From Freudian Symptoms to Lacanian Sinthom #1

What is a psycho-analytical symptom?

What do we mean by psycho-analytical symptom or symptom in a psychoanalytical sense? To try to answer this question I followed a considerable number of criteria, the criteria which are usually ascribed to symptoms or the ones used to draw the distinction between symptoms in a psycho-analytical sense and, for example, the symptoms in medical or social sense. Our objective is to highlight a number of ambiguities and the relative or obscure aspects of some of these distinctions.

Here are a few examples of the numerous questions which are asked: what does the description of symptom’s subjective refer to? What is the symbolization or symptomatization which is traditionally linked to the use of the symptom? What is the status of the desire, the signifier and the sense inside the symptom? What is the symptom’s destiny in the transference and in the process of cure? Let us first take a symptom from its most general sense, in its role which can be called social before gradually arriving at what would be its definition and its role within the psycho-analysis.

1) The symptom is a message and a symbolic construction at all times.

This implies that it is addressed to the Other. Generally, this is worthwhile even in medicine. In fact, medical semiology can only be regarded as a vast dictionary of translation used by the one who receives the message – symptoms on the subject identified as sick. Without this enormous corpus inherited from the entire medical history and governed by very precise linguistic rules, no complaint, pain or malaise could be interpreted by doctors. Therefore, it can be realized that a symptom is a symbolic construction even in medicine. It is a determinant for a complaint or bodily signal according to the specific information and theoretical references within the medical science.

In fact, although the interest of medicine is to focus on the real, it spends much of its time ignoring this real which nonetheless gives it a signal. The recent evolutions and the more and more technical side of the medical circles are not going in the different direction. The aim is to construct a new artificial object which is more manageable and hassle-free than this living and speaking body which offers itself to bistouries.

In other traditions such as the Western Medicine there are other kinds of translation dictionaries used. They interpret in a different manner and give different meanings to the complaint and the suffering. But they play the same fundamental role i.e. to insert by always forcing, at a possible risk, the complaint’s real into the symbolic universe which is full of meaning. 90% of the world populations does not refer to the biomedical universe (scientific/scientist), but to a kind of universe full of invisible entities. Too often we pick up the indigent word “magico-religious”, whereby the distinction between an illness, misfortune and pain does not exist. This event that befalls you and hurts you is associated with a set of forces and external agents around the subject who complain. It could be witchcrafts, supernatural spirits, being possessed or a destiny which could be a divine punishment.

Seen from this angle, the Western Medicine, medical-technology or traditional medicines and divination techniques are strictly equivalent. They symbolise the real (what befalls you) and suggest an acceptable sense to the event in the eyes of both the subject and his/her relatives. And this is the first step of the entire therapy.

Scientific and technical fine-tuning which enables our Western Medicine to treat and heal a considerable number of diseases from which we die, does not make any fundamental difference under certain conditions. This means that they do not change anything to the principle of symbolisation of the real itself. Furthermore, if we look at things with hindsight, the western medical technological progress does not prove its superiority over traditional techniques in an obvious manner. We have to think of all its derived, secondary and harmful effects, such as iatrogenic pathologies, nosocomial diseases (hospital-acquired infections) medicinal addictions and more generally a noticeable weakness with regard to the first signs of the illnesses which result from intra-psychological or relational conflicts, etc.

From there, two questions transpire.

1) If the entire symptom is a product of a symbolic translation referred to by a specific cultural code of whatever kind, we must admit that all the subjects addressing their complaints to the Other presuppose that this Other has the keys of the code. As a result, the way in which this complaint is going to be expressed already includes an effort of translation which is equivalent to an effort of making oneself heard or understood by this Other. In principle, this is why it is impossible to neglect what we call a symptom which shall be a remarkable or subjective dimension belonging to the complaining individual and a social dimension borrowed from the Other’s speech. Therefore, what needs to be clarified is firstly the relationship between the symptom and the social such as speech.

The second question emanates from this observation. If the entire Symptom is already a symbolic construction addressed to the Other and that it means something to this Qther, therefore, what is this psycho-analytical symptom called? What is the symbolisation of the an illness which would be specific to the psycho-analytical operation? What is the symbolisation? What is it that will distinguish psycho-analytical symptom from the medical or traditional symptom?

2°) Constituting the symptom inside the other

If we accept the foregoing, therefore the entire symptom is immediately formed inside the Other, by at least speaking to the Other and in an effort of recognition that involves the use of signifiers of the Other.

Although there are always two combined sources to the symptoms, that is, this element of the real which makes some sense and an offer of the preliminary proposed sense or rather imposed by the Other, it is worth-realising that the symptom’s expression is first restrained by this limited register made up by the symbolic code, that is, the pool of available signifiers which refers to a culture. While some will relate their symptoms to the Djinns and Ancestral Spirits, others will draw from Marie-Claire’s Health Science, Television Programmes or the latest Lucien Israel’s Book, etc.

But it is worth-going further, because this offer is not neutral or passive. It works like a real demand addressed to the suffering subject.

When a human being is affected by misfortune, pain or an illness, given that he/she is also a social being, he/she has to match his/her problem and demand to what is expected of him/her. This is why symptoms evolve according to the historical and geographical context and according to the social status of the addressees. This phenomenon was fully described through the hysterical symptoms with pseudo-epileptic hysteria crisis example which was given a neurological look from the 19th century. It can, however, perfectly be generalised. The signifiers which henceforth most often carry the complaint and demand are borrowed from the depression register, traumatism, obsessive compulsive disorders “O.C.D”, and other entities in use.

But it is worth making some extra conclusions to avoid attributing the responsibility of the form it gives to its initial demand and to the subject itself and, or even worse, to put on the account of a change of the subjectivity in general, or “psychological economy” which would govern the observable variations of these demand to the modern human being. We can give several examples in support of this evolution.

Thus, it is a less disputable fact that the increasingly numerous demands borrow their formulation from the claim register. We spot the idea of a right to compensation and the hope that repairing the injury is going heal up the symptom. This can be quite shocking if the misfortune in question is the death of someone closer, the birth of a handicapped child, results of a natural catastrophe or an accident that befell a person of which nobody is responsible. But where does this construction come from? An evolution of the subjectivity in the sense of taking away the responsibility or rather an evolution of social speech and the judicial arsenal which is increasingly dominated by reference to the law-and-order, preventing any risk, and the inflation of the figure of the victim? Who is responsible? The complainant subjects themselves or the public offer made to them to treat their misfortunes on a mode of legal repair?

Another example is that we quite quickly denounce the aesthetic surgery or artificial procreations demands by attributing a kind of perversion to the individuals who choose it or we accuse them of pleasing in forbidden acts of immorality. However, these demands are firstly induced by the new techniques proposed to the public which make up a profitable market, and by the legal system accompanying them. The medical institution in some leading technical fields such as Artificial Insemination with donor even elaborate a sham and a specific legal fiction to justify the maintenance of donor’s anonymity and the internal failure of the Artificial Insemination Donor device to detect that it assigns paternity to a sterile male. The possible problems that can arise later for this male or his children or their mother tend to be attributed to the character’s psychology instead of the secret and the sham instituted by the law and it is never questioned as it is.

Faced with this induced dimension of the demand and the symptom, the psycho-analytical process can only be conceived for what it is likely to find or to draw the distinction between the consistant, requested and expected formulation and subject enunciation. The first-class psycho-analytical intervention is the one that identifies what is irrelevant between the interpretation which is supposed to be true by a patient concerning his symptom and the reality that obtains.

This first feature of the symptom as constituted in the Other can be generalised, whatever the meaning given to this Other.

- The big Other of the code :
- The little Other of the couple or the family without which most of the symptoms are incomprehensible. From the frigidity addressed to a particular partner, to the agoraphobia which necessarily includes the company’s contra-phobic role, or to a suicide attempt which is addressed to one’s relatives, etc. Without this Other, the symptom no longer has the reason for being.

- The Other is going to be made up by the psychoanalyst whose action shall consist in offering itself as a symptom’s address to gradually reduce this Other’s consistency in order to make it understood that the other possible recipient of the massage is the subject himself.
- and it is this “Other scene” represented by the unconscious on which the symptom as message is going to appear as a question that the subject asks himself from a knowledge that he ignores.

Lacan would have said that the symptom always has a footing inside the Other.

3°) What “symptoms” in the absence of Other?

There are cases in which a symptom is not built inside the Other in this manner. In such cases, maybe we should find another word to designate the symptom in order to avoid assimilating it to neurotic or analytical symptoms.

Sometimes the symptom cannot be built up in this manner because the Other is absent i.e. there is neither one nor the other.

It may happen that they had never existed, because the field of the other was not built up at the earliest stages of the subject structuring, that is, putting in place the third party and the imaginary at the mirror stage. This is the paradigmatic case of autism or certain forms of schizophrenia, especially paranoid schizophrenia, in the course of which it can be realised that hermetism and incommunicability of symptoms such as delirium, hallucinations and interpretation show difficulty to be communicated to the Other. In some situations, there is neither code nor interpreter to translate or interpretat the real. The Real directly makes sense or signal. The real talks on its own. The word equals the thing . There is a kind of continuity between the real and the symbolic without the intervention of the imaginary. Lacan figured the symptom as a kind of small patch separating the real and the symbolic in some topological sketches.

Maybe it no longer exists, this is to say that the Other has fallen down or has left. This is a traumatic neuroses case which is characterised by this sentiment found in “trauma subjects”, of not belonging to the universe of the living, being dead-alive, disaffiliated, abandoned and without any symbolic attachment which makes sense. The Other is no longer there to enunciate this initial demand necessary for the establishment all the subject, the need to exist and the belief to exist. This is why traumatic neuroses symptoms and especially repetition syndrome have nothing to do with the transference neuroses symptoms or the symptom as message derived from the Other. The nightmarish symptoms that we encounter are rather empty calls, emanating from beyond the grave.

Question : Is symptom a message transmitted to the Other in paranoia? In this case the difficult thing is that unlike in the case of schizophrenia, the Other exists i.e. maintenance of imaginary to similar relationship. However, this Other or this imaginary image is an object of an erotic passion or an object full of hatred which prohibits any mobility between the different plans and any translation of the message which would open to a series of meanings (univocal meaning of persecution).

4°) The Symptom in Psycho-analytical Context

From this very general definition of symptom as a message communicated to and built inside the Other, the efforts to surround its meaning and its psycho-analytical scope shall operate by a series of reductions which are, in the strict sense of the word, only valid to a specific framework of psycho-analysis i.e. contact with another person who is a psychoanalyst.

The first reduction to operate is the one that with start with the different meanings of the Other (the big Other of the code, the little Other of the similar relation, etc) then focus on the precise role of this Other who is a psychoanalyst. Without this operation created by the artifice of a particular meeting, it seems wrong to talk about the presence or absence of the psycho-analytical symptoms in a person. At best, it is in the aftermath of this meeting that the symptoms and the initial terms of the demand could appear to be fulfilling a particular role in relation to the unconscious.

Although all the symptoms are messages, they only acquire their role in the eyes of the unconscious on condition that they are received by the listener who will allow the recognition of the operating unconscious in their formation.

This implies that the distinction between neurotic or non neurotic symptom, between analytical and non analytical symptom, does not so much depend on the preliminary structure which will be easy to diagnose or to predict (this is what in a strict sense of the word, the psychoanalysis is once again unable to do), but it depends on the possibility or impossibility that the symptom is recognised by the subject as its own massage communicated from another place which is however, itself.

In other words, a symptom in a psycho-analytical sense never precedes sharing with the analyst. Adopting this point of view, already means showing resistance to the sense whereby Lacan put it in the discretion of the psychoanalyst because the absence of a dully standard symptom could lead to a contra-indication of the analysis.

A symptom is the possible construction of the analysis, that is, there is no guarantee. The limits of this construction consist, on the one hand, of resistances from the subject of demand as well as the analyst and on the other hand, it consists of the impossibilities of which there is a need to specify the reasons for not folding up too quickly on the existence of a defect, a deficit or the personality’s lack of maturity. [source: http://www.psf-en.com/spip.php?article19]