The percipiens versus the percepta

Since his MD thesis on paranoia (Lacan Reference Lacan, Cutting and Shepherd1932) Lacan had maintained two positions concerning psychogenesis. The first, following Bleuler and de Clérambault, was that psychiatrists should attend more to the structure of subjectivity (the percipiens) than to collating Jasperian descriptions of the phenomena that patients experience (the percepta). Lacan was seeking the psychogenesis of disordered subjective structure rather than, for example, that of hallucinations. This echoed Bleuler’s quest for the ‘generating disorder’ underlying the vast range of psychotic symptomatology and de Clérambault’s attention to the ‘mécanismes du délire’ (‘mechanisms of delirium’).

The formation of subjective structure

Lacan’s second guiding principle was that ‘psychogenesis means identification’. He was convinced that the formation of subjective structure arose through processes of identification, misidentification and failed identification. His famous theory of the mirror stage begins with an infant, aged 6–18 months, looking at their image in a mirror. Some infants identify with that unified image as their selfhood. This is arguably a mistake, an illusion, a misidentification and an idealisation, since their actual bodily and psychical subjectivity remains needy, fractured and uncoordinated. Thereafter, the infant loses introspective access to their true self and misrecognises themselves as their ego or image. A split is thus established between their subjectivity (their unconscious) and their self-image (the ego that they take themself to be). This is what Lacan calls the psychogenesis of neurotic subjective structure.

Psychotic traits and states

Some infants do not identify at all with their own image in the mirror – ‘specular identification’ fails. Instead, much later in infancy, they will identify with close others, such as siblings, and copy their behaviours. These ‘social identifications’ allow a fragile ego to be belatedly constructed. Such individuals are likely to suffer later difficulties arising from the tension between their chaotic inner reality and their improvised, public-facing ego. (Contemporary phenomenological psychopathologists call something similar to this ‘disordered ipseity’ or ‘anomalous self-experience’ (Sass Reference Sass and Parnas2003).)

In a lecture on psychogenesis, Lacan offered a fuller theory of the psychogenesis of psychotic subjective structure, now adding an account of how acute psychotic illness is precipitated (Lacan Reference Lacan and Fink1946). He suggests that those with a psychotic clinical structure continually extend the chaos of their inner reality into the world they inhabit. Florid psychotic breakdown occurs when a stressful event leads them to try to put this chaotic world to rights, to reorganise it. Delusional certainty then compensates for the chronically disordered self-hood and is a creative attempt to self-treat (Lacan Reference Lacan and Fink1946). Note the important distinction here between ‘being mad’ (psychotic structure as a sustained trait) and ‘going mad’ (psychotic illness as a temporary state).

‘Signifiers’ and ‘signified’

In the field of linguistics, Saussure (1857–1913) had distinguished between speech and language. In speech, a chain of signifiers strung together over time runs in parallel with a wave of constantly evolving connotations. In contrast, in language, as it may be found in a dictionary or grammar, all elements are present simultaneously. Saussure also distinguished ‘signifiers’ (words) and ‘signified’ (their connotations, their context-dependent meanings). For example, if ‘table’ is the signifier, the signified is the associations we have with the word, not the thing in itself. Building on Saussure and others, Lévi-Strauss (1908–2009) had then recently introduced structuralism into anthropology and drawn attention to the profound way in which symbolisation carves up nature to create meaningful shared worlds. His structural anthropology considered how binary opposites, such as ‘family and non-family’ and ‘raw and cooked’, build distinctive cultures – their laws and prohibitions as well as their language. Thus, he placed particular emphasis on the structuring effect of signifiers. Lacan brought all of these ideas to bear as he studied the speech of patients with psychosis and followed Freud in giving attention to Judge Schreber’s account of his psychosis (Schreber Reference Schreber1903).

In Memoirs of My Nervous Illness, Schreber discloses how the word Seelenmord (‘soul murder’) initially occurred to him as empty of meaning (Schreber Reference Schreber1903). However, despite the lack of meaningful content, he sensed that the word was significant – there was meaningfulness without specific meaning. Furthermore, Seelenmord was addressed and would have significance specifically for him. This all contributed to the perplexity characteristic of the pre-delusional state. Then, suddenly, Schreber had the revelation that Seelenmord was what his psychiatrist had done to him so as to turn him into a ‘strumpet’ to be sexually abused. Later the delusion was elaborated until Schreber was transformed into a woman with whom God will procreate to save the human race. Lacan emphasises the disrupted relationship between signifier and signified here that is resolved in the final delusional motif. The delusion is a compensatory mechanism that stabilises meaning, introducing a new order into the person’s world: Schreber now knew he was God’s wife. A neologism, initially with no signified, comes to be overloaded with personal meaning for Schreber – connotations that are not conventional but can be revealed to an attentive clinician. Lacan offers contrasting examples of ‘empty refrains’ – repetitive fragments of speech that are entirely devoid of meaning for both patient and listener.

The paternal function – a ‘quilting point’

Having found these distorted relations between signifier and signified, Lacan asks what caused them. He concludes that some organising principle that governs language use must be missing in psychosis. How are the laws of shared language and cultural prohibitions transmitted? Lacan answers as a Freudian, using an original take on the Oedipal triangle. For him, the dyadic relationship between mother and baby is inherently too intense – incestuous seduction or aggression will ensue unless something intervenes to triangulate the situation. He proposes that the paternal function (also known as the ‘name of the father’ or ‘paternal metaphor’) fulfils this crucial role of rescuing the infant from intrusive maternal desire and introducing them to the wider world of culture and language outside the family. The paternal function offers the infant the rules of this wider culture and hence access to the world of shared meaning. Note that it need not be the biological father, or indeed a man, who delivers this function – an institution, female family members or a role model can provide it.

So how does the paternal function fail? Lacan suggests that it is not a simple matter of presence or absence. Rather it is how the paternal party is presented to the child, how they are spoken of by the mother, or how they position themselves in relation to the child, that determines whether they fulfil the function. For example, a dead father, being readily idealised, may serve the function well. An overzealous yet hypocritical father might fail to transmit the essential laws of language and culture. Lacan insists that for psychotic structure to occur, ‘foreclosure’ of the paternal function is required. Foreclosure means the utter non-existence of this function, a kind of radical excision, for the patients with psychosis, who is then left to invent forms of triangulation for themself where the paternal function has failed.

Borrowing a term from contemporary cybernetics, Lacan called the paternal function a ‘quilting point’, a privileged point where meaning is established and inscribed in the world of the child. If it is missing, for any reason, signifier and signified are cut adrift, and it may then be up to a delusion to solder them back together, as Schreber did when he managed to create his delusion of being God’s wife. The emphasis here is on how delusion helps to fix meaning and treat disturbing states in which the person feels at the mercy of the world around them, where there is too much opaque and threatening meaning.

Summary

Lacan’s early theory of the psychogenesis of psychosis emphasised a non-response to the image in the mirror stage (failed specular identification), whereas his later theory, expounded in Seminar III, rests more on failed Oedipal triangulation. His focus moved from non-identification with an image to absence of the paternal function. The first position is closer to phenomenological psychopathology, whereas the later theory is more rooted in Freudian psychoanalysis, but with a structuralist twist.