Who runs the Cure in Psychosis?

"The intolerant begin to annihilate the thought, then muddy adjectives, kidnap the verb, and in the end, go for the subject" Bertolt Brecht's ideological crisis (end of the illusion that something must be done by others); economic crisis (huge cost of outpatient treatment), the crisis of representation of analysts in society endanger the Psychiatric Reform and push together, not just the answer biologist, but towards the solution insane opinions. Now, analysts have an alternative answer to psychosis?. We are accustomed to a series of formulas: Unconscious No, No object, no object choice, No Name-of-parents, no symbolization. All negative statements. Freud has provided an understanding of psychosis, a series of causal hypotheses, but with an honesty that honors him, concluded: "It is impossible psychoanalysis with psychotic patients." (Another negative formula). What to do when we take in our office, public or private, to a patient who barred entry have access to the fruits of the analysis? The truth is that every time I encounter a psychotic animated "My desire analyst?, I open the Unconscious, where the unconscious has been rejected, with a technique and a framework that will continually violated, each Once you set a meeting (which is not always) happens something there that questioned the theory.

Psychosis raises many questions. I picked one of them to entitle this introduction: "Who runs the cure in psychosis? '. It's a trick question, because who heads the cure is always the same: the desire of the analyst. Not the analyst, but his desire. The question I ask is: what is at stake desire psychosis in the analyst's place?, Where we no longer worth the happy formula: the opening of unconscious desire. When we encounter a psychotic faced with the absence of shared budgets, absence makes our speech for him to be as contentious and lacking any certainty as to his to our listening. Two speeches are, and each is revealed to the other as a place where every utterance can be radically rethought in which no evidence is certain to be evident to the other. Psychosis questions the common heritage of certainty and causal logic on which it is our culture. Psychoanalysis is a practice. This means that in the Freudian field of experience is no place for a theoretical knowledge of psychic phenomena, without this knowledge makes possible (do not say to ensure) an action on the phenomenon.

The paradox is that, on the one hand, we have a theoretical model that allows us to "understand? psychotic discourse and, second, that understanding is in general (or in most of the cases) ineffective. The psychoses question what we mean by psychoanalysis, analytical device and place of the analyst. I will then set forth the hypothesis that I intend to argue in this paper: "No psychoanalysis of the psychotic? but the psychotic can benefit from psychoanalysis, the analyst to use to get something (in certain circumstances) he and he alone among all mental health specialists, is able to offer, precisely because psychoanalyst. What authorizes us to speak of an affair (that of the psychotic) that, unlike neurosis, we have not experienced subjectively?. This makes obstacle to cure. We can not understand anything of psychosis, because our neurotic mindset is organized according to our neurotic ghost, ghost which is based on castration, which is what the psychotic there. We live with our "paranoia?, Our" schiz?, What we call our "melancholy?, With all the horrors that we are passionate and ill, with our" madness? In short, without which we would not be who we are.

Lacan says: "And as the man not only can not be understood without madness, but he would not be the being of man, but madness itself take as the limit of his freedom? (? About psychic causality?) All rave. But the psychotic delusion, we know, is something else. Knowing that displays the psychotic is a knowledge that is not repressed, it's there. Only, perhaps, having had the experience of his own unconscious, consent to allow an analyst to leave the safety of a device, from a place and a desire to analysts, to consent to that device, this place and desire, are oriented the call itself the psychotic. What is this called?. One answer has been given to why psychoanalysis is not possible with psychotic individuals, it is because there is no transfer in psychosis. It is not a trivial explanation, since it is what gives Freud himself in Introduction to Narcissism (1914). The transfer is love, and love is the sign of maximum development of object-libido, the libido of the subject is out of it, is placed in another. Freud makes a quote: "Where love awakens, dies I despot grim" and the reverse: "Where love dies (in the esuizofrenia) states the self despot grim."

No object relationship, says Freud. And there is no object relationship because he, the psychotic is in place of the object. A few days ago, a psychotic patient I'll call Nicholas, gave me a simple example of this death and finishing the object. This is a schizophrenic who, for an excessively long time, is driven by physical hyperactivity drug has been able to curb any and imaginary hyperactivity, metonymy, which leads to a signifier to another, from one object to another, unable to tie his libido to none. Suddenly a privileged object emerges: a woman he has known for some time. Plans to marry her and make plans for that. After so long to drift, to channel your libido to an object is, at least, reassuring. But I do worry that unrealistic plans that can lead to another failure, a new outbreak and a new appointment. Then that gives significance is eliminated in his speech: the possibility that this woman does not share your projects. Naive on me ... I answered: "What does that matter? There are so many women!?. That is where the object to him: "so what?

There are so many!?, And continuing the mad rush to nowhere. There is no desire, no object of desire, libido because it is not placed in the field of the Other. This discovery changes the entire relationship with the Other: in the field of love, in the field of desire in the field of analysis. So there is no transfer in psychosis?. Evidently the imaginary transfer, the libidinal cathexis of an image projected onto the analyst, is given in the psychoses, which stand up to scrutiny is the excess, not their absence. The psychotic transferred to the analytic situation that continues to repeat its relationship with the discourse of the Other: delusional relationship with the Other. Joseph was a smart kid, "normal?, All that was struck in the small Joseph, was an obsessive fear of others to use your belongings: clothes, utensils, etc.. After the death of his father, Joseph enters a religious sect. The sect is absorbed completely. He would be responsible even for the most professional work: the construction of a temple. Everything seems to go smoothly, at least to Joseph, and then rupture. Joseph broke with his girlfriend. Sooner or later break with the sect.

He returns to his mother's home, to offer as an object of the Other.

The first symptom reported by the family is an incestuous attempt to kiss her mother's mouth. Shortly after underpants can not locate. This lost him apart. 18 hours remains standing, motionless and silent.

When he comes to speak (it is said quickly: it took months of patience to speak first, and to say something, after). When he returns to say "something?, Says his delirium: A Council all know, is the decision maker. Joseph did not know why it does things that are designs of the Council.

That's it: now delirious. And now what do we do?

The Council received José are not pictures, are ideas, which he conveys through even acoustic imaging: do not hear voices, receives only feel, feel full, finished, do not chain .. It requires no explanation, so and he knows it. And if I may say to me is to convey to him a knowledge that is evidence. For this analysis does not seem possible, there is no analytic knowledge (or doctor) as possible. It is he who knows, and who knows what crushes, remove it as a subject, it only remains that knowing that comes from the Other. Joseph is going to withdraw your car. In Traffic put a stamp on the documents he has led. The seal reads: "OUT OF CIRCULATION?, And that is significant to the place of a response for their identity. It is he who is "out of circulation? and Joseph goes to the hospital to apply for membership. What to do? Does it encourage imagination? Will it help to find an imaginary object of his election to that tie your libido?. Maybe, but it is not always possible. It can occur as with Nicolas, that captures what the neurotic does not "see?: It's not worth tying to an object, always" there others?.

Other works have pointed to the contrary. Given that psychosis is a symbolic deficit, we should shore up the symbolic, making the analysis of the institution or a symbolic prosthesis. He has already sought (after the death of his father, lest we forget) a symbolic prosthesis Sect. The sect has performed well in place of the father, in a non-registered, and has called him to that place to entrust the construction of a temple, contributing aldesencadenamiento of psychosis. Are we not the case if we offered to us as a symbolic prosthesis?. Yet, often the institution functions as prosthetic calming imaginary disorders. Appeasement that can last a lifetime. Subjectively poor life, but many psychotic fit well to the condition of objects: the mother, psychiatry objects, objects of the institution, objects, why not?, Psychoanalysis. Provided, of course, that the prosthesis remains Institutional often leaving for any reason, the organization, a new outbreak occurs. I particularly remember one case, several years ago. This is a patient, who attended in outpatient settings.

To announce that I would quit my job at the hospital (this was in Argentina), the patient asked me to continue their therapy in my practice, to which I reach. In the following interview, even in the Hospital, began to question me on what my query. In a series of questions, there is one that stands out: - "Are there other people in your practice? Is there a waiting room?. I made the mistake of interpreting it in relation to their fear of being locked in a dual relationship with me. The next day the patient calls me and tells me very anxious -? Dr., want to sleep with you?. That's your response to my interpretation. Precipitation, a confusion between subject and other (sensitive) by elimination of the Other (with capitals). A collision imaginary, for lack of symbolic mediation. What is missing here is not the transfer is the Unconscious. I think this error brought me my desire, that is, paradoxically, the same desire that led me to being an analyst, I want to know about desire, desire for openness of the Unconscious The essential question for all subject is: Who am I? . My word did not question the unconscious of the patient, but was a response that was articulated in the place of an impossible question to ask.

Our knowledge of analysts can be heard by the psychotic and certainty that is responsive, with the risk that the analysis itself becomes instead of repeating his delusional relationship with the Other. Piera Aulagnier cites a very interesting case of a psychotic subject. The core of delirium is very similar to Schreber: God wants femineizarlo. Shortly after beginning his analysis, he rejects her delirium. The analytic discourse has taught him that it was God who wanted to do woman. That was a mistake. Now he knows that is not God but his mother who supports this desire. Delirium language changes, but it remains equal to itself. Nicholas makes me gifts, brings objects significant to him, and steal objects, indifferent to me, in my practice. Search the concreteness of love objects, articulates the love with the enjoyment of the Other, represented by the analyst. Seeking a third instance, which stands in the collision imaginary. Referral to another psychiatrist to medicate him. Become a psychotic transference object has its risks, we can not resort to interpretation to cut off the transfer, all I can do is endure ... But this can lead us to an impasse come out of the impasse Nicholas interposed there between him and his analyst , an imaginary mediation: a woman who bears my name.

He himself built a road that leads (these are his words): "From mother to women, women to women?. Now the "so many women in the world? can acquire a new sense: not the fall, the devaluation of the object, but "there are other women? that are neither my mother nor my analyst, building an outline of object, or at least a place to house it. Another risk in working with psychotic is erotomania, only apparently opposed to the "delirium of love?. Both respond to the question of the enjoyment of the Other. One can not ask: "Who am I? without asking "What is the one for me? (Question to which it responds delusional love) and "Who am I to the other? (Question to be answered by erotomania). I make a point in an analysis erotomaniac Jose builds a delirium in which the nurse I'm jealous, jealous that he is the reason. He accuses me of "Jealous? (Charge the mother and father had made). Wondering what I want from him, whom no one seems to expect nothing, as it is accommodated in place of "crazy nice?.

The only answer he finds is love. But I do not answer your call love, not rejection, I do not go to meet his charge of "jealous? I proposed. I ask him to realize it, you add meaning. Then takes over the place from which comes this call, it is he who expects something from me. The plate rotates to "love me? "the master?. Then I asked for a kiss. Demand for the sake of respondents stated that this is my work. The equation is simple: if it's my job, what I want is money. In the next session reiterates its request at the same time extending a bill on the table. I point out that the Madrid is who pays for my work. Joseph offers the Other as object, a place he hopes will be more tolerable for yourself, to the extent that an analyst is usually a benign incarnation of a mother crocodile Another all-devouring. It's just unable to locate on the analyst who hosts a desire as an object, that a work is made possible. The desire of the analyst indicates a place where you expect the emergence of a subject, rather than the psychotic subject never found in the field of the Other.

If we can not wait to open a door of a house that does not exist, perhaps we can allow ourselves to use, support the transfer, let us work for it, being there, hence the psychotic to find a place from which to rebuild. No transfer away from the psychotic imaginary invades us, let us not shun it or fix it. These movements of the psychotic transference in relation to his analyst, who now lean on the side of erotomania, ora delusions side of love, nothing more than attempts to be objects of love of the Other (which should be much better to be objects will destroy, "senseless? the Other). But the same will be the object of our love, the object of our desire, we noted that this transfer there. Transfer that, if we can endure, perhaps revealing tie some of their "error?, That which has no words to say because there is no entry in the Unconscious. What is true love, to hate it. Sometimes the only support the transfer of a patient homicidal paranoid here allows you to stop some of his madness (yes, it is preferable that a brawny guard at the door.

Another advantage of the CSM on the office). As the psychotic can not sue a knowledge about an object that has not constituted as an object of desire, in your call to us as the object that we need to us, who, as neurotic, yes we need the object. So how do you respond?. In principle we know that, as analysts, we should never respond from where they are challenged. Joseph has divided human beings into four classes not to be confused with socio-economic classes: 1) posh: Characters that Joseph does not qualify, but that does not seem to feel any sympathy. 2) the Yuppies: Workaholics, who have been seduced by the "hoax? social prestige. 3) The pariahs, despised by the other beings (preppies and yuppies), waste of others. 4) THE Pimp: (Group that Joseph himself is part). Are those that circulate energy in the other is stagnant, thus helping everyone, especially the outcasts. He entered as a pimp, not to be outcast tombstone of the Other. To me, in principle, I like Yuppie places. Soon after, I'm not yuppie, but a pariah, then I'll be a pimp, like him: "We are both the same?.

But it seems that not always respond as pimp. "Auntie, you really are strange. Sometimes you Yuppie, other pimp. YOU CAN NOT LOCATE. USAS many veils?. And will try to reach me on another axis, not diachronic but synchronic: the axis of reincarnation. I try not to confirm or disconfirm delirium, not adhering to the means that I offer or to oppose them. Offer my place as an empty space: emptiness of knowledge, power vacuum, void of any desire in relation to it. Said tried to push as subject, to explain what happens. I invite you to tell me something of a knowledge that he has. And if not, they made it up. This does not exclude me from certain responsibilities. I can not avoid making decisions at times. Acting as a psychiatrist is sometimes the responsibility I have accepted, to accept a psychotic analysis. If a subject does not have resources to protect the phenomena invading it, I feel obliged to provide other resources, other mediations: the medication, the income, the intervention with the family or the environment. It is not always possible to combine the two speeches.

Sometimes the state income or a medication, puts us in the place of love. In those cases I think it takes two, one who acts as a psychiatrist, another analyst who retains his place empty of desire. Analyst's desire to live an empty place. We know ... But what I want? What do I want us to make "secretaries?," Witnesses?, Of "similar? or, why not, "garbage?. The psychotic desire, through their work, they make up a place, a knowledge is invented, which allow you to make the social bond. With her delirium do something, make something up. Living with their delirium, as we try to live with our unconscious, and not for delirium, as the neurotic lives for his unconscious. That is not an automaton of the Signifier, living within a social bond that is not the whole life, but it is essential for this to be possible. This requires that you consent to the psychotic experience that we offer. In closing I wanted to refer to certain terms I have used a little "happily? in this show: If the subject is not psychotic, nor can be, because it is subject of desire, is not barred, we invent another script to designate their subjectivity, not reduce it to the place of object.

As Lacan says in the Shem. III "while speaking to the other ... there is a subject?. (And how they talk to the other! With what irony). If there is no unconscious in psychosis, at least if we think of as the unconscious neurotic, yes there is something there, something Freud called "Unconscious open?, Which allows the psychotic dream. If so, according to our model, we can not call unconscious, we must invent a signifier that "Unconscious?. If there is no ghost in psychosis (at least if we accept that the ghost is subjective response to the desire of the Other), there is something there that looks like a ghost: a series of fantasies with the psychotic tries to cope with "the there?. And in some cases, we can help, as symbolic agents, to undertake a construction that allows a phantasmic social bond. If no symbolic transfer in psychosis, there is something that allows our work and so, somehow, will be appointed. For patients who have contributed to this presentation, I will not say they are stabilized, but Joseph has left his body rigid, studies English and is slowly returning to a social bond.

As she tells me her delirium, making it up to tell me: - "Auntie? She tells me "I have to explain everything?. Yes, and as I explained, systematized delirium, and he invents a world that he may dwell. Thus constructed a history of re-incarnations and, in turn, re-creating a children's story. It's my ignorance, because I do I crossed, barred, so I can locate, in the analyst's place, a demand for work that encourages the production psychotic. As for Nicholas, still trying to build a women object to use. For my part, all you have done is encourage them to work. His will be the fruits of that work. What will happen next?. I do not know. Averbach and Luis Marina Teszkiewicz PRESENTED IN THE LES États Généraux PSICANALYS - Sorbonne University - PAR? S - 2,000 Pulice EN "Acheronta No. 8", JOURNAL OF PSYCHO? Lysis. http://www.acheronta.org/