“I don’t stop; I start again.” The position of the analyst in ‘long term care’

From a lacanian orientation, the relation between ‘treatment’, ‘coaching’ and ‘care’ is questioned in case of what one calls ‘long term care’. This question is approached from the perspective of a case study. A young man accuses himself constantly of not adapting enough to society and even of attacking society. His attempts to find a solution though, are situated both in his failure and his singular answers to this failing, as well as in his self-incrimination about his failure. Indeed, the real problem is neither the lack of adaptation nor the self-incrimination, but the feminine enjoyment that he is confronted with, over and over again. Theoretically, Lacan’s conceptualization of the symptom as a knotting element forms the framework.

The Immigrant and Singularity: An “odd” Couple?

Migration is currently under investigation. On the one hand questions are raised as to whether immigrants are assimilating the norms and values of their new country quickly enough. On the other hand, in a clinical context, it is observed that mental illness when encountered in immigrants is culture-specific. However, these observations cannot be interpreted without taking account of the double context in which the immigrant is embedded: that of their native country and now the host nation. The issue of “identity” and the social context in which it derives plays a crucial role in discourse about immigrants. The objectifying public debate about migration has clear clinical repercussions at an individual level and there is a need to reframe these cultural representations from a psychoanalytic perspective. This means that the function of religious speech also deserves our attention during a cure with an immigrant. A clinical illustration of a Muslim in psychotherapy clarifies how the coordinates of a Lacanian thinking can function as a universal language to understand the singular logic of the subject.

Abstracting the Real in Take Shelter

This paper explores psychosis in Jeff Nichols’ 2011 film Take Shelter, bringing into proximity Lacan’s concept of foreclosure with Korzybski’s concept of abstraction. Lacan conceptualises psychosis as the individual encountering life experiences that cannot be reconciled with their existing semantic frameworks, creating gaps that need to be plugged by being named and identified. The genesis of the psychotic structure is the foreclosure of the Name of the Father. For Lacan, psychotic delusions function to stabilise these internally destructive and perplexing encounters, by providing shape to life’s experiences. Korzybski’s model of cognition focuses on how the individual “abstracts” from their experience, how each person creates their own semantic environment based on how they attend to incoming information, and on the subsequent inferences they make. Both thinkers acknowledge the destabilising nature of chance or perplexing encounters on the human psyche, in the form of the Real for Lacan, and the territory for Korzybski. Furthermore, both emphasise the importance of the subjective position, how each individual makes sense of their world through language.

“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.

An Act of Silent Revolt

This text is a testimony of my experience of psychosis. I do not claim to give a definitive explanation but rather to try to illustrate how easy it is to slide from a “normal” discourse into an “abnormal” one, to slide into an all-embracing psychosis (all-embracing because it entails both affect and reason) without being aware of it. My psychosis was characterized predominantly by a wide-spread delusional system with hallucinations less prevalent. I have tried to tell my story chronologically and objectively. Full objectivity is of course an illusion in this case, because of the personal nature of the article , but I have tried to avoid romanticism where possible. With this personal story I attempt to present a “small phenomenology of my psychosis”.