The Wanderings of Jouissance, with the Object a in the Pocket: On Differential Diagnosis in Psychosis

In clinical practice, when confronted with a suspected psychosis, it is critical that, beyond simply providing a label, the diagnosis is verified and further specified with regard to the particular psychotic structure: paranoia, schizophrenia, mania, melancholia or autism. Each psychotic structure requires a specific kind of treatment. When this is clarified, it will allow us to take up an appropriate position in the transference and it to orient ourselves in relation to treatment. One approach is to determine the status of the object a and the jouissance within the logic of the case. For example, the paranoiac situates the jouissance in the Other, the schizophrenic will struggle with the jouissance in the body and the autistic subject will have troubles with language and the Other. In the case of melancholia we see that the subject fully identifies with the object a and finally, in mania, the object a will no longer function. Clinical examples of each of these structures are provided.

“Shining” a Light on Psychosis and Triggers to its Violent Expression

Stephen’s King’s brilliant and terrifying novel, The Shining, is an exploration of inter-generational psychosis in a family. The novel gives a multi-layered account of paranoid psychosis and provides a narrative framing of the development of a psychosis to a violent end, making it possible to explore the triggers to its violent expression. The goal of this paper is not to seek a precise cause-and-effect of psychotic and violent phenomena but to highlight and elaborate certain clinical features that allow different modalities of psychosis in the case of a father and his son to be distinguished, to trace their mutual points of overlap and convergence and to identify triggering moments of florid outbreak. While the psychosis is the one-by-one invention of a solution of every psychotic subject and is not the same in the father and son, there are moments of shared paranoid conviction and shared delusion (délire à deux). But there are also crucial differences in the father’s and son’s psychosis, in the relative strength of the defences, identifications and imaginary supports available to each of them. Points of divergence that arise between them are highly affecting and potentially devastating. These ideas are explored via their narrative and characterological development in the book.

Lacan’s Doctoral Thesis: Tturbulent Preface or Founding Legend?

This paper presents a close reading of Lacan’s doctoral thesis with a view to disentangling the reality of Lacan’s thought in 1932 from the glosses of retrospection imposed on it by its republication in 1975. At this time Lacan was at the height of his fame as the most innovative psychoanalyst of the twentieth century and the complexities and rough edges of this work were smoothed by many commentators to create the impression of a simple developmental curve. It is hoped that this close reading will allow the reader to assess both Lacan’s neophyte status at the time and the early indications of what were to become lifelong preoccupations in his later psychoanalytic work.

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