From Leakage to Slippage: The Question of Trauma in Psychosis

I have seen roses damask'd, red and white, But no such roses see I in her cheeks;

If you are a painter, you know how important a good primer is. A low-quality primer will reportedly fail to seal the canvas properly, leading the paint to leak through over time. As a result, your painting will not withstand the passage of time. If you are a psychotic painter, the harmful effects of a bad primer might apply to you in more than one way for, unbeknownst to you, you are subject to another kind of ruinous leakage, one that also pertains to some form of primer deficiency. One of the striking features of psychosis indeed, along with the failure of the mechanisms of repression–and that is, in fact, not unrelated–is arguably the fact that the unconscious as such does not exist as a fully differentiated, sealed-off domain. Following Freud's first topography more specifically, the basic partition between the unconscious system, on the one hand, and the preconscious/conscious system, on the other hand–a partition which is, in fact, constitutive of the topography itself–is fundamentally faulty. But if I were to share this insight with a psychotic painter, I would undoubtedly be wasting the painter's time because this metaphor, like all metaphors, is radically unavailable to a psychotic perspective. The possibility of double entendre, of any metaphorical dimension can indeed be said to be barred in psychosis, as the foreclosed metaphor of the defective primer ironically encapsulates.

The primer deficiency at fault, more specifically, is a primal process, one that Freud refers to as primal repression and which he holds as constitutive of the unconscious. This is where, I believe, things have gone wrong for the pychotic, in this mythical moment when the unconscious comes to be as a distinct psychic domain. Three key-terms involved according to Freud: fixation (which he also refers to as inscription, perhaps a clearer term in this context), anticathexis (in fact, the sole mechanism operating in primal repression, as Freud insists [1915b: 181]) and trauma. Freud is talking about a mythical trauma here, naturally, a hypothetical first cause, just as mythical as the primal split that it entails. Exogenous at first, trauma thus seems to be what sets the whole thing in motion: something breaks through the external barrier, the emergence of a breach–therefore of a difference–triggering a process of inscription/fixation. This is how Freud puts it: “We have reason to assume that there is a primal repression, a first phase of repression, which consists in the psychic (ideational) representative of the drive being denied entrance into the conscious. With this a fixation is established; the representative in question persists unaltered from then onwards and the drive remains attached to it” (1915a: 148). Two difficulties we need to address in this account: a logical one and a terminological one.

The first logical difficulty stems for the fact that this “first phase of repression”, as Freud presents it, can only be understood retrospectively: for anything to be “denied entrance into the conscious”, there needs to be such a thing as a distinct conscious system. Yet, the process that is being described here is the one that precisely institutes the conscious as distinct from whatever is denied entrance into it (i.e. the unconscious). In other words, and this is quite typical of the logic at work in Freud's metapsychological thinking, primal repression can only be understood in the light of what comes next: i.e. secondary repression, itself only manifest through the repressed, or rather through the return of the repressed into the conscious. This constitutive moment thus only comes to light après-coup, in afterwardsness. Interestingly, the Freudian model of trauma is predicated on a similar structure: as discussed at length by Jean Laplanche, the temporality of trauma as Freud theorizes it involves two stages: an initial stage when trauma occurs but goes somewhat unnoticed, leaving no visible trace and a second stage when a second event reactivates the initial occurrence quite incidentally, leading to the emergence of defenses and symptoms. Just like the postman who always rings twice, trauma requires a double inscription in this model, manifesting itself retroactively, inscribed in a specific kind of temporality characterized by traumatic afterwardsness. This leads me to think that Freud uses the term trauma rather rigourously in his model of primal repression in which

the temporality of traumatic afterwardsness is equally involved and implemented.

The second difficulty, I announced, pertains to Freud's terminology in the aforementioned section from the essay on “Repression”. Freud refers to “the psychic (ideational) representative of the drive” as the repelled entity constitutive of the unconscious. As Laplanche and Pontalis explain in The Language of Psychoanalysis, the ideational representative (Vorstellungsrepräsentant) is the delegate of the drive in the sphere of representations (1973: 203-204). Let us remember that the drive pertains to the somatic sphere strictly. From this perspective, primal repression thus consists in the inaugural inscription of the drive in the psyche through the advent of a representational delegate or primal signifier. What is important for us to retain here is that, with primal repression, we are dealing with the foundational exchange between the somatic and the psychic or, as Serge Leclaire sees it, with the mythical encounter of the signifier and the biological order, an encounter in which trauma is instrumental. This foundational moment when representations and drives weave their primal links and inscribe them psychically in permanent ink is what I understand as the constitution of the unconscious: a process of primal symbolization, through the advent of a breach, the introduction of difference.

Bearing in mind the twofold temporal model I posited earlier, this initial inscription is, in fact, the first stage of primal repression, reminiscent of the first traumatic occurrence in the Freudian model of trauma. As Laplanche describes it, this is the moment when “the net, the network of signifying oppositions is cast over the subjective universe; but no particular signified is caught in any particular mesh” (1960: 307). In Laplanche's evocative account of this original landscape, it is important to stress the absence of any footholds or anchoring points in the relation between “signifying oppositions” and “signified”. In other words, difference is introduced but it is not anchored in meaning. This is where the mechanism of anticathexis comes into play: the function of anticathexis is to seal off this initial inscription/fixation, like a lid, to generate a split, a partition between the unconscious and the preconscious-conscious system, eliciting the advent of repression proper and, more generally, the constitution of the first topography. The best way perhaps to envision anticathexis in this context is in terms of repulsion, considering that it takes place in the absence of any prior cathexis, that there is nothing there to start within that mythical substratum of the psyche, nothing that draws or attracts any particular element as in the case of secondary repression. Anticathexis repels the primal signifiers that arise from the initial trauma, it embeds them, unalterable, in the negativity and the atemporality that characterize the unconscious where they are supposed to remain, hermetically sealed. A process of primal repulsion, anticathexis might well be the faulty primer I was mentioning earlier: it could well be what precisely fails to operate properly in the case of psychosis where, as I suggested, the lid is not shut tight, leading to a disastrous leakage.

Before considering the consequences of this leakage in more clinical terms, I would like to return to the unavailability of metaphor in psychosis and briefly discuss its consequences in terms of technique. For reasons that I will address a little further on, the psychotic perspective is characterized by its radical literality: to put it bluntly, it does not accommodate any form of “as if”, a feature which is consistent with the failure of the mechanisms of repression. By confining representations to the unconscious, repression indeed allows the subject to operate as if the repressed representations were not there. In this sense, repression can be envisioned as the instatement (primal repression), the implementation and the maintenance (secondary repression) of a fundamental “as if” which functions as an anchoring point. In the case of psychosis, this constitutive “as if” fails to be instated properly and in the absence of an anchoring point, the subject does not have the luxury of “pretending” that anything is not there when it actually is (and vice-versa). This has obvious linguistic consequences that underlie the specificity of the psychotic (schizophrenic, more particularly) relation to language as I will later suggest, accounting, paradoxically, for the fact that psychotics cannot recognise themselves as the subjects of what they say. Like repression, language is indeed predicated on a fundamental “as if”: we use words as if they stood for the things they name. But we also “know” that they are not the things, the way we “know” of the presence of unconscious representations in the substratum of our psyche. This “as if”–the locus of lack–is incidentally what allows us to

(mis)recognise ourselves as the subjects of what we say. But if the word is the thing as it is for the psychotic, if the very possibility of “as if” is permanently foreclosed, language can never be the site of any form of subjective (mis)recognition: the void of literality replaces the lack inherent in the figurative.

In response to this distinct clinical situation, analysts are led to bring their own capacity for metaphor to bear upon such crippling and obliterating literality. This mobilises subtle and difficult strategies of metaphorisation likely to elicit a temporary shift from the sway of void to the experience of lack, as French psychoanalyst Gérard Pommier puts it very nicely (1987: 281). The point of these strategies is to offer the relevant mediation of something impersonal and universal enough (e.g. proverbs, well-known facts, universal truths, references to institutions, to the law, etc…), something likely to function like a net (to return to Laplanche's earlier metaphor) that might catch the psychotic subject's signifiers into the mesh of some temporary signified. In other words, the analyst must strive to provide some sort of anchoring point, so as to yield a transient illusion of meaning and thus effectively suspend the unfettered and persecutory slippage of signification. But this in no way suggests that the analyst should ever expound the missing metaphorical dimension or even hint at its existence and validity: this would be perceived, at best, as completely irrelevant and incomprehensible. At worst, it could result in a rather serious mistake in the form of a potentially persecutory intervention laden with obliterating implications for its recipient. For telling a psychotic subject what he or she precisely cannot think implies a virtual alignment with the omnipotent expropriating violence that presides over his or her psychic life. Just as resistance is on the side of the analyst in the clinic of neurosis, I would venture to say that metaphor is on the side of the analyst in the clinic of psychosis.

When working in the area of psychosis, one must remember that the therapeutic space is one where, paradoxically, there is not enough room for two. For the analyst, it is a subtle task as the danger of not putting the psychotic subject “first” is a permanent one, despite the analyst's best intentions. Too much knowledge, too much empathy, too much understanding even can thus be deadly. For the psychotic does not have the capacity to put him or herself second because there is no second place to be, except for a space of obliteration. Putting oneself second implies a process of eradication, often registered by the psychotic episodes that can arise as a result and during which the expropriating violence literally takes over, seizing the subject and removing him or her from reality and consciousness. As my psychotic patients report, they emerge from those terrifying experiences of persecution and loss–loss of self and loss of reality–brought back to reality by the sound of their own screams as they are arguing with the voices in their heads, sometimes with no recollection of anything, wondering if they might have killed or hurt someone–and sometimes they actually kill themselves–an acute reminder that they cannot put themselves second, something they are also naturally drawn to do, compulsively repeating the experience of expropriation and depletion.

But I would further add that by hearing and reading the metaphors that dwell, oblique and foreclosed, in the statements and reports of my psychotic patients, I might be better equipped to provide an adequate clinical response to their therapeutic needs but I am also “using”, somewhat reappropriating and expropriating this material for my own purpose, even though this purpose is to be of help to them. Schizophrenics often complain about being “used” and, ironically, the only way I can strive to do my job well–always an approximation–is by partaking in this depleting process. This is a wall, a radical limitation that I keep encountering in this kind of work, leading me back to some fundamental impossibility that I find essential to the work itself and which, in my view, must always be borne in mind. Because the depleting threat of the omnipotent expropriating other never ceases to loom on the psychic horizon of the psychotic subject, my job might be to always remain aware of that threat, consistently bound by the radical impossibility it embeds at the heart of the therapeutic relation. Not so much with a view to keep the threat of annihilation at bay but as a constant reminder, rather, that I do not have the power to do so.

But let us now return to the consequences of the disastrous leakage we started this discussion with. Obviously, if the unconscious does not exist as a sealed-off fully separate domain, secondary repression or repression proper as Freud also calls it is necessarily

precluded, accounting for the failure of the mechanisms of repression in psychosis. In other words, if the bar–which was introduced through primal repression insofar as primal repression consists in the introduction of difference, through a breach in the system, that would be the initial trauma–if the bar in question is a porous one instead of one that effectively separates the unconscious domain from the preconscious/conscious system, nothing can ever really remain below that bar and the mechanisms of attraction and repulsion that are characteristic of the exchanges between the conscious and unconscious are bound to operate in a kind free-floating way, as they are not anchored in topographical differentiation. Another consequence of this porous bar or lid takes on the form of a kind of linguistic leakage resulting in the permanent slippage of signification I evoked earlier. As you might remember, Freud distinguishes between thing-representations (essentially visual representations derived from things) and word-representations (essentially auditive representations derived from words): “The conscious representation comprises the representation of the thing plus the representation of the word belonging to it, while the unconscious representation is the representation of the thing alone” (1915b: 201). In the case of psychosis, and schizophrenia more specifically, because of the malfunction of the topographical differentiation, this distinction does not apply: the word is the thing as I already mentioned and as Freud famously demonstrates in section VII of his essay on “The Unconscious” (1915b: 196-204). This implies that, for the psychotic, there is no such thing as a “conscious representation” predicated on a thing/word duality (representation derived from things + representation derived from words). As we can infer from Freud, there is precisely a collapse of the thing/word duality in schizophrenia, leading language to behave like a dream, subjecting all its components to the same “considerations of representability” (Rücksicht auf Darstellbarkeit) as the ones involved in the dreamwork, imposing that all be expressed through , exclusively.

This is well illustrated by what my schizophrenic patients refer to as “memories” and which, as the term suggests, involve the resurfacing of past traumatic events and experiences. The account of such “memories” tends to signal, in my experience, the possibility of a brewing crisis, especially when paired with an increase in the relentlessness and brutality of the patient's hallucinations (voices are reported as “louder” and “closer”) as well as with radical behavioural changes (sudden shift from catatonic introvertion to voluble extrovertion, for example). Whenever such resurfacing takes place, it relies on the exact same configuration and formulation and the accounts are characterised by an incredibly vivid dream-like and hallucinatory quality. The recounted “memories” most often feature an abuse of power, in the form of a terrifying, sadistic, out-of-control authority figure who perpetrates unfettered acts of violence, from a vicious mother slaying a cat with a knife or sprinkling pepper on her daughter's genitals to an unrepenting father who shamelessly rapes his son. What is striking in these recollections of abuse from a schizophrenic perspective is the fact that they seamlessly combine elements undoubtedly pertaining to the factual or the incidental (be it cruelty, ill-treatment, neglect, violence, or expropriation) with material that could rightfully be referred to as unconscious representations, including imagos, i.e. unconscious prototypical figures (e.g. the phallic mother, the sexually insatiable father), complexes (e.g. castration, Oedipus) as well as fantasies (e.g. murder, seduction, etc…). As opposed to its neurotic equivalent in which such representations would be equally “present” but they would be veiled by repression, betraying their unavowable existence in a variety of symptomatic ways, the psychotic “memory” is not subject to censorship and the unconscious representations it includes function as standard signifiers, endowed with the same weight and status as elements pertaining to factuality, all thrown together into one horrifying undifferentiated heap. In this levelling process, unconscious representations literally flood the conscious without any delineation or demarcation which, incidentally, precludes the possibility of signification. In the psychotic memory, nothing stands for anything else, everything is literally and concretely there, open to an infinity of meaning, which paradoxically deprives the whole thing of meaning, a tragic reminder that pure sense and non-sense are actually the same thing. On the psychic landscape of psychosis, trauma remains inscribed in permanent images, impervious to the passage of time, unmetabolised, without any possibility of integration or working through. It haunts the

psychotic subject literally like a bad dream, resurfacing, fresh as a rose, senseless and arbitrary, always hallucinated, never remembered.