In the field of psychoanalysis, more so than in any other discipline, the tension between ‘instituting’ analysis and ‘institutionalising’ analysis is palpable and never more so than when the ethics of its praxis rear up to counter the demand that it conform to a format which is acceptable to the prevailing cultural structure in which it finds itself. To meet with the demand that it take unto itself the identifying features, – the uniform-ity, – of a profession like any other so that it would be ‘at ease’ in society, would certainly miss the rendezvous with the dis-ease inherent to civilisation itself and the effect of socialisation. This risks sounding like the usual (and not terribly imaginative) platitude drawn upon when psychoanalysis finds itself with its back against the wall of ‘others’ forcing it to account for itself in their terms. The debate becomes more interesting however if we remind ourselves that when Lacan was applying himself to Freud a lettre the dis-ease with his theory and praxis provoked an outraged response not from society but from the psychoanalytic society. Here it seems less a question of whether psychoanalysis can be tolerated by society than it is a question of whether those who practice the discipline can tolerate their relation with psychoanalysis itself.
A more elaborate reply is evidently necessitated when the societal demand comes not from outside but from within the field itself. What then are the possible responses when in particular there is a demand from within a more or less loose psychoanalytic grouping, (and if the irony of the situation is missed then we have lost our sense of humour), for a … ‘Society’! In short, given the ethics of psychoanalysis, is a society of psychoanalysis possible? This is not an entirely new question for us here in Ireland, – a number of years ago right here in Dublin we were witness to a heated and truly passionate debate by analysts from all over the world on the psychoanalyst’s position with relation to the dictates of the State. If at the time, while finding the debate ’intellectually stimulating’, we were slightly bewildered by the emotional altitudes reached by the protagonists, it is not the case here now. Contour lines on our landscape are changing and we too are beginning to scale new heights! …Continue reading
THE LETTER 10 (Summer 1997) pages 1-13
The word ‘Institute’ can be understood to refer to a society or organisation for the promotion of scientific or educational aims or objects. The process of creating structures through and within which these objects can be fostered on a continuing basis could be considered to be what is referred to as ‘institutionalising’ something. It has to do with making it permanent and fixed and looks to the lasting establishment of whatever desirable aim is in question. In this sense then the word ‘institute’ – (and the derived ‘institutional’ and ‘institutionalise’) – has clearly positive associations and sounds like a thoroughly worthwhile enterprise – depending of course on the particular aims in question.
There is also the verb, ‘to institute’, which can mean to establish, found, or initiate and sometimes to appoint. The word is usable legitimately in a wide variety of contexts and with a wider variety of meanings fairly generally carrying the notion of initiating some procedure or system. To ‘institutionalise’ carries something like the same meaning, with the additional sense of putting what has been initiated on a longer-term basis.
However, in contemporary usage the word ‘institutionalise’ more easily carries a negative connotation. For an individual subject to be institutionalised is indeed a fairly dire fate and only something to be done as a last resort, if at all, in these enlightened days. But to institutionalise a set of procedures or a way of doing things is not in any sense so ominous, though carrying with it indeed some risks of killing off the spontaneity and charisma of the original set of ideas. To avoid the negative aura here, one might prefer to speak of the structuring of an activity or set of procedures. This structuring of a set of activities will give rise to a patterned way of proceeding that…
THE LETTER 10 (Summer 1997) pages 14-25
I should like to begin this presentation by describing a little of my own state of mind prior to receiving the phone call in which the patient I shall be discussing was referred to me. I had just returned from a three week summer vacation trip and spent an additional week vacationing at home. My plan was to resume work with my private patients in a few days’ time and to return to my job the following week. Like most of us, I was anxious about the gaps that had lately appeared in my private practice schedule and wondered whether and when my next referral would come.
It was with considerable excitement then, that I responded to a phone message from a former patient from whom I had not heard for about eighteen months since he terminated his treatment. In the interim, I had learned that his father, who had been chronically ill for years, had died. At the time we had stopped working together, I felt that, though there was still much we could have done, the timing of the termination made sense in the light of his life’s circumstances and the significance of what we had, in fact, achieved over a period of many years. My wishful thought was that he was calling now to resume treatment.
When I phoned him, he was cordial, told me of his father’s death and briefly of some advances in his career before indicating that he wished to refer a patient to me. He said that he had met the prospective patient socially, that he, like my former patient, was a gay man, that he was troubled about his homosexuality, depressed and had expressed suicidal ideas. My ex-patient thought that I would be a good therapist for this man. Here, I must clarify that my ex-patient is also a psychotherapist. He added that, within the next few weeks, he too would like to come in for a session. …
THE LETTER 10 (Summer 1997) pages 26-39
The case presented raises many questions. I should like to raise only a few of these here.
To begin with, the context is not without significance. William Fried has supplied us with some very important information that allows us to advance a couple of hypotheses about this.
You returned from your holidays and were somewhat anxious ‘about the gaps that had lately appeared in [your] private practice schedule’ and you asked yourself ‘whether and when [your] next referral would come’.
For this reason, you were very happy to receive a call from a former patient and your ‘wishful thought was that he was calling now to resume treatment’. When it turned out that he wanted to introduce a new patient to you, at first you were happy about this but you had a few doubts and scruples as to whether you should be accepting him at all from an ex-patient, especially since the latter wanted to visit and eventually to resume treatment.
The reasons that you give (as you yourself observe) sound like rationalisations. The interesting thing about your description is that you are conscious of this but that this does not influence your conduct or your decision. The doubts which arise are quickly eliminated. But perhaps the most important thing is that you have the courage to mention them and that, by describing the inner process of what is agitating you, you open yourself up in such a way that this present discussion is rendered possible. …
THE LETTER 10 (Summer 1997) pages 40-72
Lacan decided that an analysis of the Symposium of Plato in his Seminar of 1960 – 1961 would be an illuminating detour by which to investigate the transference relation in psychoanalysis. This investigation centred on the question of the desire of the analyst and the ethical implication of where the analyst ought to situate himself in order to respond to the transference.
Central to the discussion is the concept of identification and the role of the ego ideal. There is a danger in analysis that the analyst is offered the place of the ego ideal for the analysand and that he assumes this position by abandoning his role as subject-who-is-supposed-to-know (sujet-suppose-savoir) and erroneously taking the position of the one who knows (master of knowledge). In this case the desire of the analyst is the desire to ‘understand’ the analysand and falling for this lure is a sign of the incompetence of the analyst. The challenge facing the analyst is much more difficult than reaching an understanding and communicating that understanding to the analysand. It requires the ability to know how and when not to know, to be able to be desiring in the full sense that Lacan gives to this term, and to do this in a way that makes possible the realisation of the desire of the analysand by the analysand. It is primarily by a certain refusal on the part of the analyst that the dynamic of the transference should work. This refusal, this Versagung or…