An Introduction by Gabriela van den Hoven, March 2014.
I would like to say a few words in order to give a point of reference for this series of meetings whose aim is to discuss our practical case-‐work. Why convene this case-‐based discussion group?
First of all, if we consider the advances being made by the scientific discourse over the clinic, and especially the institutional clinic, it is now especially important for those of us that have an institutional practice to produce a space outside those institutional coordinates where we might think about the effects of this discourse on our work.
Secondly, for some of us who have attended seminars for many years, a clinical space of this sort provides the vital opportunity to transmit our work experience. It gives us time to articulate the clinical application of Lacanian concepts and to question the limits and possibilities of applied psychoanalysis.
The work of this seminar aims to line up with that of our colleagues around the world in the Freudian Field who have done, and who continue to do, much work on the contemporary clinic. The NLS congress in London (2011), gave us a great opportunity to focus on this in the UK, and we spoke of new symptoms and of new ways of working. At that time I referred to the clinic of addictions and the decline of ideals.
In any case, we need to work and to specify what these new symptoms are, and to consider the shades and the varieties they present in our locality. We need not take the contemporary symptoms as global, but we might produce a series of symptoms by making use of the clinical details that help us to find the singular threads in each case.
So, we shall focus by interrogating the way we intervene and how we think about the clinic today. Following on the tracks of the work initiated by Jacques-‐Alain Miller in the context of the clinical section, I suggest that we make use of the developments produced there to investigate the new symptoms. Let's take for example, the idea of Ordinary Psychosis. This is a signifier that has been around for some time now and was introduced by Jacques-‐Alain Miller at the conversation in Antibes, in 1998. In "Ordinary Psychosis Revisited" he says, "I invented a word, I invented an expression, a signifier, a sketchy definition to attract the various meanings, the many shades of meaning around a signifier" He went on to say, "I did not give you any know-‐how about using this signifier. I bet this signifier could elicit various echoes in the clinician in the professionals."
He then explained that the utility of inventing the signifier ordinary psychosis was to move away from the rigid binary of neurosis/psychosis. In a funny way he says, people took years to make a diagnosis, and I too can testify to this as it was something very present during my training in Argentina: at that time we spoke much about pre-‐psychotics and the risk of triggering a psychosis. There was an absolute, an either/or which proceeded in concert with the Name of the Father. It was 1 or 0; there is or there is not; true or false.
Jacques-‐Alain Miller's invention with the idea of ordinary psychosis, concerns the knowledge of the clinician – with knowing something about a patient. He says: ordinary psychosis is recognised but can be inferred by various clues. Such as the subject's relation to the social other, or a particular relation to the body.
Moreover – and I consider this important for us to take into consideration for our meetings – he says "you mustn't stop at saying: this is ordinary psychosis. You must go further and look at what is there of classical psychoanalytic and psychiatric clinic."
The question of ordinary psychosis is situated at a juncture and in reference to a new link to the Other and the object a. So a key text of reference for us to study the contemporary clinic, is the seminar of "the Other who does not exist and his ethical committees". Here, Jacques-‐Alain Miller and Éric Laurent show that the classic bonding of the subject to its signifier appears disturbed, by the eruption of the object and its link to an ever-‐present push to jouir which demands complete satisfaction. As manifested in the clinic of addiction (I refer to the extended version of this clinic) so also to addiction to drugs, food, sex, etc.
This change in the relation to the object not only affects symptoms but it also has an impact on the way people speak of their symptoms.
Hence my invitation to work on this matter – this change in the patient's presentation is also inseparable from and reflects the effect of the contemporary discourse of hard science – as we saw in the first case in our CLC series.
On the other hand, Lacanian practice is not a clinic organised around the measurement of a function ie work-‐studies etc, but it is organised around contingency. We can say that it is contingency under transference that orients the analyst's intervention, in this sense therapeutic effects are secondary.
Having said this, our case-‐based discussion group is an opportunity to sharpen our clinical understanding and to assert a clinical discourse. We will see if the study of clinical cases presented in our meetings can give us a chance to know more about our the contemporary clinic in London and thence to contribute to the WAP's nebula or "clinical cloud".
Most of us know of the classificatory mania that runs in our mental health services today. However, we know very little of how we work with it, how we manage its effects or how it affects the patient presentation, the patient's discourse or transference. Our first presentation brought up the opportunity to grapple with these issues, present in daily institutional practice, the second presentation will present a contrast with a case from private practice.
I will finish by quoting some words from Jean-‐Daniel Matet's on the clinic, "Each clinical presentation and supervision can be the occasion to extricate the lines of force from an original variation of everyone is mad".