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Forecasting what the debates over psychoanalytic treatments of psychosis will be in a few years is a difficult task indeed. Nevertheless, one can expect that the current debates between ego psychology, self psychology, and object relations theories will continue. One could also expect that another stream will be more and more taken into consideration-the Lacanian stream, which started in the 1930s. There might be at least three good reasons for this expectation: (1) The Lacanian theory has always maintained a dialogue with the other currents. (2) It has always maintained a close connection with psychiatric practice, and a significant number of psychiatrists and psychologists in French-, Spanish-, and Italian-speaking countries have been and are still strongly influenced by Lacanian concepts. (3) Cognitive and biologically oriented theories have seemed to be gaining more and more influence in the field of psychiatry and psychotherapy, and, since the 1950s, the Lacanian theory has been trying to counterbalance this influence by including a mechanist point of view in its concept of the human psyche, via the theory of signi-fiers.
While points 1 and 3 seem to be more and more acknowledged, point 2 is probably less familiar to American clinicians. After providing a few examples of the former points, this paper shall examine primarily the latter point, which presumably needs more explanation.