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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, see Jacques Lacan: Introductory Overview.

Criticisms of Freud: Commentary on the Freud Wars

Criticisms of Freud: Commentary on the Freud Wars

Criticisms of FreudToday’s Wall Street Journal offered a book review by Adam Kirsch of, yet another, “quasi-biography” of Sigmund Freud.  The book in question is Freud: The Making of an Illusion by Frederick Crews, the latest in his seemingly endless criticisms of Freud.  As noted by Kirsch, this endless war on Freud by Crews is a direct attack against the person of Freud and, by extension, an assault on nearly everything Freud had to say about the human mind.

Crews, a Professor Emeritus of English of UC Berkeley, is a well-established literary critic who had once embraced psychoanalytic theory, but has since become one of its most vociferous dissidents.  His current work goes beyond his usual attacks against psychoanalysis as a “pseudo-science” and is a direct disparagement of Freud himself as a con man, liar, bully, plagiarist, and false prophet.

As a psychoanalyst myself, I wonder if Crews’ apparent obsession with destroying Freud and psychoanalysis represents what would be labeled a reaction formation–the exaggerated attempt to conceal a private truth (envy) with its opposite (contempt).  This was not Crews’ first harsh criticism of Freud, which dates back decades.  His agenda to eradicate Freud and Freudian theory ironically betrays his indebtedness to Freud for having established a basis for Crews’ career.

No doubt that Freudian psychoanalysis has changed significantly since Freud (who died in 1939), as he, himself, revised his ideas at least five times over a 40-year period.  Nevertheless, he provided 23 volumes of writings on the human condition that have stimulated the search for understanding the complexity of the human mind, our motivations, and our unique forms of psychological sufferings.  Freud offered a humane approach to understanding madness, an early attempt at clinical treatment, a recognition for the importance of child development and child-rearing practices, and a method for understanding the humanities.  Obviously, the legacy of Freud’s ideas has been remarkable.

Despite Freud’s many critics and continued controversy, Nobel-laureate neuroscientist, Eric Kandel, noted that “psychoanalysis still represents the most coherent and intellectually satisfying view of the mind” (Kandel, 1999, p. 505).  Freudian theory, while not a rigorous scientific model that can be easily tested in a laboratory, poses necessary questions that require inter-disciplinary study from all the humanities.  Humans live in both a shared empirical reality and a private, personal world of fantasies and imagination.

Rational-empiricists, like Crews, seem to believe that science, in its purest form, is the only truth. If that were so, why become an English professor?  Science is not a subject matter, but rather is a methodology for research.  The humanities represent other methodological forms that also explore stories about the human experience.  A psychological truth that ignores these other stories denies the essence of the inquisitor.  Humans are ultimately story-makers regardless of what those stories are about; physics, poetry, or dreams.  All our knowledge, no matter how rational or empirical, will always remain human knowledge.

Criticisms of Freud can make important contributions toward a dialogue of ideas.  Unfortunately, character assassination presents as excessive disputation that does little to promote meaningful discussion.  Freud, the man, is dead; eviscerating his corpse appears to me as spiteful and mean-spirited and serves no intellectual or scientific advantage.

To read more on Freud’s theory, see Classical Psychoanalytic Theory.

Kandel, E. (1999). Biology and the future of psychoanalysis: A new intellectual framework for psychiatry revisited. American Journal of Psychiatry, 156, 505- 524.

Kirsch, A. (2017, September 30-October 1). Why the Freud wars will never end. The Wall Street Journal, p. C7.

 

 

What Is Psychoanalytic Psychotherapy?

Psychoanalytic Psychotherapy

Psychoanalytic PsychotherapyPsychoanalytic psychotherapy (also called psychodynamic psychotherapy) is a contemporary form of treatment for mental health issues that has evolved from its roots in psychoanalysis over the last 100+ years.

This form of treatment emphasizes a comprehensive understanding of the client (“patient”) as a person, as opposed to following a strictly symptom-oriented approach. By considering the importance of a person’s life history and their capacity to take ownership of their choices, psychodynamic therapy works toward long-term growth and change.

The patient develops an honest and personal understanding of who they are, what they desire from their lives, and how they can effectively pursue these goals. While gaining insight, understanding, and acceptance, the patient also develops improved interpersonal skills vis-à-vis their relationship with the therapist. Research has shown that the therapeutic relationship (alliance) is a key factor in any psychotherapeutic success (Wampold et al., 1997). As a microcosm of the patient’s life, the therapeutic relationship has the unique potential of promoting an exploration of sensitive and important questions that may not be possible in any other context. Likewise, the therapist’s focus is determined by the best interests of the patient. The specifics of psychoanalytic psychotherapy are unique to the person as are the goals of the treatment. Overall, the intent is for the therapist to help the patient enhance their life with minimum conflict and stress, while also maximizing their sense of self-efficacy.

Are psychoanalytic therapies really all about sex, mothers, and toilet training?

There are a lot of misconceptions and myths about psychoanalytic theory and psychodynamic therapy. The approach views the person both historically and in terms of their present life. Scientific research has confirmed the importance of early childhood experience and the quality of early relationships as determining factors for shaping personality (Shedler, 2010). What makes each of us unique is how we have navigated the trials and challenges in our histories.

From a psychodynamic perspective, sex is a broad concept that encompasses all of a person’s biological predispositions. The importance of understanding sexuality is largely to recognize the basic life drives and needs. Over time and maturation, these drives differentiate into the pursuit of pleasure, comfort, love, and personal identity. Mothers, of course, typically provide our first experience of love and acceptance and set the prototype for all subsequent intimate relationships. And, while toilet training may seem like a strange event for extensive concern, it represents another prototypical experience regarding socialization. Toilet training may be illustrative of the quality of a child’s experience with being socialized into the standards and expectations of the culture. Most importantly, at the time psychoanalysis was being created, toilet training was an indicator of harsh and punitive child-rearing practices. So, while out of context, these concepts can sound bizarre or archaic, they have come to be recognized as important metaphors for describing a young person’s challenges with the world.

Will a psychoanalytic psychotherapist offer advice or solutions for problems?

In most cases people are intelligent and resourceful enough to solve their life’s problems, but may be blocked by fears, thoughts, and memories that are obstacles. In psychoanalytic therapy, patients learn to identify those obstacles and explore what can be done to move beyond them. A person’s strengths and creativity are built upon so that expertise in living becomes part of the patient’s skill set.

How long does psychoanalytic psychotherapy take?

Psychoanalytic psychotherapy is not time-limited. The length of therapy is a mutually determined issue, based on the patient’s needs and desires. As everybody has different needs and issues to consider, it would be presumptuous to dictate how long a therapeutic process should take. On the other hand, the therapist recognizes and addresses when therapy is no longer necessary or counter to a person’s needs. The goal of any effective psychotherapy is to become no longer necessary.

Who should seek psychoanalytic psychotherapy?

People best suited for this form of therapy are those with a sincere interest in knowing themselves better. The prospective patient should be willing to examine their thoughts, actions, and emotions honestly and openly in a trusted relationship with a qualified professional. While “quick-fixes” are not typical or even the intent of this form of therapy, many patients find significant improvement within weeks of beginning treatment.

Additional Resources

For more information on the basics of psychoanalytic psychotherapy, see the online course Classical Psychoanalytic Theory.

References

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 66(2), 98-109.

Wampold, B. E., Modin, G., Moody, G., Stitch, F., Benson, K., & Ahn, H. (1997) A meta-analysis of outcome studies comparing bona fide psychotherapies: Empirically “all must have prizes”. Psychological Bulletin, 122, 203-215.

Isn’t Psychoanalysis Dead?

Psychoanalysis

PsychoanalysisI heard the question again just last week, this time from an undergraduate in my Abnormal Psychology class. I’ve heard it many times over the years, from colleagues and grad students as well. I had also been taught, all through college and throughout graduate training, that no one considered Freud’s work anymore. I suspect that most Americans have been taught the same.

I left my graduate training, armed with all the “best practices” in “empirically-based” primarily cognitive and behavioral techniques. I recall arguing with colleagues who mentioned psychoanalysis or psychodynamic approaches that research had not demonstrated their effectiveness. When one colleague commented that some patients had found them to be helpful, I privately wondered about his competence as a clinician.

Then I met Mary. She had been referred to me for depression. No problem, I thought. Lots of techniques had been demonstrated empirically to be effective in treating depression. When she asked if she could leave a cup in my office because medication had made her mouth dry, I had been trained to think only in terms of the practicality of having a cup available. But I quickly came to understand that such questions, and many others that followed, had far deeper significance—dependency needs, unconscious tests regarding acceptance, attempts to challenge boundaries, splitting. Her feelings—and relationship with me—were filled with turmoil. Idealizations swung to devaluations, and back again. She raged and despaired. She challenged all of my beliefs about the therapeutic process as manageable by the “right” charts and techniques.

I feel so fortunate to have met Mary early in my practice. To this day, I do believe that cognitive and behavioral techniques have merit, but I also see the enormous value of psychodynamic psychotherapy, as well as humanistic, emotion-focused, supportive, and countless other approaches. Humans are very complex creatures. Each therapeutic approach provides us with a lens through which to view a person. I believe we have a responsibility to become as familiar as we can with multiple ways of viewing each case, so that we can best address our patients’ needs in the moment, and as they evolve.

I was heartened to hear a comment from another student later in the week that she appreciated that I included psychoanalytic approaches when talking about treatment options with patients. Interestingly, she is a foreign exchange student from a region of the world where such approaches are generally understood to be of value.

To quote Eric Kandel, neuroscientist and Nobel Laureate, “Psychoanalysis still represents the most coherent and intellectually satisfying view of the mind” (American Journal of Psychiatry, 1999).

Resources

For the basics of psychoanalytic theory, see the course Classical Psychoanalytic Theory.  For more on the psychotherapeutic relationship, you may find Psychodynamics of the Therapeutic Relationship interesting.

The Value of “Having Your Head Examined”

Psychotherapy

PsychotherapyThe profession of psychotherapy has been around for over 100 years, with less formal versions of personal consultation going back to biblical times.  So why is it that the voluntary seeking of psychotherapy can be such a polarizing issue?   

Skeptics of psychotherapy cast doubts on the effectiveness of “talk” to change anything in a substantive manner.  Human beings are talkative creatures, so what is so special about talking to a psychotherapist rather than to a hairdresser, bar tender, cab driver, or next-door neighbor?  “If all therapists do is talk, then I can get that anywhere, and for a lot less than $150 per hour!”  

But talking is only one part of the picture.  An even more significant aspect of psychotherapy is the therapist’s capacity to hear what is being said—not just with words, but also in a larger implicit sense—hearing the meaning of a person’s truth.

Some advocates of psychotherapy might argue that it has changed their lives, saved their marriages, or even freed them from a life of abuse.  

What does seem clear to me though is that many people are afraid of psychotherapy.  Considering how therapists get portrayed in movies or the embarrassing presentation of media psychologists, there seems to be good reason to fear them.  I am often asked if psychotherapists are motivated by their own deep-seated issues and if they are as “crazy” as the people that they portend to treat?  My answer is simply . . . of course!  Being human is, in itself, a crazy proposition.  We live in an artificial world of our own invention by rules we make up, and we kill ourselves needlessly in wars, with drugs, on highways, in airplanes, and sometimes for pleasure.  There is good reason to think humans are crazy!

Yes, we do good things too, and we invented science and ethics and laws.  But while it is easy to be seduced into exalting the remarkable advances produced by the human race, our fellow (nonhuman) creatures may have a profoundly different opinion of us—if we could only hear them speak!  Humans have one foot in a virtual world of seemingly limitless creativity that seems wonderful, if not artificial, and the other in a biological reality, with specific needs and limitations.  People need to be nurtured, for instance, by another person who will validate their existence and uniqueness.  (Think about how painful it can feel to be ignored, or have your feelings and thoughts dismissed and devalued).  

Perhaps the most valuable contribution made by the profession of psychotherapy has been to create an industry designed to help persons retain their connection to their humanity.  In spite of all we have invented, we remain fragile living organisms, clinging to each other for survival—a reminder that there is no substitute for real human contact.  

With dozens of forms of psychotherapy to choose from, what they all have in common is that they provide a private, protected space, where the challenge of being alive can be acknowledged and supported by another who respects and listens to the struggle for sanity.

A good resource for clinicians for more information on the complexities of the therapeutic relationship is the course Psychodynamics of the Therapeutic Relationship.

Why Can’t We Simply Choose Happiness?

 

Happiness

HappinessAs a psychologist and psychotherapist, I’ve spent the last 30 years listening to people struggle with anxieties, depression, and loneliness, in search of ways to alleviate unhappiness.  And as a professor, I’ve spent as many years researching ways to build resilience—hoping to find ways to prevent people from “succumbing” to unhappiness.  The more I explore these issues, however, the more I’m convinced that Freud was on the right track.  We are extraordinarily complex creatures who, by nature, are probably not headed toward tranquility or happiness.  If we wish to build a happy life, we’ll have a darned hard fight on our hands.

Brain Research On Neurophysiology of Experiences

I keep returning to a delightful article by Hiss (2014) on the human brain published in the Reader’s Digest a couple of years ago.  Hiss reviews fascinating research on the neurophysiology of such experiences as love, procrastination, reactions to criticism, and road rage, and the basis for many of our emotional struggles. 

We like to think that our intellectual abilities accorded to us by the magnificent cortex provide us with the tools needed to control unpleasant emotions and primitive urges.  But why, then, do we feel our blood pressure rise and rage take over when someone “waves” to us with a single finger from their car?  What just happened?

As Hiss notes, the cortex is a relative newcomer to the brain party.  It’s built on a more primitive mammalian, emotional part of the brain, which is built on an even more primitive reptilian part.  How peaceful—or cooperative—a party should we expect? 

Our Expectations On Handling Life And Emotions

She draws an analogy to a speed boat that’s been built on a row boat base.  We expect to zip through life’s rough waters with ease—something our rickety base may not be able to manage.  It’s amazing that our brains aren’t out of service more often!

So when I hear patients question what’s wrong with them that they can’t seem to manage their emotions or just “choose” to be happy, I remind them that they’re not a Golden Retriever.  And some days, their lizard is active.

References

Hiss, K. (Sept. 2014). The beautiful life of your brain. Reader’s Digest.

Are There Really No Psychological Accidents?

Psychological Determinism

Psychological Determinism
Slip of the tongue?

Perhaps the single most representative concept of psychoanalysis is that of psychological determinism.  By this I mean a fundamental belief that human behavior, consciousness, and experience are determined or explainable.  Freud followed in a scientific tradition that was dedicated to uncovering the laws and mysteries of life, hopefully to lead to a comprehensive theory of the mind.  

Is Action Accidental or Random?

Such an approach would never be satisfied with a conclusion that suggested that a certain action was “accidental” or “random” or that a thought occurred strictly from a spontaneous, meaningless neurochemical action.  Unlike radical behaviorism or even social learning theory, which propose to account for some behaviors as incidental contingencies or fortuitous accidents, psychoanalytic thinking would tend to view such explanations as naïve, simplistic, or superficial.  

What Does Psychoanalysis Tell Us About Action?

Psychoanalysis proposes to describe mind and behavior as meaningful and understandable.  Thus, our lives are the products of our being.  Our intentions, as well as our accidents, are worthy of understanding.  While critics may argue that psychoanalytic theories make too much out of too little, the supposed error is committed in the pursuit of knowledge, with an implicit expectation and respect for the complexity of life.  It should also be noted that such an attitude is reflective of an appreciation for the humanism of psychology, not its mechanization or reduction to biochemistry.

What is the Focus of Psychoanalytic Explanation?

Even if one could demonstrate, once and for all, that the universe and life are random, nonsensical phenomena, this would not contradict the view of determinism.  The focus of psychoanalytic explanation is on the human experience of life.  What is characteristically human is our mind’s proclivity for making sense out of nonsense.  We cannot tolerate being in a state of uncertainty or confusion.  Psychological determinism addresses this characteristic of being human by suggesting that all human knowledge, no matter how sophisticated, abstract, or profound, is always, ultimately, human.

Freud and Breuer’s Studies in Hysteria

Freud’s and Breuer’s Studies in Hysteria are classic examples of the humanity inherent in a view of psychological determinism.  In their investigation and treatment of hysteria, they stressed how patients’ peculiar behaviors stemmed from important but forgotten episodes of their lives.  Hysteria, understood in the context of a person’s life, represents a meaningful continuity of being, such that the mental life of the patient is respected as relevant and the patient is further accepted as exhibiting psychological processes common to humankind.  The “logic” of symptoms soon led to an appreciation for the logic of dreams, mistakes, jokes, and slips of the tongue.  With acceptance of determinism, we can never take life’s events for granted again!

For more on psychological determinism and other psychoanalytic concepts, see the course Classical Psychoanalytic Theory.  If you would like to receive a specialization Certificate in Psychoanalytic Psychotherapy and learn more about issues of interest, please see our home study psychology continuing education courses, available online.

Psychoanalytic Psychotherapy with Adolescents

Psychotherapy with Adolescents

 

Psychotherapy with adolescents could help this young man.Psychotherapy with adolescents provides a unique opportunity to impact identity at a key time in development.  Understanding the roles of “self” and “identity” is helpful in this process.

Self and identity have been variously defined and, at times, viewed as synonymous.  It is clinically helpful to distinguish between the two in psychoanalytic psychotherapy with adolescents.  Compensatory identities are sometimes formed during this period, in response to profound psychic conflict.  Exploring the function of these identities as objectified processes to cope with psychic trauma must be balanced with respect for the “subjectivity of self as a vehicle for psychological truth.”  

In a recent article, Dr. Michael Gerson discussed such distinctions and their clinical implications, as they applied to his psychodynamic treatment of two adolescent patients.  The article is “Clinical Implications for the Expressions of Self and Identity in Adolescent Psychotherapy: Case Studies of a Vampiress and a Gangster,” published in volume 24, issue 6 (pp. 718-732) of Psychoanalytic Dialogues: The International Journal of Relational Perspectives.  

Struggles with self and identity impact the adolescent mind.  The adolescent’s experiences of self–as derived from bodily experiences and emotional confusions–can create an ineffable sense of alienation from others.  In adolescents, self-conflicts can also present with transient dissociative states.  Experiences of identity, by contrast, can provide a compensatory, reflective function.  

The article describes Dr. Gerson’s work with two troubled adolescents.  One had taken on the identity of a vampiress and the other of a gangster.  The psychodynamic treatment focused on exposing, understanding, and working through the internal conflict, thus helping the patients negotiate between the perspectives of self and identity.  By examining the contrast between identity and self, these patients were able find ways of living that, ultimately, felt more truthful, authentic, and integrated.

Please contact Dr. Gerson at mgersonphd@psychstudies.net to receive a free personal copy of the article.

For more background on self and identity, also see the courses Classical Psychoanalytic Theory or Ego Psychology.

“Self” and “Identity”

Neuroscience, Self, and Identity

Neuroscience, Self, and IdentityWhat do we mean when we refer to self?  Is self distinct from identity?  The constructs of self and identity have been understood and discussed historically in diverse ways.  Neuroscience research is now supporting that they are indeed distinct constructs.

Neuro-imaging research is consistent with self as reflecting right hemisphere, reflexive, nonlinguistic experience.  In contrast, identity involves left hemisphere, reflective, linguistically-mediated experience.  

Self and identity have distinct functions as well as developmental significance.  Self refers to how we experience the moment, from the perspective of “I”.  Feeling the exhilaration of reaching a mountain top, for example, would be engaging the self.  Identity reflects our experiences from the observer, or “me”, perspective.  Thinking of oneself as an adventurer would be an example of identity.  

Very young children are more likely than adults to be in touch with the self.  Clashes between self and identity are often particularly evident during adolescence–a stage of enormous neurological growth and changes.  As noted by Erikson and many other theorists, adolescence may be a time of turmoil as a life-long identity is forged.

Understanding the differences between self and identity can be helpful clinically.  To read more, view the fascinating article, “Reconsidering Self and Identity Through a Dialogue Between Neuroscience and Psychoanalytic Theory,” published in Psychoanalytic Dialogues, 24(2), 247-251, as well as the commentary with discussion, Gerson, M. J. (2014). “A meta-commentary: Response to the commentaries of Marks-Tarlow and Solow Glennon.”  Dr. Gerson discusses the empirical study of consciousness in terms of contemporary psychoanalytic concepts and argues for interdisciplinary research in which neuroscience and psychoanalysis may engage in a mutually informing dialogue.  Please contact him at mgersonphd@psychstudies.net to receive a free personal copy of the article.

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