LACAN IN THE CONSULTING ROOM
The theories of Jacques Lacan are well-known, if not always well-understood. But the application of that theory into psychoanalytic practice (as opposed to, say, film or political analysis) is discussed far less. The first chapter of Bruce Fink’s book Lacan to the letter, a methodical untangling of the Ecrits, focuses on Lacanian technique as practiced in the consulting room.
The starting point for Lacan is that the ego of the neurotic person is not too weak, but too strong. It represses anything – a prejudice, say, or a fantasy – which does not fit with how he likes to see himself. The ego refuses to allow such ideas in, and rather than dealing with them, it pushes them down, rejecting their integration. But however hard the ego tries to repress them, they still exist, poking through as painful and confusing symptoms. The goal of analysis, for Lacan, is therefore to loosen or unfix the ego and to help the person to come to terms with these difficult concepts.
This goes against the grain of the prevailing ego psychology which dominated psychoanalysis when Lacan was writing and practising. Ego psychology takes its lead from Freud’s second topography of the psyche – the topography of ego, superego and id. It tries to get the patient to model his ego on the analyst’s (on the basis that the analyst’s ego is healthy – a kind of role-model for the distressed). The strengthened ego may then more successfully crush the crude drives of the id.
For Lacan, this is both impossible and undesirable. Impossible, because it depends on the analyst having a ego which the patient will choose as a prototype; undesirable because it alienates the patient from prejudices and fantasies which he has every right to face up to.
Using the analogy of a game of bridge, Lacan suggests that there are four ‘players’ in therapy. The analyst appears both as ego (the personality and image which, for all her training, the analyst inevitably wants the world to see) and as Other (the holder of truth or authority). The patient also appears as ego, but his unconscious must also plays its hand. In other words, the patient arrives with two voices – that of his conscious ego, and of his unconscious. He meets the analyst as a person, but more significantly as a figure which can help him – an authority figure, a holder (in some sense) of truth or of language itself. It is rather like going to see one’s GP – we recognise her as a person (with feelings, tastes, preferences etc), but we go to see her because she is a GP and she can diagnose and cure our particular problem.
Lacan drew this fourfold relationship as a diagram:
From top-left, S is the patient as a subject of their unconscious; other (autre with a lower-case a) is the patient’s ego; Other (Autre with a capital A) is the analyst as holder of authority; and ego (also an autre with a small a) is the ego or projection of the personality of the analyst. This diagram helps to see the two possible partnerships between analyst and patient – the ‘imaginary’ realm of the ego psychologists, and the ‘symbolic’ realm of Lacan.
When the analyst interprets, he is heard by the patient as doing so not from the position of flesh-and-blood person, but “as the person he is imputed to be by the analysand in his transferential relation to him” (Fink 2004: 6). The analyst cannot therefore think that she can step out of the relationship and interpret the transference as if she were not a part of it. If she does, the patient may see (and criticise) himself from the point of view of the observing analyst. He will step into the analyst’s shoes, which may help him to understand himself better, but will only prolong his alienation from himself.
This – the analysis of the transference by two egos – is the ‘imaginary’ transference of the ego psychologists. It is arbitrary – because it depends on the foibles and tendencies of the analyst – and it only operates on the surface. It may also have unintended consequences: “the analyst who believes she is adopting the most dispassionate tone of voice in speaking to the analysand is taxed with being hypercritical, like the analysand’s father it may turn out, and thus another dimension of the transference, the symbolic dimension, persists despite every attempt to eliminate it” (Fink 2004: 7). Despite the best efforts of the two egos, the patient’s unconscious remains alive and kicking.
‘Symbolic’ transference does something different. Here, “the analyst strives ... to analyse on the basis of ... the Other” (Fink 2004: 7). Not on the basis of what the analyst thinks, the values and beliefs she holds, her blindspots and biases, but solely on what she hears.
What does it mean to take the place of the Other? For starters, it does not mean taking the position of ‘I’ – for example, the common technique of immediacy, in which the therapist might suggest, “I feel like you are angry with me” – since this is one ego talking to another. Such a comment may feel accusatory and the patient may strengthen his ego in defence. Any attempt to speak to the healthy part of the patient’s ego (in Lacan’s words, “the part that thinks like us”) is narcissistic (after all, if I am an analyst, what’s so special about my ego?). Instead of a partnership between the analyst-as-Other and the patient-as-unconscious-subject which seeks to interpret, the analyst ‘confronts the analysand with the reality he supposedly refuses to see’.
So – again – what does it mean to situate oneself as the Other? Very briefly, the Other (with a capital O) is a radical form of otherness which we absorb and learn from childhood onwards. If you think of language, rules, codes of conduct, family histories etc, you get the rough idea. It is through the Other that we understand our place in a society. In childhood, we interpret conversations between our parents and try to understand how we fit into the world they describe. If they talk about the books they love or the God they worship, we will understand that we live in a bookish or a religious family, and must therefore decide whether or not to read or worship. If one of our parents cheats on the other, we try to decipher how we fit into that adultery – do we identify with the wronged parent, or the adulterous parent, or both? Whatever we choose, we take our subjective form from what we hear and try to understand.
The Other relates to something symbolic which is publicly known – a cultural frame of reference, a set of laws or codes, the things we are told by our parents. It is out there – both in the sense that it is publicly available to us, and also something separate from us. In Seminar I, Lacan describes the treatment of a North African patient with symptoms relating to his hands. His previous analyst had fallen back on psychoanalytic tropes such as shame about masturbation, and the analysis was not successful. This analyst had ignored the Koranic laws which unconsciously were so integral to the patient (his father had been accused of theft, which the Koran says must be punished by the cutting off of one of the thief’s hands).
By occupying the place of the Other, the analyst must try as far as possible to set his ego aside: “the analyst is able to hear a slip precisely because he has managed to put himself aside, so to speak, precisely because he has managed to take the analysand’s speech not as a personal attack but rather as directed elsewhere, directed at something or someone else.”
Interpreting the transference as a personal attack, and basing one’s interpretation on how the analyst believes the patient feels about her (even if her thesis is correct) is, for Lacan, an abuse of power. Why ‘even if her thesis is correct’? Because this still entails interpreting the transference solely on the imaginary axis, on the basis of ego vs ego.
Fink illustrates his point by citing a number of case studies. Freud’s famous case study of the Rat Man is a lesson in interpreting on the symbolic level. Aware that the unconscious speaks in signifiers (not signifieds), Freud observes the complex grammar with which the Rat Man speaks and, through a forensic scrutiny of the Rat Man’s words and their link to his very painful symptoms, speaks to the Rat Man’s unconscious. But Lacan (a Freudian purist) is far more critical of Freud’s treatment of an attractive young woman who dreams of a sexual relationship with another woman in order to escape from her marriage (and her father). Here, Freud interprets the transference only on the imaginary level, suggesting that “beside the intention to mislead me, [her] dreams partly expressed the wish to win my favour.” Whether or not Freud is right here is immaterial – he is clearly analysing from the position of his own ego, and therefore missing the bigger picture. (Lacan suggests that Freud generally finds it difficult to move beyond the ego level when analysing attractive young women...)
I won’t go into the other case studies. But by way of conclusion, Fink’s final section – entitled “why we should not encourage our analysands to identify with us” – is worth exploring a little further. For Lacan, there is a fundamental question that we all have to grapple with: why can my desire to be something never quite be satisfied? Why can desire itself never be fulfilled? We all yearn to be something – to be richer, more respected, better loved, more worldly etc. Yet, however much we succeed in becoming these things, we never quite achieve our objective in a way that sufficiently satisfies us. Our endless efforts to be something better hide the fact that what troubles us is a fundamental and unfulfillable want-to-be – and it is this that we must face up to. Identifying with somebody else, trying to be what they are, is an easy way out – and even when we occupy the place of our object of desire, our want-to-be stubbornly remains. As Fink concludes, “it is a misfortune to identify with someone, for it keeps me from grappling with and going beyond my lack of being. It leaves me with the same inadequacies or failings as my analyst. Now that is unfortunate!”