mathesis). To classify means to construct the similarities that are repeated in order to include them in a set or class. To organize, on the other hand, means to discover the rules of formation that govern the articulation between the different types of signs. Constitution is both what exposes and predisposes the patient to the ailment and what clinical practice also presumes that a clinical picture is established over the scene of a constitution, the term constitution referring to what is proper to an illness in that individual. Constitution is both what exposes and predisposes the patient to the ailment and what in this ailment should be distinguished as its particularity. A fragile constitution can predispose someone to colds, but the weakness caused by the colds should not be mistaken for the idiopathic fragility of this patient’s constitution. But constitution refers not only to individual facts about a patient. There is a constitution involved in space, such as in cities where some epidemics break out, and in time, such as the seasons of the year, when certain infirmities are more frequent than others. The clinician must be aware of the patient’s constitution should not interfere directly with clinical practice. The clinician must be aware of the patient’s constitution and weigh its value in the emergence and evolution of a situation, but not necessarily act on it.

Semiology The articulated functioning of these operations of classifying and organizing can be compared to the construction and mastery

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of a type of language. On the one hand, there is semantics, and with it one can determine the clinical meaning of signs, traits, symptoms, and syndromes. There are iconic signs, such as skin irruptions, and indications, such as the aspects of stools, and symbolic signs, such as the length of the intervals of time between contractions before childbirth. Besides semantics, a grammar must be established, which contains the rules of formation and transformation in pathological figures according to an order that allows anticipation and predictability. The basis of this grammar is divided between the morphological aspects, provided by anatomy; physiological aspects, provided by chemistry and physics of living matter; and functional aspects, given by the specific objectives of the various organs and tissues. One can thus understand why a semiology is established at the root of the classical clinical project. This semiology consists of a classification and organization of the signs, indications, symptoms, and traits that should appear to the clinical gaze as significant differences. For example, fever, changes in the colouring, texture or form of a region of the body are signs that are articulated concurrently and successively. It is this articulation that the clinician’s gaze must catch. We might recall that the term semiology refers to the science of signs (semion) and that this was how Saussure (1915/1977) defined the field of studies on language, of which linguistics was to be a part. In sixteenth- and seventeenthcentury medical books, the term semiotics was also used to designate this part of clinical practice. Upon establishing semiology as a basis, the medical clinic, as well as any other practice intended to operate as such must adopt, even if tacitly, a conception about language limited to the signs related to it. As Doubles says ([1811] apud Foucault, op. cit., p. 134): Particular, isolated observations are for science what letters and words are for discourse. This can only take place when letters and words are joined together. One must have studied and meditated on how [letters and words] function and their value before being able to make positive use of them. The same is true of observation.

In this sense, the clinical gaze submits a disease to a nominalist reduction. The essence of an ailment is equivalent to the essence of a

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word, which includes its opposites, modes of use, declinations, and regularity. Botanists and zoologists must make similar nominalist reductions, but within spaces of fixed categories, whereas clinical semiology presumes a closed system, similar to what one finds in chemistry. But semiology should also include a specific sensitivity of this gaze, which will enable him to note at a glance the fundamental gestalt or pay close attention to a minor but distinct detail. In other words, this is not a mechanical gaze, or look, but the result of experience. The difference between symptom and sign is decisive in the clinic. In its earliest meaning, symptom meant an infirm state that had to be deciphered, but was not necessarily a physical ailment. Deciphering it implied a type of division between the natural and the existencial pain, between necessary and contingent, suffering, between social and individual symptoms. The distinction between a disease of the body and one of the soul was part of this division, but it was neither the most important nor even the only possible division. The emergence of the classical clinic in the eighteenth century changed this method of division. Symptoms came closer to the question of language before it was divided into significant units. This suffering is transformed into a symptom, in the strict sense, through the clinical operation of discourse. A sign becomes a symptom when it is part of a description and is supplemented by the physician’s consciousness. It is this movement that turns a symptom, as a generic complaint, into a true symptom in the clinical sense. Through this reduction, a sign takes on a triple value, namely, anamnesis, prognosis, and diagnosis. A clinical sign can also be broken down into smaller units known as traces, which determine the value of a sign. Traces introduce paradigmatic oppositions by which, for example, a sign takes on pathognomonic value (of diagnostic interest) or functional value (without diagnostic interest). But the most constant semiological operation is that which takes into account the meaning of the sign in a syntagmatic reaction. This is the diachronic between appearance (triggering on), evolution, disappearance (healing), and final stage (epicrisis) that characterizes the course of an illness. This shows why the opposition between acute (synchronic) symptoms and chronic (diachronic) symptoms was so important in the process of constituting the classic clinic. This opposition did not

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so much bring about a universal diagnostic standard, but it did make the articulated functioning of the system of language visible. The fascination that the notion of syndrome exercised during this period is explained in the same way. Syndromes are blocks of signs that appear in regular association. As discursive equivalents of coined expressions such as catchwords and musical preludes and refrains (Barthes, 2001b, p. 236), syndromes show repetition (as diachronic) that does not change over time (synchronically). In the medical clinic the relationship between signs and what they refer to must be stable. Signs are truly signs when they are immediately legible in the relationship between the clinician’s gaze and the patient’s body. Aspects that depend on the patient’s speech or memory, accounts by family members and friends, or simple impressions by observers are of secondary importance and subject to doubt. These elements constantly relativize the content of the signs involved in the disease being investigated or treated. Signs must be purified by a more careful gaze, consisting of examinations, auscultation, photographs, laboratory analyses, and so forth. But in this case we are no longer in the specific field of the clinic, but in an extension of it. In this regard, clinicians may hear their patients without listening to them. Or, we might say, they only listen to the extent that the information the patient is providing can be understood in the light of some anatomo-pathological reference. The patient therefore serves as a mere informer about what cannot be seen directly, such as pain, nausea, or the intensity of a symptom. Anything that escapes this neutral account is dispersive and prejudicial to the clinician. But her or his work nonetheless deals exactly with this dispersion, this uncertainty, and these diversions. Bichat defined health as the “silence of the organs”. In other words, a sickness begins when the organs speak and is complete when the clinician is able to read their message. From this point of view, in the classical clinic the sign seeks to exclude the subject. Or, we might say, that there is a sign only when its subject is the doctor, since she or he establishes, legitimizes, and certifies the disease as such (Clavreul, 1983). A sign represents something for someone, but what it represents for a doctor is different from what it represents for the patient. Nothing is more distant from the clinic than the idea that there is some type of automatic reading involved, with identical results according to a standard that is fully

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mastered. As was seen above, the art of the clinic implies decisions and risks taken within the context of treatment and healing. In the classical clinic, great value was given to experience, the meaning of repetition, and the strength given to the practical and individualized knowledge of the physician.

Diagnosis The second operation in the structure of the classical clinic is diagnosis. Semiology represents the practice of reading, whereas diagnosis is an act. It presumes a stable organization of semiology, namely, nosography (as writing and the systematization of signs) and nosology (general theory of syndromes and diseases). A diagnosis implies the skill to discern the value and meaning of a set of signs when they appear simultaneously or successively in a particular case. As we saw, the term case refers etymologically to a fact or a happening, and is the organic correlate to the emergence of a question. Recalling the linguistic connotation of the word case, we can see how nosology functions as an attempt to classify and particularize the operation of a case within a general grammar. It is in this context that the idea of typical, ideal, irregular, or rare cases comes up. A case is only a case within a set of a possible variety. Diagnosis similarly begins with declensions, groupings, and insistences between signs. Therefore, it would be better to speak of a diagnostic process than a diagnosis. A diagnosis is a specific act, whereas a diagnostic process is the act that makes it possible. A diagnostic process implies a long and continuous attitude of attention to signs, observation of evidences and articulated hypothesis in a specific form of clinical investigation. Therapy is the test of this hypothesis. It implies a transposition from the singular to the particular and a remission from the particular to its genus. These groupings define a nosology, that is, a relatively stable but not unvarying classificatory system of the types and genuses of pathological manifestations. From this point of view, a clinician must distinguish between what is contingent, or possible, and what is necessary or impossible as a disease sets in. If the body becomes legible through semiology, it can now be subordinated to a broad rule of causal determination by the object, namely, the pathogenic agent.

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A diagnostic process therefore presupposes semiology. But while semiology is a process of reading, a diagnostic process is the reading that leads to dialogue between the clinician and the disease. This is an investigation that includes acting on signs, exploring their receptivity, causing minor changes and identifying reactions. It would be a mistake to think that a diagnosis is limited, once and for all, to naming a pathological form found in nosology, and this, for a number of reasons. It is usually unnecessary to specify the exact type of pathology involved in order to cure a disease, but in certain cases it is crucial. For example, a doctor does not have to identify the exact type of flu virus a patient has if there is no specific treatment for each type. But it certainly is crucial to determine whether a cold has led to pneumonia or not in order to define the type of prognosis, intervention, and risks involved. In other words, defining the level of ascertainment is in itself a clinical decision. Diagnosis is only for providing information for treatment, and its depth depends on the changes in direction that take place and the ability of the diagnosis to affect this direction. Diagnosis is primarily an operative hypothesis, a rule of action. Consequently, it can and should be subjected to constant correction, verification, and reformulation. This implies a certain degree of measuring probabilities and gives the diagnosis the nature of a decision. It is an act prescribed by clinical mechanisms and it therefore implies a degree of certainty, rather than consensus, as a criterion for legitimization. Finally, a diagnosis contains several different levels, namely, a syndrome, a clinical picture, a disorder, a dysfunction, and a symptom. A first level diagnosis, namely, a syndrome, can remain indefinitely at the simplest strata, which are correlative to the decomposition to which a sign is subject in a trace, letter, phoneme, signifier, or meaning. A diagnostic practice is even more complex because signs do not have fixed diagnostic value when considered separately, nor even when integrated into a situation of co-presence or a process of transformation. For example, a patient complains of muscular weakness, paleness, spots on the body, and swelling of the gums. Each sign taken independently may indicate a specific diagnosis, including malnutrition, constipation, smallpox, or tartar. The same individual may seem to have contracted four different maladies. But the signs can be grouped into two hypotheses: the spots and paleness indicate a skin disorder, whereas the gums and muscular

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weakness might point to gastric poisoning. But the signs can be broken down further: the spots are typical eruptions of erysipelas and can be discarded, and the problem in the gums might be a congenital deformation. However, all four signs in our example can be brought together into a single disease, scurvy. There is a practical rule operating here, the co-presence of symptoms should be attributed to a single cause unless the contrary can be proven. Diagnostic reasoning operates through exclusion and reconstruction of the simplest hypothesis for each case (Wyngaarden & Smith, 1985, pp. 69–111). A diagnostic process can also be divided into its synchronic and its diachronic aspects. All diagnoses must therefore be both differential and evolutionary. In differential diagnosis a comparison is made and signs and symptoms are chosen that will allow a comparison with and contrast to other types of pathology, as we saw in the example above. In evolutionary diagnosis signs are weighed simultaneously, but greater emphasis is given to their sequence and transformation over time (Wyngaarden & Smith, 1985, pp. 112–143). In the above example, new signs of scurvy might emerge or one or more transitory symptoms might disappear with time. In differential diagnosis, the synchrony of clinical types depends on the diachronic nature of the disorder, whereas in evolutionary diagnosis the opposite happens. A clinical examination is an example of a procedure related to differential diagnosis. There, a sagittal and current can be isolated and certain details immediately come to the fore. Anamnesis illustrates evolutionary diagnosis by investigating the succession of appearances of clinical signs. Here the reading becomes the ability to interrogate and stimulate the patient’s memory. The idea that diagnosis involves anamnesis, or “dis-forgetting”, is completed by the fact that the quality of the diagnosis is synchronically related to its ability to provide a prognosis. A diagnosis therefore implies not only an evaluation of the disorder, but also information about the patient’s resources and circumstances that can be called up in order to overcome the infirmity.

Aetiology and causality Besides a semiology and a diagnostic process, the structure of the classical clinic also supposes a theory of causality, that is, a concept

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of aetiology. This is the most that can be expected from diagnostic work, not only to classify the disease but to precisely indicate its causes. This may sound redundant when we consider that the nosological tree is constructed on finite clinical conceptions and clearly described causes. Diagnostic work can also lead to the discovery of a new type of disease or a disease with unknown cause. Diagnostic investigation changes and verifies aetiological hypotheses, and the aetiological hypotheses affect diagnostic practice. Let us look at an example. In 1847 the obstetrician Ignaz Semmelweis was working at the Vienna General Hospital, the same institution where, thirty years later, Freud began his medical practice. Almost 10% of Semmelweis’s patients were dying of a terrible disease known as childbed fever, since asepsis and the transmission of disease through germs were unknown. The generally held hypothesis was that there was some particularity in the women or in the nature of childbirth that predisposed them to develop the fever. There was thus diagnostic research being done to isolate this clinical picture early in their pregnancies. But the signs were very dispersed and the only perceived constant was the fever. Semmelweis tried to isolate which signs were contingent and which were necessary in order to determine which aspects were symptoms and which were the disease. But he looked for this in the women, and not outside of them. His efforts came to nothing, and precisely because he was not satisfied with either differential or evolutionary diagnoses, he continued to investigate and began noticing a strange regularity: 18% of the women who gave birth in Delivery Room I died whereas only 1% in Delivery Room II died. He then noted that Delivery Room I was used on the days in the week when dissection class preceded obstetric activities. He realized that there was some aetiological relationship element involved that was being transmitted from the dissection room to the delivery room. So he placed a bowl of water and soap at the door of the delivery rooms and succeeded in eradicating childbed fever at the hospital. At the same time, he discovered the practical principles of germ control. It should be noted that Semmelweis did not isolate the specific causal agent of the infection, nor even the fact that diseases were transmitted through germs. He only introduced the aetiological dimension of the problem into his diagnostic research (Adler, 2006, pp. 115–131).

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Aetiology provides information for describing a pathology founded on common causal principles related to more or less regular sets of signs. This step can lead to a nosology governed by the same causal principles now detected in the sphere of the functioning of the body in general. Semmelweis certainly knew something about the cause of childbirth fever. He knew, for example, that it had something to do with the delivery room and that it receded in reaction to basic asepsis. But he was unaware of the aetiology of the fever. Without the aetiology, it was impossible to note that the fever is only one variant of a broader disease, infection. It is not a specific disorder. We thus see that such a conception can modify semiological factors, establish new nosological criteria and, consequently, new diagnostic processes. The paradigm set down by Bernard (1813–1878) was decisive for sedimenting this aetiological perspective (Oliveira, 1981, pp. 387–393). He introduced a procedure that enabled clinicians to come to conclusions as to clinical entities on the basis of anatomo-pathological changes. More important yet was his idea that even unknown aetiologies should behave according to this rule. As the result of Bernard’s work, Galen’s model was permanently put to rest. One can thus see the importance taken on by explanations of the processes of certain diseases that were to serve as models for categories of similar diseases. Causal processes could be applied to one category or another regardless of the semiology involved. Aetiology, as one component of the classical clinic, thus brings in a third level of objectification, by which one can understand the evolution of a disease in the body’s overall functioning by considering only the electrochemical system and its visible correlate, the degeneration of tissues. Even what is invisible to the naked eye becomes objectified, now in the form of a representation, on the one hand, and on the other, a theory regarding bodily functions and their re-establishment. This theory is seen as an integral part of a common and universal language through which the pretensions of medicine as a natural science are legitimized. It is the principle of aetiology, and neither the semiological practice nor the diagnostic process, which establishes medical science. We should also not confuse medical science and clinical experience. The level of precision required by the anatomical or physiological doctrines is never equivalent to what goes on at the clinical level. From the point of view of science, time is infinite, but, for the clinic, it is finite.

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Therapeutics The fourth and final component of the classical clinic is therapeutics. This concept includes all the strategies aimed at intervening in and transforming the causal chain that constitutes aetiology, in order to confirm the diagnostic process and clarify the semiological value of signs and symptoms. This is a conception for both healing and treatment. As we saw above, therapeutics is generally associated with the introduction or the removal of an element or condition considered relevant from the aetiological point of view. Since a causal chain is involved, there are always decisions to be made in terms of the importance of aetiological factors and the order in which they should be considered after the appearance of a disease (therapy) or before appearance of a disease (prophylaxis). It is also essential to simultaneously mitigate the negative effects represented by the symptoms. This is the origin of the distinction between primary and symptomatic treatments. Therapeutics includes two types of action: care and intervention. The sphere of care includes continuous and constant attention to certain aspects of the patient’s life. Hospitalization, for example, is a practice of caring. Another aspect is deontology, which consists of a set of recommendations and prescriptions that patients must strictly obey during treatment. Such deontological suggestions and restrictions include questions of diet, behaviour, environment, and the notion of prophylaxis. Another example of therapeutics in the sphere of care is the Hippocratic topic of the relationships between doctor and patient. Here there is a double interest at stake: to inculcate a certain willingness in the patient to face the process of treatment and to bring her or him to continue with the process. Here one finds all the tactics and topics of rhetorical persuasion we examined in Chapter Four, but now they become more enigmatic clinically speaking. In Jaspers’s words (1986, p. 17): At this point one might, wonder whether a doctor’s personality does not serve as a legitimate healing figure, without his having to be a wizard or a saviour and without there being any suggestion or illusion involved. The presence of a personality, in his desire to help, is completely there for the patient at that moment, but will not be there forever.

The care is carried out according to diachronic articulation in the sphere of treatment, whereas interventions constitute the

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corresponding synchronic element. Whether an invention is surgical, pharmacological, or mechanical, the intervention follows the principle of economy because it should be as brief and as non-invasive as possible. In addition, intervention should aim at the most elementary point possible in the causal chain. Therapeutics also operates according to an economical logic in order to constantly appraise the risks and costbenefit aspects for the patient. Between the dimension of care and that of intervention, there is an intermediate practice known as propedeutics. It is intended to prepare and set down the conditions that make the intervention as effective as possible. It also involves care, but it functions through specific actions, such as disinfection, preparation of an operating room, or a special diet.

Structure of the classical clinic on the surfaces of healing, therapy, and treatment In the dimension of care and treatment, as well as in intervention, therapeutics must be based on semiology. This includes new signs, changes in symptoms, and relapses, which will orient the strategy and continuation of treatment. Everything takes place as if one were making an about-face that re-starts the process on a lower scale. Semiological observation during treatment was responsible for the discovery of a number of aetiologies, and decisive reformulations of the diagnostic strategies involved. Intervention, therefore, must not be thought of as a blind operation. Once its objective has been determined, it is modulated by articulated functioning of the structure of the clinic, which we can now represent in Figure 1. Semiology

Diagnostic process

↓↑

Aetiology

↓↑

Therapeutics

Figure 1. Structure of classical clinic. This very concise scheme of the classical clinic shows the functioning of its structure, related to a transformative group similar to the Klein Group (see Chapter Eight, on Structure).

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It is impossible to carry out a diagnostic process without joining semiology or therapeutics. It is also impossible to go from the diagnostic process to aetiology without first passing through either semiology or therapeutics. Finally, one can conceive of closed circulation between diagnostic process and therapeutics, or between aetiology and semiology. There is also a single diagonal line that points in only one direction: from therapeutics to semiology. The structure of the clinic is seen as a system with two essential properties, namely: homogeneity between its elements and covariance of its operations (Dunker, 2001, pp. 39–61). The first property, homogeneity, means that the elements have the same nature. For example, Claude Bernard’s principle confirms this property of homogeneity in his assertion that material causes have material effects. The nature of the elements is defined by the same type of causality that governs them. It is not very likely, for example, that phlogiston as a psychic or spiritual entity operates as a cause of material changes in the body. This is irrelevant from the point of view of structure. The problem begins when an aetiology based on ideal entities is connected to a system of therapeutics based on material intervention, such as leeches or purgations, for example. Above all, it is the status of the semiology in relation to the other elements in the structure that defines the nature of the causes. Another example of a breach of the property of homogeneity is astrology, which holds that the movement of the planets causes stable arrangements in one’s personality. This is a case where there is heterogeneity between semiology, the ontology that this semiology presupposes, and the aetiology that correlates with it. But one very important element is missing, therapeutics. Astrology, therefore, has no clinical structure. Homeopathic medicine is an example in the opposite direction. This field of practice is based on the aetiological pre-supposition that like cures like, which may be either true or false. But this is irrelevant to the question. In any case, the semiology of homeopathy is compatible in nature with its diagnostic process and the corresponding therapeutics. The second property we need in order to decide whether or not we are dealing with a clinic, in the structural sense of the term, is covariance. This concept means that the elements mutually and necessarily affect one another. For example, a reformulation in semiology must be able to change or prescribe a possible set of

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diagnostic, therapeutic, and aetiological reformulations. Changes in the aetiology should be able to bring about major changes in diagnostic procedures and throw light on semiological aspects that were unknown before such changes could be measured. Diagnostic and pathological findings should have sufficient implication to undermine strong aetiological convictions. In fact, covariance is a type of proof of the application of the first principle, that of homogeneity. In other words, if the elements can mutually affect one another, this certifies their homogeneity. Several steps are necessary if one is to decide whether or not a practice is clinical, in the structural sense of the term, as we are developing here. The four elements that have comprised clinical practice since the ancient world (semiology, diagnostic process, aetiology, and therapy) must be determined, as also must the two structural properties (covariance and homogeneity), besides the functioning of this practice articulated with the mode of treatment (method and investigation). We can now represent the set that comprises the clinic in its relationship with treatment and healing as provided in Figure 2. Healing process

Therapeutics

Diagnostic process

Aetiology

Semiology

method of treatment

method of investigation

Figure 2. Classical clinic: Merged to surfaces of treatment, therapy, and healing. The two structural properties, homogeneity and covariance, were extremely important, in fact, determinant, in the evolution of the classical clinic. The development of medical specialties, which began in the nineteenth century, suggests that the properties of homogeneity and

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covariance were applied on ever lower scales, starting with the entire body and its systems, then moving to the organs, then the cells and, finally, to genetic material. The breakdown of the properties of covariance and homogeneity also made it possible to explain a number of failures in clinical projects that historically were not carried through as such. This was the case with Lavater’s phrenology, Lombroso’s criminology and numerous other psychological and psychiatric systems. The idea then spread that structural properties, reduced here to covariance and homogeneity, are criteria for any and all projects that are either tacitly or explicitly intended to be clinical. They thus constituted a type of epistemological standard to determine whether a given practice was or was not a clinic. It would be well to explain that this model is set up to examine any and all practices that are intended to be clinical, and this is the generality and simplicity of its parameters. The second objective of the model is to show that, simply because the first historical form of clinical practice was the medical clinic, this does not mean that it is the only clinical practice in existence. Much less is it a model on which other types of practices should necessarily be based. Medical practices in the ancient world, as well as astrological medicine in early modernity, have built up models of treatment and developed a great many of the aspects of clinical practice. But they do not comply with the criteria we propose here for recognizing the structural functioning of clinical practice today. Not everything in medicine is clinical: there is prophylaxis, epidemiology, physical-chemical science, cell studies, and analysis with tissues. Inversely, not everything that is clinical can be included in medical sciences. Such lines include speech therapy, nutrition, education (in certain cases), and psychology (in certain cases). Even certain institutional and organizational practices can be considered forms of clinical practice, and not merely in a metaphorical way. Methods such as Piaget’s, for example, are referred to as clinical, and it is correct since it involves methodical questions, observation of signs and reconstructive diagnostic, but it isn’t a structural clinic since it involves no therapeutic intervention and no ambition to change the process. It would also be well to stress that, seen in this light, the structure of the clinic in general should not be fully equated with the medical clinic. The distinction involves formal criteria that, to some degree, do not depend on the epistemic and ontological conditions

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adopted by each specific type of clinic. For example, Empedocles of Agrigento (495–430 BCE) whom we discussed in Chapter Two, set up a clinic with aetiological principles that were compatible with his diagnostic method and his semiology. His therapeutics are fully homogeneous and covariant with other aspects of the structure. It does not matter that his ontology may be questionable, improbable, or simply false. He nonetheless set up a clinic. Let us now look at two examples of practices, psychiatry, and psychoanalysis and discuss two important questions about them, namely: Are they clinical structural practices?

The project of constituting psychiatry as a clinic The nineteenth century saw the growth of many different clinical specialties, each of which was defined by its specific object and by the structure of its clinic, its objects, and its operations. This specialization, which implied the division of medicine into different areas, plus the growing development of technical examinations and meticulous investigation of aetiological agents (such as in microbiology), became widespread during the nineteenth century. We can therefore speak of various clinics (cardiology, dermatology, paediatrics, etc.) in contrast to the classical clinic. In addition, each specialty had to bring together its experience and the variants of the structure of its clinic with the social warrant of its practice in the broader field of medicine. A specialty such as epidemiology, for example, requires a strategy of discursive implementation that is totally different from obstetrics or paediatrics. The case of psychiatry represented a special difficulty during this process of specialization. Just as Linnaeus’s biology was used to classify the species and Mendeleev’s chemistry classified the types of atoms, attempts were made to establish the limits and conditions for a semiology of madness, or insanity. Clinicians like Kraepelin, Charcot, and Esquirol took up this task, which they soon saw was a very complicated and inglorious enterprise. One part of the difficulty was the fact that the most outstanding phenomena that, grouped together, made up the types of madness are expressed not only by language, such as pain, which affects a certain part of the body, but also through dysfunctions that influence

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invisible aspects of the patient (memory, consciousness or perception, for example). Contrary to other branches of medicine, whose clinical practice started off from a referentialist semiology (the systems of the human body), psychiatry adopted semiological abstractions as its references. Even the radical chosen for the name of this area of medicine, “yatria” (psychiatry) makes evident this difficulty. Instead of choosing a radical that refers to discourse (logos) (as did cardiology, pneumology, and infectology), psychiatry adopted the suffix iatros, which indicates disorders in a type of person, rather than a type of disease. Instead of psychology, the name chosen was psychiatry. It is true that other areas chose similar types of names, such as paediatrics (care for children) and geriatrics (care for the elderly). Nor were such phenomena defined in language, as were aphasias, but essentially by the intersubjective use of language. In other words, the reality of delusion is a linguistic reality. It consists of words, and not of tissues or fluids. The totality that includes delusions goes beyond the totality of the body. It corresponds to the open universe of meanings. How can a reference be found from which signs fulfil their functions as indexes or icons in a stable relationship, if this relationship is defined by its arbitrariness rather than by its intrinsic motivation? Finally, how can one set up a semiology that is not a mere moral convention or abstraction related to the universe of meanings of the clinicians themselves? For such semiology to be created a universal anatomy of the modes of production of meaning would first have to be set up. But attention, memory, imagination, thinking, will, and consciousness appear here as components of a vocabulary that allow one to link the clinical types to some level of objectivity. However, these mental faculties do not have the same ontological properties as tissues do, whether or not they are visible. Such abstract processes lead to a type of artificial reproduction of the whole, an analogy of the organic body. The result is a psychic body to which one could apply the same laws of equilibrium, functionality, and homeostasis that apply to the functioning of tissues. But this type of abstraction became very inconvenient: it was not visible. From it one could only grasp other inflections of linguistic substances or behaviours whose meaning was similarly open. In other words, the semiology that psychiatry had to construct in order to establish itself as a clinic was expressed in a metalanguage.

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The problem was not limited to the fact that the mind is an ideal object, whereas tissues are real objects. The challenge was how to pass from a narrative substance through which suffering is expressed, to a descriptive substance where the symptom is defined. We saw that the clinic begins with descriptions that chart regularities and differences. But a map of all the meanings engendered by all the games of language in all possible worlds is not only impracticable, it is also useless. One would be so close to reality that it would no longer serve to guide us around inside it, like the map of Borges’ imaginary geographer, which was so perfect that it occupied the whole island he sought to represent. On the plane of classification, semiology ran into a number of problems, but the difficulties in organizing the signs were also considerable. When the history of a disease is confused with the patient’s history, it is no longer a succession of signs but a narrative, and narratives suppose certain rules that must be constructed or interpreted, and these rules are essentially different from those that regulate descriptions.

Semiological failure: language as obstacle This double semiological difficulty explains why the nineteenthcentury clinic was marked by conflicts between different descriptive traditions that arose from many different ways of conceiving the interpretative matrix of the meanings brought on by insanity. Strategies to provide objective references by which one could deduct patients’ disorders, or deviations, had a common principle, namely, Claude Bernard’s anatomo-pathology. In contrast to the classical clinic, which found its stability through the gaze, the clinical figures of insanity were defined by facts of language, and were therefore invisible. A symptom needs an enunciative scene if it is to be defined as a symptom. The equivalent in psychiatry of the unhealthy tissue that a physician in other areas must diagnose consists of repetitions, refrains, neologisms, and syntactic and semantic incongruence, as well as varying forms of mutism and interruptions in discourse. The different delusions and hallucinations that are described, as well as melancholia and mania, are inseparable from the way the patient uses his or her speech. Outside of this reference the patient’s anomalies would be precariously described as speeding up or slowing

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down the emission of words, agitation, or paralysis of movements, incapacity of sensory systems, sleeping or eating disorders, and so forth. It is at this point that psychiatry unexpectedly crosses the line between Kant’s anthropology and his theory of the universal conditions of the possibility of knowledge, action, and judgement. Once this line has been crossed, the anatomy needed for determining semiological standards is ready, finished, and available in Kant’s theory of the constitution of objects. Clinical facts gathered by ethnographic observation can now be positively and directly connected to the categories of phenomena. There is thus a violation of Kant’s initial strategy of maintaining a negative relationship between his criticism and his anthropology based on the failure to adjust human experience to the limits and conditions that define human reason. Criticism has no more restrictive value, as the expression limits of reason suggests, and takes on a prescriptive value, indicating how reason should be practiced. The psychopathology of the mental faculties (Vermögen) is the end product of this operation of transposition and reification. The work of Berrios (1996) constitutes today the most widely recognized reference on the history of psychiatry and mental symptoms. To our surprise, Berrios treats all the categories and divisions indicated by Kant in Anthropology. There, one can find semiology of understandingsensitivity (cognition, consciousness, memory, and perception), semiology of the affects and emotions (pleasure-displeasure) and semiology of will and action. The psychiatric research on hallucinations, for example, progressed from a more or less theological discussion, as we saw in Swedenborg’s accounts, (see Chapter Nine) to analogies of hallucinations as dreams (Baillarger), and then to the topic of the continuity from the senses to the imagination (Micheia). The description of Bonnet’s syndrome, in 1872, characterized by hallucinations without visual or cognitive difficulties in elderly patients, led to the clinical establishment of hallucinations in the sphere of perception. But this gave it no diagnostic or aetiological value. This was not due to the fact that hallucinations can occur with or without there being any pathology of organic tissues (toxic psychoses). We saw that the criterion for Claude Bernard’s paradigm is not true verification, but verifiability. But even though successive semiological hypotheses were presented regarding such verification, none could resolve

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the diagnostic problem involved. As Falret pointed out, the clinical presence of psychosis is not defined by the presence or absence of hallucinations, but by the relationships of beliefs, certainties, and influence that they exert on the patient. In other words, the problem does not depend only on the categories of sensoriality, but on the synthesis that the ego makes about them in the form of apperception. Kahlbaum and Griesinger advanced this hypothesis in an associationist perspective, stating that hallucinations were a type of error or confused crossing between perception and memory. This line of investigation was scrapped after the splendid account by the psychiatrist Victor Kandinsky, written around 1880. Kandinsky was the head of the Psychiatric Asylum in St. Petersburg when his psychosis broke out. He set out to describe this process based on the reliability of Kant’s semiological categories, and he concentrated on hallucinations. According to him, hallucinations are not experienced as having any objective externality, as is the case with illusions, nor do they have subjective externality, as dreams do. They are vivid and sensorially intense and do not imply any alteration in consciousness. They are involuntary and clearly identifiable as not being real. Therefore, they are not hallucinations in the sense of the term as understood up to that point. They were rather pseudo-hallucinations. For Kandinsky the only truly distinctive semiological fact resided in the irresistible character they assumed. At times this gives the individual the psychological impression that something or someone else is dominating the experience, rather than the subject’s own perception or senses. This makes it possible to clearly identify hallucinations as facts of the logic of appearances, and not of the logic of phenomena ( Berrios, 1996, pp. 35–60). Séglas, Clérambault, and Ey started out with this approach to describe mental automatisms as the key to psychopathology. These automatisms were characterized by being ego-dystonic (there are forced or imposed on the subject) and they precede delusions and minor forms of illusion. Mental automatisms are distributed between those that proceed from sensory images felt as imposed, those that emerge from arbitrarily and verbally formulated ideas in the form of voices or other noises, and those that consist of volitional or affective inclinations recognized as foreign by the subject himself (Berrios & Diego, 1996, p. 106). In the words of Clérambault (2006):

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By automatism I understand clinical phenomena such as premonitory thinking, enunciation of acts, impulsive verbal outbursts, and tendencies towards psychomotor phenomena. ... I contrast these automatisms to auditory hallucinations, understood as objectified, individualised and thematic voices. I also contrast them to psychomotor hallucinations. In fact, these two types of voices, auditory and motor, appear later than the phenomena mentioned earlier.

Automatisms and, more specifically, elementary phenomena were the first great diachronic regularity to be actually described in psychiatry. That is, automatisms always and necessarily occur before other symptoms emerge. They are not equivalent to states of agitation, insomnia, depression, or hypochondria. They are precisely pre-phenomena, apparent phenomena. The existence of these predelirious states opened the way to the centrality of the problem of interpreting and understanding phenomenon. This perception set the groundwork for Jaspers’ construction of a psychopathology based on the notion of intentionality, as well as the countless forms of compromise, displacement, and collusion between psychiatry and the many lineages of psychology and psychoanalysis. This brief rundown on the history of hallucinations between the nineteenth and the mid-twentieth centuries also holds regarding delusions, which are the equivalent of hallucinations in the field of disorders of thinking, if we are to follow the evolution of Kraepelin’s school, or with respect to disorders of affect, if we follow Bleuler’s work. There is a systematic displacement that leads from the search for a semiology and an aetiology, which comply with the demands of the anatomo-pathological model. This movement continued until it was completely inverted in a register that defines its categories: in political terms of the privation of freedom (imposition and coercion), in psychological terms, through appearances rather than phenomena, and in moral terms, through certainty rather than through truth, by empirically using Kantian categories. This displacement clearly violates the very principle of homogeneity that defines the structure of a clinic. A semiology based on a subject’s reactions cannot fit in with an aetiology that has anatomo-pathological underpinnings. Not that such a connection is not possible or because an idealist position is necessary, but because it implies a logical incongruence

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between pre-suppositions and conclusions. This does not mean that psychiatry cannot be considered a science, a technique, an experience or a stable description of symptoms. It only means that it never went so far as to constitute a clinic, in terms of its structure. What is known as the psychiatric clinic never went beyond being a project. In this regard, Bercherie (1980, p. 217) said that: The joint result of the impasses of the psychiatric clinic of doctrinal urgency and the perspectives of therapeutic pragmatism was the gradual disappearance of the clinic, first in spirit and then in its contents. If we open a classical manual on psychiatry we will see that it is closer to being a pile of concrete described and analysed documents than a treatise on pathological psychology, like our modern writings, without examples, without accounts of clinical cases, without illustrations, without a plan for examination and a true semiological inventory. Over the last several decades, psychiatry has gradually become embarrassed with the pure clinic of simple observation, of the gaze.

Therapeutic failure Besides failing to establish a referentialist semiology, psychiatry’s attempt at setting itself up as a clinic faced a second difficulty. It never succeeded in developing a therapeutics that was consistent with its hybrid combination of Kant and Claude Bernard. The techniques of counselling, confinement, rest, and thermal, chemical, or electric applications applied by psychiatry were not only ineffective; they were never seen as procedures related to specific causes. There are some curious examples of this impasse, such as cures through baths, fresh air, occupational therapy, ergotherapy, hypnotherapy, and finally, exposing of the body to controlled situations, as a way to change the language that inhabits this body. All this seems to have been a struggle against an insurmountable barrier. The only justification for such interventions is that they served as aspects of caring. Changes in therapy were never sufficient to alter the semiology and, inversely, total reflection of diagnostic schemes failed to bring about consequences for therapeutics. The second property of a clinic was thus violated since there was no covariance between its elements.

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One paradigmatic case to illustrate this therapeutic gap in psychiatry was Anton Mesmer (Cazetto, 2001, pp. 83–120). In 1774 he cured Oesterline, a 29-year-old woman affected with a convulsive infirmity that involved bleeding from the head, toothaches, and earaches, followed by delusions and vomiting. Mesmer applied magnets to the patient in continuous sessions until the symptoms ceased. He explained the functioning of his method of treatment according to a 27-point system based on the circulation of animal energy (as opposed to mineral energy), similar to the way electrical impulses are transmitted. His system included and combined elements of healing, therapeutics, and clinical activities. For him, a state of health meant that harmony has been re-established. There are symptoms that must be cured and there are critical symptoms that express Hippocrates’s principle of self-healing. An excess of fluid energy could be seen in spasms and convulsions (which were apparently Mesmer’s specialty). His cures were public and spectacular, and included the use of the baquet, a machine he invented for diagnostic purposes. In 1784 the French Academy of Sciences carried out a public test on Mesmer’s work by comparing his treatment with conventional methods. He had trained over 300 students and, despite growing objections from scientists and medical professionals against the ideas of magnetism, his system expanded into several different branches that eventually connected up with hypnotism and somnambulism. The question is not why his methodological descendants failed to obtain consensual recognition, but why his ideas did fit in so well into the landscape. It provided material and allegorical explanation for the problem of influence at a distance. Mesmer correlated the influence between two persons to the influence between electric currents or gravity, which were simultaneously invisible and affective and, in doing so, he took the impossible step needed to establish a true psychiatric clinic. In other words, he said that words affect people in the same way that electricity does. Both operate at a distance, both are material and invisible, and both are, allegorically, sources of power. So we have a type of analogical connection between the gaze that looks and the ear that listens to words. In other words, the therapeutic programme based on the action of magnetism at a distance requires a “magnetic” aetiology of mental diseases. In like manner, a programme based on the action of the word

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at a distance requires an aetiology related to the word. In comparing the therapeutic techniques of psychiatry with its own aetiological cases, we see a heterogeneity. Therapeutic success is not associated only with physicalistic aetiology and, inversely, not all physicality therapeutic techniques produce the same therapeutic success. Unlike professionals in all other areas of medicine, psychiatrists cannot be deaf. Its semiology depends essentially, and not extrinsically, on the subjects’ first-hand accounts, and such accounts are invisible. Without them, it would be impossible to distinguish maniac agitation from neurological crises, a sad-looking face from depression or, the presence of hallucinations from their absence. This insurmountable contradiction gives rise to the impasse between psychology and psychiatry as they are organized around a single presupposition: As Foucault (1957, p. 139) reminds us: From here on out, might not the future of psychology be in taking these contradictions seriously, since psychology was actually born from such experience? As a consequence, no psychology would be possible except by analysing the conditions of human existence and by returning to what is most human in human beings, their history.

One unusual expression of this longing for an impossible gaze can be seen in drawings and photographs of persons committed to mental asylums. Such images, commonly displayed in nineteenth-century psychiatry, sought to portray insanity in elementary gestures, such as the tense face of catatonic patients, the glazed stare of a demented person or the expressions of mistrust and suspicion in those with hallucinatory paranoia. These themes caught the attention of painters including Dummier, Van Gogh, and Brouillet. Charcot’s hysterics were portrayed in detail in postures of spasms, clonic contractions, or delight. The sequences of hysterical attacks grasped in all their passionate plasticity transformed Augustine, Blanche Wittman, and Rosalie Dubois into authentic fictional characters (Trilard, 1991). These representations most decidedly do not fall into the same category as photographs and diagrams of changes in tissues, muscles, or organs. They do not reveal what was present at the instant the photograph or diagram was drawn up. On the contrary, the

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iconography of insanity condenses life histories, metonymies of social contradiction, and metaphors of affects and experiences. In other words, it lets us hear what is absent as a fact represented by images. In a few cases, the invisibility of the aetiological agent and the ensuing Babel was compensated by the establishment of a clinical frame of reference that had a proven anatomo-pathological reference by which one could apply the mechanism of aetiology to a mental disease. Syphilis, the final stage of which led to catatonia, was the first example, published by Bayle in 1825. Next came dementias, used as a paradigm by Kraepelin in 1883, then, epilepsy, anencephalitis, brain injuries, and even aphasias. In all these cases, an organic finding, often associated with a form of discourse, seemed to suggest a causal connection. But even this connection was unable to produce, of its own accord, a semiology, a diagnostic process, and a line of therapy that could operate covariantly, since there was an enormous difference between the aetiological agents involved and their symptomatic effects. But if a biological basis for mental functioning were found, this would mean that psychiatry was based on neurology, thus demolishing psychiatry’s own object and reducing it to a therapeutic practice within the neurological clinic. This is an epistemological paradox whereby the proof of a pre-supposed hypothesis destroys the objective of the proof. If one adheres to the criterion of homogeneity, covariance is lost, but if the covariance is maintained, there is no longer any homogeneity. All this went on as if there were no problem with the absence of a line of therapy in psychiatry by which one could distinguish between the subject’s condition and the objectivity of organic realities. This ambiguity, at the precise level of the referential value of the signs to objects, destroys the pretension of psychiatrists to establish the structure of their clinic. Clinical expressions in psychiatry include the transmission of experiences, the common practice of observations, and the naming of phenomena. With Pinel, deontology evolved into moral treatment and to the different practices of re-education that were attempts, each in its own way, to reduce the arbitrariness and relativity—proper to the condition of the subject—to the conventional or the necessary. In this case, objectivity became a synonym for the social sphere. The theory of degeneration, developed by Morel and Esquirol, is one example

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of the extension of the pathological beyond the organic order. According to this position, moral vices were transmitted from one generation to the next, resulting in mental disease through a process of accumulation. In fact, the French moralist school of psychiatry combined the anthropological space established by Kant with the hypothesis of the heteronomy of mental faculties. In the end, and as a continued effect of the break with the constitutive suppositions of the clinic in psychiatry, the project for constituting this area of medicine as an autonomous clinical field led to a serious crisis. There is an historical arch that portrays this undertaking. It began when Esquirol (1838) replaced Pinel’s philanthropic attitude with a clinical approach, and ended when psychiatry produced its identity crisis by recognizing itself only as a mediator in the relationships between the insane and society, in the mid-1940s (Postel & Quétel, 1993, p. 471).

Contemporary technoscientific psychiatry It could be argued that this project by psychiatry to set itself up as a clinic was taken up once again, and concluded with the discovery of the importance of neurotransmitters, genetic determination, and the establishment of a true empirical theory of the subject through the neurosciences. Here one can see, in fact, a covariance between drugbased therapy and referentialist semiology. Covariance between therapeutics and diagnosis is given by the fact that certain medications “create” the diagnostic condition they are meant to address. So there is clinical practice as structure, but this operates in the opposite direction (from therapy to diagnostics and not the other way around). One consensual diagnostic reference, the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Frances et al., 1994) is related logically to a semiology and a line of therapy. But the DSM’s classification system represents a clear break with aetiology. The inexistence of a relationship between aetiology and semiology is clearly stated in the manual itself: The organising principle for all the remaining sections (except for Adjustment Disorders) is to group disorders based on their shared phenomenological features in order to facilitate differential diagnosis. The “Adjustment Disorders” section is organised

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differently in that these disorders are grouped based on their common aetiology (e.g. maladaptive reaction to a stressor). (Brakel & Brooks, 2001).

Strangely enough, the only clinical group organized on the basis of aetiology is the group that is closest to a “social” aetiology. This fact should serve as a warning that the criterion of homogeneity is ignored in this section (indicating “social” causes for “neurophysiological” problems). But one could nevertheless argue that the functionality of the DSM-IV clinical classifications and their relationship with the production of knowledge based on evidence has attained the ideal of consolidating the structure of a clinic in psychiatric practice. But this set does not seem to correspond to a clinic in the sense of bringing together: a structure, with elements, properties and a practice of treatment, experience transmitted on the basis of the case, the history and the narrative of the suffering, a method able to articulate investigations related to different scientific areas, such as anatomy, physics, chemistry, or cytology. Contemporary psychiatry corresponds more closely to a complete rejection of the clinic as experience. As we noted above, it might be described as a clinical structure in reverse (from therapy to diagnosis) and a deterioration of the method by replacing it with technoscience. This type of practice represents a direct placement of the patient as an object for medical discourse without the mediation of a clinic. It is like an experience, with its method being reduced to a technique and with science subordinated to the administrative management of the new medical order (medicine based on evidence, health insurance, actuarial calculation of risks, clinical protocols defined in economic terms, etc.). The figure of the clinician and the experience that is coextensive with this figure are completely useless in this practice. It is cheaper and simpler, for example, to change the types of medication available until a solution that is “adjusted” to the patient is found, than go through a precise diagnostic process as to what type of depression is present in any specific case. Studies comparing medical doctors and computer programmes have shown, for example, that computer programmes can carry out diagnoses and prescribe treatments more effectively, more cheaply and with greater precision than clinicians. Even if ethical and practical restrictions make such a procedure unadvisable, its current roots are to be found more clearly in today’s

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health policies and the dissemination of biopower, than specifically in clinical practice. There is an enormous division of tasks between those who work in psychiatric aetiology (in the pharmaceutical laboratories), those who investigate disease categories (in university laboratories), those who define diagnostic processes (in professional associations), and those who practice therapeutics (as psychiatric practitioners). As a result it would be safe to say that the function of the psychiatrist is reduced to that of a technician who bureaucratically issues orders for procedures. Patients soon surpass them in quality and skill in this art. The discourse that characterizes the clinic operates according to the shuttling described above in Chapter Six, dedicated to Real healing, between the university discourse and that of the master. These discourses are rounded off by the hysterical counter-discourse. There is little doubt that Charcot’s presentations would be unthinkable outside psychiatry as a clinical field (Allouch, 1995, pp. 37–57). But psychiatric techno-science is of another nature. It is organized around the capitalist’s discourse, which differs from the master’s discourse in that the capitalist’s discourse inverts the relationship between the subject and the master signifier (Lacan, 1970–1971: 2/12). Lacan sometimes referred to the capitalist’s discourse and occasionally associated it with the master’s discourse. At other moments he separated them, and from this we might infer two forms of discourse related to the social phenomenon of capitalism. The main characteristic of this latter form of discourse, as coined by Lacan, is that in it the place of the truth is no longer a sheltered place, but exposed to and inhabited by a master signifier. In the capitalist’s discourse (Gonçalves, 2000, p. 67):

↑

Semblance/Agent

Other ↓

Truth

Production

We have, then, two possible routes, which could also be called circuits: Route 1: Truth

semblance/agent

Route 2: Truth

other

production

other

production

semblance/agent

semblance/agent

Figure 3. Discourse of the capitalist.

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the master signifier is in the place of truth object a is in the place of production knowledge is in the place of the other, and the subject is in the place of the agent (or of the semblant).

The area for circulating between places is not closed in the capitalist’s discourse as it is in the other discourses. One goes from the master signifier to knowledge and from the object one goes to the subject. This enables us to talk about the two surfaces of this discourse: the surface of superegoic consumption (from object to subject) and the surface of ideology (from master signifier to knowledge). In contemporary psychiatry, this is seen in the widespread consumption of medication related to the pathologization of everyday life. This reverse and technoscientific clinic had been described as the general functioning of medicine even before the pharmacological revolution of the 1980s and the model of medicine based on evidence. In Jaspers’s words (1986, p. 42): Modern patients, they say, do not want to be treated personally. They go to a clinic the same way they go to a store, to be served with the best by an impersonal system. And modern doctors are seen as acting in a collective way, by which patients are treated without the physician personally standing out.

I do not want to suggest, as has become usual nowadays, that there are some great invisible agents in the background who are represented by the pharmaceutical companies, like the heiresses of the tobacco companies of old, who produce demands for merchandise. This would be to hold solely to the visibility of a semblant of discourse. One could argue that we are increasingly migrating from the consumption of objects to the consumption of experiences, and this fact might be considered grounds for including psychoanalysis in this same criticism. The point I want to stress here is that the clinic as experience is incompatible with the capitalist’s discourse. This characteristic has been systematically pointed out by those who study capitalism as social discourse and social bonds. In other words, capitalism corrodes, obstructs, and destroys the possibility for true experiences, replacing them with simple pre-fabricated adventures (Benjamin, 1994, pp. 197–222).

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Psychoanalysis as subversion of the classical clinic Freud was trained and did most of his work during a period when the classical clinic was in its heyday in psychiatric and neurological circles. He himself was a clinician, in the sense that he was: a. a researcher well trained in the art of anatomo-pathological descriptions and in the semiology of neurological symptoms, as he shows his experience at the Brücke Laboratory in Vienna and in his study about cocaine (Freud, 1884/1960). b. a skilled practitioner of the clinical method, especially in the art of diagnosis, as revealed in his experience with Charcot at Salpetrière and on his study on Aphasia (Freud, 1891/1977). c. a meticulous investigator of the causality of psychic symptoms, shown in his first articles on the aetiological role of sexuality (Freud, 1895a), while still under the influence of his contacts with Fliess. d. a curious and demanding therapist in terms of his mastery over the techniques for relieving psychic suffering (hypnosis, suggestion and shock treatments, for example), as shown in his partnership with Breuer (Freud & Breuer, 1893/1988). But Freud introduced an entirely new perspective in the closed space of problems that psychiatry and neurology were facing in order to be constituted as clinics. Instead of patiently moving from semiology to the construction of a diagnostic connection with aetiological hypotheses, he started off from the weak point in the system: its therapeutics. The basis for this step was his discovery that hysterical symptoms could be simulated by hypnotic suggestion. When Freud converted Charcot’s method of semiological investigation into a method of treatment—the cathartic method—all of the elements of the structure were mutually affected. It was still a hybrid clinic located somewhere between gazing and listening, but the gaze that was involved in hypnosis was not designed for seeing. It was a type of subterfuge for the truth to emerge somewhere else, a propaedeutic procedure for suggestive intervention, a tactic to stir up and extract recollections. Freud once said that the use of the couch was a recollection of the cathartic method that remained in the psychoanalytic method. As a symbol of the transition from gazing to listening, the couch is also a

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specific instrument for blocking the gaze. The patient lies down, but the doctor’s gaze is not directed to the patient. Just as the classical clinic began when doctors took the step of touching their patients while examining them, at their bedsides, the psychoanalytic clinic began when Freud decided to take his hands off his patients and stop using what he had called the pressure method. This variant of catharsis can be read about in the case of Emmy Von N. (Freud & Breuer, 1893), and was used for only a short time. The doctor would place his hand on the patient’s forehead and suggest that, when he withdrew his hand, the patient would remember things from the past. The failure of this technique led to free association. It is interesting to note the clinical nature of the arguments Freud used to justify his abandoning the cathartic method: It was an exclusively symptomatic method that did not affect causes and merely resulted in relapses; it depended on the doctor’s authority and the patient’s corresponding empathy, which did not always materialize, it did not have a stable diagnostic correlation because very few hysterical patients were hypnotizable and, finally, it did not separate the nature of the symptoms from the patients’ complaints. These perceptions represented a critical argument against the four elements of the structure of the classical clinic, described above. Listening thus became the essence of this new clinical project, namely, psychoanalysis. It was methodical listening and the therapist had to be attentive to details, minor incongruities, lapses, repetition, and faltering in speech. The practitioner lets his attention float, and the patients speech is open to interruptions, further questions, and silences in the discourse. This listening became the centre of the clinical scene that the medical gaze had left in the shadows. Psychoanalysis can thus be defined as a method of listening and intervening in speech, but it can also be considered a method of reading and writing that develops on the unstable boundary line between jouissance and the unconscious. The idea of active spontaneous listening together with non-visual reading (the technique of free association in conjunction with free-floating attention) may appear strange when presented as a technique. One must keep in mind here that we are dealing with a technique in a sense that is analogous to a musical, artistic, or theatrical technique. Just as we saw in the case of the classical clinic, clinical practice in psychoanalysis involves a technique subordinated to a method of treatment,

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and these aspects cannot be dissociated from experience or from a scientific method of investigation. In a study on the history and structure of psychiatric knowledge, Bercherie (1980, p. 25) includes some comparative observations regarding psychoanalysis. His position is that: [W]e can talk about the psychoanalytic clinic under the condition that we not forget that the adjective in this expression is more important than the noun, but that the two terms are inseparable.

In other words, psychoanalysis is a clinic, but a clinic that submits its structure to its own pre-suppositions. The hypothesis that might be introduced here is that psychoanalysis subverts, in the strongest sense of the word, the status of the standards of the clinic from which it emerged. There is a factor of interruption and constitutive mutation when one thinks of the passage from the clinic of gazing to the clinic of listening. There is also a relationship of subversion when one considers the elements involved. To subvert means to invert and displace the meaning of a process. It is not merely a passage to an opposite. It is this, plus a further displacement, and can be better represented by a ellipsis than by an circle. In other words, it is a passage that inverts the centre and holds it in displacement. The word versus comes from the Latin verb versar, which means “to turn around”, “to twist”, “to examine”, or “turn toward”. One can note Lacan’s insistence on the variations of the word version in Lacan’s work: “subversion of the subject” (sub-version), “traversing of the fantasy” (tra-verser), the inside-out (which, in French, is envers), the versions of the Name-of-the-Father (versión and pére-version), and others.

Semiology of language and subversion of aetiology Admitting this total decentring of the gaze in Freud’s subversion, what role might be reserved for semiology? By abandoning a system based on organic semantics, which requires stability between a sign and what it signals, Freud went on to deal with the unique and unstable character of the connection between the signifier and the signified, and with the multifaceted and temporal aspect of the production of meaning. For example, a hysterical conversion, such as

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the paralysis of a member, is based on the representation the subject makes of this member, and not of its anatomical structure. But even such a representation is not only a cognitive conception produced by the subject. It carries with it the narrative interplay from which it arose and is only understandable on this basis. Case descriptions and clinical fragments that Freud presented and the psychoanalytic tradition he founded represent a stylistic and epistemic break with accounts from the classical clinic, where the analytic approach includes a genealogy of the subject and an archaeology of meaning (Birman, 1991, p. 197). The clinical accounts produced consist of stories that make use of resources from literature but do not deny what is clinical in them. A number of elements proper to subjectivity are introduced in the form of linguistic properties. This case, the semiological reference is homogeneous to the semiology of the discourse. The patient’s discourse itself (rather than the organs of his body or the reality of the world) itself taken as a reference that includes relativity, temporality, and arbitrariness of meaning, the tragic, comical, or dramatic character of the analysand’s experience, unpredictability, and overdetermination. The rules for putting together dreams, jokes, lapses, and symptoms can be related to a semiology proper to psychoanalysis. Displacement, condensation, possibilities for figurability, regression, and secondary working through all take on the character of a discursive grammar on which the notion of unconscious is grounded. It should be remembered that this similarity between the unconscious and processes of symbolization inherent to language was noted during the 1940s by psychoanalytic authors, including Lacan, but also by scholars of structural linguistics, such as Jakobson (1970, p. 33), of neo-Kantian philosophy of symbolic forms, such as Langer (1989), and others in aesthetic movements such as surrealism. The subversion of semiology is innate to any clinical project understood as different from classical clinical practice. This directly or indirectly implies that a specific and different perspective for understanding the functioning of signs must be adopted. In the case of the clinic in psychoanalysis, this brings up the problem of establishing its semantic reference. Freud was aware of this need and left continuous indications in his work in this regard. Sexuality, trauma, castration, and the broad range of concepts that refer to roots, or origins (Ur), have the function of stabilizing the semantic reference of psychoanalytic

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semiology. From rhetoric (Chaitin, 1996) to analysis of discourse (Leite, 1994), from semiotics (Saporith, 1996) to pragmatics (Freire Costa, 1994), or even from hermeneutics (Ricoeur, 1977) to the theoreticians of deconstruction (Derrida, 1997), we see how the sciences of language, rather than biology, became the field with the closest interlocution with psychoanalysis during the twentieth century. The proximity of analytic listening to the field of literature has also been pointed out for many different perspectives, including poetic listening (Chnaiderman, 1989), detective stories (Žižek, 1991b), the problem of translation (Arrojo, 1993), and genres of literature (Mahony, 1990). Lacan first tried to discard the problem of semantic references by showing that a strict reading of the concept of the unconscious would be possible without having to face the problem of the contents of the unconscious. During Lacan’s period known as the “return to Freud” (1953–1966), the unconscious is empty, in that it is a set of forms without contents, or of signifiers without meaning (Lacan, 1957b, pp. 461–495). But Lacan soon reintroduced the question from a different angle, namely, the negative semantic reference, which is what we now find essentially in Lacan’s notion of object a and his theory of sexuation. Psychoanalytic semiology has a special characteristic: it can only be completed during the treatment process. Based on the thesis that what “constitutes the analytic field is the same as what constitutes the analytic phenomenon, the symptom (Id, 1955a, p. 189), it should be clear that the signs that are of interest to psychoanalysis are defined by their relationship to the subject in the speech of the other. In other words, the unconscious is not an ontology in the third person according to which good descriptions are valid in all possible worlds for any subject. This is why psychoanalysis requires an ontology in the first person, that is, it needs a theory of the subject that makes the subject inherent to the act of speaking. Psychoanalysis introduces a correlative subversion of the notion of causality on the plane of its aetiology. For example, the notion of significant determination (automaton) and that of encounter with the Real (tuche) are two ways of materially conceiving of causality in a register different from what is found in most natural sciences. The most common conception in the classical clinic supposed the existence of causal properties that could be seen in the sphere of the organism and that were coextensive with the realities of nature in general. Some of these properties are subverted by psychoanalysis,

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others are simply ignored. For example, in the process of symptom formation and in the choice of type of neurosis (hysteria, obsessional neurosis, or phobia), as well as in the constitution of the subject, an unusual type of causality can be noted. Events that are chronologically later than others go back to change the understanding of the earlier events in some way. A given episode can become traumatic long after it actually occurred by being resignified (nachträglich). This is Lacan’s definition of signifier, that which represents a subject to another signifier. At first, for example, a woman ([Khaterina case] Freud & Breuer, 1893) who saw her uncle having intercourse with a young girl may suspend the signification of this happening for a long time. She may have become curious about what she had seen, but remains relatively indifferent. Much later, however, she may be suddenly embraced by a man who touches her in the same place where she saw her uncle touch the girl. She then retro-acts on the first scene and gives it a sexual meaning. The scene is then forgotten and symptoms appear in its place, such as breathing difficulties, a feeling of tension in her chest, or dizziness. In Lacan (1955b, pp. 13–69) the subversion of the notion of causality is not reduced to the process of significant determination. The notion of the causality of desire is also involved, and here the notion of object a takes on a specific value. Psychoanalysis presumes the concept of overdetermination (Uberdeterminierung) and holds that nothing in psychic life happens by chance. This idea does not reflect the same type of causality as that described by Laplace. On the contrary, it is a form of materialism that includes chance, precisely as Lucretius postulated with the notion of clinamen. Similarly, expressions such as event, happening and occurrence should be moved from their association with phenomena to their connection with the logic of appearance. This is an event of language rather than a connection between phenomena. In the objectivist sense, phenomena are not altered by being re-described, in other words, they are not changed by the way we refer to them. They are, in themselves, the result of autonomous syntheses between the passivity of sensorial intuition and the spontaneity of the apperception of concepts. Subjectivity, in contrast, undergoes changes when we either describe it, re-describe it, de-construct it, or narrate it. To tell someone they have tuberculosis or hepatitis has no effect on the disease itself, but can affect and greatly transform the subject. The same holds

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true for symptoms in psychoanalytic since they depend on and are inseparable from their form of enunciation and their structure of language. A symptom can be reversed by interpretation in a field of transference due to the pre-supposed homogeneity between the semiological and diagnostic conception of a symptom as material for intersubjective language, on the one hand, and, on the other, the aetiological and therapeutic conception of interventions based on the word. Therefore, even after the structural terms of clinical practice were subverted, the criterion for homogeneity among its components could be grasped. As for diagnoses, Freud’s subversion was of no lesser import. Instead of exhaustive classification and objectifying descriptions, he reintroduced a homogeneity between diagnosis and treatment, an aspect that had been abolished in the psychiatric clinic. We saw that the subject of this subversion was the medical discourse, represented by the clinician, on the one hand, and the object, the patient, represented by his or her body, on the other. Psychoanalysis inverts and displaces this relationship. Through the methodological practice of listening, the analysand is placed in the position of subject. Inversely, the analyst, even when occupying the place of an agent of discourse, exercises her or his action from the position of object. According to this strategy, it can be seen that the relationship established with this object replicates and adds something new to the modes of construction, formation, and constitution of objects that characterize the different clinical structures. A diagnosis consists of the reading of the articulations between traces, signifiers, and symptoms in their re-actualization as they are brought to the present of the sexual reality of the unconscious.

Diagnostic process of the transference and the subversion of therapeutics In other words, this diagnosis is carried out not only through the transference, but from the transference. This implies a drastic reformulation of psychopathology, which provides no fixed descriptions for an anonymous observer, but rather more or less regular forms of transference. Here we could break down the different orders of diagnosis as a function of the numerous levels of questions implied in the notion of transference. These levels would include: the type of relationship defined in terms of speech, by properties of discourse (the specific way that a message returns to the subject himself

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in an inverted form), the type of relationship that is established with attributed, supposed or exposed knowledge (supposes, attributed, exposed); the type of completion of the symptom effected by the demand (in the Other, of the Other, from the Other), the location of the lack (in the side of the subject, in the side of the Other); the type of discourse (hysterical, university, or master); the type of relationship with lack (repression, foreclosure, or refusal), and so forth. As we saw, the diagnostic work depends on the semiology. If psychoanalytic semiology does not imply a fixed semantic regime of signs and if its universality is pre-supposed only in the empty form of the laws of articulation of the unconscious and the drive, then the diagnostic work must isolate the particular signifiers as they appear in their singular articulation for each patient. Language enters into the psychoanalytic process of diagnosis not only as structure, but also as fundamental mediation in the dialectic with the Other. Just as in the classical clinic, the diagnosis in psychoanalysis is an activity that can be continuously broken down. But, differently from what occurs in the classical clinic, diagnosis in psychoanalysis is not an act because this would imply the objectification of the patient into a new form of alienation and would counter the principle that, in analytic treatment, the only subject present in the situation is the analysand. But there are two possible correlates of the diagnostic act in psychoanalysis. The first correlate consists of making diagnosis a condition for the act of entering into analysis, that is, only when one has a minimally formulated diagnostic hypothesis should one feel authorized, on the basis of transference, to interpret. Here the diagnosis is a condition, not an act. The second correlate consists of naming the symptoms. It is not always needed but may be a strategic benefit for treatment, the decision depending on the logic of the patient’s discursive semiology. In other words, a symptom can also be decoded in the “neurotic’s currency”. We are referring here to a comment in Freud’s case of the Rat Man, where he said psychoanalysts should accept the neurotic’s currency. This metaphor suggests that all neurotics have their own universe of values, modes of expression, cultural and social pursuits, life styles and linguistic styles, family romances, individual myths, and childhood sexual theories, and they also have their own language, dialects, and idiolects, words they give special value to, based on each one’s own singular history. Freud’s recommendation

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is clear and significant. The “neurotic currency” must be accepted and used insofar as is possible in the “exchanges” that make up the analytic dialogue. We must convert our own language to be in contact with the patient’s language (his or her currency) and not force an “exchange” on our patients that would compel them to accept our currency as being stronger or better than theirs. We saw that breaking down the diagnosis is less common in the classical clinic and tends to be limited to the process of confirmation or correction of the diagnostic hypothesis during the healing process. But in the psychoanalytic clinic, it is common practice to breakdown the hypothesis, and is necessary for two reasons. The first reason is that during every session the analyst must make a microdiagnosis of the state of transference, as well as of the specific question of the first moment of the session. At each session one must re-read the particular configuration of the economy that includes the symptom, the inhibition, and the anxiety in their specific variants and their relationships with ways of acting. The position of the subject must thus be noted through diagnostic listening during each session of the treatment. This is why a psychoanalytic diagnosis can only be complete at the end of treatment. The second reason refers to breaking down the diagnostic investigation in the process of exploring and constructing the subject’s fantasy. Here we find the clinical idea that the final objective of the diagnostic process is to real-ize the aetiological diagnosis, in the sense of making it real (Dunker, 2006, pp. 121–140). If psychoanalytic aetiology, at least in Lacan, is subverted through the notion of object a, and if this object is the central articulator of the subject’s fantasy, aetiological diagnosis consists of locating and classifying this fantasy. Here a consideration is in order regarding the difference between the diagnostic and semiological categories in psychiatry and in psychoanalysis. A psychoanalyst must be aware of the different levels of diagnosis, such as symptoms, structural traces, the fantasies involved, the structure of narcissism, and the economy of jouissance. If these aspects are not taken into consideration, the analyst will end up resorting to the clinical temporality proper to the medical clinic, where the diagnosis comes first, followed by one or more interventions under transference. A diagnostic process in psychoanalysis is different from this simple scheme of successions because the temporality that articulates it is different. In psychoanalysis diagnostic processes go on from the

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first to the last session of the experience, due to its intimate retroactive connection with the modes and conditions of therapeutic intervention used in it. To imagine that this diagnostic process can operate independently from aetiology (where the question of the constitution of the subject is inscribed) means to separate construction, formation, and constitution non-dialectically. At the bottom line the psychoanalytic diagnostic process should be able to clearly infer the clinical structure in question on the basis of the structure of the transference (Calligaris, 1986). Inversely, the structure of the clinic should not go beyond the modes of constituting the transference. Freud borrowed and held to descriptive notions that had been established in psychiatry, such as hysteria, obsessional neurosis, phobia, paranoia (dementia praecox), schizophrenia, melancholia, sadism, fetishism, and masochism. This same trend can be noted at other semiological levels. In contrast, three sets of decisive procedures characterize the psychoanalytic clinic, as it subverts the classical clinic, from the diagnostic point of view: Reorganization of psychiatric categories according to new aetiological criteria. The first set of procedures are those that reorganize these classifications according to different levels of principles. For example, a division can be made between defence psychoneuroses (phobia, obsessional neurosis, hysteria, and paranoia) on the one hand, and actual psychoneuroses (neurasthenia, hypochondria, and anxiety neurosis), on the other. This division is based on the organization of the differential relationship with the presence and effects of sexuality. The principle for organizing the differential relationship of the circulation of the libido between the ego and the objects is the basis for differentiating the transference neuroses (anxiety hysteria, conversion hysteria, and obsessional neurosis), on the one hand, from the narcissistic neuroses (melancholia, paranoia, and paraphrenia), on the other. Finally, the criterion for separating psychoses, neuroses, and perversions is the type of loss of reality. In other words, psychoanalytic concepts, and not purely clinical descriptions, command reorganizations of psychoanalytic psychopathology. Introduction of new semiological groups. This second set of procedures is aimed at introducing new clinical categories. These additions have included anxiety neurosis (which Freud differentiated from neurasthenia and is described today as panic syndrome), paraphrenia (a hybrid between paranoia and schizophrenia), character neuroses,

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fate neurosis, and traumatic neurosis. In other words, there is nothing exclusively psychiatric about the origin of these descriptions and, it is important to note that these groupings have been true contributions of psychoanalysis to clinical practice in psychiatry in general. Redescription of psychiatric categories according to their therapeutic responsiveness (transference). This third and perhaps most important set of procedures consists of a process of redescribing the categories of the classical psychiatric clinic that does not simply reduce them to a regional language to be used only by psychoanalysts. If the clinical application of this process is limited to the situation of treatment according to the conditions we examined above, this does not mean that they are not to be examined according to a method of investigation that is proper to psychoanalysis but not exclusive to it. This work of re-description is an indication of the covariant functioning of the structure of the psychoanalytic clinic. In other words, the categories of psychoanalytic diagnostic processes can be redescribed because they are subject to and dependent on its semiology, its therapeutics, and its aetiological conception. This work of re-description, which is generically oriented by the demands of metapsychology, is not always practiced with attention, as the history of psychoanalysis attests. Countless diseases have migrated into the area of psychoanalysis without going through a process of subversive re-description. Categories such as depression, substance abuse, attention deficit syndrome, psychomotor disorders, learning problems, and myriad other correlates are used at their descriptive face value with no consideration for their functioning in any other clinical situation. But some categories have been introduced by psychoanalysis itself, such as borderline states. At this point we could draw up a list of criteria for affecting these types of re-description. Such a list might include the following points. The clinical picture should always be described in terms of possible treatment or of its aetiology, understandable in the light of psychoanalytic theory. A clinical picture should indicate possible symptoms and the determining structure of their phenomenology, and both symptoms and structure should be seen in the light of the transference. A clinical picture should be presented in a way that either integrates it with metapsychological premises or questions them, and this requires topical, dynamic, and economic clarifications regarding them. A clinical picure must be possible to contrast and compare the clinical picture with others in order to avoid tautological descriptions

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and in order to accept competing and reducible explanations in the process of studying them (Id., 2002, p. 104).

Clinical experience We have seen, then, that psychoanalysis is a clinic because it complies with the principle of homogeneity and covariance between its constitutive elements. Psychoanalysis is not the only clinical approach that deals with questions and history left by the classical clinic. Different modalities of psychotherapy, certain lines in education and speech therapy, and even a number of types of knowledge and practices that transit around the edges of instituted fields of knowledge are involved in such processes. These areas survive on, reverse, prolong, or replicate issues left by the classical clinic, through a great many different combinations. Therefore, the splintering and subversion that psychoanalysis applies to the classical clinic consists of a joint operation that ushered in a new discursivity, as Foucault (1970) pointed out. This is why the semiology of psychoanalysis, based on speech, words, and language, its diagnostic process based on the transference, and its conception of aetiology based on the unconscious and the drives, have indeed become the basis for a clinic. But the gaze that was ousted by the changes made by psychoanalysis returns in a type of automatic reconstruction, by the patient, of his or her position in the classical apparatus. This reconstruction provides coordinates for the transference and absorbs the gaze through a mutation, as Lacan (1967a, p. 14) said in The Analytic Act: [W]here psychoanalysts finally find themselves in relation to what they refer to as a experience is that they could not find there a model for recalling the sign, that they could not institute anything in the world of their experience without having the absolute need to bring in, as such, the function of their own gaze.

Bringing the function of the gaze into the picture is different from bringing in a gaze. If our examination of the question is pertinent, the function of the gaze represents what was excluded in order for clinical practice in psychoanalysis to be constituted.

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There is still one final point where this constitutive subversion becomes crucial. The classical clinic is defined not only by a structure, but also by a specific form of experience and by a connection between method of treatment, therapeutic technique and ethics of cure. As we saw, the set comprising structure and experience was included in a broader space consisting of the medical discourse. It is in this articulation that the classical clinic is part of a strategy for taming bodies and exercising biopower. This is what makes it appear, in retrospect, as a purely technical, but nonetheless legitimate, procedure and this is the origin of its authority and guarantee of its knowledge. But it is an error to consider the psychiatric clinic as a truly medical clinic and it is also important to note that psychoanalysis completely ignore the structure of psychiatry by defining itself outside of medicine as a field of knowledge and practice as treatment and healing. This also implies erasing the history of clinical practice. It means forgetting that the State has been at the top of this structure since its beginnings with the emergence of social medicine. Based on all this, one might conclude that what is at stake, including in psychoanalysis, is a technique, in other words, the anonymous application of a set of rules aimed at certain objectives. But this conclusion would mean to ignore and virtually repudiate that, besides being clinical practice that includes treatment, psychoanalysis is a form of healing. It so happens that a technique is only a technique if it is independent of the desire of its user or practitioner. For example, the technique for extracting a certain type of tissue is always the same regardless of the clinician who applies it. This clinician may be more, or less, skilful in applying the technique, and may introduce variations in its details or discover new situations where it can be applied. But the technique itself will continue to be an anonymous empirical or formal instrument for attaining certain results in a systematic and reproductive way. And an instrument used in a more versatile or a more mechanical way does not cease to be a mere instrument. But, since psychoanalysis depends intrinsically on the subject in order to be effective, it cannot be dissociated from either the analyst’s or the analysand’s desire. If a medical doctor employs his techniques without desiring to do so, this does not affect his work as a clinician. In contemporary medicine, the clinical method and the ethics of healing have a regulative rather than a constitutive relationship with one another. This is why the method of treatment can be dissociated from the method of investigation in medicine, but not in psychoanalysis.

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Now we can respond to one of the first questions in this chapter as to the meaning of the concept of clinician. A clinician as a researcher uses the clinical method of investigation and, for this purpose, must use techniques of observation, description, and experimentation. A clinician as one who directs treatment puts the structure of the clinic (semiology, aetiology, therapeutics, and diagnostics) into action. Finally, a clinician, in an older and less precise meaning, can be one who delves into an experience, the experience of suffering, and cares for the truth contained in this experience. But if an analyst applies her or his technique without the analyst’s desire, this analyst is simply not practicing psychoanalysis. He or she is doing something else. Ethics is a constitutive rule in the analytic game, but it is only a regulatory rule in the classical clinical game. In the classical clinic, ethics comes in from outside and is intended to limit the apparatus in view of other moral imperatives. But in the case of psychoanalysis, ethics operates as part of the experience, in the constitutive sense. Now we can go back to our scheme on the relationships between psychoanalytic healing, therapy, and clinical practice. Healing

Jouissance

Knowledge

(Suffering)

(Symptom)

Therapy

Diagnosis

(method of treatment)

Semiology

(method of investigation)

Aetiology Truth (Pathos)

Figure 4. Classical clinic: Merged to jouissance, knowledge, and truth. On the surface that connects healing to diagnostic process we see the clinical practice of broadening the diagnosis. This broadening consists of the mapping of the subject’s quaestio, his or her significant articulations, and the insistences and repetitions by which the clinical narrative is expressed. This surface is permeated with what does not cease to not be inscribed, meaning the subject’s preferred modes of

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jouissance, his or her recurrent choices and everything that a position of the subject in relation to sexuality offers us under transference. On the surface that connects healing to therapy we find the work of deciphering the unconscious, that is, of interpreting and constructing the fantasy, which is equivalent to the notion of causality (object a). This surface, like the others, is crossed by a straight that extends from the opposite angle. In our scheme, this represents the point of torsion (equivalent to the lateral inversion on the Moebius strip), which projects a point of discontinuity on the opposing surface. This point of passage, or of inversion in the case of the surface that runs from healing to therapy, is jouissance (organized by discourses). Notions such as the development and working through of knowledge suggest what an analysis can produce for a given subject in terms of his or her suffering and modes of intersubjective demands of recognition. Finally, on the surface that connects therapy to the diagnostic process we find the work of managing the transference and modulating anxiety. These interventions are aimed at sustaining the transference and carrying out what Freud called analysis of resistances. If resistance is primarily the analyst’s resistance and a fact of discourse, we can understand how this surface is crossed by the dimension of the truth and pathos, through which the transference is undone, as discussed above in terms of the concept of subject supposed to know. And here the notion of the analyst’s desire is central. It is thus clear that psychoanalysis can be characterized as a clinic, or as clinical practice, but it is essentially different from the medical clinic. Freud (1926a, pp. 165–234) gave explicit recommendations regarding the distinctions between psychoanalysis and medicine. Each one requires a different type of training but they share an experience (of suffering), a field (pathological phenomena), and a method (the clinic). The subversion between psychoanalysis and medicine is not to be found only in an epistemological cut, but in a revolution, as we have shown in relation of the ethics imminent to the notion of healing. There is nonetheless a constant tendency to include psychoanalysis in the medical sphere. I hope to have shown the error involved in this idea, as it results from both a misunderstanding of what psychoanalysis is and a lack of awareness of the historical experience of the clinic in general. In this regard, the notion of healing emerges as a factor of political resistance to the complete absorption of psychoanalysis into a strategy of biopower.

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CHAPTER ELEVEN

Hegel: the real and its negative

The ego is only real after it has been surpassed. —Hegel

R

icciardo Minutello is in love with Filippello’s wife Catella. Despite his best efforts, however, Ricciardo’s love is not returned. When he discovers that Catella is extremely jealous of her husband, Ricciardo decides to take advantage of this weakness. After making a public display of his lack of interest in Catella, Ricciardo finds an occasion to convey the same impression to her directly; at the same time, he informs her of approaches Filippello has purportedly made to his own Ricciardo’s wife. Catella is furious and wants all the details. Nothing could be easier, Ricciardo replies. Filippello has made a date to meet Ricciardo’s wife the next day, at a nearby bathhouse; Catella has only to show up there instead, and she will be convinced of her husband’s treachery. So Catella goes to the bathhouse where she finds Ricciardo in her husband’s place. She fails to recognize him, however, as the meeting place is completely dark. Catella cooperates with the desires of the man she takes to be her husband, but then immediately begins to reproach him, 295

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explaining that she is not Ricciardo’s wife, but Catella. Ricciardo reveals in turn that he himself is not Filippello. Catella is distraught, but Ricciardo convinces her that scandal would be in no one’s interests, and “how much more savoury a lover’s kisses are than those of a husband” (Todorov & Porter, 1990, p. 27). This synopsis of a story by Boccaccio is a good example of the two general principles of a narrative: succession and efficacy of transformation; simultaneity and permanence of excellence. We could embellish our account with long descriptions about the physical and moral characteristics of the characters, as we saw in Homeric narratives. This would contrast with the development of a doubt always hovering over the shuffling states of desire, and can easily be seen in biblical narratives. In any case, in Boccaccio’s story we see a double process of healing: the healing of Ricciardo’s unrequited passion for Catella, and the healing of Catella’s desperation over her act. But these events of healing do not take place through any integration or purification of what are alien forces that led the characters to this hubris, as happens in Greek tragedies and shamanistic healing. There is no imbalance between components that are eventually returned to a former configuration. From one point of view, the healing in our story is Hippocratic, in that it shows how, with the passage of time, constructive moments emerge that Ricciardo knows how to take advantage of, since he has the desire to investigate and prove, as did Oedipus and Empedocles. There is a typical moment of caring for oneself, since Ricciardo and Catella speak to one another as friends united by the suspected infidelity of their respective spouses. But this moment of caring for oneself lasts only an instant, as it quickly turns into a rhetorical decision about what to do. Should we act like the historical examples that teach us about cultivating honour? Should we be transformed by the experience of a great disappointment in love? Should we go up into the tower of scepticism and investigate the anatomy of the inconsistency proper to human madness? Catella skips the chapter where all the knowledge that comes to her senses and through others should be submitted to methodical doubt. The time of understanding quickly gives way to the moment for concluding in view of this Other who both deceives and does not deceive. “Is she foolish, stupid or an idiot?” Kant would ask. What specific kind of assent to this pathological object—from which her jealousy flows

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and on which her freedom is based—is at stake in this disease of the spirit? Is it delirious jealousy or blind erotomania? What can be said about the categorical imperative in the principles that govern Ricciardo’s action? Is it perversion? Is it a Sadian reversal of naturalist morals? Or perhaps extreme cleverness, like those of Ulysses or Antigone, carried forward by action in conformity with desire? Is certainly no doubt that the final consolation practiced by Ricciardo in the face of Catella’s despair lets her see things from neither too far away, nor too closely. This is a meditation not on the truth of the contradictions of desire, but on the practical ends he aims at. At the beginning of the story, Catella seems to show no doubt that she neither loves nor even desires Ricciardo. There is not the slightest indication that she is interested in him. Her subjective reality is limited by the indeterminate negation of this factor, and the unity of her being excludes such a possibility. The inherent and spontaneous passivity of her subject eliminated this cause named Ricciardo. The idea of an affair is completely out of the question. Is not possible but it is not impossible either, nor necessary, nor contingent. Ricciardo wants his desire for Catella to be recognized, but through a specific type of recognition: not only that she know of his desire, but that, upon being recognized, it should also be fulfilled. Like every desire, this one is based on a lack and is alienated in an object. Ricciardo denies this desire precisely to assert it in another way, in the form of a private, hypothetical and assertive judgement, namely, “if Filippello is unfaithful then he will be in the bathhouse with my wife”. With this statement Ricciardo denies his desire, just as he has asserted it in his enunciation. It is a trap. The empirical confirmation will therefore come from the encounter in the darkness. Now the inversion (Verkehrung) of Catella’s love for Filippello falls upon her being, but the object that determines this inversion is only a semblance. The effort at recognition that moves Catella’s desire and is expressed in her jealousy proves to be the fulfilment of a passage to the contrary (Umschlagen). The act makes her unfaithful and shows that her desire is now equivalent to the desire of the Other. The negation of something that was not there at the beginning produces an ontological transformation to which the test sought to correspond, that a lover’s kisses are the most savoury. The narratively exposed transformation is speculatively identified with the concept

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that the transformation shapes. Subject and desire pull to themselves everything that they negated to be constituted (Aufheben). The desiring experience that unfolds between Ricciardo and Catella is an indication of the dialectical structure of intersubjectivity. We saw that Kant introduces the notion of negativity on two different levels, the ontological and the judgemental, but this brings up a problem: does this mean that being is an attribute like any other? Just as someone can be a woman, a psychoanalyst or a dry cleaner, might one also have the quality, or property, of either being or not being? Let us remember that this was the key point in the demonstration of the existence of God in both St. Anselm and Descartes. On the level of phenomena, being, taken as an attribute, is just one more descriptive trait conditioned by the categories of my understanding, my sensitivity, and my will. But then how can we understand the psychological or anthropological experience of someone who categorically says, “This is the love of my life” and, at the same time, act as if this statement could be raised to the status of a universal law? Is it a cognitive error, an imaginary illusion, a romantic idealization? But how can we understand the reality of this illusion in its symbolic effectiveness? How can we act towards this false being, except through rhetoric of the critical clarification of the wellsprings of deceit (in other words, in the last resort, we tell the subject that, “You love the law and freedom more than the pathological object that is put in its place”)? Kant would be a very bad therapist. Up to this point in our treatise, the archaeology of the practices of healing has unearthed fragments of three great types of strategies: discursive strategies and narratives based on the tension between therapeutic effectiveness and excellence of healing, conceptual and descriptive strategies based on the tension between the universal of the clinic and the particular of healing, and strategies for integrating therapeutic contingencies with the rational system of needs and contingencies required by the clinical system. The questions we raised about the story of Ricciardo and Catella could be organized so as to construct a case, in the clinical sense of the word. This would imply choices in terms of the relevance and function of each question, the hierarchy and order in which they should enter into the direction of the treatment, and the clinician’s choices. The different genres of psychotherapy and the

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various styles of psychoanalysis could be arranged according to the choices made in terms of the order and importance of these questions in the direction of the treatment. In the two previous chapters (Kant and the Pathological, and Rebirth of the Clinic), we saw how the birth of the classical clinic corresponded to different ways of occupying the space formed by the surfaces on which these fragments are placed. We also saw that both the successful strategy of medicine and, in particular, its most fragilely established specialty’, namely, psychiatry, ended up occupying this space by positivizing descriptive details and redirecting them to universals guaranteed by the geometric texture of the body and by the transcendental dimension of mental faculties. But, in the case of psychoanalysis, we showed that this occupation is negative occupation not only because it subverts the practical elements of its structure but also because it conserves its properties. For this purpose, we would have to admit that we are dealing with something Real without, at the same time, reducing the Real to its constant and regular expression in the form of phenomena. It would be better to say that the Real is expressed in the failure to form the phenomenon. In other words, the real is in the deformation, subtraction, or negation of an aspect of the object that cannot be grasped. The Real is the pathology of the phenomenon. One would thus have to respect Kant’s starting point of a logic of appearances, or of semblance, without reducing it to mere narrative ontology. The term appearance is often placed in opposition to the notion of essence. These nouns can be converted into verbs by using the word “being”, which is both a verb and a noun. Being (essence)

Non-being (semblance)

Non-being (nothing)

Similar non-being (non-semblance)

Figure 1. Being and semblance dialectic. It was precisely this task that Hegel (1770–1831) took on. Hegel is an interesting case for the relationships between healing, treatment, and clinic. More than any other nineteenth-century thinker, including those considered as belonging to German Idealism and Romanticism, the supposition of Hegel’s philosophy consists of a

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fundamental determinant for psychoanalytic practice, namely, an awareness of the historicity of consciousness. If, as we saw, the notion of treatment is intrinsically related to a conception of the past from which the idea of re-establishment flows, and if the notion of clinic is fundamentally connected to the present, in order to conceive the idea of healing, one must include a dimension of the future in consciousness. In the novel The Mandarins, by Simone de Beauvoir, an envious and unbearable woman finally decides to go into psychoanalysis. She is healed and becomes a normal woman, but then she becomes worse than before. She becomes uninteresting and boring, a tediously adapted person. This is the prototype of a model of treatment that rules out the dimension of the truth, which treats reality as an inert figure and approaches illusion as pure but non-existent future. In other words, it is treatment that either excludes the idea of healing or reduces it to adjustment (Hyppolite, 1989, p. 113). Here the idea of universal is reduced to the notion of social totality, just as the idea of singularity is reduced to that of particularity. Hegel is interested in the same problem that arose with respect to psychoanalytic treatment, namely, how can a unique event, a single case, also be considered universal? How can one face oneself, sunder oneself and finally separate oneself from what formed is as culture (Bildung)? How, in the history of each one, as well as in the history of a nation, an epoch, or a system of thought, can a negation be real-ized as such? Less than a thought about concise totality, Hegel writes for readers who no longer trust a pre-established purpose in life and who, at the same time, do not totally take on the condition of masters of their own history. Such persons must recognize the uncertainty and precariousness of socially shared meanings and at the same time renounce the absolute sovereignty of their own meaning. In many ways this is the subject that psychoanalytic treatment presupposes a kind of modern sceptic (Lebrun, 2006, p. 109). Hegel’s scheme is a system in time and its basic operators therefore refer to space. It is a universal system of all knowledge where the exposition does not dissociate the concepts from the movements they emerged from. This construction is, at one and the same time, logical and narrative, and its final solution is found in what Hegel called the Concept, the time in which the real is seen as rational and the rational is seen as real.

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Hegel’s thinking can be divided into three broad currents (Habermas, 1998, pp. 33–50). In the first current we find the idea of the historical real-ization of the truth. The truth does not take place through established relationships where there is a correspondence between the thing and its representation. Truth is a time, or position, which is displaced according to the transformation in rationality that makes it possible. The second current for interpreting Hegel’s thought is related to a theory of intersubjectivity that is meant to show how an anthropological space can be occupied on the basis of the negation that constitutes consciousness. This activity is seen in three elementary forms: language, work, and desire. We can see here the idea that there is a form of logic (dialectics) that presides over the entire process and whose driving force is contradiction and negativity. The third current for reading Hegel is the search for a theory that shows that the structure of the real can be grasped logically by a negative ontology. These three currents in Hegel refer to three reflexive activities, or three methods of subjectivization: introspection, genetic explanation, and the truth as experience (Id., 1999, p. 187). In the space of psychoanalysis they seem to converge with the demands of psychotherapy (introspection), the clinic (genetic explanation) and curing, or healing, (as a process of transformation and as enunciation of the truth). Now let us see how the first Hegelian current served as a model for conceiving of the constitution of psychoanalytic treatment from beginning to end. This current brings us to the circuit of problems related to the effectiveness of treatment. Next we will approach the range and limits of a theory of intersubjectivity in psychoanalysis centred on the notion of desire that can be derived from Hegel. This leads us to an examination of the impasses of genetic explanation in psychoanalysis. Finally, we will examine the argument that the theme of logic and the real in Lacan derives from Hegel, and that its purpose was to go beyond the formal plane towards a negative ontology, on which grounds the theme of the truth can in fact be approached. Taken either in conjunction or independently, these three forays are made here in order to demonstrate the alternative taken by psychoanalysis in its strategy for occupying Kantian soil. They are based on three versions that we find in Lacan for the topic

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of the real, namely, the real of the structure, the real of the subject, and the real of the drive.

The phenomenology of the psychoanalytic experience Hegel’s thinking entered psychoanalysis through a number of different doors to fit in with its themes and purposes. Hegel comes in at many points of Lacan’s work and was the first reference for dialectic of master and slave. His is the best known but not the most important. This leaves open Hegel’s value for constituting the concept of clinic in psychoanalysis. Clinical practice supposes a number of different types of knowledge, including ethical, intellective, and emotional arrangements, forms of rationality, listening, styles, and management. We saw above that the concept of clinic, is an experience within a structure. We have examined in detail one of the aspects of this structure, namely, the therapeutic aspect represented by the treatment. The important thing is to understand whether there are forms of constitutive rationality in the order of the matters and in the articulation of the problems in the psychoanalytic clinic, and not only a generic homology with the clinic in general. Clinical practice is an experience, and a method, much less a science of logic, as Hegel once intended to establish. Hegel realized that the history of knowledge, which consists of scientific, artistic, or religious practice, also establishes the limits and conditions of its experience and truth. And a process that develops by absorbing its resistances, its ambiguities, moments of its own history, and its contradictions into itself has a good deal in common with psychoanalysis. In this case, the history of a psychoanalysis could be seen in the same way that Hegel conceived history in general (Dunker, 2003, V. 6, pp. 49–68). This was Lacan’s first and declared project (1936, pp. 77–95) in relation to Hegel: to establish a phenomenology of the analytic experience, importing, for this purpose, the model of the Phenomenology of the Spirit. It is interesting to remember that this project emerged at the moment in Lacan’s life when he was in analysis with Lowenstein. The project therefore represents a double interest in establishing the concept of experience. Although Lacan abandoned this project in the mid-1960s, it reappeared in the controversial

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idea of the pass (Id., 1967b, pp. 248–264) as the moment when the subject narrates his or her experience of analysis to two witnesses (the so-called passers), who then re-present this reformulated narrative to a jury, which decides on the appropriateness of this specific experience. Lacan’s reference for the idea of a phenomenology of psychoanalytic experience is Hegel’s phenomenology, not Husserl’s or Heidegger’s, nor is it the notion of phenomenon absorbed by logical positivism based on Kant, Frege, or Wittgenstein. Let us look at the first aspect of Hegel’s influence on Lacan, which is the philosophy of history, not of logic (logic will be analysed later). The Phenomenology of the Spirit (Hegel, 1807) was an immense intellectual undertaking consisting of a conceptual narrative on the history of the constitution of the spirit through its relationship with all knowledge and with the figures of its otherness. This is the discourse on the spirit as it appears and takes place in experience with the other. It is thus different from anthropology and psychology. It is not a study of the soul or of man in himself, but an analysis of the deceit of consciousness on the road that leads to self-fulfilment. It is an analysis of the illusions of consciousness and how they are preserved in a modified way in every version of their forms and appearances. This concrete and explicit development of the individual’s culture begins with the earliest origins of the consciousness and continues on to its elevation to an absolute spirit, and it is synchronic with the moments in the history of knowledge that are immanent to this consciousness (Hyppolite, 1999, p. 57). Phenomenology of the Spirit can be read as a succession of four figures of consciousness: sensorial certainty and perception, strength and understanding, self-consciousness and certainty, and the truth of reason. But it can also be read as the logical consequence of systems of thought, such as Platonism, scepticism, stoicism, and others. There are a number of uses for this text of Hegel’s, depending on how one accentuates different stages in of the social life of mankind (Marx), the universal history of experience (Herder), and the constitution of individual consciousness (Wallon). But the supreme wisdom here is in the fact that in each fragment or passage one finds the logic of the contradiction that presides over its totality. The forms of otherness that have constitutive value for the subject cross each other in a double relationship, as they are at one and the same time, the object of knowledge and the territory for resistance and

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confrontation for self-fulfilment as a being of freedom. In Foucault’s words (1981–1982, p. 591): How can the world be an object of knowledge and, at the same time, a place for testing the subject. How can there be a subject of knowledge that offers itself to the world as an object through a techne, on the one hand, and a subject of the experience of self that offers itself to this same world, on the other, but in a completely different way, from a place of testing. If this is the challenge of Western philosophy, we can understand why Phenomenology of the Spirit is the apex of this philosophy.

It is this logic of the disparity between the forms of knowledge and the experience of self that Lacan set out to apprehend in his essays for a phenomenology of psychoanalysis. It was in this perspective that he always endeavoured to describe inversions and moments of going beyond that would, so to speak, be at the core of the process and that could be apparent at its end. Lacan’s great interest in the question of the end of treatment came from this idea that the process, to be truly equivalent to Phenomenology, should have an end. There is an analogy between the topic of the end of history, in Hegel, and the theme of fulfilment of the being of the subject, in Lacan. The importance Lacan gave to the end of treatment is non-existent in Freud, and his conceptual elaborations on this point are not found in the work of other theoreticians of psychoanalysis, because they derive from Lacan’s reading of Hegel. A brief look at Lacan’s statements about the end of treatment leads us to recognize this central idea in Hegel, that the end of history can be seen in several different lights. It is, at one and the same time, the fulfilment of the subject and his or her absorption into a fundamental negativity, the moment when one has come to the ecstatic edge of the “Thou are this” (Lacan, 1937, p. 103), the advent of true speech that allows the subject to fulfil his or her history with respect to the future (Id., 1953b, p. 303), the moment when the subject’s satisfaction is a means to contribute to the satisfaction of each of the persons with whom he or she has associated in a given human endeavour (Lacan, 1937, p. 322), the instant of subjectivization of death itself (Id., 1955c, p. 350), the recognition of castration [Φ (a)] in man’s desire and [barred A (ϕ)] in woman’s desire (Id., 1961c, p. 690), the destitution of the subject,

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the fall of object a in the transference and in traversing the fantasy (Id., 1967b, pp. 251–253), and, finally, the moment when there is an identification with a special and reduced form of symptom, known as sinthome (Id., 1976). In all these theses regarding the end of an individual psychoanalysis one can see that the subject’s being is asserted and grasped in a negative way. There are two expositive strategies for approaching this negativity, the logical and the aesthetic. In both cases it can be formalized, but it can also be hypostatized without difficulty in the psychoanalytic ideology of the end of analysis (Dunker, 1998, pp. 57–87). This negativity is the lack of being (manque-a-letre), and the countless figures of the negative are scattered throughout Lacan’s intellections in his versions of the end of treatment, as he once wrote: There is never a subject without an ego, which would be a completely fulfilled subject, but this is what one should always try to obtain from the subject in analysis (Lacan, 1954a, p. 287).

From this, one does not necessarily conclude that there is a negative theology based on the acceptance of the lack and on a conversion to an attitude of resignation that would lead us back to the contents of stoic morals. What is important is the historical path one has taken, the forms by which this failure in being is organized and repeated, and how new alternatives are created. This is where one can see the importance of the logic of inversions (Verkehrung) and inter-versions (Umschlagen) that are summarized and sublated in what Hegel called the time of the concept or reconciliation (Aufhebung). This was already visible in what was possibly Lacan’s first formulation on the treatment, specifically, the idea that the analyst operates on two registers—intellectual elucidation through by interpretation, and affective manoeuvring through the transference—and that the crucial task is to modulate the moments of these interventions (Lacan, 1954a, p. 88). The entire process is described as a series of inversions and progressive assimilation from the image to the real, followed by a consequent symbolic real-ization of the image. Treatment is thus portrayed as a set of concentric revolutions around two movable centres (Id., 1953a, p. 191). Several concepts can be seen in the big Other the “unconscious of the subject’s ego,” the trauma

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and, generically, the unknown or ignored part of the ego. This part consists of a fragment of the subject’s history that can only be restored by speech in the first person. It therefore involves symbolic real-ization, in the sense of the truth as effectiveness (Wirklichkeit). To real-ize is to make real, that is, to make effective what is ideal, by “completing” the imaginary’ (Lacan, 1954a, p. 89). But this completion fails and thus repositions the Real for the subject. From the analyst’s position, the echo of this point is found in the big Other. Like the specular characteristic of an image, this echo locates the subject’s truth outside himself in the image fashioned for the other. In other words, the echo consists of what I recognize in myself plus what I suppose the other recognizes in me. When the analysand moves too rapidly towards the big Other, the transference is intensified and resistance arises, especially in the form of silence. Here the analyst should not let himself be totally encompassed in an image formed by the analysand’s supposition. The analyst should change positions so that speech is directed towards the big Other. Basically, this is Lacan’s criticism of Freud in his conduction of the Case of Dora (Id., 1951). Lacan felt that Freud moved too fast in his interpretations and failed to de-install himself from the image he had occupied for Dora. He thus real-ized the self-image that Dora constructed, instead of symbolically dialectisizing it in the transference. What emerges in this discussion on truth and the real-ization of the subject’s being is a type of clinical rule: when the subject comes close to objectifying his desire, interpretation acts to instigate the images that make up the ego. Inversely, when the subject comes close to objectifying his ego, the response is to question desire. This reflexive symbolization occurs in the transference and expresses a conception of treatment. In Lacan’s words: First, the subject talks about himself without talking to you, then …, he talks to you without talking about himself. When he is able to talk to you about himself, the analysis will be over’ (Id., 1954b).

Lacan even goes so far as to indicate a possible scheme for this path. The analysis begins by instituting the analyst as a symbolic character, an authority, and master of my truth. This is the real-ization of the symbol (rS). This authority, even though illusory, evolves into

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the real-ization of an image through narcissistic alienation (rI), in what Freud called the “analytic honeymoon”. This gives rise to the disappointment, which confirms that what we have is simply one more imaginarization of the image (iI); one should pay attention to the first signs of resistance, such ellipses, traces, or other signs. This trick thus becomes an attempt to negate the image. It becomes an appeal and a demand for transforming the image into the real (iR). This is the moment of negative transference, of organized delusion, and directed paranoia that characterize the treatment. This crisis is settled through a type of consolation. When the subject cannot find the reality of the image, he creates, or invents, a transferential reality for the image that is being produced, thus symbolizing and bringing something new into existence. Gradually, making the imaginarization of the real is replaced by the imaginarization of the symbol, a necessary process if any identification is to be broken down. This is the moment when formations of the unconscious find their full inscription in the treatment and it involves decisive dreams (due not to their contents but to their position of presentation). It is also the moment Lacan referred to as communication between “unconsciousnesses”. At this point the analyst intervenes actively by inverting the initial phase of treatment, characterized by imaginarization. He does so, first of all, by confirming the symbolic nature of symbols (sS), the greatest of which is the superego (speech that says nothing). Next the analyst asserts the symbolic nature of the image (SI) by interpreting symptoms. Finally, he leads the patient to recognize the Symbolic nature of the Real (SR) by recognizing the transference. This triple recognition carries out a first form of intersubjectivity and is accompanied by an effectiveness that Lacan compares to recovery of one’s health. The cycle of sS, SI, and SR is repeated many times, interpolated by the reappearance of rI, iR, and iS, and this constitutes the middle phase of treatment. The end of analysis is characterized by two new operations: the real-ization of the real (rR) through the speculative identity between the real and the rational that verified the experience as such and, through the possible return to the first position, that of real-izing the Symbol, now no longer identified with the analyst as master, but with the concept of analysis (Id., 1953c). The idea expressed in the notion of real-ized personality is distinct from the solution of pathological structures, and is indirectly related

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with this dialectical solution. For example, the self-punishment paranoia, described in Lacan’s Doctoral Thesis of 1932 (Id., 1932), does not rule out the real-ization of the personality, as do paraphrenia, delusions of relationship, persecution or demand, and hallucinatory psychosis (Allouch, 1997, p. 77). This is a very important and permanent idea in Lacan: healing does not correspond to a solution to the neurosis, psychosis, or perversion. Such a solution comes in as an addition. This thesis is synchronic with the assertion of another type of recognition that is foreign to that of a closed authority represented by the family. In Family Complexes Lacan wrote (1938): Hegel holds that an individual who does not struggle to be recognised outside of her or his family group never attains a personality before death.

We see here the entrance of the topic of death as an anthropological reference to the real-ization of the personality. On a lower scale, the real-ization of the being of the subject must be simultaneous with the establishment of the concept of analysis, just as, for Hegel, selfconsciousness (Selbstbewustsein) takes place in an absolute spirit. Poorly or well carried out, this project of drawing up a phenomenology of analytic treatment and showing that psychoanalysis is a dialectical experience, is long and drawn out, and is recognizable in the notions of act, analytic discourse, and the transformative series of topology. Countless times, especially in his theory of the subject, Lacan used graphs to express the combinatory between the registers; (the symbolization of the real, etc.). What changes is the understanding and formalization of dialectical logic with the inclusion of problems and solutions proceeding from formal logic (Cantor, Frege, and Russell). It would be a serious simplification to exchange the steps obtained in this way with a type of overcoming of the immanent dialectic between formal logic and discursive and narrative logic. In this respect, we can only agree with the thesis that Lacan became truly Hegelian not at the beginning of his work, but at its end (Safatle, 2006). Here we face a crossroads. It is proper to Hegel’s project to attempt to dominate all of experience by using the concept of concept, or using a strong concept of concept, a concept that would be something

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more than a representation of objects, but that would express and contain the time and the process of its own formulation. This is a system of thinking that admits of nothing that is given, nothing that comes from outside. Exteriority is already contained interiority, even when not revealed. The only presupposition is an original division (Entzweinung) between being and non-being (Inwood, 1997, p. 47). Might Lacan have inherited this way of thinking in his understanding of the theory of the clinic in psychoanalysis? It has been observed that there is a very important difference between Freud’s and Lacan’s metapsychologies (Souza, 1998, pp. 81–92). For Freud, concepts have a tentative nature and are submitted to constant revisions and criticism from experience. In his words (1915a, p. 113): Only after having more extensively explored the field of phenomena in question is it possible to apprehend more precisely the basic scientific concepts and refine them to make them usable on a broad scale and, in addition, to make them completely exempt from contradiction. So the time might be nigh to coin some definitions. But the progress of science tolerates neither rigidity nor definitions.

That is to say that concepts are related to an exteriority that can negate and transform them. According to Kant syntheses are successive and they permanently and strongly strengthen new empirical intuitions with categories of understanding, and vice-versa. Even in his postulations that were very close to speculation, Freud always maintained at least one notion that indicated the limit where an object can no longer be conceived in strictly psychoanalytic terms. This is the Q function described in the Project for a Scientific Psychology (Freud, 1895). He also called it outside energy, that is, energy before it is converted into Qn inside the psychic apparatus. This was also the function of the trauma before Freud invented the theory of the fantasy. It was the function of outside reality and of the drive towards self-conservation until Introduction to Narcissism (Freud, 1914c). It is also the mythical function of anthropology, biology, and even geology in the arc that runs from Totem and Taboo (Freud, 1913b) to Beyond the Pleasure Principle (Freud, 1920). In psychoanalytic theory these boundaries indicate an aspect of the object that is outside it. The boundaries between phenomena and

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appearance where pathos emerges an excess of unproductive experiences of determination or as a deficit of productive experiences of indetermination. They are regulating ideas that cannot be recognized, but they function as horizons of integration and mediation of understanding through reason. This is fully in line with a theory of the constitution of the subject as seen in Kant, with the difference that, in Freud, this is not a theory derived from speculation; it has an empirical origin. Lacan seems to have made a break with this procedure. His concepts are hard to pair up empirically and his narrative references are generally literary, aesthetic, and even epistemological objects. Clinical cases of other analysts are abundantly commented on but nonetheless filtered through the conceptography of the one who constructed them. But the key question is, what is in a relationship of exteriority in view of the Real, the Symbolic, and the Imaginary? In other words, are we faced with a system similar to Hegel’s where nothing stays outside it? And, when we choose a metapsychology without exteriority, whose only resistance is between one concept and another, are we not also making an ethical choice? To summarize, let us consider four criticisms of the absorption of Hegel as a theoretician of psychoanalytic practice: a. His tendency to formalize eliminates part of the experience contained in the concept, namely, the contents of the object. b. Clinical narratives of others are “interpreted” according to the concepts, this losing the aspect of contradiction between narrative and concept. c. Psychoanalytic practice is conceived as a system without exteriority (not as a clinical experience in the broad sense, nor as any other form of theorization). d. The ethics on which this project is based is very dangerous, due to its dogmatism. These criticisms admit of three counter-arguments. The first counter-argument is that by basing himself on Hegel, Lacan left behind him the pre-supposition of exteriority and brought in his own contradiction into the concept. In this case, it would suffice to try, for example, within the Real that negates and contradicts the concept to recover the same creative and transformative strength afforded by the “shock” of experience. This first counter argument

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is weak because it recovers the importance of contradiction only in a displaced way, but it does not actually posit an exteriority. The second counter-argument is that the Real, the Symbolic, and the Imaginary, are mutually outside of one another is just one variant of this problem. In this light, all exteriorities are local and enveloped by the whole system. And this does not take into account any criticism of the very notion of exteriority, trivially discarded with topological arguments. There is no escape hatch that is not included in this same totality, and this would oblige psychoanalysis to constantly be an epistemological enterprise about. This second argument is justifiable but it undoubtedly represents a serious mischaracterization of the scope of the clinical basis of psychoanalysis. Indirectly, it helps us understand why it is so hard, within the Lacanian sphere, to separate the theory of treatment from the theory of the clinic, and the theory of the clinic from a metapsychology. The third counter-argument is that Real, Imaginary, and Symbolic do not form a universal of universals. Lacan may have introduced the fourth knot (the Name-of-the-Father as sinthome) to get around this problem. This counter-argument is also weak because the movement can be better understood by extending Hegel’s triad to a set of four terms, a procedure that is common in attempts to formalize dialectical logic. But the number of categories does not matter; what matters is that they should not be exhaustive. I would like to believe that this third counter-argument is the most plausible. Exteriority and contradiction occur between the modalities of knowledge that characterize the clinic. This is therefore a heterogeneous totality. I hope that our passage through the archaeology of the psychoanalytic clinic has made this clear. Healing, clinic, and therapy are related, but they are also equivalent to practices that are exterior to one another due to their historical constitution. They appear in a non-exhaustive relationship of mutual negation. This is what is conveyed in Lacan’s attempt to establish a phenomenology of psychoanalytic treatment. In other words, he added a category that is completely foreign to both the order of therapeutics and the order of the clinic. Specifically, he introduced the concept of the truth in psychoanalysis and its correlate on the side of the analyst, represented by the analyst’s desire. For example, the theory of the pathological would be unthinkable without Kantian anthropology. The psychiatric clinic depends on this anthropology, just as it returns us to rhetoric and to the origins

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of medicine. These forms of rationality are completely transformed and, at least in part, cannot be reversed to their origins, but this does not mean that they are erased from the experience that gave them life. This is an exteriority that remains active and problematic within analytic practice. Another consequence of the same thesis is that the theory of the constitution of the subject in Lacan owes a great deal to Descartes, Kant, and Hegel. There is a gap, a great transformation of pre-suppositions or, we might say, a deformation of concepts, but this does not authorize any opportunist methodologism that sees in these incorporations the creation, for example, of a “Lacanian Descartes” or a “psychoanalytic Saussure” for internal use. This would only make sense in the light of our own interests and concepts. To say that all the concepts and notions of psychoanalysis only make sense in the clinic, and that the clinic is the sovereign privilege of psychoanalysts, is witness to ideological rigidity and the establishment of impermeable boundaries. Its immediate side effect is that we no longer know how to define what clinical practice is without reducing it to the sphere of treatment. Besides Descartes and Kant, there is a third source of clinical practice, which is not reduced to the theory of the subject or even to the theory of the pathological. It is a type of general theory of the construction of objects. Here psychoanalysis comes into contact with ontological and ontic topics, as well as with the problem of the bases of morals, with aesthetic objects and with erotics. Its interest is diffuse in each case and it seems to consist of the mapping and theorization about that which resists being psychically inscribed. In this case, the notion of psychic reality seems insufficient. This makes us neither philosophers nor scientists, but rather investigators of boundary lines as signs of exteriority. These are the three theoretical tasks that make up the basis of clinical knowledge: a. a theory of the formation of symptoms b. a theory of the constitution of the subject c. a theory of the construction of fantasies At the same time, they are separated from both their simple therapeutic efficacy and from the work of caring that is intrinsic to

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healing. These tasks should not be classified together with categories such as Real, Symbolic, and Imaginary. It would be more appropriate to say that each one implies a way of articulating the economy between the registers. It is easy to note that each of these intellections corresponds to a form of clinical rationality that uses the concepts in a slightly different way, depending on the intentions, or purposes, that are proper to it. For example, the enormous oscillations we see in the use and ways of understanding the notion of Real, even among very qualified commentators, does not seem to be a problem that can be solved through cognitive correctness or refinement of the interpretation of texts. It reflects regional differences and, sometimes, the individual style of each analyst in facing the contradictory demands of healing, therapy, and clinic. According to this hypothesis, it would be important to look for a type of tension between the theory of the constitution of the subject, which refers to different modes of contradiction with experience but a contradiction that is encompassed in the space of the clinic, the theory of the formation of symptoms. Using Hegel as a standard for the phenomenology of psychoanalytic experience shows a double face here. On the one hand, it is a useful but questionable procedure for systematizing all of treatment. On the other hand, however, it brings up once again the problem of the relationships between the treatment as the unification of knowledge, desire and power.

The master and the slave The romantic plot that unfolds between Ricciardo and Catella deals with a central fact of intersubjective experience. When Ricciardo falls in love he feels a form of domination by the other, since the object of one’s love is always a source of a power over which one is not the master. Kant had already explored a set of paradoxes contained in the notion of freedom of the will. His argument is that we are apparently free to want what we freely want, but if this were so, why, when we want an object that is not available, which was the case of Ricciardo towards Catella, can we not use our freedom to choose to love someone else. This is the theme of the pathological (pathos) as passivity, loss of autonomy, and a desire for servitude.

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There are three permanent sources of loss of sovereignty over oneself: desire, which we cannot master entirely, since it is desire of the desire of the other, love; which leads us to voluntarily give what we do not have (the “free obligation” to retribute) and, jouissance, which compels us to serve as the object in order to find our own satisfaction. When Freud established sexuality as the driving force of intersubjectivity, he brought together these three conditions of the pathological. We also find these three dimensions in the structure of the transference. Structure can be read as a type of mimesis, and they make the impasses of the sovereignty over oneself real-ized in a concrete intersubjective situation. These impasses find a first model of solution in the idea of recognition. Let us see how a reading of Hegel enables us to locate both the importance and the boundaries of the dialectic of recognition in the figure of master and slave. Let us remembered the four cases of negation we isolate till here, in order to understand the change of places and positions between master ans slave. 1. 2. 3. 4.

opposition (indeterminate negation) inversion (recognition of contradiction) interversion (internal contradictions) sublation (Aufheben) (crossed contradictions)

The master is one who risks his life to be recognized as a master by another man. In other words, he would rather be recognized, ideally or symbolically, than protect his own life, which is a real and biological fact. The act of recognizing has a nature of its own, and its central figure is naming, in this case, giving the name of master. This is not the same thing as to imagine that others perceive him as such. The secondary figure of the master-slave dialectic salve derives from the fact that recognition by the word may be false recognition, due to some use of force and coercion. The real proof that the master is the master and the slave is the slave is in the work they do. The slave works for the master and gives over to him a part of the product of his efforts. A part, but not all, since even if everything else is taken away from a slave, he still retains the knowledge needed in order to work. Just as the master dominates the slave, the slave dominates nature and the slave thus becomes a master too, a master of nature

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(opposition). But a true master lives off of nature without struggling against it. He enjoys nature, obtains satisfaction, or jouissance, from it (Genuss), through the slave. Satisfaction without effort is pleasure (Lust), and the consequent state of this is satisfaction (Befriedichkeit). What the master desires is not to live a life of satisfaction but to be recognized as a master. At the end of the struggle, he is recognized by a slave, not by a true man like the master himself (inversion). Therefore, he must face another master in a new struggle. But the alternative between life and death is then transformed into a struggle for prestige and recognition, taking the previous struggle of life and death to another level. But this is impossible because it would result in the same impasse arising from the fact that his triumph (as master) is also his failure (being recognized by a slave). Death is now the negation of the condition of both master and slave. Only death, and no master in particular, is the absolute master (interversion). Therefore, the master can only be truly satisfied by death, either his own or the slave’s. As a result, the master will always be dissatisfied or haunted by the fantasy that his satisfaction is only partial, insufficient, or merely false. The fantasy does not symbolize what it should. Domination is an existential impasse—to die struggling or to become brutal in pleasure. In both cases he will be dissatisfied with what he is. This negation that is proper and intrinsic to the consciousness of the master can only be real-ized through the recognition that his truth (Warheit) is given in and by the slave. The master appears only to engender the slave that both sublates and safeguards him (Aufheben). Inversely, the slave who recognizes himself in his master becomes an ex-slave, a citizen. He is therefore no longer only a master of nature, but also a slave among others (sublation). Humanity enslaved itself because of the fear of death. Our dependence on the master reflects our dependence on nature as selfpreservation and the transformation of objects. This fear is a fundamental experience. It shows that the slave experienced angst and the dread of death, and had a glimpse of the void. He has thus understood that his existence is nothing more than death suppressed and conserved in Being. And his Being is only negation of what he apprehends he is. This fear of death continues on as fear of the master during the process of work, but it is not the same fear because now death and the master are apprehended as a concept, the concept of angst.

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In the name of the figures in this concept, the slave represses his pleasure and receives knowledge in exchange. This is technique on one level, science on another, and ideals on a third. The initial struggle develops into a process of negation represented by work. The slave, through his work and knowledge, and the master, through his courage and jouissance, jointly constitute the concept of freedom. The slave and the master free themselves in order to freely be enslaved. The master is the master of insufficient freedom, since freedom is real-ized, and devoid of any ideal. But the slave has an un-real-ized ideal for freedom. Only the slave can real-ize ideals and therefore surpass his own condition, and this progress can only have meaning for him. As we saw, the struggle ends in an impasse for the master and he must continually begin anew unending inversions. The slave’s freedom can only be attained if it is universally recognized by those whom he recognizes as worthy of recognizing this freedom. Therefore, there is a real at stake in this recognition. At first this real is questioned by the fact that it is based on the recognition by the slave, but a reverse struggle then begins, of the slave against the master to make his own concept of freedom have some value, not only inverting positions, but creating new places by interversions (the citizen). In this concept, the master’s reality and his human dignity are sublated, since they are universal, whereas the master’s freedom, for himself, is particular. It therefore suffices for the slave to impose his freedom on the master in a way that will make it recognized, in order for the process to be interrupted, destroying the categories of master and slave and encompassing them in a further stage of the Phenomenology of the Spirit (Kojéve, 1947, pp. 168–172). This is fulfilled intersubjectivity. There are several questionable pre-suppositions in this reading of Hegel. The first is the association of action with negation. Contrary to behaviour, all acts are acts of negation. For example, there is negation of nature, by work; negation of the thing, by language; and negation of the object, by desire. The three fundamental figures of act are language, work, and desire. From this thesis of the act as negation one can conclude that the subject of desire is necessarily empty, otherwise it could not be an agent of negation. It is occupied by a type of positive imposture, which is the feeling of oneself, different from true consciousness of oneself. Another consequence is that desire is the desire for another desire.

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It cannot be fulfilled by an object but only by another act, an act of recognition. Therefore, its form is time, and not space. So there are three moments: the constitution of the subject by negating the feeling of oneself; the formation of desire as negation and recognition of the other; and the construction of the object by work and knowledge. Desire is humanized through risk and through the renunciation of self-preservation, into recognition. To desire a desire opens up a history, the history of desired desires. Desire is the desire of the Other because this history is the place where it is fulfilled. In other words, it is a dialectic between positions that determine desire, that aspire to be fulfilled as places. So its reality is based on recognition. For this to happen, both desires must remain, in their difference, after the fight. But here there is no longer any opposition between master and slave, but only opposition and recognition between desires. Through consumption, the desire of the master destroys what the slave’s productive work constructed. But the slave’s work is also to transform his anxiety and confront the law of the master (Kojéve, 1947, 11–31). We see in this conceptual narrative the inversions, negations, and contradictions that Lacan used in his theory of desire and transference. The narrative takes on an anthropological connotation and moves towards reconciliation. It does not lead to integrative catharsis, whose origins are found in a natural or metaphysical ontology, but narrative does presume that the drama unfolds in the subject himself in his symbolic relationships with the Other. The narrative also complies with Kant’s criterion of being a negative anthropology where a man is defined by his lack in being and by his negating activity. There is not much space here for caring, which, as we saw, accompanies the entire archaeology of the clinic in psychoanalysis, but recognition appears as a cure for social resentment and for the suffering in general. One cannot fail to note that the narrative of master and slave is directly related to the topic of power and domination. This dimension was forgotten in Lacan’s reading of the constitution of the subject and the formation of symptoms, which laid special emphasis on desire and language, respectively. The topic of power, excluded in thus theoretical vein, seems to return, but somewhat displaced, when one discusses Lacan’s conceptions of treatment and of the transmission of psychoanalysis.

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Let us now look at how the notion of authority and power is approached in the dialectic of master and slave and reintroduces a number of topics related to caring for oneself. This notion is first approached through the four forms of authority described by Hegel, namely, stoicism, scepticism, unhappy consciousness, and rational consciousness. 1. Stoicism represents the attitude of consciousness wherein one leaves the world and delves into one’s own interior, recognizing the superior strength of the other as an opposition. 2. Scepticism is the inversion of this attitude in that it is directed to the world but puts the master’s moral superiority in doubt. Scepticism obeys in practice, but subjectively resists recognizing the master but, just as stoicism it consists of passive resistance to power. 3. Unhappy consciousness interverts the previous oppositions. It represents the recognition that there is a master and a slave inside oneself or, we might say, a division between the master and the slave (as positions) within the subject. 4. Rational consciousness interverts and universalizes (sublation) the previous recognitions by applying to them the division inside and outside the subject as llocated and recognized. The crucial point here is to discern whether this division in the subject and the division in the Other is actually the object of reconciliatory identity or of insurmountable disparity. Therefore, transformations of power are indicated by movements of periodic crises in certain modes of relationship. The ethics of recognition, based on sensitivity, empathy, or pleasantness, comes into conflict with the interpretation of power as a real fact. It is through the mutual action of these two strategies that the moments of transformation and the activity of freedom develop. So freedom is not contentment or well-being, but the experience of division. For example, in disobedient dependence, proper to stoicism, the slave rebels and insults the master, but this is so he can continue feeling safe in his hands. So the rebellion is produced to keep the master in his place. Hatred of the master makes him stronger, not weaker. The opposite happens in scepticism authority because it is an authority with neither love nor hatred. It is rather based on

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resentment. By pretending to be indifferent to differences in power, sceptic authority maintains acquiescence in order to sustain the care. Care thus becomes a type of obligation that the master owes us in return for our passivity towards him. Unhappy consciousness can dissociate the authority from the person who exercises it. It thus corresponds to a symbolization of the two preceding positions and to the distinction between the existence of rules and the order of law. Unhappy consciousness expresses a double movement of separation from the other and the establishment of knowledge. The following question therefore comes up: What was I like under the influence of this authority? What did I do to for it to be exercised on me? Here is the first occurrence of the relationship to oneself as a source of resistance to power. But unhappy consciousness brings up a new choice that has to be made: if I can free myself from the domination of a relationship of authority, can I move back to it? (Sennett, 2001, pp. 174–178). This production of knowledge and this choice that opens up to unhappy consciousness engenders two therapies: the mask and expurgation. The mask is a schizoid strategy that corresponds to the internalization of the relationship of power. It inflates the internal dialogue as a substitute for external dialogue, and deepens the meditation on passivity. It cultivates the existence of a type of secret ego that is protected from the domination suffered because of the public face of the ego. This is evident in Montaigne’s quaestio. Expurgation is an inverse paranoiac therapy. Here everything that is seen as a source of influence is to be kept far from oneself. Through this strategy, the subject actively presents itself as passive, as we saw in catharsis and confession. The act of expurgation is not relief from pain, but an increase in suffering in order to exclude something destructive, even if it is enjoyable. These two strategies of unhappy consciousness (similar to integrative and functional catharsis) are extremely limited because real authority cannot be undone by a simple libertarian act of the will. The essential images of unhappy consciousness, autonomy, and paternalism are thus presented as ways of being (Sennett, 2001, p. 218), places with fixed occupants, and not the effect of a game of positions. Their constant use reinforces one form of identification over the other, the form of the victim. The nineteenth century saw a vast transformation in the sphere of the morals of suffering. We saw that the model for these morals

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was martyrdom and the exemplary character that martyrdom could represent for a community. Here we are in a completely different regime from that of the unheroic victim and from suffering as an experience that takes on immediate moral value. If there is suffering there is an executioner, and the victim must be protected from him. There is a crucial difference to be noted here. Care for oneself implies care for the care that others have for themselves, and not direct care for others. But the figure of unhappy consciousness, in the form of victim, is rethorical technique (even if not premeditate) of the exercise of power exactly because it prevents the subject from caring for himself. The caring is passed onto the other, whether this other is the family, civil society, or the State, and thus keeps people from caring for themselves. Instead of facing power directly and instead of traversing authority through approximation and separation, suffering is reduced to a practical problem. Power is thus increasingly the power to inspire fear in exchange for security. This tactic is in conflict with the two strategies described in the sphere of care for oneself as related to the topic of power: well-established verdict (sophrosine) and assurance in the face of danger. From Machiavelli to Max Weber, the study of charismatic figures is the study of the ability to evoke and transfer fear. This is why Hegel describes the overcoming of unhappy consciousness as a process whereby one brings the images of authority closer to oneself in order to look at them so intensely and so closely that the fear is eliminated and becomes anxiety, the concept of anxiety. Here we recognize the combined strategies of the ancient concept of care for oneself, indicating seeing at close range, seeing from a distance, meditating on death, and premeditating evil. Hegel’s solution for unhappy consciousness and the attainment of intersubjectivity is dependent on the concrete universalization of the constitutive division of power. In other words, it is a rational State that operates in total dissociation between the agents of power and the places that these agents temporarily occupy. If psychoanalysis seems to accompany Hegel as far as the impasses of unhappy consciousness, it takes a different road when unhappy consciousness is overcome. One outstanding aspect of the narrative is that it is, at one and the same time, a history of desire and a history of power. The history of power in its microscopic aspect can be recognized in the relationships between husband and wife, father and child, employer and employee,

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and—why not?—analyst and analysand, or any other combination. But this course, which includes desire, love, and jouissance in the same dialectic, suggesting its final defeat through intersubjectivity, presupposes a proportionality between the division of the subject and the division of the Other. This sets up a serious obstacle to its inclusion in the field of healing. It can easily be seen that the figures of the slave and the master cannot be sublated by the figures of the man and the woman. The dialectical relationship between master and slave can only be sublated in a mono-sexualized subjectivity, which can only have a common measure and a point of return in the relationship with death and proportionate jouissance. We could solve the problem by suggesting that what is at stake in the end is the recognition of two different forms of desire, two different positions towards castration, or two irreducible values for phallic inscription of jouissance. The reference to the master-slave dialectic brings up yet a further difficult situation. How can one suggest the dissolution of the figures of the master and the slave when replaced by those of father and child? There are solutions here too. One might suggest that, as master, the father is dead once the slave has triumphed, and that the father continues on in the arch-symbol represented by superego (jouisance), Ideal ego (knowledge) and castration (truth). But the best clinical incorporation of this narrative takes place when one takes the theme of narcissism as a reference. In fact, it is in the sphere of the fulfilment of love that one might suppose the model of a fulfilled intersubjectivity. But it is exactly in this case that Lacan vehemently refutes the idea of a concluded love, as a delirious ideal of modernity, and the idea of a genital drive as a false clinical presupposition. Intersubjectivity has a limit and this limit is sexuality. It is in this scope, therefore, that the incorporation of psychoanalysis into the apparatuses of power can be distinguished either by locating the subject’s truth, through the hypothesis of repression, or by taming bodies. The impasses in integrating psychoanalysis into the anthropologized model of Hegelian dialectic represent, each in its own way, this core by which the difference that cannot be dialectized emerges as the core and disseminating source of the exercise of a power. The political function of sexuality is expressed in the countless metaphors that interpret the social body and tend to portray it as a harmonious unity and totality. Matter and form, act and power, heat

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and cold, activity and passivity are figures of this proportionality that equates the cosmological, or metaphysical, sphere with the political sphere and, as we saw, the ethical sphere with the therapeutic. The allegory of the king’s body, or the body of the Eastern despot (Grosrichard, 1992), the analogies between the social strata and the functions of the body, the metaphors of disease and cure, have always accompanied discursive strategies and political practices. It was in this environment that happiness became a political factor and the modern State evolved into the administration of well-being, attention, and care as a political objective. As I discussed in an earlier work (Dunker, 2002), jouissance, is both an ethical and a political category. There is a permanent and unresolved tension in Lacan between the dimension of recognition, act, and intersubjectivity, on the one hand, and, on the other, the critical dimension of the parity between the universal and the existential, between desire and jouissance, and between totality and unity. This is expressed in Lacan’s theory of sexuation and in his clinical project that constantly insists on the aspiration for the logic of recognition. Even in the notion of destitution of the subject nor does Lacan back down on the importance of the primacy of the object (even if the experience of its disintegration is involved). Let us now take a quick look at how this theory implies a recovery of Hegel’s logic of negation at a level other than that of dialectic and that of master and slave. Here we again come across the same quaternary logic that we described in the structure of treatment and in the theory of the subject, but with several major changes. The starting point is Freud’s problematic of the disparity between the phallus, as the universal premise of sexuality, and the theory of bisexuality, as an existential dimension of the choice of object. We might recall that these two points have been harshly criticized by scholars in both the culturalist and post-structuralist traditions in psychoanalysis. And, the premise that the phallus is the central organizer of human sexuality has led to phallocentric, patriarchal, heterosexual, and androcentric objections against psychoanalysis. The premise of bisexuality has led to the objection that it represents the exclusion of homoerotism, the primacy of genitality, and a dichotomy between the sexes. With the theory of sexuation, Lacan maintains these categories without their having a relationship of unification in each of them

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and with one another. On the man’s side there are two ways to relate to the phallus. In the first, the universality of the phallus and, coextensively, of castration, is asserted. In the man’s second way of relating, there is an element that carries out the function of exception to this rule, namely, that only the mythical father of the primeval horde has access to all the women. Here we once again come across the idea that the universal has its roots in exception. On the woman’s side, it is said that no woman exists who is not castrated, which could be defended on the basis of Freud’s thought through the argument of anatomy or through the notion of penis envy (not-without the fallus). It is also asserted that the woman is not wholly inscribed in the phallic function and, therefore, that there is a form of jouissance that is specifically feminine and supplementary to phallic jouissance. (Lacan, 1973a 105): Therefore, there is no common measure between the phallic universal and the existential of the object, or “there is no universal that should not be contained by an existence that negates it” (Lacan, 1973b p. 450). Here Hegel’s reference to the logic of intersubjectivity between the universal and the singular is changed to the primacy of the object as difference. This disparity applies to both sexes. But there is another disparity that is internal to the feminine between the universal, so defined, and the not-universal. This not-universal is neither the particular nor the singular, it is the not-all (pas tout). These formulas operate in conjunction with the fantasy and with the position of the object. Therefore, from the man’s side, the woman

Man's side1

Woman's side

x .  x

x .  x

x .  x

x .  x



------------

a (men)



---------

... not-whole feminine jouissance

S ()

---------

... the women which does not exist

Figure 2. Sexuation formula.

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is taken as the object of his fantasy, whereas the woman takes the man as phallus. But, at the same time, the woman has a particular relationship with the signifier of the lack of the Other [S ()], from which she extracts her supplementary jouissance. Here the political articulation of sexuation emerges, and it includes a broad range of understandings between the commentators of Lacan as to the scope to which one should apply the notions of man and of woman found in the formulas of sexuation. Might this be a reference to man and to women in the empirical sense? Might each subject be divided into a male face and a female face? Are these positions Changeable discourses? This diversity can also be found in the appropriation of this thesis by theoreticians of gender and of cultural issues. I do not think this quarrel can be resolved merely by examining and clarifying Lacan’s statements. Some see sexuation as a confirmation of the traditional sexism of psychoanalysis in the declaration that “the woman does not exist”. They see it as a further strategy for silencing and encouraging women’s speech in a new version of the production and expropriation of their identity. There are others who find in Lacan’s theory a description of the primary inscriptions of the modes of jouissance of a subject, making them depend on the Freudian notion of fixation (Prates & Silva, 2001). Some hold that these are modes of saying that satisfy or fail to satisfy the propositional phallic function, and of specific types of disorders or failures in the phallic function (exceptionality, divided-universality, not-without, not-all). So might it be that the contingent grouping of these modes of telling the truth produces the place of enunciation of the subject of the unconscious? Sexual identity would then result from a secondary identification through the moi’s occupation of this place (Porge, 2006, pp. 259–263). Finally, there are those who see a similarity between the formulas of sexuation and the theory of discourses, thus understanding that the male and the female positions fluctuate and depend only on the performativity imposed by the discourse (Butler, 2005). In any case, the more distribution of more essentialist, or more deconstructionist, empiricist or formalistic positions, reflect the core of the psychoanalytic theory of sexuality, figures that cannot be integrated into the dialectic of intersubjectivity. This is the case, for example, of object a and the Real. At the bottom line, then, we are dealing with a new form of negativity, the most prominent

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characteristic of which is to go beyond the register of conflict and lead to a revision of the theory of recognition. The choice of one type of reading or another can lead back, then, to a type of politics of jouissance in psychoanalytic treatment. Impassioned topics, such as the erroneous association between homoerotism and perversion, sexuation in psychosis, and the controversy over sex-reassignment surgery, are related to this fluctuation of interpretations on the theory of sexuality in Lacan.

Logic of the real Dialectical thinking in psychoanalysis is therefore based on a tension between ontological negation (the Real) and the imperatives of recognition (intersubjectivity) (Safatle, 2006, p. 323). The hope of bringing together these two factors into the sphere of treatment revolves around the notion of truth. Whether as authenticity (veritas) or as sincerity (emunah), or even as pure speech (aletheia), the aspirations of intersubjectivity that are present in the master-slave dialectic always refer to the limit where intersubjectivity is self-dissolved as symbolic activity and becomes an experience of the Real. In the end, the passion for the Real of love, sex, or desire is found in a concept whose truth is deflated from its aspiration towards control, power, and knowledge. It is a particular and partial truth whose object is negative. Let us now see in one of Lacan’s rare clinical accounts how the dialectic of recognition was articulated with the experience of the Real according to a logic of negativity. Since this account is extremely compact, we have chosen to interpolate into it aspects from the theory of treatment and the conception of obsessional neurosis, in order facilitate understanding. The case is about a man “in his maturity years” with a disillusioned spirit (unhappy consciousness). He had been in analysis with Lacan for quite some time and was nearing the end of the process. He suffered from his obsessional neurosis and with the consequent change of his life into a type of boxing ring where he played out performances of imaginary aggression and interminable revenge. He caused numerous similar conflicts in his work and family, as well as with friends, and brought to light variations of his heroic identification and the continuation of his feelings of persecution and injustice (stoicism). The dispute for possession of reason of reasons and the

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last word was played out before a background of scrupulous and courteous social demeanour. Lacan expressed complete indifference to this fact and the analysand correspondingly wondered when his aggressiveness was finally going to be interpreted correctly. But the analysis moved in another direction. It made the patient realize that he had occupied an unfavourable place in the game where his mother practiced a type of destruction of his father’s desire. To do so she used her son, Lacan’s analysand, as a third element who served to both incite his father’s desire and block its fulfilment. The analysand realized that this had something to do with his own feeling of impotence. In order to desire he had to destroy the Other in some way, but in so doing he destroyed his own desire. He knew this, but it was still difficult to accept the fact that desire, since it is the desire of the Other, cannot be separated from this desire of the other without annihilating his own condition. He consoled himself with the obligations of the demand and, in return, felt like he was a spectator to his own life (scepticism) Lacan strongly insisted on the analysand’s manoeuvres to protect the Other. He had established a strict and artificial separation to keep the Other at a distance, since this other insisted on behaving at the expense of and parallel to the analysand. Hard work in the transference allowed him to work through this distance from the other as a symbolic and impersonal place of the law, the other. As the supervisor and ambassador of the Other, he identified himself as being outside the scene, and suffered from the boredom that this position laid on him. Therefore, there had been some overlapping between the place of the Other and his position as subject. This had some relationship with his constant feeling of there being an imposture, falseness, and inauthenticity. The advantage was that, based on this overlapping, he could watch the performance of oppositions between the object a and his own ego, which served him as a shadow. Life, then, was a theatre, a game, and a war, but in all of these cases, he was safe and absent. The patient’s narcissistic problems with this complex of facade seemed more like an endless maze. After many ins and outs Lacan seemed to guess the combinatory and the cycles that were inevitably repeated in the patient’s intersubjective relationships. For example, there had been a sequence that made him pass from an attitude of seduction to a questioning close to insurrection, but it

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ended in cold impassivity. The moments of transition were marked by short irruptions of anxiety, and always seemed to involve a feeling of contradiction. A successful performance was experienced as failure, resentment occurred side-by-side with generosity, and instability of affects existed concurrently with rigid loyalty. At these moments of transition it was not rare for him to openly confront Lacan, complain of the analyst’s ineptitude and indifference, and accuse him of excessive proximity and interference. These, of course, were contradictory complaints, but were in line with his personal experience. This sequence became boring and he felt his energies and appeals become exhausted by the comic irony of repetition. His analysis thus seemed to be coming to an end or of simple fatigue. But at this point a final manoeuvre came up: for the first time he became impotent with his mistress. He attributed this to “menopause” and to Lacan’s impotence in saving him from his boredom. Based on his discoveries about the function of the third potential for a couple’s erotic competence, he suggested that the mistress sleep with another man in order “to see what would happen”. The mistress, who had a notion of the unconscious workings that sustained the patient’s desire, showed neither complacence nor reticence towards his demand. That same night she had a dream: “[S]he had a phallus—she sensed its shape under her clothing—which did not prevent her from having a vagina as well, nor, especially, from wanting this phallus to enter it” (Lacan, 1958a, p. 528). When the analysand heard his mistress tell him her dream, he immediately recovered his powers and proved this brilliantly “to his shrewd paramour”. Lacan recognizes the demand he formulates to her as an earlier offer to get Lacan to sanction his “repressed homosexuality”. It is clear that this was never at all explicit, according to the unconscious articulation of the demand, and in some way it was satiated by the transference. By both the refusal and the supposed postponement of his response, the demand fit into the script for managing demands with which he was familiar. The mistress’s sagacity resided, first of all, in the fact that she did not introduce any supporting character into her dream. Therefore, she both did not respond and responded to the demand of her master. What the analysand refused to recognize was the castration of the Other. This seemed to be the central point in Lacan’s listening

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at that moment. Instead of the castration of the Other, he offered all the emblems of his own lack, especially impotence and frustration. This was the price he had to pay to obtain a position that was concentric with that of the Other. In the game reconstructed from his own family novel, the destruction of the father’s desire must also be a way to overcome the mother’s lack. But this semblance of someone who had disdained the analysand’s father’s desire did so through the patient’s fantasy, by which he remained an object. The fantasy that his mistress should go to bed with another man became clearer. It was not only because this would reveal the mistress’s desire, but because this desire was governed by the dictates of his own demand. She would do it for him, through unconditional love for him. This was how the mistress, in her own figuration of sexual intercourse, showed an Other without lack, a pure agent and executor of the law whose object was himself. The second aspect of the mistress’s sagacity was in the fact that she dreamed for him, but beyond his demand. Here she figured the desiring Other and touched the subject’s unconscious desire. This is why the dream was able to immediately re-establish the erotic strength of the patient’s desire. The dream and its telling fulfilled the function of the psychoanalyst’s intervention. But this was also the occasion for Lacan to insist on the function that the phallic signifier had for the patient’s desire. In the dream, this signifier was not the phallus (as a euphemism for penis) nor the vagina or even the clothes that covered them. Nor was it the desire to be penetrated. The phallus is an unpronounceable signifier, a position formed or inferred by these other signifiers by which it is displaced. We cannot permanently isolate or identify it with any of these terms but, without them, and in this articulation between them, the phallus cannot be located. In short, the phallus is a position, not a place. But the fact that, in the dream, the mistress is shown as having the phallus does not explain the restitution of its erotic value. In this regard, Lacan wrote: Having a phallus was not, in effect, enough to restore to her an object position that allowed her to fit a fantasy on the basis of which my patient, as an obsessive, could maintain his desire in an impossibility that preserved its metonymic conditions. … The woman restored here by a ruse, the crudeness of which

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concealed a subtlety that perfectly illustrates the science included in the unconscious (Lacan, 1958a, p. 528).

In this passage, the problem involved in the formulas of sexuation and in the dialectic of recognition appears condensed. In other words, to have or not to have the phallus, to be or not to be the phallus, involves two different modes of negation: inversion, by which this particular woman appeared to have a phallus, and interversion, by which she had one, but not without having a vagina and not without ceasing to desire to be penetrated. These two fractures in the phallic universal should also take into account the object of the fantasy. The fantasy made the object apt for pleasure by making it compatible with the phallus. This appropriation responds to the style of the fantasy and, for this reason, the fantasy can infer the (obsessional) clinical structure as a way of articulating desire (impossible) and a discursive (metonymic) strategy. If we recall that recounting the dream to the patient was equivalent intervention by a psychoanalyst. In fact, this inclusion of the phallus in the object only functions because the patient’s desire is the desire to be the phallus, and this means that the Other must have the phallus. To recall that, for the subject, being the phallus is a position; for the Other, having the phallus is a place. Place and position are not exactly the same thing, and can be associated only at the expense of the operation of the fantasy. This is why, even though the fantasy indicated the possession of the phallus, like the mythological figure of the Medusa, it revealed to the subject his own castration. As a response to this image of castration in the place of the Other, we find the object that causes his desire and restores his potency. The sequence therefore operates as an interpretation of the childhood neurosis that made the mother someone who disdained or was recalcitrant towards the intensely desiring image of the father. In this disdain, the analysand found a place to install his desire. But there is an additional element in the impasses involving the universality of the phallus: despite having both a phallus and a vagina, the mistress kept on desiring. It was at point that the patient’s “lack” was touched. Not the lack of being the phallus, but the lack of being at the level of the subject’s being, in other words, the level of existence and not of universality. To refer to this universality Lacan uses the expression “exodus of being”. Lacan eventually dealt with

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what is involved here only twelve years later with his formulas of sexuation. In other words, a type of negativity that is not reduced to opposition, inversion, or passage to the contrary. It is a negation that creates an experience that Lacan constantly associated with the end of analysis. But in 1958, when Lacan presented this case, experience of the termination of analysis was still approached through the traditional approaches to negation. Here the experience of the lack-to-be was located between the phallus and the object, and thus produced inversion. It was at this point that the presentation of the case called attention to a number of coordinated contradictions. The mistress’s position between desire and her disdain for him fits in with the fact that, despite having the phallus, the woman still desires. This is why he oscillates between the difficulty of desiring (impotence) and the desire for difficulties (the potency of the Other). Having the phallus is a “guarantee [that] is too strong not to be fragile” (Lacan, 1958a, p. 529). Her having the phallus does not guarantee that she cannot take it from him. Her having the phallus can be seen in a sign: “And it is by displaying this sign as such, by making it appear where it cannot be, that this guarantee has its effect” (Lacan, 1958a, p. 529). It is a sign that can only be represented by denying nature and by destroying the referential and denotative function of the sign. This problematic sign is not the phallus, but object a, the cause of desire for this subject. There is a conflict here between predicative negation of recognition and ontological negation of sexuation. In this respect, we are in agreement with Safatle (2006), when he says that, at the beginning, Lacan was not truly dialectical, inspired as he was by Kojéve in terms of the activist dialectic of recognition, and also inspired by Hyppolite in terms of the philosophy of history. Lacan was dialectical as the theoretician of the Real and of logic. Hegel’s discourse is about a possible concrete logic, and is therefore critical of the division between form and contents. In this light, we can carry out an exercise of formalization of the different modes of negation that were raised as criticisms against Kant in his passage—too fast, in fact—from ontological negation to predicative negation (David-Ménard, 2004, pp. 193–200). This exercise has two objectives: to call attention to the negative strategy of the occupation of clinical territory by psychoanalysis, and to show that the point of

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connection between the hermeneutics of the unconscious and the drive theory of sexuality lies in a negative conception of the Real. This position is based on the fact that this procedure is similar to what is found throughout Lacan’s work in terms of the use of dialectics. The crucial difference between formal logic and concrete logic is in the type of relationship that is set up between the truth and the Real. In contrast to the more familiar solutions to this point, Lacan does not try to establish a theory of truth-telling the Real (concrete logic), nor a theory that separates the relationships between the truth and the Real (formal logic) or make them arbitrary. Therefore, the problem is similar to that of the possible formalization of dialectical logic faced by some commentators on Hegel. For them the core of this formalization resides in the possible methodological reduction of the types of negation. For example, the Hegelian types of negation could be represented according to Boolean algebra. According to this formal language, first an alphabet of valid signs for the system is defined, together their relationships with words, terms, and propositions. An operation of naming follows, by which words become first-category symbols. Thus, through indeterminate marks, such as letters, we can designate any terms, such as set, class, subset, etc. Next, it is established that the second-category symbols designate operators that affect the terms, such as complementation and intersection. Finally, it is determined that third-category symbols affect the propositions, which are the connectors, such as negation and implication. Based on this syntax between words, terms, and propositions, it is possible to perceive what a well-formed expression is in this system. The most primitive well-formed expressions are divided into two classes: definitions, such as conjunction, equivalence, meeting and equality, besides the notional terms, such as the void and the universal, and axioms, such as the classical rules of deduction (non-contradiction, excluded middle, identity, etc.), the law of Morgan, etc. The problems with Hegel start when his notion of concept fails to admit that there is such a thing as an empty term. An empty term—such as the zero in operations of addition—is always the result of a suppression between two terms where the zero retains its truth, or substance. An operation that involves a neutral term does

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not affect the product, but it affects the process and, as such, should be considered an operation. At this point, it becomes clear how difficult it is to employ formal logic to consider time as immanent to the concept. It is thus possible to consider an empty term or a neutral element as what represents the time of the transition between Hegel’s positions (Dubarle, 1979, p. 160). To refer to the figures in Descartes and Aristotle, discussed above with respect to the topic of hypokeimenon, a position is articulated with a presupposition, giving rise to an ex-position. But this ex-posed is, in turn, a new position that retrospectively creates further presuppositions, and so forth. This transition from one position, such as a product, to another position, such as a sub-position, creates an identity between what is posited at the two moments through operations of negation. But the Real is insensitive to these negations. It can only be intuited by negating this grammar of negations. We can represent this identity by adding an operation or an empty term: P + 0 = P. Another, similar operation could be applied to the second moment, that of the creation of the sub-posed: S1 + 0 = S1. In this case we would have to admit that the empty term has a double meaning: it is a neutral element of a formal operation and a non-neutral element in an ontological operation. We can now apply this distinction between, on the one hand, the countable, where the zero can be counted as an element in the set and, on the other, the void, as a reference to the number of objects that are present, in extension, in this empty set, the void. The zero is not the void. In Hegel’s terms, this is equivalent to the difference between the bad infinite (represented by the straight line with no beginning and no end) and the good infinite (represented by the circle with determination and limitation). The good infinite is a set, as zero. The bad infinite, on the contrary, represents a problem, since it is, simultaneously a set (the empty set) and the negation of a set (the non-set, the void of set). It is important to remember that Hegel’s types of negation deals with the zero (the concept of no object) and of the void (the concept with no object). The universal is decomposed into an ordered pair [(U) and (U + P)], where the first value (U) refers to the countable empty set (the zero) and the second refers to the uncountable universal (the void) plus the particular. The second value refers to the implication of the universal

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in the particular, that is, the neutral void, the lack of object. As Hegel (1979, pp. 497–498) said: The third term is third at the same time in relation to what is first placed as negative, or formal negative, and in relation to absolute negativity, which is the second negative. Whereas this first negative is already the second term, that which is counted as third can also be counted as fourth, and instead of a tripticity, the abstract form can be considered a quadruplicity.

So we have a scheme with four positions, where one central axis reflects the purely formal relationship (for which being does not exist) and the other, an ontological implication (for which being is a way of existing). The concept is also presented according to its own logical moments, namely, universality, particularity, and singularity. The concept of subjectivity is presented as singular, of which the universal and the particular are the constitutive moments (Dubarle, 1979, p. 164). Adding the empty term we can write the problem as in Figure 3.

Universal Singular

Empty Particular

Figure 3. Hegel dialectic: Basic opposition. Between the universal and the particular there is a complementary or intersectional type of negation, since it involves negation between terms. In this case, the universal is divided into two types: in logic, a class at the same level as the particular, where there is a complement, and a position of contents where there is intersection with the particular. In this second case, the presence of the particular has the function of emptying the contents of the universal, making it an empty space (Dubarle, 1979, p. 167). Hegel calls Hegel calls this operation absolute negation, or second negation. In Boccaccio’s narrative, this is the equivalent to the moment, before the events begin, when Ricciardo decides to give up his pursuit for an ideal woman, when he opposes [The woman] to the

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negation of [The woman]. This negation is indeterminate. The set, consisting of [not -The woman], can be extensionally filled in both with elements such as (man), (animal), or (child), or with determinations of this universal (a woman), (this woman), and also by global negation of the set (nothing), (no one). It can even be filled with an indiscernible element such as (I myself ) or (a part of me). Therefore, this universal is empty of contents. It is not opposed to the particular, but only to the non-universal. This is the universal from which one has extracted all the relationship with the contents of the particular through second, or absolute, negation. In the clinical case described by Lacan this moment corresponded to the childhood sexual theory when the patient’s mother was seen as the uncastrated Other (what explains his stoic oppositional attitude). But as far as we know our hero Ricciardo has already carried out a negation of a different type. He is married and he has a woman. Here the universal as a logical class admits of an intersection with the particular. This particular is an element of the universal set called [Woman]. This is a different type of negation: formal negation, or first negation. In Lacan’s clinical case, this position is figured by the relationship with the mistress, which, to a certain extent, represents and negates the maternal position (what explains his sceptist a distant attitude). The problems begin when Ricciardo becomes interested in this other woman and when Lacan’s analysand faces impotence and conjectures as to the entrance of this other man. Here the question is not just a woman or just a man, one particular among others, but of that term which will be an exception to the set [a woman/any man]. In other words, the question involves one among others, but of a specific one. Upon choosing it, he negates both the universal empty [The woman/The man] and the particular [a woman/a man]. This is the paradox of demand. It cannot be satisfied because no particular contains the (phallic) universality that she demands. The grammar of oppositions and inversions that characterizes the patient’s exhaustion indicates a repetition of this paradox. But there is one type of answer, figured by the mistress’s dream, that potentially negates both the first negation (accept/refuse) and the second negation (universal/particular). Here the terrain opens up to the third type of negation: the negation of negation (interversion).

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Non Universal

Universal

Universal and Existencial Singular

Void Non particular

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Particular

Zero

Figure 4. Hegel dialectic: Negation of negation. So we have three movements, which logically express the complementary negative, the negative of intersection, and the negative of the negative, that is, the logical meeting of the first two. One can thus see how the negation of negation does not correspond to a simple assertion, but to a problematic assertion, as expressed by the dream of the mistress of Lacan’s patient. The intersubjective plot is resolved only when the last transition. The intersubjective plot is resolved only when the last transition occurs, where there is a renewed type of double negation. In Boccaccio’s story, the error is undone when Catella becomes desperate, because her act negates the intentionality that the act presupposed. Here the Real coincides with its own impossibility, showing that the “essence of the object is own failure” (Lacan, 1973a, p. 55). It is the same type of contradiction interpreted by Lacan’s analysand when his mistress recounts her dream to him. By indicating, in reality, a fragment of the Real, either Catella’s particular condition as Filippello’s wife is undone (formal negation) or the mistress’s involvement with a supposed third element. But it must be recalled that there is yet another inversion. Catella gives herself to a man in the dark (supposedly Filippello). The mistress of Lacan’s patient still desires, even when she is endowed with the phallus. In Boccaccio’s story the presumed love Catella gives in to is inverted, through an opposition of contents, into hatred. In the case of Lacan’s patient, the eroticism returns from impotence back to potency. This transition corresponds exactly to the extraction or disposal of the contents of the particular (absolute negation). Non Universal

Universal

Void (Empty) Non particular

Universal Negate by Existencial Singular

Particular

Zero (Non particular)

Figure 5. Hegel dialectic: Absolute negation.

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The outcome of the story is that Ricciardo becomes a singular figure for Catella. With his cleverness and persistence he takes a path of negations that removes him from the condition of one among others [the husband of x]. Cattela also becomes singular for Ricciardo by negating her position as particular [Filippello’s wife] and by recognizing her desire at the encounter, because a mistress’s kisses are more savoury. In the circumstances of Lacan’s clinical case discussed here, this enables the analysand to re-encounter his own lover, as other. This successful failure of the position of the object suggests that one element that the transference allowed him to satisfy, in terms of demand, now becomes separated. The object a appears as separated from the phallus (sublation). This interpolation corresponds to a negation that suppresses and conserves the path taken. It is our fourth type of negation: Aufhebung, a dialectical contradiction, or a real contradiction between phallus and object a. Here we have to leave behind the Boolean formalization since it requires the suspension of ontological considerations. This type of negation brings in the object that, in a certain sense, was already there and grasps it according to a specific logical negativity. It implies the passage from appearance to a different domain that is not that of the phenomenon in its positivity, but the failed essence of the constitution of the phenomenon (exceptionality, divided universal, not-without, not-all). We can now understand why Lacan describes psychoanalytic treatment through two Klein semi-groups and a mysterious operation of inversion towards the vectors that are components of these semi-groups, as we saw in Chapter Eight. These operations also have a converging termination in the position of the singular. Therefore, they have a product, in the expression of Boole’s logic. This product has the value of formation of symptoms, transference, and interdiction of the passage to the place of truth. Clinical operations of counter-blocking, or de-alienation, act on this product, namely, the true real-ization of the passages to the contrary, of the first negation and of the second negation. Finally, there is a mutation of the transference that results from its enigmatic reduction to object a. In order to show that the psychoanalytic occupation of the territory of anthropology demarcated by Kant is a negative occupation, it was necessary to also show how this negativity intervenes in the healing process (understood as a dialectic), in the theory of the

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subject (understood in its therapeutic activity of intersubjective negation) and, in relation to the Real in the symptoms (understood as the object of clinical practice). For Lacan, the syntheses by Kant that made it possible to lay down a ratio of identity between the object and the subject perform a theoretical function would seem to be equivalent to the clinical function of the fantasy. Fantasies are a type of catalyser of the drives. According to Lacan (1964b, p. 710): the statements Hegel makes, even if one sticks to the text, provide the opportunity to always say something Other. Something other which corrects their fantasmatic link with synthesis, while preserving the effect they have of exposing the lures of identification.

This fantasmatic synthesis cannot be entirely converted into modes of intersubjectivization, but neither does it authorize a return to pre-reflexive immanence nor a direct refusal of the notion of the truth. It is not because the truth of the fantasy cannot be enunciated that the modes of failure in enunciating it cannot be described. This is because there are two factors that are not symmetrical, namely, the constitutive character of alienation regarding the subject, and the irreducibly negative character of the object. This is one possible translation for the tension between the imperative for recognition resulting from the constitution of the subject, and the negative ontological dimension consequent to the construction of the object in sexuation.Between them one can see the space of formation, compromise, and overlapping between phenomenon and appearance. For example, Lacan refers to the formation of the ego as a symptom because the ego is, at one and the same time, the placement of an object, a message to the Other and a mode of symbolic real-ization of the desire in the subject. The continuous work of inversion between alienation (Entfremdung) and remembering (Erinnerung) (Safatle, 2006, p. 36), as well as the work of interversions between alienation (Entäusserung) and taking positions as a subject. carried out during treatment operates on formations of the unconscious and on formations of anxiety, separating and bringing together their expressions of desire and of jouissance.

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Clinical practice on judgemental negations enables intersubjectivity to progress according to the modes of subjectivation, which are relatively permanent modes of negative judgement, which are repression, denegation, and foreclosure. This clinical practice on negations is different from the clinical practice on non-judgemental modes of negation. The negations that take place through judgement are, for example, judgement of attribution, judgement of value and denegation (Verneinung), where judging is equivalent to repressing. They have a constitutive value for the subject. Lacan (1946b, p. 146) put it this way: Freud designated [the phenomenon of synthesis in the subject] […] as the very locus of lace of Verneinung. The latter is the phenomenon by which the subject reveals one of his impulses in his very denial [dénégation] of it at the very moment at which he denies it.

But there is also negation that is a condition for all possible judgements. Freud uses different terms to refer to this operation. In some places he uses expulsion (Ausstossung), in other places, splitting (Spaltung), and in others yet, foreclosure (Verwerfung). This first act, and only if we consider it an act, is also an affirmation (Bejahung). In other words, it is not an affirmative proposition, but affirmation as a gesture of existence, which only later is incorporated in the form of a judgement. This corresponds to Hegel’s concept of Enzweiunug, which Lacan examines extensively. It involves a type of original division between being and non-being, between the singular and the nothing. This leads to the conception of a primordial foreclosure (Urverwerfung) as prior to the clinical structure itself and to the indeterminate fate of the Real, before castration, strictly speaking (Safatle, op. cit., p. 51). This Real can be partially compared with Kant’s Thing in itself. The crucial difference is that it is a constitutive Real of the subject as object, not of the world. It is what Lacan called the Thing (lachose). This is why, when I try to adjust my perception of the object to its fantasmatic inscription, the attempt is inverted to a demand for recognition and displacement of the lack of adjustment. The symbolic return of what was excluded by the judgement is different from the real return of what was excluded by the act.

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There is a reflexive symbolization of the subject is being that is asymmetrical with respect to the non-reflexive real-ization of the object. This real-ization returns in the Imaginary and constitutes the psychic reality as a first formation of the subject. The fantasy, which is the structure that makes the connection between them, is therefore both the highest standard of the subject’s reality and the central articulator of the relationships of desire with jouissance. It is important to distinguish between this return from the real of what cannot be inscribed in symbolic and the imaginary formations that block symbolization of the desire. 1. In the return from the Real to the Imaginary, failed symbolization derives from the variants of denegation (Verneinung) and is organized by a continuation of automation; 2. The imaginary formations that block symbolization imply a noninscription (Bejahung) of experience (foreclosure). They are organized by a lack of continuation of tuche. (Lacan, 1964a, pp. 55–68) Fantasy therefore organizes the heterogeneity of the modes of constructing the object and constituting of the subject. It is due to the existence of two very distinct forms of negation that Freud had to add the notion of fundamental fantasy (Urphantasie) to the concept of fantasy. We can note that the constant point in this grammar is precisely egation as a way of producing objects and identifications, desire and jouisance. We might also remember that, according to Freud, in The Instincts and Their Vicissitudes (1915a, pp. 113–134), there are four possible fates for any drive. First, there is repression (Verdrängung), by means of which the representative (Vorstellungsrepräsentanz) of the drive is disconnected from its representative of object, returning in symbolic substitution through one or another derivative such as a substitutive idea (obsessional neurosis), a part of the body (hysterical conversion), or an object (phobia). But we should include other modes of substitution in the same class of repression. There is imaginary substitution (Verleugnung), which characterizes perversion by returning as a fetish, and non-substitution (Verwerfung) that characterizes psychosis by returning as a hallucination or delusion. This first group of fates of the drive could be named by its most important generic figure,

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denegation (Verneinung), of which there are three types. We saw in the discussion above that this is a lesser negation because it operates with only two terms: the negated term and its return. It matters not whether it applies to the opposition between the One and the multiple (as in neurosis and perversion) or to the being and the nothing (as in psychosis). Second, there is transposition to the contrary (Verkehrung ins Gegensteil), as a second fate of the drive, corresponds to the movement of inversion of a drive, for example, from its active to its passive mode, and so on. The condition and result of this movement is an original operation, which is identification. For example, a child who acts sadistically towards an insect goes beyond the drive when he or she identifies with this object and then real-izes his or her own masochism. Transposition to the contrary is crucial for understanding both processes of constituting the ego on the basis of primordial masochism and the processes of symbolic introjection and imaginary projection. Introversion is very similar to what Hegel called passage to the contrary (Umschlagen), which could also be called the identity of opposites. The action of repression and similar processes has the effect of blocking these passages to the contrary. This would include, for example, the topic of the repression of passivity in obsessional neurosis and activity in hysteria. But the most interesting aspect of this fate of the drive is the anomalous case represented by love. Love does not admit of only one transposition to the contrary (active ↔ passive), but three: to love and be loved, which corresponds to passage to the contrary (Umschagen); to love and to hate, which corresponds to the inversion of the contents of the drive; and to love and to be indifferent, which corresponds to indeterminate negation. Hegel had an expression of his own to designate this inversion of contents without a passage to the contrary. He called it the position of the particular that empties the universal and characterizes the first moment of the dialectic between universal and particular. The opposition between loving and being indifferent is exactly the type of opposition we saw to be problematic from the point of view of its representation in Boole’s algebra, namely the opposition between the singular and the nonsingular, as the side of pure negativity. The third fate of the drive is the return to the person herself or himself (Wendung gegen die eigene Person). This refers to the functioning

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of narcissism as a mode of articulation between the first and the second fates of the drive. It is through identification that the subject finds the motives for and consequences of repression, and it is also through identification that he alternates the passages to the contrary proper to Verkehrung. There are three distinct and complementary developments on this topic in Lacan. a. The first development derives from his theses on the Mirror Stage (Lacan, 1937, pp. 96–104). Here, the alienation of the ego is based on the child’s very early but aetiologically verifiable experiences, and they are a gradual source of disorder and crisis due to the entrance of a discrepant image. Examples include specularity, the eight-month anxiety, transitivism, negativism, jealousy and envy, as well as the complexes of weaning and intrusion, and the Oedipus complex. Here a reverse type of Kantian theory is expressed about the function of knowledge in an intersubjective relationship. This is the familiar inversion of the thesis that, if paranoia is a phenomenon of knowledge, knowledge is a paranoiac phenomenon. In other words, narcissism is operating here as a system for forming objects in close dependence on the categories of transcendental aesthetics, namely, time and space. b. In the second development, narcissism becomes a critical and unstable system due both to its intrinsic antinomic demands and to the heterogeneity of its extrinsic functions. As Lacan insisted narcissism aims at distinguishing between what the function of the ego imposes on the world in its imaginary projections and the defence effects that they remove for furnishing the place where judgement is produced (Lacan, 1966d, p. 561). In other words, narcissism has three functions: imaginary projection, effect of defence, and place of judgement (Dunker, 2006, V. 2, pp. 11–34). To real-ize the illusion proper to projection, the subject cannot be included in the image and, inversely, if he is included in the image, the object does not form. The defence function against the lack of object (Versagung) induces effects of a new order, such as, a relationship of impotence, false domination, alienation, masochism, regression, etc. In other words, the idea that the narcissism related to the construction of judgements leads us to the topics of repression, self-esteem (Selbsfuhlung), distance, and authority. If, in the first

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development, emphasis is given to the notion of Ideal ego, which is a symbolic formation that produces imaginary objects, now narcissism is articulated with the superego, which is a symbolic formation that produces effects in the Real. Narcissism should not be apprehended in a simple way, as adjustment of the ideal ego to an image in referenceto space. Narcissism has [its] purest moment in the gesture by which the child at the mirror turns around to see the person who is holding him, appeals with his glance to the witness that decants, by verifying it, the recognition of the image, from the jubilant assumption in which he certainly was already there (Lacan, 1961d, p. 568). The child’s reaction of turning around to see who is holding him up to the mirror introduces the experience of time, confirmed by the experience that the other was already there. This is the first symbolic gesture of recognition and contains in itself the dimension of witness and appeal. It is transformed, a posteriori, into a first gesture of judgement or of comparison between the image and the object by which the child puts himself in third place. Experiences of non-identity, propitiated by analysis, modify this narcissistic circuit without being equivalent to a disintegration of the subject (Safatle, op. cit., p. 29). c. Lacan’s third and final development on narcissism was in his discussions of the problematics that extend from anxiety to fantasy. At this point he adds to the optical model the idea that narcissism is a type of frame of reference for an object without specularity and not apprehensible to judgement, namely, object a. Up to this point, the return to the person herself or himself could be assimilated into a form of subjectivization of desire. At this point, the clinical perspective of real-izing intersubjectivity is drained, but an object that is between the real and the sexual remains. Through strategies of symbolizing inversion, one moves to an experience of decomposition, or reduction, of this object, and this can only occur by way of a true dialectical negation based on real contradiction. Sublimation (Sublimierung) is the fourth fate of the drive, and it contains the type of negation expressed by objective contradiction. That is, thought and object are inscribed in the interior of an appearance presented as organized through relations of similarity.

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It presents the object by configuring its edges without wholly naming it and by introducing a special type of effectiveness (Wirklichkeit) (Safatle, op. cit., p. 133). Here we could recall the enigmatic and dispersed way that Freud treated sublimation. He described it variously as transmutation of the libido, a change in its means, and use of the fantasy to produce socially recognized objects. But if there is a clinical procedure that could compete with symbolization and subjectivization, this procedure must have the structure of sublimation. This is the basis for the affinity between the topic of construction, in Freud, and writing, in Lacan. It has even been posited that writing performs a function similar to that of a fourth clinical structure (Juranville, 1987, pp. 243–264). This idea somewhat confuses the logic of judgemental negativity (that defines the structures) with ontological negativity (that defines the modes of relationship with jouissance), but its intuition is basically pertinent. A number of authors (Baas, 2000) have been working with nonstructural use of the notions of defence first described by Lacan. The proponents of these efforts have constantly pointed out the importance of recognizing the relative autonomy of different modes of negation during treatment. Contrary to other forms of clinical intervention—that are reductive, each in its own way—the interventions that have a structure of sublimation are constructive. In other words, they do not operate through semblances by which the figures of lack (castration, frustration, and privation) and their operators (phallus and Name-of-theFather) are articulated in the formation of symptoms. This is why Lacan had to insert a third category between the negativity of appearance and the negativity of the phenomenon, namely, the semblance. We saw the importance of the field of appearance in the constitution of Kant’s anthropological space. Now we can say that the semblance is the appearance placed as pure appearance, and is therefore distinct from the notion of imitation, virtuality, veil, or mask. The semblance, like the notion of letter, is not an imaginary or symbolic representative of something else. It does not invite one to decode it, but to continue codifying it. We thus re-encounter, around the figures of sublimation, a requirement of clinical theorization that is both negative and irreducible to the constitution of the subject and to the formation of symptoms.

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We thus point to the presence and importance of negativity in the conceptual regime of psychoanalysis, in the formalization of its treatment and in the theory of intersubjectivity. It can be argued that the central place occupied by negativity in psychoanalysis has epistemological implications and affinities with many other discourses in culture. Our argument here, however, is about the importance of this aspect for the politics of healing. In other words, the theory of negativity is not a pretext for more precisely establishing the type of ontology that psychoanalysis presupposes. It is a way of asserting the type of freedom that one can hope for in the sphere of psychoanalytic healing.

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CHAPTER TWELVE

Logic and politics in psychoanalytic healing

In the beginning there is not the origin, but the place. —Lacan

L

et us begin this chapter with a quotation from Michel Foucault (1973–1974, pp. 13–14):

[The patient was] a young boy dominated by religious prejudices, and he believed that, to attain his salvation, he should imitate the abstinence and maceration of the ancient anchorites. That is, he should reject not only all the pleasures of the flesh, but food as well. One day he refused the soup he was served with more vehemence than usual [and Pinel was called to intervene in the matter]. The famous doctor arrived on the scene with a display aimed at frightening the patient, with a stern look on his face and a resounding voice, with a group of servants around him armed with heavy chains which they furiously rattled. They placed the soup beside the patient and left the room. The patient spent the night in torment and fear of punishment and the idea of guilt in his future lives.

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The fear triumphed and he accepted first the soup, then regular food and then the use of reason. During his convalescence he confessed his cruel agitation and his bewilderment during that night of trials.

This theatrical scene, carefully planned by Pinel, required no diagnostic discussion nor the application of any medical technique. It was a moral confrontation between the doctor’s will and that of the insane man. Pinel (1765–1826) inspired Hegel in his position that insanity confronted with its (or man’s) own unreason, restores its (or his) reason. Thus, both moral treatment and the practice of dramatization systematically played with inversions and acts of recognition. The relationship with outside force is replicated in the internal conflict between giving in or resisting. Intersubjectivity imitates intrasubjectivity. There is an exact point of conversion when the patient recognizes his error and abandons his beliefs. The scene ends with confession, which certifies and legitimizes the truth in a cause. The ceremony is a rite that runs from the loss of sovereignty to regaining it. The freedom that is attained has the mark of a debt of gratitude towards the therapist, in an operation of transference and restitution of power. By submitting to the theatre of reason, between master and slave, as a mimicry of the theatre of healing, the patient can reciprocally recognize his or her own (lost) reason and be recognized by others as someone having reason. There are four forms of power that define the healing process, following its long metamorphosis that began with the ancient practices of caring for oneself, namely, dependence, confession, the inadmissibility of desire, and debt (Pinel, 1765–1826, p. 222). This fourfold subjection to discipline is brought together and limited by a new form of association between healing and truth. Truth can now be found in the sovereign enunciations by physicians and their practice of modulating reality. They are representatives of the State. This episode with Pinel, in 1820, can be compared with the way Liébault approached his patients 40 years later. His therapy was based on the notion of attention, which he believed had a specific action on the concentration or dispersion of the fluid energy of magnetism. The more attention that is given, the greater the fluid strength becomes and there is less unconscious attention. The suffering was caused by unconscious attention. For example, of the direction of

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unconscious attention could be decisive for the future health of the child of a pregnant woman. The attention expresses a mode of caring for and relating with the other. From this point of view, healing focuses on redistributing attention by transferring its strength and redistributing its qualities. For Liébault, this relationship between doctor and patient is comparable to the relationship between a mother and her baby; it is a reminiscence of the child’s earliest bond. With no introductions, examinations, or diagnostic considerations, Liébault saw between 40 and 50 patients every day, in his own home, using a system of non-obligatory payment. He would place his hand on the patient’s forehead and say: “You are going to sleep”. Then came the soothing words: “You’re going to get better, your digestion will be better, you’ll sleep better, you’re going to feel more strength in your arms and legs, etc” (Cazeto, 2001, p. 304). This firmness contrasts with authoritarian imposition and the theatre seems to be based on mutual consent. The technique was justified by a scanty theory of mental faculties through which the dynamics of attention were related to the three basic modes of mental functioning: imitation, love, and group phenomena. In what way was Liébault’s theatre different from Pinel’s? For Liébault, dependence and debt were present in a reduced and concentrated way, and the inadmissibility of desire and confession are completely excluded. Liébault’s authority was different from Pinel’s. Whereas Pinel was a liberating medical doctor, a friend of Hegel and an aristocrat, Liébault was a poor peasant worker aspiring to be a priest. He had many admirers but no disciples or students. Pinel’s theatre was no different from Liébault’s in terms of welcoming techniques or of the type of more or less legitimate knowledge on which they were based. The fundamental difference is in the way each one understood the power that existed in their healing practices. There are two traditional ways of analysing relationships of power: The model based on law, where special emphasis is given to laws, prohibitions, and institutions, and, the model based on war, where the emphasis is on questions of strength, strategy, and security (Foucault, 1986, p. 241). Whereas the birth of the clinic is intimately related to the model based on laws, the invention of psychotherapy is closer to the model of war. It would be tempting to describe psychoanalysis as a combination of the two. The result would be a spontaneous geography in the

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psychoanalytic field, between practices of fraternity, strategies of freedom, and politics of equality. The different types of individualism that psychoanalysis carries along with it would thus be redistributed. In the contrast between Pinel and Liébault, we can trace a surface organized by three discursive complexes: intellectualization, trauma, and transference (Parker, 2006, pp. 373–391). We are not talking about categories that delimit therapeutic discourse from the perspective of psychoanalysis itself, but about the inscription of psychoanalysis among the practices of subjectivization of modernity. In other words, psychoanalysis participates as an apparatus of knowledge and treatment, and it also deals with the way we think about ourselves, a discourse on a technology of the self, and in its coextensive forms of power. The year 1897 is known by psychoanalysts as the year during which Freud abandoned his theory of the trauma and began gradually to replace it with the conception of neurosis based on the role of fantasy. In Freud’s famous letter to Fliess of 21 September, 1897, he said, “I no longer believe in my neurotic”. Some historians (Mannoni, 1994, p. 66) consider this moment as the true inauguration of psychoanalysis, because it was then that he asserted the supremacy of the symbolic aetiology of neuroses and his farewell to the cathartic method. Since then, trauma and fantasy have constituted an opposition that has been constantly dialectized throughout the entire history of psychoanalysis. The notion of trauma insidiously questions the status of reality, or of the real, that should be taken into account in psychoanalysis. The trauma can be considered a hyperintense event, the weight of which goes beyond the individual’s representational capacity and takes hold of the subject before he can psychically process it. The disruptive, disorganizing, or unforeseeable character of the trauma is a central concept in Freud. In contrast, fantasy emerges as a screening, distorting, and resistant spectre that both supposes and presumes this reference. If this were so, things would be very simple: the trauma is reality that the fantasy covers up as illusion. The problem is that there is a reality proper to this illusion and there is illusion in this reality. But let us go back to 1897. In that same year during which Freud began his “self-analysis”, Emile Durkheim published a model study for sociology. It was a study that put into effect the rules of a new sociological method, indicating, for the first time, the non-individually conscious character of the social fact and its

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determination. The topic of this study is suicide, and Durkheim’s thesis was that its occurrence tends to remain constant over time, with oscillations that are eventually dissipated when one considers longer periods. This regularity can be explained by the trend towards the reciprocal balancing of three collective inclinations that are expressed in the act of suicide. What constitutes [suicide] are the currents of egoism, altruism and anomie that operate in society in consideration of the tendencies toward languorous melancholia or active renunciation or exasperating lassitude that are consequent to such currents. It is these trends in society that, taking hold of individuals, leads them to kill themselves. (Durkheim,1897, p. 487)

Altruism, egoism, and anomie function as a complementary series: when one factor loses strength, another compensates for it. Trauma, fantasy, and narcissism are the three elements that Freud (1939, pp. 72–75) cites in his own version of the problem. Durkheim’s study was based on an evaluation of the suicide rate in different regions of Europe over a relatively long period and was all the more persuasive to the extent that he lengthened the time analysed. But the data presented were curiously irregular. Precisely in 1848 the rate of suicide fell drastically in those same regions. The year of 1848 was a key historical period of diverse social upheavals that culminated in the establishment of liberal regimes. It was a year of broad indeterminacy and uncertainty. Why, then, at the moment of greatest “insecurity” would there be a lower, rather than a higher suicide rate? An analogy can be made to provide us with a trivial answer to this question if we remember the retroactive nature of the efficacy of traumas. In other words, traumas do not produce their effects immediately, but through their later resignification, related to fantasies. We might recall, for example, that Freud’s Emma (1895) went back to the store where she had been seduced. The event had been forgotten, but the scene returned in this inhibition against going into clothing shops. Therefore, the traumatism in its own reality and intrinsic violence, was not especially important in determining the aetiological effectiveness of the trauma. At a considerable distance from this generally accepted notion of trauma, we can direct our attention to certain aspects that suggest

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the exact opposite to what this victimological conception implies. That is, the apparently greater severity of the trauma, rather than suggesting a more acute deleterious effect, would seem to indicate a favourable prognosis. It is along this line that Freud, in Analysis Terminable and Interminable, says that the traumatic neuroses show responsiveness and a more favourable perspective for healing than the neuroses where the role of the trauma cannot be clearly determined. More surprising yet is the observation that in the case of traumatic war neurosis, the presence of physical damage is much more favourable to recovery than merely having seen or participated indirectly in dangerous situations. Along the same lines, it is said that the threat of castration can be much more insidious in the aetiology of neurosis than the real experience of castration. These two indications lead us towards the intersubjective character of the trauma, in other words, its dependence on interpretation and its signification derived more from the Other than from the empirical dimension. Another problematic argument could also be raised—and was actually used by Freud—namely, the category of real anxiety (real Angst) in this case, the neurotic angst is consequent to the development of the sign of anxiety in the fantasy, which is completely different from the anxiety triggered by a real danger. Freud clearly found it difficult to precisely delineate what this real angst consisted of as it arose from a realistic danger, but what I would like to stress here is that Freud opposes neurosis and reality as different sources and destinations for anxiety. Once again, psychic suffering, now indicated by the real origin of danger, appears as an indication of the benign character of its psychic working through. Here we could list a number of clinical phenomena that suggest the existence of a type of pacification brought about by the encounter with an unforeseeable, dangerous, and disruptive real. The mitigation of the intensity of neurotic symptoms upon discovering an organic disorder, a reduction in anxiety upon the occurrence of a great loss, the displacement of inhibitions, and the solution of phobias related to situations of imminent risk of death. I believe that, with these arguments and through the regularity of the clinical circumstances they are related to, it is possible to conceive of a therapeutic function of the real, as was seen above in the case of Pinel’s clinical practice. We saw how this function

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relates primarily with the act, an act that is placed in a precise way between the repetitious renewal of the trauma and the insidious fixedness of the fantasy. In this sense, we can also distinguish “passage to the act”—as a way of bringing the trauma up to the present (actualization, in French)—from “acting out”—as a way of bringing the fantasy to the present. In both cases we have this function of real-ization, both, in thesis, associable to the therapeutic function of the real. We can then situate psychoanalysis as a healing (cure) that is placed between the knot of Real-Symbolic (violence and act), where power structures as a war, and the knot of Symbolic-Imaginary (love and authority), where power structures as changing discourses. In all examples of this chapter we have seen how the change in structure of power remove symptoms, reduce suffering and heals (take care of) pathos. To treat, to heal, to cure means to change power structures. We see that, from Hellenic times to Montaigne, from Cartesian clinical method to Kantian psyquiatric; from Pinel to Liébault, the notion of treatment has in common a politics of the transference, trauma and intellectualization. Rhetoric, narrative therapies through conversion, compromise, and submission consist of a set of tactics concerning the traumatic. They are attempts at re-installing caesura, division and fragmentation that are sometimes themselves induced by the recomposition of positions. In other words, they re-situate the subject in the world, give him a position, or hermeneutically transform reality in order for their position to be maintained or altered. Strategies based on intellectualization, such as those that we find at the pole of the positive occupation of the anthropological space delimited by Kant, or at the pole of the negative occupation of this space, represented by Hegel, are aimed at transforming places. Let us now look at an example from Charcot’s clinical practice, remembering that his method is based in clinical investigation upon the technique of hypnotism, with no direct therapeutic pretension. The father of a 13-year-old girl who suffered from serious anorexia nervosa wrote to Charcot in despair. Charcot wrote to him saying that he should commit the girl to just any hydropathic clinic and leave her there, letting her know that her parents had moved

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from Paris. The parents followed these instructions but could not separate themselves from their daughter under those conditions. When Charcot was told about the failure of the treatment, he was furious and insisted that his orders should have been followed to the letter. He threatened to abandon the case and then persuaded the parents that the cure would require sacrifices. After her parents left, the girl sobbed for an hour. Then she began to eat. In two months she was cured. Only after that did Charcot question the patient, and she said: I knew that you wanted to confine me and I didn’t believe that my disease was serious. And since I hated to eat, I didn’t. When I saw that you were the winner, I was terrified and so I tried to eat and, little by little, I was able to. (Forrester, 1983, pp. 32–33)

Exactly as in Pinel, confession comes after the traumatic act of conversion. It would seem to justify its own transformation in the authentic exercise of reason by the losers. After the violence that repositions the subject there is the narrative that integrates him subjectively. The world is reorganized between winners and losers; the power-form of the family is sublated and absorbed into that of the State in the figure of its representative, the physician. Let us compare this procedure with the intellectualistic strategy of another case, contemporary to Charcot’s, but that was located in an entirely different sphere of discourse. A young woman, referred to under the pseudonym of Mlle Helène Smith, lived in Geneva at the turn of the twentieth century (Todorov, 1996, pp. 353–363). She constantly fell into sleepwalking and trance-like states in which she began to speak in strange tongues. She lived in two alternating novelistic experiences. In the first she would visit the planet Mars and speak with its inhabitants; in the second she had a love affair in India. Theodore Flournoy, the professor of psychology who was responsible for her case found himself dealing with two languages that were completely unintelligible to him, Martian and a form of Sanskrit. To unveil the farce, he called in an eminent specialist in oriental languages by the name of Ferdinand de Saussure. To Flournoy’s disappointment, Saussure confirmed that the woman was truly speaking a dialect of Sanskrit, whereas the Martian was a deformation of French, her mother tongue. Saussure became

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fascinated with the case, since Mlle Smith had never had any contact whatsoever with either spoken or written Sanskrit, which is very different, lexically, and syntactically, from the Romance languages. The most startling aspect was that Mlle Simandini (her name in Hindi) spoke in Sanskrit, a language that was prohibited to Indian women. They spoke in Prakrit, a tongue that is structurally different from true Sanskrit. Saussure attended the medium sessions and became convinced of the fluidity and naturalness of the patient’s speech. What she said did not consist of memorized text, but of a true incorporation of another language. But her Sanskrit was not perfect, since parts of her speech were meaningless. A detailed analysis of these meaningless blocks of speech showed that they were not errors or deformations that might be contained in the structure of Sanskrit, but were rather compatible with the structure of Latin. There was another intriguing fact. Mlle Simandini never used the consonant “f” in her constructions and, in fact, this phoneme does not exist in Sanskrit. Therefore, even if Mlle Smith were lying, it would be difficult to explain the rigorous logic of this linguistic creation. Here linguists were divided. Victor Henry defends the idea that the absence of the “f” can be explained by the symbolic procedure of an acrophony where the letter “f” referred to “French”, a language that is opposed to Sanskrit in Mlle Smith’s linguistic unconscious. According to him, it is a formative production of language, and not constitutive. His explanation is closely related to the individual value of the language to Mlle Smith, and not merely to the functioning of the language as a universal symbolic sphere. Saussure takes the opposite position. He holds that it would be easier to admit the principle of the transmigration of souls than to refute the premise of the arbitrariness of signs. So the problem faced by analysing the Martian language, which would seem to be an easier task, is displaced. The Martian that Mlle Smith spoke was a deformation of French based on relatively simple and regular principles. For example, chécké (check) means paper in her Martian through material synecdoche of the French chèque (check); épine (thorn) means pink; chine means porcelain, midée is a contraction of misére (disgrace), and hideux (hideous) means ugly in Martian. These references would seem to back up Henry’s position, against Saussure’s: a glossolalic language is a motivated language. This hypothesis was confirmed in clinical work with the patient.

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Upon noting that Flournoy’s team had deciphered the Martian language, Mlle Smith shifted into a different language, Ultramartian. A type of cognitive crisis arises between the knowledge that took place in her symptom, and her legitimation by the other. Therefore, an admittedly recognized non-conscious use of language (no one makes conscious use of the rules of the language while speaking or writing), becomes intersubjectively shared knowledge. Between arbitrary and non-arbitrary, motivated and unmotivated, the symbolic and the allegorical, we recognize the point of both separation and intersection between logic and politics. The therapeutic strategy, clearly overshadowed by clinical practice, is nonetheless an intellectualist strategy. Just as hysterical symptoms can move from one place to another in accord with suggestive interventions, Mlle Smith changed the form of her linguistic expression. It is clear that Charcot’s and Flournoy’s strategies are symmetrical. The anorexic young woman treated by Pinel, discussed above, changed positions when she realized she had lost. Mlle Smith, on the contrary, held to her position as a linguistic enigma but changed the place from which this position was asserted. Both includes the master slave dialectic of recognition and both articulate a compromise between clinical and therapeutically surfaces. Let us now look at the combination between these two politics of healing in the case presented by Lacan in his thesis. Marguerite Anzieu is a young mother taken in by Saint Anne’s Hospital after spending two months in prison. She was there because she had attacked the actress Huguette Duflos with a pen knife. Lacan’s case princeps (1932), was also a case where this therapeutic function of the real is clearly evident. Aimée, a young woman who worked for the postal system was tormented by anxiety and suffered greatly from a persecutory drama that included erotomania, insomnia, and agitation. This situation changed completely after a passage to the act where she tried to stab the famous actress. According to Lacan, his treatment resulted from a type of real-ization, but the text tells us little about this statement. Sometimes he refers to confession, sometimes to the expiation of guilt through self-punishment, and sometimes to her real-ization of the loss of her son. Lacan seems to note a type of therapeutic value in Aimée’s real act, as the act implied a dimension of language and involvement in its unexpected and unpredictable consequences (Allouch, 1997). Finally, the finality

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of the act implied an object a, and it is characterized by the fact that it “cannot hold down the presence of the subject in its instant” (Lacan, 1967a, 11/27). According to Aimée’s long and delirious production, the actress was implicated in a scheme in which the Prince of Wales also participated, together with members of her family and several of her co-workers at the post office. Aimée, the pseudonym chosen by Lacan, wrote narratives, letters, and novels that portrayed her delusion and indicate that the central point of all this was the loss (or kidnapping) of her son. These factors were all part of a strategy to appeal and claim for recognition from the place she was in. The passage to the act thus represented the moment of the conclusion and singling out the persecutory figure of the actress. Lacan accompanied the case for fifteen months, during which time he encouraged Aimée’s literary production. He directed his attention to the moment when she was healed (cure). In other words, the therapeutic value of the act. This allowed her to attack herself through the ideal image of herself, represented by the actress, thus carrying out the self-punishment that characterized her paranoia. After everyone else was in bed, at about seven in the evening, I started to sob and say that the actress wished me no harm and that I shouldn’t be afraid.’ ... The entire delusion fell at the same time, “both the good and the bad”, she tells us. All the vanity of her megalomaniac illusions comes to her at the same time as the inanity of her fears. ... All the themes of altruistic idealism and erotomania, together with those of persecution and jealousy, according to her own declarations, fell at the same time (Id., 1932, pp. 173–250).

It should be noted how forms of the verb to fall appear repeatedly. In fact, once and for all, it entered Lacan’s vocabulary of curing, or healing, impregnating his theory of the act and of the end of analysis. This description bears close resemblance to Pinel’s theatre: the confrontation with her will, the regret, the admission of desire, and the debt. Lacan’s participation is closer to that of a witness. The fulcrum of the events is the incarceration and symbolic value of the punishment consequent to the act. Throughout the thesis this interpretation oscillates with the idea that the true

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symbolic real-ization takes place around the permanent loss of the child and the consequent satisfaction in terms, not of the superego, but of the death drive. Attention has already been drawn (Allouch, op. cit., p. 119) to the contradictions arising from the fact that, despite her healing process, Marguerite continued in hospital, and numerous lesser symptoms remained. Is there still the clinical indeterminacy of what exactly had been healed: the delusion, the psychosis, the antagonisms in her personality? Aimée undoubtedly changed her position when she became reconciled to her foes, and changed her place upon re-dimensioning her later true literary production. As Lacan (1966c, p. 52) wrote: “For faithfulness to the symptom’s formal envelope, which is the true clinical trace for which I acquired a taste, led me to the limit at which it swings back in creative effects”.

These creative effects should not be understood only as integrative catharsis. There is recognition in them that belongs to a different sphere of discourse, which took place when her work was published by Paul Eluard, and she was hailed as one of the stars of surrealism. The symbolic effect of this recognition may have been to do with the association with her first boyfriend, whom she called a “starpoet”. But this makes no difference. Aimée’s integration into French literary culture introduces something new into the discursive sphere she occupied. This seems to have been the lesson that Lacan learned from Aimée and from Bataille. Dean, referring to Bataille wrote that: He reconsiders boundaries in terms of the father’s prohibition, which will always be a source of pleasure or in the terms of healing that will always be pathological and the pathological that is always a form of healing (Dean, 1992, p. 243).

The dimension of healing, differently from that of treatment or of the clinic, supposes a space for reversing the pathological, which is not opposed to either normality or to recovery. So, let us now move on to our concluding argument. All forms of power exercised in healing derive from the injunction between the position of the subject, the place that this subject occupies in a discourse, and the space that conditions and limits it. Power functions

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by unifying and homogenizing space, place, and position. As Lacan (1959–1960, p. 33) said in The Ethics of Psychoanalysis: A particular order is unified into a more universal knowledge, where ethics flows into politics and, beyond, into an imitation of the cosmic order.

It is the attempt to incorporate the exception into the universal. Some resistances are exercised, first, as a type of structural effect of heterogeneity between the space that is pre-supposed in each power-form and places, and secondarily, between places and positions. I feel that it was these effects of resistance and incorporation that Foucault studied when analysing the practices of individualization in the forms of discipline in modernity. This heterogeneity appears in categories such as statements, apparatuses of power and discourse (Foucault, 1969). It admits of evolution in its linguistic sphere (speech, discourse, and language) and its political sphere (tactics, strategies, and proper politics). It would be well to remember that references to space have accompanied our entire history of the constitution of the psychoanalytic clinic. Since its beginnings in narrative shamanic and tragic practices, the idea of re-establishment in places and positions is significant. In rhetoric as well as in medical techniques of the ancient world, we saw this concern to synchronize space and position, or position and place, through a reflection on time and being. However, it was with respect to practices related to care for oneself that we saw, for the first time, a systematic reflection on the divergence and separation between political space and ethical places of the enunciation of the truth of an experience. Montaigne restored this disjunction and developed it into a unique practice of healing. In Descartes we saw the broad affinity between his theory of the constitution of the subject and a new conception of space, conceived by Galileo and Copernicus. Different notions of space are involved here, but the persistence of this allegory is intriguing. These strategies of migration, reduction, and logical-political subjection define the movement we want to describe. Also, in modernity, we showed how, by inhabiting an anthropological space, as described by Kant, in a relationship of negative inversion of the categories of pure reason and practical reason, one can include not only the formation

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of the medical clinic, but also the psychiatric and psychoanalytic clinics. So, would it not be correct to say that Hegel is the best example of how this totality can contain an immanent contradiction within itself? The real, whose political reference is territory, is related to with the real, whose ethical reference is the dwelling. But space is still continuous. This is one of the most constant premises of onto-theology and of Western metaphysics. It expresses a trend towards considering that place necessarily includes and contains the exhaustive set of positions, just as genus contains species. Through a grammar of inclusion and exclusion, we came to suppose that every position is included in a place, and that both position and place are encompassed in a space that has thus become invisible and homogeneous. I proposed to contribute to the deconstruction of this idea based on the premise that the space considered to conceive of place need not always be continuous with the space considered for conceiving position (Dunker, 2003, V. 37, pp. 2–11). This determination is political and logical, but the two facets are not caught up in the same movement. Early on, Napoleon asserted that geography is destiny. Later he claimed that the modern form of destiny is politics. Through this operation happiness has become a political factor. One effect of this type of closing of political space, strictly speaking, is its entire distribution throughout ethics, economics (that science of unhappiness), forms of the legal sphere, and technologies of oneself. Foucault noted this movement, and his critical essays on psychoanalysis often refer to this aspect. It can be summarized in four points. First, psychoanalysis participates in the apparatus of sexuality by placing the truth of the subject in the continuous and repressive enunciation of its own sexual desire (Foucault, 1976, pp. 73–109). The theories of perversion and sexuality are conceptual indications of this movement of the positioning of the subject. Second, psychoanalysis participates in a discourse that attached the apparatus of sexuality to the apparatus of alliance, allowing a solid combination between public power represented by the social disciplines and the power-form seen in the family (Id., 1977a, pp. 229–242). The theory of the Oedipus complex is the best conceptual example of this operation of connection between place and position. The incitement of desire by parents is correlative to the

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apparatus of the medicalization of the family. Therefore, the idea of incest, far from being unbearable, is at the very origin of the pastoral of the flesh. Third, psychoanalysis is part of a repressive strategy that, in its practice, can be seen as a variant of the legal and moral apparatus of confession (Id., 1975c). Transference and recollection are the notional remnants of this tactic of articulation between position and place. Fourth, psychoanalysis is part of a long process of silencing insanity and expropriating its truth, contributing to and innovating in the process of pathologization and individualization of its experience (Id., 1961). This includes psychoanalytic psychopathology and even the structure of treatment that characterizes the positive integration of places of the pathological into the generic space of the politics of discourse. Foucault’s objections are all pertinent. Although no psychoanalyst would recognize these traits in his own practice nor the objections to the generalization Foucault makes of psychoanalysis, there is no doubt that the social implementation of psychoanalysis owes much to its articulation with these operations that unify space, place, and position. To deny this is to deny that psychoanalysis has a history and that its constitution is not hagiographic, nor is it oriented by the divine providence of the court. No form of constituted discourse can guarantee a place of deconstructive or critical resistance, because its constitution is already, in itself, an ideological articulation in a space that precedes it. Criticism depends on experience, and it is in criticism that one can better analyse the relationships between space, place, and position. Narrative is not discourse, discourse is not language, and language is not space. In Lacanian terms, we can say that the politics of treatment results basically from the way one conceives the place of the Other and how one understands the position of the subject in the fantasy. The two notions of place of the Other and position of the subject are closely related to the spaces of ethics and of discourse where an analysis unfolds. In the best of circumstances, an analysis produces the experience of an object that is irreducible to the space that made it possible. It can thus be supposed that an analysis has a triple task from the point of view of its politics: to allow the subject to identify the contingency of his phantasmic position, to carry out the experience of making the place of the Other a non-entirely consistent place,

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and to introduce an object that is resistant to its integration into the uniform space between the subject and the Other. It is in this context that one can see the importance of a disjunction between the types of knowledge that make up the reference of its clinical practice. Lacan’s seminar, The Ethics of Psychoanalysis (1959–1960), is often referred to by commentators as an anomalous seminar. As we have seen, it represents a type of parenthesis and inversion in Lacan’s programme of investigation. In the first six seminars and texts after the Mirror Stage, Lacan’s project undergoes a continuous deepening of his proposal for a theory of the constitution of the subject, based on Freud’s considerations on narcissism and Hegel’s dialectic, read from Kojève’s point of view. This corresponds with a type of parallel programme based on the progressive refinement of investigation into the forms of symbolic mediation that allow one to understand the unconscious in a structural way. The result is a type of thinking that identifies desire as the effect of a network of places that overdetermine the position of the subject. The task of analysis is to undo the alienation that prevents the recognition of the constitutive value of this network of places called the Other, the Other being defined as the place of language. But then, what is the nature of these places? In what domain could one find their reference? In answer to a direct question about the ontology of the unconscious, Lacan asserted that, “The status of the unconscious is not ontological, but ethical” (Id., 1964a). Therefore, ethics is referred to when speaking of place in psychoanalysis. Contrary to places in logic the place of ethics has a history and implies politics, places in ethics. From the methodological point of view, investigation into the symbolic mediators of desire is strongly based on linguistic structuralism as well as on approximation to mathematics, especially with several introductory aspects of topology, namely, the theory of series, graphs, and Klein groups. The result of this is formalized in the scheme of the structure of speech (Id., 1955a), the graph of desire (Id., 1957–58), the theory of the subject developed on the basis of a reading of The Purloined Letter (1954a), or an attempt at topologically apprehending the clinical developments of Little Hans’s phobia (1956a). The use of topology strongly marks and characterizes the period prior to the seminar, The Ethics of Psychoanalysis.

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Similarly, if we examine the period after the seminar, The Ethics, and the two articles that correspond to it, namely, The direction of the treatment and the principles of its power (1958), and Kant with Sade (1963), we see a constant use of topology. At this point, the notions of space, place, and position begin losing their metaphoric value and take on a progressively formal use. Considering the sequence of seminars that immediately follow The Ethics, we can note that even the thematic shift from analysis of desire to analysis of the drive safeguards the intense methodological presence of topological categories. So if there is this methodological frequency of topology both before and after the seminar on ethics, why do we find not the slightest mention of the relationships between ethics and space, or of the relationships between ethics and mathematics? The problem becomes even more intriguing if we remember that such an approach is clear in authors who were admired by and familiar to Lacan, such as Spinoza and Nicholas of Cusa. According to our hypothesis, this absence of topological references in the theme of ethics represents a political position taken by Lacan. This may help to explain why a complete logic that could unify place, space, and position is exactly what should be avoided in psychoanalysis. This would correspond to a type of political pathology based on the sovereignty of treatment and clinical practice over the healing (cure) surface (Dunker, 2003, V. 4, p. 1). In other words, the logical structure of treatment is neither united nor dissolved in the totality that comprises the space of clinical practice, including a fundamental notion, rather than a synthetic notion, of treatment. Authors of Lacanian extraction, interested in the topic of politics, have insisted on aspects that are different from our reasoning here. The theoreticians of radical democracy (Laclau et alli, 2000) stressed the idea that one must separate. The political from politics in order to conceive of the social antagonism that constitutes The political without reducing it to the practices of articulating demands around floating signifiers, which refer to politics. Their criticism of democracy based on excessive reliance on the notion of representation is based on the idea that the place of power has become an empty space, which should not be occupied hegemonically by any position (Stravrakakis, 1999, p. 123) Displacing Lacan’s notion that the Other does not exist, these theoreticians hold that Society does not exist. In other words, the unification of political space is the consequence of

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contingency, and not of exclusion, or elimination, of the positions that indicate its absence of the political. This interpretation by Lacan especially explores the idea of a fractured universal as the definer of political space. The authors belonging to the Slovenian school of psychoanalysis (Žižek, 2002) have insisted on another aspect of the problem. For them it is in the idea of act and its correlation with political act that one sees not only the negativity that underpins the universal dimension of politics, but also the fall of an object that cannot be incorporated into it. In other words, all imaginary aspects formed by political space can be decomposed by a specific subversion of the relationship between place and position, and this corresponds to a possible reading of the notion of act in Lacan. The Post-Marxist perspective assumed by Badiou (1996) invests in recovering the notion of truth to establish a new theory of the subject. In carefully examining the relationships between logic and ontology, Badiou seems to be seeking a type of network of paradoxes between the dimension of place, space, and position. Here we find the notion of event as the emergence of an anomaly that is contingent to the political space, which Badiou sees as coextensive with the place of love and aesthetics today. Badiou details the type of problematic relationship between the different modes of the subject in its path to the truth: the indiscernible, the undecidable, the naming, the forcing, and the fidelity. His work gives important indications concerning the nontotalizable relationship between logic and politics. Finnaly, the perspective developed by the Manchester Group of critical psychoanalysis (Parker, 2007; Burman, 2008; Parker, 2006; Parker, 1999) evolves a systematic critique around reification of psychopathology categories, against ideological authority of professional discurse in alliance with therapeutic approach of subjectivity. This perspective seems to be decisive to reintroduce political implications and practices in “neutral technical naturalized” clinic-therapeutic surface. These critical enterprises are located outside the specific scope of this book. My mentioning them is therefore to suggest a possible homology with the notion of politics in social theory. But the impact of this type of investigation on the modes of social and cultural inscription of psychoanalysis is still far from being felt. The attempt to face institutional and associative problems as well as institutional and specifically political issues by directly using the psychoanalytic clinical

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theory without mediation—or, inversely, completely separating psychoanalysis as a method and public action of those who exercise it—are effects of rendering invisible political space and the consequent positive occupation of places in pre-defined forms of discourse. In contrast, another possible understanding of politics should be mentioned, namely, that which can be found, for example, in the idea of politics of the symptom. This expression refers not only to the choice of neurosis and to clinical structures and types but also to the subject’s responsibility for the jouissance he derives from his symptom (Goldenber, 1994, p. 94). This approach emphasizes politics on the side of the analysand, but leaves its correlate on the analyst’s side blank. This is precisely this position we find in practices of caring for oneself. The first problem here is that this blank position, which is consistent with the generic principles of abstinence, free association and the analyst’s desire as the desire to obtain pure difference, is nonetheless a position. It is a political position based on a negative ontology of political space. The argument that it is a strictly ethical position and place eliminates any possibility of discussing important objections, such as those of Foucault. The second problem related to this position is that it tends to restrict the connotation of ethics to the scope of particularity. Again, this is not false, but it is also not entirely true. The interesting aspect of the way Lacan sees ethics is not in its possible consequences to justify the customs of a community of analysts or a formal deontology of the situation of treatment. It is not the same specific meaning by which one could speak, for example, about an ethics of the Ostrogoths or an ethics of the sixteenth century. The radical nature of ethics lies in the fact that it does not renounce universality. It is constituted in the very fracture of this universality and in the practical demonstration of its impossibility and existence. Therefore, it should not be used as an argument to legitimize any and all therapeutic action. The notion of politics in psychoanalysis could also carry a third connotation. This would be the sense it which it is inscribed in the scope of the politics of happiness, in the same direction that Freud (1930, p. 69) took when speaking of the techniques of happiness: to flee from displeasure, seek pleasure, hold down or arouse the (erotic) pleasures of the body, lower the weight of nature on man or reduce the demands that civilization imposes on him. The indications of

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psychoanalysis on this point are no doubt scarce, but they do exist. There are love and work, and each one must find the solution that is possible for them to transform neurotic suffering into everyday unhappiness. Lacan did not hesitate to say that patients ask us for happiness and that psychoanalysis gives them some answer, even though it may subvert the meanings of what they want. These meanings have a long history: the ideals of concluded love, authenticity and non-dependence (Lacan, 1959–1960), pp. 17–19). Therefore, there are politics of happiness to which psychoanalysts dedicate themselves in view of the singularity of their patients. The concern and undercurrents related to this aspect of the problem emphasize the negative dimension. Specifically, they do not promise a cure, they are not overly avid in seeking it, but they do not hold to any ideal of happiness. Their politics is less ambitious. It is prudent but it does not discard a specific form of freedom that is not delirious real-ization, but is compatible with an experience of the truth. It should also be noted how the main images used to designate the analyst’s position and place in treatment are images that indicate a type of displacement or decentring of it in relation to the place where it is. This is the situation of a foreigner in a strange country (Koltai, 2000), an immigrant, a traveller (Calligaris, 1999, pp. 11–23), a poet (Kehl, 2002, pp. 183–187), a passer-by (passant) (Fingerman & Dias, 2005), a roaming saint (saint homme) (Teixeira, 1999) or a court jester. All this, not to mention situations of interval such as between two deaths, between implication and reservation (Figueiredo & Coelho, 2000), or conditions that cannot be located, among which utopia (Souza, 2006), atopia (as in Socrates’ desire), and dystopia can be included. If analysts must be up on their times, they will always seem a little out of place. Contrary to these images, our patients usually present themselves as people who are attached to modes of jouissance, imprisoned in their imaginary circuits, identified with positions or alienated to places. I am suggesting that it is precisely the ambiguity of the discourse on the notion of healing (cure, in French) that is absent from the idea of treatment, and much less in the idea of recovery, which is at the historical roots of this transitivity between space, place, and position.

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But you will become convinced that it is a great ambition, if we manage to transform hysterical misery into common misfortune. —Freud

W

e started our long journey by pointing out how important it is to distinguish, in the broadest spectrum of the idea of healing (Genesung), between the notions of treatment (Behandlung) and recovery (Heilung). It was through the notion of recovery that we were able to understand the earliest strategies for healing based on compromise formation and the narrative re-balancing of individuals to the symbolic totality where they can realize that they are understood. At this point the first ethical dissociation is made between the effectiveness of treatment and the excellence of the healing. And healing then led us to the problem of the origin and legitimacy of power in its relationship with the truth, in the healing process, in relation to knowledge in the clinical methodical treatment and in relation to the economy of happiness in discursive rhetorical techniques of psychotherapies. 365

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The birth of Greek medicine gave us two models for this problem. The first, represented by Empedocles, seems not to renounce the excellence of the practical dimension and demands that excellence hold a specific relationship with the truth and with the real, so that treatment becomes possible. The second, represented by Hippocrates, stresses the dimension of care, referring the origin of the power of healing to a system of transmission of shared knowledge based on tradition and oath. Both consider disease as consisting of a narrative path and a history, but Empedocles suggests the importance of acts that can change the course of a disease, while Hippocrates focuses on modulating its phases and accepting its own specific cycle of discourse. Less than an answer to this relationship between power and truth, Greek tragedy indicates a development, a movement, of this question. We were thus able to see how the truth we are talking about cannot be enunciated outside the space of the fiction that, since that time, has marked the theatre as one of the essential places for healing. Through both its non-thetic nature and its connection to time, this new regime of connection between truth and power approaches the forcing of this truth (hybris), the source of disorders of the polis. The use that psychoanalysis re-encountered for the notion of catharsis cannot be reduced either to its Platonic sense of expurgation and exclusion of evil, nor to its Aristotelian sense as a moment of reconciliation and integration of evil into the conditions that made this evil possible. So we suggested that the notion of disintegrative catharsis be used to express how family structures are irreconcilable with the political sphere. This point represented a fundamental divide for psychoanalysis in terms of the possible use of its basic tragic structures: narcissism, the Oedipus complex and the death drive. There is no way to discard the integrative and reconciliatory function to which the Oedipal, narcissistic, and thanatic narratives are subject during treatment, but the question is whether they coordinate the different clinical projects that can be extracted from psychoanalysis. In other words, the question is whether the strategies of symbolization and subjectivization in psychoanalysis are sufficient to provide a description of it that does not reduce it to the sphere either of practice as a clinical treatment or as psychotherapy, as technical post-education. Whether through the narrative structure of the disorder, through the type of cultural formation that is seen in tragedy, or through

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the participation of the mythical in the conception of healing, psychoanalysis is a treatment that operates on narratives and with narratives. For this purpose, they can be used as instruments that, on a formal level, allow one to describe and operate on the structure of the narrative in the categories of logic, discourse and linguistics as one may want. However, this effort at formalization should not serve as a justification to unify space, place, and position as the politics of the cure. The main so-called technical questions of psychoanalysis can be seen in an ancient system of reflection on and intervention into discourses, namely, rhetoric. Interpretation, diagnosis, transference, and even the temporality of language and the length of sessions can be thought of in terms of the rhetorical topics of the ancient world. As a technique for managing language, rhetoric has always been questioned as to its connections with the various strategies of power. The fictional aspect introduced by the tragedy thus became a radical replacement for the truth through similarity, of certainty through persuasion, and of proof through sincerity. Rhetorical excellence fails to take into account any ontological dignity for the function of the agent of a discourse, but neither does it leave any room for the participation of desire. This is like a type of inverted complement for rhetoric that was seen during the Hellenic period, namely, the practice of care for oneself (epimeleia heatou), from which a reference to the notion of healing (Genesung) was derived. Beginning with the enigmatic and atopic condition that one can intuit from Socrates’ desire, and going on to its dilution in the figure of a director of conscience, one can insinuate a space where, for the first time, the conditions by which a subject is transformed in his problematic and continuous relationship with the truth are systematically and methodically examined. As we saw, this is not an interior truth, much less an individual truth. It takes place in a borderline space between education and political action. We thus find the idea that there is no first and final point of resistance to political power other than in the relationship with oneself. In this sense, the project for dominating oneself is as problematic as dominating the other. Care for oneself is a combination between art and medicine of the soul, between philosophy and the science of everyday life, and it affords a new repertoire of topics and tactics that psychoanalysis took up in the interpretation of dreams, the

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method of healing, meditation, the importance of the relationship of speech, recollection, and the implication of the subject in his own fate. trough the politics of actively refusing exercise of power. Here we could see only a precarious form of ethics, fruit of the disintegration of the Greek empire, and the rise of Latin Christianity. On the other hand, I insist that it is here that one sees a special type of politics, politics of criticism, and of the inevitability of “The political”, we might say. It is understandable that care for oneself has been the matrix that the apparatuses of confession, sexuality, and conversion have been built upon. But the very path of care for oneself shows that this assimilation is not necessary. It is contingent on the instatement of a new form of power. The most impressive form of this montage, which ranges from healing to its incorporation by power, is expressed in the thaumaturgic healing carried out during the rise of absolutism. The characteristic of the emergence of modernity, in both its disciplinary matrix and its liberal and romantic reactions, is that the political space of positive power has taken the space of healing. Its administration, organization, and legitimization are also the paradoxical control over possible freedom. Everything takes place as if possible freedom were also that which is immediately realized as lost. This does not mean that healing has ceased to contain the critical ideal of freedom, but it becomes unthinkable through the methodological reduction that made it possible. Here we find the figure of Montaigne as an example of how this current of resistance to power survives in the same space as the administration and control of healing. Its strategy of discourse inverts the place that, until then, had been given to writing. With greater sedimentation and struggle against the perennial nature of legal and moral forms, writing takes on a transitory therapeutic meaning and is marked by the problematic of the subject. Its inspiration is neither deontological nor programmatic, but rather sceptical. Like care for oneself, truth and scepticism are not two necessarily exclusive positions. The experience of the truth is different from the discourse about the truth. Montaigne succeeded in practicing a type of conversion in the sense of returning to oneself and a type of reform of oneself in the sense of a transformative investigation which is inscribed in a completely different discourse. This is a good example of how one single apparatus cannot dominate all the narratives that are inspired by it.

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Descartes and the seventeenth century saw a reorganization in the relationships between truth and healing. Healing was no longer foreign to the subject nor was it tied to the experience of friendship and writing about oneself. At the same time, healing is deeply singular, according to the new technique of meditation practiced by Descartes, and it is universal, according to the relationships established between existence and thinking. So, deflated of its ethical or aesthetic potential, the truth became accessible to all, without a transformative process. Inversely, the truth lost its power to heal. Or we might say, a healing process of the truth was conceived in this way through the critical exercise of reason. A subject condemned to provisional morals thus comes on the scene. The deepening of the current related to the knowledge of oneself was a symptom of this situation. Although the modern world implies the unification of all symbolic systems into the form of a consistent Other, the soul of glass, which is correlative to it, admits only of treatment (Behandlung) or recovery (Heilung, Genesung) but never healing (Kur, Sorge). The eighteenth century seemed to suspect this programme and showed interest in its limits. The critical treatment of reason then took on the condition of exercising the freedom and source of resistance to illegitimate power. In general, Kant is not a good example for a narrative practice. But, by radicalizing both Descartes’ demands on the primacy of reason and Hume’s demands regarding the knowledge generated by sensoriality, Kant brought to light a type of residual and persistent effect, namely, the irreducibility of human experience to the domain of representation or, we might say, the disparity between the three Criticisms and the concrete practices of human beings. The destinations of Kantian anthropology, in terms of the precarious nature of his first formulation, determined a field of strategies of power under which the different practices of treatment, or of psychotherapy, were installed. Kant set down the conditions so that the terrain for treating and therapeutics could be included in a broader space, which one could call the clinic, or clinical practice. Clinical practice potentially includes treatment, therapy and healing, but it expands in a wider space of knowledge where one can recognize a type of psychoanalytic anthropology. This field includes the theory of the constitution of the subject, the theory of

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the formation of symptoms, and the theory of the construction of the fantasy. The problem inherited by Kant can be handled in several different ways. Some would see a critical project for a deontological dimension. In this case, the pathological is a mere deviation to be corrected by education and clarification. Others would dedicate themselves to the positive occupation of this anthropological terrain by inferring and creating psychological or psychopathological categories, the transformations and understandings of which could be multiplied indefinitely. Finally, there were the heirs of Kant who noted that the human being is a construct of negative value, and the lack of parity of its ethics, epistemics, or aesthetics with those which should be (sollen werden) is not the effect of contingency. In this group, we could include Schopenhauer and Nietzsche, in the philosophical tradition, and certain forms of romanticism, in the aesthetic tradition. Psychoanalysis found scattered and heterogeneous articulations between these three inheritances from Kant. But it should be emphasized that in this third current the notion of healing maintains its political weight of counter-power and resistance. In Hegel we find a possible articulation of these three strategies that resulted from Kantian Enlightenment. There is, on the one hand, a negative anthropology based on the negative effectiveness and excellence of work, desire, and language, as Kojéve pointed out. In contrast, there is the specific moment of formation (Bildung) by which alienation is recognized in positive and systematic forms in the relationship with the other and with history itself, as Hyppolite stressed. Finally, we have Hegel who studied the most primary logic of the relationships of negativity, including on the ontological level. Hegel is a very good source—even if one does not adopt any of his specific theses—for delving more deeply into the notions of recovery (as dealienation), treatment (as recognition), and healing (as separation). All through this process of historically constituting psychoanalytic clinical practice, we have made a number of forays into the same hypothesis, to the effect that there are more or less formalized structures of the course of psychoanalytic treatment and even of the clinical practice in which treatment is included. But the ethics that regulates its strategies does not guarantee the necessary passage to politics, through which psychoanalysis is included between other discourses, to the point of easily being subordinated to them.

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If this course of treatment can be used as a way to historically introduce psychoanalytic practice, it is also a warning about the non-reducible connections between logic and the politics of psychoanalytic clinical practice. In other words, it is in the failure of logic that one finds the enigmatic point at which psychoanalysis is a political act. Inversely, it is in the failure of politics that one can find the paradoxical point where psychoanalysis is a logical operation. At numerous points in this book we left the work of historical reconstruction aside and went into discussions on topics and problems that are present in current psychoanalytic discussions. This may have been prejudicial both to going further into these topics and to their possible elucidation. However, this procedure has helped us in our attempt to show how historical discussion is internally connected to the theoretical and clinical problems of psychoanalysis. In this regard, the history of analytic practice has played a role that is somewhat different from what is usually seen in epistemology and the history of science. One might object that the cost of this option for historiographic precision has been too high and that the result is a mere projection of the present on the past, with its consequent deformation and partialiality. In fact, the accuracy and details of the intuitions presented here imply a call for contributions from professional historians. I will therefore be satisfied if I have been able to indicate, differently in each case, the presence of the theme of power in the constitution of psychoanalytic clinical practice. It will suffice if the readers consider three main aspects. First, there is the long road that led to the constitution of a specific type of subject with respect to the forms of the truth. Second, we have the no shorter road of ethics, with respect to the forms of the Real, which determine our practice. The third essential genealogical theme is that of current power or any future counter-power represented in psychoanalytic practice. This theme refers not only to the generic situation of the influence of psychoanalysts over their analysands (psychotherapy). It also includes a surface where power is seen not only in the domination of and servitude to ourselves, but also in the possibility of freeing us from ourselves (healing). Connecting, but also separating, these two surfaces we have the clinical method that operates ideologically, depersonalizing the power of psychotherapy and neutralizing ethics through the power of technique.

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Of course, many aspects of the problem have been left in the shadows. I especially feel the absence of a more vertical discussion with thinkers in the history of political philosophy and the sociology of economics. Also, due to the length of this project, the examination of other modalities and traditions that exist in psychoanalysis have been left aside. But I hope that, here also, readers can ponder over their own inferences, for example, regarding the similarity between Kant’s writings and clinical practice based on Bion, or between the topic of caring and the clinical practice instituted by Winnicott. I do not want to suggest that the archaeology of psychoanalysis can be complete based solely on considerations in Lacanian practice, no matter how substantial they may be. But I do feel that the examination of specific topics is better for making evident the usefulness of the archaeological and genealogical method for psychoanalysis.

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CHRISTIAN.indb 392

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INDEX

Analytic honeymoon 307 Anamorphic cylinder of the tragedy 35 Anatomo-pathological model 271 reference 255 underpinnings 271 Ancient World 126 Anthropological demarcation 239 justification 226 Antigone act of 31–49 daughter of Oedipus 31 King of Thebes 31 knowledge, power, and desire 46–49 total loyalty to family 36 tragedy 33–36 Anti-individualizing function 23 Antiochus, Prince 25

Abductive hypothetical reasoning 48 Ab-sense of sexuality 83 Absolute negation 335 Absolutism 368 Aesthetization 114 Aetiological reformulations 264 Aetiology and causality 258–260 language and subversion of 282–286 Aimée’s integration 356 literary production 355 Alcebiades 99, 126 cure of 125–129 Alienation 337 Allegorical method 86 An Essay on the Maladies of the Head 240 Analysand’s supposition 306 Analyst’s clinical hypotheses 28

393

CHRISTIAN.indb 393

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394

INDEX

Anti-philosophy 52 Anti-psychoanalysis 57 Anzieu, Marguerite 354 Apodesis 75 Apophantic judgements 13 Apophatic theology 85 Arbitrariness and relativity 275 Aristophanes 128 Aristotelian group of syllogisms 178 inspiration 39 sense 366 Aristotle’s Lyceum 96 Artmidorus of Daldis 122 Ascesis 115–118 Assimilation 105 Assis, Machado de, character 224 Augustine conversion 144–145, 147 Augustinian surface of therapy 155 tradition 157 Aurelius, Marcus 120, 153 Authentic rhetorical inventory 65 Automatisms 271 Autonomous self-discipline 124 Babylonian and Roman occupation 80 Babylonian physicians, courage of 21 Barthes, Roland 127 Benevolent complicity 58 Bercherie 272 Bernard, Claude 272 anatomo-pathology 268 paradigm 269 principle 263 Beyond the Pleasure Principle 238, 309 Bichat 255 Blasphemy and cursing 67 Block symbolization 339

CHRISTIAN.indb 394

Boccaccio 296 Bombastic prosopopeia 65 Bonnet’s syndrome 269 Book II of Rhetoric 57 Book of Job 4 Brás Cubas 224 Brücke Laboratory in Vienna 280 Byzantine Emperor Constantine 142 Canguilhem 248 Capitalism as social discourse 279 Capitalist, discourse of 278 Cartesian classes of propositions 178 clinical method 351 metaphysics 182 problem 188 temporality 173 theory 186 transference 176 Castration 127 Catella 296–297, 313, 335–336 Catharsis 93 disintegration 36–39 functionality 36–39 integration 36–39 Causality 258–260 Charcot’s clinical practice 351 method 280 strategies 354 Charles II of England 141 Chemical component of sexuality 83 Childhood sexual theories 287, 334 Chinese rhetorical strategy 84 Chinese theory of strategy 84 Christian ascesis 116 asceticism 98 conversion 114

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INDEX

couple 140 hermeneutic 81 patristic hermeneutics 80 Christianity 97, 112, 114, 164–165 Christianization 151 Civilization 104 Classical clinic structure of 262 surfaces of treatment, therapy, and healing 264 Clinical instrument 72 narrative therapy 25 theorization 343 therapeutic surface 138 Cognitive discipline 125 Cold impassivity 327 Collectivization 68 Colonization processes 60 Combinatory topology 71 Complex clinical problem 60 Consensual diagnostic reference 276 Consolation 122 Constitution 252 Contemporary technoscientific psychiatry 276–279 Control of diaphragm 19 Corpus hippocraticum 24 Creon ceases 36 edict 32 to Haemon 36 Crusades 148 Crusoe’s megalomania 224 Cultured doctor 27 Cura sui 93–104 Cure-clinic surface 138 David-Ménard 240 Deciphering 254

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395

Deixis 24 Delusion 339 Deontology 22, 275 Depersonalization 61 Descartes 183, 220, 369 cogito 203 Discourse on Method and the Meditations 164–165 evidence 175 Hellenic asceticism 164 meditation of 163–182 provisional morals 170 theory of circulation 167 universality, negativity and existence 171–176 Diachronic articulation 261 Diagnosis 257 Diagnostic process 258 reformulations 264 reasoning 258 Diagnostic and pathological findings 264 Diagnostic and Statistical Manual of Mental Disorders (DSM) 276 Diagnostic process of transference and subversion of therapeutics 286–291 Dialectical thinking in 325 Differential diagnosis 258 Discourse articulation 94 Discourse on Method 184–185, 190 Discursive rhetorical techniques 365 semiology 287 Dispositio, temporal structure of analytic session 68–75 Doubles 253 Dream and madness 169 Dreams of a Visionary Explained by Dreams of Metaphysics 240 DSM-IV clinical classifications 277

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396

INDEX

Duflos, Huguette 354 Durkheim, Emile 348 Ego 99, 176, 226, 305 Egyptian hieroglyphics 89 Eleatic thinking 17 Elocutio, figure and logic of conflict 75–83 Eluard, Paul 356 Empedocles 21, 26, 94–95 authority of 23 between order and disorder 18–23 cure-healing model 30 method 19 model of cure 20 of Agrigento 266 political terms 23 return of 17–30 school of 27 thinking 28 to Faustus 28 Empirical exposition 72 English kings 140 Enthymemes 65, 71, 91 Enunciation 75 Enunciative modalities 95 Epictetus 97, 101 Epicurists saw friendship 113 Epicurus 121 Erasistratus, Hippocratic physician 25 Ergotherapy 272 Eroticization 117 Ethical disposition 124 Evolutionary diagnosis 258 Exhaustiveness 149 Exteriority 309 Eye-turner 89 Eymerich, Nicholas 149 Family Complexes 308 Fantasies 337, 339

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Fantasmatic synthesis 337 Faust’s melancholia 224 Ferenczi’s active technique 30, 198–199 Fibonacci series 209 First counter-argument 310 Floating signifier 68 Flournoy, Theodore 352, 354 strategies 354 Foucault’s work, meta-hypothesis in 101, 151, 230 efforts 129 Frankness and free talking 109–111 Free-floating attention 73 French critical epistemological historiographers 167 French revolution 222 Freudian categories, surfaces 138 Freudian theory 38 Freud 39, 204, 365 act of outwitting, or fooling 56 analogy 7, 194 Analysis Terminable and Interminable 350 contrary to Lacan’s view 54 criterion of psychoanalysis 6 descriptive notions 289 determinant of psychoanalytic treatment 58 epistemology 224 father function and the origin of authority 39–46 grammar of love 207 hypothesis of the primordial father 40 identification 224 maxim on psychoanalytic treatment 155 medical practice 259 neurotic currency 57 notion of interpretation 61 own notion of sublimation 224 psychoanalytic tradition 283

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INDEX

psychoanalytic treatment 198 recommendation 287 sexuality as driving force 314 superego 226 Unconscious 89 verbal expressions 66 Galen’s conception 248 theory 249 Galileo’s astronomy 184 General Theory of Negativity 227 Generic paradox of education 147 Genetic determination 276 German Idealism 299 Glanz auf die Nase 88 Glossographic languages 89 Gnostics and Neo-Platonists 133 Gorgias 51–52 Greco-Roman inspiration 6 narrative 6 Greek cosmos 4 empire 368 hero 4 legal and political systems 7 legal practices 41 medicine 366 narrative rhetoric 85 philosophy 7 Roman religious 145 scepticism 126 society 22, 26 tragedy 47 warrior 13 Greeling’s paradox 187 Groupism 103 Hallucinations 270, 399 equivalent of 271 Hallucinatory psychosis 308

CHRISTIAN.indb 397

397

Harmonization 93 Healing agent, psychological discourse of 189 Healing process 94 Heavenly Secrets 240 Hebrew community 80 Hegelian current 301 dialectic 321 Hegel’s authorities 318 dialectic 333, 335 logic of negation 322 negation of negation 335 phenomenology 303 philosophy 299 real and its negative 295–344 scheme 300 Selbstbewusstsein 205 Hellenic asceticism 164 period 143 Roman period 111 world 96 Hellenic care 98, 133 of oneself 153 Hellenistic ascesis 116 ideas 115 period 94 philosophy 114 schools 105, 136 sources 126 Hermeneutics of Origen 83 Heterogeneity 90 Heteronomy of mental faculties 276 Hetero-segregation 107 Hippocrates 94, 106, 136 doctors 26 medicine 23, 26, 248 medicine and psychoanalysis 30 oath of 23–26 of Kos 20

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398

INDEX

therapeutic principle 25 transmission of the art of medicine 24 Historical practices, distribution of 137 History of Lipogram 71 Holy Mother the Church 87 Homeric hero 4 narrative 14 Homer’s epics 93 poetry 2 Homogeneity 263 pre-supposed 286 Homology 9 Hospitalization 261 Humanity 315 Hypnotism 273 Hypochondria 234 Hyppolite 330 Hysteric’s discourse 159 Ideal ego 321 Ignatius of Loyola 164 Imaginarization 307 Imperial Rome 98 Indeterminate negation 314 Indian poetics 83 Individualism 348 Individualization 359 Infinitive mood 75 Instant of the Glance 62 Institutionalism 103 Intellectualization 351 Intersubjectivity 325 fulfilled 316, 321 Intersubjectivization 337 Intransitive moral demand 226 Introduction to Narcissism 309 Inventio, places of interpretation 63–68

CHRISTIAN.indb 398

Investigative doctor 27 IQ tests 202 Italian naturalists 143 James Joyce case 49 Jameson’s argument metaphor and allegory 85 Jesus Christ 87 historical figure of 80 Jew-Christian narrative 6 of excellence and its irreducible theme 7 Jewish-Christian hero 4 Jokes and their Relation to the Unconscious 65, 67, 192 Jouissance 77, 293 phallic 323 phallic inscription of 321 supplementary 324 Jubilant assumption 342 Judeo-Christian experience 4 hero 3 inspiration 6 lineage 123 narrative 14 texts 93 Julius Caesar 113 Juan, Don, erotomania 224 Kandinsky, Victor 270 Kant, Immanuel, and pathological 221–243, 369 Kantian categories 271 enlightenment 370 Lacan 228 philosophy 227, 240 psyquiatric 351 soil 301 theory 341 transcendental idealism 232 universal 232

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INDEX

anthropological space 343 anthropology 233–241, 251, 269, 311, 369 Anthropology from the Pragmatic Point of View 232, 237 criticism into positivee force 233 Critique of Practical Reason 225 duplication 241 initial strategy 269 morals 230 notion of negative grandeur 227 person-to-person relationship 233 person-to-thing relationship 233 philosophy 227 semiological categories 270 theory 230, 232 thinking for Lacan 228 Kantianism 228 Kant’s obsessional neurosis 224 Kant’s theoretical importance 224 Khaterina case 285 King of Thebes 37 Kings and cures 139–144 Klein bottle 218 Klein group 201, 204, 209, 217, 262 analytic discourse 217 Klein semi-group 210, 336 Knowledge-power, unification of 94 Knowing-being-able-desiring 47 Know thyself 96 Königsberg 221 Koyré’s thesis 186 Kraepelin 275 Lacan 35, 110, 127, 177, 204, 330 algebraic and formal understanding of metaphor 77

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399

analysand 326 anthropological connotation 317 clinical case 334, 336 conception of metaphor 77 criticism of Freud 306 description of interpretation 65 doctoral thesis 308 first conception 43 formation of ego 337 formula 180 formulations on transference 210 initial interest in Indian rhetoric 83 interpretation based on Midrash 79 listening 327 metapsychologies 309 method of treatment 198 Oedipalization of analysis 44 protasis 70 psychoanalysis to mystical ascesis 238 psychoanalytic treatment 194–195 psychotherapy 105 rare clinical accounts 325 sexuality in 323 symbolization 76 theory of sexuation 322 theory of subject 173 thesis 13, 43 third and final development on narcissism 342 transference 197 treatment of affinity 129 vacillating interest 167 Lacanian classicism 246 ethics 237

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400

INDEX

extraction 361 sphere 311 Laplanche 77 Latin-Christian influence 112 Latin Christianity 368 Lavater’s phrenology 265 Legitimization 368 Lévi-Strauss 9, 202 Liébault’s authority 347 Linguistic connotation 256 Linnaeus’s biology 266 Lipogram 71 Liponyms 71 Lipophonemes 71 Liposyllables 71 Logic of real 325 Logical paradox 68, 90 Logical-political subjection 357 Lombroso’s criminology 265 Louis XIII 139, 141 Louis XIV 141 Love philosophy 133 Lowenstein 302 Maenadism 7 Magical-religious process 94 Manchester Group of critical psychoanalysis 362 Martians on Mars 181 Marxism 132 Masochism 230 Masturbatory desire 91 Masturbatory thoughts 91 Mathematical formalization 186 Medical personality 59 School of Epidaurus 100 moral situation 248 Medieval Christian 36 medicine 140

CHRISTIAN.indb 400

Meditation 117–121, 163–182 Meditation and method 168–171 Memory 121–123 Mendeleev’s chemistry 266 Mental automatisms 270 chemistry, model 38 Merovingian Dynasty 139 Mesmer, Anton 273 Metamorphosis 346 Metaphoric negation 78 relationship 101 Metaphorization 77, 78 Metaphysics 240 Metapsychology 311 Metonymy, metaphor of symptom 77 Midrash Jewish method of interpretation 79 Minutello, Ricciardo 295 Mischaracterization 311 Modernity, clinical practice 247 Moebius strip 218 Moment of Concluding 62 Montaigne, Michel de 183, 203, 368 anatomy of the soul 152 anthropological attitude 163 art de conférer 152 Discourse on Method 184 discursive surface 161 doubt 163 Hellenistic care of oneself 153 hysteric’s discourse 154 irony 160 kidney stones 154 moral anatomy 155 questioning the self 148–162 self-examination 157 the most skeptical of the hysterics 139–162

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INDEX

writing about oneself 154 Moral quality 109 Morel and Esquirol 275 Myrmidons 2 Mystic writing pad 81 Narcissism 127, 230, 342 Narrative imbalance 73 scansion 74 Nasal bleeding 87 Negation 206 Negative grandeur 228 Negative theology 85 Neo-Kantian philosophy 283 Neo-Platonism 112, 114 Neuroses 348 Neurotic, currency 57, 287, 288 structure 76 Neurotransmitters 276 Neutral technical naturalized 362 New Testament 2 Bible 86 Newtonian concepts 247 Non-deterministic materialism 251 theory 251 Non-Euclidian geometries 227 Non-reducible connections 371 Non-rhetorical discourse 59 Neurotic’s currency 287 Object of Psychoanalysis 126 Occupational therapy 272 Oedipal child 46 Oedipalization of analysis 44 Oedipus 32, 42 certainty 42 complex 44, 46–47, 193, 226, 358, 366

CHRISTIAN.indb 401

401

drama 45 gesture 45 knowledge 45 true father 42 Oedipus Rex 34, 41, 43, 48 Old Testament Bible 86 heroes in 2–3 Oneself, taking care of 93–138 Ontological negation 325 Open subjectivity 39 Orphic and Pythagorean 19 Overdetermination concept 285 Oxymoron 91 Paradox, interpretation in structure of 83–92 Parallel Lives of Plutarch, imitation and submission in 145–148 Paranoiac universe 88 Parrhesia 109–110, 112, 127 Paternal metaphor 76 Pathognomonic value 254 Pathologization 279, 359 Patient’s intersubjective relationships 326 narcissistic problems 326 transferential relationship 54 Peirce combinatory 179 Personal and family loyalties 37 Personal relationships and dialogue 99 Personalism 103 Phallic jouissance 82 Phallus 46 Phantasmic position 359 Phenomenology of the Spirit 303, 316 Philantropia 27 Philon of Alexandria 86–87, 103 Philosophical medicine of the soul 94

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402

INDEX

Philosophy 26–27 foe of 52 Philotechnia 27 Pinel 275 clinical practice 350 philanthropic attitude 276 Placing psychoanalysis 186 Plato, medicine of the soul 26–30 Platonic Aristotelian philosophy 86 Christian 114 extraction 38 philosophy 136 sense of expurgation 366 tradition of self-knowledge 129 Platonism 114, 133 Platonist conversion 113 Plato’s Academy 96 Dialogue Alcibiades 98 Socrates 128 Pleasure-displeasure 124 Plutarch conversion and submission 147 neo-platonic philosopher 145–148 Political conflict 131 Politzer’s criticism of psychoanalysis 189 Polynices 31, 37 Post-conventional morals 225 Post-Marxist 362 Practice of the method 185 Pre-conscious memory 81 Pre-constituted knowledge 135 Prejudice 173 Premeditation on calamities 119 Pre-modern configurations 135 Problematic and continuous relationship 367 Prophetic memory 122

CHRISTIAN.indb 402

Propositions Cartesian classes of 178 Protestant reformation 148–149 Provisional morals 170 Pseudonym 352, 355 Psychiatric Asylum 270 clinic 272 Psychiatry as clinic 266 clinical expressions in 275 contemporary 277 contemporary technoscientific 276 Psychic symptoms 280 Psychoanalysis 5–6, 15, 28, 35, 58, 64, 75, 88, 121, 126, 129, 152–153, 160, 169, 185, 188–189, 197, 230, 243, 284, 286, 291, 320, 347, 359 and Marxism 132 archaeology of 230 as clinical treatment 219 as healing experience 219 as subversion of classical clinic 280–282 clinical practice in 291 clinical territory by 330 conceptual regime of 344 diagnosis in 287 diagnostic processes 288 dialectic 152 dialectical thinking in 325 discourse of 243 experience of 29 experience of curing 132 from psychotherapy 54 genealogical method for 372 historical constitution of 132 history of 302 in medical sphere 294 interpretation in 92

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INDEX

master narrative of 44 Name-of-the-Father 40–41 peculiarity of 191 phenomenology of 304 post-structuralist traditions 322 rhetorical tradition in 71 scientificity of 191 semiology of 291 Slovenian school of 362 social and cultural inscription of 362 space of 195 subjectivization in 366 technical questions of 367 third model of subjectivity in 39 transmission of 317 transmitting 103 Psychoanalyst, discourse of 217–220 Psychoanalytic act 217–220 anthropology 369 clinical practice 371 interpretation 56, 82 method 169 notion of free association 109 praxis 242 psychopathology 289, 359 Saussure 312 semiology, semantic reference of 283–284 session 70 technique 59 theory 132, 309 Psychoanalytical discourse 48 idea of method 125 Psychoanalytic clinic 282 political ontology of 101 Psychoanalytic experience phenomenology of 302

CHRISTIAN.indb 403

403

Psychoanalytic healing 293, 344 logic and politics in 345–364 Psychoanalytic practice 92, 117 fundamental determinant for 300 Psychoanalytic treatment 47, 126, 219, 300 emergence of subject of unconscious 200–207 first moment in 200–207 method of treatment and science 185–200 phenomenology of 311 second moment in 207–210 structure of 183–220 third logical moment in 210 Psychological influence 85 Psychologized interiorization 130 Psychopathology 188 Jaspers’ construction of 271 of the mental faculties 269 reformulation of 286 Psychotherapeutic surface 95 Psychotherapeutic technology of discourse 219 Psychotherapies discursive rhetorical techniques 365 precursor of 52 Psychotherapy, different modalities of 291 Pyrrhonian 159 Pyhrronian attitude 153 Pyhrronic position 153 Pythagoric ascesis 116 Queneau, Raymond poet and mathematician 71 Quesalid case 10–12 doubt 14 reputation 10 uncertainty 12

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404

INDEX

Quixote, Don, hallucinatory madness 224 Rational consciousness 318 Raven Test 202 Real-Symbolic knot 351 Re-articulation of conflict 76 Rebirth of clinic as structure and as experience 245–294 clinical experience 291–294 therapeutics and therapeutic failure 261–262, 273–276 Referentialist semiology 276 Regressive identification 56 Resistance 73 analysis of 294 Rhetorical discourse 61 Rhetorical excellence 367 Rhetorician 91 Rhetoric of space and time paradox and interpretation 51–92 persuasion, convincing, and conviction 54–63 Ricciardo 297, 313, 333, 336 Ritualistic acts 9 Roman Emperor Marcus Aurelius 113 Roman Empire 96 Roman oppression 80 Romance languages 353 Romantic idealization 298 Romanticism 299 Rousseau’s notion of perfectibility 235 Rules for the Direction of the Spirit 169 Russell’s paradox 187 Sacred personality 16 Sadducees 80 Saussure, Ferdinand de 253, 352

CHRISTIAN.indb 404

Scepticism 318 School of therapists 87 Self-appropriation 105 Self-approximation 120 Self-centredness 161 Self-consciousness 308 Self-conservation 234, 309 Self-contradictory formation 92 Self-critical reversal 158 Self-determination 224 Greek theme of 113 Self-flagellation 164 Self-observation 117 consciousness 226 Self-preoccupation 161 Self-renunciation 98 Self-subjectivization 114 Semantic paradox 68, 90 Semantic peculiarity 55 Semblance dialectic 299 Semiological failure language as obstacle 268–272 Semiological operation 254 Semiology 252, 258 of language and subversion of aetiology 282–286 Semmelweis, Ignaz 259 Serenity 117 Sexual arousal 64 desire 358 identity 324 intercourse 64 object 26 reality 206 Sexuality 131, 283 aetiological role 280 drive theory of 331 political function of 321 psychoanalytic theory of 324 Sexually dirty 82 Sexuation

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INDEX

formula 323 theory of 322 Shamanism 9, 94 Shamanistic magic, psychoanalytic practice 9 Sickness 25 Simandini, Mlle 353 Simone de Beauvoir 300 Sinthome 49 Smith, Mlle Helène 352 Social and hermeneutic hierarchy 80 antagonism 85 component of human relations 83 configuration 16 legitimization 245 myths 9 Socrates and cure of Alcebiades 125–129 Socratic inspiration 95 philosophy 97 Platonic philosophy 17, 96 Platonic stage 98 Somnambulism 273 Song of Solomon 4 Soteriologist tradition 95 Stoicism 318, 325 Subjectivity 39, 285 mono-sexualized 321 Subjectivization 34, 77, 108 methods of 301 of desire 203 Subjunctive mood 75 Sublimation 342 Suffering-passion-disease 105 Sulamit’s breasts 87 Superego 68, 226, 321 Superegoic consumption 279 Surfaces and discourses 162 Surrealism 83

CHRISTIAN.indb 405

405

Swedenborg’s spiritual experiences 240 Syllogisms 178 Symbolic aetiology of neuroses 348 effectiveness 95, 298 excellence 95 imaginary knots 351 negation 77 organization 76 realization 305–306 Symbolization 76–77, 319 clinical mechanisms 76 inherent 283 Syntagmatic reaction 254 Systematizations 96 Taking care of oneself 93–138 epistemic question 99 Hellenic tradition of 129 meditation 117–121 memory 121–123 practices involved in 115 therapy, treatment, and cure 129–138 to culture of self 111–115 The Ethics 361 The Ethics of Psychoanalysis 360 The Hermeneutics of the Subject 101 The Interpretation of Dreams 121, 192 The Mandarins 300 The Other Side of Psychoanalysis 217 The Psychopathology of Everyday Life 193 The Purloined Letter 360 The Republic 114 Theology 85 Therapeutic reformulations 264 Three Essays on the Theory of Sexuality 192 Thymos 3 Time for Comprehending 62, 70

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406

INDEX

Time, truth, and discourse 104 Tischgesellschaft 239 Totem and Taboo 309 Traditional relationships 76 Transcendent scheme of language 69 Transcription 89 Transference 176 coordinates for 291 logic of 176–179 management of 210 matheme of 208 mutation in transference 207–210 notion of 286 Transference and recollection 359 Transformative group 262 Transliteration 89–90 Transliterative listening 89 Transmissibility of knowledge 188 Transmissible knowledge-form 189 Trauma, intersubjective character of 349–350

CHRISTIAN.indb 406

Traumatic act of conversion 352 Traumatism 349 Trimethylamine 82–83 Unhappy consciousness 318–320 Universal symbolism 64 Ulysses 42, 100 case of Quesalid 10–12 contrary to 3 doubt of 1–16 excellence and effectiveness 5–10 experience 14 thymos in 3 Violence inherent 60 Western political imagination 45 Zealots 80 Zermelo’s paradox 187

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