A Neuro-Psychoanalytical Approach of Anosognosia

This article argues the case for increased recognition of a neuro-psychoanalytic vision within the field of neuroscientific research. It demonstrates how the neuro-psychoanalytic approach to concrete clinical problems can result in new clinical and theoretical insights that can serve to advance the field of neuroscience. The clinical phenomenon of anosognosia, the denial of illness, is used to illustrate the importance of this approach. The article begins with a brief outline of the neurological and clinical symptomatology of anosognosia and a discussion of the main problems encountered in research on, and the clinic of, anosognosia. The two classical explanations of anosognosia are described in order to highlight the shortcomings of the dominant paradigms in neuropsychology. Finally this article discusses anosognosia from a neuro-psychoanalytic point of view with reference to the work of Kaplan-Solms & Solms (2000), Schore (1994; 1997) and Weinstein (1955; 1991), who indicate aspects of the phenomenon which are unjustly neglected in pure neuropsychological research and which ought to form the basis for further investigation. It is argued that a different approach to this phenomenon can lead to the formulation of new questions and hypotheses. The article concludes with some clinical and theoretical implications.

Sexuality and the Real in Psychosis. Clinical Vignette

This article deals with the case-study of a psychotic subject in which jouissance and the fragmented body play a dominant role. The jouissance of an abusive mother is inscribed on the body of this subject, a subject who is compelled to mutilate his or her body in order to ensure its unity and as such to make it his or her own. It is the same mother with her same jouissance, that appears in the Real to this subject. Through discussion of elementary phenomena – which, within the Lacanian structure of psychosis, can be divided into two categories: one the symbolic, as that which is signified by the Name-of-the-Father (P°) and consequently one which concerns the body and the jouissance (?°) of the Other signified by the phallus – it is argued that this case is situated beyond the two sexes by negating sexuality as a non-sexed being.

Forgotten voids in the Gaze. On Melancholia

The author reports on some structuring moments in the etiological history of melancholia from a metapsychological point of view. It is argued that this clinical picture tends to be too readily categorised as psychotic, leaving open the question of its psychic structure. Freud’s findings from the article “Mourning and Melancholia” (1917e [1915]) are examined along with the work of M.-C. Lambotte (1993) and J. Hassoun (1995). Melancholia is described as suffering caused by a lack of symbolisation of object a, through which mourning is made possible. The focus is on a crucial etiological moment in the very coming into being of the subject. This moment is connected to a failed inscription of the desire of the first Other. The importance of the gaze on the object of desire emerges – in more than just its metaphoric dimension – as determining for identification and the libidinal economy of the subject. This primordial identification contains a nothingness, a void, which is related to the way in which the father appears in the discourse of the mother (Hassoun). Furthermore it is revealed that an original experience of pleasure, followed by a “catastrophic moment”, provides an explanation for the nihilistic discourse of the melancholic; it is the void in the place of the desire of the Other, which will become libidinally, i.e., symbolically, cathected (Lambotte). This sequence of an original experience of pleasure followed by a “catastrophic moment” allows melancholia to be characterised as an affliction of a specific impossible loss, namely, the loss of the desire of the mother which was once enjoyed.

Reflections on the wild growth of the Imaginary in Dissociative Identity Disorder: An approach from the mechanism of identification

One of the most striking phenomena of recent psychiatric history is the quasi-epidemic increase in diagnosed cases of Dissociative Identity Disorder (the former Multiple Personality Disorder). Several critics have argued that the disorder is created in therapy or is generated by media attention to the disease. This paper investigates the creation of DID from a psychoanalytical standpoint. The main focus of the paper is on the notion of identity and the way in which we acquire an identity (identification). It is argued that an identity is not a unified structure but a collection of different partial identifications. Furthermore we focus on the difference between symbolic and imaginary identification. This also provides a clue for understanding what happens in the therapy of DID patients. The appearance of alter-egos is considered to be the result of an uncontrolled increase in imaginary identifications. Lacan’s L-schema indicates which position the therapist should take in order to prevent this uncontrolled growth of the imaginary.

Interpretation as/of Fiction. Julia Kristeva’s point of view

In this article, the author examines the validity of an interpretation of literature based on psychoanalytical theory. In the first part, he considers the metaphor that compares the text to a woman and the woman to a text, and investigates the relationship between the (psychoanalytical) interpretation of desire, and the desire for interpretation itself. Is the place where a text longs for an interpretation not also the place where the interpreter yearns for his long lost object a? Moreover, is the text, like an accomplished femme fatale, not able to use this desire against us? The author argues that any reading of a text is influenced by this desire. This makes it impossible to master a text, just as it was impossible for Sigmund Freud and his literary pendant Sherlock Holmes, both outwitted by the women they believed they mastered. In the second part of the paper, the author gives an overview of the theoretical work of Julia Kristeva, who rejects too rigid an opposition between the word and the body, between the symbolic father and the pre-oedipal mother. This also implies that our bodily desire and our knowledge are inseparably linked. In the last part of the text, Kristeva’s theory is used to propose an alternative reading strategy, as a mixture of jouissance and savoir, a strategy that creates, rather than discovers, truth. Opposed to the idea of an absolute Truth, as much as resisting an absolute nihilism, reading is presented as an act that brings us “in process”. If every theory is an imaginary construction, a fiction, Kristeva shows us the importance of this fiction in giving the subject the chance to create a poetic language for his desire.

The Voice and the Invocative Drive

Lacan introduced the voice and the gaze as two new objects of the drive, besides the anal, oral and phallic object. In this article the author provides a brief overview of the conceptualisation of the voice and the invocative drive in Lacan’s seminars. This overview permits the characterization of the voice as a tension between sense and nonsense, between speech subjected to the Law on the one hand, and something of the real, the object a as that which should be situated beyond discourse on the other hand. Furthermore, the voice appears to be a special object in that it is not a partial sexual object but rather a subjectifying object. It is the voice of the mother, the mother’s sonata, that “sings a subject into being”. It transmits a certain dimension of the Law, but it also contains its transgression when it abolishes the discontinuities particular to speech. The first period of the invocative drive is the dynamic between the song of the mother and the cry of the child. The second period is that of the real privation of the mother. The Phallus names the mother’s absence in the third period and thus realizes a primordial repression. As a result of this the voice as object is lost between mother and infant. The question of a fourth period of the invocative drive is addressed in the last part of this paper and is related to sublimation on the one hand and the cure on the other.

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