Lacanian Psychoanalysis & Psychosis – 3. Manic – Depressive Psychosis
Helen Koumidi
Psychologist – Psychotherapist
www.elenikoumidi.gr
«Lacanian Psychoanalysis & Psychosis – 3. Manic – Depressive Psychosis»
‘The bag or the life?’ (Λακάν Ζ., 1964): Through this question that Lacan poses as an example, he gives us the exact picture of the structural alienation of the human being. Man either chooses the bag [bag without life, therefore death!] or chooses life [life without bag, therefore life mutilated!] he is condemned to the alienating action of the Other. This same image can be used to describe Manic – Depressive person: Whether the manic person in pursuit of jouissance chooses the bag or the melancholic person in pursuit of it chooses life, ultimately in both cases the manic depressive person is endlessly searching for his place in the endless game of the death drive.
1.Lacanian Interpretation of Manic – Depressive Psychosis
Note: This text follows the text ‘Lacanian Psychoanalysis & Psychosis – 1. Schizophrenia’[1] for the description of Psychosis (definition, causes, ‘triggering’ of psychosis, management of the transference) according to the Lacanian psychoanalytical approach and the text ‘Lacanian Psychoanalysis & Psychosis – 2. Paranoia’[2] where there is a detailed analysis of the Mirror Stage, narcissism, aggression, Fantasy, primary identification etc.
→ «Epidemiological facts»:
At first, it is important to mention some epidemiological facts about Bipolar Disorder (the new term for Manic – Depressive Disorder): According to the World Health Organization, in 2019 we had 40 million people diagnosed with Bipolar Disorder[3]. Research puts the rate of the disorder at around 1 – 5% of the world population. This mental disorder has a high risk of suicide, as statistics show: Of these, 4-19% commit suicide while 20-60% make a suicide attempt. In particular, it is considered that the risk of suicide is 10-30 times greater in patients with Bipolar Disorder and specifically 3-14% of suicide cases in the entire population belong to this specific mental disorder[4].
These suicide rates reveal the self-destructive nature of this mental disorder. In this text, we will note the Lacanian interpretation of this self-destructive behavior that characterizes all individuals with Bipolar Disorder, whether they are in a phase of mania, where a false impression of a happy experience is given, or in a phase of melancholia, where is given a clearer picture of this difficult mental state.
→ «The clinical picture of Manic – Depression – Physical and mental exhaustion»:
I gathered in a table[5] the possible features (Ουλής Π., 2006) that make up the clinical picture of this mental structure, whose number, severity and frequency vary (DSM-5, 2013).
According to Lacan, Manic – Depression belongs to the Psychotic structure. In addition to the general psychotic features that also apply in the case of Manic – Depression, we would add the following special features:
→ «Manic – Depression develops as a result of fixation and subjugation during the narcissistic Mirror Stage»:
Mirror Stage is the phase in which the subject develops its choice of the structural defense against psychosis: Paranoia or Manic – Depression: «During the Mirror Stage, if the person has ‘passed the danger’ of the structural genesis of Schizophrenia (where the person will remain captive in the experience of the fragmented body, without the possibility of entering the Mirror Stage), but at the same time fixated on this, then opens up either the possibility of a paranoid psychotic structure or that of a manic – depressive psychosis» (Koumidi H., 2023).
As we mentioned in the text on paranoia: « […] the narcissistic relationship characterizes the imaginary dimension of human relationships. Narcissism is considered the love attraction of the mirror image and can range from extreme self-love to so-called ‘narcissistic suicidal aggression’. The person is therefore ‘captured’ by the mirror image, the mirror game, as on the one hand, the image seduces, has an erotic character, on the other hand it leads to a fixation, has an aggressive character, not letting the person move forward (Koumidi H., 2023).
The fixation of the individual in the narcissistic stage of the mirror and the subjection of the ego to the position under the shadow of the other – that is, of his omnipotence – leads to the establishment of the manic – depressive mental structure. The manic – depressive person may immobilize at the same stage as the paranoid person, but his position in front of the imaginary other is different. In the text on paranoia (Koumidi H., 2023) a description was made of the relationship between the imaginary ego and the imaginary other, where the pattern of the dual-imaginary relationship with the other prevails (a-a’). The manic – depressive person’s relationship with the other is fragile, weak. So in paranoia there is an imaginary relationship of the ego with the other, but at the cost of the other becoming the individual’s persecutor, while in manic – depression there is a weak imaginary relationship – identification with the other, with the result that the ego folds in on itself and the ego itself becomes its own persecutor and loneliness a permanent state of mind.
→ «Lacan: ‘The omnipotence is on the side of mother’»:
What is the key point that determines the choice of subject position between Paranoia and Manic – Depression? We would say that it concerns the child’s response to the ‘Omnipotence of the Mother’. Lacan has spoken of this dimension of omnipotence of the mother: «[…] the mother is primordially omnipotent […] all primordial imaginary objects are concentrated within the vast content of the maternal body […]. There they are indeed, since the mother constitutes a potential field of symbolic annihilation from which all future objects will each in turn take their symbolic value (Λακάν Ζ., 1956-57) […]. For omnipotence to produce a real depressing effect on the subject, he must also reflect on himself and confront his helplessness» (Λακάν Ζ., 1956-57), which is what happens during the Mirror Stage. The intensity of the subjective experience of this ‘Omnipotence’ – as Lacan characterized it – is perhaps the point where the subject succumbs to his depressive position. The person succumbs precisely to a position of captivity where identifications beyond the mother are obscured.
Specifically, in the first phase of the stage, the child may experience jubilance as a consequence of the imaginary identification of the ego with its image, but in the second phase, it may experience something like defeat when the moment when the interference of the real maternal body as an image comes as contrast with the helplessness of the child. It is there that the child will take a position against the omnipotence of the other and either escape from it or fall into a depressed or paranoid position.
From the mother’s side, her absence, her castration is necessary in order to give the necessary mental space to her child and the alternations of presence – absence contribute to this: «For every child it is essential to be able to experience both the presence of the mother as well as its absence. Without experiencing the alternation of the mother’s absence and presence, the presence can acquire persecutory characteristics and become suffocating, while the absence can cause depressive experiences and experiences of abandonment» (Recalcati M., 2015). That is, later in life, as Darian Leader writes: « […] another person is viewed as omnipotent, the source of all provision, and the slightest insult or frustration is magnified and turned into a feeling of rejection» (Leader D., 2013).
A child has to deal with all this during the Mirror Stage, with himself but also with the dimension of the Other, the mother, an Other who either helps him in his recognition or hinders him, either antagonizes him or it diminishes him, according to his fantasy. But the child’s fixed identifications will give the final course of the position in the structure of psychosis – Paranoia or Manic – Depression – as both sides of the imaginary mother-child pair should be taken into account.
The fixation on the object position of the mother leads the subject to a difficulty in creating new identifications. The new identifications would have the beneficial role of psychic rejuvenation and identity creation beyond the inbreeding duality pair. The subject here adopts, accepts his submission, as a kind of resignation, a resignation that later concerns life itself. Thus, the omnipotence of the mother shrinks the ego of the individual. This sense of imprisoned identity is a chronic sense of the depressed subject, where impasse is a permanent psychic experience and suicide seems to be the only way out.
→ «Manic – Depression is strictly a Drive Disorder – The vicious cycle of the Death Drive»:
In no other disorder are the effects of impulse dysregulation so evident. It is evident both in the symptoms that touch the body and in the person’s thinking, where the drive seeking only its satisfaction, without reaching an end, leads the person to self-destruction and to mental and physical exhaustion: «The manic person hasn’t the feeling of weariness, and the physical and mental hyperactivity can lead to severe physical exhaustion. It is evident in delusional mania or Bell’s mania, where due to the exhaustion of the patient from incessant hyperactivity before the introduction of the drugs, many of the cases ended in death» (Λεωτσάκου Χ., 2011). The manic – depressive subject goes through a vicious life cycle characterized by the alternation of the mania phase with the melancholia phase. In each phase, this person changes his mental position towards himself and the environment.
Their common characteristic, the one that unites the two positions in a common manic – depressive psychotic structure, is the dysregulation of the impulse, with the consequence that the individual becomes a slave to his own jouissance. That is, the subject becomes the target of the death drive in both the melancholic and mania phases. Mania and depression are two sides of the same coin as the site of the dual expression of the death drive. Lacan described these positions by defining the relationship of the individual to the mode of jouissance, that is, the object a, as follows:
- «Position of Melancholia – One side of the death drive»:
It is the ‘visible’, so to speak, side of the death drive. The subject is embodied by the object a. This means that the individual identifies with a, the jouissance of the Other, as he is unable to identify with the signifier of an Ideal. Thus the melancholic subject experiences his identity as zero, as the discarded object, as ‘I am nothing to the other’. Melancholic delusion reveals the relentless side of jouissance.
Lacan has stated that: «The ego ideal can, itself, become something corresponding to that which, in love, can give the full satisfaction of the will to be loved» (Lacan J., 1960-61). The absence of the Ego Ideal also brings the absence of the feeling of ‘being loved’ by the other. Here, it is the point of the sense of loneliness of the melancholic person. The main consequence of the absence of the Ego Ideal is that the object a does not function as a cause of the individual’s desire, thus binding the individual to an exclusive, solitary relationship with its jouissance.
→ «Suicide in psychotic melancholia – Identification with the rejected object»:
As I have mentioned in another text, the act of suicide is not exclusive to the psychotic person. A neurotic person may also do this following an ideal with which he has identified his own life and the sign of love.[6] The act of suicide for Lacan (1962-63) constitutes a passage à l’ acte (Lacan J., 1962-63), a passage from the symbolic to the real. This act is an impulsive act. The subject is identified with the object a and it is canceled as such. The subject thus takes the status of object a. With this action the subject completely withdraws from the scene of the Other as a solution to the emergence of his anxiety. Lacan’ s expression ‘se laisser tomber’ is precisely this ‘letting oneself fall’ on the stage.
«The melancholic person turns the deadly effect of language against himself, in the context of a suicidal act by which he fulfills his destiny as Κακόν» (Miller J.-A., 2008). Of course, melancholia can also be present in Neurosis, but it differs in its decisiveness, or in other words in its certainty, regarding the desire for death: «Undoubtedly the melancholic course is extended to the neurotic, whose desire is perhaps less determined» (Miller J.-A., 2008). While in Neurosis the symptom carries a message to the Other, in depression of the psychotic type the Other is absent: «As for the melancholic person, his sudden suicide, if it is not an appeal to the Other, not even to its absence, translates the violent transformation of the subjective absence of being in a» (Miller J.-A., 2008).
Lacan described the course of a melancholic subject committing suicide as follows:
«But the fact that it is an object a […] usually disguised behind the i(a) of narcissism and misrecognized as to its essence, which forces the melancholic to pass, if I may say so, through his own image and to attack it primarily so that it can touch, from within, the object a that transcends it, from which the command escapes – and whose fall will drag it into a hasty-suicide, with the automation, the mechanism, the character of necessity and deeply alienated way in which you know the suicides of melancholics happen. And they don’t do them in just any context. If this happens often from the window, if not, through the window, it is not random. It is the recourse to a structure which is none other than that of a fantasy» (Lacan J., 1962-63).
The melancholic person cannot touch the i(a), that is the ideal, and is faced with the object, becoming an object himself and not something that would occupy the position of an ideal. The fall of the object thus draws the melancholic into his own fall, as he follows that object.
In melancholia, the individual as he is penetrated by a, without the mediation of the demand, an ideal waiting for him to identify with it, ultimately identifies with the object a, as zero, where, being in a state of narcissistic self-contempt, he is led to become the being towards whom the aggression will be directed. The melancholic person attacks his own self by committing suicide, an act of urgent necessity for the individual’s Being. It is the manifestation of the individual as a ‘can’t help it’. This is precisely the image of the melancholic person that Lacan sketches, when he falls from the window, traversing his fantasy, the jouissance he derives from the object, penetrating it, unable to keep it at a safe distance, so that the demand of the other will find space for existence, but instead to ‘take it with him’ in the fall.
In melancholia, the individual passes through jouissance, as the image described by Lacan showed us, that is, through a and there it stops, there it is fixed and immobilized, it becomes a, so it stops both body and speech reaching at the stationary point zero where he ‘doesn’t want to know anything’.
→ «Example: ‘The Hours’ (book & film)»:
In the book (Cunningham M., 1998) – film ‘The Hours’ (2002, ‘The Hours’), we find an excellent example of different types of melancholia. Initially, we see the story of the writer [actress: Nicole Kidman] who, fighting a mental illness, living with hallucinations, reaches the decision of suicide. She thinks that she could continue to live, that she could do this last good deed, that is, it would be a good deed to live, which Lacan has noted regarding the moral error of suicide.
Then we see a melancholic mother [actress: Julianne Moore] who thinks that she could kill herself, leave this life… spending a few hours in a hotel room wanting to isolate herself. When this moment finally passes, when the desire to die penetrated her but finally did not stop and passed her by, with thought that such a thing would be criminal, for her husband, for her child, for the child she is carrying, something that it would be morally wrong, as we noted above, so she leaves the hotel and returns to pick up her son from the neighbor’s house where she left him.
In the extraordinary scene that follows, from a psychological point of view, the drama that will accompany the life of this child unfolds. The child longing for his mother runs to her, but she is still trying to get back on track and the child realizes something… The mother’s gaze meets her child’s gaze and for the first time she cannot understand this new indefinite gaze. We will see later that it was precisely the decisive moment when the child perceived another kind of distance of his mother from him. It is also the moment when the mother cannot understand her son’s gaze. It is from that moment onward that the son, as he grows up, will internally experience the answer to every child’s question about his parent: «can she lose me?». At that moment, this question was answered in the affirmative. This answer he gave himself, that yes, «my mother can lose me», she wanted to leave life, from a life she would live with him… Let us remember here also Lacan’ s position on children who were not desired by their mother and the tendency they have towards death (Lacan J., 1957-58). At the same time, however, the child’s structure will determine the response he will give to this experience.
So the mother with a less determined desire for death, that is, melancholia of a neurotic structure, overcomes death, while her child, experiencing himself as unwanted by his mother, will later take this position of garbage, of no-thing for the other, a position that structurally, impulsively he will not be able to change, but will kill himself by falling from the window of his house. He thus throws himself out of the window as an object, taking with him the answer of his existence with all this experience with which he identified, unable to find other imaginary identifications that would act as a thread of connection with life. This is also shown by his lack of interest in his prize, where the ideal is absent, a prize for which his friend will make a party, but he himself cannot place himself in a social bond, he feels alone and detached.
→ «The Language of Melancholy – The moral error’s side»:
The ‘I don’t want to know anything’, the immovable position, as characterized by Lacan, which also governs the suicidal act, leads to mental stagnation, to the ‘I want to die’ of the melancholic person. «Suicide is the only act that can succeed without going through failure. […] this means that this act results from the immovable position: ‘to know nothing’» (Lacan J., 1974). Here lies for Lacan the moral error of melancholia, as he describes sadness as an ethical error that goes against the ‘well-said’ of each structure. To sadness as the moral error of ‘not wanting to know anything’, as the desire for ignorance, for death, as the moral cowardice that opposes the task of structure, Lacan contrasts joyful knowledge as virtue, as ‘well-said’: «Sadness, for example, we describe it as depression by supporting the view of a soul […]. But it is not a state of the soul, it is simply a moral error, as Dante and indeed Spinoza expressed it: a sin, which means a moral cowardice, which is ultimately only placed in thought, that is, in the duty of ‘well said’, or by ‘coping with’ with the unconscious, within the structure» (Lacan J., 1974). In essence, as Lacan states, emotion depends on the structure of the individual, that is, how it is positioned within language.
- «Position of Mania – the other side of the death drive»:
It is the ‘invisible’, so to speak, side of the death drive. For the manic subject, as is also the case for the melancholic psychotic type, jouissance is dysregulated, that is, object a does not function as a cause of desire: «[…] what we call mania in the psychiatric clinic corresponds to the case when object a does not function, that is, to a case of logical incoherence, and goes with the perceived non-existence of the Other – since it is a declaration that is not posited as truth» (Miller J.-A., 2008). The maniac’s body thus becomes the tool through which the jouissance flows without stopping, without feeling tired, without rest.
→ «The Language of Mania – The metonymic side of Mania»:
The jouissance in mania is without end, without stop. The manic subject becomes an object of the jouissance of language, not delimited by any period, any punctuation. It is an unstoppable metonymic process: «In mania, let us immediately clarify that what we are talking about is the non-functioning of a and not just its misrecognition. The subject is not stopped by any a, a fact that leaves it, sometimes without any possibility of freedom, in a pure metonymy, the endless and playful, of the signifying chain» (Lacan J., 1962-63). The words thus flow in the river of non-meaning of language and the manic person enjoys simply speaking. Miller pointed out: «In mania we have an accelerated death drive […] because of the heightened jouissance derived from language» (Miller J.-A., 2008).
→ «Absence of identification with the ideal I(a) – Chasing the object»:
In mania, there is no relation of the individual to any ideal, he is not supported by any ideal, but exalts himself, with the consequence of the usual megalomaniacal tendency manifested in his beliefs.
In mania, the person follows jouissance, follows the a, does not stop even as a body, so the body is in constant motion, but also not as speech, so his speech is non-stop, consequently the physical and mental exhaustion. The ego of the manic person is ‘wasted’ in a constant movement of the psyche, in a search for an object. The ego of the manic person shrinks annihilates itself into the object of the impulsive waste. He thus reaches the zero point of his existence.
→ «Example: The symptom of gambling»:
«[…] the maniac enjoys at least two hundred thousand francs» (Miller J.-A., 2008). With this image we can approach the symptom of gambling when it touches the manic subject. Gambling can bring out the dark side of mania. The ‘all or nothing’ gambler is essentially chasing the pleasure of nothingness, of zero, staying ‘on the ace’. With this nothingness it has been identified as an object that enjoys its own condemnation. It is this zero that takes on a positive sign, according to Lacan, as it ‘positivizes’ the death drive, that is, jouissance for further jouissance.
There is no end for a maniac except by perpetuating the cycle of impulses. For the gambler, who gambles furiously, this end can be reached when he loses everything.
Then begins either in the pessimistic scenario the new game cycle or in the optimistic scenario his freedom, as the movie ‘The Gambler’ (2014) [actor: Mark Wahlberg] very nicely presented us where zero for the protagonist marked the beginning of his freedom, for a new different life. So in the movie, the grandfather asks the protagonist if he is any ‘worth’ as a person in case he leaves him no money and the protagonist answers that he will do ‘everything’ he can and he really did. He then began a path of ‘all or nothing’, where ‘everything’ is essentially a life as he wishes it or ‘nothing’ is a «better to die» situation as he characteristically tells his girlfriend. His value as a human being cannot be measured by money, just as neither life nor the relationship with the mother can be measured. A mother who does not answer the question about his father, how she ‘got rid’ of him, but the protagonist also wishes to ‘get rid’ of his mother, while at the same time he throws away the bag of money, giving the image of mother-money identification, thus annihilating their relationship.
Let’s focus in particular on the following answer of the protagonist to his girlfriend about his own solution to his problem, that he must start over without a past… Here is the essence of all this behavior towards zero, here we have a nice picture of man’s attempt to free himself from the symptom of the past and start again from zero, with zero dependencies on the other but this is now no longer a choice of his zero of existence, it is not ‘I deserve nothing’ but instead it is ‘I deserve as existence’. He thus chose life, not the bag (!), a life ‘without a cent’ but as he desires it, this is precisely the price of neurosis: the path of desire needs to pass that of enjoying the symptom, to put an end to it. And this position, the position of his desire, is the position from which he can say ‘f*ck you!’. Of course, we are not dealing with psychosis here, but I quote this film here as an example of the nature of the drive, which never stops anywhere unless the person is able to put a stop to it. Whether he can put a full stop has to do with his mental structure.
An excellent film, I would say, that gives us a very good picture of what it means to impulsively enjoy the symptom, a symptom that is tied to the person’s history and that person by his own choice can reverse his fate. But a choice within the context of each structure, as the symptom of gambling differs if it is framed by the neurotic or the psychotic structure. Neurosis has on its side desire while psychosis has impulsive jouissance, which in turn is characterized by impulsive waste on the part of the individual.
Specifically, in psychosis, the gambler identifies with the identity of the gambler, with the very object of his jouissance, the ‘gambling’, he cannot thus stop, put an end to the game, that is, he identifies his very life with the game so impulsive waste prevails. In neurosis, on the other hand, the person with the gambling symptom can keep a distance from the gambling object, the object of his drive, and stop in favor of some other ideal with which he can identify: the protagonist of the film says about himself that he is not truly a gambler precisely because his existence stopped being wasted on nothing…
→ Manic depression as a ‘search for an identity’:
We would therefore say that in Manic depression the imaginary relationship with the other is more unstable, as a consequence of the inability to identify and the autonomy of the death drive. This in turn leads the person to turn towards himself and to the feeling of loneliness. Identification with the object ‘nothing’ leads him to an unsustainable identity, to an ‘I am nothing’. Suicide thus comes as a result of this sense of self as ‘nothing, zero’.
→ Paranoia & Manic – Depression as ‘The Pendulum of the Psyche’:
During the Mirror Stage the individual’s ego is structured. If the person gets trapped in it and cannot, with the assistance of the other, pass to the Symbolic, that is neurosis, psychosis will develop. Psychosis, at this stage, has passed fixation in the stage preceding the Mirror Stage, where schizophrenia can take place, and faces two roads: either the road of paranoia or that of manic – depression. Here the psyche resembles a pendulum: where will the subject stand? The person will respond defensively with the fantasy that will be structured within the stage, where he will answer the question ‘what am I for the other?’, he will take a position either by distancing himself from the other, who will, however, henceforth have a persecutory character, that is in paranoia, as ‘I am the object of jouissance of the evil other’, or folded in on himself, that is in manic depression, as ‘I am nothing to the other’.
But these two positions have something in common: they are ‘related’ to delusional thinking. This is because the time period in which they were formed is common, thus governed by common rules, those of the Mirror Stage: imaginary identifications and relationships, narcissistic aggression (of self and others) and the search for identity. Delusion can therefore appear equally in both of these psychoses, an element that was also given by Lacan in his doctoral thesis on paranoia (Lacan J., 1932). Paranoia and Manic – Depression have a common root: fixation in the narcissistic Mirror Stage. Moreover, we see that the delusion in paranoia is more evident than that of manic-depression, but this does not mean that it does not exist: «It is a kind of annihilation, micromania, which is the opposite of megalomania» (Λακάν Ζ., 1956-57).
However, their subsequent course, as we saw in the texts, the symptomatology, the resulting defense is different: like a pendulum that points in one direction at one moment and another direction at the next, so does the subject, depending on the position he is in, his mental reality and the direction of his impulse is filtered differently, only here the moment concerns an entire life.
2.Lacanian Psychoanalysis for Manic – Depressive Psychosis… Why?
→ «On the one hand, the limit is identification and on the other, language»:
The limit to the endless demand of jouissance would be an identification, but this is missing here. «Its limit is clearly what we call identification» (Λακάν Ζ., 1964). Furthermore, Miller points out: “The reference to mania remains important because it shows us something like an acceleration of the death drive, with unbridled jouissance. Why is this jouissance without a limit? What would be the limit? The limit is simply grammar […]. It is mainly about the meaning […]. The shield of meaning or better of meanings. Let us say that meaning effects introduce a measure of mildness into our relationship with language» (Miller J.-A., 2008). So language, so to speak, mirrors the mental structure. Just as the neologism, a new language, the holophrase, concerns psychotic speech, just as a slip of language concerns the neurotic subject when it reveals an unconscious thought, so we can perceive the language of the manic-depressive person in which way it reflects his position in his mental structure.
→ «The shield of meaning»:
So, on the one hand, identification is the limit and on the other is language, meaning, significance. Specifically, identification here refers to imaginary identification in the absence of the symbolic in a psychotic structure. It is important for the manic – depressive person to stand in an imaginary identification, and this can happen by finding there a meaning for himself. A kind of meaning that can lead to some kind of quest for knowledge to bypass the path of ‘I don’t want to know anything’. Thus, this identification, even though it is unstable, that is, without the strong bond of the symbolic, can play the role of punctuation needed to resist the slippage of language and by extension the imaginative bond needed in life against the infinite death drive. This is the point we refer to when we say ‘let’s not shake the identifications of the psychotic’ because these may be exactly what keep him alive…
Psychosis has always been considered a complex issue both theoretically and practically for the entire field of mental health. The combination of medication and psychotherapy now aims to improve the quality of life of the mentally ill. Lacanian Psychoanalysis has contributed both on a theoretical level – with the study for the causes and interpretations of mental illness – and on a practical level – with its own direction of treatment.
→ «Joyful knowledge»:
Lacanian Psychoanalysis is primarily concerned with the transference relationship that develops between analyst and analysand. The manic-depressive person through his relationship with the analyst will try to find his ‘own place of speaking’ and above all a relationship with the other where the relationship itself will be a place of connection with life.
The search for a new identity that will lead the person’s thinking to paths beyond zero, to a happier knowledge, to a knowledge that will lie in the decoding of the unconscious and will thus constitute an effort for a different way of life. The meaning can become a thread that will connect the analyst with the analysand to life itself is the main concern to avoid unhappy ‘passage à l’ acte’.
From Psychosis… to Perversion and Neurosis
In closing this analysis of the three chapters on psychosis let us summarize (see also Appendix B):
- Fixation in the Mirror Stage leads to psychosis and the ‘search for identity’ leads to an equally fixed answer of certainty to the question of existence ‘what am I for the other’. This is also the reason why we see how difficult changes are for a psychotic person compared to a neurotic.
- In psychosis, the Ego identity is fragile, unstable, vulnerable, and needs imaginary props to play the role of the missing symbolic Ego Ideal.
- Each person has his own defense, according to his mental structure. For the psychotic, defense is his delusion. For the neurotic, the defense is his fantasy… In any case, let’s keep in mind that: «Objective reality exists only through subjective reality» (Καγγελάρης Φ., 1988).
For the neurotic person, the question of his identity leads him down different paths, which we will see in subsequent texts.
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Bibliography
- DSM-5 (2013), Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 5th edition, American Psychiatric Publishing.
- Evans D. (1996), «Εισαγωγικό λεξικό της Λακανικής Ψυχανάλυσης», μτφ. Γ. Σταυρακάκης, Ελληνικά Γράμματα, Αθήνα, 2005.
- Fink B. (1997), «Κλινική Εισαγωγή στη Λακανική Ψυχανάλυση: Θεωρία και Τεχνική», μτφ. Ν. Ηλιάδης, Πλέθρον, Αθήνα, 2006.
- Καγγελάρης Φ. (1988) «Η διαδικασία της αποπροσωποποίησης στη σχιζοφρένεια», εκδ. Καστανιώτη, ΑΘΗΝΑ.
- Κουμίδη Ε., «Ομαδική Αυτοκτονία, η περίπτωση της σέκταςHeaven’s Gate» στο wwelenikoumidi.gr
- Koumidi H., «Lacanian Psychoanalysis & Psychosis – 2. Paranoia», https://www.elenikoumidi.gr/lacanian-psychoanalysis-psychosis-2-paranoia/
- Koumidi H., «Lacanian Psychoanalysis & Psychosis – 1. Schizophrenia», https://www.elenikoumidi.gr/lacanian-psychoanalysis-psychosis-1-schizophrenia/
- Λακάν Ζ. (1955-1956), «Οι ψυχώσεις», μτφ. Ρ. Χριστοπούλου, Β. Σκολίδης, Ψυχογιός, Αθήνα, 2005.
- Λακάν Ζ. (1956-57), Σεμινάριο Τέταρτο, «Η σχέση αντικειμένου», μτφ. Ανθή Αθανασιάδου, Νινέττα Δυοβουνιώτου, Βλάσης Σκολίδης, Ρούλη Χριστοπούλου, Ψυχογιός, Αθήνα, 2021.
- Λακάν Ζ. (1964) Το Σεμινάριο, βιβλίο ΧΙ, «Οι τέσσερις θεμελιακές έννοιες της ψυχανάλυσης», μτφ. Α. Σκαρπαλέζου, ΡΑΠΠΑ, Αθήνα, 1982.
- Lacan J. (1932), «De la psychose paranoïaque dans ses rapports avec la personnalité», Έditions du Seuil, Paris, 1975.
- Lacan (1957-58), Le Séminaire, livre V, Les formations de l’ inconscient, Seuil, Παρίσι 1998.
- Lacan J. (1962-63), Le Séminaire, livre Χ, L’ angoisse, Seuil, Παρίσι 2004.
- Lacan J. (1974), Autres écrits, «Télévision», Έditions du Seuil, Paris, 2001.
- Leader D. (2013), «Strictly Bipolar: Δοκίμιο πάνω στη διπολική διαταραχή», μτφ. Μιχάλης Μεντίνης, OPOSITO, Αθήνα, 2022.
- Λεωτσάκου Χ. (2011), «Διπολική Διαταραχή», στο περιοδικό Τετράδια Ψυχιατρικής, τεύχος 113, Αθήνα, 2011.
- Miller J. – A., «Λακανική κλινική των ψυχώσεων», μτφ. Γ. Αρχαύλης, Δ. Βεργέτης, Β. Γρηγοροπούλου, Ε. Lefeuvre, Ν. Περτέση, Γ. Φουντουλάκη, Πατάκη, Αθήνα, 2008.
- «Mental disorders» in https://www.who.int/news-room/fact-sheets/detail/mental-disorders
- Ουλής Π. (2006), «Εγχειρίδιο κλινικής ψυχοπαθολογίας», ΒΗΤΑ, ΑΘΗΝΑ.
- Recalcati M. (2015), «Τα χέρια της μητέρας», μτφ. Χρήστος Πονηρός, Κέλευθος, 2017.
[1] https://www.elenikoumidi.gr/lacanian-psychoanalysis-psychosis-1-schizophrenia/
[2] https://www.elenikoumidi.gr/lacanian-psychoanalysis-psychosis-2-paranoia/
[3] «Mental disorders» in https://www.who.int/news-room/fact-sheets/detail/mental-disorders
[4]«Suicide Risk in Bipolar Disorder: A Brief Review» in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723289/
[5] See Appendix Α.
[6]Ελένη Κουμίδη, «Ομαδική Αυτοκτονία, η περίπτωση της σέκτας Heaven’s Gate».
APPENDIX A
APPENDIX B