What in general might immunology and psychoanalysis have to do with each other? What might be common in both fields? Is there sufficient justification for a research programme that sets out to identify common structures in immunology and psychoanalysis? Such a programme could lead to questions such as - Is allergy a phobia? What is innate about intestinal ontology? Is biology a branch of psychoanalysis?
I have argued elsewhere that there are parallel structures in three closely related categories: in the histories of immunology and psychoanalysis, in the clinical techniques of immunology and psychoanalysis and in their theories. Here I sketch two aspects of one structure as it is currently theorised: allergy and phobia. How might allergy and trauma be understood as versions of the same structure?
Firstly let us be clear about some vital distinctions between ‘metaphor’, ‘identity’ and ‘structure’, all terms we will use to develop our argument later in the paper. Metaphor or something like it exists perhaps, but not everything is metaphor, as hippies and cultural relativists have claimed. If everything were truly metaphor then metaphor would itself be a metaphor for metaphor, for metaphor, for metaphor… There would be a ridiculous infinite regress and meaning would fall over wholesale. It is certain that there are at least three categories of non metaphors in language and psychoanalysis. Proper names, fundamental fantasies and what I call ‘standard word meanings’ or common meanings found in a community, or a sub culture. So the phrase or signifier ‘9 o clock’ must have a common meaning or we would be forever unable to meet at the time designated. If everything were metaphor then there would be no common time or place to meet, no true or false, or right or wrong. If everything were metaphor we could not even disagree. Even the idea of ‘randomness’ could not be sustained.
‘Identity’ is not a metaphor either. A shoe is not a metaphor for itself or for another shoe. It is a shoe. They are both shoes, that is their identity. They both have structural features in common: they both have a sole that protects the foot, they both have a method of attachment, and both designs take into account the movements of the foot. It is the relation of one shoe to a different shoe that I claim for the relation of allergy to phobia. That is they possess or share in vital part the same structure or essence.
| Some features of phobia: | Some features of allergy: |
|---|---|
| 1. The object of phobia is generally harmless, at least in relation to the anxiety it produces. For Freud's ‘Little Hans’ the object of his phobia were horses. Horses can be dangerous but in Vienna some 100 years ago they were ordinarily used for transport, generally without hazard. | 1. The object of allergy is generally harmless, at least in relation to the anxiety it produces. For hay fever sufferers the object is pollen. If someone has hay fever then pollen can cause the same physiological effects as phobia, even unto death. Otherwise pollen is harmless. The immune system of the hay fever sufferer has attached a great importance to something otherwise trivial. |
| 2. The onset of phobia is variable but perhaps typically around age three. A child's phobia is regarded as a plastic structure, something transitional and is generally made light of by those experienced in rearing children: an adult with a similar phobia would probably be referred to a professional for help. Children with phobias typically ‘grow out of them’ or seem to. |
Pollen and horses are non-mother and so are common to the structures of allergy and phobia. The question that the phobic and the allergic have both answered is, ‘What will separate me from mother?’ What agent has sufficient repressive force to constitute a sustainable ‘no’ to my identification, my bondage with her? In both cases there has been too little repression, too little non mother. Thus, to avoid phobia it is not sufficient for there to be a ‘good enough mother’; there must also be a bad enough father - not a Homer Simpson, a weak, absent father or husband, but some agent with sufficient force to separate mother and child. The phobic / allergic subject's made-up answer is something arbitrary and harmless in its environs such as horses, pollen and indeed anything benign to which the subject has sporadic access in principle. This allergen / phobic object has the effect of causing anxiety in the subject with its characteristic physiological effects. The anxiety marks the absent separation of the subject and its mother in allergy and phobia. The phobic object and allergen are not sufficient to properly
separate the mother and child but they are a partial compensation. Separation of a different order is achieved when the mother is seen by the child desiring something or someone other than the child. It is one thing for there to be an episode of separation and another for the function of separation to be institutionalised. There is some fine tuning called for here. In Lacanian terms this other is not simply non-mother that would remedy the child's phobia but the identification by the child of the mother's desire for someone other than the child, perhaps her work, a lover or another sibling. This is a continuous function rather than a single episode. What is the parallel here in immunology? The idea of a ‘sufficiently large reservoir of non mother’, in place of Lacan's idea of ‘the mother's desire for someone other than the child’. Where is this other?
The sufficiently large reservoir of non–mother in psychoanalysis is the symbolic father: in developmental immunology where the reservoir is typically populated with a stable population of some 10 trillion bacteria. That is some ten times the number of cells that exist in (the remainder of) an adult human.
This is the space available as a vacuum, an empty space in each of us, a multidimensional hole that passes all the way through our centre. This hole is a demanding invitation, an insistent hospitality, sporadically interrupted by antibiotics. The area from mouth to anus is typically 400 metres square: the average UK home - including older and new-build properties is 85 sq m. To put it simply, are our intestinal bacteria part of us or not?
There is a currently popular domestic program of bactericide that is closely correlated with allergy. Mothers armed with Domestos eliminating 99.9% of all known ‘non-mother’ are far more likely to produce children with allergies: this broadly phobic program is aimed against some other imagined to be terrible. In fact, in the healthy human gut, bacteria generally help us digest food, protect us from other pathogenic bacteria that could make us ill, and produce vitamins for us. As x (assuming this is a quotation) says:
Most of the microbes associated with humans appear to be not harmful at all, but rather assist in maintaining processes necessary for a healthy body. A surprising finding was that at specific sites on the body, a different set of microbes may perform the same function for different people. For example, on the tongues of two people two entirely different sets of organisms will break down sugars in the same way. This suggests that medical science may be forced to abandon the one-microbe model of disease, and rather pay attention to the function of a group of microbes that has somehow gone awry.
There are at least three related reasons:
Being born too soon, after only nine months is vital in our acquisition by language. Giraffes and elephants are born only after a much longer period of gestation. And they are able to stand up and walk at birth. It is the human's prolonged helplessness, extended by his premature birth that work to increase the vacuum or space in which the variable meanings of language and culture can take root. The roots of the symbolic, which includes language need time to establish their space.
In other organisms things are very different. They either have a relatively comprehensive set of instincts, that is a repertoire of vital behaviours and signs of fixed meanings rather than the absent set of instincts found in humans, or they have far less helplessness for a shorter period. So the so called ‘social insects’, bees and ants communicate with signs of fixed meanings: they never use their signs as variable meanings to make a joke or as a metaphor. That is they are not afflicted with the plague of indeterminacy that the Bible marks with the Tower of Babel. Instincts are genetically determined behaviours: being born after some nine months is genetically determined and in most cases leads to the creation of the subject of language.
The variability of meaning or its indeterminacy is the essence of trauma - the not knowing.
Lacan argued that language is a universal trauma, or wound, taking a unique form for every person. People are radically different from all other organisms because we speak, and one word, phrase or sentence can mean a confusingly indeterminate number of different things. Animals and plants communicate but with a lot less trouble than people: plants and animals use signs with relatively fixed meanings, not confusing signifiers whose meanings are highly variable.
How do you make an animal neurotic? By introducing variable meanings or indeterminacy in place of fixed meanings. Pavlov, in a variation on his best known experiment conditioned dogs to expect food, after having been shown a circle, and to expect an electric shock after having been shown an oval. The dogs seemed content. Then Pavlov increasingly made the circles oval, and the ovals more circular. For the first time the dogs exhibited obvious signs of what we might call ‘anxious behaviour’. Thus a meaning was varied or made indeterminate, and an ‘animal neurosis’ was simulated and indeed stimulated.
Being a man or a woman is to be something indeterminate, of unknown value. The central appeal of orthodox Judaism and Islam are the wholesale answers they set out to provide to the ultimately e idiosyncratic questions of gender and sexual identity.
So it is almost certain that we have genes for our acquisition by language but that they are not in essential part positive ones but that they in most cases cause or underline an absence or lack, something missing and with it anxiety. We have genes that determine premature birth, without which we would not be helpless for long enough for language to take root, alongside these we also have missing genes for instincts that would also have us less helpless. I suspect that some types of autism and psychosis are casualties of these lacks, when the lack does not lack enough, or too much.
No doubt there are also some ‘positive genes’ for vocal cords and perhaps other important aspects of our domination by language but in essential part we have genes that specify a space where it can be identified that something key for language is missing, that must be found or created independently and idiosyncratically by each of us. So I believe that we do have genes for language but not the kind that the early Chomsky and Pinker argue positively constitute a universal grammar in the tradition of given Platonic Forms. Instead we have a powerful invitation to trauma, to an important set of absent meanings.
Trauma is not necessarily sporadic, a violent collision or a chance unwelcome sexual encounter. It is also embodied in the indeterminancy of meaning, in Lacanian terminology, the real entangled with the symbolic, and the imaginary. Trauma is an every sentence phenomenon. The Tower of Babel is in every utterance. This is why when patients first present with obvious trauma it is generally only within just a few sessions that they introduce material that predates the trauma first presented.
Trauma exists everywhere there are symbols. So it is in mathematics too: π, for example cannot be comprehensively and simply symbolised with a single value. π can only be expressed as a ratio or as a number that continues to be written indefinitely. It resists symbolisation. There are a great deal of traumatic numbers of this type, known as ‘real numbers’ and ‘imaginary numbers’ in mathematics, more than there are regular numbers of the sort used to count apples.
Language cannot all be misunderstanding or ‘lack of rapport’ there must also be some common ground of meaning, some rapport. Trauma is on the side of misunderstanding, of the lack of rapport, of that which resists symbolisation.
In the same way that the research program pursued by Burgoyne, to find common structures in mathematics and psychoanalysis, sets out to solve mathematical problems with psychoanalysis, and psychoanalytic problems with mathematics, so identifying common structures in psychoanalysis and immunology will also solve problems in both fields, as well as opening up the identification of further parallels between mathematics and immunology.
This would have theoretical consequences for all three fields and consequences for clinical technique in immunology and psychoanalysis. The being of humans does not divide up neatly according to the divisions found in universities: ‘medicine’, ‘mathematics’, ‘psychoanalysis’…
| 2. Onset is often early but is variable. Children with allergies typically ‘grow out of them’ or seem to. Late onset can mask an underlying autoimmune disease, which it guards against. |
| 3. Phobia is theorised by Freud and Lacan in the case of Little Hans as being caused by too little repression, that is, by something absent. Little Hans gave an importance to horses that he was unable to attribute to his own father. In his family it was his mother who was dominant, his father's position was opaque: horses took a place of authority, where the father of Little Hans was lacking. Horses took the place of the absent father. What exactly was missing for Little Hans? An agent able to separate him from his mother. That is a sufficiently identifiable non mother. | 3. Allergy is currently theorised a s being caused by too little repression, that is, by something absent. Allergy is very rare in the third world and very common in the first. Why? The current paradigm in immunology is the ‘cleanliness hypothesis’ that argues that the developing immune system of a young child requires exposure to something foreign, ideally bacteria. Should there be insufficient viruses or bacteria that the child's immune system comes into contact with then it typically reaches for something harmless that it has already made contact with such as pollen. The immune system then treats the harmless allergen, the pollen with an exaggerated importance: a potentially fatal immune response is made. In the third world childrens' immune systems typically have plenty of contact with viruses and bacteria, so they do not have to compensate by becoming allergic. Note the absent element here is sufficient exposure to viruses and bacteria. Viruses and bacteria are non mother. That is they are collectively an agent that marks the child as different from the mother: if in general a child had an immune response to his mother's body then it is likely that the child would have been spontaneously or ‘naturally’ aborted. |