After Lacan: Clinical Practice and the Subject of the Unconscious (Book Review)

Author:  Apollon, Willy, Danielle Bergeron and Lucie Cantin
Publisher:  New York: SUNY Press, 2002
Reviewed By:  Charles Turk, Winter 2004, pp. 45-48

Cultivating Lacan's Garden in Quebec

In Quebec City, adjacent to the rolling Champ de Bataille high above the Saint Laurence river, lies a large formal garden. From the statue of Jeanne d'Arc implanted in its center, summer breezes course across lush lawns, setting the vibrant heads of massed flowers to nodding in defiance of the winter-winds that in a few months will still them. Willy Apollon, Danielle Bergeron and Lucie Cantin reside and work in this most European of North American cities. The fruits of their long collaboration have been collected in a slim volume, entitled After Lacan –a work that occupies a unique place among the profusion of books about Lacan. The authors come "after Lacan," first in the sense of following in his footsteps, next by creatively reworking Lacan's concepts.

The authors support a logical unfolding of various Lacanian concepts: signifier, the Other, jouissance, "letters of the body," absence and desire with clinical vignettes, which bring them to life. The chapters of After Lacan are interwoven through a discursive style where one senses that the authors speak to each other—a notion corroborated at times by their explicitly referring the reader to each other's chapters. Thus the book itself is as a fabric of concepts laid out in three tiers: the authors speaking among themselves, the authors drawing upon Lacan, and Lacan returning to Freud.

In the first chapter, The Trauma of Language, Lucie Cantin lays out the foundation of Lacanian theory: that our humanity rests upon the phylogenetic rise of a creature who speaks. Once this being speaks, he is irrevocably detached from the rest of the animal kingdom, destined to live as a human in a manner totally different from any other creature. Willy Apollon pursues this theme in the next chapter by tracing out how language structures us as subjects. He describes how the most obvious property of language—that speech is addressed to someone—produces the concept of the Other. As language separates us from animals, it also severs us from the instinctual satisfactions we assume animals enjoy. This split-off inaccessable remainder, Lacan termed jouissance. While it is often mistranslated as "pleasure," jouissance is in fact beyond pleasure; thus it is not by accident that Freud was interested in what lay "beyond the pleasure principle" nor that Lacan linked jouissance to Freud's death drive. Apollon explicates the attribution of jouissance to the Other and its relation to narcissism, to sexual difference and to the drives—and how, if unchecked, it can course destructively through us.

Next, as if in response to Lacan's oft-quoted phrase, "The unconscious is structured like a language," Danielle Bergeron deftly illustrates the "stuff of language" –the signifier—by inviting the reader to accompany her on an excursion, first behind the stage at the Paris Opera, and then into the bowels of the City of Lights on a tour of its sewers. Through this metaphoric journey "behind the scene," and "into the depths," she demonstrates how Lacan transformed Freud's unconscious "memory traces" (wahrnehmenzeichen) into "psychoanalytic signifiers" (as distinct from the purely linguistic signifier).

Lacan taught that the subject is determined by, and positioned with, respect to three fields of experience: the Real, the Imaginary and the Symbolic. The authors emphasize the particular relevance of the latter field, the symbolic order, to analytic work. In practice this means that the analyst has only speech to rely upon, a fact that Willy Apollon develops in a sequence of three chapters. He traces out a trajectory, starting from the unrepresentable, to its partial inscription in "letters of the body," to its partial capture in the symptom, and finally to the symptom's dissolution into fantasy.

This tracing of the path of "the cure" brings home the disquieting proposition that much of the difficulty encountered in the course of analytic work is often aided and abetted by the analyst himself. Furthermore, the implications for practice as the full meaning of "absence" dawns upon the reader, will lead him to question whether he can ever be "an object" for the analysand, as an "object relations" perspective might imply. We note that "object relations" are representations and thus lie within Lacan's Imaginary field. As the analyst properly works within the Symbolic field, it would appear that our ears would be the only satisfactory "object" we could offer. To offer ourselves as an "object" –as in the contemporary preoccupation with the "here and now" –is to risk impasse by frustrating the subject's drives and obscuring the fact that his unconscious is ready and waiting to speak.

After Lacan helps the reader negotiate Lacan's dense thickets. In a chapter entitled Perverse Features and the Future of the Drive in Obsessional Neurosis, Danielle Bergeron provides access to Lacan's (1977) difficult text, "The Subversion of the Subject and the Dialectic of Desire." By using some of Lacan's "graphs of desire," she delineates how Freud's system of ideals (superego, ego ideal and ideal ego) are framed within a linguistic context and how this system functions with respect to the drives. By way of contrast with the neurotic structure, Lucie Cantin illustrates the perverse structure in a pair of chapters: Perversion and Hysteria and The Fate of Jouissance in the Pervert-Hysteric Couple. Cantin draws a useful distinction between the "scenario" that the pervert orchestrates with his partner, and the "perverse features" of the neurotic that Bergeron describes above. By revisiting such terms as signifier, desire, Other, organism and "letters of the body," Cantin evolves a coherent linguistic framework for understanding perversion, connecting what is demonstrated in the perverts scenario to the structure that determines it.

Lacan considered the Lack that language introduces into the human being to be symbolized by the phallus, imaginatively assumed to be missing part of a woman's body. Where better to distinguish between organism (women lack nothing biologically) and body (universally fantasized to be actually or potentially missing a part). Thus, womens' bodies come to be "lettered" as "lacking a phallus." The pervert denies castration by orchestrating a scenario that demonstrates that "nothing is missing." Such demonstrations serve to erase the (linguistically derived) drive and reduce the "drive-lettered" body to an organism pervaded by jouissance. The pervert promises access to Jouissance. But as Jouissance is impossible for the human, the pervert never succeeds, and so is compelled to repeat his scenario. At stake in the treatment of the pervert is to get him "off stage," to give up his demonstration and to speak of it.

Lacan formulated psychosis to be a structure determined by the "foreclosure of the Name-of-the-Father." This means that the psychotic lacks the symbolic father, as a position, upheld within the family structure, necessary for the reliable transmission of cultural values. After Lacan draws to a close in a style reminiscent of Freud's Schreber case, which relied solely on the memoirs of that unfortunate man. Danielle Bergeron explores the works of a psychotic writer, Yukio Mishima, to draw out his struggle to compensate for the absence of the "Name of the father." He attempted to use his extraordinary talent to capture unfathomable jouissance within a network of words. But, unable to stem with his pen the workings of jouissance that coursed violently within him, he took up a sword and ended his life in ritual suicide.

In a panoramic introduction, Robert Hughes and Kareen Ror Malone, the editors of After Lacan, locate this work within the breadth of the Lacanian field. They go on to describe how over thirty-five years ago Willy Apollon, Danielle Bergeron and Lucie Cantin founded an organization known as GIFRIC (Groupe interdisciplinaire freudienne de recherches et d'interventions cliniques et culturelles) that developed both a school, EQF (Ecole freudienne du Quebec) and a treatment program for psychotic young adults, known as "388" (its street address). The painstaking work the authors have done on the problem of psychosis excerpted in After Lacan provided the foundation for "388" –a wedding of theory and practice that seems to fulfill Freud's prophecy that one day a method of treating psychosis would be found. To achieve this they focus upon the interplay of jouissance, delusion and dreams in the treatment of psychosis

While delusion and dream bear a superficial resemblance, they have totally different relationships with jouissance. When the psychotic breaks down he constructs a delusion that first attempts to explain what happened as he witnessed the destruction of the world, and next activates a restitutional effort. The hallmark of delusion is absolute certainty. Delusional work requires that the psychotic must right some wrong or repair some great damage—generally viewed as a defect in the universe. In contradistinction, the dream employs language in a functional way to interpret what arises from the unconscious. This provides the psychotic with an alternative to the delusion that traps him. The true dream offers access to the past, including the events that traumatized him.

The distinction between delusion and dream is exploited to clinical advantage by regarding the psychotic as a speaking subject and offering him a place where he can speak his mind. But he is also required to produce and report dreams. By listening, the analyst demonstrates that he "does not know," tacitly acknowledging that it is only the psychotic "who knows." In this way the psychotic's delusional certainty remains unchallenged, and this ensures that persecutory and erotomanic transferences will not be generated. The awaited dream will emerge like tendrils that grow and brake into the frozen delusion. There develops a new transference that the psychotic makes use of to experiment with the reliability of the spoken word, whose source in the dream opens him to the truth of his history.

Over the past twenty years, the young psychotics treated at "388" have all engaged in analysis. They were not "previously high functioning" individuals, who constituted those "rare" cases of psychotics who are amenable to psychoanalytic treatment. Quite to the contrary, they were a group of repeatedly hospitalized schizophrenic young people, already embarked on a chronic downward course unaltered by the administration of high doses of medication that had served only to perpetuate their frozen delusional world.

If After Lacan had simply explicated Lacanian difficult concepts and animated them with clinical vignettes, it would have accomplished a great deal. But clearly this volume is more than that. It reshapes the psychoanalytic landscape by recasting a theory of psychosis and basing successful treatment upon it. At the same stroke it provides an answer to neurobiological concepts and treatments, by demonstrating how the psychotic can take leave of his illness by having his speech well received.

Charles Turk  received an exemplary psychiatrist award from NAMI for his work with severely ill patients in a public partial hospitalization program. He obtained his psychoanalytic training at the Center for Psychoanalytic Study, Chicago, and is a founding member of the Chicago Circle Association—an affiliate of the Ecole Freudienne du Quebec.

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