Beruflich Dokumente
Kultur Dokumente
109
The Construction of Reality in Neurosis and Psychosis
When Freud speaks of the loss of reality in psychosis, he does not mean that
there is a failure in how reality is perceived; instead, reality, as it is experienced
through the window of the fantasy, is altered.6 Fantasy acts to screen out the
real, and psychotic individuals are not able to construct such a fantasy; for
them, hallucinatory phenomena can, in certain cases, come to compensate for
this absence of the fundamental fantasy. In psychosis, reality is approached
without the protection of this fantasy. In this sense, reality is “deranged
[déréglée]” in psychosis: it is disturbed in relation to a reality that can only be
approached through fantasy.
While Freud did maintain the notion of a loss of reality in psychosis in
1910 (“Formulations on the Two Principles of Mental Functioning”) and in
two articles from 1924 (“Neurosis and Psychosis” and “The Loss of Reality
in Neurosis and Psychosis”), by 1938, in his “Outline of Psycho-Analysis,” he
states that a complete detachment from reality “seems to happen only rarely or
perhaps never.”7 Further, he states several times that reality is also problematic
in neurosis: the neurotic person wants to know nothing about reality—the
reality of castration—which s/he seeks to escape from because it is unbearable.8
The fantasy is what enables the neurotic to circumvent castration.9
When he speaks of troubles in perceiving the world, Freud does not
differentiate the real (the body affected by jouissance) from reality (the world
as experienced through the frame of fantasy); this crucial distinction comes to
us from Lacan. It thus becomes a question of determining whether the subject
defends him/herself against the real or reality. Although the pleasure principle
directs neurotic fantasy and provides a way for the subject to get some measure
of satisfaction, it does not direct hallucination. The dislocation of jouissance in
psychotic hallucinatory phenomena is not coextensive with the hallucinatory
satisfaction of neurotic desire that occurs in dreams.
These two forms of confronting reality—through the fantasy in neurosis
and through hallucination and delusion in psychosis—do not have the same
function. The purpose of fantasy is to spare the neurotic from having to
encounter castration; hallucination and delusion are supposed to protect the
psychotic from being invaded by the jouissance of the Other. If the psychotic
is haunted by the real of jouissance, the neurotic is trying to get away from the
reality of castration.
While neurotic fantasy participates in a “symbolic” arrangement based
on the laws of language, in hallucination the symbolic does not have this
organizing capacity and, as a result, the subject is not able to limit the Other’s
jouissance. How can such jouissance be warded off? One tragic option would
be to bring about symbolic castration by effecting a real loss of an object,
for example through self-harm, breakdown, suicide or murder of the specular
double. Another option involves imaginary invention—hallucination and
delusion—which are expressions of both a jouissance and a limit to jouissance
set by the subject.
110
In psychosis, a person is exposed to the real (of the jouissance of the Other)
without having the ability to defend him/herself with fantasmatic reality. The
psychotic must find another way to circumscribe jouissance, while trying
to rebuild “the edifice of the universe, one brick at a time.”10 This edifice
is reconstructed in the delusion, but is already present in hallucinations. As
Freud states, hallucination is a “new reality,”11 a “new world…constructed in
accordance with the id’s wishful impulses.”12 This reconstructed form of reality
is “bound up with a generation of anxiety,”13 yet it also constitutes “an attempt
at a cure.”14 What can a person with psychosis do when reality is splitting apart
and there are no means of stopping the process, except by imagining that s/he is
being persecuted? That is how the psychotic version of the neurotic fantasy is
written: through the interpretive intermediary of hallucinations and delusions.
111
For his part, Merleau-Ponty views hallucinations as a form of disorder in
consciousness.19 In his Phenomenology of Perception, he states:
112
acts on one of the percipiens’ sensoriums. Yet, according to Merleau-Ponty,
having hallucinations does not lead a person to lose all contact with the “true”
world. “Illusions” can occur although hallucinations are never perceptions, and
although the hallucinating person suspects what is happening in the true world,
even while s/he is turning away from it.
The problem is that those who hallucinate hear voices that “normal”
people do not hear: indeed, they are indeed the only ones who hear them.29 An
hallucination is thus not a perceptum. In other words, it is not a phenomenon
that can be shared or experienced with others: “I hear what you hear, so we
aren’t crazy.” For Merleau-Ponty, then, hallucination does not pertain to the
perceptual world.
Yet the dimension of the other, of another who would agree with the subject,
does not suffice to guarantee either that the latter is perceiving reality or that s/
he is not mad. The psychiatrist and Lacanian psychoanalyst Jean Clavreul asks,
“What is the difference between Napoleon and the madman who thinks he is
Napoleon?” He then replies, “It would be an especially bad idea to answer that
the other knows who is and who is not Napoleon.”30 This also seems correct
as regards hallucinations. Clavreul analyzes the case of Ludwig II of Bavaria,
whose madness included, in particular, the belief that he was a king; he was
not, however the only one to have this conviction, for all of Bavaria and even
Europe itself thought he was a king.31 “We see clearly that, for Ludwig II, the
other did not do anything to help matters.”32 In other words, even if the other
concurs with us about our lived experience—whether by having had the same
experience or by viewing things in the same way as we do—this does not
ensure the actual facticity—the truth—of the phenomenon. Clavreul adds that
“the question of the other is quite essential for everything related to madness,
but only if great care is taken when appealing to it. Otherwise, one only ends
up glorifying the most vapid conformism.”33
Yet for Merleau-Ponty, intersubjectivity remains a criterion of truth.34 As
a phenomenon that cannot be shared with others, hallucination is an error of
consciousness.35 In this sense, the perceptual world is an objective world, one
in which the singularity of the percipiens and the qualities of the sensoriums do
not perturb the facticity of the perceptum. There is a “public”36 and a “private”
world, which are divided into the world of facticity,37 of shared reality and of
intersubjective relations on the one hand, and on the other, the solitary world
of hallucination.
An object is either in the world or it is not; the hallucinated object and the
activity that produces it are not in the world. If the object is in the world, it
also exists in time, for temporarily and the world are “the invariable frame
of every illusion and of every disillusion,” according to Merleau-Ponty.38 In
hallucination, the time of the object is lost: the subject creates, for him/herself,
113
a world apart, one that is outside time and is separate from the “temporal”
world of perception.
114
discourse of desire, of jouissance, of will. The Other makes the subject into an
automaton, by forcing the subject into a position of submission in relation to
his/her own hallucinations.
Hallucinations are thus involuntary, ineluctable, and compelled or forced.
“It won’t stop, it never goes away,” as a young woman once told me, someone
who, despite being treated with antipsychotic medication, could not get rid
of the voices she heard. “Anyway,” she continued, “I know that they’ll just
come back. They’re coming from the outside, not from me.…I feel powerless,
there isn’t anything I can do….” The patient was forced—she had no choice
but to listen to these voices, which were usually those of women, and which
constantly hectored her:
When one listens to what psychotic people say about their hallucinations,
it becomes clear that what disturbs them is not so much the accusatory and
insulting character of the hallucinations (i.e., their signification), but instead
their automatic, forced, intrusive and uncontrollable aspect. For the subject,
the voice’s enunciation takes on an enigmatic dimension, an enigma that has
been imposed: the person is surprised, or even petrified, by what is heard.
115
For Lacan, the object appears in the real,46 and the hallucination is more real
than reality, as he frequently notes.
The consistency of these different types of hallucinations is homogeneous
with the different drives.47 There is a correspondence between drive and
hallucination, for they have the same materiality: the body. The body of the
drives is the “Other” body that appropriates the subject; the “real” of the
body returns, violently, in hallucinations, whether these are verbal48 or visual.
Merleau-Ponty writes: “Every hallucination is first an hallucination of one’s
own body.”49 Hallucinations transform subjective division into dissociation,
on the basis of a spatial dislocation of the body. The psychotic subject is
“absorbed” by the body, by his or her own body, a body of the drives that
reappears as external, in its real dimension. It is a question of inside and
outside: in hallucinations, something of the subject—the body—comes back
from the outside. In such hallucinations, drive material, which has been
displaced to the outside (in the world), is insistent, although the subject is
unaware that the impetus is coming from him/herself. There is an inversion, or
rather a confusion of space: between inside and outside and between the body
and the Other. The body thus loses its symbolic and imaginary coordinates, its
boundaries.
It is also possible to represent the drives in spatial terms. Between the subject
and the Other, the movement of the drive finds its space, between “rejection”
and “insistence.” When an hallucinatory phenomenon occurs, the drive follows
a dual, vectorized trajectory through space. In the movement from the subject
to the Other, the subject identifies with the object of the jouissance of the Other.
Then, in the opposite movement from the Other to the subject, the force of the
drives returns from the outside by means of visual and auditory hallucinations.
Conclusions
Lacan suggests that it is important not to skip over the time that allows
us to see “whether the perceptum itself bequeaths a univocal meaning to the
percipiens.”50 Indeed, it is not only the hallucination that is “fictional” for the
subject. Reality, understood as the world as it is perceived, is itself an “indirect”
world, one that is ambiguous and equivocal. For in “normal” subjects, between
the subject and the world, between the subject and the real, there is fantasy.
In psychosis, the fantasy is not constituted as a defense—a defense against
the real—as it is in neurosis. When fantasy does not succeed in screening
out the real, this can, as we have seen, bring about hallucinations. Psychotic
fantasies only produce a fragile channeling of drive energy; they do not screen
or dam up the drive’s power to fragment. The fantasy “surges forth” within the
real in the form of hallucinations or delusions, before the subject has the time
to project him/herself there.
For Lacan, the perceptum is not the real,51 a real that must be distinguished
from reality; as he stated in the lecture known as “La troisième [The Third],”
116
“the real is not the world.” This distinction is blurred in Merleau-Ponty’s work,
where it is less a question of the relation between the real and the perceptum
than of how the percipiens interacts with the perceptum. In this sense, when
they explore hallucination, Merleau-Ponty and Lacan are not talking about
the same object at all. In neurosis, when symbolic castration is shown to
be operational, the voice-object is repressed. The voice becomes inaudible
and serves as an anchoring point for the enunciation. This is not the case in
psychosis. For Lacan, it is the psychotic and not the neurotic who falls prey
most easily to the real: the real of the body—jouissance—that returns in the
form of hallucinations.52
Hallucinations are intrusive and persecutory; from the moment they occur,
the subject finds him/herself in the position of an object. Spaces become
jumbled together, with the space of the subject becoming that of the other and
vice versa. In this chaotic spatial confusion, subjectivity becomes unmoored.
Unlike the symptom, with its return of the repressed, this situation does not
involve a conflict between the subject and a drive that has an annihilating
character. In hallucinations, subject and Other are conjoined. This state of
affairs triggers the psychotic break.
Hallucination: spatial disturbance, subjective instability, worlds that cannot
be communicated, a confusion between inside and outside. Where do the voices
come from: from without or from within? Where is the subject located when s/
he hears voices or sees things that are not there? In this spatial confusion, what
space is there for subject and Other? In hallucinations, another, singular reality
is disclosed: a reality that is incoherent, solitary and brave, for it bears the mark
of a rebellion against the mold and form, the rebellion of the subject.
Silvia Lippi
slippi@club-internet.fr
117
NOTES :
1 Philip K. Dick, “Man, Android, and Machine (1976),” in The Shifting Realities of
Philip K. Dick: Selected Literary and Philosophical Writings, ed. Lawrence Sutin (New
York: Vintage Books, 1995), 231.
2 Sigmund Freud, “The Loss of Reality in Neurosis and Psychosis (1924),” in The
Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol 19,
trans. James Strachey (London, England: Hogarth, 1961), 183–90.
3 [Translator’s note: As Bruce Fink explains in his translation of Lacan’s seminar Encore,
Lacan’s term “dit-mensions” involves a play on words: “‘Dit’ (the t is silent) means
‘what is said’; here Lacan is suggesting that it is a dimension of the said or spoken.
Mension combines the homonyms mansion (from the Latin mansio [dwelling], which
in French was the term for each part of a theater act in the Middle Ages), and mention
(mention, note, or honors, as in cum laude).” See On Feminine Sexuality, The Limits of
Love and Knowledge: The Seminar of Jacques Lacan, Book XX Encore, 1972-1973, ed.
Jacques-Alain Miller, trans. Bruce Fink (New York: Norton, 1998), 21, note 21.]
4 Jacques Lacan, Le séminaire, livre XXIII: Le sinthome, 1975-1976, ed. Jacques-
Alain Miller (Paris: Seuil, 2005), 144. The symbolic is the dimension attached to the
functioning of language and, in particular, to that of the signifier. It has a relation with
the father as founder of law and desire. The imaginary proceeds from the constitution
of the image of the body. It must thus be understood in terms of the image, that is, the
register of the specular and the lure. The real is what resists; it is impossible to say and
to imagine. For Lacan, all traumatic experiences are of the order of the real.
5 Here the term “jouissance” designates the strange satisfaction, beyond the pleasure
principle, that Freud discovered in relation to a series of experiences of physical and
psychical pain. Lacan described such experiences related to pain and excess, which
are always uncontrollable, as belonging to the order of jouissance; symptoms are an
example.
6 Lacan states that the “…field [of reality] functions only when obturated by the screen of
fantasy.” See “On a Question Prior to Any Possible Treatment of Psychosis,” in Écrits:
The First Complete Edition in English, trans. Bruce Fink, Héloïse Fink, and Russell
Grigg (New York: Norton, 2006), 496, Note 14.
7 Sigmund Freud, “An Outline of Psycho-Analysis (1938),” in The Standard Edition of
the Complete Psychological Works of Sigmund Freud, Vol. 23, trans. James Strachey
(London: Hogarth, 1964), 201.
8 Sigmund Freud, “Formulations on the Two Principles of Mental Functioning (1911),”
in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol.
12, trans. M. N. Searl (London: Hogarth Press, 1958), 225; Sigmund Freud, “Neurosis
and Psychosis (1924),” in The Standard Edition of the Complete Psychological Works
of Sigmund Freud, Vol. 19, trans. James Strachey (London: Hogarth, 1961), 151; Freud,
“Loss of Reality,” 185; Freud, “An Outline of Psycho-Analysis (1938),” 202.
9 Here we recall the typical defense mechanisms in neurosis (repression, negation,
projection) and in perversion (disavowal).
10 Paul-Laurent Assoun, “Le délire architecte. Figures freudiennes de la construction,” in
Délire et construction (Toulouse: Érès, 2003), 19.
11 Freud, “Loss of Reality,” 185.
12 Freud, “Neurosis and Psychosis (1924),” 151.
13 Freud, “Loss of Reality,” 186.
14 Freud, “Neurosis and Psychosis (1924),” 151.
15 Ibid., 152. That same year, Freud would write “…in a psychosis, this same ego, in the
service of the id, withdraws from a piece of reality” (“Loss of Reality,” 183).
16 Freud, “Neurosis and Psychosis (1924),” 150. Erwin Straus does not share Freud’s
opinion on this. Straus distinguishes between perception and sensation; in the latter,
reality is given without reflection. “Hallucinatory certainty,” he writes, “is sense
certainty. Hallucinations are primary modifications of sensing, not disturbances of
118
perception.” See Erwin Straus, The Primary World of Senses: A Vindication of Sensory
Experience, trans. Jacob Needleman (London: Free Press of Glencoe, 1963), 357.
17 Henri Ey, Paul Bernard, and Charles Brisset, Manuel de psychiatrie (Paris: Masson,
1960), 116. Ey’s work here is based on Henri Clause’s statement that hallucinations
are defined by the “personal belief that one is perceiving an object that is not there…
The objective reality of a false perception is the basis of hallucination.” Cited in
Henri Ey, Robert Michel Palem, and Jules Séglas, Hallucinations et délire: les formes
hallucinatoires de l’automatisme verbal (Paris: l’Harmattan, 1999), 65.
18 Ey, Bernard, and Brisset, Manuel de psychiatrie, 115.
19 This discussion will focus principally on Merleau-Ponty’s discussion of hallucinations
in Phenomenology of Perception, trans. Donald Landes (New York: Routledge, 2012).
Nevertheless, it is important to note that some change in his thinking on this theme
can be found in his posthumously published work The Prose of the World, ed. Claude
Lefort, trans. John O’Neill, Northwestern University Studies in Phenomenology &
Existential Philosophy (Evanston: Northwestern University Press, 1973). Merleau-
Ponty’s later thoughts on the question of language led him to change his earlier view
that hallucinations involve a factual variation of the cogito.
20 Merleau-Ponty, Phenomenology of Perception, 360.
21 As Lacan writes: “By assimilating the phenomenon of hallucination with the sensory
order, associationist psychology thus merely reproduces the absolutely mythical import
that the philosophical tradition attributes to this phenomenon in the standard question
regarding the error of the senses. The fascination characteristic of this theoretically
scandalous role no doubt explains the true misrecognitions in the analysis of the
phenomenon that allow for the perpetuation of a position regarding the problem that
is so erroneous, yet still tenaciously held to by many a clinician.” See “Beyond the
‘Reality Principle,’” in Écrits: The First Complete Edition in English, trans. Bruce
Fink, Héloïse Fink, and Russell Grigg (New York: Norton, 1966), 62.
22 Lacan, “On a Question,” 446.
23 Ibid.
24 Merleau-Ponty, Phenomenology of Perception, 356.
25 Paul Sérieux and Joseph Capgras, Les folies raisonnantes: le délire d’interprétation
(Paris: Félix Alcan, 1909), 7.
26 Ibid., 63.
27 Ibid., 66.
28 Merleau-Ponty, Phenomenology of Perception, 350.
29 Here Merleau-Ponty draws on Eugène Minkowski’s article “Le problème des
hallucinations et le problème de l’espace (Quelques réflexions au sujet d’un halluciné),”
L’Evolution Psychiatrique 4, no. 3 (1932): 59–76.
30 Jean Clavreul, Le désir et la loi: approches psychanalytiques (Paris: Denoël, 1987),
103.
31 As Lacan writes, “…it should be noted that if a man who thinks he is a king is mad,
a king who thinks he is a king is no less so. This is proven by the example of Louis
II of Bavaria and a few other royal personages….” See “Presentation on Psychical
Causality,” in Écrits: The First Complete Edition in English, trans. Bruce Fink, Héloïse
Fink, and Russell Grigg (New York: Norton, 1966), 139.
32 Clavreul, Le désir et la loi, 103.
33 Ibid.
34 Merleau-Ponty, Phenomenology of Perception, 347.
35 For Lacan, “We cannot, of course, overestimate the magnitude of the displacement
which occurred in the position of this problem by the so-called phenomenological
envisioning of the data of hallucination.
But whatever progress has been made here, the problem of hallucination remains just
as centered as before on the attributes of consciousness. This is a stumbling block
for a theory of thought that sought the guarantee of its certainty in consciousness.
As such—at the origin of the hypothesis of this counterfeiting of consciousness that
119
one understands as one can using the term ‘epiphenomenon’—it is once again and
more than ever as a phenomenon of consciousness that hallucination is subjected to
phenomenological reduction, [phenomenologists] believing that it yields its meaning
to us when we triturate the component forms of its intentionality.” See “Response to
Jean Hyppolite’s Commentary on Freud’s ‘Verneinung,’” in Écrits: The First Complete
Edition in English, trans. Bruce Fink, Héloïse Fink, and Russell Grigg (New York:
Norton, 1966), 320–1.
36 Merleau-Ponty, Phenomenology of Perception, 352.
37 Ibid., 360.
38 Ibid.
39 Massimo Recalcati, Jacques Lacan. Vol. 2: La clinica psicoanalitica: struttura e
soggetto (Milan: Cortina Raffaello, 2016), 218.
40 Jacques Lacan, The Psychoses: The Seminar of Jacques Lacan, Book III, 1955-1956,
ed. Jacques-Alain Miller, trans. Russell Grigg (New York: Norton, 1993), 14.
41 Sérieux and Capgras, Les folies raisonnantes, 60.
42 It was in deciphering the delusion of Daniel Paul Schreber, on the basis of Freud’s case
history, that Lacan drew out the distinction between the “statement [énoncé]” and the
“enunciation [énonciation].” This distinction is at work for all subjects, and the subject
of enunciation ex-ists in relation to the statement.
43 Lacan writes, “...it is from the irruption of One-father [Un-père] as without reason,
which accelerates the effect that is experienced as a forcing into the field of an Other,
which is thought of as the most foreign of all meanings.” See “L’étourdit,” in Autres
écrits (Paris: Seuil, 2001), 22.
44 Lacan, “On a Question,” 446.
45 Merleau-Ponty, Phenomenology of Perception, 351, translation modified.
46 Lacan, Seminar III, 136.
47 Jean-Claude Maleval, Logique du délire (Paris: Masson, 1997), 123.
48 Lacan draws a distinction between “verbal” and “auditory” hallucinations. See “On a
Question,” 446.
49 Merleau-Ponty, Phenomenology of Perception, 355.
50 Lacan, “On a Question,” 446.
51 Jacques Lacan, “La troisième,” Lettres de l’Ecole freudienne, no. 16 (1975): 177–203.
As he notes earlier in this text, “Perhaps analysis would lead us to think of the world as
it is: imaginary.”
52 This is not limited to the voice alone. Ey classified hallucinations into several categories:
visual (relatively rare in schizophrenia and chronic delusional disorders), auditory,
gustatory and olfactory, tactile, cenesthesic and general somatic, motor and kinesthetic,
and psychical or pseudo-hallucinations. See the “Psychosensory Hallucinations” entry
in Manuel de psychiatrie, 116–117.
120