Jacques Lacan is known as an important French philosopher since Descartes and is also known in Europe as the most creative and influential thinker since Nietzsche and Freud. With his legendary academic career, he created a new academic faction: the Lacan School, which became another peak recognized by the academic community after Freud. In recent years, works and research works on Lacan have been introduced and published one after another, which has played a major role in promoting domestic psychology, especially in the field of psychoanalysis. However, Lacan's theory is obscure, Lacan's thoughts are profound and complex, and Lacan's works are known for their treacherous language style, which discourages many readers who want to understand the Lacan school. Recently, "Clinical Lacan" was published by Guangxi Normal University Press. It has opened up a new direction in Lacan complex theories and obscure terms. By introducing the application and experience of Lacan psychoanalysts in clinical practice, it helps readers open the door to Lacan sect.
"Clinical Lacan"
[France] Joel Doll, author of
Wu Zhangzhang, translated by
Shanghai Bebet | Guangxi Normal University Press Publishing
"Clinical Lacan" is the French psychoanalyst Joel Doll, who is one of the key figures in the Lacan psychoanalytical movement. In the 1980s, through his large-scale introduction, Lacan's thoughts became "easy" to understand and "clear". Clinical Lacan consists of a series of lectures by Joel Doll to psychoanalysts in the training center, and centers on the diagnosis of the mental structure, allowing readers to directly contact and guide the landmarks of Lacan's psychoanalytical practice. Unlike other theoretical works, this book focuses on talking about the application and experience introduction of Lacan in clinical practice, and has a profound understanding of the definition of the spiritual structure of the human subject and its discussion on diagnosis. In the book, Joel Dore uses fascinating clinical examples to discuss in detail three mental structures - obsessiveness, perversion, hysteria, and the diagnosis and distinction of the three, which is of great value for theoretical research and clinical guidance.
Let us start to explore this problem in the field of psychopathology by considering Freud's understanding of the diagnostic problem. As early as 1895 (the beginning of psychoanalysis), Freud talked about some of the technical difficulties he encountered when applying Bloyer's detection and catharsis therapy in the treatment of hysteria and some important conclusions he drew from it. On the one hand, Freud wrote that he found it difficult to have a clear understanding of individual cases of neurosis unless it is analyzed in depth. But on the other hand, he wrote that before we can understand the case in detail, we need to establish a diagnosis to determine the direction of treatment. In other words, at the beginning of Freud's work, he accurately pointed out the ambiguity surrounding diagnostic problems in psychoanalysis: we need to preform a diagnosis in order to determine the course of treatment, even if the correlation of this diagnosis can only be confirmed after the treatment is carried out for a period of time. The paradox of
is exactly what makes psychoanalytical diagnosis unique. We need to clarify this concept and compare it with the diagnostic concept in the medical field. The establishment of medical diagnosis is based on two criteria: one is the observation standard, which aims to determine the nature of a certain complaint or a certain disease based on a fixed system of meaning; the other is the classification standard, which allows us to detect an established pathological state under a pathological classification framework. Therefore, medical diagnosis often comes from a dual perspective, namely the etiology perspective and the differentiating diagnostic perspective. In addition, medical diagnosis setting is not only about establishing the critical or functional prognosis of the disease, but also establishing the most appropriate treatment methods. Finally, doctors have a complex investigation system at work. First, the doctor must conduct past history inquiries to collect the patient's memories of the disease; then, he will use some technical, instrumental, and biological methods to conduct direct examinations.
In the clinical field of psychoanalysis, the structure of the subject makes this type of diagnosis impossible. The only investigative technique that analysts use when working is listening.Since direct examination is impossible, the clinical materials provided by the patient are all composed of his words, and from the beginning of clinical investigation, these materials are limited to the patient's actions of speaking and what he says.
However, as we know, this field of speech is filled with lies and imaginative constructions; in fact, fantasy is unfolding in this field. And it is also in this field that the subject will show his own blind spots; he does not know that through the rhetoric he expresses, he is talking about the truth about his desire, so he does not know what is hidden behind the symptoms that cover up his desire. Therefore, it is impossible for us to make some kind of diagnosis based on objectively verifiable experimental data. The assessment is basically subjective, it is based solely on the patient's words and is underpinned by the listening of the analyst.
However, despite the fundamental differences in this diagnosis and medical diagnosis, we still have some stable and reliable guidance in the intersubjective field. This is not an area of purely empathetic interaction or suggestive influence; when Freud realizes that he must avoid his intervention as a suggestion, the particular nature of psychoanalysis becomes a discipline. We have every reason to believe that a topography of psychopathological complaints can be portrayed based on a method of building landmarks and covers some of the most basic properties of its object, namely, mental causality, and especially the unpredictability of unconscious operations. The logical relationship between
diagnosis and selection of treatment is unique. Although this is not a logical relationship problem like a clinical medical case, analysts must also rely on certain stable elements to make a diagnosis and choose the corresponding treatment model. As we have seen, if we do not want to turn it into a barbaric analysis criticized by Freud, then the process of building a landmark in this way requires us to be extremely cautious.
(This article is excerpted from the first chapter of "Clinical Lacan" "Diagnostic Concept in Psychoanalysis")
Author: Joel Doer
Editor: Zhou Yiqian
