< return

Return to the juncture

“[B]efore the madman, before the delusional, do not forget that you are, or were an analysand, and that you, too, spoke of what does not exist.”[i] This is how Miller concludes his text, “Ironic Clinic”, in 1993. In his text, Miller opposes the differential clinic between neurosis and psychosis with a “universal clinic of delusion”. The delusional and the analysand both speak of what does not exist. In this there is no difference between them. However, they do not have the same relationship to lalangue.

Miller understood when, in 1979, Lacan said: “everyone is mad, that is, delusional”[ii].

Can we assume that, in saying such an enormous thing as this, Lacan based himself on Freud?

At which point in Freudian theory? In the Freud that considered that everything was a dream perhaps, but, above all, in the Freud who kept turning over in his mind the difference between neurosis and psychosis.

First, in his text ’Neurosis and psychosis”(1923)[iii] Freud conceived them as distinct in so far as, in neurosis, the ego is in the service of (a repressed) reality and so separates itself from a part of the Id, and in psychosis, on the other hand, the ego separates itself off from a piece of reality because of its dependency on the Id. In this way, the loss of reality was a psychotic phenomenon and did not take place in neurosis.

The following year however, in “The Loss of Reality in Neurosis and Psychosis”[iv], Freud recognizes that this doesn’t contradict the observation that in neurosis, the relation of the subject with reality is also disturbed and that in neurosis there is also a flight from reality.

It is very interesting how, from this moment on, without being announced as such, it is psychosis that allows one to read neurosis and not the other way around.

“The contradiction exists”, says Freud, in the second of the two texts, with only a year between them, “only as long as we keep our eyes fixed on the situation at the beginning of the neurosis, in which the ego, in the service of reality, sets about the repression of an instinctual impulse. This, however, is not yet the neurosis itself. The neurosis consists rather in the processes which provide a compensation for the portion of the id that has been damaged”[v] – in other words, in neurosis there is also a loss of reality on the basis of something that does not cease not being inscribed in the symbolic.

The suffering is caused by the fictions that the subject has invented to treat the Real. When someone comes to see a psychoanalyst, it is because it is necessary to treat the treatment they have invented, which has caused them more suffering.

It is then a matter of reducing the auto-therapeutic fictions until most of their meaning has been exhausted – but never entirely – cutting back the symptom and, beyond that, reaching the logical use of it, which is what we call the sinthome at the end of analysis.

In psychosis, what changes is not just the make-up of what comes to cover over the void in the symbolic, but correlatively, the place of the analyst as well. The latter stops making use of the semblant most apt to disturb the defence, and becomes instead a fixed point, who says, “this way yes, that way no…” which allows the subject to sustain himself in the world with his invention, his delusional invention, and make it as efficient as possible in confronting whatever comes from the real. “Both neurosis and psychosis are thus”, says Freud, “an expression of a rebellion on the part of the id against the external world, [which we can understand as the effect of the push exerted by the drives and the way this push echoes in the body] of its unwillingness – or, if one prefers, its incapacity – to adapt itself to the exigencies of reality, to Aνάγκη [Necessity]. Neurosis and psychosis differ from each other far more in their first, introductory, reaction than in the attempt at reparation which follows it.”[vi]

In both, then, there is an attempt to “create a new reality”: phantasmic in neurosis, delusional in psychosis. Yet, if we take into account that both are productions of meaning in relation to a jouissance without meaning, both are delusional.

Lacan took a bit longer than Freud to reverse his position, but eventually he took it further than Freud.

Several years pass by between “Whoever wants to be mad isn’t” [n’est pas fou qui veut], scrawled on the walls of the Saint-Anne hospital, and “Everyone is mad, that is, delusional”. Notwithstanding the fact that they do not actually contradict each other, the passage from one affirmation to the other is radical.

We have found the Freudian basis for “everyone is mad”, which sets us before of Freud, for whom the archetype of the analysand was the neurotic. Yet, for us, on the other hand, the archetype is “everyone is mad” and here we will have to distinguish in this “everyone is mad, that is, delusional”: the madness that stems from the fact of being a speaking being, which gives rise to a radical inadequation between the real and the mental; the madness, I will say, proper to each person, in other words, the invention through which the knot is realised, such as is transmitted in the pass; and the singularity of the psychotic subject.

In “Ironic Clinic”, Miller tells us that the schizophrenic is the only subject that does not defend himself from the Real by means of the symbolic, because for him the signifier is real.

I remember a psychotic patient in an institution, who, when he was told, in relation to his unshakeable certainties, and in an attempt to open up some kind of dialectic, that it was convenient to leave some doors open, he immediately stood up and went to open the door of the office, thereby demonstrating the real value of the signifier.

It was an instance of irony. The irony of the schizophrenic that goes against the Other, that shows that the Other does not exist, as opposed to humour, which doesn’t work without the Other.

It would be a mistake to take this as a witz. It’s not directed towards any Other, but rather denounces the latter’s status as a semblance.

With respect to the dependency on semblance to treat the real, there is a subtle frontier between neurosis and psychosis.


Madness and freedom. The madman is the free man.

One of the first things I told my analyst was that I wanted to analyse myself to be free. Only later did I learn that Lacan had said to the psychiatrists that the mad man was the only free man[vii].

I knew, I experienced, with the passage of my analysis, that one chains oneself to the S1s, the master signifiers, from where one wants to be seen by the Other.

The speaking being remains a prisoner of the identifications that have given him a place in the Other.

“Not only can man’s being not be understood without madness, but it would not be man’s being if it did not bear madness within itself as the limit of his freedom.”[viii]

We know this affirmation of Lacan’s from “A Question Prior to Any Possible Treatment of Psychosis”.

In a lecture given in Paris in 1987 – On the lesson about psychosis– Miller says that “…the thesis that supports this affirmation (“Not only can man’s being…”), is that no identification, trace or mark is operative on the subject if there isn’t a decision of the being”.

Madness consists then in getting rid of the appeal of identifications that have a mass effect.

It is the refusal to consent to the identification with the Father, with the signifier, through a rejection of the paternal imposture. It is the rejection of semblance [make-believe], which would be the mark common to all psychosis.

What Miller emphasises in Lacan’s sentence, is that foreclosure is a decision of the being. An unfathomable decision of the being. He warns here about the risk of being so mesmerized by the concept of foreclosure, in the light of structuralism, that we ignore the status of the subject in the psychotic. As if foreclosure was a mere mechanism without correlation with a decision of being, a subjective position. A subjective position characterised by a lack of love for language. It takes a love of lalangue for the inmost juncture of the sense of life to occur[ix].

Freud called the effect of this love, Bejahung. The madman is a free man because he rejects identifications, starting with the most unfathomable one, the Freudian identification with the father, who is rejected for being an imposter before the Real. The psychotic is free because he has not put the cause of his desire in the field of the Other, nor has he ceded the object.

From this point on, two paths remain for the psychotic: one, is that of the moral cowardice of mania and sadness, a consequence of the metonymic sliding resulting from the foreclosure of Name-of-the-Father, which can also lead to the melancholic identification with the waste object.

The other, is the path of courage, of “speaking well” and the rigour of the delusion that unfolds from the logic that follows the foreclosure.

“All logic is correlative to a foreclosure”, says Miller[x], in order to point out that the rejection of the appeal of identifications is the condition for the invention of knowledge before the real.

This gives us another way of reading neurosis from psychosis: it is by rejecting identification that a way opens up to invention.

Evidently, the psychotic demonstrates that one cannot be free without being bound to something else. He can be free from the identifications that make a social bond, but he is still – as a woman said to me recently – stalked by the heteronomy of language.

This certainty that what she says is outside, comes in some way from a radical exterior. Even though she uses language to speak and to try to express what she wants does not stop her from having the feeling that what she makes use of to talk about comes from outside.

It is an experience of lalangue that is not usually felt so clearly.

Perhaps, this is why so many psychotics are so strict with themselves in terms of “speaking well”, which situates them in the register of ethics. Saying well what they suffer from as a way of treating the xenopathic phenomenon. The psychotic can free himself from identifications, but not from the intrusions of lalangue. The neurotic does not free himself from either of them, he only veils and remains unaware of how determined he is by the body event in the encounter with lalangue and in analysis, he can aspire to liberate himself from the weight of identifications to the point of reducing them to the traits that go to make up the marks of a style.

From this perspective, an analysis taken to its end, comes close to the experience of heteronomy of lalangue.


The inmost juncture

When we read in “A Question Prior to Any Possible Treatment of Psychosis” (1958), that in certain cases there can be “a disturbance that occurred at the inmost juncture of the subject’s sense of life”[xi], we are at the zenith of Lacan’s “speaking well”. Once this “inmost juncture” has been pronounced, there is no going back on one point: life in speaking beings, its ties, passions and satisfactions, are made up of loose pieces, which must somehow be joined together [juntar].

In 1958, the operator that brings about this juncture [juntura] is the phallus. There we read that the subject, alienated in the symbolic, mortified by the signifier, “is identified [to the phallus]… with his living being”[xii]. Or again, that the child “identifies with the imaginary object of [the mother’s] desire insofar as the mother herself symbolizes it in the phallus”[xiii]. It is an imaginary-symbolic assemblage.

However, as we know, this changes for Lacan. The Name of the Father and the phallic semblance reveal themselves to be increasingly impotent as a means for regulating jouissance. They have lost their primacy in the treatment of the Real, being one solution among others which the speaking being has at his disposal to treat jouissance.

With the pluralisation of the Names of the Father, the effect of generalised foreclosure, each person is confronted with the task of finding their own response when confronted with the real at stake in their lives [que le toca vivir].

In this sense, all discourse is a defence against the real and justifies Lacan’s irony: “We are all mad, that is delusional”.

A delusion is as delusional as a fantasy, in the sense that both are defensive constructions against the real without law – an attempt to put together all the loose pieces that constitute us.

With the deflation of the Name of the father and the clinic of the symptom which is its correlate, the expression “disturbance at the inmost juncture…” acquires more weight. More life.

Miller invents a concept that very readily accompanies the idea of juncture: ordinary psychosis.

To these two – juncture and ordinary psychosis – we will add a third point of reference: feminine jouissance.

The Name of the Father was already put into question with the introduction of the object a as what is left over as a remainder of discourse. First connected with the real of the drive, it later becomes a semblance itself, in other words the part of jouissance that is capable of being elaborated by the symbolic.

As of Seminar XX, Encore[xiv], what of the drive cannot be elaborated is called feminine jouissance.

Lacan lets go of Schreber’s hand to take hold Joyce’s and the clinic of sinthomatic repair in order to traverse the field of psychosis.

Foreclosure becomes generalised, beyond the foreclosure limited to the Name of the Father, through the signifier of “Woman that does not exist”. Each person treats the way in which this generalized foreclosure is inscribe for them.

In this way, the generalized foreclosure that feminine jouissance introduces corresponds to the clinic of the sinthome.

Now, we can read “everyone is mad, that is, delusional” as an ironic assertion on Lacan’s part to say that all our discourses are a defence against the real that manifests itself in that unnameable jouissance[xv]. This implies that we leave behind the clinical types, to be guided by the singularity of sinthomatic responses.

But Miller is very clear in his text, “Ordinary Psychosis Revisited”, that none of this exempts us from making a diagnosis between neurosis and psychosis and specifying what kind is at stake for each person. Ordinary psychosis is a concept torn between, on the one hand, a desire for extreme precision, and on the other, by the desire to grasp what is most singular about each case, the inventions of the analysand and his or her writing. Something similar happens, says Miller, when he compares the concept to the “American soul”, “torn between a desire for extreme precision and numbers, on one side, but on the other side, a desire to be able to speak one’s own mind and follow one’s own ideas”[xvi].

The discrete signs, syntagma that make a pair with ordinary psychosis, are discreet in the sense that they are minimal, not flashy or outstanding, as in full-blown psychosis, but also in the sense of discrete elements, as Lacan says in relation to the signifier. In other words, what is in question is a clinic that includes nuances and the localisation of what is “different”, different from everything else that we hear in the analysand, dissonant; not different from others, which would strike a segregative tone.

What we are looking for are the discrete signs of an externality, which could provide a clue to the disturbance at the inmost juncture of the sense of life.

In terms of the bodily externality, the discrete detail, needs to be located in whether the analysand needs an artificial way to inhabit his or her body. One patient had a series of tattoos, and explained to me that she had had them done at important moments in her life. It was her way of remembering them and fixing them.

The tattoo served the function of stopping time and avoiding the unavoidable loss, by making these marks in the body. The problem was that one day she stopped liking those tattoos and anxiety emerged. What served to link her to her own body, stopped having that function and the tattoo, instead of the Name of the Father, was experienced later as a weight in her life. The intervention was almost of common sense: “We will need to invent something because you will have to live with them”. The solution came on the side of transforming the tattoos . She couldn’t take them out , but she could change the colours. She decided to change them from being very colourful to monochromatic. That eased the anxiety.


Pass, ordinary psychosis, autism and the investigation of the inmost juncture of the sense of life.

We must also say that Miller clarifies that ordinary psychosis is an idea inspired by the pass, in the sense that no very precise definition is given, nor would it be appropriate for it to be, but only the main strands, because a very precise definition would stop what is singular from being heard.

With Ordinary Psychosis, it is the same. It’s not about finding the precise universal parameters with which to diagnose it, but about being able to listen to what is unique in each case. Thus, with the continuist clinic, we can venture to bring together what happens at the heart of the pass and what happens in ordinary psychosis and compare it to what happens in autism.

The sinthome – a concept born through the investigation of Joyce’s work – is the singular way in which each person realises the articulation between absolute elements like the body and language in a contingent way. In the testimonies of AS, we witness the moment in which the analysand was confronted with this articulation between absolute elements of a contingent existence. This was brought out in Oscar Ventura’s pass testimony in Buenos Aires. A phrase concludes the narration of the family romance about his birth: “entonces, me tienen, nazco” [then they have be, I am born], and the subject hears the voice of the analyst cut in: “entonces, me tienen asco” [Then they feel disgust for me]. A small twist in the writing that reveals an identification with the waste object that had played a determining role in his life.

I am particularly interested in what Ventura says about this interpretation:

“Enigmatic, radically surprising, dismissing the analyst from the scene, leaving me to the mercy of my own lalangue… If I can locate a moment of passage from analysand to analyst, it is this. By touching my identification with the waste object, it also threw the imposture of the melancholic trait into disarray, the jouissance that seemed to have been sealed to a tragic destiny deflates”. At this moment of detachment from the transference, the analysand appears alone, in his dimension as speaking body, a body affected by lalangue, in such a way that a whole life seems destined to make a silence resonate which can only make itself heard in the encounter with an analyst.

Well, I say that the pass shows and demonstrates ordinary psychosis by the invention of something that makes believe [haga creer] in a solid articulation of the absolute and contingent elements that determine it and autism, by its failure to articulate them is the privileged place to investigate order and disturbance at the most intimate juncture of the subject’s feeling of life.

Lacan knew how to locate there, early on in his teaching, the crucial point in the life of the speaking being, the point that is at the same time his bliss and his suffering.


Translated by Liliana Kruszel, revised by Philip Dravers

[i] Miller, J.-A. “Ironic Clinic”, Psychoanaytical Notebooks 7 (2001), p. 21.

[ii] Lacan J., “There are Four Discourses”, Culture Clinic 1 (2013), p. 3.

[iii] Freud S., “Neurosis and Psychosis” SE XIX, p. 149-153.

[iv] Freud, S. “The Loss of Reality in Neurosis and Psychosis”, SE XIX, p.183-187.

[v] Ibid., p. 183.

[vi] Ibid., p. 185.

[vii] Lacan J., “Petit discours aux psychiatres”, 10 November 1967.

[viii] Lacan, J., “On a Question Prior to Any Possible Treatment of Psychosis”, Écrits, p. 479.

[ix] [TN. An allusion to what Lacan says on page 466 of his Écrits, which has been translated into English as “a disturbance that occurred at the inmost juncture of the subject’s sense of life”.]

[x] Miller, J.-A., « La leçon de la psychose », en L’expériencie psychanalytique des psychoses. Ates de L’Ecole de le Cause freudienne, ECF, Paris, 1987.

[xi] Lacan, J., “On a Question Prior…”, op. cit. p. 461.

[xii] Ibid.

[xiii] Ibid. p. 463.

[xiv] Lacan J., The Seminar, Book XX: Encore, London & New York, Norton, 1998.

[xv] Miller, J.-A., “The Unconscious and the Speaking Body”, HurlyBurly 12 (2015), pp. 119-132.

[xvi] Miller J.-A., “Ordinary Psychosis Revisited”, Psychoanalytical Notebooks 26 (2013), p. 34.