This is the first of a series of edited volumes on applied psychoanalysis from the University of Minnesota Press that seeks to demonstrate how useful the theories of the French psychoanalyst Jacques Lacan can be within the domains of culture and the clinic. Even while these domains are invoked as seemingly separate categories here, there is also a simultaneous attempt to show how they are actually structured as a continuum (of both theoretical and practical concerns) within ‘the Freudian field’. So, for instance, while the early Freudians made universal claims for psychoanalysis as a discourse, there is now a growing realization that the cultural articulations of psychoanalysis are as important as Freudian metapsychology. It is therefore important to pitch psychoanalysis as a discourse that is continually aware of how ‘culture’ and ‘clinic’ affect each other rather than to say that clinical discourse can situate and subsume cultural discourse or is fundamentally superior as a source of explanation about human action. These revised approaches to psychoanalysis are based on the realization in the works of Sigmund Freud and Jacques Lacan that the pre-figurations of psychoanalysis in the works of great artists and writers must not be read reductively, but must instead be related to psychoanalytic theory through more nuanced forms of methodological reciprocity. So while it is true that the Freudian clinic has a lot to say about culture, it must be remembered that there are different forms of clinical interventions and that there is no form of clinical intervention that remains totally unaffected by socio-cultural determinants. This is one of the main gains in methodology that comes in the wake of research in areas like anthropology, deconstruction, and the history of medicine. The title of this volume brings out the methodological challenges and problems quite well. What does it mean to be mad? Is madness defined by medical discourse? Or is it a way of situating behavior in the context of society and culture? Where, for instance, does psychoanalysis itself get its models of psychosis? What, for instance, is the contribution that literary representations can make to the history of madness? Once we articulate these questions, we will realize at once the importance of invoking ancillary domains to thinking through the history of either reason or madness. This series of volumes on ‘applied psychoanalysis’ is an attempt to facilitate this process of discovery, and takes further the idea that psychoanalysis has a lot to learn and not just teach on matters that bear a thematic resemblance to its main concerns; hence, it is not false modesty to contemplate a limit, as Miller does, to the discourse of analysis.
The contributors to this volume of essays are related to the ‘Freudian Field’ - a term that brings together theorists from those forms of psychoanalysis that are inspired by the
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foundational teachings of Sigmund Freud, Jacques Lacan, Jacques-Alain Miller and the institutions that are devoted to disseminating these teachings and practices like the Department of Psychoanalysis at the University of Paris VIII, Ecole de la Cause Freudienne, and the World Association of Psychoanalysis. The term ‘field’ implies a range of applications that are possible in what the French call ‘the human sciences’; another term for the ‘Freudian Field’ is ‘French Freud’. French theorists have made an important attempt to reinvent the theory and praxis of psychoanalysis from both within the contexts of cultural analysis and clinical practice. What this series of volumes attempts to do is to take these forays in the Freudian field forward to a larger audience that is wondering what such interventions look like. There are four parts to this volume: the first part comprises brief exercises in Lacanian metapsychology including the topology of knots, the second part is a collection of essays on the phenomenology of analysis, the third part spells out the formal considerations of how popular culture is shaped and the final part discusses the institutional structure and applications of psychoanalysis in a globalizing world. While it may not be possible to discuss all the essays included in this volume, I will try to pick up the main theoretical themes and adduce a few examples of how psychoanalysis is deployed within the discourses of culture and the psychoanalytic clinic. The theme that organizes the entire volume however is the fact that a universal notion of normalcy or normality is under threat in the context of globalization; it is not easy, for instance, to work out the criteria of diagnostic evaluation that would apply without exception anywhere in the world. It is therefore time to ask whether the cultural determinants of Freudian metapsychology have been well-understood, and whether clinical practitioners are careful enough to consider cultural-differences sufficiently when they apply analytic theory while making cultural or clinical interventions.
The volume begins with three important interventions of Jacques Lacan that attempt to differentiate, in a sense, between the ‘discourse of analysis’ and the ‘discourse of the university’. Lacan's main preoccupation – as always – is whether it is possible to teach psychoanalysis? What does it mean as Lacanians put it, to ‘teach that which cannot be taught’, but can only be learnt? The fact that the texts of Lacan's interventions at Paris , Yale , and Columbia have not been easily available before in translation does not mean that these questions have not already passed into the discourse of psychoanalysis and into theories of pedagogy. A great deal of the work that was done by the Yale critics (in both deconstruction and psychoanalysis) was an attempt to bring precisely these type of questions into prominence following Lacan's Kanzer Seminar at the Yale Law School in 1975 and even earlier. The topics articulated in these interventions however are worth noting: they include the problem of delusions, the body, and the symptom. This volume is actually about the ubiquity of delusional behavior in the human subject since what is really at stake is the ‘scope’ of metapsychology in Freudian theory and differential diagnosis in clinical practice.
Defining the scope of analysis is important because an important cultural difference between French and English psychoanalysis is the question of ‘borderline phenomena’, which make it difficult to separate the psychoses from the neuroses. While there is no consensus on whether or not borderline phenomena exist as such and whether clinical interventions will be more successful by assuming models of psychopathological ‘continuity’ or ‘discontinuity’ between such phenomena, the very fact that there is a lack of consensus is important for those theorists who want to consider – as do the theorists assembled in this volume – the relationship between culture and the clinic. If we want to
put this theoretically, we might even go to the extent of saying that cultural differences in matters pertaining to differential diagnosis have implications for what we presuppose by the (ontological or ‘pre-ontological’ notions of the) unconscious and its ‘formations’. The term ‘delusion’ is also important because we must differentiate between delusional symptoms and delusional states. The complicating factor here is globalization since the encounter with alien forms of jouissance (considered here as forms of existential alterity) could be an exacerbating factor for delusional phenomena because they trigger off the need by socio-cultural units to dominate. Delusional fantasies are not just specific to patients (especially ‘delusions of grandeur’), but can affect whole communities; they can be addressed only if we understand the need to move beyond conventional diagnostic models and relate the phenomena in question to both the problem of identifying cognitive universals and relating it in any given instance to the emergence of the particular in a given culture.
While Lacan has already considered some of these problems in detail in his earlier work on the psychoses (including most famously in his doctoral dissertation on the paranoid forms of the psychoses), what makes the rediscovery of his articulations on the differences between analytic and university discourses at Paris, Yale, and Columbia useful for us is the potential that it has to throw light on the problem of how making explicit the structural inter-dependence between culture and the clinic can serve as cognitive matrices (for rethinking these phenomena in a globalizing world). What is also at stake is the role of psychoanalysis in the search for cognitive universals (which is not unlike what was at stake for Claude Levi-Strauss in structural anthropology). Understanding how culture and the clinic relate to each other then has important implications for the Lacanian notion of discourse, which as the editors of this volume put it, must not be ‘driven by pedagogy but by the transmission of desire and its enigmas’. Lacan's Paris intervention of 1979 introduces the four discourses of Lacanian theory and points out the difficulty in teaching these discourses (given their lack of universality) and the main achievements of the department of psychoanalysis in the University of Paris VIII. The challenge going forward for Lacan, when the department was being moved to Vincennes, was to overcome the ‘antipathy between the university and analytic discourses’. This antipathy is related to the fact that all the four discourses make claims to being in the locus of the dominant player. This problem however is not reducible to the specific instance in which Lacan found himself since the peripheral relationship that psychoanalysis has had with the discourse of the university in many parts of the world illustrates the problem, the symptom, that Lacan tried to call attention to in 1979. The main criterion for inclusion in the university curriculum, needless to say, is that a discourse must have a universal scope.
What shape will psychoanalysis take if it problematizes the cognitive universal in the discourse of the academy? Miller attempts to resolve this impasse by arguing that while all the four discourses constituted by the discourses of the master, the university, the hysteric, and the analyst try to dominate in their turn, what makes a discourse ‘the best’ is its awareness of its own constitutive structure as provisional, as a semblant. What follows from this is that, as Miller points out, the discourse of psychoanalysis should not attempt to dominate. He thinks that it is naïve to argue that all politicians should be analyzed or even that ‘mass analysis’ of the population, as envisaged by the early Freudians, is a good idea. Any attempt to extent the scope of analysis beyond reasonable proportions – in an epidemiology of the neuroses or the psychoses - is self-defeating since psychoanalysis will then become subject to its own forms of delusions. It is important then to situate
psychoanalysis as that which exists between the universal and the particular. The introduction of a self-imposed limit is not only a matter of epistemological nicety but, above all, a form of political hygiene. Two important examples of this are given in the last part of this book: they pertain to the problem of war neuroses in the Weimar republic and whether the findings of psychoanalysis are applicable to all societies - or are they reducible to those that already have sufficient exposure to psychoanalysis? Freud, for instance, wanted psychoanalysis to treat war neuroses (created by shell-shocks and bomb explosions) to be made available widely to treat injured personnel in the German Army during World War I. This would not only help to make psychoanalysis useful for a large number of patients in need, but also make it possible to extend the ‘scale-and-scope’ of psycho-therapeutic interventions. This however was not to be since when the war ended, the German Army was not in a position to fund such large scale interventions. There was also the danger that psychoanalysis would lose its formal structure and become something else altogether; the unintended social consequences of applying the analytic method in mass analysis to either cure patients or to treat ideological distortions must not be under-estimated.
There was however an idealistic attempt to make psychoanalysis available to the masses – including those who could not pay for the treatment - through the Berlin Policlinic starting in 1919-1920. The Freudians however noticed that not charging for their clinical interventions did not mean that patients were sufficiently incentivized to participate in analysis. There was an interesting link that analysts observed between the socio-economic conditions of the patients and the symptoms that they suffered from. The adhesiveness of their symptoms was not reducible to forms of psychopathology per se since the symptoms also had a defensive function; they were ways of coping with difficult situations in the lives of the patients. So it was not analysis per se that could cure them since the incentive to participate in seeking a cure had to be socio-economic rather than just clinical in its orientation. The patients were willing to get well (i.e. drop their symptoms) only if there was a sense of assurance from society that their lot in life was about to improve substantially after the war. The idea that psychoanalysis is more likely to be deployed on patients who could pay for the treatment has some truth to it since it appears that the evidence of the Berlin Policlinic gives us reason to believe that poverty exacerbates the symptom in ways that were not sufficiently anticipated by the Freudians who set out on programs of ‘mass analysis’. The problem of psychotherapy in societies - with prior exposure to analysis - relates to examples of how relief efforts in areas prone to natural calamities and disasters often have relief workers who try psychological techniques that don't necessarily make sense to the native populations. The problem here, as one of the contributors to this volume points out, is that despite good intentions we wind up ‘exporting our expectations about symptomatology’; and furthermore ‘we are disconnecting that local population from indigenous modes of healing’ that may be available from local healers (who can make more effective interventions since they understand those who are affected better than relief workers). The risk factors in making interventions across cultures then in matters pertaining to mental health have important implications for both the epistemological foundations of psychoanalysis as a discourse and for the ethical dimensions involved in designing these interventions successfully; one solution might be to get relief workers to partner with local healers rather than design interventions on their own.
This volume also has brief narratives of analysts who recount their own formative encounters with psychoanalysis and how they came to terms with their desire to become
analysts. These narratives, including what it means to be analyzed while free-associating in more than one language, make for fascinating reading. Habitual readers of Lacan will know that he was given to experimenting with the structure of the analytic session by varying the length in order to precipitate the disclosures of the unconscious, but they may not have stopped previously to consider what it means to work-through their sessions in more than one language. If the ‘unconscious is structured like a language’, what does it mean to unravel its structure in ways that correspond to the structure of more than one differential system? Will this compound the problems of translating the symptom into an idiom that makes sense for the patient? Or is it rather the case that ‘switching between linguistic codes’ (as a linguist might put it) will be much more therapeutic for the patient? Will not free-associating in more than one language ‘precipitate the disclosures of the unconscious’, reduce resistance, and make it much more difficult – if not impossible – for the patient to manage the sessions with any number of rehearsed remarks rather than say whatever comes to the surface of his mind? These then are some of the more important - though not the only considerations - that this interesting volume of essays will leave the reader with. As Lacan points out in one of the citations included in this volume, it is important for an analyst to understand not just the structure of language per se, but engage with the problem of translation (across natural languages and psychic systems) as well if he is to make sense of ‘desire and its enigmas’ in the patient; or more generally, ‘be aware of his function as an interpreter in the strife of languages’, since he cannot avoid ‘the whorl into which his era draws him in the ongoing enterprise of Babel’. This however is only the first of the forays that this series of volumes from the University of Minnesota Press has made to make sense of this ‘enterprise of Babel’ – readers who share at least some of the psychoanalytic concerns articulated in this review should not only read this volume for its theoretical content, but dig out even more examples - in addition to those that I have done so in this review - to make sense of how increasing interactions or even exposing the theoretical interdependence of the structure of the culture and the clinic will make it possible to re-vitalize the applications of psychoanalysis in contemporary society.