THE LETTER 24 (Spring 2002) pages 48-63

By way of an introduction

How can psychoanalytic theory introduce itself within a present day mental health care institution without solely producing toxic effects of Truth amongst the members of staff? Can an ethics of the real invade the dominant discourse of mastery as it is presently identified in the bio-engineering of human behaviour and cognition? How does a psychoanalyst speak when working together with a multidisciplinary team? The history of psychoanalysis in (clinical) institutions suggests various modi operandi for organizing institutions based on psychoanalytic theory and ethics. But what about the introduction of psychoanalysis within an ‘established’ institution? In this paper I investigate whether psychoanalysis, given its marginal position on a cultural level, has any assets (left) in dealing with the unbearable real and the impossible sexual relation. Anxiety, psychoanalytic experience and Lacan’s logic of the four discourses will serve as signposts.

Setting the Scene

In Belgium the year 2001 has been declared the year of Mental Health Care. The patient rights movement, the tearing down of the walls segregating the mentally ill, providing information about mental illness to the lay person, teaching people how to cope with mentally ill family members, all these actions and intentions illustrate the nature of the…