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Samenvatting: In deze tekst schuiven we hypothese naar voor dat de eerste stappen in het klinische werk gekenmerkt kunnen worden door een overgangsrite, dit van stagiair tot teamlid enerzijds, van stagiair tot clinicus anderzijds. De overgangsrite van de schoolbanken naar de klinische praktijk is er één van zich al dan niet in te schrijven in de eigenheid van de instelling, met mogelijke dehumaniserende effecten en het opschorten van de klinische vorming. Deze dehumaniserende aspecten van een team zien we verschijnen in de sociale verdedigingsmechanismen eigen aan elk team. Voor jonge clinici zal het werk er voortdurend uit bestaan te schipperen tussen de keuze voor een klinische vorming en het klinisch redeneren enerzijds en de verbindende, verblindende liefde voor het team anderzijds.

The joke of surplus-value and the guffaw of the saint

Today, society is driven by capitalist discourse, which profoundly affects our way of life. In this article we discuss how, from an analytic viewpoint, we can respond to this. According to Lacan, the psychoanalyst will offer a way out of the capitalist discourse by taking the position of lathouse from the analytical discourse. This means that the analyst should incarnate the object a, and personify the lost cause or object: “he acts as trash.” However, there seems to be some caution required, for which Lacan referred to the position of the Saint and Balthasar Gracian. We will discuss the tricks put to the fore by Gracian: silence, absence and appearance, which will all revolve around the question of desire. Next, we turn to the position of the Saint in Seminar XXIII, introducing three new tricks from Joyce: silence, exile and cunning. We end by discussing the concept of the ‘scabeaustration’. There can only be ‘a saint’ when one no longer wants to be ‘a saint, castrating the ‘desire-to-know,’ the ‘desire-to-interpret,’ and the ‘desire-to-die.’ The saint will have localized his symptom, recognized it, beyond the therapeutic changes, as a specific modality of jouissance.

An extraordinary observatory

In recent years, there has been a call for qualitative research in addition to quantitative research. When we can observe that a change occured within therapy, it is interesting to understand what this transformation has been and to grasp the cause of this change. The latter is a question that also concerns analysts and for which Lacan has developed a specific research method: the procedure of the pass. We believe that the testimonies of the pass can be an interesting addition to study Lacanian psychoanalysis. The purpose of this article is to review this procedure. What is this procedure and what are the historical and theoretical frameworks. We provide a brief illustration and some critical notes in this procedure.

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.