Lacanian Clinic of Psychosis
In a previous work, I set out to show the path taken by Lacan with respect to psychosis and, more specifically, what occurred between the structuralist mark he received from Clérambault and the universal clinic of delusion. On this journey, the non-deficit conception of psychosis served as a guiding thread. From this perspective, the refusal to qualify psychosis in negative terms links the Lacan of the 1930s, where his approach found an echo in the surrealist movement, with the reversal of the 1970s, when he proposes generalized foreclosure as a model for the real kernel of every symptom, using the topology of the Borromean knot to reformulate the concept of structure.
In order to account for the last period of Lacan’s teaching, where he took James Joyce as a clinical paradigm, we have to examine psychosis in greater detail. The concept of the sinthome coincides with the definition established for the psychotic symptom: an intersection between the symbolic and the real outside the imaginary, in which an element of the symbolic, solitary and unchained, moves towards the register of the real as a letter.
When he abandons the mechanistic clinic, privileging the non-deficit approach of psychosis and emphasizing the universal clinic of delusion, Lacan opens the way to a practice of psychoanalysis that does without the fiction of universals in accordance with his last teaching in which “the universalisation of the signifier is what precludes the singularity of a subject from being circumscribed in speech”.
To introduce the theme of the 11th Congress of the AMP, from this perspective, addressing ordinary psychosis not without the others aims to link up with the continuous effort to elucidate Lacanian practice which – when not a question of case studies, a discussion of patient presentations, or even the teaching of the pass – requires that its foundations be demonstrated.
Let’s start with the lecture that Jacques-Alain Miller gave in Rio, “Habeas Corpus”, isolating the following references: the object a as a contribution and a “solution that Lacan found and used for many years”; the object a “downgraded” as “a modelling of jouissance on the model of the signifier”; and the “parlêtre by nature” [parlêtre de nature]. A path that goes from the object a as the Lacanian contribution par excellence, to its downgrading in order to open the way to the parlêtre by nature.
The Lacanian clinic of psychosis also contributes to the theme of the end of analysis and ordinary psychosis came to revitalize the approach to psychosis in analysis through one of the solutions indicated by Jacques-Alain Miller.
When considering “how to link the symbolic, characterized by the effect of meaning, with the real without meaning” and “How to approach the radical disjunction between the real as impossible and meaning?” Lacan responds that “the effect of meaning required of the analytical discourse is not imaginary; nor is it symbolic either; it must therefore be real”.
The effect of sense ex-sists, and in this it is real
In Lacan’s sentence, the point to emphasize is that the analytic discourse requires an effect of meaning that is real. On the one hand, the analytic experience begins by giving meaning to the symptom; the offer of meaning is the pivot of the analytic act. The subject of the unconscious arises from the experience as a subject represented in the interval between two signifiers in a chain. On the other hand, little by little, this will give rise to the parlêtre, and it is no longer a question “of meaning, but of enjoy-meant” [jouis-sens].
A meaning effect that is real is not obtained in a simple or automatic way, and from this point we can start with the work of J.-A. Miller in elucidating Lacan’s teaching and, more specifically, his comments in “L’Être et l’Un”, where he evokes the evanescence of the Subject Supposed to Know correlative to dis-being. According to Miller, there is the unveiling of the negation of the essence and the meaning of the Subject Supposed to Know. It is the idea of knots “that in fact are built up through developing chains of the signifying material. For these chains are not of meaning but of enjoy-meant [jouis–sense]”. This explains why the term “subject” is replaced by that of parlêtre (speaking-being), which includes the body, which is more consistent with the notion of jouissance, “there is no meaning without jouissance, there is no desire without a drive, and the root of the Other is the One”.
This is not accompanied by a new meaning for what has to do with castration: this makes the muddle of meaning cease. For the symptom is not reduced with meaning; it is characteristic of jouissance to resist meaning and recourse to logic is the only way to make meaning dry up.
For Lacan, the relation between the effect of meaning and the real is only one of exteriority at the start, since this exteriority supposes that the knot is projected on a flat surface. If we use this knot, it is to introduce ourselves to the notion of ex-sistence and thereby deduce that the effect of meaning ex-sists, and is therefore real. The division between being and existence leads Lacan to establish the One that ex-sists in relation to the Other which does not exist, and, since the knot is flat, he adds, “because we think horizontally”. There may be a construction whose consistency is not imaginary, and this implies that there is a hole, which, in turn, leads us to the topology of the “torus”. In the last period of Lacan’s teaching, the exaltation of the hole serves to give existence to the pure “does not exist” [il n’y a pas], which helps to place us in the realm of the ultrapass [outrepasse].
What impact does all this have on practice? From this perspective, the emptying of meaning must be obtained as a know-some-how [savoir y faire] with the symptomatic remainders. I return here to Miller’s proposition regarding the two dimensions of the pass: truth and knowledge. The pass of the sinthome as a “conceptual extension of the fantasy” places the accent on the lying truth. Truth is a lie when confronted with the irreducibility of the sinthome and fails to absorb these symptomatic remainders. In this sense, the knowledge-pass highlights more clearly the limits of the symbolic.
When we speak about the Lacanian praxis of the pass we have to include the ultrapass [outrepasse], as Miller called it. This is related to the body event: it is precisely jouissance that remains beyond the resolution of desire. Symptomatic remainders arising from an acceptance of prohibition are of the order of existence, as opposed to desire, which is in the realm of being.
The renunciation of ontology in the pass was initially conceived by Lacan as a deflation of desire. He immediately exceeded that limit with his “There’s such a thing as One” [Yadl’un]. In this way he inaugurates the primacy of the One to the detriment of the primacy of the Other of the speech, which is necessary for the recognition of meaning. On this basis, the body appears as Other of the signifier.
With the sinthome, we shift to the existential field; it is towards this that Lacan leads us when he renounces his ontology, which was governed by the notion of being and “want-of-being”; encountering the limits of the symbolic led Lacan to consider in a different way the real at stake in analytic experience.
The pass according to the regime of truth “evokes, over and above a demonstration of knowledge, a satisfaction, an experience of satisfaction”. Whatever the case, beyond the nomination to the title of AE, it is the relation to the hole that, as Miller points out, is situated in the realm of the real. Therefore, it is in the space of the ultrapass [outrepasse], in which the subject speaks to himself, without any possible communication, which makes the Lacanian praxis of the pass an existential real.
We will return to a point in the text “Habeas Corpus”, in the last paragraph of the section entitled, “The Lacanian Reversal” (Le tournant Lacanian), when he states that this reversal will only be concluded with Seminar XX, in which Lacan forces things to downgrade the object a, situating it as a false semblant.
A modelling of jouissance on the model of the signifier
For Miller, knowledge about jouissance may be the only psychoanalytic knowledge we have about life; about what the living being is. Moreover, he adds that enjoying [jouir] the living body is all that we know. He backs up his argument with what Lacan formulates when he says: “we don’t know what it means to be alive except for the following fact, that a body is something that enjoys itself”.
The relationship between the signifier and the body is different at the beginning of Lacan’s teaching, with the thesis that language is a body – ‘body’ here referring to materiality of the speech and language. The body as a enjoying substance, which is introduced in the 1970s, refers to the living body, to the substance of the body insofar as there is a jouissance of the body: “It enjoys itself only by “corporizing” the body in a signifying way”. 
We can only affirm that a transformation of perspective takes place when Lacan passes to a position in which he situates the signifier at the level of enjoying substance: “The signifier is the cause of jouissance. Without the signifier, how could we even approach that part of the body?”
For Lacan, at the start of his teaching, the materiality of the signifier is inanimate, materiality of language, and even satisfaction is on the side of the symbolic: the elaboration of a semantic satisfaction. A jouissance, without the living body, is a signifying satisfaction: satisfaction through recognition, borrowed from Hegel’s phenomenology.
Considering that a signifying satisfaction of the drive could be possible is the way in which Lacan comes to situate the Freudian drive as symbolic, in keeping with the notion of the mortified body. Yet, it is not the signifier, of the enjoying substance, turning the body, cutting the body until jouissance arises. It is not the signifier of enjoying substance that transforms and cuts into the body to the point that jouissance is produced.
These are the two aspects that Lacan introduces: the living body and the subject of the unconscious. By linking these two aspects, the parlêtre emerged from the binary. This leads Lacan to put forward his hypothesis: “My hypothesis is that the individual who is affected by the unconscious is the same individual who constitutes what I call the subject of the signifier”.
The “natural” object a
Until Seminar X, Anxiety, the body had only been conceived as that which is essentially involved in the formation of the ego, namely the visual body. We can affirm that the body that enters onto the scene with the emergence of the object a in the constitution of the subject of the unconscious is the erogenous body, the body of the erogenous zones, zones beyond the rim, without limit, overlapping with the body of the Other.
For Lacan, the signal, a term that Freud uses to designate anxiety, is not the same as the traumatic situation. The originality of Lacan’s contribution lies in having articulated with the greatest accuracy that what Freud relates regarding the danger that anxiety signals is linked to the cedability that marks the constitutive moment of the object a, the anxiety signal.
If, on the one hand, the danger signals the typically cessible object, on the other, it indicates that anxiety is not a message. This separation from the object affects the libidinal body, which is not the visual body, which implies the body of the Other.
Cessibility characterizes the object a and Lacan makes anxiety an operator of separation, this is why it is not a message, but only an affect.
Nonetheless, in an interview with an Italian magazine, when Lacan answers a question about what anxiety is for psychoanalysis, he goes on to say that: “It is something that is situated outside the body, a fear, but a fear of nothing that the body, including the mind, can motivate. In short, the fear of fear!”
From 1963 to 1974, from Seminar X to the interview, the object a undergoes a long development in Lacan’s teaching, from its emergence as pure bodily extraction to its sophisticated form as a pure logical consistency. To help us understand this development, J.-A. Miller underlines that although a pure bodily extraction, the physiology of the object a develops;  in other words, under the signifier of topology, the object a has a topological consistency, and it is on this basis that it emerges .
The aim is to put the topological aspects of the object a and those concerned with its corporal extraction, in Seminar X, in tension with one another, once the places of anxiety and what the object a is become interchangeable. In order to do this, in Seminar X, it is important to locate where the effect of the cut is situated from which the object a emerges.
In chapter IX, Lacan says the following: “The cut that interests us, the one that leaves its stamp on a number of clinically recognizable phenomena, and for which we cannot elude it, is a cut that, thank goodness, for our idea of it, is much more satisfying than the cut of the child who is born when he falls into the world.
A cut from what? From the embryonic envelopes.
I need only send you off to any old textbook on embryology from the last hundred years for you to grasp that, to have a complete notion of this pre-specular bundle that the a is, you have to consider the envelopes as an element of the child’s body. The envelopes are differentiated starting off from the egg and you will see in what forms they are, most curiously, distinguished – I truest you quite far now after last years’ work on the cross-cap.”
Although the reference here is linked to the body, more exactly to the body of the embryology, the cut, or the cessible moment, is not confused with any substance. The envelopes, on the basis of the egg, which are differentiated with curious shapes, are closer to the topology, in other words, their forms are more hollowed out.
In the last chapter, Lacan returns to this when referring to the mark of the a, in relation to the moment in which it is constituted, and proposes the cry as the first effect of cession for the nursling: “He has yielded something, and nothing will ever conjoin him to it again. A cry that coincides with the very in the world of the he who is going to be the subject.” Lacan concludes that the cry is the very core of the big Other, the starting point of the first effect of cession.
If the anguish was chosen by Freud as a sign of something, Lacan speaks of the infant’s own inhaling as a moment of danger: “This is what has been […] the trauma of birth, which, is not separation from the mother but the inhalation, into oneself, of a fundamentally Other environment.”
Both the excision of the envelopes and the cries are examples of moments of cession in the constitution of the object a, examples that promote the denaturalization and de-substantialization of object a. It is not by chance that the example given of the object a and its separation is the foreskin in circumcision, an example of a practice that is clearly cultural. “It’s put together like that when the slice has been made, whatever it may be, the slice of the umbilical cord, the slice of circumcision…”
Disengaging the function of the object from its substance allows us to glimpse the structure of the surplus-enjoyment in the form of the object that the drive turns around, the presence of a hole, a void, which can be occupied by any object.
For Miller: “Seminar X is the access route to the object a as nothing. It is even the object-nothing that can become the cause of the act, an act that always involves a moment of suicide, a moment of the subject’s death”. It is the denatured, topological object a that will allow the analyst himself to be inscribes within the same series as the object a nothing.
In spite of affirming the denaturation of the topological object a, we can observe that Lacan is still in thrall to the separation between the unconscious and the drive, present at the beginning of his teaching. In his Rio lecture, Miller states: “the object a is part of the armature of the fantasy, it lies at the heart of the drive and it possesses certain properties of the signifier. Notably, it presents through units. It is countable and numerable, and therefore is already a jouissance. If it is surplus jouissance, it’s a surplus jouissance that is already a shading off of jouissance, a modelling of jouissance on the model of the signifier”.
“Parlêtre by nature”
The last teaching opposes the living body to the dead body, it throws the term subject into question as a want-of-being and replaces it with that of parlêtre, subject plus body. In this way, the concept of Other is also thrown into question. Here, the Other is represented by a living body.
There is an inevitable paradox of the human body: being alive [être vivant] and at the same time speaking [parlant]. However bodily a man may be, he is also made a subject by the signifier, the fact of the want-of-being. For man, being and body cannot be equated, while for an animal this is possible. This is why Lacan affirms that man “has a body”, an assertion whose value lies in its difference from “being a body”. The want-of-being divides one’s being from one’s body, reducing the body to the status of having.
It is in the context of 1975 that Lacan, by “devoting himself” to the reading of Joyce’s books and other books on him, takes up the notion of the imaginary body extracted from the Borromean knots: “In so doing, I am introducing something new which accounts not only for the limitation of the symptom but also for what means that it is by tying itself to the body, i.e. the imaginary, and by thus tying itself to the real, and to the unconscious as a third term, that the symptom takes on its limits”.
In recalling the old spelling of sinthome, in French, Lacan specifies the characteristics of the parlêtre, saying that “it is necessary to maintain that man has a body, that is, that he speaks with his body, or in other words, he is a parlêtre by nature”, and at the same time defines the symptom as a body event.
In the course of his teaching, Lacan gives consistency to the main signifying functions that he isolated. He is sceptical about the purely logical consistency of the function of the Other. By embodying the big Other, he introduces the body of the speaking partner, saying that: “For example, a woman is a symptom of another body”.
Here we see that the concept of parlêtre “rests upon the original unconscious-drive equivalence”. Lacan created such a neologism on the basis of the pure jouissance of the unconscious.
Eric Laurent, meanwhile, in his book The Other Side of Biopolitics conducts a reading of Joyce and refers to the sentence in which Lacan speaks of the parlêtre by nature, underlining that the equivalence between “having a body” and “speaking with the body” leads to the following deduction: having a body equates to speaking with the body to such an extent that man parlêtre[s] by nature. He adds that the thesis that “man has a body” implies necessary corollaries that transform the device invented by Joyce as a centre of the tension between art and nature.
The tension between art and nature characterises Joyce. His artistic project does not pass through naturalism, nor through symbolism, themes that mobilised aesthetic debate at the end of the 19th century. The opposition between “the natural” and “art” leads to their reconciliation in the parlêtre by nature.
In this paper, I have gathered together references from the clinic of psychosis and, among these, the downgrading of the object a as a false semblant is key. Jacques-Alain Miller comments on this moment of Lacan’s teaching in two lectures given in Rio, twenty-one years apart: in 1995, “La Imagen-Reina” and in 2016, “Habeas corpus“.
Between heresy and orthodoxy, between common sense and orthodoxy, between the master signifier and the object a, Lacan’s choice of object a entails a prevalence of heresy over orthodoxy.
The place given by Lacan to psychosis, except in the period in which it is defined in terms of the foreclosure of the Name of the Father, leans towards the idea of an original forced choice.
Proposing the syntagm of ordinary psychosis establishes a practice based on the search for a singularity that is unlinked to any universal and is, like an unshakeable forced choice, the only way that psychosis enters into analysis.
Translated by Liliana Kruszel & Maria Lopez, reviewed and edited by Philip Dravers
 Harrari, A. Clinic Lacaniana da Psicosis. 1st ed. Rio de Janeiro: Against Capa, 2006.
 Miller J.-A., 2016 – “Habeas Corpus”, The Lacanian Review 3 (2017), p. 100.
 Lacan, J., Seminar XXII, R.S.I., unpublished, session of 11th February 1975
 Lacan, J., “Television”, Television: A Challenge to the Psychoanalytic Establishment, London, Norton 1990, p. 10
 Miller, J-A., L’Être et l’un. Paris: unpublished, 2011. (11/25/2011)
 Lacan, J., “Television”, op. cit.
 Miller, J-A., 2011, Cours No 14, p. 10
 Miller, J-A., “L’Être et l’Un”, Cours No 13
 Ibid, Cours 13 du 18/05/11
 Ibid, Cours n°12 ,11/05/11.
 Ibid, Cours n°9
 Miller, J.-A., “Habeas Corpus”, TLR 3 (2017), p. 100.
 Miller, J-A., “Lacanian Biology and the Event of the Body”, Lacanian Ink 18 (2001) pp. 6-29
 Lacan, J., The Seminar, Book XX: Encore, London, Norton, 1998, p. 23.
 Ibid. p. 24.
 Miller, J-A., “Lacanian Biology…”, op. cit.
 Lacan, J., Seminar XX: Encore, op. cit. p. 142.
 Miller, J-A., “Introduction to Reading Jacques Lacan’s Seminar on Anxiety”, Lacanian Ink, 26, pp. 6-67.
 Lacan, “’Freud Forever’ – An Interview with Panorama”, Hurly-Burly 11 (2015), p. 21].
 Miller, J-A., “A Fantasy”, Lecture given at IV Congress of the World Association of Psychoanalysis in Comandatuba-Bahia, Brazil, in August 2004 (available on the London Society website: Miller, “A Fantasy”
 Miller, J-A., “Introduction to… Seminar on Anxiety”, op. cit.
 Lacan, J., Seminar X: Anxiety, op. cit., p. 121.
 Ibid., p. 326
 Ibid., p. 327
 Ibid., p. 97
 Miller, J.-A., “…”, NLS Messenger 103.
 Miller, J.-A., “Habeas Corpus” The Lacanian Review 3 (2017), p. 100.
 Miller, J.-A., |”Lacanian Biology…”, op. cit.
 Lacan, J., Seminar XXII: The Sinthome, p. 148.
 LACAN, “Joyce le symptôme”, Autres Écrits, p. 566.
 Miller, J.-A. “Lacanian Biology”, op. cit.
 Lacan, J., “Joyce le symptôme”, Autres Écrits, p. 569.
 Miller, 2016.
 Laurent, E., L’Envers de la Biopolitique, p. 145.
 Ibid. p. 147.
 Miller, J.-A. “Os Hereges (II) Da Heresia à Orthodoxy”. Podcast radiolacan.com, July 8, 2017. Available on: RadioLacan.com.