This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of the American Psychoanalytic Association, Sep 30, 2023
This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psy... more This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.
In this chapter Stijn Vanheule examines the reliability of the DSM. In the early days of psychiat... more In this chapter Stijn Vanheule examines the reliability of the DSM. In the early days of psychiatry, diagnosis started from elaborate prototypical descriptions of diverse types of psychopathology. These were replaced by classification systems such as the DSM, due to a crisis in psychiatric practice during the 1960s and 1970s: several academic researchers demonstrated that diagnoses were unreliable, critical scholars pointed to weak points in the overall ethos of psychiatry, and societal changes challenged the actual practice of psychiatry itself. A group of so-called neo-Kraepelinian psychiatrists responded to this malaise by defining psychiatry as a strictly medical discipline, thus switching to a criteria-based method of diagnosis. However, Vanheule demonstrates that with the DSM, psychiatric diagnosis did not become more reliable. Moreover, the key problems that critical researchers had been addressing in the 1970s, such as the issue of hasty decision-making and the problem of reification, stigma, and power, still remain unresolved.
This article examines central ideas from Jacques Lacan's later psychoanalytic theory on p... more This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis. In the 1950s, Lacan formulated a structural model of psychosis, asserting that the central element of symbolically organized mental life, the Name-of-the-Father, is missing, leading to a latent vulnerability for psychotic episodes. In the 1970s, Lacan made significant changes to this model by introducing two new concepts: Father-of-the-Name and père-version. These concepts are plays on the original Name-of-the-Father concept and refer to two other aspects of the father function: the creative act of naming and embracing modes of life, respectively. Furthermore, in the 1970s, Lacan suggested that creating coherence in mental life does not necessarily require an exemplar of a paternal identification figure. Drawing from the case of the modernist writer James Joyce, he argued that singular inventions can just as effectively establish stability. This argument is elaborated upon by introducing the concepts of "sinthome" and "escabeau."
This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis... more This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis. In the 1950s, Lacan formulated a structural model of psychosis, asserting that the central element of symbolically organized mental life, the Name-of-the-Father, is missing, leading to a latent vulnerability for psychotic episodes. In the 1970s, Lacan made significant changes to this model by introducing two new concepts: Father-of-the-Name and père-version. These concepts are plays on the original Name-of-the-Father concept and refer to two other aspects of the father function: the creative act of naming and embracing modes of life, respectively. Furthermore, in the 1970s, Lacan suggested that creating coherence in mental life does not necessarily require an exemplar of a paternal identification figure. Drawing from the case of the modernist writer James Joyce, he argued that singular inventions can just as effectively establish stability. This argument is elaborated upon by introducing the concepts of "sinthome" and "escabeau."
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of the American Psychoanalytic Association, 2023
This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. ... more This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Het chronische-vermoeidheidssyndroom en betekenisverlening door artsen j. v a n d e nb e r g e n ... more Het chronische-vermoeidheidssyndroom en betekenisverlening door artsen j. v a n d e nb e r g e n , s. v a n h e u l e samenvatting Op basis van een uitgebreid literatuuronderzoek betreffende het chronische-vermoeidheidssyndroom zijn vier wetenschappelijke verklaringsmodellen te onderscheiden: een biomedisch, een psychosociaal, een psychoanalytisch en een gezondheidspsychologisch model. Zowel arts als patiënt maken van dergelijke modellen gebruik wanneer ze betekenis verlenen aan het chronische-vermoeidheidssyndroom. Uitgaande van een algemene kennistheorie en een theorie over individuele betekenisverlening aan het ziek zijn, wordt dat keuzeproces in kaart gebracht, en wordt aangegeven welke invloed de arts-patiëntrelatie heeft op dit proces. [tijdschrift voor psychiatrie 47(2005)6, 359-367] trefwoorden arts-patiëntrelatie, betekenisverlening, causale modellen, chronische-vermoeidheidssyndroom Ablata causa … tolluntur effectus … Les effets ne se portent bien qu'en absence de la cause (Lacan 1973, p. 117
In this chapter Stijn Vanheule discusses how the DSM-5 takes context into account and clarifies t... more In this chapter Stijn Vanheule discusses how the DSM-5 takes context into account and clarifies the “kind of entity” the manual considers mental disorders to be. In the DSM-5 the context of the individual (i.e., the personal life history, social circumstances, and cultural background) is thought to play a minor moderating role in relation to symptom formation and expression. Moreover, as the manual follows a sign-based logic, it coheres with the assumption that biological irregularities lie at the basis of mental distress. The author argues that, by doing this, the DSM cultivates a naive essentialistic view of mental disorders, which is not supported by relevant evidence. Starting from phenomenological psychiatry and Lacanian psychoanalysis, Vanheule proposes an alternative model of symptom formation. Within this model, the symptom is a multidimensional product with certain speech-act specific qualities, biological characteristics, and contextual configuration features covering characteristics that are specific of an individual, family, social context, and (sub-)culture.
... En toch is er 'iets' dat maakt dat we alle-maal bang blijven voor wolven ... op vaa... more ... En toch is er 'iets' dat maakt dat we alle-maal bang blijven voor wolven ... op vaag, omdat deze verhalen meestal van mond tot mond gaan zonder dat duidelijk is wie of wat ... Nog voor er sprake is van enig tastbaar bewijs ontstaat er binnen een gesloten bio-toop een extreme vorm ...
Contrary to Freud, who first trained as a neurologist, Lacan started his career as a psychiatrist... more Contrary to Freud, who first trained as a neurologist, Lacan started his career as a psychiatrist and focused on psychosis. Between 1927 and 1931 he underwent training in several psychiatric clinics. At the Sainte-Anne hospital he worked under the supervision of Henri Claude, and at the Special Infirmary of the Paris police headquarters, under Gaetan Gatian de Clerambault (Roudinesco, 1994). Henri Claude was one of the first clinicians in France to institutionalize the teaching of psychoanalysis, where he combined psychodynamic theory with biological determinism. This theoretical position was subsequently elaborated and termed Organo-Dynamism by Henri Ey, a pupil who trained under Claude together with Lacan. Gaetan Gatian de Clerambault, on the other hand, was less influential at that time, perhaps because he was not a university professor. This is reflected in Lacan’s doctoral thesis, where de Clerambault is only a minor reference (see Lacan, 1932, pp. 126–34, 355). It was nevertheless de Clerambault that Lacan (1966c, p. 65) would later refer to as his ‘only master in psychiatry’, largely owing to his systematic method of examining case studies, which Lacan replicated in his thesis (Lacan, 1947, p. 138). In the period between 1909 and 1933 de Clerambault wrote about the mechanisms of disruption in mental life preceding the crystallization of delusions (de Clerambault, 1942, pp. 455–655) using concepts such as ‘mental automatism’ and ‘passivity syndrome’.
... Waar de afdeling vooral mee bezig lijkt te zijn, is met het produceren van lege bedden. ... I... more ... Waar de afdeling vooral mee bezig lijkt te zijn, is met het produceren van lege bedden. ... It was a blow to my ego dealing with him because we're used to getting people out at a rapid pace' (Rhodes, 1991, p. 76). Doorverwijzen wordt in deze context een soort sport. ...
After having focused on the signifier for many years, Lacan makes an important shift in the early... more After having focused on the signifier for many years, Lacan makes an important shift in the early 1960s. Problems that he first approached with strict attention to the logic of the signifier are now addressed in terms of the limits of the Symbolic. The new idea he embraces is that some aspects of being cannot be grasped via language and that the registers of libido and drive cannot simply be reduced to the Symbolic. Whereas in the 1950s Lacan argued that the drive is expressed via the signifying chain, by the 1960s he concludes that aspects of the drive resist representation and cannot be articulated in the signifying chain.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of the American Psychoanalytic Association, Sep 30, 2023
This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psy... more This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.
In this chapter Stijn Vanheule examines the reliability of the DSM. In the early days of psychiat... more In this chapter Stijn Vanheule examines the reliability of the DSM. In the early days of psychiatry, diagnosis started from elaborate prototypical descriptions of diverse types of psychopathology. These were replaced by classification systems such as the DSM, due to a crisis in psychiatric practice during the 1960s and 1970s: several academic researchers demonstrated that diagnoses were unreliable, critical scholars pointed to weak points in the overall ethos of psychiatry, and societal changes challenged the actual practice of psychiatry itself. A group of so-called neo-Kraepelinian psychiatrists responded to this malaise by defining psychiatry as a strictly medical discipline, thus switching to a criteria-based method of diagnosis. However, Vanheule demonstrates that with the DSM, psychiatric diagnosis did not become more reliable. Moreover, the key problems that critical researchers had been addressing in the 1970s, such as the issue of hasty decision-making and the problem of reification, stigma, and power, still remain unresolved.
This article examines central ideas from Jacques Lacan's later psychoanalytic theory on p... more This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis. In the 1950s, Lacan formulated a structural model of psychosis, asserting that the central element of symbolically organized mental life, the Name-of-the-Father, is missing, leading to a latent vulnerability for psychotic episodes. In the 1970s, Lacan made significant changes to this model by introducing two new concepts: Father-of-the-Name and père-version. These concepts are plays on the original Name-of-the-Father concept and refer to two other aspects of the father function: the creative act of naming and embracing modes of life, respectively. Furthermore, in the 1970s, Lacan suggested that creating coherence in mental life does not necessarily require an exemplar of a paternal identification figure. Drawing from the case of the modernist writer James Joyce, he argued that singular inventions can just as effectively establish stability. This argument is elaborated upon by introducing the concepts of "sinthome" and "escabeau."
This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis... more This article examines central ideas from Jacques Lacan's later psychoanalytic theory on psychosis. In the 1950s, Lacan formulated a structural model of psychosis, asserting that the central element of symbolically organized mental life, the Name-of-the-Father, is missing, leading to a latent vulnerability for psychotic episodes. In the 1970s, Lacan made significant changes to this model by introducing two new concepts: Father-of-the-Name and père-version. These concepts are plays on the original Name-of-the-Father concept and refer to two other aspects of the father function: the creative act of naming and embracing modes of life, respectively. Furthermore, in the 1970s, Lacan suggested that creating coherence in mental life does not necessarily require an exemplar of a paternal identification figure. Drawing from the case of the modernist writer James Joyce, he argued that singular inventions can just as effectively establish stability. This argument is elaborated upon by introducing the concepts of "sinthome" and "escabeau."
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of the American Psychoanalytic Association, 2023
This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. ... more This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Het chronische-vermoeidheidssyndroom en betekenisverlening door artsen j. v a n d e nb e r g e n ... more Het chronische-vermoeidheidssyndroom en betekenisverlening door artsen j. v a n d e nb e r g e n , s. v a n h e u l e samenvatting Op basis van een uitgebreid literatuuronderzoek betreffende het chronische-vermoeidheidssyndroom zijn vier wetenschappelijke verklaringsmodellen te onderscheiden: een biomedisch, een psychosociaal, een psychoanalytisch en een gezondheidspsychologisch model. Zowel arts als patiënt maken van dergelijke modellen gebruik wanneer ze betekenis verlenen aan het chronische-vermoeidheidssyndroom. Uitgaande van een algemene kennistheorie en een theorie over individuele betekenisverlening aan het ziek zijn, wordt dat keuzeproces in kaart gebracht, en wordt aangegeven welke invloed de arts-patiëntrelatie heeft op dit proces. [tijdschrift voor psychiatrie 47(2005)6, 359-367] trefwoorden arts-patiëntrelatie, betekenisverlening, causale modellen, chronische-vermoeidheidssyndroom Ablata causa … tolluntur effectus … Les effets ne se portent bien qu'en absence de la cause (Lacan 1973, p. 117
In this chapter Stijn Vanheule discusses how the DSM-5 takes context into account and clarifies t... more In this chapter Stijn Vanheule discusses how the DSM-5 takes context into account and clarifies the “kind of entity” the manual considers mental disorders to be. In the DSM-5 the context of the individual (i.e., the personal life history, social circumstances, and cultural background) is thought to play a minor moderating role in relation to symptom formation and expression. Moreover, as the manual follows a sign-based logic, it coheres with the assumption that biological irregularities lie at the basis of mental distress. The author argues that, by doing this, the DSM cultivates a naive essentialistic view of mental disorders, which is not supported by relevant evidence. Starting from phenomenological psychiatry and Lacanian psychoanalysis, Vanheule proposes an alternative model of symptom formation. Within this model, the symptom is a multidimensional product with certain speech-act specific qualities, biological characteristics, and contextual configuration features covering characteristics that are specific of an individual, family, social context, and (sub-)culture.
... En toch is er 'iets' dat maakt dat we alle-maal bang blijven voor wolven ... op vaa... more ... En toch is er 'iets' dat maakt dat we alle-maal bang blijven voor wolven ... op vaag, omdat deze verhalen meestal van mond tot mond gaan zonder dat duidelijk is wie of wat ... Nog voor er sprake is van enig tastbaar bewijs ontstaat er binnen een gesloten bio-toop een extreme vorm ...
Contrary to Freud, who first trained as a neurologist, Lacan started his career as a psychiatrist... more Contrary to Freud, who first trained as a neurologist, Lacan started his career as a psychiatrist and focused on psychosis. Between 1927 and 1931 he underwent training in several psychiatric clinics. At the Sainte-Anne hospital he worked under the supervision of Henri Claude, and at the Special Infirmary of the Paris police headquarters, under Gaetan Gatian de Clerambault (Roudinesco, 1994). Henri Claude was one of the first clinicians in France to institutionalize the teaching of psychoanalysis, where he combined psychodynamic theory with biological determinism. This theoretical position was subsequently elaborated and termed Organo-Dynamism by Henri Ey, a pupil who trained under Claude together with Lacan. Gaetan Gatian de Clerambault, on the other hand, was less influential at that time, perhaps because he was not a university professor. This is reflected in Lacan’s doctoral thesis, where de Clerambault is only a minor reference (see Lacan, 1932, pp. 126–34, 355). It was nevertheless de Clerambault that Lacan (1966c, p. 65) would later refer to as his ‘only master in psychiatry’, largely owing to his systematic method of examining case studies, which Lacan replicated in his thesis (Lacan, 1947, p. 138). In the period between 1909 and 1933 de Clerambault wrote about the mechanisms of disruption in mental life preceding the crystallization of delusions (de Clerambault, 1942, pp. 455–655) using concepts such as ‘mental automatism’ and ‘passivity syndrome’.
... Waar de afdeling vooral mee bezig lijkt te zijn, is met het produceren van lege bedden. ... I... more ... Waar de afdeling vooral mee bezig lijkt te zijn, is met het produceren van lege bedden. ... It was a blow to my ego dealing with him because we're used to getting people out at a rapid pace' (Rhodes, 1991, p. 76). Doorverwijzen wordt in deze context een soort sport. ...
After having focused on the signifier for many years, Lacan makes an important shift in the early... more After having focused on the signifier for many years, Lacan makes an important shift in the early 1960s. Problems that he first approached with strict attention to the logic of the signifier are now addressed in terms of the limits of the Symbolic. The new idea he embraces is that some aspects of being cannot be grasped via language and that the registers of libido and drive cannot simply be reduced to the Symbolic. Whereas in the 1950s Lacan argued that the drive is expressed via the signifying chain, by the 1960s he concludes that aspects of the drive resist representation and cannot be articulated in the signifying chain.
The Freudian concept of Nachträglichkeit is central to the psychoanalytical understanding of trau... more The Freudian concept of Nachträglichkeit is central to the psychoanalytical understanding of trauma. However, it has not received much attention within the contemporary field of trauma studies. This paper attempts to reconstruct the logic inherent to this concept by examining Freud’s remarks on the case of Emma. Furthermore, it is argued that Nachträglichkeit offers an interesting perspective on both (a) the well-established yet controversial finding that traumatic reactions sometimes follow in the wake of non-Criterion A events (so-called minor stressors or life events) and (b) the often-neglected phenomenon of delayed-onset PTSD. These two phenomena will appear to be related in some instances. Nachträglichkeit clarifies one way in which traumatic encounters are mediated by subjective dimensions above and beyond the objective particularities of both the event and the person. It demonstrates that the subjective impact of an event is not given once and for all but is malleable by subsequent experiences.
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