Issue 19 & 20 (Summer/Autumn 2000)


In a slight departure from the normal run of events, this publication of THE LETTER comprises both the Summer issue and the Autumn issue for the year 2000. Our hope is that this double dose will be medicine enough to carry the reader through to Spring 2001, when the third and final issue in this volume will see the light of day. That will bring to you the proceedings of the Seventh APPI November Congress, which will be in full swing as this present number is being distributed.

André Michels’ article on anxiety opens our work, in two senses: it is the first paper and it is one which allows for an opening into psychoanalytic work itself via the gateway of anxiety which, he explains, always announces the arrival of that which is truly new. On that note, it might be appropriate to mention here something which, if only in a modest way, can lay claim to that character of ‘newness’ – something, incidentally, to which André contributed his share. APPI this year launched a series of clinical seminars – The Direction of the Treatment Today – involving the participation of clinicians from at home and abroad, most of whom have already made their way to our shores on other occasions, all of whom have left something behind in their wake – a little something that usually makes its way into the space of THE LETTER. The clinical programme occurs once a month over a weekend – Friday evening given over to a theoretical session, Saturday morning devoted to.clinical applications. The series is seen on the whole as in the nature of an experiment, the follow-up to which might contribute to the formation in psychoanalysis in Ireland. The products of this we hope to be able to bring you in published form at some time in the future. …Continue reading

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THE LETTER 19 (Summer 2000) pages 1-31

To begin with I would like to examine the relationship between anxiety and neurosis in the way Freud impresses it on us. Does a neurosis have a stabilising effect, even stemming anxiety or, on the contrary, does it contribute to its increase? Can we assume a correlation between the two insofar as anxiety decreases at the rate of the structuring of the neurosis and vice versa? What meaning can we attribute to the physical discharge of anxiety? This is very different in hysteria, hypochondria and the so-called psychosomatic illness. A feature of the latter, if it appears in its ‘pure form’ and is not covered too much by the neurosis, is an almost complete absence of fear which can be understood as one of the reasons why the subject may not see any clear reasons for undergoing treatment. In most cases, however, anxiety appears as a motivational factor and so will generally be included in the list of psychical suffering.

Protection against anxiety?

Freud says:

… I think the question has never been seriously enough raised of why neurotics in particular suffer from anxiety so much more than other people. Perhaps it has been regarded as something self-evident: the words xnervosy and ‘angstlich’ are commonly used interchangeably, as though they meant  …

THE LETTER 19 Summer 2000, pages 32-41

During his seminar of 9th January 1997 Charles Melman made the following remark:

The 21st. Century will be Lacanian or it will be barbarian. What people call barbarian can be given a very strict, very rigorous definition. It is not simply a metaphor for vaguely designating the foreigner or the Barbaros, the person who could only say bar-bar-bar! Barbarism deserves a rigorous definition and I am happy to propose it to you. It consists in a social relation organised by a power that is no longer symbolic but real. From the moment that established power is supported, takes as reference its own force and nothing else, and does not try to defend or to protect anything other than its existence as power, well then we are barbarian.

What is proper to democracy, is that the real power, the real forces by which it is supported, the police, the army, this real power is at the service of an authority that has a purely symbolic reference. Barbarism, for its part, is outside discourse, it is not based on a discourse, it is based only on the number of agents that are at its service.

If I gave this title to my presentation, it is not – contrary to what some people wanted to understand in it – in function of some all-conquering…

THE LETTER 19 (Summer 2000) pages 42-49

I doubted my own existence, and even today, I have no faith in it, none, so that I have to say, when I speak, Who speaks, and seek and so on, and similarly for all the things that happen to me and for which someone has to be found, for things that happen must have someone to happen to, someone must stop them.

The speaker here is the voice in Beckett’s Unnamable. It is not just that things that happen must have someone to happen to, someone to lock on to, but also, as the voice says, someone must stop them. How? Earlier the voice spoke of his vice-existors, Murphy, Mahood, Worm etc. as those old buffers who carried a mere tittle of his own pain, the tittle as he says, that he thought he could put from him in order to witness it. It is this gesture of putting from one, this installation of the lying old buffer of our fictional identity, which is absent in the passage a Vacte.

In the Seminar on The Psychoanalytic Act, Lacan refers to a particular type of absence as constitutive not just of the passage a l’acte but of any act: ‘It is a common dimension of the act not to include in its agency the presence of the subject’, he says. This statement is repeated at a number of points throughout the seminar. In fact Lacan specifically says that this is what the psychoanalytic act and the passage a Vacte have in common; this fact of knowing ‘that in every act there is something which escapes him as subject’.

Lacan’s fascination with the act has a long history. Indeed his very first incursion into psychoanalytic theory, the doctoral thesis of 1932, had been motivated by his desire to come to grips with the passage a Vacte. His patient Aim6e had committed a crime of passion which bore all the hallmarks of a passage a Vacte, and Lacan’s thesis suggested that the root cause of this crime was to found in Aimee’s relationship with her elder…

THE LETTER 19 (Summer 2000) pages 50-91


The subject the Cartesian subject, is the presupposition of the unconscious …

The Other is the dimension required in order for speech to affirm itself as truth.

The unconscious is, between the two of them, their cut in act

Despite its fundamental rule of free association, psychoanalysis is notorious for preventing one particular thing from being said – ‘No’. Pinned to a sofa, much like a point de capiton, the analysand can and must say anything at all. However, caught in the matrix of the analyst’s interpretive framework, he is unable to deny the accuracy of the remarks of this grande Autre. In the context of the session, yes means yes, but no also means yes. In fact, Freud makes a fundamental clinical rule out of Shakespeare’s ‘methinks thou doth protest too much’. The more frequent and vigorous the patient’s denials are, the closer the analyst presumes to be to unconscious truth.

Critics of psychoanalysis are justifiably alarmed by this facet of its therapeutics. On the one hand, they fear the spectre of pseudo-science due to an absence of falsifiability criteria. On the other hand, they perceive the potential for harmful, authoritarian abuses of patients by analysts. If the analysand’s responses all amount to the same affirmation of the analyst’s interpretations, then how is it that one can discern the…

THE LETTER 19 (Summer 2000) pages 92-116

Lacan reads Rousseau: a narrative instance of the body-in-pieces

Book VII of Rousseau’s Confessions involves the story of an encounter between Jean-Jacques and Zulietta, a Venetian courtesan, which presents one of the richest highlights of an autobiography whose status is paradigmatic. I have read this episode in conjunction with a spectrum of Lacanian theory which has as its focus the psychopathological incidence of anxiety and its effects on the emotional and perceptual faculties of the human subject. My objective in bringing Rousseau and Lacan together is to look afresh at the possibilities yielded by psychoanalytic inquiry into the work of Rousseau, and to provoke further exploration and discussion of the ways in which our understanding of autobiographical texts can be revitalised by detailed readings inspired by the work of major psychoanalytic thinkers.

Psychoanalysis abounds with idols in the form of idealised figures which it theorises as projections of the idealised image of the self. The analyst thus proposes that the idealisation of the human form is dictated by narcissism, and is both intersubjective and intrasubjective in nature.1 In Lacanian theory these two related levels are structured by the interplay of three psychical registers; and it is on a particular relation between the registers that the cohesion of the idealised form of the body rests. The Imaginary, Symbolic and Real as these registers are now widely known, respectively span the realms of space and visual images, language and meaning, and an absolute dimension, distanced by the others, which, for…

THE LETTER 20 Autumn 2000, pages 117-129

Formulation of the Problem: A New Diagnosis?

The psychiatric landscape has undergone a lot of changes in the last couple of years. This constant evolution shouldn’t surprise us, considering its youthful existence and bearing in mind that psychiatry always follows in the wake of an ongoing society. Hysteria is commonly known to adapt itself to the prevailing discourse, but that psychoses should also be appearing in a new attire is a relatively new feature. Since Nietzsche’s creed that God is dead one has rarely come across the ‘traditional’ psychotic delusions, such as the religious delusion of redemption. In the footsteps of literary forerunners like Burroughs, Huxley and Leary, psychotics have discovered drugs, – drugs which we consider as one of the current symptoms of discomfort in our post-modern culture.

This new climate is now also tangible in the psychosis department of the psychiatric hospital where I have been working for twelve years, and which has recently become an explosive mix of questionably psychotic individuals with a serious problem of addiction. Since the success (or perhaps the failure) of the DSM-III this has been known as comorbidity or dual diagnosis: psychosis/toxicomania. Whether it is a so-called drug psychosis, a toxic psychosis or a genuine underlying psychotic structure which remained hidden, is difficult to discern, precisely because the drug-use functioned for a time as an anchoring point or suppletion -and the social environment was a supportive factor – or perhaps the drug-use was even the enticing factor. An additional problem is the rise of the new synthetic drugs with a base of fentanyl. Since their chemical structures are difficult to determine and their effects difficult to anticipate the symptomatology becomes more complex when compared with…

THE LETTER 20 (Autumn 2000) pages 130-146


Interpretations that focus directly on signification are not psychoanalytical in the Freudian-Lacanian sense. Such interpretations characterise, on the contrary, the paranoid psychosis. This is borne out theoretically by Lacan and Watzlawick. M. Klein’s clinical cases demonstrate that interpretations that focus on significations induce a paranoid-like exacerbation of the imaginary. Freud and Lacan on the other hand, aim at the signifier. The significations that Freudian psychoanalysis validates are those which result from the correlation of two signifiers.

* * *

When Lacan defines the unconscious as being structured as a language, he refers to formal language, that is to say language without inherent signification.1 For this reason, he founds his conceptualisation of the unconscious on a mathematical rather than on a classical linguistic philosophical pattern.2 Indeed, mathematical algorithms do not carry signification as such: they only acquire signification in conjunction with other algorithms which belong to the same system. Applied to the formations of the unconscious, this means that it is not relevant to…

THE LETTER 20 (Autumn 2000) pages 147-166


The philosopher Bertrand Russell once referred to common sense as the ‘metaphysics of the savages’ and in this rather smug way I think he was attempting to draw a distinction between serious reflection and what can at times pass for such. This quote struck me quite often as I was writing the present work for it seemed to cut to the quick of my subject matter. In other words, is the true-self the opium of a psychologically informed cultural discourse, a search for a psychic holy grail, or is it, as Lacan would argue, an alienating fiction produced as a defence against the painful realities of unconscious desire?

What seem to be at stake here runs to the heart of the psychoanalytic enterprise: the individual versus the subject, the ego versus the unconscious, wholeness versus division, either the true-self or the split subject. From Oprah to the self help groups and manuals, to the many ‘experts’ who are wheeled out by the media to explain psychological suffering, the inference appears to be that happiness is not only a right, but just a stone’s throw away, and can be had once we have shed the onion-layered defences that conceal our true selves. In other words, implicit in this notion is the idea that there is something organised, stable, and central about the self, that (if you like) selfhood comprises a core element of each individual’s personality and subjective existence, whether this be in the guise of some inner essence with form and substance, or in a facilitating environment and maturational process that predisposes the individual to a subjective harmony and stability. …

THE LETTER 20 (Autumn 2000) pages 167-182


This paper reviews selected writings of two people, Maud Mannoni and Valerie Sinason, both of whom have worked psychoanalytically with people with a learning disability, with a view to considering in light of their work, whether psychoanalysis is appropriate to this patient group.

Maud Mannoni

In the 1960s there was a renewal of interest in handicap in France. Here the torch for psychodynamic thinking in mental handicap was carried by psychoanalyst Maud Mannoni, and most clearly shown in her work, The Retarded Child and His Mother.1 Opening her book with the question, ‘How does one become an analyst?’ Mannoni affirms immediately that the events that marked her life are not without relation to her interests in retarded development and psychosis.

Maud Mannoni was born in 1923. Her mother was of Belgian origin, and her father was Dutch. As a diplomat, he was posted to Ceylon, where Maud spent the first years of her life. When she was six years old, her family had to return to Europe, settling in Belgium. Her school years, spent in Anvers, left her with memories of boredom and mediocrity. It was her university years that would be truly formative for her. This was paradoxical, for the University was closed at the time as a sign of protest against the German invaders in World War Two. She was thus trained ‘on the job’, at the psychiatric hospital. Due to the war, she experienced great liberty at the hospital, in particular with regard to the care of …

THE LETTER 20 (Autumn 2000) pages 183-209


In 1998, a note promoting the forthcoming Colloquium on L’Opacite Sexuelle in the Ecole Lacanienne de Paris announced, almost as if it were now a received truth, that Michel Foucault’s History of Sexuality had ‘cut the ground from under the feet of psychoanalysts’. Up to this I had held the rather complacent view that while Foucault was of course one of the more important contemporary thinkers he was not of central relevance to psychoanalysis. Even a yearlong staff seminar on The Birth of the Clinic had done little to modify this view.

But this startling and indeed sobering remark coming from such a prestigious source is certainly worthy of investigation and assessment! I am not aware that anybody has in fact taken it up either in the Colloquium or elsewhere and this article by a non-specialist is far from being the complete response that it deserves. I have simply tried to look carefully at the three-volume work in question, to see whether in fact it undermines my own position as a Lacanian psychoanalyst. I have also tried to provide enough introductory material to encourage colleagues to read this remarkable work, which so far seems to have been relatively neglected by English-speaking analysts.

Michel Foucault and Jacques Lacan

Michel Foucault’s detailed knowledge of psychoanalysis, especially in its Lacanian incarnation, is beyond question. From his twenties he was reportedly ‘haunted’ by the question of whether he should go into analysis…

THE LETTER 20 (Autumn 2000) pages 210-218

I would like to tell you, by way of introduction, about a debate I once had with some judges, about an experience which is of course a major one in our culture: that of crime. I recall that we were perpetually confronted with the hard and sombre heart of the criminal act, and that many saw, in the perplexity that took hold of us on each occasion, the sign of a radical lack of understanding which finally sent us back to the mystery of Evil itself. At that point I tried to defend the thesis which maintains that the difficulty, the complication of the criminal act, comes less from a fundamental obscurity which is thought to be essential to crime, from a hidden and as it were impenetrable identity, than from the historic entanglements, the complex sedimentation of discourses about crime, which meant that when we spoke about it we always stumbled, less because of an essential difficulty, than because of, I believe, a historical confusion of discourses.

It is this consideration that I would like to put as an exergue, or at least as a preface to our discussions: the idea that the opacity of the sexual also comes perhaps less from a difficulty belonging to the very nature of sexuality, than from the confused intermingling of discourses which, for thousands of years, have been woven around the sexual act. It is the idea that the foundation of the hesitancy that comes over us when we try to speak, this confession of ignorance about what is at the basis of the sexual, derives more from a re-sifting of discourses, from a tight knit accumulation…

THE LETTER 20 Autumn 2000, pages 219-221

Every once in a while one has the sense of being in the middle of something completely ‘cutting edge’ or ‘state of the art’, hearing something utterly fresh. Such was the sensory experience generated by the inaugural conference on Neuroscientific and Psychoanalytic Perspectives on Emotion, organised by the Anna Freud Centre in London this summer. There is an almost canonical belief that neuroscience and psychoanalysis can never meet -and it has to be said that this view is adhered to far more tenaciously by psychoanalysts than by neuroscientists. However those attending this conference will have had the sensation of having been just about to say themselves that dialogue between the two perspectives was not only possible but also essential for the survival of both. Indeed the result of the conference was similar to that of a good analytic interpretation – while memories of the factual content may have faded, what was articulated seems to resonate with what is below the surface of our thinking and it certainly gave rise to much in the way of further associations. One had the sense of something crucial being articulated without any particular view being privileged as the correct one.

The opening address was given by Dr. Oliver Sacks, well known to most through his popular paperbacks on unusual neurological disorders; the relationship between structure and function is the orienting principle of his writing. Sacks invoked the Freudian notion of the plasticity of memory and presented a number of neurological vignettes in which the process of narrative was fossilized into ‘a pathological changelessness’…


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