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How Lacan’s Theory Can Be Helpful in Psychotherapy

Lacan's RegistersHow Lacan’s theory can be helpful in psychotherapy may not be obvious and is often overlooked.

The theories and concepts of French psychoanalyst, Jacques Lacan, are considered by many as among the most significant contributions to psychoanalytic thinking and praxis since Freud; yet his work is largely unknown to many American psychotherapists. Lacan is mostly known in the US in terms of applications to literary criticism and socio-political theory, and those who are familiar with Lacan typically describe his contributions as intriguing, but esoteric and enigmatic. Much has been written regarding Lacan’s philosophical, political, and mathematical influences, but many Lacanian theorists have adopted an obscure and cryptic style, perhaps in homage to the master. Discussions have tended to be abstract and esoteric, making their practical application to psychotherapy difficult. Whereas Lacan’s concepts are complex, both philosophically and logically, my reading of his work suggests that he sought to promote creative and relevant applications by clinicians, and that his constructs can be very helpful in guiding one’s thinking in the clinical process.

Let me be clear—I do not consider myself to be a “Lacanian,” nor do I apply his concepts in what some may consider an “orthodox” manner. Rather, as a practicing psychoanalyst and psychologist of over 35 years, I have sought to integrate the wisdom from many theories and mentors. Lacan’s writings, published as Écrits, include discussions of art, literature, religion, culture, philosophy, and music, all as expressions of the human experience that are essential for venturing into a serious consideration of the psyche.

My original attraction to Lacan came from my interest in psycholinguistics. As linguistic creatures, our conscious thoughts are structured by our language. Lacan, perhaps more than any other psychoanalytic theorist, emphasized the role and function of language as the organizer of the mind.

Language serves as a vehicle for communicating subjective experience into a shared collective objectivity. In speaking, the person enacts their language to externalize what is intuitively known internally. This externalization is always an approximation of the internal known, and thus constitutes a compromise formation. In this way, speech is symptomatic of the unconscious since this linguistic translation is an approximation, adapting the subjective into the objective, with some aspect of that private experience being lost and changed in translation. The important question for psychotherapy is, what is being approximated? For Lacan, the answer is the patient’s personal truth. The speaker (Subject) works toward expressing a personal private truth by speaking in a language that is not their own but is required to be used for social discourse. The fact that all participants of that language/speech process are expected to use their language conventionally makes neurosis inevitable.

The enactment of language through speech or conscious thought must always be considered in a relational context, or discourse. Lacan proposes a psychologically-based model of social discourse that is informed by structural linguistics, political theory, and psychoanalysis.  He offers four structures that are contexts in a social exchange. These four structures are his discourses of Master, University, Hysteric, and Analyst, which serve as archetypal categories for social relations. Lacan’s discourses are comprised of a Subject, as the agent who initiates the communication, and an Object, as the “Other” who serves to complement the dialectic. When engaging in speech, the Subject’s motivation is an unconscious derivative of a subjective truth. This truth is “known,” but ineffable. Through the dialectical exchange with the Other, a product in the form of a verbal response is created by the Other for the Subject. In this way, the Subject’s truth is named by the language of the Other. By naming the Subject’s truth, one is subjugated into a social order that compromises the Subject in accordance with social convention. As was stated earlier, the process of socialization necessitates compromise and thereby ensures a degree of self-alienation.

Each of the four discourses establishes a variant in the dialectic between the person and others. The intent behind psychoanalysis becomes the empowerment of the person as their own master, without the necessity for the subordination by another. Lacan confers upon psychoanalysis an ethical directive to allow the patient the authority to know their self.

This pursuit is different from a medical or scientific agenda where the removal of symptoms is the goal. Symptoms and complaints expressed by the patient are respected as statements attempting to speak a personal, private truth known only to the patient, but repressed from speech owing to the inadequacy of language. The medical agenda for reducing or eliminating symptoms is at complete odds with Lacanian therapy. Emotional suffering, in this regard, demands understanding by and for the patient alone. Implicit in this suffering lies a passion and desire that eludes direct linguistic expression, yet may be knowable from recognizing the limits set by language. Herein lies the neurotic dilemma of speaking the unspeakable to another who is likewise a divided self.

Another of Lacan’s contributions to the understanding of the mind is the mental registers: Real, Imaginary, and Symbolic. These registers can, I believe, be thought of as forms of information created by the mind that together form knowledge. These mental registers add another degree of complexity in understanding the human experience. Lacan was most concerned with the phenomenological over a mechanical or biological understanding of mental experience. His mental registers can be thought to emphasize a multileveled nesting of mental processes that could provide a framework for appreciating the humanness of the mind.

It is important to reiterate that the focus of treatment is the patient in relationship to others. This position is in contradistinction to those forms of psychotherapy aimed at altering psychic structures such as the ego and its defenses or in working toward the targeting of specific symptoms. Lacan adopted an epistemological stance consistent with systems theories. From this position, a patient’s psychic conflict arises from an effort to preserve sanity in the context of living among others. Contemporary clinical psychology and American psychoanalysis tend toward promoting change in the patient by addressing diagnosed psychopathological conditions that are constellations of symptoms. The current Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5) and other nosological systems such as the International Classification of Diseases by the World Health Organization (ICD-10), give primacy to the disease (disorder) and secondarily to the patient wherein it is thought to manifest.

How Lacan’s theory can be applied in psychotherapy? I have found that Lacan’s key concepts are helpful in understanding and guiding the therapeutic process. As clinicians, our primary tool for treating patients is rooted in our use of language to communicate and approximate understanding. Understanding, itself, is a lifelong pursuit that may be fundamental to the mind and our sanity.

If you would like to learn more about how Lacan’s basic constructs can be applied in clinical work, please see the video course, Lacan – Inspired Psychotherapy (4 CE Credits). In it, I review the basic constructs and apply them to two clinical cases. For a more thorough review of his theory in a reading, please see the course based on an article written by an expert on Lacan: Jacques Lacan: Introductory Overview (4 CE Credits).

Jacques Lacan: A Real, Imaginary, and Symbolic Psychoanalyst

Jacques Lacan: A Real, Imaginary, and Symbolic Psychoanalyst 

Jacques LacanAs a practicing psychoanalyst for the past 30-plus years, I have sought to integrate the wisdom from many mentors. My supervisors and training analyst guided me through the collected works of Freud, Klein, Winnicott, and Spotnitz. While writing my doctoral dissertation on clinical psycholinguistics, I learned of the work of Jacques Lacan, a French psychoanalyst.

The more I read of Lacan’s ideas, the more fascinated I became with his unique take on the role of language for shaping the mind and the practice of psychoanalysis. Equally intriguing were the stories about Lacan, the man, who fought to promote a view of psychoanalysis that dared to challenge the prevailing orthodoxy of the psychoanalytic establishment.

Psychoanalysis has been fraught with in-fighting, exclusiveness, and dogmatism since its inception, which bears an embarrassing irony toward unresolved Oedipal feuds. Fortunately, my training had encouraged an appreciation for psychoanalysis as one of the humanities. Art, literature, religion, culture, philosophy, and music are all expressions of the human experience that are essential for venturing into a serious consideration of the psyche. Lacan’s masterpiece, simply titled, Écrits, included discussions of all of these topics and more.

Certainly his writing is dense and difficult; yet, I found it compelling as a source of provocative ideas and observations. A learned colleague once warned me that life is too short to read Lacan. In fact, most of my colleagues have shared similar negative biases, although they had never read his work themselves and relied, instead, on second- and third-hand critiques. Like most contemporary textbooks on psychology that summarily dismiss Freud out of ignorance or misinformation, these colleagues were content to preserve their allegiance to a particular school of thought.

Some Lacanian theorists have since become a somewhat esoteric group in the US, often adopting an obscure and cryptic style, perhaps in homage to the master. Whereas Lacan’s concepts are complex, both philosophically and logically, my reading of his work suggests that he sought to promote creative and relevant applications by clinicians, not to develop sycophants.

As an addition to Freud’s structural model of the mind consisting of the Id, Ego, and Superego, Lacan proposed that our subjective experience is contextualized with regard to how phenomena become registered in the mind. He identified three constituent contexts for the mind: the Real, the Imaginary, and the Symbolic. Broadly described, the Real is fundamentally a derivative of our senses, the Imaginary is derived from perceptual and fantasied mental processes, and the Symbolic is derived from culture and through language. These registers function as interlocking systems of knowing that collectively form one’s sense of awareness.

With the premise of these mental registers, I will attempt to describe Lacan himself. The Real Lacan was a man trained as a psychiatrist in the first half of the twentieth century. He appeared as an intellectual and scholar who studied philosophy, art, science, medicine, and politics, as well as psychoanalysis. His personality is described as intense, passionate, and charismatic. Reportedly, he successfully obtained the release of his wife from Nazi custody by charging into Gestapo offices and demanding her immediate release.

The Imaginary Lacan is the one we know as we read his words. The thoughts and questions that emerge as the reader forms associations to his ideas and through his playful use of words that tease us to push our thinking a bit further.

The Symbolic Lacan is a provocateur of psychological theory. The word “Lacanian” has come to represent courageous and radical commitment to understanding the depth and vastness of the human condition, with full acceptance of the impossibility and ineffability of that task.

Whereas Lacan is mostly known in the US in terms of applications to literary criticism and socio-political theory, he is considered one of the most influential psychoanalytic thinkers in Europe and South America. Regardless of the difficulty that some of his ideas pose, the questions he raises about self-authenticity and one’s capacity to retain sanity in a civilized society has never been more timely.

To learn more about Lacan’s theory in a reading, Jacques Lacan: Introductory Overview (4 CE Credits), provides an article written by an expert on his theory. For a briefer overview of his theory and a more practical discussion of how it may be applied in psychotherapy, see the video course, Lacan – Inspired Psychotherapy (4 CE Credits).

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