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L C NI N PR XIS

I N T E R N A T I O N A L Q U A R T E R LY O F A P P L I E D P S Y C H O A N A LY S I S Number , May

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Editorial: The Battle of Psychoanalysis in the Twenty-first Century Pierre-Gilles Guguen

Lacanian Politics
A Fantasy Jacques-Alain Miller On the False Usefulness of Anxiety and the Benefits of Working Through It Franois Leguil Toward a New Psychoanalytic Clinical Practice Marie-Hlne Brousse

Can Subjectivity Be Buried?


The Ministers Discourse Philippe Douste-Blazy The Philosophers Discourse Bernard-Henri Lvy Banking on the subject Miquel Bassols The Return of the Dangerous Classes Jean-Claude Milner How We Inform the People Eric Laurent Portrait of Freud as Behaviorist Agns Aflalo

Contents L C NI N PR XIS

NUMBER 1, MAY 2005

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INTERNATIONAL QUARTERLY OF APPLIED PSYCHOANALYSIS

Editorial: Pierre-Gilles Guguen The Battle of Psychoanalysis in the Twenty-first Century

Lacanian Politics
Director of the publication: Alexandre Stevens Scientific advisors: Jacques-Alain Miller & Eric Laurent Editor: Pierre-Gilles Gugen Coordinator: Francesca Pollock Translators: Thelma Sowley Francesca Pollock Vivian Rehberg Sylvia Winter B. W. Cann Treasurer: Patricia Johansson-Rosen Design and production: Sylvia Winter

Jacques-Alain Miller A Fantasy Franois Leguil On the False Usefulness of Anxiety and the Benefits of Working Through It Marie-Hlne Brousse

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Toward a New Psychoanalytic Clinical Practice

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Can Subjectivity Be Buried?


Philippe Douste-Blazy The Ministers Discourse Bernard-Henri Lvy The Philosophers Discourse Miquel Bassols Banking on the subject Jean-Claude Milner The Return of the Dangerous Classes Eric Laurent How We Inform the People 30

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Agns Aflalo Portrait of Freud as Behaviorist

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soon on the web at

www-mental-nls.com

EDITORIAL

The Battle of Psychoanalysis in the Twenty-first Century


Pierre-Gilles Guguen

For a while now, and in many fields, discontent has been growing in the Anglo-Saxon world concerning the weight of evaluation procedures and the management-oriented quantification of all our activities, a protest that is not always clearly targeted but is often felt. The market seems to dictate its law to all human activity, its technique to all modes of thinking, and the supposed necessity for transparency becomes a tyranny that leads to the conformity of all modes of jouissance, even within the accepted frontiers of communities. The power of quantification and the search for objectivation is such that many in the AngloSaxon world wonder today whether this does not indicate the death of subjectivity. In recent months, while the movement of the Forums launched by Jacques-Alain Miller in France has been able to mobilize enlightened opinion, signs have come from the United States or from England that we can interpret as disparate testimonies of a revolt against the totalitarianism of the audit culture and the erroneous application of statistical tools to the most intimate aspects of our lives and of our civilization. The time seems right for banking anew on the subject, on his/her responsibility towards what is irreducible in his/her specificity. Many signs in that quest for renewal stand out and make what has gone before and sometimes quite recently seem almost caricatural. For example, a serious article published in the science section of The New York Times (March 22, 2005) recounts the attempts made by some doctors professors from prestigious universities to lobby for the recognition by the DSM of a new category: the body-integrity identity-disorder or B.I.I.D. This disorder, rare for the moment, consists in attempting to have surgically removed a healthy member that has become unbearable for the subject. It is about really removing from the body an excess jouissance that cannot be resorbed in any other way. This disorder, constructed on the basis of a few cases, raises for the journalist and the doctors the ethical question: should one operate or not? The answers vary: some say we should, based on the example of transsexuals requesting a sex change, whereas others consider that the demand should be deferred with medication and/or a form of behavioral therapy called response prevention and thought-stopping therapy, intended to block the patients worrisome thoughts. This outrageous example shows not only the disastrous extent to which the DSM can go: no one thinks of analyzing this type of demand in the context of psychosis and even less of hysteria (a category which has been taken out of the Manual). The subjects demand is taken literally and his/her desire may go unquestioned. Beyond the ridiculousness of such a classification, we can see how the ethical questions and responses are biased because they are solidly linked to the way mental illness is conceived. In this example, the patients subjectivity is annulled either because the explicit demand of the individual is answered immediately, or it is ignored and combated with a treatment that reforms and forbids by attempting to block thoughts. Besides the fact that we may doubt that these thoughts can be blocked (most especially if they are psychotic certitudes), we see here to what extent the person in question is, as Marcuse said, a OneDimensional Man. This New York Times article is never critical, which implies that the vast majority of its readers is in agree1

Pierre-Gilles Guguen: Editorial

ment with this very widespread mode of thinking, and tends to make one imagine it is worthy of appearing in the science section of a respectable newspaper. There is, however, a different current of thought being expressed, most especially about psychiatry and the DSM (Alix Spiegel, The Book of Disorders, The New Yorker, January 2005). This long and informed article talks about Robert Spitzer, the one man who revolutionized psychiatry. It shows the marketing methods with which his Manual was launched. It describes the standardization and the transformation of qualitative categories into quantitative scales. It describes the unavoidable manipulations in this type of procedure and the considerable loss involved, leaving a space for discretionary opinions given by the experts (among them Spitzer himself). These decisions or personal influences always appear in the Manual anonymously. Finally, the interest of this long article is to show that the DSM, created to eliminate the psychiatrists subjectivity in his/her diagnoses, does not manage to satisfy the Manuals own scientific criteria the same criteria as those of psycho-technical tests: reliability, the ability to produce a consistent, replicable result, and validity which includes the temporal dimension. Spitzer (one of his colleagues called him an idiot savant) wanted to make it possible for psychiatrists, when faced with the same phenomenon (we would rather say and the reduction is important faced with the same information), to come to the same conclusion whether they are in California or New York. Despite the success of the DSM, which is supposed to render the greatest service to insurance companies, courts, social services, schools, etc. (it has already been adopted as a reference by these institutions for calculating profitability), Spiegel shows that the central problem that is, reliability has not been solved. We are therefore equipped with a dictionary of disorders that manages to destroy past clinical practices but whose value is questionable. Equally, from British universities, we can hear very strong criticism of the devastation wreaked by the audit culture. A professor of social anthropology at Cambridge, Marilyn Strathern, denounces the tyranny of transparency1. The British university system, whose reputation is excellent, has had to undergo the forced evaluation of the culture it has promoted, leaning on a secular tradition in order to respond to management and pedagogical criteria of immediate profitability. Two authors in particular, themselves scholars and anthropologists, Chris Shore and Susan Wright2, report the deleterious effects of the quality assessment approach: The new audit technologies are typically framed in terms of quality, accountability, and empowerment, as though they were emancipatory and self-actualizing [. . .] while [. . .] these processes beckon a new form of coercive and authoritarian governmentality. The authors show, based on a case study, how these practices break down the traditional social link with the university; how they lead to the separation of research from teaching and an increase in administrative tasks; and how they overlook the fact that teaching on a university level is not equivalent to force-feeding information for immediate use. We would say, in psychoanalytical terms, that these technological tools demolish all transference the cement of the social link as well as support for the desire to know. In the place of transference there appears a vile calculation of what will please the Master, even if this farce is only there to mask the ritualized moment of evaluation. It is obvious every time that it is the subject who is targeted through these procedures. He/she is replaced by an archetype of the anonymous and mediocre user, consumer of health and culture. This is an issue that is also very present in North American philosophy, in the mind-consciousness debate. John Searle is one
_________________________________________________________________________________________________ 1 M. Strathern, The tyranny of transparency, British Educational Research Journal, 26, (3), 2000. 2 C. Shore, & S. Wright, Audit Culture and Anthropology, Neo-Liberalism in British Higher Education, The Journal of the
Royal Anthropological Institute, 5, (4), December 1999.

Pierre-Gilles Guguen: Editorial

of its tireless protagonists: sometimes he defends the subject of conscience against the tenants of a reduction of the mind to an information system (much like Richard Dennett), sometimes he is against those who are passionate about the biological naturalism of neurosciences that, however, fascinate him. In his most recent book he opposes the mental and the physical. The mental is subjective, qualitative, intentional, and not explainable by physical processes, whereas the physical is objective, quantitative, non-intentional, and can be explained by microphysics. His denunciation of confusions and his banking on subjectivity essentially rests on the fact that subjectivity is intentional. Here we can find a phenomenological source of his philosophical thought. In this debate, Lacanian psychoanalysis has a lot to say, and is opposed to the trend of the IPA whose official instances have already allied themselves with the neuro-biological paradigm and with the CBT (Cognitive Behavior Therapy), as with the DSM. This alliance that the WAP (World Association of Psychoanalysis) strongly denounces is a form of return to Ego Psychology (as predicted by Lacan in 1966) that reduces the psychoanalytical discourse to normative psychology. The WAP is without doubt on the side of subjectivity and engaged in this battle. It takes its stand from the Lacanian orientation and the new arguments that are brought to the fore are more radical than those of the philosophers and more solid than those of the anthropologists. One has to admit, with Lacan, that psychoanalysis is a discourse which can be compared to no other and that brings out, in the mid nineteenth century, a paradigm of a different nature from the seventeenth century scientific paradigm or from the philosophical paradigm of the Enlightenment. The subject that psychoanalysis takes into account is the subject of the unconscious. Lacan, talking to young philosophers in 1966, signaled the confusions that still remain unsolved to this day in John Searles discourse: the subject of psychoanalysis is not a subject of consciousness, it is in some ways opposed to intentionality which still is the reflexive subject of phenomenology. In other words the subject of the self which Lacan predicts will be ravaging, specially because of the leveling of psychoanalysis by psychology in the domain of recruitment of executives in industry who will have to come under the yoke of the psychologist. The subject, as discussed by psychoanalysis, is the divided subject by the determination undergone through language and that makes him or her a subject of desire. He/she obeys a mental causality which is different from scientific causality: the subject of the unconscious is a spoken being. . . the being of man, and the object of psychoanalysis is not Man, it is what he lacks not absolute lack but lack of object3. Even if psychoanalytical discourse is a companion to scientific discourse, even if it houses itself in the impossible of science (for instance when having to give a ruling on ethical questions where it leaves the way to morals and religion), the order of causality obeyed by the mental is not that of science, it sends us back to the always-lost object of desire. John Searle foresees this but he does not have the tools to think it through because he thinks as a philosopher and not as a psychoanalyst. This means that psychoanalysis is led to fight battles in the social, political and ethical orders. This is what has been going on in France for the last two years under Jacques-Alain Miller and his friends initiative to which this first issue is a testimonial. We can now better understand the impact of Jacques Lacans statement, mysterious at the time: The unconscious is the political. Because he is quite certain that if psychoanalysis does not stand up to the invasion of the de-subjectivation of our society which, in mental health, in politics, in culture, advocates the ego imperative of productivity and primary utilitarianism, no other discourse will be able to do so.
Translated by Francesca Pollock and Sylvia Winter _________________________________________________________________________________________________ 3 J. Lacan, Rponse des tudiants en philosophie, Autres Ecrits, Seuil, Paris, 2001, p. 211.
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Pierre-Gilles Guguen: Editorial

Lacanian Politics

Jacques-Alain Miller

A Fantasy*

Let me begin with a fantasy, an idea that came to me yesterday morning, while listening to our colleagues tell us just about the same thing: contemporary, post-modern, or, why not hypermodern subjects are desinhibidos, neo-disinhibited, desamparados, disorientated. I was thinking while listening to them: Oh, yes! Oh, yes, yes, yes! And how much so! How disorientated we are! How true that is! It is rare to see four colleagues, one after the other, so thoroughly in agreement with each other, to find oneself in agreement with them and to have the feeling that everyone agrees with them, that there is a consensus.

The Metaphor of Nature by the Real


I wondered then while listening to them: but how long has it been so, how long have we all been disorientated? And my answer was: probably since civilized morals, as Freud said, were shaken to their roots, probably since they were disintegrated. And psychoanalysis is not for nothing in the disintegration of civilized morals. All of us here or at least almost all of us, not the younger ones in the audience remember what those civilized morals were. We are still aware of what they mean. We are at least sufficiently familiar with them to be able to understand and even to feel that the present state of our civilization is immoral, is moving towards immorality. And in fact, civilized morals, in Freuds sense, were a guide for us. They were a railing for those in distress to lean on, probably because they were inhibiting. Just the same, we can wonder why these civilized morals, during the belle poque towards the end of the second half of the nineteenth century, during the Victorian period that Lacan evoked for us why these morals were so cruel? Perhaps this moral cruelty was already a response to a crack, a fault in civilization that was to become wider and wider with time. It might be that these civilized morals, as long as they were alive in peoples hearts, had already constituted a reactional formation, as we say, to a process of disorientation that had been going on for a somewhat longer time. And so, I was daydreaming. Perhaps we have been going around in circles ever since compasses have existed, I mean since agricultural practice which is not ours, which is not necessarily in the forefront has little by little given up its dominant position in our industrial societies. We do not think about agriculture enough. Perhaps that is where all the trouble is coming from: from the metaphor that is replacing agriculture by industry. Ah, agricultural civilization, what a grand thing it was! Agricultural civilization finds its bearings through nature, through the invariable cycle of seasons. Of course, there is a history of climate that some well-intentioned people are now reconstituting. But this history changes in no way the invariable cycle of seasons that gave its rhythm to agricultural civilization, so that, in fact, it was possible to find ones bearings and ones symbols in the seasons and the skies. The agricultural real is celestial; it is a friend of nature. With industry, with what has been called the industrial revolution, all that was washed away, little by little. The artifices were multiplied. And now we are forced to
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* Lecture given at the IVth Congress of the World Association of Psychoanalysis in Comandatuba-Bahia, Brazil, in August 2004. Original French text established by Monique Kusnierek and published as Une fantasie in Mental 15, February 2005.

Jacques-Alain Miller: A Fantasy

notice that the real is devouring nature, that it is being substituted for it and is proliferating. Here we have a second metaphor: the metaphor that substitutes the real for nature. I was also thinking that this is the charm of the Seminar Langoisse 1, which I read more than once after having established the text. This Seminar presents, in effect, the object small a in the state of nature, so to speak. An object small a that is detached from the body, that is a piece of body, whether it be a sensitive piece or an insensitive piece, an object small a that is as in a state of nature, that is taken at that level. On the other hand, when what is in question is the industrial production of surplus-jouissance, if we had to describe that, we would, of course, have to put the accent elsewhere.

A New Compass
So, my fantasy continued along these lines, with a question: if we are without a compass, as my friend Jorge said, does that mean we are without a discourse? Does that mean we are chaotic, schizophrenic, as Deleuze and Guattari, who were generously discussed this afternoon, proposed? And to begin with, are we really without any compass at all? Perhaps we have another compass. There is a phrase of Lacans, which was cited twice yesterday and which formerly had served as my compass in the course I did with ric Laurent on The Other who does not exist and his Committee of Ethics. It is the phrase that signals the rise to the social zenith of the object small a the zenith and the nadir are two locatable points in the sky, the zenith the highest point and the nadir the lowest point. This phrase acted as my compass, for me at least, because it signaled that we had touched the sky. We had touched the antique and immobile sky, the immutable agricultural sky that societies that were immobile or slow to change, societies that were cold or lukewarm, had as their reference. What this phrase of Lacans signaled was that a new star had risen in the social sky, in the sociel 2 socielo in Spanish. And this new sociel star, so to say, is, as Lacan had remarked about the object small a, always the result of a forcing, of a passage beyond limits, which Freud discovered, in his own terms, precisely in a beyond. It is an intensive element that makes any notion of measure obsolete, that goes in the direction of the always more, that goes towards the measureless, following a cycle that is not the cycle of the seasons, but a cycle of accelerated renewal, of frenetic innovation.

The Hypermodern Discourse of Civilization


And so, right away, I wondered: might the object small a not be how can we put it? the compass of civilization today? And why not? Lets try to see what the principle of the hypermodern discourse of civilization is. Lets see if we can construct this discourse. In this possible discourse of civilization, we will give this object the dominant place. Object is a debatable denomination for Lacan himself. When he named what he was talking about correlative object of a subject (and, whats more, placed it within parentheses to be sure it stayed in its place), this designation did not seem totally satisfying to Lacan himself. Anyway, lets use it. This object here is our hypothesis prevails upon the disorientated subject, invites him to get past his /. inhibitions. I am going to write it, very simply, with the symbol we commonly use, S a S /
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1 J. Lacan, Le Seminaire, Livre X, Langoisse, Seuil, Paris, 2004. 2 [T.N.] The neologism sociel in French plays on social, the Spanish socielo and the word for sky or heaven in French, ciel.

Jacques-Alain Miller: A Fantasy

We recently pinpointed the term evaluation. To say we pinpointed it is going too far. Rather it was imposed on us, we have been pestered by this term, all Europe has been browbeaten by the term of evaluation, which has already passed into current use, I believe, in the United States of America. Now it is taking a tyrannical path in Europe. Suppose that the disorientated subject is invited to produce evaluation. I write it then as: a S / ___ S1 What I write as S1 is the countable One of evaluation, of the evaluation to be produced. It seems to me all the more appropriate because in this place, it is substituted for the S1 of the master-signifier that is destined to fall. I could find still other significations for this S1, for example I could see in it the signifier of what is called, in the United States, self-help. I saw that in Spanish they say autoayuda. I have no idea how we might say that in French, and I do not have the impression there yet exists a term in current use. We speak of personal development, but we hesitate in French to translate self-help, we do not yet dare. I believe you see what I am getting at in my fantasy: I am getting to where I can write S2 also in the fourth place. S2, knowledge in the place of the truth/lie, does not seem to me to be out of place today in civilization. The notion that knowledge is nothing but a semblant has attracted a great many adepts and puts pressure on us. It is not, properly speaking, a matter of skepticism, nor of nihilism, but lets say of a sort of relativism or even, as philosophers sometimes say, of a perspectivism someone from Argentina testified as to how much he had been relieved by adhering to a perspectivist philosophy. a S / ___ ___ S2 S1 This is the fantasy I propose, as the structure of the hypermodern discourse of civilization! This is where my fantasy has taken me! I cannot do otherwise than follow the direction in which I am headed. And this leads me to conceive that the discourse of hypermodern civilization has the structure of the discourse of the analyst! I am dumbfounded. The result is extremely surprising, for myself to begin with. It is a result that may seem absurd. And, after all, justifying something like that when it arises is, undeniably, a challenge.

Psychoanalysis, Civilizations Converging Point


To begin with, if we think about it carefully, tranquilly, without emotion, Lacan did not hesitate to propose that the discourse of the master had the same structure as the discourse of the unconscious. But the discourse of the master can be said to be a social discourse, the discourse of a civilization that has prevailed since antiquity. So, it is not inconceivable, a priori, that the discourse of the civilization of today might have the same structure as the discourse of the analyst. It is not inconceivable on the more or less desiring grounds from which we work. But if we accept this, we see where the difficulty lies. The discourse of the analyst was formerly the analyzer of the discourse of the unconscious, which was its other side what Lacan calls the other side of psychoanalysis is the discourse of the master. The discourse of the analyst could then analyze the discourse of the unconscious. Its interpretative and subversive power was able, in the same stroke, to have affect civilization and the phenomena of society that it has been confronted to, and that we have been confronted to as well, as Lacan tried to show, since the very beginnings of Antiquity
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Today, if this fantasy is true, if this fantasy leads somewhere that remains to be seen , the discourse of civilization is no longer the other side of psychoanalysis, it is the accomplishment of psychoanalysis. Bravo! Well done, Papa Freud! But, in that case, it calls into question both the means of psychoanalysis, that is to say, interpretation, and its end, or even its beginning. And we could say if we consider that the relation between civilization and psychoanalysis is no longer a relation of one side to the other side , we could say that this concerns rather the relation of convergence, that is to say that each of these four terms remains disjoined from the others within civilization. On the one hand, the surplus-jouissance commands; on the other, the subject works; and on again another, identifications fall and are replaced by the homogenous evaluation of capacities, and this while knowledge of different sorts is actively telling lies and nevertheless progressing. We might say that, in civilization, these different elements are scattered and that it is only in psychoanalysis, in pure psychoanalysis, that these terms are organized into a discourse. That would make of psychoanalysis the point of convergence, the focal point of civilization. In that case, we can only say poor civilization!

Freudian Fundamentalists and Nostalgia for the Past


This fantasy has at least the advantage of explaining the retreat of certain analysts into the old school discourse of the master that we used to rely on, their nostalgia for the Name-of-the-father that Nepomiachi rejected yesterday at the end of his paper none of that for me, he said. It was at least a testimony in the guise of a negation that in effect, there is undoubtedly an appeal to us for a retreat to the discourse of the master. In France at least, there is no lack of psychoanalysts and those who are preoccupied by that, who dream and are agitated by the idea of putting the order of the discourse of the master back in place are more numerous than we are. Put the master back in place in order to be subversive once more: People of France, yet another effort to be reactionary, if not you will no longer be revolutionaries! In a text that appeared two or three months ago, we could see sketched out the notion of a reactionary practice of psychoanalysis, in which psychoanalysis would from now on consist in passing on to the legendary disorientated subjects the master-signifiers of tradition. The author explains that today, the psychoanalyst, who is confronted with these disorientated persons, must really give up his former subversion in order to begin to reestablish the signifiers of tradition for his patient, to put them into his hand, into his head, without which nothing could happen. I am far from having read a great many things in the field of psychoanalysis today, but I have the impression, for the moment in any case, that this has not yet taken on a massive form, but that it is in the beginning stages. And perhaps tomorrow we will have a type of psychoanalysis whose objective will be to reconstitute daddys unconscious. Moreover, in its principle, the psychoanalytic reaction is not different from the principle behind the rise of fundamentalisms. The notion is the same. We are going to see psychoanalysts reconstituting the unconscious, trying to artificially reconstitute daddys unconscious, yesterdays unconscious, just as we see the Zealots of God taking their place on the stage of the world and changing our daily life, our voyages and our leisure activities. There is no difference: Freudian fundamentalists. .. A second position is appearing in psychoanalysis, a position that could be called nostalgic and which consists in holding that nothing is happening, nothing is taking place. The unconscious is eternal, listen to the eternal, who is your God.

A Neuro-cognitivist Translation of Metapsychology


And, it seems to me, there is a third position, that is just taking form if the first is turned towards the past and the second resides in an eternal present, we can say of this third that it is progressivist. It is the posi8

Jacques-Alain Miller: A Fantasy

tion that was presented yesterday by Agns Aflalo and Eric Laurent, who did not, of course, assume it as their own. This progressivist position consists in bringing or trying to bring psychoanalysis into step with the progress of sciences and false sciences, of regimenting psychoanalysis in accordance with such progress. This attempt is not absurd. Moreover, it was not presented to us as such. It is not unprecedented either. Thus, it could be said that Lacan undertook a logical-linguistic translation of Freuds metapsychology, which towards the middle of the twentieth century was showing signs of weakening. Lacan, himself, recognized that he had to use this means in order to give a new breath to psychoanalysis. So, in effect, it is not absurd, a priori, to try to give a neuro-cognitivist translation to metapsychology. We might say that it must be judged by its results Jorge Forbes finds that I am exaggerating, which is quite possible. I am giving proof then of an open-mindedness that I can only be congratulated for. I mean that we must not insult the future. We, ourselves, took some time to realize that there was an enormous reflexive industry that has been put into place in the last ten, fifteen, or even, as Agnes Aflalo has informed us, twenty years. For twenty years there have been industrious bees producing this honey: translating metapsychology into neurocognitivist terms. And, it must be said, we did not see it coming until it was already in place on the scene and was beginning, here and there, to make a row and cause disorder. I am in favor of having those interested by these issues go out there and bring back news of what is going on. So, these three positions that I have distinguished seem to me to open the door to practices having recourse to suggestion.

The Principle of It Works


The first of these, the reactionary practice of psychoanalysis, proceeds by exalting the symbolic conveyed by tradition. Whats more, we are witnessing astounding alliances with all the traditionalisms, which reveal a striking convergence between the Bible and The Interpretation of Dreams unquestionable. The second practice, which I called nostalgic, proceeds by the consolidation of an imaginary refuge. As for the third, which is already probably the most advanced, it is dedicated, devoted to a rallying, it sides with the real of science, or so it thinks. I have thus distributed the three terms of the symbolic, the imaginary and the real among these three practices. It seems to me that what the three practices have in common is what we abbreviate when we write: S1 S2, with an arrow between the two terms, that is, the relation between command and execution or between stimulus and response. This means that what these practices aim at, however different they are, might be stated in the following terms: in every case, it works. And then, there is the Lacanian practice or rather there will be, because this is about inventing it. Of course it is not about inventing it ex nihilo. It is about inventing it in the direction that the last Lacan, in particular, opened up. And we can probably have an idea of what this Lacanian practice will be from the direction we are moving in ourselves. The first thing necessary for this fourth practice, the Lacanian practice of the future, to hold its own, to remain differentiated from the forms I have stigmatized, is to clearly distinguish its principle from the principle of the three other practices, from the principle of it works. Well, Lacanian practice can only have as its principle, if it is to be distinguished from the others, that it fails. Lacanian practice fails. You recognize moreover, in this failing, a leitmotiv of the last Lacan. He did everything he could to place himself in the position to fail with the knots. Obviously, this failing is not a contingent failing. This failing is the manifestation of the relation to an impossible. In fact, Lacan was brought to this failing by the indication of Freud himself psychoanalysis, an impossible profession. And in effect, we, his auditors and readers, were invaded by these notions of failing and of the impossible. He inoculated us with these terms, which
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very clearly protected us, were like anti-bodies against the discourse of it works and against the new practices of psychoanalysis, all of which have this as their principle. Lacanian practice excludes the notion of success. I will go so far as to say that.

The Law of Failing


I see grimaces, discouragement. . . Not at all. The objection, obviously would be: but then Lacanian practice has no value. I do remind you that Lacan did not back off from that. He even ended one of his last lessons in an enigmatic way by saying: what its all about is that psychoanalysis is a worthless practice. You might moreover notice, at least in France and in Europe, that at all the therapeutic inquiries, psychoanalysis comes in largely last. For the psychoanalysts, that we are just as well as the others, this then engenders a feeling of guilt. But we too, we can say we have our successes. Of course, of course! But we should perhaps not be too proud of these successes either, because they belong to such a contingency that they do not invalidate the law of failing. Rather they are its demonstration. Of course, we have the pass! Some succeed. But, precisely, they are so few that it is obvious it is only to persuade the others that they have failed in their analysis! Obviously this logic is somewhat peculiar, and Lacan once gave us an indication that I took up myself some time ago. It is a logic in which contingency proves, or at least attests to, the impossible. Fundamentally, the fact that contingency exists means that we cannot even say that failing is the law of the real, but, according to Lacans enigmatic formula, that the real is lawless. If there were no contingency to belie the impossible, we would have law in the real. We do not even have that. Lets come back to our discourse of civilization. How can we understand the first line of the discourse of hypermodern civilization? What sense can we give to this matheme which is so familiar to us, what sense can we give it when, contrary to appearances, what we have is not the discourse of the analyst, but the discourse of civilization? The surplus-jouissance has risen to the dominant place. But the surplus-jouissance is correlative to what I would call, to speak like A. R. Damasio I am improving my culture a state of the body proper, as such, the surplus-jouissance is asexuated. It commands but what does it command? It does not command an it works, but an it fails, which we write, precisely, S /.When we bar a letter, in general, it is because we made an error. Here, the surplus-jouissance commands an it fails and precisely an it fails in the sexual order. And I do not see what prevents our considering that this S / means: there is no sexual relation, and so much the more so as the initial letter, S, is the same as the initial of sex. This would lead us to say that the non-existence of the sexual relation has precisely, today, become obvious to the point that it can be specified, written, from the moment that the object small a rose to the sociel. In the regime of the discourse of the master, on the other hand, the sexual relation was a truth repressed by the master-signifier. But we are well obliged to take notice that today the master-signifier, the master-signifiers no longer manage to give any existence to the sexual relation. That brings on the despair of the religious, except those who keep their distance precisely from the hypermodern civilization and who defend with talent and vigor, a previous, traditional form today, in effect, a meritorious resistance to the object small a is being exercised by the Islamic side of civilization. In hypermodern societies, on the contrary, religion is in despair on this point, sex is a source of despair for it it is still the sexual question that slows down the rise, the new rise of religion, as a Christian, Catholic sociologist I have read has explained. And if, among hypermodern societies, religion despairs on this point, it is because religion for us depends on a notion of nature that the real has outdated, that the rise of the object small a has made obsolete. Obviously, what can make us burst into laughter or tears is that a great number of psychoanalysts have no better idea than to back this up. They swear in the name of their experience that the education of children

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requires them to make their identifications with mommy and daddy. I consider this to be an abuse. An abuse that cannot possibly be established from their experience. It was already ridiculous when they turned themselves into the guardians of collective reality, but it is all the more ridiculous when the collective reality they want to be the guardians of is that of yesterday. To say this implies no enthusiasm whatever for the readjustments under way. As for most of you, I was educated in an old, more traditional way, but I do follow what is written. Psychoanalysis was invented to respond to the discontent in civilization, a subjective discontent, we might say, of a subject plunged into a civilization that can be stated like this: in order to give existence to the sexual relation, jouissance must be hampered, inhibited, repressed. Freudian practice had paved the way to what was to be demonstrated with all the quotation marks you want to be a liberation of jouissance. Freudian practice anticipated the rise of the object small a to the social zenith and this practice contributed to its installation. Besides, this object small a is not a star, it is a Sputnik an artificial product. Lacanian practice has to deal with the consequences of this sensational success. Consequences that are felt to be of the order of a catastrophe. The dictatorship of surplus-jouissance is devastating nature, it is fragmenting marriage, dispersing the family and remodeling the body. This remodeling does not only concern plastic surgery or dieting the anorexic style of life as Dominique Laurent was saying it can go still further, to more important surgery and other operations on the body. Now that the genome has been deciphered, decrypted, it is really going to be possible to advance towards what some authors have called posthumanity. So, is Lacanian practice playing its part in face of the IPAs practice and its standards? Very probably. But it is above all playing its part in face of the new reals that the discourse of hypermodern civilization gives evidence of. It is playing its part in the dimension of a real that fails, so that the relation between the two sexes is going to become more and more impossible, so that, to put it this way, the one-all-alone will be the posthuman standard, the one-all-alone, all alone to fill out questionnaires in order to receive ones evaluation, and the one-all-alone commanded by a surplus-jouissance that is presented under its most anxietygenerating aspect.

The Real as a Hole


Thus, Lacanian practice, which is to be invented, will not operate with reference to the discourse of the unconscious as its other side. It will operate, it is already operating through us let us try to find our bearings it is operating in a hole of the real that works, and a hole is not a lack a lack is always in its place, the lack is the other name of the place. The lack is the principle of all substitutions and it is even what permits us to say at a given moment: Bingo! On the contrary, Lacanian practice operates in the dimension of a failing. We also say Bingo! in Lacanian practice. It is a miracle, a grace. But it must be recognized, as Lacan himself did, that it cannot be calculated. The analytic interpretation, to the extent that we know how it proceeds, is not an analytic interpretation. That is how I understand the fact that Lacan took us by the hand, finally in order to reassure us that there is nothing but different ways to fail, some more satisfying than others. We are not simply playing on words here, it is not simply a Witz. It is under this condition that we will hold our own in the discourse of hypermodern civilization. So, this Lacanian practice would be the form, the deformation, the transformation, in the topological sense, that might permit psychoanalysis to overcome the real consequences that are produced from a century of its exercise, from its introduction into a civilization that, now, is converging on the structure of analytic discourse. And these consequences bring psychoanalysis to reconsider psychoanalysis itself. The conse11

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quences of psychoanalysis bring psychoanalysis to return to its foundations and, on this journey, we can even say that what had been its condition of possibility has become a condition of impossibility. I say possibility, but it is rather a matter of the contingency of the event that Freud represents and it might be that the impossibility, which had already been pronounced by Freud and which was articulated by Lacan, be the condition of the very exercise of psychoanalysis. In any case, this is what has become clear for us, not intellectually, but in practice: psychoanalysis ex-sists with an impossible as its basis. Moreover, we must note that we have lost the taste for telling each other our therapeutic successes. It is rather when we testify to an obstacle that we have the impression that what we say is true which Mauricio Mazzotti, for example, understood very well yesterday when he related an interpretation that missed its mark, a failing in his practice that was much more appreciated than would have been the euphoric narration of a presentation such as I pushed the button; I got this result and the mask fell. This is precisely because we do not understand how interpretation functions, because success is not obtained by pushing buttons, whatever the perfection of the diagnosis or of the clinical experience. It is precisely for this reason that we spend time explaining to each other, trying to explain to each other what happened. Psychoanalysis, which, I would say, is a Socratism with a strain of cynicism, has shaken all the semblants on which discourses and practices reposed. It thus brought to light what Lacan called the economy of jouissance. Well, now, derision and cynicism have passed into the sociel, with just the amount of the humanitarian necessary to conceal what it is about. And this propagation of derision has not spared psychoanalysis itself. Psychoanalysis concludes today that it is the victim of psychoanalysis. And psychoanalysts, even themselves sometimes, are victims of psychoanalysis, victims of the suspicion that psychoanalysis instills and distills when they do not manage to believe in the unconscious. The semblants by which psychoanalysis itself was produced the father, Oedipus, castration, the drive, etc. have also begun to tremble. That is why, for twenty years, we have been witness to a return to the discourse of science, which we hope will give us the real that is in question and which we hope will be able to give us some surplus-jouissance, and that this will get us past the barrier that separates S2 from small a in the discourse of hysteria.

An Intention of Sense in the Real


I need now to recall the condition of contingency under which psychoanalysis appeared, specifically Freuds discovery of the hysterical symptom, which was made in the context of the discourse of science, of the psycho-physiological materialism of the end of the nineteenth century, in the context of a real in the scientific sense, of a real of the Galilean type, of a real One, lodging, including, knowledge. It is in this context that Freud discovered there was sense in the real. This, we know, caused a scandal and psychoanalysis appeared to be a corruption of scientific knowledge, because scientific knowledge can be in the real, but it must have nothing to say. That there be sense in the real implies that the real means something, that it has an intention. And that was, for psychoanalysis, its condition of possibility. The sense in the real is what supports the being of the symptom, in the analytic sense. And yet, what Freud was doing was tolerated. We might wonder why. What Freud and his disciples, who began to proliferate, were doing was tolerated. They were allowed to tamper with the symptom, the mental symptom, they were allowed to contaminate it with sense. It was even tolerated that psychiatry be won over to it. Probably because they did not have the knowledge in the real that could give a response to symptoms of this kind, except for the radical response: they had lobotomy or the sleeping cure. So, the intention of sense that Freud attributed to the real was tolerated. The treatment of the symptom was left to the manipulation of sense. Moreover, at least since Pinel, the imperative sense, the S1, had already been in use for the treatment of the symptom, it was traditional.

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A Scission Between the Sense and the Real


The Freudian S2 was thus accepted, that is to say the associative sense, in addition to the imperative sense. And this up to the present day, when, in order to add, so to speak, to the discontent in psychoanalysis, a scission between being and the symptom has been introduced, or more exactly a scission between the real and sense. But this scission was expected, logically expected. It is the result of the pulverization of the symptom, which is testified to by the successive editions of the DSM, after the first edition, which was psychodynamic. What permitted the symptom to hold together was what it was saying. The symptom had something to say. It was, in the end, the unconscious intentionality that held the symptom together. Well! in the word symptom, the sym has gone away and all that is left is the ptom! The symptom is from now on reduced to the trouble. And English says that better when it speaks of disorder, a word that takes its reference from the order of the real. For science, the real is what works. And that is what the knowledge in the real is for. That is why we can say that science has affinities with the discourse of the master which Lacan pointed out a thousand times. But in hypermodern civilization, no one believes this any more. On the contrary, the idea is maintained that scientific knowledge, in the real, fails, is going to fail. The genetically modified organisms, nuclear technology, none of this any longer generates confidence in the correct functioning of knowledge in the real and this was so of course from the moment we had begun to tamper with it. What used to be the symptom, and which is now nothing but a trouble, is from now on divided into two, doubled. On the side of the real, it is treated as devoid of sense, by biochemistry, by medication that is more and more precisely targeted. And as for its sense, it continues to exist as a residue. It is the object of a sidetreatment, which can take two forms, it seems to me. On the one hand, a practice of listening that is pure semblance come here so I can listen to you , which has a value of accompaniment and often even a value of control over the operation that is accomplished in the real by the use of medication and, in effect, the biochemists are the first to say: but not at all, our patients also need to be listened to. On the other hand, we have the authoritarian, protocolary use of speech in the cognitive-behaviorist therapies. The symptom finds itself then divided into two. On the side of the real, the aim is to more or less suppress the trouble; and on the side of sense, we find a reception of sense, a trickling of sense and, at the same time, a leveling of sense. It is especially on the side of the cognitive-behaviorist therapies that we find a refusal, a refutation of the symptom, while in psychoanalysis, the symptom had a value of truth, represented the truth, always presented it behind a mask, and so as a lie, and it was necessary to take the time to verify the symptom, verify in the sense of rendering it true. Today, we see that in France, this time that must be taken is no longer a matter of course. How can we respond to that? Firstly, we have a psychoanalytic protest that is appealing, but vain, and which consists in impugning the knowledge in the real. Secondly, we have what I called a rallying of knowledge in the real. Thirdly, we have the attempt to renovate the sense of the symptom, which Lacan set out to do. This is what he introduced by modifying the spelling of the word itself, as sinthome. Here we must go back to Freud and his discontent in civilization, which was not simply a diagnosis, but a support for psychoanalysis, its promise for success. Today, I will take as a reference, rather, the outline he gave in 1908, under the title Die kulturelle Sexualmoral und die moderne Nervositt (Civilized Sexual Morality and Modern Nervous Illness). It is a text that is amusing to reread and it is not very long. Freud cites in it all the observers of the times, who at the turn of the century, between the nineteenth and twentieth centuries, took note of the new symptoms that were marking this turn the most celebrated,
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which has remained with us, being Beards neurasthenia. All the observers noted one social phenomenon: the growth and propagation of nervous illness. This passage is very amusing, well-chosen, it gives a description of modern life, of the fatigue involved in it, of the over-stimulation. We could really believe it was talking about today. What is striking is that Freud quotes all that at the beginning of his text, only to put it aside and insist, on the contrary, on one unique factor, one essential determination: monogamy, the monogamous exigency. This is how he puts together a theory of sexual jouissance in civilization. First step: free access to jouissance that is as Jean-Jacques Rousseau says : Let us get rid of the facts. Second step: the restriction of jouissance which is only permitted for reproduction. Thirdly, jouissance today, is only permitted within monogamous marriage. It is amusing to follow this text in detail. Freud establishes what causes neurosis by considering the effort to make the sexual relation exist and the sacrifice of jouissance it entails. We find there the finger pointing to what Lacans contribution will be.

The Symptoms of the Sexual Non-relation


Lacans contribution does not at all consist in impugning the scientific real and knowledge in the real. Impugning the discourse of science is a path of perdition, which opens the way to all the finagling of the psy finagling is not an insulting term. It is not a question of impugning this knowledge, but of admitting that there is knowledge in the real and, at the same time, posing that in this knowledge there is a hole, that sexuality makes a hole in this knowledge. This is a transformation of Freud, probably, and it means making a new alliance between science and psychoanalysis that reposes on the non-relation. There is no sexual relation gives us then the site of Lacanian practice, because it must be heard in light of the statement that asserts there is knowledge in the real. There is no sexual relation is the counterweight of there is knowledge in the real. It is the sexual relation that objects to the all-powerfulness of the discourse of science moreover, for the moment, matrimonial agencies are left in the hands of a certain number of matrons with experience. The evaluators have not yet taken over matrimonial agencies, but they will not be long in coming! So, for the moment, and this is what is, despite all, striking, the sexual relation makes a hole in the real and in the knowledge in the real. That the sexual relation makes a hole in the real can be expressed simply like this: there is a lack of software at this point. This is the principle of a practice or of a clinic in which the symptoms are not troubles or disorders, because at that point there is no order. That means that the knowledge in the real does not dictate its law and we cannot intervene at that point from a consideration of the knowledge in the real. This is a negative statement that calls for positive statements, and I will have to make a choice, because I am at the end of my talk. First, symptoms are symptoms of the sexual non-relation. This means they are probably articulated into signifiers, but that is secondary, it is their chitter-chatter. Symptoms are not essentially messages. They are above all signs of the sexual non-relation, possible punctuation marks. Lacan spoke of symptoms as question marks in the sexual non-relation. Yesterday, I heard a patient say that what anxiety remained for her was linked to her body like a comma, like a pause in respiration. So, symptoms are signs. That is another approach than treating them as messages.

Symptoms Are Real


On the other hand, symptoms are necessary. They do not cease to be written and this is what founds their equivalence with the etcetera. This means they are real to such an extent that they can be very easily confused with the real that works. There lies the paradox. This is why, at the same time that Lacan says the
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symptom is real, he can also say: we must believe in it. Precisely, they are so real, these symptoms, that it is arbitrary to detach them as such, there must be someone who really wants to. Would you like an example? Take homosexuality. It was posed as a trouble within the natural order. When you impute to a trouble its being of the natural order today, there is only one thing to be done: you must form a lobby. And if you form a lobby, the outcome is that you no longer have a trouble of the natural order. As you know, it was the result of pressure, of a political balance of forces that homosexuality came to no longer being considered as a disorder, or classified as a disorder. We can see to what extent this is in accordance with the results of psychoanalysis, of a particular psychoanalysis, for which perverse jouissance is permitted. The question is what one does with it. A third positive assertion: symptoms are jouissance-symptoms, so to speak. What they say is that jouissance is not at the place where we thought it should be, that is to say in the sexual relation that Freud gives us a caricature of in the guise of monogamy. We never have the right jouissance, the one that there should be. And from there, we accede to a certain number of quilting points of this clinic, which I am not going to tell you about today and which are found in questions such as these: The incorporation of the unconscious, is the unconscious corporal? Lacanian practice and Lacans oh, so troubling question on practice: does the effect of interpretation come from the use of words or their jaculation? Which means that for an interpretation, you have to find the tone moreover those who have the chance to be able to relate some of Lacans interpretations always repeat them using Lacans tone. The poetics of interpretation is not there for its aesthetics, it is not there to be kitsch. The poetics of interpretation is the materialism of interpretation. Someone who has been following a patient for nine years told me yesterday, or the day before yesterday, during her supervision, that she had obtained an effect unlike any other she had obtained during the nine previous years simply by saying: Basta!, in a tone whose virulence contrasted drastically with the usual soft tone of her voice. One must, then, bring ones body into play in order for the interpretation to be raised to the power of the symptom. I am looking for a point of suspension, not of conclusion.

Love, Which Makes the Unconscious Exist


With the last Lacan, we find ourselves with rather three unconsciouses, three different modalities of the unconscious, but we need some time to explain that. We can say that the Freudian unconscious works to satiety. Whats more, Marco Focchi brought a list of references in which we see the Freudian unconscious exhaust itself at work, while the Lacanian parltre (speech-being) is never exhausted at work. Rather, it rumbles, boils, reeks, its style is parasitic. Lacan wanted the Lacanian parltre to replace the Freudian unconscious. He wanted it to bring a response to the problem that I posed on the blackboard, precisely that psychoanalysis must go into fourth gear. The considerations that I had to leave aside would lead us to invert what we say traditionally: the subject supposed to know is the pivot of transference. It seems to me that the last Lacan says something else, he says rather, if I may put it this way: transference is the pivot of the subject supposed to know. In other words, he says that what makes the unconscious ex-sist as knowledge, is love. Moreover, the question of love, starting with the Seminar Encore, has provoked special interest, because love is what could effect a mediation between the Ones-all-alone and with that in mind, saying that love is imaginary presents some difficulty. This means that the unconscious does not exist. The primary unconscious does not exist as

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knowledge. For it to become knowledge, to make it exist as knowledge, love is necessary. And that is why Lacan could say at the end of his Seminar Les non-dupes errent: a psychoanalysis requires that one love ones unconscious. It is the only way to make the relation, to establish a relation between S1 and S2, because in the primary state, we have disjoined Ones, we have scattered Ones. So, a psychoanalysis requires that one love ones unconscious in order to make, not the sexual relation, but the symbolic relation, exist. But a psychoanalyst is not required to love the unconscious. A psychoanalyst is not required to love the effects of truth from the unconscious. And that is difficult, because an analyst is also an analysand or a former analysand. And yet, in the name of what Lacanian practice could be, we must not love the true any more than the beautiful or the good.
Translated by Thelma Sowley

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Franois Leguil

On the False Usefulness of Anxiety and the Benefits of Working Through It*

To say that anxietys opacity raises questions has become, in clinical practice, a truism it is so obvious. That opacity serves as a pretext for those who want to know the physiopathology of anxiety: the fact that it seems to be so far beyond the limits of comprehension justifies assigning a biological cause that will explain it (erklren), and giving up any attempt to understand it (verstehen). That same opacity leads proponents of psychopathology to believe that the difference between anxiety and fear resides in the absence of object, or in the derisory allegation of some far-fetched reason for it, for instance as the sequel of an infantile phobia. A third path for research, more reflective, considers that the opacity interrogates a persons very existence, questions the mystery of his/her place in the world, and can become an occasion for a return to the roots of being, or as proof that (and sanction for) the subject not facing up to things as well as he/she could. The clinic of anxiety is relatively recent, almost contemporary with that of pain; we only began seeing its premises at the end of the eighteenth century. Not knowing what to do next, another century was needed to specifically distinguish it. Its subsequent destiny shows its relationship to its epoch to be different from that of pain. Pain finds, in Culture, a way of expressing itself, a way of inventing the truth of its real, even a way of dealing with it (eventually by suppressing it thanks to the science and technique of pharmaceuticals). The Culture and the Zeitgeist that are its symptoms do not treat anxiety, they hide it. They do this thanks to the collective fantasies of big scares (grandes peurs), or, (as in Poes Purloined Letter) by showing it in a way that leads to contemporary medical syndromes called panic attacks, or to a finicky accentuation of the differences between anguish and anxiety. Society as a whole does not do any better than each subject with the real when he/she limits his/her choice for denial to either instituting a fantasy that lies or to impudent exhibition.

Anxiety Is Involved with Ones Being


Pain is to history as magic is to rituals: pain remains a business of body and of meaning whereas with anxiety one has to penetrate the murkier zones of the piacular and the propitiatory. That explains why historians and graduate students have been throwing themselves at the former for the last two or three decades and that, apart from some deserving research into big scares, we are still waiting for a history of anxiety that will throw a little light on Freuds ambition: to acquire some knowledge about its essence (eine Einsicht, die uns das Wesen der Angst erschliesst1). Be that as it may, the effective history of anxiety, which is only about two hundred years old, is shared by the three traditions we mentioned earlier. First, medicine: for doctors, anxiety is physical. Second, psychology maintains that anxiety is anomaly (for the cognitivists, anomaly of judgement; for the behaviorists, anomaly of adaptation, of development). Finally, philosophy existential, eidetic, ontological main_________________________________________________________________________________________________
* Originally published as De la fausse utilit de langoisse et du bienfait den venir bout, in the Lettre Mensuelle, Bulletin de cole de la Cause freudienne, rue Huysmans, Paris, October 2004. 1 S. Freud, Gesammelte Werke (G. W.), XlV, Hemmung, Symptom und Angst, Imago, London, 1940, p. 162.

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tains that anxiety is on a par with metaphysical experiences. A fourth, Freudian, tradition breaks with the three others (that are unaware of it, but celebrate its creator and recognize in him the father of the real modernity of this history). This fourth tradition does not imagine itself as anything but a breakaway from the three others. Still, we tend to take the easy way and mix them up. We have neither the intention nor the leisure here to show how the Freudian clinic of anxiety does not imply that we denounce these frequent hybridizations by vituperating our conceptual indolence. These hybridizations are inevitable, and JacquesAlain Miller showed us, some time ago, that hybridism is precisely one of the principal components of our current Zeitgeist (on the front page of Le Monde, at the end of November 2002). But we locate them, these hybridizations, through a punctilious intellectual dissection, so as to rediscover the veritable meaning of the clinical analysis of that affect which is the king of all affects, of that unpleasure that can reach the heights of unpleasure. This is not a question of theoretical purity but of practical efficiency: to say that anxiety, its essence das Wesen der Angst is not physical or metaphysical or psychological, is to put forth the reasons that explain why our clinical work cannot do without a metapsychology. Let us accelerate by beginning with the third of the proposed traditions: the philosophical; metaphysics. We repeat, with good reason, that anxiety is involved with ones Being. But isnt this like Monsieur Teste saying he had been involved with women (touch des femmes), through a kind of incredulous adhesion, an astonished conceit, in reality trying to marginalize the memory of a misunderstood experience. Misunderstood because momentary certainty leaves the protagonist unsure of a contiguity that allows no access to a substantial revelation. It is a big step from there to making anxiety a concept illuminated by the fire of original sin, a step taken, as we know, by Kierkegaard.

Something Felt
Ninety years later, Freud almost responds to Kierkegaard: anxiety is not a concept, it is first of all something felt (in erster Linie etwas Empfundenes 2); it is not a concept but a phenomenon, a fundamental phenomenon that poses a crucial problem (das Grundphnomen und Hauptproblem des Neurose 3). To say that this phenomenon poses a major problem is to say that one concept is not enough; many interconnected concepts are needed. This articulation is what Freud called metapsychology. Anxiety teaches the anxious person nothing except that it is sometimes urgent to take every shortcut possible to get away from the active zone. With anxiety, where id was, ego cannot be: mit der Angst, wo Es war kann nicht Ich werden! That anxiety involves ones Being underlines the fact that it does not reach the Being, that it does not authorize access, it obstructs; Lacan refers specifically to this at the end of his seminar on the ethics of psychoanalysis4. It is when one is closest to horror that horror is barren, because one cannot go farther: what is left over is a bitter taste of authenticity deprived of its maieutic virtues, that can only find its resolution in ontological boasting, as if one had to represent the etymological relationship between tenebrous and temerity. In a similar vein, the only privilege one gets from having known anxiety is the hope of never having to know it again. So the wise words that claim to know how to arm Man against suffering end up making pain the irresolute destiny of anxiety. Freud denounced this idea on the last page of Chapter II of Inhibitions, Symptoms and Anxiety: the philosopher doesnt do much better than the churchman who has been teach_________________________________________________________________________________________________
2 S. Freud, G. W., XIV, op. cit., p. 162. 3 Ibid., p. 175. 4 J. Lacan, The Seminar of Jacques Lacan VII, The Ethics of Psychoanalysis, trans D. Porter, ed. J.-A. Miller, W. W. Norton, New York and London, 1992.

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ing, for two thousand years, that the meaning of Gethsemane is to be found in Golgotha; attaching anxiety to an identification of the Being with the will of the Other leads to an ultimate masochism. Anxiety as a phenomenon is useless, because if it were useful we would say it is necessary and that, like the symptom, we wish it on everyone. Between the necessity of the symptom and the impossibility of the real, the phenomenon of anxiety is as superfluous as love is contingent. Medicine does no better than philosophy with the essence of anxiety, but it has more excuses. Medicine, much more than philosophy, is seriously confronted with the real demands of the times, even the legitimate demand to be anesthetized. Medicine does not exalt its doubtful experience in the certainty of anxiety. If medicine confuses anxiety with pain, that is because its knowledge is limited: from one neurotransmitter to another, medicine cannot distinguish between what comes from the formation of phenomena and what comes from the deformation of words. Medicine at least has the nerve to insist that anxiety should be respected because it carries along with it something propaedeutical. At worst, medicine doesnt give a damn, but its furor sanandi deserves credit for maintaining that anxiety should be respected as a phenomenon in the same way one respects an enemy one must conquer. The difference between the medical doctor and us is that we think only the subject can decide what he or she has to fight.

False Utility
The first hybridization that exalts the experience of anxiety tries to convince itself that anxiety can be useful because, like a problem, it has ontological potential. Lacan, in the first Lesson of Seminar X, LAngoisse, emphasizes that anxiety is not the problem. The second hybridization, combining the spirit of clinical medicine with our own, has a logical consequence that is more unexpected and also more interesting: it leads one to believe it suffices to think the symptom is a defense against anxiety. That, in reality, is an anachronism that does not take into account Lacans re-reading of Inhibitions, Symptoms and Anxiety. Jacques-Alain Miller said very recently that Seminar X is devoted to this: but he also said that the Lacan who read Freud in 1926 is also the Lacan who had just written Kant avec Sade; that is to say a Lacan who shows ipso recto that fantasy is notably absent from the 1926 text, a book by an author who remembers having written The Ego and the Id without exploiting the discoveries of A Child is Being Beaten. Of course Freud envisaged maintaining that the symptom is a defense against anxiety. He noted early on the limitations of this somehow self-contradictory thesis, because the symptom is also jouissance: symptom formation. . . tends to give substitutive satisfaction more and more space, at the expense of denial (die Symptombildung. . . geht dahin, der Ersatzbeffledigung immer mehr Raum auf Kosten der Versagung zu schaffen5). We can make two more observations. The first of these is admirably shown in Lacans Lesson of June 12th, 1963. In the Freudian clinic, the particularity of the effect is to not be effectuated. This explains the Lacanian effort to distinguish the effect from the result. The effect, or: defense is desire. The symptom, as result and not as effect, shows that the effect is never proportional to the cause because the cause is not exterior but heterogeneous. Medical epistemology at least in the classical clinic cannot accept the idea of this non-proportionality, or that the cause can result from a transfactual order. It is equally inconceivable that the symptom be a jouissance. So this epistemology is not entirely unrelated to the thesis that is content to think the symptom is a defense against anxiety, a thesis that, in the end, will explain that anxiety itself is a symptom.
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5 S. Freud, G. W., XIV, op. cit., p. 148.

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The second observation is that one risks not taking heed of one of the points Freud insists upon: although anxiety is universal, it is not general. Freud says many times that one can have symptoms without anxiety, or anxiety without symptoms. What is more, 1926 shows that the symptom is a very bad defense because it fails to protect the ego, durably, from this anxiety. Because it is the expression of the implacable constancy of the demand of the drive, anxiety reduces this ego, which can then only either multiply the symptoms or shrink away to nothing.

Anxiety As a Function
The third hybridization, with psychology, is perhaps the most torpid. Freuds great discovery (which began much earlier than 1926), when he made anxiety a signal, is that anxiety has no use but does have a function. The function of anxiety, the key formula of Inhibitions, Symptoms and Anxiety, is a formula that Lacan took up at several points in his seminars. This discovery of Freuds cannot be separated from another that accompanies it. Not everyone is anxious, and the light Freud hopes that could be thrown on what the essence of anxiety is would come no doubt more likely from examining people who are not anxious. In short, the essence of anxiety is its function, and that function does not imply the existence of the anxiety phenomenon itself as it appears in its role as signal. To maintain that anxiety, as a phenomenon, is a signal, is not to find it useful but is to maintain that it is not a message, that it does not spring up between the subject and the Other but between the subject and the real. The psychologist takes advantage of this loophole: the signal he/she knows is the famous couple stimulusresponse or something like it. A complacent biologico-transcendental reciprocity! The psychologist draws on one of Freuds discoveries to make him say the contrary by presenting anxiety as a malfunctioning of the alert function, of a warning from the ego, the malfunctioning of an attitude and of a felt reaction to danger; a malfunction of the functions of fear and flight. Distinguishing anxiety from fear is what makes the stakes complex: anxiety could be exaggerated fear, excessive, erroneous; a reaction that exceeds measurable norms. To strengthen the self (behaviorism), or to correct errors (a spider does not mean to do you harm and that little mouse does not represent a serious danger, get hold of yourself: cognitivism) are a godsend for this third adulteration. When he comments on an example taken from Chekov in the winter of 1963, or in the last Lesson of Seminar X, Lacan offers another conception of fear and goes back to the Freudian definition, unheard of before him, of what can be a danger for the subject: one insists on the fact that the effects of fear would elicit, in principle, an adequate response, that is to say, would provoke flight. This thesis is . . . compromised. . . It is therefore necessary to look elsewhere for the reference that points to the distinction.6 The concept developed by Lacan the function of anxiety between the opaque function of the real opposed to that of the signifier7 gives the real scope of an approach to the phenomenon of anxiety in its value as a signal. As early as 1916 eleven years before Sein und Zeit Freud showed that anxiety is not an abnormal or excessive fear, because anxiety logically precedes fear. Why refuse that demonstration of Freuds, if we want to understand how, clinically, fear treats anxiety?

Face Up to It, Deactivate It


This unassimilable series of Freudian paradoxes makes up the clinic of anxiety that Lacan spoke of, in his 1962-1963 teaching, as the consequence of the elusive character of the subject of the unconscious. These paradoxes led Freud to trace the meanders of complicated metaphysics, almost bitter sometimes, when a
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6 7 J. Lacan, Le Sminaire. Livre X, Langoisse, Seuil, Paris, 2004, p. 187. Ibid., p. 188.

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Franois Leguil: On the False Usefulness of Anxiety and the Benefits of Working Through It

logical impasse requires an important revision. This metapsychology, the doxa wanted to diminish it by saying that Freud had two successive theories of anxiety, whereas an attentive reading showed that to be too schematic, that Freud did not problematize things in that way and that, from the middle of the 1900s on, he hesitated continually not so much between two theories of anxiety, as between the question of anxiety approached from the point of view of truth or from the point of view of the real. In 1932, far from issuing a challenge, he gave his reasons for not choosing one theoretical construction that another would refute. Thus Freud, through his dissatisfaction with the stumbling blocks he encountered when thinking about anxiety, proved that his metapsychology is the sign that makes of this affect a cause of his unwillingness to not give up on ones desire, on a desire that can be named, thanks to Lacan: to not give up on ones psychic causality. In the same way that a wound to the hip joint bears witness to what happened at the ford of the Jabbok where, in his fight with God, Jacob fought the fights of God, the imperfection of Freudian theories about anxiety bears witness to the fact that Freud, in his fight with anxiety, fought the fights of the signifier. On the last page of his Seminar, Lacan evokes what it is to confront anxiety, what it is to surmount it and the trace of something that goes from the existence of a to its passage into history. Over forty years have passed since that July of 1963, and we could follow Julien Gracq when he took up a verse of Baudelaires: the forms of the clinic change faster than a human heart. On that last day of the Seminar, July 3rd, 1963, the front page title of Le Monde (in the edition dated July 4) was M. Khrushchev proposes to link a moratorium on surface nuclear testing to a Warsaw non-aggression NATO pact. John Kennedy had only three months to live. In the night of 2 to 3 July 1963, he came back from Naples where he had been received with a triumphal welcome (Le Monde again). History passes. We do not read either Freud or Lacan as witnesses to their times but as heralds of an ethical exigency in clinical practice that insists we know what we are talking about when we want to transmit our practice concerning anxiety. An exigency that compels us not to repeat what the wise or clever person does, too inclined to seek in extreme unpleasure an exquisite unveiling of the human condition, to avoid what the psychologist proffers, and to try to go farther than the doctors.

The focus of the next Study Days implies that beyond the phenomenon of anxiety whether it exists or not we can reflect on what its function might be today, which depends on the way we manage to speak of it. So dsangoisser to relieve anxiety what does that mean? The front page of the newspaper seen by those in attendance at the seminar that July 3rd, 1963 can give us an idea. If we soberly follow on the metaphor of nuclear tests, relieving anxiety dsangoisser is to be understood as: deactivate. How can one deactivate anxiety in and through the analytical act? Or: how can one make it fade absolutely, how can one exhaust the phenomenon in a subject so that he or she can assess its function? With anxiety, what metamorphosis of the subject does one have to solicit so that he or she can be promised the peace that seals 8 that metamorphosis?
Translated by Sylvia Winter and Francesca Pollock

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8 J. Lacan, Proposition sur le psychanalyste de lcole, Autres crits, Seuil, Paris, 2001, p. 254.

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Franois Leguil: On the False Usefulness of Anxiety and the Benefits of Working Through It

Marie-Hlne Brousse

Toward a New Psychoanalytic Clinical Practice*

In a recent text1 I was able to draw out four elements that constitute the current master discourse: the common market, that is, the universality of an imperative for exchange as new master signifier; the procedure or protocol as mode of knowledge; the network as it has come to take the place of the subject; and lastly, a new form of jouissance linked to the status of waste, as the master discourse defines the contemporary object. Once it has agreed to accompany the movement of the real of the epoch, psychoanalysis must consider the conditions and consequences of its act and situate its therapeutic application within these coordinates.

The Current Master Discourse, 1, 2, 3, 4


1. Nothing escapes exchange, nor does anyone; it is no longer situated between groups or ethnicities, but is global, universal. Entirely delocalized, the market is the contemporary form of the One. The principle of exchange remains profit; there is no realm of human affairs that is not submitted to its law, and this includes the sacred and tragic realms. Its mode of functioning is abstraction through the calculation of quantity, which enables the universalization of exchange or valuation and competition. The beneficiaries are as universal as the debtors. So, this is no longer a world of masters and slaves, capitalists and proletarians, male and female citizens, but a world of real or virtual consumers, a world of potential users. A new psychopathology arises from these premises. 2. These modes of exchange make an object out of every incoming element. In his Seminar LAngoisse 2, Lacan showed that the general institution of the field of the object ensues from the matrix of the imaginary that is the mirror stage. It is formed through the introduction of the mediation of a common object, an object of competition, the status of which stems from the notion of belonging. In this structure, everything is transformed into an object; everything can be consumed. Utility is similarly defined. What is consumable is useful. The useful is no longer referenced to the vital. This affects desire, as it does jouissance. 3. Knowledge, in its scientific form that is, as demonstrated by the response of the real and in its form of savoir-faire, obeys the same demand for universality. Moreover, the technological revolution in the field of communications transforms all data into information. As Jacques-Alain Miller noted in a recent interview3, generalized information is the new form of absolute knowledge. Alongside rather probable scientific laws, protocols and procedures are valuable rules for all human action obeying the mass management objective in a global market. Today, knowledge is entirely submitted to management. We manage stocks, flows, phenomena, natural or other catastrophes, populations, the environment, criminality, feelings, passions, ones own suffering, stress, or violence. The management principle applies to all realms of human affairs. The world is a gigantic warehouse and we train well-advised storekeepers. This management prin_________________________________________________________________________________________________
*Originally published as Vers une nouvelle clinique psychanalytique in Mental 15, February 2005. 1 M.-H. Brousse, Marchs communs et segregation, Mental 13, December 2003. 2 J. Lacan, Le Sminaire, Livre X, Langoisse, Seuil, Paris, 2004, p. 107-108 3 J.-A. Miller, interview, Agence Lacanienne de Presse, January 14, 2005.

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

ciple regulates the therapy market and therapists are first and foremost managers of public health, which itself has become a constitutive element of public order. 4. The subject exists in a network and is no longer subject to a hierarchy. As such, it is informed, it is no longer ordered. The counterpart to its given right to information is that the Other can know all of the information about it. This means concretely that it is subject to infinite quantity of information, without any ordering principle, to which it can and sometimes must participate as producer of information. This modifies the question of the subjects relationship to the symbolic. The consequences of the transformation of the forms of jouissance correlating with these different points appear more clearly.

Transformed Modes of Jouir: Enjoy x


There is an anecdote about how Lacan, when traveling in the United States, came across a gigantic illuminated advertisement that read Enjoy Coca-Cola. He said he did not want the concept of jouissance that he was developing to be translated into the English term enjoyment. The association with a trivial consumer object did not fit the real he was seeking to grasp through the term jouissance. Some thirty years later, we might ask if Coca Cola has not won this epistemological battle. Indeed, the form of jouissance proper to the new master discourse has imposed a new definition of jouissance in strict keeping with that of the slogan: a generalist definition compatible with any object. The formula enjoy x, which puts the superego at the command posts, is a function stating the kind of use of the mass-valued object promoted by the master. When an object resists this function, it is futile and condemned to disappear. If Lacan could say that holding jouissance in check [. . .] is at the essence of every human formation,4 the check the new master discourse puts into play differentiates itself by not presenting itself as a limit, a barrier, or a prohibition. It manifests itself through the bias of the object. It dictates an objects use, which contributes to defining that is, limiting what can be an object. One could say that it does not check through prohibition but through function: if jouissance can be experienced from it, then it is an object. Paradoxically, this checking mechanism presents itself as an imperative: a push to enjoy. As such, it produces a general restoration of jouissance. Every human object sees its value brought to Coca-Colas level. This triumph of enjoyment over a different sort of satisfaction allows us to deduce a development of pathologies linked to the superego, in particular, addictive pathologies, whether they are present as forms of excess obesity, simple bulimia , or reduction anorexia, bulimia with vomiting. Yet, addictions to different substances or even to certain activities are capable of entering into the same structure. A therapeutic orientation provided by Lacans teaching is inferred from the differentiation he effectuates in the category of objects, by separating common objects of exchange from the objects he calls objet a (object a). When these objects a mix with objects of enjoyment, they are recognizable through the anxiety they produce. Generalizing standardization comes up against the limit constituted by these objects a. This limit stems from absolute difference and is not a return to the function of prohibition, which is moreover impossible because it is obsolete. The modification of the very nature and function of the limit radically transforms clinical practice today. We shall see how Lacanian oriented psychoanalysis responds.

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4. J. Lacan, Allocution sur les psychoses de lenfant, Autres crits, Seuil, Paris, 2001, p. 364.

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

The Object and the Subject: A Relationship Without Veils Instead of Sexual Relations
Advertising slogans are the masters new instructions and participate in its mode of governance. During the January 2005 sales, a London department store put up the following four posters: I shop therefore I am, Buy me, Ill change your life, Its you, its new, its everything, its nothing, You want it, you buy it, you forget it. Consummation as the current form of relation is explicitly stated. Two of the slogans are on the objects side, the two others are on the subjects in an undifferentiated transitive state its you, its new. There is no longer any need to seek pretexts of utility, Beauty or Wellness. When the object speaks, it addresses itself to the subject barred by fundamental lacks in being or the lost object, by promising the jouissance of being or a change of life. The promises, of course, do not commit the object. One could make out neo-fetishism there. The consumer object sharply addresses our division, titillates it, and presents itself as the silent partner that will erase the traces of castration through language. From the side of the subject, the object is no longer presented as having an intrinsic, agalmatic value. On the contrary, it is cynically unveiled as just about anything. Its value where satisfaction is concerned is linked solely to the fact that it is for sale and therefore can be purchased. It is a waste product of the function; its absence of value affects the consumer, who can convert himself or herself into a waste product of management discourse. In his Seminar The Ethics of Psychoanalysis, Lacan had already underscored that the difference between modernity and earlier epochs could be distinguished in the privileging of the Beautiful as a veil in front of the Thing that is in front of the unnamable of the real. The status of the objects waste product including the art object achieves the lifting of this veil. Ours is the epoch of unveiling. Eric Laurent has developed this point by articulating it alongside the disappearance of feelings of shame. These slogans make evident a new world of jouissance that rests on the separation of jouissance from desire, which is necessarily correlated with the law. Jacques-Alain Miller5 showed how the end of the paternal signifiers authority in culture is concretized in this breakdown of desires link to jouissance when they are no longer bound together by the law of S1. Obviously, neither the veil nor the mi-dire (half-speak) masks the truth. We are in a period of the effacement of the question of the truth, or as Lacan said in the Seminar The Other Side of Psychoanalysis, of suspense that introduces the question of the truth into the people.6 We are in one of these periods in which enigma disappears, allowing a real to surge up that the veil of fantasy had formerly masked. What is this real? The only relationship that can be put down is the relation between quantities: such and such a product, because I am worth it, proclaimed another advertisement. The sexual relation was only sustained as fiction by the paternal metaphor. If the master-signifier is no longer the One of the Name of the Father as exception the calculation, that is the One of the multiple and of duplication, having taken its place then the fantasy that organizes jouissance through the law is no longer the organizing principle of jouissance. Not all jouissance is correlated with prohibition. There can be contingent jouissances produced by this market form of relation to the object. In the face of this, psychoanalysis responds by reintroducing enigma into discourse and by transforming the waste product into a truth effect on the object of the drive, whatever it is. It seems this may explain the profound change in the discourse held on perversion, which marks a muta_______________________________________________________________________________________________________
5 6 J.-A. Miller, Intuitions milanaises, Mental 11 and 12, December 2002 and May 2003. J. Lacan, Le Sminaire, Livre XVII, Lenvers de la psychanalyse, Seuil, Paris, p. 140.

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

tion in clinical practice. During the Victorian period, an entire psychopathology was based on a fine classification of perversions, which Freud took up in his Three Essays on the Theory of Sexuality. Today, we have profoundly simplified the discourse on perversion. It no longer stems from clinical practice, even that which is objectifying, it stems from a juridical discourse and the extension of the realm of the contract. The distinction between perverse and not perverse proceeds from a single criterion: two consenting adults. If this criterion is present, the sexual practice does not belong to the realm of perversion, and if it is absent, then it does. Thus, most contemporary articles treat the form of perversion pedophilia. This criterion is evidently not a simple issue of how it is handled. The question of consent is present in the hunt for abuse, manipulation or suggestiveness. The notion of being of age brings with it in counterpoint a heterogeneous category grouping together children, the mentally disabled, even animals. . . Practices formerly considered perversions homosexuality, or sadism and masochism are no longer considered as such as long as they take place between two consenting adults. Sexual jouissance is torn from the paternal signifiers empire and no longer responds to its law. To each his or her own jouissance, as long as it takes place with someone similar, that is, along the imaginarys axis. There too, we end up with a paradox: if the field of perverse sexual practices, properly speaking, has been reduced, the field of perversion has considerably grown. Indeed, all forms of living together might be qualified as perverse as long as at least one of the actors involved refuses consent: the popularity of the terms sexual or moral harassment testifies to this. All forms of power can enter into the category of perversions. Lacan is prophetic on this point: in the Seminar R S I he provided a definition of perversion as version toward the father, which provoked much surprise. One could say today that any affirmation of hierarchical power is likely to enter into the field of perversion if it does not respond to a consensus. The clinical axis is the consensus of fellow beings.

Three Names of the Father


In his final lessons, Lacan endeavored to think through the alternatives he had named paternal metaphor and substituted for the Freudian Oedipal myth. It no longer seemed to him that the father of the name, the power of naming and the letter on the real of jouissance, could center a contemporary clinical practice marked by the decline of the paternal function strictly speaking. As such, he proposed a pluralization of what might serve the function of master signifier for a subject. Taking up Freuds Inhibition, Symptom and Anxiety, he made these three terms into three modes of functioning of the name of the father, three ways to shore up jouissance when it is no longer limited by desire, that is, the law of the signifier. We can hypothesize that anxiety is a manifestation of the limit posed on the imperative of enjoyment. Within the proliferation and indifference of the objects on offer, anxiety indicates the presence amongst them of an object of another nature, the object a. The object a manages to order this proliferating indifference. Enjoyment has no hold on it, as a result, it allows desire to keep on insisting. This underlies the question: what are the conditions in which this object can come to occupy the place formerly occupied by the signifier, that is, by the symbolic? In this way, one could say that the limit to the tidal wave of objectivization through calculation and science would be constituted by objectality a dimension stemming from this object having been lost during the production of the parltre (speakingbeing). Lacan thus considered anxiety as a veritable nomination. Coming to occupy the same place as prohibition, it indicates an unbearable point for the subject. The analytic cure that offers to place the object in command follows the vein of this evolution in social ties, not without making the latter explicit. Out of a

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

subject innocently caught in anxiety, it means to make a parltre aware of the object that determines its mode of jouissance. As Dominique Laurent has noted, an analysis tends to link anxiety to an object or provide it with the name of signifying coordinates and make a compass out of it.7 Inhibition is another name of the father, this time in the realm of the imaginary. The limit our society places on perversions, as a consensus of fellow beings, displaces perversion into a virtual world that recalls what Winnicott refers to as transitional space, whose relationship with fetishism he emphasizes.8 In our period, an imaginary process on the order of inhibition control of one by the other has checked perversion. Psychoanalysis, rather, offers to articulate perversion with fantasy, that is, it attempts to make a symptom out of it. The third name of the father, the third form of limit placed on jouissance, is the symptom that stems from the symbolic. One cannot help but note the paradox characterizing current master discourse. On the one hand, science continues to make the symptom disappear chemically or through reconditioning, with or without the subjects consent. But on the other, because of symptoms subjects are filed in less and less generalist and more and more segregational institutions institutions specializing in eating disorders, specific therapies for phobias, welcome centers for victims, the violent, etc. We can see at work here the fragmentation of the Name of the Father. Certainly, the symptom has been reduced to inadequate behaviors; it is not envisaged as a process of adaptation or mode of jouissance. However, the master uses the symptom to put segregational management into place. The analytic cure does not envisage the symptom in a parceled or classificatory way. It considers, as Lacan remarked, that a subjects symptom is what is most real for the subject. The treatment it proposes aims to separate the subject from its traumatic Other, its virtual partner that, being included in the symptom, provides meaning to the world. It makes resonate within the symptom the truth of the mode of the link the subject precociously encountered in the initial moment where it was marked by speech, opening up the possibility of a variation or a new encounter in this link. Lacan went even further by setting the Oedipal paternal metaphor closer to a delirious one and radically transformed the landscape of differential psychoanalytic clinical practice: he created a new trans-structural concept, the sinthome, as a fourth modality serving as a name. This allowed for a listening freed from the prejudices of parltre in a network, mentioned earlier, which is no longer the subject produced by the symbolics domination of the imaginary and the real. With regard to the old master discourse, the network interrogates the padding of meaning in a new way. The intersection of networks, like the multiculturalism of modern societies, has two contradictory consequences: a chaotic flourishing of symbolic and imaginary identities on the one hand, and the multiplication of barriers, on the other. This is a consequence of reinforced and ramified segregation, about which Lacan spoke in a note dated October 12, 1968, during the Congrs de lEcole Freudienne de Paris, held in Strasbourg. Today, the difference between neurosis and psychosis is presented in a new way. Scientific discourse has also contributed to this orientation by pushing toward objectivization through the systematic forclusion of the subject, which constitutes one of its conditions of possibility. The traditional vision of psychosis is, by the way, distorted by the fact that it only appears as such when it fails. Psychoanalysis is not powerless when confronted with this increase in the power of psychosis. The notion of ordinary psychosis, developed by Jacques-Alain Miller in Antibes in 1999, is an effort to theorize this
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7 8 D. Laurent, Inhibition, symptme, et angoisse, La cause freudienne 58, Navarin, Paris, 2004, p. 56-59. D. W. Winnicott, De la pdiatrie la psychanalyse, Payot, Paris, 1969.

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

question, which he approaches from notions like neo-triggering or over or under-identification. In the same way and in this perspective, Dominique Laurents article, which I have already cited, approaches the question of multiple personalities as the neo-dis-inhibition of the ego. Lacans last clinic, inspired by his reading of James Joyce and Joyces treatment of language in the Seminar The Sinthome which Jacques-Alain Miller recently clarified in his course Pices detaches (Spare Parts) enables psychoanalysis to follow this orientation of the subject of modernity, in the use of the signifier or in that of the object.

Language, Marking of the Body


New paths for analytic critical practice rest on analysts capacity to let themselves learn from subjects current forms of response to the master discourse, to follow the thread of analyzing discourse in particular when it does not seem to respond to psychoanalytic doxa without, however, distancing themselves from the rigor of the analytic framework. This particular link, this new discourse relies on the structures veins. It relies on language not as an instrument for the pursuit of meaning, of mastery, as a mode of communication or expression but as a marking of the body by random signifiers from which an always repeated loss results, which defines a mode of jouissance that is ignored by the subject. It is this marking that an analysis modifies or seeks to inscribe through a novel manipulation of speech: a speaking dictated by the real of the signifier.
Translated by Vivian Rehberg

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Marie-Hlne Brousse: Toward a New Psychoanalytic Clinical Practice

Can Subjectivity be Buried?

Philippe Douste-Blazy

The Ministers Discourse*

All through the week I was asked the following question: Are you sure you know what you are doing, going to the Psys Forum? I was asked this question quite often. Well, let me reassure you: I do know. I know that I am in one of the main sites of dispute regarding the debate that came up last year, and the site that has led to the creation of many other Forums all over France. And it is precisely here that I want to say that a Minister, without necessarily sharing all of your theses, can appreciate the enthusiasm you bring to psychoanalysis and the disciplines it has influenced: humanist psychiatry, clinical psychology and relational psychotherapy.What I would like to retain of its history is that psychoanalysis was born in the German language out of the genius of a single man, Sigmund Freud. With the exception of within a few enlightened circles, including that of the Surrrealists, France at first shunned its influence. A great French woman, Marie Bonaparte, played a formative role in enabling psychoanalysis to take hold in France, as well as in the physical survival of its founder, by helping Freud escape the Nazi deportation. Another great French person played a major role, this time in Freuds intellectual survival. I am of course referring to Jacques Lacan, who renewed Freudian studies and carried on with Freuds discourse. I would like to acknowledge that his daughter Judith is present here. Whatever quarrels may oppose Freud and Lacan, I pay homage to them together here. I would like to use this platform to acknowledge the place that the Socit Psychanalytique de Paris and the Ecole de la Cause Freudienne occupy in psychoanalytic life in France, without leaving out the numerous groups that also work to promote French psychoanalysis. I am also addressing those who practice relational psychotherapy and all the others the general public commonly refers to as psys. I know that you have recently felt misunderstood. I know that there have been misunderstandings. So, I would like to personally confirm that we have turned that page now. What is particular about mental health is that it must face the most intimate suffering. In confronting this secret, unspeakable suffering, the first obligation of a society founded on solidarity but also and especially on freedom, is to recognize that there cannot be only one kind of response. Psychic suffering is difficult to communicate; it cannot, in any case, be evaluated, nor can it be measured. I understand the extent of your conflict with the publication of a certain report on the evaluation of psychotherapies in 2004. I know that its content and its promotion have particularly offended you. In addition, at the time, this report had been placed on the Minster of Healths website. As soon as you pointed this out to me, my dear JacquesAlain Miller, I had it taken off the site. You will never hear a minister mention t again. Jacques-Alain Miller told me: they will be happy. He was right. Psychological illness resounds, as everyone knows, in a person as individual, but also as a social being, precisely because it alters ones relationship to the other, which is the basis for social ties. It is at once an individual and a social malady.
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* Originally published (in a slightly different form) as Le Ministre in Le Nouvel ne, n 6, 21 March 2005.

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Philippe Douste-Blazy: The Ministers Discourse

Yesterday I presented the general orientations of a working document called Psychiatry and Mental Health, which we have been developing by listening to some thirty actors in the mental health fields, including some of you, by the way. I am opening it up now to a very broad dialogue in order to come up with a plan of action that corresponds to the wishes of all the participants. I also wanted to address professionals working in medical or non-medial psychiatry; these are exemplary professionals who are motivated, competent, devoted, hard working despite extremely difficult conditions, and also exhausted from having to constantly maintain an ill-equipped ship afloat. And you know this: things are not going well in psychiatry; there is a strong feeling of disquiet, especially in hospitals. There have been many reports. Each Minister has asked for a report. Unfortunately these successive reports have not translated into visible action on the ground and as soon as I arrived at this ministry I sought to take stock of what has really been taking place. In fact, I discovered psychiatric hospitals suffering from a lack of means adapted to their needs. And in the face of mental illness, society keeps quiet, matching the silence that surrounds a system full of taboos. Like the delicate problem of confinement, which is different now than it was when Michel Foucault had already brought it to light. I would like to provide a response today that has been formulated with all of the actors involved, including psychoanalysts and psychotherapists, not only for public health, but also simply for our society as a whole. In order to respond more effectively to patients suffering from mental illness, it seems to me that one must listen to them, speak to them and establish the indispensable communication between them and the outside world. These invisible gestures restore dignity to patients and affirm their place, not only as someone suffering from an illness, as someone separate, but also as a citizen. And today, it has to be said and I have said it: psychiatry is confronted with a paradoxical and complex situation in our country. Comparisons with other European countries in the realm of mental health demonstrate that France is not living up to its ambitions: France has the highest suicide rate amongst the elderly, the second highest amongst adolescents, while its consumption of psychotropic drugs is also amongst the highest. We have one of the lowest recourses to psychotherapies in Europe General physicians treat more that 80% of patients suffering from mental disorders. Access to specialized treatment with a psychiatrist remains difficult. Of course, for a ministry of health not to mention this is more than an error. Paradoxically, France has more psychiatrists per inhabitant than any other country apart from Switzerland. It is the form of specialized medicine with the most practitioners: there are currently 13 000 practicing psychiatrists in France. France is in third place with regard to its hospitalization capacities, measured in the number of beds per inhabitant. But today, we are making a dual observation: public response is not appropriate and the psychiatric care offered is uneven all over France and suffers from being compartmentalized. These are the reasons, ladies and gentlemen, that have pushed me to draw up a Psychiatry and Mental Health plan, which I presented yesterday, and which reflects the priorities corresponding to the preoccupations I expressed during the listening phase. I will only cite the broad orientations of this document as I know that the talk I gave yesterday is already on your website and has been given to you. I thank you for that. It includes:
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Philippe Douste-Blazy: The Ministers Discourse

Preventing the withdrawal of investment in hospitals by obtaining a moratorium on the shutting down of beds in psychiatric wards; reinforcing human resources, in particular in zones lacking in psychiatric care, in order to allow for a better reception of patients; improving nursing training by providing nurses with an adaptation period to their jobs, and with guidance and tutoring; developing available socio-medical programs so as to relieve full-time hospitalization by creating jobs in home care; improving the treatment of depression and the battle against suicide. A number of people taking anti-depressants probably do not need them. On the contrary, less than half of those suffering from serious depression are cared for. The suffering linked to life difficulties is often confused with depression. There are no easy responses for combating suicide, but we should follow through and reinforce our efforts to reach young people. I would like to say to you now that this plan, it is a plan. . . and it is normal that the Health Minister is proposing a mental health plan. . . especially considering these paradoxes. But I would also like to return to the theme of our Forum: the secret. Bernard Henri-Lvy has just spoken about this so well. I am particular interested in this issue. Indeed, I am a doctor and I know that medical acts require speech. They require the speech of the patient who confides where it hurts and admits his or her anxiety and the speech of the doctor whose diagnosis might sometimes come across like a verdict were he or she unable to use all of the resources available in language to soften things or to maintain hope without lying. This is not simply a transference of information, it is a much more affective, much deeper and much more mysterious relationship; it is a transference in Freuds and Lacans senses of the word. And the one who is doing the confiding must be assured that no power will have access to the contents of his or her confidence. Of course, the right to the secret is not mystical depth; it is this inviolable sphere that was mentioned earlier, that makes a person act with discernment. The right to the secret is essential to the practice of medicine. This right belongs to the oldest traditions in the medical arts. The right may seem threatened, as you have noticed, at a time when the medical art tends to become a science of medicine. The fact that medicine has become scientific is the sign of incontestable progress. But scientific medicine must fight to preserve this space for the secret, without which it will wither. Without the secret there is no speech! And the Health Minister has to say this out loud in front of others, in our country. There is a law, a rule; there is also an ethics, which is the medical secret. In psychiatry more than anywhere else, stretching the rules on the trust between a patient and a doctor is unthinkable. But, because over the past weeks I have been confronted with difficult realities, I would like to ask you a question that I have been asking myself. I would very much like you to help me find a response to this question because I do not have one. I have been questioning certain limits. First, can we put limits on the secret? And if so, what are they? And, should we ask ourselves if we should not, on occasion, infringe on the secret where certain subjects are concerned? For example, I recently encountered this problem in a case where it was an issue of danger. It was a question of a person who had just committed a crime for a second time, who had already killed, and whom we know may kill again if this person does not get proper care. The question I am asking is whether or not the doctor has the right to say, when we find a person dead, assassinated, Hold on, this might be him? It is a question that haunts me because I have just lived through it and I do not know how to respond. For

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it is obvious to me that I am obliged to say that the medical secret must remain intact. I have always said this. But deep inside I wonder if at a given moment such danger should not, at least in the collegiality of our reflections, pose a delicate problem for the lawyer, the priest, or the doctor. There is at least one moment where the question may be asked. As for the personal medical file, we must be clear. The personal medical file, Bernard-Henri Lvy, is not an open medical state. The personal medical file will only exist under the condition that the secret remains intact and of course especially with regard to mental health, psychological approaches, and psychiatry. It will be monitored, naturally. But, I can tell you this: I personally do not want there to be psychic, psychological or psychiatric data in the medical file. Of course I considered this when I was thinking about the personal medical file and when I decided to include it in the law. But I also thought about other potentially terrible relationships: The relationship that a company doctor might have with the personal medical file. The relationship that predictive medicine might have with a personal medical file. Today, we can know if a young girl of ten or eleven years old is predisposed to breast cancer. We can know if a ten-year-old boy is predisposed to diabetes or high cholesterol. And this is a major concern for what follows, for personal events. And what if the company doctor or the insurance company had access to this information? This would be the beginning of a serious infringement on individual freedom, on who we are. Psychiatry, mental illness, psychology, but other things too. We are really only at the beginning. So, I, as an epidemiologist, a public health doctor, would like a medical file with scientific data, but with barriers and limits that cannot be infringed upon that will be set from the beginning. Finally, I would like to say that for me, the medical file is certainly not the medical file of a hospital, a doctor, or a clinic; it is human beings medical file. And so it is absolutely crucial to be able to continue thinking in this direction. So, ladies and gentlemen, even if the boundaries between psychoanalysis and medicine are not always easy to define, the therapeutic and social applications of psychoanalysis are growing. An increasing number of participants from different sectors are making reference to psychoanalytic practice. The importance of listening is very widely recognized in the realm of business and on the level of the State. It was therefore natural and necessary to call upon psychoanalysts when elaborating the Psychiatry and Mental Health Plan. And if your Forums meet with such a response, it is because, beyond any circumstantial dispute, they stem from a genuine humanistic concern that the person remain at the center of our society, that the person preserve this space for the secret without which our liberties would perish, that the person keep his and her right to speech, which is just another name for democracy. When it is a question of defending these highest values of humanism and democracy, I will always be on your side. It seems to me that one of the obligations of the state is to create spaces for free choice and responsibility for those who act and who know. I know you play a major role in our society and I will respect it. You will see, as much through the method as through the means made available, I do not want to create a simple plan, but a genuine policy involving all of its partners. I know that I can count you amongst these partners. You can count on me.
Translated by Vivian Rehberg

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Philippe Douste-Blazy: The Ministers Discourse

Bernard-Henri Lvy

The Philosophers Discourse

My dear friends, dear Jacques-Alain Miller, Mr. Minister, I would like to speak to you not as a doctor, obviously, nor as any kind of practitioner, but as a philosopher. I would like to make several philosophers remarks on the question of the secret and the right to the secret that has brought you together.

Nuances
My first remark may surprise or disappoint you. But I do not think one can claim that one has the right to a secret without nuance, without precaution and without at least attempting to complicate the notion a little. For, in the end, we know: the right to secrets is also, at the same time, a right that governments proclaim. This right to have secrets is one that also means having the right to stifle the truth, the right to undertake clandestine action. It is a right that is written in all of the best and the most honorable as well as the worst and the most horrifying treaties on how to govern. I have in mind, for example, an eighteenth-century treaty that Michel Foucault gave a commentary on, the treaty of the Abby Dinouart, from 1771 I think, called Lart de se taire (The Art of Keeping Quiet). Yes. . . the art of stifling the truth, the art of creating secrets, the genuine art of the secret that is found at the very heart of good government action. May I remind you, moreover, that it is the reason why the last of the democratic revolutions in the twentieth century took place under the heading of glasnost, of transparency, of the unlocking of secrets? This should not be forgotten. Another preliminary remark. One mustnt either lose sight of the fact that this case of the secret, this notion, this very word secret, this thematic of the secret is radioactive and so quite toxic within French thought, in European culture generally. In his book The Nineteenth Century Across the Ages, Philippe Murray has already shown how the obsession with secrets and the occult, the thinking of history in terms of secrets, the occult and conspiracies ended up feeding some of the darkest pages of the nineteenth and twentieth centuries in the West. Isnt this still true today? We would do well to locate the traces. And I am not going to teach you anything about how the inventor of psychoanalysis perceived this. He happened to admit his secret inclination for the occult, I think that was his phrase, in his New Conferences, in particular. He found himself surrounded by an entire group of men that went beyond the secret inclination and who became very implicated in this issue of the occult. Of course, I have Jung in mind, but not only him. I am also thinking of Fliess, of Jones, of Ferenczi, whose early texts deal with questions of spiritualism and magic. So I will not instruct you as to the energy with which Freud cautioned against the black tide of occultism and how he ended up saying that the unconscious is not the secret; that repression is not the occult; that the unconscious is what is encrypted in speech, hidden in the text, but that it is not secret in Jungs sense or as in the early Ferenczi. So, it seems to me that we still need to use caution with respect to this particular issue. Caution is absolutely necessary. And then, finally, for my part at least, the last reason for my wariness and for which one has to arm one_______________________________________________________________________________________________________
* Originally published as Le Philosophe in Le Nouvel ne, n 6, 21 March 2005.

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Bernard-Henri Lvy: The Philosophers Discourse

self with a bit of vigilance when approaching this affair of the secret comes from what I retained from my acquaintance with the great thought of Sartre. You know how he insisted that human freedom does not depend on fidelity to what a person is, nor on fidelity to what a person is hiding what one of his contemporaries called the miserable pile of secrets but it depends on the actuality of what a person does, in the poetry of human acts and the encounter between the persons being in itself and his or her being in the world. Sartre, who declared with familiar insolence his joy of being delivered from inner life. . . Sartre, the anti-Proust, declaring that he had finally been freed of his Proustian illusions. . . Sartre, who may have had a bit of a tendency to confuse Proust and Bourget, but in the end, I retain from him this doubled over, reiterated, vigilance with regard to the issue of the secret. So, these are my reservations.

The Hunt for the Secret


Well, inversely of course, it is evident that the opposite is at least as true. . . It is evident that it is even truer, that it is what is currently threatening us and it is what we are speaking about today. If those who govern keep their own crimes a secret, they keep themselves apprised of our activities. For them, the secret; for the others, intelligence. The secret for their own machinations; light for those they govern and administrate. Everything that has been said since I have been here, everything I have heard, testifies to this with much precision and elegance. It is indisputable. More specifically, and more profoundly still, after the horrifying experiences of the nineteenth century, we know today that totalitarianism deals in transparency and light as much as in opacity and shadow. It is a light shone, or supposedly shone, into souls and into their secrets. It is the infamous history of this conventional deputy who jumped out of his skin on his bench when Robespierre appeared at the tribunal the night of the 8 Thermidor. His neighbor asked him, Why did you jump? and the deputy responded: Because I just saw Robespierre and he is going to think that I am thinking something. This is a terrible story and it is recurrent. This hunt for secrets is at the heart of all totalitarian projects. At the heart of all fascisms lies what Bernanos, citing Malraux citing, I think, a sentence in LEspoir, called the conspiracy against an inner life. No, there is no totalitarianism, whatever the ilk, no despotism, including its most barbaric and most recent forms, that does not resort to this conspiracy against inner life, to this conspiracy against trust or confidentiality. There is someone here on this panel, I have in mind Edwy Plenel, who I dare say has experienced the two sides of this relationship that power, or super power, or power on the road to super power has to the secret. He experienced it first in his investigations of the Rainbow Warrior case, and others, for Le Monde. He dealt with the will to stifle cases, the will to keep secret State secrets which is the primary aspect of governmentality. And then he had to deal and is still dealing today, in the trial you all know about, with this monstrous indiscretion which is also proper to the State when it starts hunting, casting light on to each persons or some peoples privacy; onto some for the moment and on everyone someday.

Small Conceptual Operations


So, fine. If these two things are true, if the two aspects of this right to the secret are correct, as it seems to me, then I would like to briefly add a few words. It seems to me that we are invited to perform a little bit of conceptual work, a small task of epistemological recasting of this very idea of the secret. It seems to me that in order to validate this proclamation for the right to the secret and escape this dual stumbling block that I have just described, we need to undertake a couple of small conceptual operations. Now, we are not going to undertake them today, naturally. But we can suggest a few directions.
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Bernard-Henri Lvy: The Philosophers Discourse

The half-said For example, it seems to me that one must try to get out of the conceptually absurd and politically ruinous frontal confrontation in this question of the secret between saying everything and not saying anything. And on this front, I think the Freudians, and particularly the Lacanians, are well equipped with the concept of the half-said. Forgetting and unveiling It also seems to me that in order to ask this question of the right to the secret in epistemologically acceptable conditions, one must get out of the frontal confrontation that nourishes the vacillation between the two conceptions of the secret and the way that governors or tyrants seize hold of them; that is, the face to face, then, or the opposition, the reduction of the question of the secret to opposition, if you prefer, between veiling and unveiling. There is a text by Heidegger called Serenity in Question III. It asks this question of the secret and it more or less says: the question of the secret, that is, the question of the relationship between its veiling and unveiling is analogous and it should be posed according to the same terms as the question of the relationship between forgetting and unveiling, between Lth and altheia. Liquidation of forgetting: a sophistic position. Fixating on forgetting, on what is ineffable in a being that will efface itself forever in an ontological retreat: this is the metaphysical position. If we do not want to fall into the sophistic or into the metaphysical position, Heidegger says, then we must see appearing as a mode of being of the secret, forgetting as mode of being of altheia, and vice versa, ad infinitum.

A Secret Being
And then, I especially believe, and this is the most important thing, I especially believe that if we want to escape this vacillation, the real work entails de-ontologizing this affair. Thirty or so years ago, Pierre Boutang published a book called Ontology of the Secret. Pierre Boutang was a great intellectual. But he was also a follower of Maurass and someone I feel quite at odds with. Anyway, he wrote this book Ontology of the Secret. And it seems to me, yes, that this is the third conceptual operation we must undertake: work that would de-ontologize the question of the secret; work that would tell us that, at bottom, the real secret in this affair of the secret is that there is no bottom, that the question of the secret should go beyond this verticality refuted by Sartre, and by the theoretical anti-humanism of the sixties and seventies; a reversal replacing this vertical question with a relationship between a surface and a depth that would gradually skim and come back to the surface, an entirely different arrangement that I would like to describe as horizontal. And in which pockets of singularity coexist with pockets of subjectivity, which, whatever their definition, whatever their depth, whatever their philosophical allegiances, are each well isolated and distinguished from all the others. In the end, speaking of the right to the secret and speaking of it in an operative way would consist, should consist, in returning to the very etymology of the word secret. Secret means discreet, means discernere, so it means to separate, yes, separate in discrete units, distinguish wellisolated units from each other, accommodating one with the other only when a face-to- face experience takes place and the singularities that make up a society decide to communicate or get to know one another. In other words, the right to the secret means: not getting caught up in a kind of mystical and indescribable depth. But, supposing that around each being there is a sort of invisible and inviolable sphere that makes of each a discerned being, a separate being, indeed a secret being. The guardians of the secret And now finally, my last remark. Since it is not enough to create a separate space around each being, one must watch over this separation and for that, one needs institutions, or more precisely, watchmen, guardians
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Bernard-Henri Lvy: The Philosophers Discourse

of the secret, guardians of this invisible and inviolable sphere around each person you have named these guardians, they are represented around this platform, these guardians of the secret are lawyers, journalists, doctors, and the fourth is missing: the priests, the confessors. Here we are. What appears to be the case today and what has brought us together is that each of these places where secrets reside are jeopardized. The lawyers are jeopardized because all it takes I do not know if Thierry Lvy spoke about this, surely he did is a suspicion of complicity between a lawyer and his client for the inviolability of the secret he or she holds to be called into question. The journalists are jeopardized, because the review I write for every week, Le Point, is a testimony to this: journalists who refuse to give up their inalienable right to the secret of their information, which is the very condition of the quality of a journalists work of informing, risk penalties. Over the course of the past year and in the battle we have waged and are still waging together, now with the support of Philippe Douste-Blazy, we have seen the extent to which doctors are jeopardized: JacquesAlain Miller mentioned this risk earlier; it is the risk of what Michel Foucault referred to as the Open Medical State, parodying Fichtes title. Yes, today there are Open Medical State projects that are jeopardizing the third place the secret resides. And finally, there is a case that I was led to by chance, which seems to be perhaps even more characteristic and almost even more characteristic than the Icelandic case about human guinea pigs that we spoke about so strangely and terribly earlier. There is a decree by the Court of Appeals from December 2002 bearing on a case of pedophilia within the Church. A priest accused of pedophilia appeared before the archdiocese of Lyon. The plaintiff thought the procedure was taking too long or getting bogged down. He appealed to a civil court. He appealed to an investigating magistrate in Nanterre, more precisely. The investigating magistrate confiscated the diskettes more or less involved in this case from the archdiocese and, in the process, gained access to a certain amount of confidential information pertaining to the private life of individuals implicated in this case, and even beyond. And the Court of Appeals then rendered this decree dated December 2002 that says that the question of the secret in the auricular, face to face meeting between the priest and the parishioner, this question that is almost as old as the Hippocratic Oath, the question of this secret is now at the judges discretion.

The Four Fronts


Today, there is a veritable battle being waged on these four fronts: on priests and confession, on the ill and their doctors, on lawyers and their clients and on journalists and their obligation to inform. There is a battle for indiscretion, a wind of indiscretion blowing on our societies. And I believe that all those who respond to the question of knowing whether we should defend society or the subjects that compose it no matter what our definition of the subject, by the way, traditional humanist or otherwise all those who, respond to the question of knowing whether we should defend society or defend subjects by saying that it is urgent to defend subjects and to defend them here against societys indiscretion, against this upside down panopticon that misdirects the gaze of all onto each person and no longer of the sovereign onto all I say that today one must demonstrate the same ardor that you have, Jacques-Alain, and that all of you have in fighting against the Clry-Melin plan and the Accoyer amendment. It seems to me that we also have the duty to defend lawyers, journalists, doctors and priests in our duty to preserve the secret.
Translated by Vivian Rehberg

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Bernard-Henri Lvy: The Philosophers Discourse

Miquel Bassols

Banking On the Subject

The French Health Minister, Philippe Douste-Blazy, banks on the subject when he says, convincingly and with solemnity: Mental suffering cannot be evaluated or measured.

The Phrase
That sentence opened his talk at the recent Forum des Psy on February 5, 2005, and had been given at a press conference the previous day. The Minister banks on the importance of preserving the singularity of the speaking, suffering subject. It is also a position aimed at safeguarding the idea of the subject that the analytical experience finds at the heart of the symptom as that thing irreducible to meaning. Today, this conception of the subject must be defended on many fronts against scientific and evaluational inertia. The Health Ministers phrase does not state an obvious fact; not for the general public, or even for many professionals in the therapy world. It is quite possible that it is not evident either for a politician bombarded with figures and percentages as well as demands for profitability and efficiency. Yet it is that phrase that drew the most applause from the audience since this was a victory obtained thanks to a very broad and unfailingly intense movement brought to the attention of the French public by Jacques-Alain Miller. This movement has been sustained thanks to the collaboration of all who have supported the Forum des Psy since the famous episode last year concerning the Accoyer amendment. Someone asked the Minister before he went to the Forum: But do you really know what you are getting in to? he tells that story himself. The person who asked that question probably thought he was running a political risk, speaking to an audience Le Monde considered turbulent. It wasnt much of a risk compared with the risk he took in defending the argument in favor of the subject that was the basis of his talk.

The Consequences
No, Philippe Douste-Blazys phrase was not at all obvious, any more than the consequences it will have if we follow it to its limits: as much for clinical psychoanalysis on a case-by-case basis as for everything that concerns the politics of the symptom, once the scope has been extended to mass phenomena of the subject today. One has to see that. . . If, in fact, there is, in the subjects suffering, something that cannot be evaluated or measured, then each time one wants to assess it, to quantify it, one will be suspected of trying to camouflage the subjects most intimate truth. So it is with great reserve that one can read and manipulate figures, and there is always a price to pay: that of not hearing the truth in a case that cannot be totalized. If there is, in a subjects suffering, something that cannot be evaluated or measured, then the myth of efficiency that sustains the new techno-scientific religion and its preachers of evaluation constitutes, in the end, a subtle deception and a real danger for any policy that purports being responsible for the subject. It is a blindfold for the clinician and that could be a siren song for foolhardy adherents to sociomania a term coined by Philippe Sollers and recently emphasized by Jacques-Alain Miller.
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* Originally published as De Douste-Blazy Elena Salgado in Le Nouvel ne, n 6, 21 March 2005.

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Miquel Bassols: Banking on the Subject

If there is, in a subjects suffering, something that cannot be evaluated or measured, then the therapeutic prudence invoked by Graciela Brodsky, the Delegate General of the World Association of Psychoanalysis, in her Project for a declaration of principles in analytical practice. It is the prudence recommended by Sigmund Freud in the face of all furor sanandi, that he interpreted as a veritable religious fanaticism. And it is, in fact, a fanaticism not so easy to get free of, as one can see in the fact that we are having to deal with its triumph in todays mental heath policies, those policies that act in the name of so-called efficiency in the disappearance of the symptom.

The Ethic
In Spain we are not by far protected from the control of evaluation, guided by the ideal of efficacy. Its effects, in fact, can be felt in a more secret and subtle way than in France, but they influence all care and training systems, especially in the field of mental health. The argument of profitability is also at the forefront, for example, in the declarations made by Elena Salgado, Spains Health Minister: When we say we want to be efficient, we are not calling for the introduction of indiscriminate mechanisms of containment in health expenses, but we insist on setting up ethical norms. By this I mean it is not ethical to be inefficient, because then we would be dilapidating the resources that belong to everyone and are always limited. (Forum of Cinco dias, Madrid, 16 November 2004). It is not easy to respond to such a petition of principles, so politically justifiable, even though one can say that it has to be expressed in a double negative. Inefficiency cannot, of course, be an ethical principle. But on the other hand, can efficiency be the main guide for political actions? When the psychic suffering of the subject is at issue, this principle could, paradoxically, lead to an absolutely inefficient result, to a return of the symptom in increasingly insidious forms. The fatality of clinical observations turns against statistical efficacy. The ethical problem for psychoanalysis is to explain this inefficiency and the subjects part in it. It would not be out of place to evoke here the Aristotelian difference between efficient cause ascribed by Lacan as the cause for the efficacy of magic and the material cause, that implies the subjects relation to the truth. But in any case, ethical exigencies consist in seeing to it that subjects can find their own relation to truth and assume their own responsibility, and that they do not disappear with truth as so often happens in statistically cured cases. On this point, the quantifiable of the efficient cause will always mask the truth as cause; a cause that is implied in political action as well as therapeutic practice. So it is in that sense that we take Philippe Douste-Blazys phrase as a radical turning point in todays health policies, as banking on the subject beyond and against any quantifiable criteria of so-called efficacy.
Translated by B. W. Cann

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Miquel Bassols: Banking on the Subject

Jean-Claude Milner

The Return of the Dangerous Classes*

The nineteenth century lived with the conviction that the poor could be dangerous; terror came from below: a conclusion drawn from the French Revolution. One could say that the twentieth century lived with the conviction that one would know how to treat that danger: with a clever combination of repression and social progress. The main danger came from the people above: a conclusion drawn from two World Wars. This conviction was intense in France, where one tends to mistrust governments and administrations whatever their persuasion. It is true that France has had, repeatedly, resolute and harsh lessons along that line.

A change has taken place, nevertheless. At the threshold of the twenty-first century, a specter is haunting Europe: the terror of a danger from below has returned. The powerful have contrived to spread that terror throughout society, even among the common people. We believe, once again, in the dangerous classes. In 1838, the French Academy of Moral and Political Sciences awarded a prize to a work entitled Des classes dangereuses de la population dans les grandes villes et des moyens de les rendre meilleures (On the dangerous classes of the population in large cities, and the measures for their amelioration). The author, a certain Frgier, was administrator at the Prefecture of the Seine. With an undeniable sense of rhyme and assonance, he enumerated the links in the danger chain: large classes, indigent classes, depraved classes, laboring classes, dangerous classes. Thus alerted by the Sciences, the most moralistic politicians found the answer: a merciful society. Even if that meant disguising Christian mercy in its secular clothing: social progress, going forward, acquisition, etc. In 2003, I came across a Senator who expressed himself as follows in a committee on social affairs (Commission des Affaires Sociales): Some people think the laboring masses should be psychiatrized ; he added, it is true: Im not there yet an admission of weakness perhaps. Out of a sense of decency, the Senator substituted the qualifier laboring for dangerous, but the synonymy brushes the surface of the tongue. Implicitly, he takes note of an innovation: social-Christian mercy is no doubt necessary, but it is no longer sufficient even in its secularized form as social progress: it must be completed by medical science. The latest innovation: we can no longer be satisfied with effects, we must reason in terms of prevention and precaution. Not a merciful society but a cautious society. It is clear then what is at stake in mental health. As a segment of public health, it is the place where the most dangerous disorders find their deepest source. If it is so important to impose order among the mental-health professionals, it is so those professionals can play their social role scientifically: go to the root of what produces dangerous classes. That root is the dangerous individual before she or he becomes dangerous; it is the suffering individual while he or she is still just suffering. In matters of prevention, the decisive moment is beforehand. The great failing of therapists in the eyes of a society once again in the throes of terror, is that they come afterwards. And what if one could change
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* Originally published in French in Le Nouvel ne, n 4, 9 February 2005.

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Jean-Claude Milner: The Return of the Dangerous Classes

that? Medical knowledge guaranteed by academic titles that could detect, in advance, potentially dangerous individuals: that is called psychiatry today. Probably not French psychiatry, too attentive to what subjects say, but a psychiatry which will have found its models where social efficacy is at its zenith. In the United States of course, but that is only because we no longer dare speak of the Soviet model, so heavy with infamy and yet much more operational than we can say. Do you think I am making this up? That I am going too far? I am often reproached for that. But here is a text that appeared in the official French bulletin of education, the Bulletin officiel de lEducation nationale, dated November 11, 2003. Its preamble: Schools have a particular responsibility, in close collaboration with families, to watch over the health of the young people entrusted to them and to encourage the harmonious development of their personalities. The school also participates in prevention and in the promotion of health. . . A quote chosen at random: The protection of young peoples health is the first link in the chain that preserves each health capital [. . .] That is the importance of the schools role in watching over the well-being and the physical, mental, and social development of the student, and to ensure, throughout the school years, a health education that is adapted to contemporary issues and contributes to the prevention of risky behavior and situations. From this we have a series of measures, investigations, and surveillance that involves everyone: teachers, nurses, doctors, cooks, in what can only be called a cordon sanitaire of children, adolescents and soon parents. Of their bodies and their psyches. Health capital. Those who have read Stalin will remember one of his titles: Man is the most precious capital. Such echoes make sense. The school is to be the magic operator that permits one to act in advance, to prevent social dangers. We have come full course; I denounced its premisses twenty years ago. We have clouded teachers minds to such a point that they literally dont know what to do anymore: impart knowledge or not, accept ignorance with blissful admiration or fight it, respect their students or serve the powerful; they have been told one thing and its contrary. But basically they have been told just one thing: if you do what you know how to do, and you do it well, you are wrong; get in touch with modern times and accept to do very badly not only what you do not know how to do but what it is your duty to not know how to do. Some time ago, these youngsters were encouraged to become heads of companies; that was when we believed that the response to the danger from below would be economic. Young people from the working-class suburbs would stop being dangerous if they got rich. After that experience, start-ups looked suspicious: the danger must be treated at a deeper level, through the mental and its mechanization. In the schools, professors had to become therapists and bad ones. Outside the school, we see that imposing order on the therapists is pure pretence: we make people believe we want to prevent just anybody from calling themselves therapists, but the contrary is true; the program is the become-a-bad-therapist of any agent of the powerful. Because in the meantime the therapist, will come under the control of the civil-service scientist as the first link in what? Not even social order, but social tranquillity. Like the concierges of former times (controlled by the neighborhood police chief), who had to prevent people from making noise after 10 p. m., the therapist will now be called on to be the guardian of the masters sleep. For the masters are indeed sleeping, and they want to go on sleeping. It is true that the more they sleep the more difficult bedfellows they will be; without having to wake up, they want to occupy an ever wider space in the bed and we who have to share that bed with them are always at risk of being tossed out. It is up to us to make a noise, a noise loud enough that, should they sleep like logs they will be prodded, so loud that they wake. Brutally if necessary. And if by chance they are walking in their sleep, they will fall.

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Jean-Claude Milner: The Return of the Dangerous Classes

Eric Laurent

How We Inform the People**

On Saturday March 12, France Culture ran a radio program in the series Science-frictions produced in collaboration with Le Monde, from 12 to 12:30 pm. Its title: Can psychoanalysis be evaluated? Michel Alberganti, from the Science section of Le Monde, used the sentence pronounced by Health Minister Philippe Douste-Blazy as his point of departure. According to Douste-Blazy, psychic suffering cannot be evaluated, nor can it be measured.. Alberganti countered it straightaway. He adopted the point of view of the Inserm (National Institute for Health and Medical Research) report, as if this collective expertise was the voice of science and asked three questions, each more biased than the others. Here they are (the parentheses are mine): Can a single Minister decide to banish (nothing less) a report undertaken by the principal medical research institute in France? Can psychoanalysis refute the very principle of an evaluation of its practices and results when a great number of patients put their trust in it? (The Minister claimed that it is psychic suffering that cannot be evaluated nor measured). The Inserm report is a synthesis of almost a thousand studies on psychotherapies worldwide. Can the method the researchers followed be scientifically criticized and, as such, can their results be contested? (Note the hijacking of the nice word researcher to designate experts who think they know everything). In response, he called Mr. Cottraux and Mr. Widlcher to a face-off. He carefully hid that Mr. Widlcher had already been heard by the experts, and had encouraged them. We were led to believe that there were two points of view, but in fact the two of them are as thick as thieves. Mr. Widlcher began by saying that he was surprised by the Ministers gesture. The document may be criticized, but the report was ordered after all. . . He went on to say that he was partial to evaluation, which is inevitable when one works in the healthcare professions. There are two tendencies in the psychoanalytic movement, he continued, the IPA and the others. Mr. Widlcher thinks he can claim that no member of the IPA was present when the Minister spoke. He emphasized that the other current, represented by Roland Gori, Elisabeth Roudinesco and Jacques-Alain Miller, is not part of his parish. As for Cottraux, he said that this study was poorly read for malicious reasons. Psychoanalysis is not at issue in it; short-term psychotherapies inspired by psychoanalysis are. With the same persuasive tone he must use in the therapies he practices, he declared: We have only studied psychodynamic (psychoanalytic) therapies.
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* Psychoanalyst, Le Monde subscriber. ** Originally published in French in Agence Lacanienne de Presse, New series, no. 36, 14 March 2005.

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Eric Laurent: How We Inform the People

It just doesnt add up. Its like hearing OBrien in Orwells novel 1984. No, we did not discuss psychoanalysis; we discussed psychoanalysis in parentheses. Cottraux also guaranteed that the evaluation had been made on the request of patient associations and Bernard Kouchner. Cottraux thus presented himself as simultaneously sponsored by consumers and the major Left political party. He complained that he had been censored. Those who support behavioral therapies are now presenting themselves as the victims of a Ministers inconsiderate schemes, while they are the ones militating in sciences favor. Yet, the report is sold in bookstores, on line, it can be entirely downloaded from the Inserm website. One can also consult the sites of associations for Cognitive Behavioral Therapies (CBT), and now the France Culture radio website. Oh the poor persecuted! How brave they are indeed! After Cottrauxs tirade, Widlcher felt relieved. I am relieved, he said. It does not concern psychoanalysis. He recognized that short-term psychoanalytical therapies are not psychoanalysis and that they cannot function without persuasion. In this way, moreover, they are closer to CBT. As for psychoanalysis, he said, it must be evaluated. He distinguished between psychoanalysis applied to people with life difficulties, where the therapeutic benefits are difficult to evaluate, and psychoanalysis integrated into health care systems, where its effectiveness must be evaluated. It is as if we have gone back to listening to former health minister Matteis discourse, which carefully distinguished between the blues and true disorders as outlined in the DSM. Clearly, Widlcher is in this camp. Throughout the interview we learned that he has often worked as an assessor at the Inserm, in order to establish protocols in the pharmaceutical treatment of depression. We also learned that he was the first president of the French Association for Practitioners of Behavioral Therapies, at a time when he considered them unjustly persecuted. He was surprised that the representatives of these associations are now persecuting him and psychoanalysis and at their arrogance. Having Widlcher speak as a so-called defender of psychoanalysis is like being in a Fritz Lang film in which the police chief is none other than the terrible Dr. Mabuse. He who is supposed to defend psychoanalysis turns out to be the first president of the French Association of CBT. He who is supposed to defend psychoanalysis hides behind the miserable distinction between short-term therapies, or targeted action, and long-term therapies that serve to prevent lapses. He who is supposed to defend clinical practice admits a distinction between life difficulties and DSM recognized disorders. It might be an occasion here to recall Freuds opposition to authoritarian suggestion and the exercise of persuasive power. He only mentioned Freud once, citing his infamous 1918 phrase about his refusal to mix the pure gold of psychoanalysis and the base lead of authoritarian psychotherapies. Subtle Germanist that he is, Widlcher mentions that the German text does not speak of lead, but of copper. Copper, he says, is a very useful alloy. Its just unbelievable! Everyone should listen to this radio show. It is an instrument for edification. When confronted with Cottrauxs brutal attack, Widlchers defense consisted in repeating (I summarize): we are doing the evaluation, but it is difficult and it is taking a long time. One cannot evaluate a treatment for schizophrenia in three months; it takes years. One would think he has never even read the Inserm report. CBT practitioners and expert statisticians like Bruno Falissard, who went to Polytechnic, do not back off in the face of these details. They think they know perfectly well how to measure CBTs effectiveness in

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treating personality disorders, and in six months. They do not see where the difficulty comes from. They know how to measure, luxuriously. Caring for schizophrenics over long distances is another thing altogether. The difficulty, the humility inspired by the recent dramatic events in Pau and at the Jean Moulin medico-psychological center, does not occur to them. Cottraux blandly accepted Widlchers contortions. He reminds him that CBT are equal to psychoanalytic therapies in their effectiveness in treating personality disorders. Well well! He forgot about his earlier rhetorical precautions. In passing, he recognized the over enthusiastic CBT associations blunders. But, really, one should understand them: it has been shown that CBT are more effective in treating fifteen out of sixteen disorders. Here we quickly arrived at the true subject of the radio show. The journalist, who had pretended to set two colleagues in a face-off, brought up the common ground between Cottraux and Widlcher: the denunciation of La Cause freudienne. Widlcher asserted that he feels no solidarity with those who practice a technique in which one does not think with the patient and with short sessions. The journalist then asked why the psychoanalysts he represents have not made their approval of the report more loudly heard. Cottraux denounced La Cause freudienne as a manipulative lobby that has played an entirely negative role in this story. He likened us to Tartuffe and the Company of the Holy Sacrament. We would be a sect seeking to get its hands on the State. He noted that, if the director of the radio program would like, such violent statements could be cut from the radio show before being played. They were not. Perhaps others were. How did Cottraux arrive at this lovely analysis? By speaking with thirty or so colleagues in Quebec, England, and the United States. To summarize: thirty of Cottrauxs colleagues, which it takes three countries to bring together, are Reason. The twelve hundred people that attend the Psychoanalysts Forum are a sect. How long will it take Cottraux to realize that it could very well be the opposite? In France, there is only a small group of behavioralists, but they cast a quite an unfortunate shadow on French thought. It is true that the CBT practitioners have managed to make the highest representative of the IPA, over which Widlcher presides, fold. What would our Argentinian friends affiliated with this group say? The final moments of the exchange, as the journalist noted, were bathed in reconciliation. Cottraux said all the good he thinks of Fonagys report, promoted by the leaders of the IPA, which seeks to force an out and out evolution in psychoanalysis worldwide. In fact, Fonagy has invented nothing of worth in psychoanalysis today. His point of view only encourages the proliferation of administrators that want to colonize and bring all practices and activities, in Europe as in the United States, into line. Our two colleagues agreed that Fonagys path is the path of the future and that German and Swedish psychoanalysts have shown the importance of the measure and traced the way. In the end, Widlcher clarified that if he had known how things with the report were going to turn out, he would have put greater methodological precautions into place. And, furthermore, due to a lack of time, he had not been asked his final opinion. In short, he washed his hands of it. This is Widlchers idea of psychoanalytical ethics. Widlcher himself had told Elisabeth Roudinesco that Lacan had refused to shake hands after his last meeting with him. Now we can better understand why.

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The same methods used in this radio program governed Catherine Vincents article in Le Monde on March 9. They pretend to questions the pros and cons as if in a scientific debate. It is nothing but a Potemkin village, a pure pretence. In reality, they question people who think the same thing; they do not give voice to a true opposition. This finds its expression in Le Mondes letters to the editor. It appears then that after the structuralist phase of the history of the human sciences, a small group has seized hold of the prestige of the signifier science and wants to bring the human sciences, restored to their certainties and delivered from post-modern relativism, into line. This leaves room all over the field for little techniques like CBT, which, like the little biology denounced by Philippe Pignarre for its comparative medicine versus placebo test trials, would like to grow into a science. Generalized benchmarking is taking place everywhere instead of articulated thought. Perhaps we could use this occasion to remind those who read Le Monde what one of the newspaper writers, Jean-Paul Fitoussi, recently wrote about the benchmarking. Throughout the interview, Widlcher cited the fable of the fox and the stork. He would have been better off mentioning the frog that wanted to be as big as the ox. As for maneuvers of certain members of the Science rubric in Le Monde, they are hardly scientific. It is time that the world was informed. It will be.

Translated by Vivian Rehberg

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Agns Aflalo

Portrait of Freud as a Behaviorist*

Freud wrote letters, numerous letters. Many of them have been translated and published in France; many still remain to be translated and published. Christfried Tgel has edited a selection of letters from trips Freud took mainly, but not only, to Italy between 1899 and 1923. Fayard has published this selection in French with a preface by Elisabeth Roudinesco. A well-known author (Philippe Sollers) provided an account of the book in the March 4, 2005 issue of Le Monde des livres. His article is a masterpiece of gentle irony. For its account, Le Figaro chose Franois Lelord, a corporate psychiatrist specializing in cognitive-behavioral therapies, who has written books on the subject. He writes: Freud suffered from a phobia of trains, which was undoubtedly aggravated by the frequent news of rail accidents. He was quickly healed of them by traveling with his brother Alexander, a transportation specialist and author of a railway guide, who was well placed to reassure him about the real danger of train travel. He comments on this in the following terms: The patients information of the real risks, exposure to the feared situation: here is a magnificent example of the behavioral therapy of a phobic patient, a technique that certain followers of psychoanalysis vigorously denounce today. Nothing is further from the truth. Freuds fear of travel is linked to infantile desire for women, which proceeds from the infants identification with the mother. He wrote about this in the following terms on October 3, 1897 (Letter 70, The Birth of Psychoanalysis): The first thing to generate a neurosis in me was a woman [. . .] I also discovered later (between the ages of two and two and a half) that my libido had been aroused and was turned toward matrem, and this during a trip in a train [. . .] that I took with her and during which I must have seen her nude, as I was sleeping in the same room. While he had not yet formalized the castration complex, the core of infantile neurosis, Freud used this concept to examine a symptom in his adult life. His letters from November 14 and December 2, 1897 confirm the cause of this symptom, which he healed at the beginning of his self-analysis with Fliess. His brother Alexander was not the only person to have accompanied him in his travels: Ferenczi, Jung, Martha, Minna or Anna did as well. Last Thursday, Le Monde gave an entire page over to experts from the Inserm (National Institute for Health and Medical Research) for a fitting self-celebration of their own competence as well as their courage in persevering in their magnificent quantitative effort concerning the much needed evaluation of psychotherapies, despite results recognized by the very authors of the reports as hardly probing, even invalid, and above all despite the nasty jibes launched by mocking Lacanians. Le Figaro does even better: drawing from the best sources, the person in charge of the review transforms the founder of psychoanalysis into a behaviorist. A forced policy of the cognitivization of psychoanalysis began shortly after Lacans death. A certain member of a well-known and eminent international association devotes his work and his days to it. One would
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* Originally published in French in Agence Lacanienne de Presse, New series, no. 36, 14 March 2005.

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be happy to see this hero of thought supported in his effort by the most important organs of the written press. However, these experts are incompetent, their report is a sham, this hero is idiotic and the press dysfunctions in such an obvious way that we are embarrassed for it and its readers who, luckily, can take recourse by writing to the editors. Should we despair of French intelligence? Not at all, because after the masterful issue of Cliniques mditerranenne, coordinated by Alain Abelhauser (editions Ers) and the official report Affront lInserm (An Affront to the Inserm, published by Navarin) we shall witness shortly what Lacan, borrowing from Claudel, called the Pontius Pilate effect: When he would go out for walks, he said, whenever he passed by what we call, in Claudelian terms of course, an idol as if an idol is something repulsive, ugh! well, for having, I suppose, asked the question precisely where one should not, to Truth itself, each time he went by an idol, ugh!, the idols stomach opened up and one could see that it was just a belly. These lines are taken from the text Le boniment des psychanalystes (Psychoanalysts Patter) in Le Nouvel ne, special issue, March 7, 2005. They come from Mon enseignement (My teaching), forthcoming in the Paradoxes de Lacan series published by Seuil.

Translated by Vivian Rehberg

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Agns Aflalo: Portrait of Freud as Behaviorist