In 1972,
while Lacan himself was still in the process of forging his large and complex
conceptual apparatus, a book entitled La
psychose appeared. The author,
Alphonse De Waelhens, set himself the challenging task not only of putting
together a clear and coherent overview of Lacan’s difficult teachings on the
psychoses—although the third seminar of 1955-1956 and the roughly
contemporaneous écrit “On a question
preliminary to any possible treatment of psychosis” are the best known Lacanian
texts dealing with psychotic phenomena, various other remarks on psychosis are
scattered throughout the Lacanian corpus—but also of demonstrating the ways in
which a Freudo-Lacanian theory of madness furnishes the building blocks for a
new sort of philosophical anthropology, for a reconsideration of the very
nature of subjectivity per se. 
Furthermore, De Waelhens’ project, at least at an implicit level, also
attempts to wed, in certain interesting ways, two normally antagonistic
frameworks, namely, structuralism and phenomenology (De Waelhens coming
primarily out of a more phenomenological background).

In 1978, La psychose was translated into English
by Wilfried Ver Eecke and published by Duquesne University Press under the
title Schizophrenia: A Philosophical Reflection on Lacan’s
Structuralist Interpretation. This
title is, in fact, more accurate than the original one in French, since De
Waelhens chooses to focus specifically on schizophrenia as the type of
psychotic disorder concerning him in his study. Sadly, this classic piece of Lacanian literature lapsed out of
print. Fortunately, a revised version
entitled Phenomenology and Lacan on
Schizophrenia, after the Decade of the Brain, which includes an extensive
introduction by Ver Eecke as well as a brand new chapter by him on recent
developments in the treatment of schizophrenia (hence Ver Eecke being listed as
a co-author), is now available from Leuven University Press.

In the
introduction, Ver Eecke begins by contextualizing De Waelhens’ work in relation
to philosophy. More specifically, he
uses issues raised by Sartre and Wittgenstein to explain why, philosophically
speaking, one would be interested in turning to psychoanalysis. For both Ver Eecke and De Waelhens,
following in the footsteps of Freud and Lacan, extreme psychical pathologies
such as schizophrenia are not totally aberrant and anomalous afflictions
marking off as different-in-kind a sick minority from the rest of the mentally
healthy population. Instead, these
“maladies of the soul” are windows opening out onto a view of some of the key
universal components involved in the functioning of the psyche; the psychoses
negatively highlight, by virtue of the psychotic individual’s lack of
integration into the shared space of human socio-linguistic experience qua “consensual reality,” certain
essential mechanisms underlying and making possible the field of “normal,”
“everyday” experience. When these
mechanisms malfunction or are non-existent (the latter case of non-existence
being what’s at stake in the Lacanian concept of “foreclosure”), stable
subjectivity and its experiential correlates cannot come into being. The individual, stranded somewhere in an
anxiety-ridden no-man’s land between the pre-subjective and the subjective,
falls ill.

According to Ver Eecke, Sartre’s
analyses isolate as a crucial existential topic the question of the self’s origins: Where does the “I” come from? How does one conceive of one’s origins (or
one’s death, for that matter) without projecting oneself as a witnessing gaze
into the moment of the self’s emergence, thus paradoxically always-already
positing one’s own existence even at the very point of the ostensible advent of
this same self? The psychoanalytic
theory of the “fundamental fantasy” (especially as outlined in a 1964 paper by
Jean Laplanche and J.-B. Pontalis entitled “Fantasme
originaire, fantasmes des origines, origines du fantasme”) directly
grapples with this Sartrean theme. The
basic idea is that the subject creates (unconscious) fantasies that “fill in
the gaps,” the necessary holes, of its ontogenetic, life historical experience
as regards, for example, its birth and what transpired before this birth. The fashion in which the individual thus
embellishes the tableau of his/her selfhood has, in the psychoanalytic view,
decisive consequences for later psychical developments. One of De Waelhens’ claims is that human
finitude, as the kernel around which fundamental fantasies wind themselves, is
an especially troubling and perturbing problem for those destined to lapse into
psychosis. In short, the psychotic has difficulty
answering, to his/her own satisfaction, queries regarding from where the “I”
comes. This leads then, in Ver Eecke’s
introduction, to a brief discussion of Wittgenstein (particularly the later
text On Certainty).

Ver Eecke contends, in connection
with a brief examination of Wittgenstein’s musings on personal pronouns and
proper names, that an essential part of the process in becoming human (i.e.,
the quasi-mythical moments theorized to exist in the passage from immediate
asubjectivity to mediated subjectivity) is the assumption and interiorization
of the symbolico-linguistic mediators of one’s identity/selfhood. This identification effectuated in and
through language is a prerequisite for entry into human social reality. Not only does the psychotic have severe
difficulties with his/her psychical relation to the enigmas of the self’s
origins, but he/she also never fully comes to terms with the representational
emblems of selfhood normally taken for granted in those with comparatively
normal egos. In this light, Lacan’s
teachings on psychotic pathological structures can be broadly taken to be
inquiries into the psychical repercussions of the failure of the individual to
be assimilated into the “symbolic order” of language. The remainder of Ver Eecke’s introduction summarizes the crucial
contributions of De Waelhens’ work as regards a Lacanian theory of psychosis
and its philosophical consequences.

Before
proceeding to a synopsis of the book, a few remarks about how De Waelhens’
phenomenological background impacts his approach to Lacan’s “structuralist”
account of the psychoses are in order. 
Although far from forced or blatant—De Waelhens doesn’t openly drag
figures like Husserl, Heidegger, or Merleau-Ponty into the fray of
psychoanalytic debates here—two of De Waelhens’ emphases reveal his underlying
philosophical leanings. First, his
additions to Lacan’s battery of concepts dealing with psychosis derive from the
attention paid to the experiential qualities of the hallucinations and
delusions endured by those suffering from this class of pathological
phenomena. De Waelhens, employing the
Lacanian registers, speaks of these illusions as an “imaginary real” (more will
be said about this phrase subsequently). 
Second, in line with themes from existential phenomenology, De Waelhens
productively maintains that human finitude (issues surrounding the matter of
birth as well as something like Heideggerian Sein zum Tod), rather than simply sexuality as per classical
Freudianism, is perhaps the central focal point in the psychical economy, the nucleus
of the formations of the unconscious. 
And, apart from these issues, De Waelhens’ entire analysis is deeply and
profoundly Hegelian at various decisive junctures, with Ver Eecke aptly drawing
out these myriad connections between philosophy and psychoanalysis in the
copious footnotes to his translation.

As already
noted, De Waelhens is interested in showing how an inability to integrate
oneself into language, as do other subjects, is complicit in generating
psychosis. And yet, it’s sometimes hard
to tell whether linguistic shortcomings are causes or effects of a disorder
like schizophrenia (in his supplementary chapter in the revised edition, Ver
Eecke’s attempt to reconcile physiological and ideational etiologies in the
diagnosis of schizophrenia via his “dual epistemology” speaks to this opacity
in De Waelhens’ presentation—on this, see some of the concluding paragraphs
below). Does the “rejection/foreclosure
of the signifier” trigger psychosis?  Or,
alternatively, is the lack of capacity to unproblematically enter into the
socio-symbolic order itself a symptom of psychosis, a symptom perhaps
pre-determined by neurological defects? 
In his treatment of hallucination, this ambiguity is especially
pronounced, with disturbances in the individual’s relation to language and the
hallucinations allegedly thereby resulting being simultaneously both visible
manifestations of psychosis (i.e., symptoms qua
effects or consequences) as well as underlying determinants or catalysts of
psychosis (i.e., causes leading to psychotic disorders).

Introducing a biological level of
explanation helps break the deadlock of this vacillation. However, De Waelhens
rejects this option. Employing a now
all-too-familiar argumentative tactic, he observes that biologistic diagnoses
are powerless to account for the particular content of the ideational
disturbances characteristic of the psychoses. 
At most, a neurologist can show that a patient hallucinates and possibly
explain some of what is transpiring at the cerebral level when such symptoms
are reported; a neurologist might even be able to predict that certain
impairments or injuries to the gray matter of the brain will likely lead to an
individual becoming schizophrenic. But,
De Waelhens contends, the genuine interest, the true explanatory task, lies in
showing why specific individuals are plagued by specific delusional
contents. Different psychotic patients
are trapped in different hallucinatory worlds, and a psychoanalytic-philosophical
analysis sets itself the goal of revealing the reasons for the material of
delirium taking on the contours that it does for each and every analysand (with
this analysis requiring an investigation into the experiential, ideational
elements of particular ontogenetic histories). 
Nonetheless, even if De Waelhens is correct regarding the explanatory
limits of physiological diagnosis, this shouldn’t be mistaken for a carte blanche to totally ignore the
burgeoning field of neurological research into the physical underpinnings of
psychosis. Only a fool could today deny
that the body plays a causal role in predisposing people to schizophrenia. De Waelhens himself isn’t such a fool,
although his deliberate and careful avoidance of treading onto the soil of
biology might, in a contemporary context (as opposed to when this text was
originally written), be seen now as an unjustifiable theoretical shortcoming
given the progress that’s been made in the natural scientific study of schizophrenia.

Part of what distinguishes a
psychotic from an ordinary, run-of-the-mill neurotic is the presence of
delusions and hallucinations. Whereas the
neurotic maintains a connection with the consensus reality of the
socio-linguistic order by repressing that which runs counter to the dictates of
this order, the psychotic lives out these normally unconscious aspects of
ideational life on the surface of his/her conscious perceptions. Taking his lead from Lacan, De Waelhens
insists that the individual’s relation to the Symbolic qua language is absolutely decisive in the genesis and subsequent
unfolding of those symptoms most characteristic of psychosis. The “big Other” of the symbolic order
introduces a measure of mediation into the pre-linguistic immediacy of the
infant-child’s chaotic soup of libidinal bonds. Although it has become a commonplace of Lacanian theory nowadays,
De Waelhens deserves credit for being one of the first interpreters to
recognize that, in Lacan’s structural account of the Oedipal family unit, the
paternal function (i.e., the Nom-du-Père
as the emblem of Symbolic intervention in the libidinal economy) isn’t simply a
negative factor, namely, the mark of a prohibition introducing an unpleasant,
resented loss into the infant’s existence. 
De Waelhens rightly stresses that, for Lacan, the paternal function is
that which makes possible an exit from a potentially psychosis-inducing state
of perturbing dyadic dependency upon an unpredictable and seemingly capricious
maternal desire. He also foreshadows later
developments in psychoanalytic theory by pointing out that the mother’s own
psychical processes (for example, her unconscious libidinal investments) are
major factors determining whether or not the child will become psychotic. The Symbolic Nom-du-Père serves as the child as a sort of lever or fulcrum
enabling him/her to pry loose from the situation of primordial helplessness in
which all human beings find themselves initially; in his more Hegelian moments,
De Waelhens likes to speak of this pre-Symbolic state in terms of an
“immediacy” to be contrasted with the “mediation” establishing subjectivity
proper. The stabilization of affect and
cognition resulting from the intervention of the paternal pole of the Oedipal
triangle is necessary for the construction of a non-psychotic self-identity.

This is not the place to rehearse
the arguments explaining why Lacan, in his “return to Freud,” identifies
language as essential to the dynamics of the Oedipus complex and the type of
subjectivity produced therein. Suffice
it to say that, in De Waelhens’ view, failures to be integrated into a
language-structured world are decisive for the emergence of psychotic
symptoms. So, what about the category
of the “imaginary real” employed in this study to describe schizophrenic experience? Freud speaks of psychosis as involving a
massive “dis-investment” in the Umwelt
of external objects and persons; De Waelhens proceeds to hypothesize that a
correlative “reinvestment” of this thus-withdrawn libidinal cathexis is placed upon
language by the psychotic. But, hasn’t
it already be claimed that the psychotic remains, in a manner of speaking, outside
of language? A greater degree of precision
is required in response to this question: 
De Waelhens stipulates that the psychotic has problems specifically with
that dimension of language consisting of intersubjectively-recognized
significance, this being what disintegrates with the collapse of the Symbolic
for the psychotic. The hallucinations
and delusions of the imaginary real, in this model, result from an excessive
reinvestment in language not as a matrix of socially shared meaning, but as a
series of signifiers construed in such a hyper-literal fashion by the psychotic
that they lose all anchoring in a set of stable signifieds (this “unmooring of
signifiers” being what Lacan describes in terms of the unraveling of the
“quilting point” [point de capiton]
established through the Name-of-the-Father). 
For instance, a metaphorical idiom or turn of phrase might be understood
by the psychotic in such a literal way that this idiosyncratic interpretation
generates corresponding hallucinations or somatic disturbances (the favored
example used by De Waelhens is of a German-speaking patient whose symptomatic
eye trouble is the effect of a German phrase describing a deceitful person as a
“twister of eyes”). The hyper-literal
misunderstanding is the “imaginary” moment, and the return of this
misunderstanding under a delusional-perceptual guise is the “real” aspect.

De Waelhens maintains that
hallucinations cannot simply be explained as nothing more than false
perceptions. In fact, careful
questioning of hallucinating patients reveals that they themselves are aware of
the experiential qualities distinguishing hallucinations from genuine
perceptions. Combining Lacanian theory
with phenomenological sensitivity to the task of accurately describing the
sensory world of the individual, De Waelhens adamantly insists that the
illusions associated with psychotic delirium are already attempts at recovery
spontaneously undertaken by the afflicted person. The often intricate and highly developed delusional systems of
psychotics represent a struggle to reestablish a firm foundation of meaning in
the wake of the Symbolic’s collapse. 
The psychotic tries, however inadequately, to reintegrate him/her-self
back into the domain of trans-individual significance. Unfortunately, a by-product of this furious
activity at self-recovery is the disorienting kaleidoscope of the imaginary
real. In a more recent study from 1997
entitled A Clinical Introduction to
Lacanian Psychoanalysis, Bruce Fink articulately develops this line of
analysis presented by De Waelhens. Fink
contends that, in the Lacanian clinic, the analyst tries to help the psychotic
not by trying in vain to permanently banish the “false perceptions” haunting
the analysand—this assumes, of course, that full-blown psychosis is, to a large
extent, incurable—but by assisting the psychotic in constructing a stable
delusional system, a set of metaphors that, although perhaps not in line with
consensus reality, nonetheless enable the sufferer to cling to meanings that
help him/her have a bearable existence. 
Again, on this point too, De Waelhens stands out as a pioneer in
Lacanian exegesis.

The biggest difference between the
1978 and 2001 editions of this translation of De Waelhens’ text is the
supplementary chapter by Ver Eecke on recent advances in the diagnosis and
treatment of schizophrenia. The “decade
of the brain” mentioned in the new title of the revised book presumably refers
to the 1990s, and Ver Eecke puts De Waelhens’ ideas into dialogue with a past
decade’s worth of research both in psychoanalysis and psychology as well as the
natural sciences. This is a welcome and
refreshing approach. Normally, those
working with Lacanian theory, especially if they have a philosophical agenda to
pursue, opt to ignore empirical data stemming from the clinical observation of
various mental pathologies. The
standard, well-rehearsed arguments for the avoidance of “biological
reductionism” are trotted out, and those faithful to the letter of the text are
released from the annoying obligation to determine whether or not their
conceptual acrobatics are relevant to the boring banality of human life. On the other hand, it bears mentioning that
a complementary-but-inverse risk is run by those who espouse a materialism that
truly is reductionistic, that is to say, those who have always-already
concluded that all facets of a human being can be explained away as results of
physiology. Ver Eecke pleads his case
for a “dual epistemological” account of schizophrenia. Although the missing link between the
ideational and the neurological has yet to be pinned down—if one believes
certain authors working on the philosophy of mind, one might assume that such a
link cannot ever be located and/or conceptually delineated—Ver Eecke urges
thinkers on both sides of the soma-versus-psyche debate to cooperate rather
than bicker in seemingly endless intellectual turf battles. Behind this urging is the conviction that
schizophrenia is the outcome of a physiological predisposition combined with
certain “immaterial” factors (i.e., early socialization, the processes of
accession to language-use, environmental stimuli of various sorts, etc.)
aggravating or even setting off the psychotic episodes associated with
schizophrenia.

Furthermore, Ver Eecke uses all
kinds of research to buttress the Lacan-inspired contention that a dysfunctional
body image often lies at the root of a malformed self-identity. And, if it is indeed true that disturbances
of the “I” are an inherent feature of psychosis as De Waelhens asserts, then it
follows that investigating the formative dynamics of body image is an important
part of the effort to understand psychosis. 
What’s more, since both soma and psyche are at play in the body image as
an ideational representation of a material, physical reality, both psychical
and neurological levels of explanation are useful here. The most general philosophical upshot of all
this is that a human being is a much too complex entity to be exhaustively
analyzed from a single discursive/epistemological perspective. However, in this supplementary chapter, one
encounters a tension between De Waelhens and Ver Eecke: the latter argues against the former’s
strict partitioning of psychoanalysis and biological inquiries. Ver Eecke’s position, in which he
incorporates the findings of the natural sciences into a Lacanian framework, is
more plausible for two reasons. First,
as mentioned earlier, the sheer weight of the ever-increasing empirical
evidence concerning the body’s role in schizophrenia makes it intellectually
(as well as therapeutically) unpardonable to neglect this dimension of the
illness. Second, an exclusively
ideational explanation of schizophrenia is in danger of falling into a vicious
circle in which psychical phenomena are made to lead an untenable
epistemological double life as simultaneously both causes and effects of mental
pathologies (as argued above, De Waelhens occasionally courts this danger when
discussing the rapport between language and psychosis).

Overall, Phenomenology and Lacan on Schizophrenia, after the Decade of the Brain
offers a rich and interesting collection of insights into both schizophrenia as
well as the fundaments constitutive of subjectivity. For those dealing with Lacan’s theory of psychosis, this text is
absolutely essential reading. Both De
Waelhens and Ver Eecke bring the much-needed light of clarity into some of the
darker conceptual corners of psychoanalysis’ metapsychological edifice; such
difficult topics as primal repression and foreclosure are productively
illuminated here. And, hopefully, this
book’s subtle interweaving of psychoanalysis, clinical psychology, philosophy, and
the natural sciences will encourage future investigators to similarly nuance what
have previously been rather heavy-handed approaches to the psyche, approaches
stemming from false dichotomies which are themselves consequences of a
tacit-yet-flawed philosophical anthropology.

© 2002 Adrian Johnston

Adrian Johnston
recently completed a Ph.D. in Philosophy at SUNY Stony Brook. His dissertation
was Time Driven: Metapsychology and the Splitting of the Drive. He currently lives in Tennessee.

Categories: Psychoanalysis