Middlesex University Research Repository An open access repository of Middlesex University research http://eprints.mdx.ac.uk Grammatopoulos, Ioannis (2016) Conceptualization and treatment of schizophrenia in Lacanian psychoanalysis: towards a clinic of the sinthome. PhD thesis, Middlesex University. [Thesis] Final accepted version (with author’s formatting) This version is available at: https://eprints.mdx.ac.uk/21218/ Copyright: Middlesex University Research Repository makes the University’s research available electronically. Copyright and moral rights to this work are retained by the author and/or other copyright owners unless otherwise stated. The work is supplied on the understanding that any use for commercial gain is strictly forbidden. A copy may be downloaded for personal, non-commercial, research or study without prior permission and without charge. 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See also repository copyright: re-use policy: http://eprints.mdx.ac.uk/policies.html#copy Conceptualization and Treatment of Schizophrenia in Lacanian Psychoanalysis Towards a Clinic of the Sinthome A thesis submitted in partial fulfilment of the requirements for a PhD in Psychoanalysis, awarded by Middlesex University Student name: Ioannis Grammatopoulos Student number: M00384064 Date: April 2016 1 Γι’ αὐτὸ τὸ µέτωπο ’ψηλά – τραϊλὰ τραϊλά, τραϊλὰ λαρά, Θρᾳκόπουλα, καϋµένα, καὶ ψάλλετε µ’ ἐµένα!1 1 ‘So keep your head up/ la-la-la-la-la-la-la-la/ poor Thracian children/ and sing along with me’. Last stanza of the second version of Georgios Vizyenos’ Thracians’ song (2003, p. 495) [my translation] 2 Abstract Schizophrenia is rarely referred to in Lacan’s scholarship, and even more rarely in the so- called later Lacan. Yet the French psychoanalyst’s teaching on knotting and the theory of the sinthome of the 1970s can be utilized for the theoretical and clinical approach to this psychotic type. The gradual emphasis on the real in Lacan’s teaching can act as a guide both for its conceptualization and for the treatment supported by those clinicians who see schizophrenic subjects. My investigation of the conceptual history of schizophrenia led to the conclusion that despite psychiatric scholars having noted from early on an aspect that pertains to the real – schizophrenic discourse – this was disregarded, having been deemed one of the condition’s numerous morbid outcomes. In the same way, early psychoanalysts emphasized the aspect of subjectivity that Lacan calls the imaginary in the treatment of schizophrenia, trying, thus, to address it via a mechanism typical of the other major psychotic type, paranoia. This approach does not seem consonant with Freud’s reading of the two types, although he never elaborated upon their differentiation beyond the early 1910s. In fact, although the suggested Lacanian approach to schizophrenia derives from the last decade of Lacan’s teaching, it has roots in Freud’s view of psychosis of the mid-1910s and early 1920s. I have attempted to create a paradigm for the impact of those findings in examining the case of the late-19th-century Greek poet, writer and scholar Georgios Vizyenos. I argue that Vizyenos was characterized by a schizophrenic’s relation to the body, language, and the social bond. In his life and work, examined in detail, we see how the cause, triggering, and temporary treatment of his psychosis are linked to a concept with a direct relation to the real: ‘child’. Testimonies from Vizyenos’ childhood show his resistance to semblance, which had specific effects upon his body. It is, then, demonstrated how in late adolescence and mature life the subject renamed himself and acquired a sense of his body thanks to a ‘modified’ narcissism that did not resemble the coordinates of the paranoiac’s ego. This construction is approached through the later Lacan’s theories of the sinthome and the escabeau. Finally, it is shown how that invention was temporary, with Vizyenos being unable, in the end, to avoid the return of jouissance to the subject’s body. The theoretical and clinical implications of the study of Vizyenos’ case are discussed in relation to the contemporary Lacanian approach to schizophrenia. It is suggested that the singular character of the subject’s relation to the real could lead us to cross schizophrenia with a bar, schizophrenia, as Lacan did for the signifier ‘woman’ in his later teaching. Thus, the sinthomatic approach, which emphasizes the subject’s relation to the real rather than the universal subscription to Oedipus, does not seem unsuitable for the treatment of subjects who are schizophrenic. This is argued at greater length by comparing it with psychoanalytic orientations that place more emphasis on the use of the imaginary or the symbolic. 3 Acknowledgments The following people and institution most assuredly deserve a few words of gratitude from the author for their contributions to the completion of the present thesis: The Director of Studies and the second supervisor, Dr. Werner Prall and Dr. Anne Worthington, psychoanalysts and lecturers in psychoanalysis, for always being there when I needed their support, and for withdrawing discreetly when I felt I wanted to walk the tangled and lonely paths of doctoral research on my own. I feel that my thesis would be a less appropriate and interesting read were it not, I would like to add, for their two very different, yet complementary styles. Psychoanalysts Nassia Linardou-Blanchet and Réginald Blanchet, for their known and unknown input to the commencement, continuation, and completion of research for the present study. If it were not for them, I am convinced that the reader would not be able to hold the present study in their hands today. Charalampos Orfanidis, for his graphic illustration of my sinthomatic approach to Georgios Vizyenos, which generated the figures shown on pages 153, 159, 163, and his copies of existing illustrations of Lacanian theory found on pages 56, 64, 72, 76, 77, 83, 85, 90 and 198. I hope that his vibrant talent has managed to breathe some life into the Dead Sea of the more than 80,000 words that make up the present thesis. The Greek State Scholarships Foundation [Ίδρυµα Κρατικών Υποτροφιών], for funding the completion of the thesis from the bequest in the memory of Maria Zaousi [εις µνήµην Μαρίας Ζαούση], from October 2013 to March 2016. I hope that the present study honours the late Maria Zaousi’s wish for academic research that contributes to the alleviation of the suffering of patients with mental illness. 4 Table of contents Introduction…………………………………………………………………………...8 Chapter One: Schizophrenia in Freud and Lacan………………………………...….15 I. 1. Introduction……………………………………………………………….….......15 I. 2. From the splitting in associations to the unity of the ego………………….…………17 I. 2. a. Between three Ψs: psychology, psychiatry and psychoanalysis….………...................17 I. 2. b. Before Freud………………………………………………………………..................17 I. 2. c. Freud…………………………………………………………………………..............29 I. 3. From the ego to the subject…………………………………………………………….43 I. 3. a. A long and entangled pathway……………………………………………...…………43 I. 3. b. The imaginary: the predominance of the image………….…………………...............43 I. 3. c. The symbolic: the predominance of the signifier……………………………..............52 I. 4. From the subject to the parlêtre………………………..………………….…..............70 I. 4. a. Lacan of the symbolic excommunicated...……………..………………………….…..70 I. 4. b. The real: The predominance of jouissance....…………………...…………………….70 I. 4. c. Sinthome……………………………………………………………...…….................82 I. 5. Summary……………………………….………………………...……………..........…95 Chapter Two: Rise and fall of the Body in Georgios Vizyenos………….…….........96 II. 1. Introduction………...………………………………………………….…...……96 II. 2. Psychotic structure: the effects of paternal ‘poverty’.…………………………..…..98 II. 2. a. The paternal failure………………………………………………………….…….….98 5 II. 2. b. The family constellation………………………………………………….……….….98 II. 2. c. The failure in metaphor……………………………………………………...….......105 II. 3. The beautification of Vizyenos’ body…………………………………………...…..111 II. 3. a. A discourse on the One……………………………………………………...............111 II. 3. b. The subject’s entrance onto the world’s stage……………………………................111 II. 3. c. The zenith of Vizyenos………………………………………………………....…...123 II. 3. d. A sudden downfall………………………………………………………………......133 II. 4. The schizophrenic dissolution……………………………………………….……....138 II. 4. a. The outbreak of symptoms……………………………………………………...…..138 II. 4. b. The end of signification and the beginning of delusion………………….……...….138 II. 4. c. In the asylum………………………………………………………………...............145