Lina Balestriere - Working in the Field of Psychosis

Psychosis questions the very foundations of the concepts on which analysts rely to represent psychic functioning. More than any other pathology, it undermines the pillars of analytical thinking, reveals the intimate core of conceptual thought, dismantles the shared scaffolding of theoretical construction and questions ultimate convictions about the foundations and functioning of the psychic apparatus. What becomes of representation if it disintegrates, becomes a thing, or indeed an empty sound? What becomes of the trace if emptiness, nothingness, paralysis, blankness occupy such a large place in the psychic life of the subject? And then what becomes of a subject or, in Freudian terms, an ego when not only that sense of identity but also more fundamentally that sense of existing, in a relationship, in relation to others, fi rmly grounded on land, which upholds all people, is simply not sustainable? What becomes of anxiety if it reaches the borders of non-existence, if the annihilation process deforms perception, of one’s body, oneself, of others? What then of the encounter, what of the transference, that major process, the decisive lever for psychoanalytic work, at once repetition and a possible exit from repetition, if that encounter perpetually takes place beneath the sword of Damocles, of the inescapable, of powerlessness, annihilation, of that which never happened, or happened too often, of uncontrollable anxiety or persecutory emptiness? To advance into these zones with the concepts we make our own leaves us anxious and distraught. We fear then that these, our beams of light amidst obscurity, to cite a Freudian metaphor, will lose substance before such radical questioning. Once divested of their robes, of their elaborate scaffolding, what will remain? The vertigo of doubt is inescapable. After all, there is no guarantee they have their own existence, in the sense that their relevance might hold for that core of the real which conceptual abstraction attempts to capture. It is undoubtedly not fortuitous that for a long time analysts, and Freud fi rst and foremost, cast doubt upon the psychotic’s capacity for transference. The young science had to preserve itself from too radical a questioning. It was no doubt easier to think the psychotic incapable of transference than to have to submit to the risk of doubt and so risk ruining those convictions acquired in the field of the neuroses.

Nor is it fortuitous that a theory of the psychoses nearly always introduces new concepts: I am thinking of Aulagnier’s pictogram, of Bion’s β-elements, of Lacan’s foreclusion of the Name-of-the-Father, to cite only those theorizations which find a new currency for the problematics of representation. But the force of those theories spares no psychoanalyst confronted with psychosis from asking the essential question. What remains when the building totters and cracks, what of the living core that resists and has our conviction prevail, the raw material, grain of sand from the real, around which can coalesce the pearl of the concept? There is no set answer. Things come to light in singular fashion, for each practitioner, thanks to salutary, vertiginous experience and the collapse of certainties. (pp. 407-408)

Lina Balestriere (2007): The Work of the Analyst in the Field of Psychosis, International Journal of Psycho-Analysis, Vol. 88, pp. 407-421.