Psychoanalyst, Teacher and University Lecturer
(Translation by Mme Françoise C-M, thanks to her)
Sections of this text, first written in 1984 were included in my conference on the psychotherapy of psychoses, but as its global approach is different, its publication is not redundant and therefore warranted.
The approach I deliberately choose for this presentation is somewhat peculiar.
It is usually said : « there is PSYCHOSIS, NEUROSIS, PERVERSION », etc, or "THE PSYCHOTIC, THE NEUROTIC, THE PERVERT", etc... One then quickly move on to speaking of STRUCTURE, either putting in opposition neurotic structure and psychotic structure for instance, or stating 'non-psychotics are structured like so and so, while psychotics are structureless'.
This very word STRUCTURE is a METAPHOR, its etymology is that of the word "construction", and this cannot fail to evoke a picture of a framework, or a skeleton, perhaps prompting the fusing of these psychopathological structures with the different types of animal species skeletons. Indeed we are in both cases dealing with a classification, with a taxonomy concerning supposed BEINGS, no matter how nuanced and "flexible" we try to be when for instance describing "transitional forms" or border-line states etc...
A more subtle use of the word "structure" calling on topology and on a combinatory of symbols, requests both finer analysis and finer critics, topics I will not broach on today.
I would rather use the word LOGIC, derived from LOGOS, since what I am trying to describe are utterances. This word itself is not exempt from critics... Instead of opposing so-called PSYCHOTIC wordings to so-called NON-PSYCHOTIC utterances, I am on the contrary going to attempt to show that they actually agree on a majority of points, and that the differences which exist between these utterances are not those one expects, for instance when one says that the neurotic text/fabric would be torn but repairable while the psychotic text/fabric would show a hole, an irremediable loss of substance.
POINTS IN COMMON :
FIRST COMMON POINT :
Human body as a biological organism has the property to repeat perceptions of every kind : it is just plain recalling. Thus any perception being repeated is a perception without object (the very definition of hallucination !!!)
It is therefore a perception-of-every-kind-repeating-machine, among which are words ; parental speech is also repeated in the psychotic's mind.
SECOND COMMON POINT :
Speech is a part of these perceptions which are repeated. So speech is known by the one who will utter psychotic statements as well as by the one who will utter non-psychotic statements. To say « the psychotic did not access symbolic order » is not justified : this could only apply to a wolf-child or to a feral child.
This speech enters a cycle of repetition of itself, « it speaks », and it speaks «of its own », like one says « it is raining », "it" being impersonal : there is no author to the speaking. To be put in relation with the "repetition compulsion" (Freud).
THIRD COMMON POINT:
In non-psychotic as well as in psychotic utterances, one finds the same bipartition, which is as follows:
Some perceptions are acknowledged as being without current object, as repeating bygone perceptions. These will be named MEMORIES.
President Schreber, though uttering psychotic statements, can very well name memories some of the perceptions going through his mind. Examples to come...
On the contrary, some perceptions are not acknowledged as repetitions, with some possible reshuffling. One is then going to maintain that what is being perceived here and now happens for the first time and owes nothing to the past : the temporal dimension of repetition is going to be disclaimed.
Such is the case for a number of utterances which spontaneously come to mind : "creativity" is oblivion of previous experiences.
FOURTH COMMON POINT :
Another common ignorance in non-psychotic and psychotic utterances is due to the fact that irrefutably non verbal phenomena are either summoned by the VERBAL (affects and pictures which arise after reading or hearing a word, for example in a novel), or legible as a GRAPHIC REBUS of something that was at FIRST VERBAL:
– the dream with its pictures is a rebus ;
– the symptom is a rebus ;
– a musical tune crossing the mind can be a rebus. See my paper "Translation and interpretation" (in french) here :
FIFTH COMMON POINT :
Neither psychotic nor non-psychotic utterances make up anything when their authors say they are hearing something. There is no question that something is CURRENTLY perceived. The difference between both types of utterances concerns the answer to the question « who says it, what I hear here and now? ». See examples below
SIXTH COMMON POINT:
Looking for « who says it » implies a belief (shared by both types of utterances) in a potential author to the speech.
Psychotic and non-psychotic utterances collude to deny that « it speaks of its own », and to affirm that someone has to do the speaking.
"I" is then mentioned as a possible author to the utterances, "I" is the name given to an authority which would co-ordinate and synthesize perceptions. "I" is the name of a being endowed with freedom and willpower, who eludes any previous determination at the very moment he speaks out, who created himself, who is the cause of each and every action attributed to him. He therefore matches God's attributes, eternity put aside.
But here is one difference between psychotic and non-psychotic utterances. I am not claiming to account here for all psychotic utterances. I am only going to talk about what goes on in MENTAL AUTOMATISM, in which the subject says « all that I do or say, I am made to do or say ». In this utterance, "I" is therefore assumed to exist: the subject does not say (as Lacan) « what speaks without knowing makes me "I", subject of the verb », or elsewhere « the very fact that I say "I" is imposed on me ». No, s/he says « "I" exists, but deprived of freedom and will to which s/he should be entitled. The author to what I hear is not I, what causes my utterance is EXTERNAL: ONE speaks to me ».
The non-psychotic utterance will on the contrary say « "I" exists, and is indeed the author to what I hear being said in my head right now, the cause of my speech is INTERNAL: I speak to myself, and doing it I demonstrate MY FREE WILL and MY INTENTION ». How to explain this difference between psychotic and non-psychotic utterance?
Well, paradoxically with the help of another POINT COMMON to both utterances which is THE PRONOMINAL TRANSFORMATION or more precisely THE REFLEXIVE one. It is my hypothesis, and I will demonstrate it in another paper.
During the IDENTIFICATION stage of the child by one or several talking adults, whom we will name SPOKESPERSONS rather than parents, whence reminding that they may not be the progenitors, we are going to assume that any utterance of the adult with the form A * B, "*" being a verb, undergoes in the child's mind a transformation generating the statements:
B * B
B * A
B * C .
For instance the statement made by the adult « I keep her/him » (implying ”because it gives me complete satisfaction") becomes for the child who we will roughly qualify as obsessional:
– I keep myself safe ;
– I keep my parent or parents safe (filial piety, haunting fears to lose them) ;
– I keep every other object C (impossibility to cut ties with even apparently valueless objects).
In the case of the child holding non-psychotic statements, what does the parent or rather the spokesperson do?
S/he INTERPRETS at least in parts, even before the child can speak, the experience of the child, his/her feelings, her/his supposed needs, in a kind of interpretative delirium where (s/he imagines knowing beforehand what the other wants without him/her having to say it. One does not need words to understand the other, it is Love.
The reflexive transformation of « I know him/her, I can interpret him/her» spawns « I know myself, I can interpret myself ». The apex of which is the paranoiac utterance : « I understand everything of my inner functioning ; of what the others want without them even having to voice it ».
On the contrary the disinterest of the spokesperson for the unloved child, like « I don’t know what’s the matter with her and anyway I don’t care », could account – by a reflexive shift – for « I do not know what’s the matter with me nor what I am », hence the repeated appeal, however to no avail, to an outer knowledge, characteristic of the hysterical type statements.
In the case of psychotic utterances, we can assume the spokesperson's utterance to be like « I do not want to know anything about her, just that she is a biological body with perceptions. I refuse to interpret anything of what she feels or want » (A DOES NOT INTERPRET B).
The psychotic statement will adopt the adult’s refusal at interpretation, as these utterances by President Schreber tend to demonstrate :
« They say I'm a paranoid, and paranoid are people who relate everything to themselves. In this case they are wrong, it's not me who refers everything to me (B DOES NOT INTERPRET B), it is this God who speaks incessantly within me through its various agents and extensions. It is he who has – whatever I experience – the unfortunate habit of immediately making me notice that I am targeted, or even that it is coming from me. I cannot play a Magic Flute aria without he who talks awarding me with the related feelings, but I myself do not have them ».
On the other hand, from the moment the child who is repeating the utterance of the adult begins to speak, the adult will usually play the BELIEVE THE CHILD IS AUTHOR TO WHAT S/HE SAYS game. This "it is you who say it" is for the child an "it is I who say it" that will from now on accompany the out loud at first and the then later inward repetition of the adult’s words (case for non-psychotic utterances). By contrast the absence of that "it is you who say" in the adult's speech could – and it is our hypothesis – lead to the absence of "this is I speaking" in psychotic utterances.
ANOTHER POINT (THE SEVENTH) COMMON to psychotic and non-psychotic utterances will allow us to understand how the same logical sequences generate different utterances simply because they are fed different input data. This common point is the ability to use REASONING, to make SYLLOGISM.
One such reasoning is: if two propositions A and B (the premises) are both validated, this means that a third proposal C (conclusion) is also true. Two things :
– If this C proposal is known, I acknowledge and confirm its veracity.
– If this C proposal is unknown, I invent a name for it and affirm its truth, possibly inviting others to experience it.
For instance in the first case:
– A photographic emulsion is being impressed
– There is light in the room
– Therefore the light has the property to impress a photographic film. I had heard it be said, and I can confirm it.
In the second case (discovery of the X-rays):
– The film is impressed
– There is no visible light
– Thus, incredible but true, there is an invisible radiation that I baptize X-rays, and invite others to repeat the experience.
Let’s apply these arguments or syllogisms to psychotic and non-psychotic statements.
Concerning non-psychotic statements, three situations may arise:
1) – I hear here and now, no doubt whatsoever about this perception
– I had this perception before, I know it is a repeat
– So I call it MEMORY.
2) – I hear here and now. It's a perception I deny is repeating itself (ignorance/misknowledge as mentioned above)
– Something tells me "it is you who say it"
– Thus this is I talking, I talk inside to myself.
3) – I hear here and now, and I deny that this perception is a repeat
– Nothing says to me "it is you who say it"
– Therefore it’s someone else speaking.
– Is there anyone here?
– Yes, s/he moves her lips, so it is she who speaks
– No, s/he did not move her lips, so either she's a ventriloquist, or I left the radio on, or I’ll go see a doctor (temporal lobe epilepsy is a possibility...).
Concerning the mental automatism type of psychotic utterance :
– I hear here and now, there's no doubt, and this is not an old perception repeating, it is not a memory
– Nothing says it is I speaking
– Therefore it’s someone else speaking.
First instance : I see my contact in front of me, but she does not move her lips. And besides, other people present in this room do not seem to hear what I am hearing. This demonstrates that one can talk without moving one’s lips. Therefore telepathy exists (see the account below, where my psychiatrist colleague who had stayed silent during a face-to-face consultation is told by her schizophrenic patient: «You have to tell me these things with your lips”).
Second instance: no one is here. Therefore the author of the utterance is either a human who can do remote voicing (possibly with devices such as a radio transmitter) or, unbelievable but true!, it is entities I heard of with disbelief: God or the devil, witches or wizards, aliens, and so on... The experience gives me proof of their existence.
Thus Schreber illustrates with examples owing to the technique of his time that he could hear alien words others did not hear (see Memoirs of My Nervous Illness, p. 254).
Let’s consider now the case of a statement void of psychotic mental automatism, but containing verbal hallucinations.
Lacan* relates the case of a woman who comes across a neighbor in the hallway of their block of flats. She said to him, "I come from the butcher" (french “charcutier”). She then hears the neighbor say to her "sow" on an insulting tone.
This woman acknowledges that her utterance is NON-METAPHORICAL, it describes the action as it was just performed.
Conversely, the utterance that she hears coming out of her neighbor’s mouth is METAPHORICAL.
*Lacan, in “On a question prior to any possible treatment of psychosis” (Écrits, 1966) :
« It was the daughter who, during my examination, presented me—as proof of the insults to which she and her mother were subjected by their neighbors—a fact concerning the boyfriend of their female neighbor who was supposedly harassing them with her onslaughts, after they had had to break off an intimate friendship with her that was at first kindly received. This man—who was thus an indirect party to the situation and, moreover, a rather secondary figure in the patient's allegations—had, according to her, flung at her the offensive term "Sow!" as he passed her in the hallway of their apartment building.
On hearing this, and being hardly inclined to see in it a retort to "Pig!" that would be too easy to extrapolate in the name of a projection which in such cases is never anything more than the psychiatrist's own projection, I asked her straight out what in herself had been proffered the moment before. Not in vain, for she conceded with a smile that, upon seeing the man, she had murmured the following words which, if she is to be believed here, gave no cause for offense: "I've just been to the pork butcher's ... "
At whom were these words aimed? She was hard pressed to say, giving me the right to help her. For their literal meaning, we cannot neglect the fact, among others, that the patient had suddenly taken leave of her husband and her in-laws—and thus given a marriage her mother disapproved of a conclusion that had not changed in the interim—due to the conviction she had formed that these country bumpkins were planning nothing less, in order to finish off this good-for-nothing city girl, than to carve her up piece by piece.
(...) This is how the discourse managed to realize its rejecting intention in the hallucination. In the locus where the unspeakable object was rejected into the real, a word made itself heard because, in coming to the place of what has no name, it was unable to follow the subject's intention without detaching itself from it by the dash that introduces the reply —opposing its disparaging antistrophe to the grumbling of the strophe that was thus restored to the patient with the index of the I. (…) »
What assumption can we make about the genesis of such utterance?
The adult A talked in such manner about the child B: "I am willing to talk in a descriptive manner about this child, to comment on her/his actions, BUT I will not talk about her/him metaphorically".
Indeed to ‘metaphorize’ is to fantasy, it is to revel in the existence of this child thru the use of words. "For example I would never tell her/him ‘my little bunny, my little PIGLET, I’m going to eat you’" ("oral" metaphor which bears witness to a "devouring" love and accounts thru reflexive transformation for the fear of unloved children to "be gobbled up" or "to be stewed" (french) : "hysterical" speech)
The reflexive transformation of the above statement triggers generates in B's mind "I talk about myself non-metaphorically. No metaphorical statement will ever be uttered by me. If a metaphor is heard, then it is not I who says it, it is the other."
So the reasoning is as follows:
– The sentence "I have just been to the butcher" is heard by me.
– It is I who speaks to myself and this comment (non-metaphorical statement) can be shared with another and so I can tell the man in the hallway "I have just been to the butcher”, knowing that this is I speaking.
– Now a word is heard: "sow" (what we find at the butcher).
(It should be noted here that this lady had divorced a husband who wanted to skin and slice her like salami. She therefore could refer metaphorically to herself as something hailing from the butcher).
– But, she thinks, this word is a metaphorical statement, and no metaphor about me could be uttered by me.
– Therefore it is the other, the man in the corridor, who says it : he is insulting me.
There is still much to be said about, for example non-verbal hallucinations, or how to apply the foregoing reflexions to the "psychotherapy of the psychotics"...
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