LACANIAN PSYCHOANALYSIS THEORY AND TECFINIQI'E BRUCE This page intentionally left blank. A CLINICAL INTRODUCTION TO LACANIAN PSYCHOANALYSIS Theory and Technique L Of iowa iowa City, IA 52242 BRUCE FINK HarvardUniversityPress Cambridge, Massachusetts London, England 1997 Copyrighted Material Copyright t 1997 by thePresident Fellows at Harsrard Coflege ALl rights resenred liii Printed in I Fe tJniic&I Hu hal First I larvard University Press paperback edition, ibrary ii Congress Data I Fink, Bru4it', 19S6— A clinical introduction to tacanian theory and technique / Brute F;:i, cm J' includes bibliographical references and indr* ISBN O-a14- (cloth) [SUN Q-674-13536--9 (pbk) Jacques, 1"*)i-t 2. Psychoanalysis. I. Title! 1. 8F109L2SE54 1997 151119 3'092—-dc2 1 96-52127 Copyrighted Material ACKNOWLEDGMENTS Jacques-Alain Miller—the general editor of Lacan's seminars and head of the Ecole de La Cause Freudienne, who is widely recognized as the foremost interpreter of Lacan's work in the world today—taught me the lion's share of what I know about Lacanian psychoanalysis. I am greatly indebted to his ongoing "Orientation lacanienne," the weeldy seminar he gives as chairman of the Department of Psychoanalysis at the University of Paris VIII, Saint- Denis, which I attended from 1983 to 1989. He provided many of the keys that have allowed me to read Lacan, and—as was true of my previous book, The Lacanian Subject (above all, Chapters 2—5 and 10 and the appendixes)—! rely considerably on his published and unpublished lectures here. Chapters 6,9, and 10 are in part based, respectively, on his essays "An Introduction to Lacan's Clinical Perspectives," "On Perversion," and "Commentary on La- can's Text," and a number of the figures I use in Chapters 8, 9, and 10 are derived from figures that he discusses extensively. Indeed, references to his work occur throughout, since it forms the backdrop for the view of Lacan's work I present. Colette Soler, one of the most experienced Lacanian psychoanalysts affili- ated with the Ecole de Ia Cause Freudienne, has been especially influential in my understanding of Lacan's clinical work, and her work is quoted exten- sively here as well. Her essay "Hysteria and Obsession" was extremely useful to me in Chapter 8. Still, neither Jacques-Alain Miller nor Colette Soler would necessarily endorse the views expressed in this book—they would no doubt take issue with various interpretations proffered here. Héloise Fink made many useful comments that helped Improve the read- ability of this book, and provided moral support throughout the writing process. This page intentionally left blank. CONTENTS Preface xi I. Desire and Psychoanalytic Technique 1 Desire in Analysis 3 2 Engaging the Patient in the Therapeutic Process 11 3 The Analytic Relationship 28 4 Interpretation: Opening Up the Space of Desire 42 5 The Dialectic of Desire 50 II. Diagnosis and the Positioning of the Analyst 6 A Lacanian Approach to Diagnosis 75 7 Psychosis 79 8 Neurosis 112 9 Perversion 165 III. Psychoanalytic Technique beyond Desire 10 From Desire to Jouissance 205 Afterword 218 A Note on Documentation 223 Notes 224 Recommended Reading 280 Index 289 This page intentionally left blank. PREFACE The goal of my teaching has always been, and remains, to train analysts. —Lacan,Seminar XI, 209 Despite the great complexity of Lacan's writings, many of his clinical notions and innovations can be clearly and simply formulated. Yet few if any books on Lacan available today talk about how one goes about doing Lacanian psychoanalysis, what it really involves, and what thus distinguishes it from other forms of therapy, whether psychoanalytically oriented or not. This book sets out to rectify that situation. it is designed for clinicians (psychoanalysts, psychologists, psychiatrists, psychotherapists, counselors, social workers, and so on) and for people in—or interested in going into— therapy. It grew out of my work training new therapists at Duquesne Univer- sity, and supervising clinicians already in practice—some for quite a number of years. Few of them had much prior knowledge of Lacan's work, yet we were able to find common ground in our clinical experience, dealing with the kinds of problems faced by a wide range of practitioners: getting our patients involved in the therapy, dealing with their anxiety and demands, handling transference love, setting aside our own feelings for (or against) the patient, keeping our own prejudices out of the therapeutic setting, working with the patient's aggression, sarcasm, and criticism, and so on. In my experience, clinicians of many different persuasions find Lacan's work quite accessible when it is used to elucidate concrete clinical situations and individual case histories. Thus, I have done my best here to discuss everyday aspects of a practitioner's experience, and to use as many examples as possible to illustrate my points. I assume no prior knowledge of Lacan's work, and I provide suggested reading to supplement my discussion in a separate section at the end of the book, including books and articles by Freud, I.acan, and Lacan's students. Unlike much of my previous work on Lacan, this book does not include meticulous interpretation of complex Lacanian concepts or painstaking deci- PREFACE Xli pheringof formulations from his extremely dense writings. I assume that the reader is confronted with the myriad practical problems presented by thera- peutic work with patients, and is not yet sure Lacan's approach interests him or her enough to devote hours and hours, or more likely months and years, to working through the finer points of Lacanian theory. My approach here can thus be viewed in at least two different ways. (1) It constitutes an unjustifiably bowdlerized popularization of Lacan's work, in- volving gross generalizing and reductionism—I am bound to be accused of this by some. (2) It attempts to provide a sorely lacking meeting place for theory and practice, of the type that exists in many Parisian hospitals and outpatient clinics run by Lacanians. In such clinical settings, new therapists and therapists-in-training engage in daily work with Lacanians—not on the nicer points of Hegelian dialectics, modal logic, topology, Heideggerian theo- ries of being and truth, or literary tropes, but on concrete cases where diagno- sis, medication, hospitalization, and involvement of the patient in therapy are vital issues. it is in the context of case presentations, discussion of what needs to be done for a particular patient, or interpretation of a dream, fantasy, or daydream that clinicians in France often first encounter concepts such as the analyst's desire, the symbolic, object a, jouissance, and so on. They do not automatically grasp them even then, but at least there is in France a context in which I .4wanlan conceptsare used in everyday clinical settings to formu- lih• what is going on for particular patients at particular times and to make to the therapists seeing them. Not everytme is bornan analyst, and theFrench manor woman in the street understands nothing of Lacan's grammar, much less of his multilayered, 1iolyv4ili'nt pronouncements. No one in France comestounderstandLacan by nailing his main written work, the Ecrits;as Lacan himselfsays, "they were not to be read" (Seminar XX,29). French therapists learn about Lacan In academic and clinical contexts, where they are taught by one or more of the thousands of practitioners who worked directly with Lacan and his associates, attended lectures, went to case presentations at the hospitals, spent years on the couch, and so on. They learned about Lacan's work first hand—as a practice. In America, Lacanian psychoanalysis has thus far been viewed as little more than a set of texts—a dead, academic discourse. For Lacan's discourse to come alive here, his clinical approach will have to be introduced through analysis, sllpervision, and clinical work—in other words, through subjective experi- eiwe Hooks are just a beginning. If, by reaching clinicians at the level of their experience, I am able to motivate them to take a longer look at I as olten Impenetrable opus, and to take more seriously his view of