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CLINICAL NOTES

Jacques-Alain Miller (1986). ‘How Psychoanalysis Cures According to Jacques Lacan,’ edited by Ellie-Ragland, Newsletter of the Freudian Field, Vol. 1, No. 2, 1987, pp. 4-30.

These clinical notes summarize the main arguments put forth by Jacques-Alain Miller on July 25, 1986 at Chicago in the first Paris/Chicago Psychoanalytic Workshop.

Jacques-Alain Miller’s intervention takes the form of a critique of the recent work of Richard Chesswick and Heinz Kohut. The title of Miller’s paper, for instance, is a pun on the title of a book by Kohut.

Miller is mainly preoccupied with five important misconceptions about what Jacques Lacan was up to in France given the huge theoretical assumptions and differences between ego-psychology and Lacanian psychoanalysis.

The first misconception is that Jacques Lacan is just another structuralist or post-structuralist thinker ‘on a par with Roland Barthes, Claude Lévi-Strauss, Michel Foucault, and Jacques Derrida.’ Miller points out that while Lacan was also influenced by the theories of structuralism, he was mainly a clinician and not a literary intellectual or philosopher.

In fact, Lacan saw more patients than any other analyst of his generation and began his career as a psychiatrist who was influenced by Henri Ey. Lacan’s doctoral thesis was on ‘self-punitive psychosis’ and was not on a literary or philosophical topic.

Those who are acquainted with Lacan mainly from the innumerable applications of psychoanalysis in the human sciences were not aware of this forcing Miller to clarify what Lacan was really up to in the Chicago workshop.

The second misconception is that the Lacanian schools let students decide who should or should not be trained as an analyst. Miller points out that

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the ‘idea of training analysts is not Lacanian,’ and that Lacan does not differentiate between a training analysis and a therapeutic analysis like most schools of analysis.

Lacan himself was however trained as an analyst and did his training analysis under the supervision of Rudolf Lowenstein; he qualified as a training analyst in the same year (1938) as Heinz Hartman in Paris.

Miller makes these points because Lacanian theory was subsequently positioned as a major critique of the ego psychology of Lowenstein and Hartman; Hartman became the President of the International Psychoanalytic Association after moving to the United States.

The third misconception, according to Miller, is that psychoanalysis is thought to be a form of hermeneutics. The fourth relates to the role of the death instinct in the Freudian doctrine, and the fifth is on the relationship between Lacan and surrealism.

Miller’s response is that unlike most analysts who distanced themselves from the death instinct, it was Lacan who thought through the implications of the death instinct in the Freudian doctrine and made it his own.

Chessick’s contention that Lacan is a surrealist who was not serious about the propositional structure of his doctrine is simply not true as the primary and secondary literature on Lacan demonstrates. This misconception is due to Lacan’s close friendship with Salvador Dali.

Miller is also keen to emphasize that Lacan did not see himself as doing his own thing or a form of hermeneutics like Paul Ricoeur, but was quite serious about grounding his interventions on a close analysis of the Freudian text.

Hence, his preoccupation with the poetics of the Freudian text, with questions of accuracy in translation, and in coming to terms with the problems of literary figuration in his seminars.

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Before commencing a critique of Heniz Kohut, Miller identifies the model of mental illness and cure that constitutes Kohut’s approach to psychoanalysis.

Kohut’s main contention is that the patient lacks ‘a responsive self-object.’

This is the case for both neurotics and psychotics. This lack may be complete or partial, but it is always there. Kohut’s approach then is to offer himself ‘as a self-object’ for what is lacking in the patient.

Not only is a self-object made available to the patient, Kohut ensured that the self-object was willing to be empathetic and even smile, if required, at the patient.

Miller disagrees with this approach saying that the empathetic approach overlooks the fact the unconscious is structured like a language.

This means that what is at stake is getting the patient to free-associate on the couch which he will not (especially in cases of hysteria). The patient may prefer to remain silent and let the analyst do all the work if he comes across as too empathetic.

Another difficulty in Kohut’s approach is that it presupposes that he, as the analyst, understands what the patient is saying.

But this is not the actual experience of free-association where the patient will say any number of things that do not make sense or which appear trivial to him at first.

The presence of the analysts is to guarantee that the elements that appear in the act of free-association are not arbitrary, but are subject to psychic determinism.

So it is worth the patient’s while to press on even if there are phases in which it appears that free-association is circumlocutory or a waste of time. As Miller points out, ‘the analyst is there to say that what you believe you are saying by chance, is, as a matter of fact, perfectly determined, has a reason, has a cause.’

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It takes a while for the patient to get a feel for free-association since it is mediated by fantasy. What the patient encounters is that the revelations of the unconscious don’t increase the feeling of being at home in the analysis or with his ‘own’ psyche.

There is necessarily a sense of Otherness, of something ‘uncanny’ in the revelations of the unconscious that will not go away no matter how long the patient has been in analysis.

That is why Lacanian interpretations take the form of a ‘surprise’ rather than that of an ‘explanation.’ As Lacan was fond of putting it, an interpretation that can be understood by the patient is not a psychoanalytic interpretation.

Miller is anxious to point out that psychoanalysis does not have anything to say about the biological structure of the body, of the brain, or the natural functions. Psychoanalysis only comes in to the picture insofar as there is a gap between the biological and the cultural realms of being.

So, for instance, Lacanians are fond of pointing out that the human infant is born premature (compared to other species) and the period of dependence on the parents is long enough to activate the phenomena that constitute the stuff of a typical analysis.

Even the cry of a premature infant for its mother’s presence is not ‘natural,’ but is patterned on the language that he is exposed to.

So it is not a question of child language acquisition in which a child’s self acquires a natural language from the outside with a clearly demarcated border between the inside and the outside, but more an instance of language acquiring a child.

Language percolates into a child in a way that patterns its behaviour from as early as three months.

So the mother’s response is not only to meet an urgent biological need for feeding, urination, or defecation, but is already implicated in the affective triad that Lacan termed ‘need, demand, and desire.’

There is also another important difference between the drive to which humans are subject and the biological instincts and reflexes which propel animals. Humans can procreate any time of the year unlike animals which have a specific mating season.

The drives, Miller points out, ‘insist, persist, and are relentless’ in a way that is not reducible to biological needs or simple instinctual behaviour.

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The ‘sickness’ of the human subject then relates to the fact that he cannot address his needs directly, but must have them mediated through the agency or locus of the imaginary or symbolic other.

So unlike animals that can function purely at the biological level, we have to relate to language. Miller quotes Lacan as saying: ‘It is not a matter of biology. Rather it is a matter of heraldry.’

That is because before a child is born, it is spoken about; it is already in the symbolic; the parents may have even chosen a name or subtly determined its future. So it cannot be a simple biological unfolding like it is with animals that do not carry a name, fate, or destiny.

And, finally, Miller emphasizes the need to re-engage with hysteria which has been classified away as a host of borderline disorders in psychiatry.

The ‘stasis’ in American psychoanalysis is because it prefers the predictable forms of neuroses like obsessions rather than the more unpredictable challenge of hysteria which presents itself in the clinic as ‘a lack of knowledge.’

These clinical notes are an attempt to delineate for serious students of psychoanalysis the importance of engaging with the Freudian field without getting waylaid by chronic misconceptions of what Jacques Lacan’s work amounts to.

There is no better way to get started than to read the any number of introductions, expositions, and clarifications that Jacques-Alain Miller has made available to make this possible.

SHIVA KUMAR SRINIVASAN