Does the psychosomatic phemonenon have a meaning?
2 - HOWEVER THE QUESTION OF THE MEANING OF PSYCHOSOMATIC PHENOMENA DIVIDES ANALYSTS.
2.1. For some - Groddeck would be the first and extreme example, one of the most interesting too - these phenomena convey in an organ-mimed language the repressed wish.
Illness is then the refuge of the true, biological creativity of a repressed subject, submitted to the need of showing off by a society which keeps him artificially at a distance of his own body. It means the protest of the healthy child, the « little polymorphic perverse ». Groddeck inferred from it a benevolent psychotherapy aiming at reconciliation. This position, advocating the truth of the body knowledge, against the semblance which rules the phallic social order, gets on well with the hysterical speech.
The drawback of this somewhat megalomaniac view is its lack of strictness. Through analysis, psychosomatic phenomena are obviously different from hysteric symptoms, were it only in their address.
2.2. For others - it is the current prevailing stand point and notably the one held by the « Psychosomatic School of Paris » - these phenomena are bound to psychic life only by defect. The watchword is « Stop to delirate ! The psychosomatic symptom is dumb ». Indeed this school is the one which puts forward the concept of « pensée opératoire ». Not only has the psychosomatic phenomenon no meaning in itself but the whole thought of psychosomatic patients would be marked by a degradation of the ability of their speech to make meaning. This phenomenon was evidenced by Marty and de M'uzan in their article written in 1963. It consists of some basic features that I'll try to reinterpret later on :
- This thought does not aim at signifying the action but at lining it.
- It has the feature of the Superego ;
- It supposes that the others are not similar but identical to the subject. - It often shows phenomena consisting of pseudo-displacements that are neither conscious metaphors nor lapsus.
- It seems to step-over or bypass the whole phantasmatic activity ... - The « subject » is present but empty ... and so on ...
Eventually, this concept has enjoyed a good fortune under the name of alexithymia but some drive towards a pure psychological description untied from the psychoanalytical praxis.
A more recent presentation of the viewpoint of this school is given by Christophe Dejours with the metaphor of the water mill summed up as follows:A primitive unconscious made up of inborn behaviours (the hydraulic force of the waterfall) provides with energy a repressed unconscious made of representations (the work of the millstone on grain). So there would be one erotic body and one archaic and automatic behavioured body. The latter could prevail at any moment under the influence of excessive stimulation (storm swelling) or of a mental running deficiency (no more grain: the mill races). Putting in action these inborn behaviours would be released by the tension of the need which would give to the discharge its imperative character. Now, if the need is certainly demanding, it is the signifier that is imperative. Our experience gives evidence to the primacy of the signifier over the claims of need as shown by Anorexia nervosis in which, by her refusal to drop the nothing, a pure effect of language, the anorectic girl comes to ignore hunger.
This viewpoint according to which psychosomatic phenomena are outside meaning because « before language » produces other consequences than the former.
1 . Unobtainable theoretical links will be searched for between a psychoanalytical anthropology and a biological anthropology ; whereas « Man », after all, is only a signifier that cannot bear the same acception in the psychoanalytic speech and in the scientific speech.
2 . The question of meaning, thus untimely and negatively answered, considering these phenomena as « before language » is bound to lead to a withdrawal of the analytic position and to look for help in the biological sciences especially the so attractive modem immunology.
3 - THEN WHAT COULD WE SAY ABOUT THE MEANING OF PSYCHOSOMATIC PHENOMENA ?
First confess our perplexity.
3.1. If meaning is sought for, meaning is found. Sometimes, the patient himself attempts to do so when a P.S.P.1 appears during a cure. One stumbles however on a major difficulty. Although in hysteria the symptom produces a cut out on the body, following the vocabulary of the language allowing a reading like a rebus (body here is not involved but in its signifying dimension), in P.S.P. it is an organ or a function that reacts in a perfectly stereotyped way : motions of ulcerative colitis, asthma attacks, and so on...
If there is any meaning in it (in the usual meaning of the word), it seems to be extremely contracted in its appearance and tied to the symbolic of the function or of the localization.
3.2. Conversely, if the « meaning nothing » theory is admitted, one has to put down to chance all the more or less marvellous correlations in the symbolic order be it the releases on such occasions as anniversaries, baptisms, crossing of a border and so on... as well as the correspondence of types of characters with each psychosomatic syndrome though the fact has been much debated, or last, the localization of the symptom and its form that may suggest a meaning according to the hurt organ or function.
Our decision was to consider that such eminent observers of both sides could not have been completely mistaken.
3.3. Moreover, it would seem that the proposition : « The P.S.P. has a meaning » must be considered as undecidable. This suggests a connection with the famous Kurt Gödel theorema :
« Given a formal system (and the unconscious as structured like a language is a formal system) if it has consistency (that means that there is in it at least one false and one true statement, or in other words that the question of the truth has a meaning in it) there is in it at least one undecidable statement ».
The P.S.P. could be a dodge to write nevertheless this undecidable statement, ignoring the impossible. Thus we should reach to the underlying significance of the « Pensée opératoire » phenomenon : « A thought no more prompted by the question of true and false ». Truth indeed can never be said in its entirety. It is a choice without guarantee and behind any choice there is a wish. The price of this forcing would be then the loss of truth, of wish and therefore of the subject of the unconscious.
4 - LET US ILLUSTRATE AND TEST THIS INTUITION IN AN EXAMPLE : SHINGLES (HERPES ZOSTER) OCCURED IN THE COURSE OF A PSYCHOANALYTIC CURE.
4.1. This man came to psychoanalysis because of difficulties in expressing himself : making his girlfriend know that he loves her, having a gesture towards her all that is impossible for him. At that time, he had a companion for several years but they were not living together.
Once he dreamt :
« I was climbing up a tower. Suddenly I found myself stuck at the waist. Nevertheless I succeeded in reaching the top and climbing down again at the expense of great efforts .... »
On this occasion, he told me about two somatic phenomena : - His waist streams with sweat when making love,
- shortly before, he had shingles on his waist, the day he learnt that his companion's former lover, a much older man than himself, had a date with her without him being able to signify his disapproval. « He had already arrived, he said, or at least she knew he was to arrive ».
Let us notice. In this statement, the subject himself is grammatically absent and the burden of waiting is born by the other. As to him, he experienced that as an inhibition rather than an anguish. At that time, he said of it : « This shingles has been a way for expressing myself, for holding her back ».
Shall we follow him on this ground ? Doubts about such a finality of the phenomenon are allowed. Besides he had later other associations.
The word designating his father's job was « charron » (cart wright).
The most spectacular event during this work consists (said in local dialect) in « châtrer » (castrating) the wheels, i.e. girding them with a red-hot iron circle. This operation required hot fire, much sweat and his mother's fear that the father would fall sick. Doesn't the shingles, red belt burning and squeezing the waist, evoke (too perfectly ?) the father's job in all its glory ? It was an event indeed when the «châtrage» transcended this dreary and even resigning character. Didn't the father let on our five year old patient the burden of finding a name for his sister, and two years later for his brother ? The first time the patient remembers having been convinced of his importance. For his brother, it had a cooling effect on him but he complied and the day of baptism he announced to his parents that he would leave then and go to the seminary. He left his father with a son to take over the job.
In any case if, with the patient, we yield to the temptation of connecting together shingles and « châtrage », if we allow this P.S.P. to have a meaning, it should be understood as expressing itself through a mimetic way. Unlike a dream that speaks through the way of condensation and displacement, the shingles seem to bring out meaning without needing an articulation.
A mime is another thing than a rebus. Besides, shingles are not a signifier likely to be articulated. It is an enigmatic trace all the more speaking since it is more rudimentary. So that, to put it frankly, wanting to make the P.S.P. talk leads us to slippery grounds. For the time being let us say that it marks the place of what should have found an expression into an act or failing that into a product of the unconscious. It seems in this case to sign the missing subject as being able to assume the meaning of Œdipian rivalry.
4.2. Signature or stamp could indeed be more convenient to define the P.S.P.
Much later thanks to a lapsus : « I was born nine months after my parents got married », he told me that in fact he had been born only eight months after. « How frightened my catholic mother must have been to see me coming » ! Shingles occurring while « She knew he was to come » points out, stamps the litigious place. It seems to commemorate his first hold in the wish of the Other (in language).
Incidentally this man talked only once about having a child. It was during our first interview : « My friend doesn't want a baby because she feels herself too slight ». Since that time, they got married without any change about the question.
A striking feature of the world of these patients is to be noticed : the extreme crudeness of lived experiences unless it is the little veil or erotism they use to record then as if the wish could not have dissociated itself from the need (attesting a certain defect of the phallic function).
« My mother, he said, has always been greatly concerned in my lacking of something to eat. I saw her breast as a potato that is put into earth mixed with manure and giving new potatoes, itself remaining as an empty envelope » (besides notice a phantasm of parthenogenesis). When her children left, she had a breast cancer which she hid as long as she could. Yet she had looked after her mother's and her sister-in-law's breast cancers. It is her own sister who discovered it : it was already ulcerated. The wound stank ! Then, she had said : « Now others will nurse me ».
Notice that in French « sein » means breast as well as womb. When her last child had gone away, she let herself die. Thus the wish of this woman appeared to be concerned by nothing but need.
Another remarkable fact is an acting out of the patient probably to be connected with the circumstances of his birth. When a child, he used to play with a little cat which suffered from a huge ulcer. A passing by woman said to him :
« It can't last much longer now ». Then it was like an order : he took a spade and started to beat the cat to death. This acting, recalling his father's marvellous « châtrage », leads us to evoke the question of phantasm and imaginary in this patient.
4.3. On the one hand, imaginary is prevailing in his speech. During the sessions, he used to behave exactly in accordance with Freud's requests, « like a traveller who, sitting by the window of the compartment, would describe the landscape just as it unfolds to a person placed behind him ».
He was continuously striving to produce a linear commentary of his thinking and never to humour. Metaphor gives precedence to analogy : no word is elided. For example Charron makes me think about « charogne »... without expressing for all that a feeling of revelation, at least it was the way it appeared. On the other hand, this implanting in the imaginary we dare say is correlative in him to a certain lack of imagination.
If the phantasm is an interpretation of the structural fault in the unconscious as being the speech of the Other (« my mother tells me that, but behind all what she tells me, what does she actually want ? » What does she want me to be ?), there is a phantasm because there is no last answer to the question. However in fact the question is not ever open (or its opening is not likely to be dialectic).
To be opened, it is necessary that the first two signifiers at the origin of the subject be organized by the first metaphor in a structural ratio such as the difference between themselves be fixed forever. The bar which secures their gap is the phallus. It permits the effect of « lost object » to be produced, and the loss will have to be plugged by the objects of the phantasm called « objects a » by Lacan. Secondly, the paternal metaphor, except in case of psychosis, will propose the « names of the father » as the signifiants to be substituted for the unknown wish of the mother and from then on settles the phallic meaning towards the father's side.
In psychosomatics, clinical practice acknowledges a fragility of the function of metaphor, a failure of the bar.
If the word, as Hegel says, is the murder of the thing, the subject will accede to the speech only at the expense of a kind of death, symbolic death. Let us suppose that the signifier proposed for the paternal metaphor is itself too much of a real picture of death, what happens quite occasionally : the « pace of meaning » earned by the metaphor will become nullified. Then the effect of « symbolic death » which the naming consists in is lowered to an imaginarization of the death as real.
What Lacan names holophrase as the mechanism put forward to give an account among others of psychosomatics consists in this homogeneity of the first two signifiers which would maintain then stuck together, would prevent the constitution of the object in their gap, the possibility of its isolation and of its repression and, through that would hamper the display of the fantasm.
To say it roughly, among the three dimensions involved in human beings : - the imaginary is the glue that assembles what resembles, - the symbolic, on the contrary, articulates elements that have nothing in common, but to be considered each one as different from all the others, - the real is the hidden structure. It is what remains out of reach, subtending the constructions of the meaning, i.e. the setting of the symbolic and the imaginary that we call reality (in this meaning the real is incompatible with reality : it is the trauma).
It is obvious that there is an antagonism up to a certain point between enjoyment of the image and the isolation of the letter, basic element of the symbolic. A child who keeps seeing stubbornly in the letters of the alphabet little drawings with legs, tails and so on .... can't use them pertinently for writing or reading processus which demand to repress the meaning of the image of the letters and the loss of the direct access to the object by an image.
Similarly, in PSP, there would be a permanence and predominance of an enjoyment of representation as a form which would prevent the isolation, in the flow of the speech, of the element « letter » and its repression. Now it is this repressed literal element or, rather, its comeback which gives the frame, the bone of a symptom in the analytic meaning. This explains that the PSP is not, like the symptom or the acting out, articulated by a letter, ciphered message that the subject could decipher (or rather from which a subject could decipher himself). The PSP is no more the subject thrown out of the stage (the reality set up by the phantasm) that we call, with Lacan, « passage à l'acte » (going-into-act)2, since he had not yet gone on the stage, at the moment the PSP outbreaks.
So I'll propose, at this moment of our course the following definition.
The PSP is, owing to a special imaginary resistance to the constitution of the metaphor which makes the subject, the result of a situation or of a recalled situation in which a speaking being is forced to provide in an emergency an articulated symbolic answer to a wish that is not articulated in the speech of the Other. This answer exceeds the abilities of the symbolic for « willing » to keep both of these : and the imaginary enjoyment of the object in the so-called innocence of the child (in-fans) and the access to a symbolic position. It doesn't pay the price for castration unlike the nevrotic symptom in which the subject pays with his own castration twice rather then once in order not to lose the singularity that the symptom secures.
5 - DEFINITIONS
5.1. This answer or, if we take advantage of the English language, this response skirts round the obligation of the phantasm and, by hypothesis, draws its harmfulness through modifying radically the topology of the unconscious causing a catastrophe in the economy of the drives. (let us remember that the pushing of the drive, according to Freud, is a « konstante Kraft », is normally a constant, but we'll add, provided that there will be no change in the topologic properties of the fields in which it expresses itself). Let us try to make sensible what is going on.
5.2. Two dimensions are enough to represent the field of the unconscious if, with Lacan, we agree that it is structured like a language, since two axes only organize the language : synchrony and diachrony.
So a surface.
We never reach the end of the language. If you enter a dictionary, you'll fall asleep before getting out of it. Each word refers to several others and there is no last word and neither isolated words.
So a surface without an edge.
However this world of language we inhabit offers to intuition two opposite sides : the reality, where I am and the wish which appears to me as being its opposite. Isn't he a mad man the one who takes wishes for reality ?
So an edge less surface with in every point two sides.
However, the unconscious which weaves my wish on one side floods into reality, the other side, without myself noticing it into symptoms, into lapsus .... and so on.
So two sides which appear to be two but are in fact one since the signifier passes from one to the other without a barrier.
So an edgeless one-sided surface.
We'll use one of the simplest, the cross cap which is a sphere with a hole which has been stitched up with a Mœbius band (i.e. a one edged one sided band) Fig. 1.
Up to now, excepted some points that fix more or less signifier and signified : proper nouns, time and place signifiers that refer to the common reality of a cultural community, nothing will stop the drift to and fro the wish and the reality sides. However, the fact is that generally a subject keeps his positioning even outside his native country. Reality doesn't leave him at the community border. That is because he has made a niche for himself in the Other.
How did he do it ? By the paternal metaphor. The paternal metaphor is a signifying cutting which leans on the «defect» of the structure, which is, in our model, the point of reversion of the surface. This one cuts up a real, i.e. makes an insuperable edge in this structure up to then edgeless. Besides, by this operation, the phallic meaning is fixed, symbolized.
With this edge, the wish in the unconscious is symbolized at the expense of the loss or the fall of an « object » which is the real « dasein » of the subject.
For there to be a metaphor, a creation of a subject as an effect of language, two signifiers are needed, one repressing the other. So we'll circle two rounds around the point phallus: but, after these two rounds, the drawn line comes back to its origin to commit this first decision, this first act which is the coming into the world of the subject of the unconscious as an interpretation of the wish of the Other. Now there is an edge and therefore an orientation : the subject's life is positioned by a lack from now on fixed. There is something to catch up : the object called by Lacan « a », the object cause of the wish. Here is, according to the topology, the inventory of fixtures, after this double round cut : Fig. 2.
This surface is divided into two parts : A mœbius-like and a 2-sided disk, centered around the point, which is homeomorph to a sphere with a hole.
5.3. Now what happens when there is holophrase, when the gap between the two rounds is null ?
It means that the cutting follows a line such as the round on a side coincides exactly with the round running on the other side. Is it possible ?
Yes. It happens if, by a progressive bending of the double loop, i.e. without changing the topologic properties, we bring figure 2 into figure 3, where the mœbius-like part is reduced to a thin band up to its fading.
Then the cutting takes the two loops at once and makes only one turn. The one-sided part is reduced to the cutting itself and the whole structure changes into a two-sided disk. That is what we call somewhat bombastically a topological catastrophe. Fig. 3.
5.4.1. Apparently no object has been lost in this process. Thus there is no internalized wish and consequently if the PSP recurs this can be only an effect either of an outside imaginary stress or of the return of the same signifiant, caused by the quirks of the real (hazard) or by the physical laws that seem to govern the return of the signifiants of the real.
5.4.2. In fact no signifiant can signify itself : What this « undeciding » statement (the simple cutting) provokes, is the loss of the one-sided property by which meaning came from wish into reality.
The conditions of this cutting expressed themselves clinically by the effect called « pensée opératoire » the description of which seems to follow the line of the simple cutting.
5.4.3. The only message issued is precisely a message on the « Achilles' heel » of the structure: the phallus. In dreams can all the wishes be signified by the games of the signifiant but the phallus itself is only representable by a looking like image. In PSP, the phallic image is not issued but on the contrary it is the phallic point, as the specific point of the structure, which is ejected.
The body, which is the space in which is immersed the unconscious, received this specific One and records it as one strike under the appearance of one crisis, of one attack ... of the PSP which must be well distinguished from the signifiant which gives it its origin.
5.4.4. This singular signifying strike may (according to topology) express itself as well as on an unconscious on which a paternal metaphor has not occurred (case of psychosis, Fig. 4. a) as well as on an unconscious already marked by castration (case of neurosis, Fig. 4. b). In this last case, there are two ways of producing the single cutting. Either a modification of the primal two-loops cutting giving an effect similar to the fig. 4.a or an introduction de novo of single cutting skirting round castration (Fig. 4.b).
In both cases a free edge exists. This gives us an interest if we consider the offered ability of a « grafting » of the patient's organism on the unconscious of another being (mother or partner). The shape of « object a », taken by the unconscious of the psychosomatic patient, exposes him (theoretically) to take the place of this object in the relationship with a fellow creature who provided him with the lacking Mœbius like part: a reality covering the real. For instance, a Marty's patient says to his therapist : « My father is dead, what is one supposed to do in such cases ? ». In our example, we understand why shingles starts with the threat of losing his girlfriend as a mœbian support and why the marked organ (the waist skin) reacts as if it was his mother's waist, as if it belonged to her.
5.4.5. Thus a speaking being, indeed an animal, set as a fetish in a perverse setting of a wish that he can't or doesn't want to assume is likely to be threatened with a P.S.P.
5.4.6. A too accurate interpretation, answering before any questioning from the subject is susceptible to provoke on a predisposed ground, a P.S.P.
5.4.7. A well known clinical difficulty may be inferred from the shape of this cutting : it doesn't induce an appeal for a classical transference. Neither gap to question nor « supposed-to-know (ledge) - subject ». So the psychoanalytic cure will be most often started upon something else, possibly upon regrettable consequences of the castration avoidance : social discomfort, sexual problems and so on ...
Even if the relation to the Other is so little protected - demanding a marked benevolence towards the patient - however, the working within the cure will consist - in so far such a cutting is only a limit case of a double cutting - in inviting him to dare to commit himself in an involving speech. Saying his mute imaginary enjoyment is already starting to loosen the single loop.
6. Let us finish with this sentence from Finnegans Wake in which Joyce, the psychosomatic, tells us about such a cutting to be held back : « Since in this Scherzerade of one's thousand one nightinesses that sword of certainty which would indentifidide the body never falls... ».Bernard Vandermersch
1. P.S.P. : psychosomatic phenomenon.2. In the forced choice for the subject between not to be or not to think the acting-out is a thought without being (a monstration of the phallic signifi- ant of the subject in an acting, the meaning of which is absolutely unconscious, not assumed) ; the « going into act » on the contrary is the actualisa- tion of the real being of the subject which is usually only represented. For instance in Freud's famous case « the young homosexual » the scandalous behaviour is on the side of the acting out, her fall on the railway a going-into-act.