(Baldwin, Yael Malone, Kareen Svolos, Thomas La PDF

LACAN AND ADDICTION
LACAN AND ADDICTION

An Anthology
Edited by
Yael Goldman Baldwin,
Kareen Malone, and Thomas Svolos
First published in 2011 by
Karnac Books Ltd
118 Finchley Road
London NW3 5HT
Copyright 2011 by Yael Goldman Baldwin, Kareen Malone, and Thomas Svolos
for the edited collection, and to the individual authors for their contributions.
The rights of the contributors to be identified as the authors of this work have
been asserted in accordance with 77 and 78 of the Copyright Design and
Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in

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To my family,
Yael Goldman Baldwin
To my sister and brothers,
Kareen Malone
CA, YAMFP,
Thomas Svolos
CONTENTS
ACKNOWLEDGEMENTS xi
ABOUT THE EDITORS AND CONTRIBUTORS xiii
INTRODUCTION
Viewing addictions through Lacanian lenses xvii
Kareen Malone and Yael Goldman Baldwin
CHAPTER ONE
Modern symptoms and their effects as forms of administration:
a challenge to the concept of dual diagnosis and to treatment 1
Rik Loose
CHAPTER TWO
New uses of drugs 39
Fabin Naparstek
CHAPTER THREE
Knows nos nose 59
Rolf Flor
vii
viii CONTENTS
CHAPTER FOUR
Brief comments on Rolf Flors case presentation 73
Bruce Fink
CHAPTER FIVE
Introducing the New Symptoms 75
Thomas Svolos
CHAPTER SIX
Comments on Introducing the New Symptoms 89
Fabin Naparstek
CHAPTER SEVEN
Bulimia: between phobia and addiction 93
Patricia Gherovici
CHAPTER EIGHT
Two people in a room: ethnographers, unruly subjects,
and the pleasures of addiction 111
Alexine Fleck
CHAPTER NINE
Toxicomanic passion for an object: the sexual relation exists 119
Gustavo Klurfan
CHAPTER TEN
The colour of emptiness: addiction and the drive 131
Cristina Laurita
CHAPTER ELEVEN
Leverage of the letter in the emergence of desire:
a case of addiction 145
Shannon Kelly and Kareen Malone
CHAPTER TWELVE
Lost objects: repetition in Kierkegaard, Lacan, and the clinic 163
Michael Miller
CONTENTS ix
CHAPTER THIRTEEN
Bulimia, anxiety, and the demand of the Other 177
Maria-Cristina Aguirre
CHAPTER FOURTEEN
Response: Bulimia, anxiety, and the demand of the Other 187
Maria J. Lopez
CHAPTER FIFTEEN
Addictions, sexual identity, and our times 189
Liliana Kruszel
CHAPTER SIXTEEN
Speech, language, and savoir in the Lacanian clinic of addiction 195
Christopher Meyer
CHAPTER SEVENTEEN
Response to Christopher Meyer 207
Kareen Malone
AFTERWORD
The contribution of addictions to the ethics of psychoanalysis 211
Thomas Svolos
INDEX 214
ACKNOWL EDGEMENTS
The editors would like to thank a number of persons who were of

great assistance in this project. First, we owe the genesis of this book
to an intimate and inspiring seventh annual Affiliated Psychoanalytic
Workgroups conference held at Emory University and mostly at
the University of West Georgia during spring 2006. We thank all
participants and the many, many West Georgia graduate students who
worked tirelessly to help put the conference together. We also thank
Elizabeth Rogers for arduous labours in putting this text through
its final paces and getting it in proper form. Her careful knowledge
of Lacan and clinical orientation were also of inestimable value. Jon
Skalski lent invaluable assistance in the final stretch. Robert Reid came
to the rescue for some last minute formatting difficulties. Lucy Shirley,
Kate Pearce, and Oliver Rathbone at Karnac showed kind patience
as we pulled the final threads together. And of course, merci to the
contributors!
xi
ABOUT THE EDITORS AND CONTRIBUTORS
Maria-Cristina Aguirre, Ph.D., is a Lacanian psychoanalyst and

psychologist. She is analyst member of the School (AME) of the
Nueva Escuela de Psicoanalisis (NEL), member of the New Lacanian
School (NLS) and member of the World Association of Psychoanalysis
(WAP). She is editor of the Lacanian Compass, online psychoanalytical
journal, and coordinator of the New York Freud Lacan Analytic Group
(NYFLAG). She is senior psychologist at Elmhurst Hospital Center,
Queens, NY. She practises in New York City.
Bruce Fink is a practising Lacanian psychoanalyst, analytic supervi-
sor, and professor of psychology at Duquesne University in Pittsburgh,
Pennsylvania. He trained as a psychoanalyst in France for seven years
with, and is now a member of, the psychoanalytic institute Lacan cre-
ated shortly before his death, the cole de la Cause Freudienne in Paris,
and is also an affiliated member of the Pittsburgh Psychoanalytic Soci-
ety and Institute. He is the author of four books on Lacan, a translator
of Lacans work into English, and has written a novel whose main char-
acter is loosely based on Lacan.
Alexine Fleck completed her Ph.D. in English at the University
of Pennsylvania, where she focused on harm reduction, memoir,
xiii
xiv A B O U T T H E E D I TO R S A N D C O N T R I B U TO R S
ethnography, and drug addiction. While completing her Ph.D., she

worked as a street-based ethnographer and educator in communities at
high risk for HIV infection through drug use and sex work. She teaches
at the Community College of Philadelphia.
Rolf Flor is a psychoanalyst in private practice. He is a member of the
Reading Group of the Boston Psychoanalytic Circle in Cambridge; the
clinical director for the Eliot Community Human Services in Lynn; and
an associate of the Simmons College School for Social Work in Boston,
Massachusetts.
Patricia Gherovici, Ph.D., is a psychoanalyst. She is a supervising ana-
lyst at Aprs-Coup New York and director of the Philadelphia Lacan
Seminar. She is the author several books, including The Puerto Rican
Syndrome (Other Press: 2003), winner of the Gradiva Award and the
Boyer Prize.
Yael Goldman Baldwin is a psychologist and the chair and associ-
ate professor of psychology at Mars Hill College in Asheville, North
Carolina. She obtained her M.A. at the University of Chicago and her
Ph.D. in clinical psychology at Duquesne University. She is a member
of the Associated Psychoanalytic Workgroups. Her publications have
appeared in the Lacanian Compass, the International Lacanian Review,
Methods: A Journal for Human Science, and Theory and Psychology.
Shannon Kelly is a psychotherapist practising in community mental
health in Georgia. She has published articles in the areas of Lacanian
psychoanalysis, clinical ethics, and gender studies.
Gustavo Klurfan is a psychoanalyst with practices in Philadelphia and
Bristol, Pennsylvania. He is a former clinical supervisor and director of
outpatient services at nonprofit organizations coordinating psychiatric
and drug and alcohol programmes. He is a member of Aprs-Coup Psy-
choanalytic Association and the Philadelphia Lacan Study Group.
Liliana Kruszel is a psychoanalyst in South Florida. She is a member of
the World Association of Psychoanalysis. Member of Nel Miami, docent
and board member of the Florida Institute for Research and Develop-
ment of Psychoanalysis in South Florida.
Cristina Laurita received a Ph.D. in Clinical Psychology from Duquesne
University. Her paper in this collection stems from her larger project
on Lacan and addictions, entitled Working with the Drive: A Lacanian
A B O U T T H E E D I TO R S A N D C O N T R I B U TO R S xv
Psychoanalytic Approach to the Treatment of Addictions. She maintains

a private practice in Philadelphia, PA, and Princeton, NJ, where she
works from within a Lacanian orientation. She is currently also a Fel-
low of the Psychoanalytic Center of Philadelphia.
Rik Loose is a psychoanalyst and clinical psychologist who is former
head of psychoanalysis (and currently a senior lecturer) in DBS School
of Arts in Dublin and who also teaches on the Masters in Psychody-
namic Psychotherapy Programme run by University College Dublin in
association with St. Vincents Hospital. He is a founding member of the
Irish Circle of the Lacanian Orientation of the New Lacanian School
(ICLO-NLS) and he is a member of the Association of Psychoanalysis
and Psychotherapy in Ireland (APPI).
Maria J. Lopez is a clinical psychologist. She is an associate of Nueva
Escuela Lacaniana and the World Association of Psychoanalysis. She is
in private practice in Miami, Florida.
Kareen Malone is a member of Aprs-Coup in New York City. She is
professor of psychology at the University of West Georgia and direc-
tor of the Doctoral Program. A fellow of the American Psychological
Association, Professor Malone has co-edited two volumes on Lacanian
Psychoanalysis. She trained with Groupe Interdisciplinaire Freudienne
pour Recherches et dInterventions Clinique et Culturelles. She is co-
author of a book, author of numerous articles on Lacanian psychoa-
nalysis and critical psychology. She is 2010 President of Division 24 of
the American Psychological Association.
Christopher Meyer, Ph.D., is a psychoanalyst and clinical psycholo-
gist in private practice in Los Angeles, California. He is a member of
GIFRIC (Groupe Interdisciplinaire Freudienne pour Recherches et
dInterventions Clinique et Culturelles), a clinician-analyst member of
the Freudian School of Qubec, and clinical co-director of the Southern
California Section of the California Psychoanalytic Circle of the Freud-
ian School of Qubec. He has published articles in The American Journal
of Semiotics, the journal Savoir, Psychanalyse et analyse culturelle, in Corre-
spondences: Courrier de lcole freudienne du Qubec, and in (a): the Journal
of Culture and the Unconscious.
Michael Miller is a clinical psychologist at Upstate Medical University
in Syracuse, New York, and is an adjunct professor in the department of
psychology at Syracuse University.
xvi A B O U T T H E E D I TO R S A N D C O N T R I B U TO R S
Fabin Naparstek is an adjunct professor at the University of Buenos

Aires in the psychology department. He is the coordinator for the pro-
fessional practice and clinical investigation group at the University.
He is co-director of the Toxic Manias and Alcoholism Center at the
Central Institute for Investigation at the Buenos Aires Clinic. He was
a member of the Freudian Institute as well as the Lacanian Orienta-
tion School from 20022005. He was a member of the Action Committee
at The School of World Association in Psychoanalysis from 20042006.
He is the author of numerous works on Lacan and addictions.
Thomas Svolos is a psychoanalyst and psychiatrist. He is a member of
the New Lacanian School and the World Association of Psychoanalysis.
He is adjunct professor of psychiatry and director of the division of psy-
choanalysis at the Creighton University School of Medicine in Omaha,
Nebraska.
INTRODUCTION
Viewing addictions through

Lacanian lenses
Kareen Malone and Yael Goldman Baldwin
In 2006, Lacanians from North America, South America, and Europe,

gathered in Georgia, at the University of West Georgia and at Emory
University for the seventh annual conference of the Affiliated Psycho-
analytic Workgroups (APW) which was devoted to the topic of addic-
tions as approached from a Lacanian psychoanalytic orientation. The
conference participants explored the complexity of the problem of
addictions for the individual, for society, for clinicians, and for treat-
ment, particularly as theorized and practiced by those who adhere to
the teachings of Jacques Lacan. Discussions were heavily, although not
exclusively, focused on clinical implications and work. The following
chapters draw their inspiration from this intense yet convivial com-
munity of dialogue about addiction that marked the discussions and
presentations of the participants whose orientations spanned Lacanian
schools (and included some non-Lacanians).
Yet our text is more than a tribute to a particularly vibrant confer-
ence. It represents a collection of views on the question of addiction as
it plays out in a certain cultural context and as it represents a subjective
choice. In the current social climate where addiction is mostly treated
by variations of 12-step approaches and pharmaceutical countermeas-
ures, it is all too easy to lose sight of the dimensions of addiction that
xvii
xviii INTRODUCTION
render it not just a disease to be managed but rather a significant form

of human suffering and a subjective responsibility, both of which are
critical components of addiction treatment. Despite high dropout rates
for 12-step programmes and respectable but less than stellar results for
conventional therapies (psycho-educational, group, person-centred,
cognitive-behavioural), there remains little new theoretical blood or
clinical innovation in the North American addiction paradigm. More
and more, addiction treatment is turning away from psychologi-
cal theorization and towards psychopharmacological measuresfor
example, towards drugs that may help addicts stay off drugs. Without
substantive empirical validation, at this time, spirituality, behavioural
treatments, and pharmacological approaches remain the sometimes
strange bedfellows of choice to respond to the suffering of addicts
(see Flor, Chapter Three).
Outside of some important essays on addictions, for example those
found in Essential Papers on Addiction (Yalisove, 1997), psychoanalysis
has not fully claimed its potential contribution to clinical and theoreti-
cal work with addiction, an odd omission given how psychoanalysis
works so closely with the interface of the organic body and its psychic
symbolization (De Rick, 2002). The experiment in speech that defines
the approach and character of psychoanalysis aims to transform ones
relationship to bodily symptoms, self-destructive actions, or compulsive
pleasures. As such, psychoanalysis is certainly as relevant to addiction
as bio-chemical approaches which too often leave the human subject
in the background (un-theorized) or approaches that seem to carry a
strong quasi-religious group identification (like 12-step or mutual-aid
support groups). Certainly psychoanalysis can offer a viable alterna-
tive to these much touted but only sporadically successful approaches
within the current arsenal of therapies. As traced in Rik Looses (2002)
book on addiction and as discussed in a number of the collected chap-
ters here, Freuds very few remarks about treating addictions and his
ambivalence about their treatment may have obscured some psychoan-
alytic contributions that could be culled from his scattered remarks on
the subject. Thus the possibilities that psychoanalysis allows, clinically
and ethically, are often underestimated. The following chapters explore
and emphasize these possibilities fleshing out how psychoanalysis is a
viable means for addressing addictions.
If psychoanalysis seems an unlikely contributor to contempo-
rary interventions on addictions, the possible relevance of Lacanian
INTRODUCTION xix
psychoanalysis may seem, at first take, even more remote. Just as Freud
did not write extensively on addictions, Jacques Lacan is also known to
have made few remarks on the clinic of addiction. However, many who
adopt a Lacanian orientation have addressed addiction, both in terms
of the role of drugs as a commodity in the economy of late capitalism
and as a clinical question for Lacanian psychoanalysis. In this book,
as well as other works on addiction (Braunstein, 1992; Melman, 1999;
Naparstek, 2002; van den Hoven, 2002), we can see Lacanians draw-
ing upon Lacan and Freud, as well as upon clinical insights that have
come from their working with individuals with addictions. The authors
included in this book explore, clinically and conceptually, how addic-
tions emerge within a cultural context and function within subjective
structures and thus require a specific sort of clinical understanding and
represent particular sorts of clinical challenges. Many of the authors
simultaneously take up the question of how addictions connect to our
specific cultural times, discuss the character of our times, and connect
drug usage to the changing relationship to the Other, the Name-of-the-
Father, the phallus, sexuality, and the Law.
Themes and ideas from this text

I. Critique of current approaches: treating drugs with identification
or drugs, and the role of jouissance
But the clinician must be sure to continue to keep the patient speak-
ing rather than becoming yet another purveyor of words and
concepts which, becoming nothing other than the stuff of imaginary
identification, do no justice to the pathos of addiction . [I]t is pre-
cisely the capacity of the clinician to offer something other than the
efficient cures the patient can get from 12-step groups, daytime talk
shows, and medical-model jargon, that can make them effective.
(Michael Miller, Chapter Twelve; emphasis in original)
A number of authors included here have worked in mental health

clinics and private psychoanalytic practice and have dealt with addic-
tions among those who enter their practice. Although the chapters are
directed to positive formulations in the articulation of approaches to
addictions, Lacanians, much like other analytic schools, subscribe to a
xx INTRODUCTION
number of reservations about the nature of contemporary approaches to

addictions, which are typically mutual aid support groups with a spir-
itual or pharmacological overlay. Miller (Chapter Twelve) and Klurfan
(Chapter Nine) ask if such support groups can do more than reinforce
the idealizations and cross-identifications that erase particularity and
may even shut down an encounter with the conditions that delimit the
subject. Certainly it is true that identifying oneself first and foremost as
an addict is requisite to participating in most group treatments of addic-
tion. One potential consequence of this demand from the group is the
loss of an opportunity to speak uniquely of ones personal history and
the specificity that led to the choice of addiction. This specificity and
subjective responsibility is exchanged for group-sanctioned identifica-
tions and the security given by membership within an idealized group
that often literally reduces the subjects speech to a given prescribed
discourse. Rik Loose (Chapter One) remarks that such solidification of
identification in relationship to sense-making short-circuits precisely
the speaking that opens up possibilities for the addict.
Additionally we believe that the idealization of the group and the
shared addictive trait are not properly theorized. Psychoanalysis and
the authors of this book critically examine these types of social bonds
and interventions and offer alternatives.
From the perspective of this book, the clinical framework of
addiction is defined by speaking, jouissance, the place of the Other,
and of course the addicts drug of choice. If the clinical regimen
adds or includes the provision of drugs (substitute drugs or antago-
nist medications) as a main component in the treatment, then the
place of the Other and the subjects relation to the Other is changed
within the process of treatment. This radically modifies the clini-
cians position, especially because, from the Lacanian perspective,
the position of the Other as the locus of speech and the unconscious
is maintained by the clinician. We must remember what Lacanian
psychoanalysis attempts to offer to the suffering of an addict (Meyer,
Chapter Sixteen):
The Lacanian clinic of addiction offers the same wager as it does to

the clinic of perversion, psychosis, or neurosis for that matterthe
analysts desire-to-know offers a space for speech to the subject of
language, subjected as they are to the Others jouissance.
INTRODUCTION xxi
As Meyers passage suggests, and as is particularly evident with

addiction, another important dimension of the Lacanian clinic is how
the subject is subjected to jouissance. There is a question of the subjects
relation to enjoyment, for example, bodily enjoyment, the enjoyment of
the object/drug, and the Others position vis a vis this enjoyment. These
questions, which may be ignored by approaches that promote manage-
ment and abstinence above all else, are taken seriously theoretically and
clinically by our authors.
What is noted by Meyer and also by Laurent (1998) is that even the
provision of methadone is a position towards the Other. In other words,
methadone provides a link with the subject. They must go and pick it
up; the Other is holding (Meyer, Chapter Sixteen). Whether it is being
provided by the clinician or used compulsively by the addict, a drug
does not stand alone but functions within a symbolic matrix. Just as it
is potentially problematic to treat a drug addiction with drugs, it is also
problematic to reduce a subjects addiction and narrative to the effects
of their particular drug of preference.
Other psychoanalysts from a variety of perspectives observe, with
Freud, that drugs cannot be separated from their subjective effects.
Jacobs (1986) and Zinberg (1975) remark how the great heroin epi-
demic of Vietnam veterans never materialized despite the supposed
over-powering effects of the drug. Save for a deadly overdose, no drug
can completely erase or usurp in itself the symbolic coordinates that
define a human subject. Within the clinic, such coordinates include the
subjects logic of the transference, the materiality of the letters, and the
identifications that the analysis must help move to truth effects. Such
symbolic constraints emerge even as we may, as Glover (1932) notes
about addicts, be dealing with a fairly primitive relationship to the
Other and a similarly elemental strategy for responding to masochism
or jouissance. A clinical relationship is a social bond and social bonds
have structural effects that position the subjects relationship to speech
and to their object (see chapters in this volume by Loose [Chapter One],
Naparstek [Chapters Two and Six], Kruszel [Chapter Fifteen], and
Svolos [Chapter Five and Afterward]).
Consequently, it is a question whether one does no harm when one
treats a drug with a drug. By only treating drugs with drugs subjective
specificity may be occluded and the subjects problematic relationship
with jouissance may be exploited rather than examined. Thus, as noted
xxii INTRODUCTION
by Zinberg (1975), an addicts relationship to a clinic is consumed with

discussion of ones ideal dose and getting it through the bureaucracy
of clinical administration; if there is a better folie deux it is hard to
imagine. Clinical cases in our book show the same staging with respect
to clinic rules and the dose. The interactions over these may provide an
occasion for speech but still operate within the very terms of an unex-
amined addiction, which is counter to psychoanalysis (see the cases in
chapters by Flor [Chapter Three], Kelly and Malone [Chapter Eleven],
Klurfan [Chapter Nine], and Meyer [Chapter Sixteen]).
II. Culture, psychoanalysis, object a, and addiction

Drawing on the work of David Rappaport, Zinberg (1975) makes an
excellent case for the significance of social context in understanding
addiction. In this volume, Fabin Naparstek suggests that historically
when cultures change, subjective positions change, and some of these
changes are reflected in the different ways that drugs are used.
Many of our authors discuss how drug use is situated within cul-
tural practices. Their approach to cultural context is foundational in
that every culture is required to establish a relation to the word, impose
its law, and to regulate the subjects enjoyment. If nothing else, our sub-
mersion in culture has the effect of our being subjected to speech in
our interactions with others. Despite the intrusion of cultural demands
and their pivotal role in structuring subjectivity, enjoyment and desire
transgress social ideals and can never be reduced to the signifiers and
meanings provided by culture. What escapes the subject and the sym-
bolic Other is the object ato use the Lacanian lexicon. This object a
is correlate of the subject, the object cause of her desire. Irreducible, it
produces the succession of objects for the subject but is irreducible to
any given particular object. The subject herself (or himself) is initially
the object a of the Other as a cause of desire.
Thus as well as language, law, and limit, all cultures mediate the
subjects relation to objects of desire through sexuality, food, love,
and various drive objects that are created and mediated through fan-
tasy. In Western contemporary cultures, there is a growing demand
and acceptance for drugs as the object that fulfils the subjects desire.
As always such objects play a role in the subjects broader submersion
within a cultures symbolic system and history. Thus the rise of drugs
as legitimate objects to respond to desire, as representatives of object a,
INTRODUCTION xxiii
reflects a significant cultural shift and must be theorized and taken into
account when working with addictions.
Although certainly the case can be made that a psychoanalytic
approach to addiction need not explicitly explicate significant cultural
referents within a particular analysis or therapy, still, in the Lacanian
case, the logic of the subject must be found and located within Sym-
bolic matrixes due to the fact of our being creatures of speech. Liliana
Kruszels exposition (Chapter Fifteen) explores some of these issues
with respect to the changing functions of jouissance in our specific
culture. And Svolos chapter summarizes the place of the object a in
relationship to the new social hegemony of so-called postmodernism.
Svolos (Chapter Five) writes,
[Jacques-Alain] Miller asserts that, in fact, it is the object a that

represents the boussole, the compass, or point of orientation for
postmodern discourseimposing itself on the Subject, lifting inhi-
bitions, giving the matheme a, vector, then Subject.
Mapping the effects that cultural shifts have on the subject, particularly
the subjects relationship to object a, is familiar territory for Lacanians.
Indeed, coming to understand the subjects always particular rela-
tionship to object a is a keystone to Lacanian clinical work. Given the
theoretical and practical place of the object a, we can ask if Lacanian
psychoanalysis has not been ahead of the postmodern curve, espe-
cially in a social world where the object a, fantasy, and jouissance seem
to increasingly pervade aspects of the social link. If, as some of our
authors suggest, the social link may be operating differently in rela-
tionship to the Name-of-the-Father, the role of the object, and Symbolic
Law, then Lacanian analysts should not be in totally new territory as it
is the role of the lost object a and the admixture of speech and jouissance
that always already marked the trajectory of Lacanian analysis.
III. Addiction, the Other, and the social link

As indicated by our authors, addictions bring an alteration in the sub-
jects relationship to the Other that has symbolic and sexual effects.
Many of these chapters touch upon the ways in which drug addiction
removes the subject from the social link, separates the subject from the
Other (or changes the relation to the Other in some way), and leaves
xxiv INTRODUCTION
the subject to their own private jouissance and their own solutions
(should they not choose the imaginary solutions provided socially) (see
Chapters by Loose [Chapter One], Meyer [Chapter Sixteen], Klurfan
[Chapter Nine], and Naparstek [Chapters Two and Six]).
In an article by Nestor Braunstein (1996), and as remarked by a number
of our authors, there is a strong assertion that the addicts experiment
in jouissance withdraws them from the phallic order, a withdrawal with
symbolic/subjective and sexual consequences. A persons involve-
ment with drugs often transforms their sexual life (see Naparstek, 2002;
Kruszel Chapter Fifteen, this volume; Laurita Chapter Ten, this volume;
Loose, 2002) either through a sort of narcotic enhancement that viti-
ates the alterity in the sexual encounter or through a loss of interest in
sex itself (see chapter by Flor [Chapter Three]). Charles Melman (1999)
observes that the a is no longer sought in the Other but rather is pur-
chased or prescribed as if it could be found in a drug/object. There
are a number of dimensions to the addicts aversion to the constraints
of the social link. Meyer (Chapter Sixteen) argues that drug use is an
attempt to circumvent a certain encounter with the Other. In Meyers
words (Chapter Sixteen), the encounter to be avoided is the following
dynamic: The advent of the Other introduces the speaking being into
the dimension of timethe time of expectation and anticipation, and
the possibility that the Other can refuse or abuse the subjects request/
demand. But the address to the Other concerns a temporality that is
beyond the subjects calculation. Put more starkly, either on a sexual
or symbolic register, De Rick (2002) notes that the addict does not need
the Other anymore; they have secured an object and thus a relationship
to the Other that is associated with an ideal dose producing predictable
effects on jouissance (or so the addict aspires).
Other psychoanalytic approaches have examined the effects of the
break with the social link as it relates to reality testing and cognition.
Both Sndor Rad (1933) and Zinberg (1975), coming from rather dif-
ferent psychoanalytic traditions, detect that the addict has poor reality
testing, which indicates that certain aspects of social life and its req-
uisite renunciations have been traded for the pleasures (so to speak) of
the drug. Wurmser (1974) makes note of other secondary effects of this
compromised relation to the social link. He suggests that problems in
logical and cognitive formulations sometimes noticed in addicts may
be attributed not to neurological factors or to the drug itself but to some
failure in communications with others.
INTRODUCTION xxv
While we can see some similarities between various psychoanalytic

approachesLacanian, Kleinian, and Ego psychologicalin the assess-
ment of the addicts relationship to the social link, we must be careful
not to too easily conflate these earlier psychoanalytic formulations of
the social link, for example, theories about reality testing and normative
cognition, with Lacanian ideas about how the addict breaks with the
social link. We can begin clarifying the Lacanian difference by looking
at the similarities and differences between Freud and Lacan. Indeed, as
Svolos argues, it is here that we might articulate a distinction between
what Freud and Lacan say about addictions (see Svolos, Chapter Five).
Svolos states:
With Freud, addictions are a means of maintaining a relationship

with the Phallusin this masturbatory sense, without the connec-
tion to the Other, a short circuit to jouissance; for Lacan, addictions
are a way of obtaining jouissance, but, instead of obtaining this
through the Phallus, he speaks of obtaining it by breaking a con-
nection with the Phallus.
Many of our authors discuss this breakage in terms of the phallic order
and how the addict avoids confronting the desire of the Other.
When Lacanians refer to the Phallic order, they are referring to the
profound effects of castration and lack on the subject. The Lacanian
notion of castration and the desire of the Other is tied to the subjects
assumption of lack; it is a matter of separation, to use the formulation
that is articulated in Lacans Seminar XI and is illustrated by the cases
in this volume by both Aguirre and Gherovici. Once a person enters the
symbolic world, a world of symbols, they incur a loss, a lack in being.
This loss exists in tandem with a lack in the Other (which in turn is cov-
ered over by drugs, ideologies, the dramas of everyday life, scientific
knowledge, etc.). However the lack inherent to the subject and the Other
is not the same as a failure in reality testing. What the Lacanian subject
must get adjusted to is a loss, not norms. Although both involve the
social link, the subjects response to lack is a different clinical param-
eter than the subjects ability to engage in reality testing. Although both
formulations may touch upon a certain strategy seen in addictions, the
assumption of a lack in being marked by the Others discourse, which
is assumed at the cost and embrace of ones own singularity, is very dif-
ferent from restoring reality testing and strengthening ego functioning.
xxvi INTRODUCTION
Likewise, moving towards appropriate behaviours and cognition is a

very different goal than the emancipatory aim of the clinic as we believe
it is articulated in the Lacanian paradigm.
On this note, one must also recognize that articulating the subjects
connection with the phallic order is not the same as aiming to restore
genital sexuality (which is seen by Glover [1932] to be problematic
for addicts). Our authors use the Lacanian concept of the phallus to
understand the subject of addiction. Lacanians are interested in how
the phallic masquerade works and how addiction may circumvent
this masquerade. A relationship with the Other is sustained through
a phallic masquerade where the phallus as a mark of the effects of sig-
nification infuses the sexual life of the subject (through a lacking that
mediates our relationship to the Other) and indicates the subjects bod-
ily re-configuration through the work of signifiers. In Lacanian analy-
sis, one comes to understand how the particular sexuality of a given
subject operates within the logic of the speaking being and how this
process may be compromised by addiction; this again is different from
attempting to help the analysand to realize genital sexuality and/or to
give up their regressive attachment to the drug. The Lacanian approach
revolves more around lack and difference.
Nonetheless, as all of the chapters, and perhaps most explicitly those
by Loose (Chapter One), Svolos (Chapter Five and Afterward), and
Naparstek (Chapters Two and Six) remind us, we should not assume
that addiction has a singular and predictable form with a prescribed
location for the Name-of-the-Father, the object a, or the phallus. We
must always also speak about specificity.
IV: Other clinical implications: diagnosis, from jouissance to speech

Unlike the diagnostic system laid out by the American Psychiatric
Association in The Diagnostic and Statistical Manual of Mental Disorders,
within the Lacanian frame, addiction works within current diagnos-
tic structures. In other words, it does not constitute its own diagnostic
category. A person is neurotic, psychotic, and one may also suffer an
addiction. Indeed, it is of foremost importance to a Lacanian clinician to
establish which psychic structure they are working with, for a clinician
would treat an addiction differently depending upon the underlying
psychic structure (see Naparstek [Chapters Two and Six] and Klurfan
INTRODUCTION xxvii
[Chapter Nine]). Our authors outline what is presupposed and entailed

by these differences.
Furthermore, regarding diagnosis, Rik Looses lead off chapter also
explicitly discusses the question of dual diagnosis quite extensively and
other chapters touch upon other aspects of this question of diagnosis.
The question of how addiction affects diagnosis, whether referring to
the categories of psychoanalysis or to traditional psychiatry, is vexing.
Other clinical concerns centre on the role of speech and jouissance.
With addicts we seem to lose a dimension of speech and we see that
jouissance effects accumulate. Perhaps this is why those authors in
this book (Gherovici [Chapter Seven] and Aguirre [Chapter Thirteen])
who examine the suffering of an anorexic or bulimic see a link with
addiction; in both the body seems to secure the debt that is owed the
Other. These authors imply that addiction and eating disorders may
force psychoanalysis into thinking differently about the logic of the
signifying chain and unconscious formations (see Chapters by Aguirre
[Chapter Thirteen], Gherovici [Chapter Seven], Loose [Chapter One]
and Svolos [Chapter Five and Afterward]).
The question of the subject, as concatenated in the unconscious sig-
nifying chain, and the subjective strategy in response to the jouissance
effects of the death drive, are what are treated by speech within psy-
choanalysis. It is the signifying logic that has defined the Lacanian diag-
nostic and psychoanalytic processes.
The addiction of course affects the relationship between the analy-
sand and the analyst. In the clinic, the clinician as Other is often affected
by the patients addiction. Addicts may proffer less subjectively reso-
nant speech within the analytic encounter; thus, as certain of our authors
suggest, with addiction the clinic may work within a different relation-
ship to speech (see Chapters by Gherovici [Chapter Seven], Kelly and
Malone [Chapter Eleven], and Loose [Chapter One]). The emergence of
signifiers and the unconscious knowledge through which they impli-
cate the subject may be a more difficult task and may tax the interpre-
tative process (see Chapter Five, Svolos). Perhaps this is because the
addict is more saturated with jouissance.
The jouissance effect of any drug, sanctioned or illegally trafficked,
is frequently described in the following chapters. For example, Loose
takes pains to discuss the subject-specific-effect of drugs. Regardless,
you cant diagnose by drug. These chapters testify to the pre-eminence
xxviii INTRODUCTION
of subjective structure over the jouissance effects, registered in the body.

The chapters make clear that it is not a bodily physiological weaning at
stake, but an effort to give the subject an opportunity to speak well (bien
dire). From speaking they may choose to relinquish the doomed project
of salvaging their jouissance through toxic substances and bodily sensa-
tions. The analyst is guided by their knowledge that the drug object is
not what it appears, despite its alluring effects. Laurent writes:
The first thing that drug addiction teaches psychoanalysis is that

the object is a semblance, not a substance. It is precisely in drug
addiction that we can find the most strongly sustained effort to
incarnate the object of jouissance in an object of the world. It is
precisely here that it may be verified that the object is semblance,
and that on the horizon, the true object of jouissanceif that word
means anythingis death.
(Laurent, 1998, p. 138)
Chapter summaries
Rik Looses inaugural chapter draws our attention to the importance of
the particularity of the subject and the particularity of the drugs effect
upon the subject, which he calls administration. He states: It is my
contention that addicts are not addicted to drugs, but are addicted to an
effect they get out of drugs: a subject-specific-effect. This is an effect that
non-addicts do not get out of drugs. I have attempted to find a mecha-
nism that can contribute to helping to understand how symptoms and
drugs affect people differently. I call this mechanism administration.
He describes how addiction can be understood as a subjects choice
for jouissance. He moves his exploration from a subjects relationship
to a drug, to a subjects relationship to the Other, stating that addiction
determines the social bond with other people, to the subjects rela-
tionship with society, about which he states that:
more and more we are being dominated by an enjoyment-and-con-

sumption culture in which we should be feeling satisfied (after all
havent all conditions for satisfaction been satisfied?) but in which
the not-feeling-so-good becomes increasingly unbearable . This
is the kind of culture that becomes less demanding of its subjects in
INTRODUCTION xxix
terms of making them responsible for finding subjective solutions

to suffering in ways that are radically singular. These singular solu-
tions are the kinds of solutions that need to be discovered by the
subject through being confrontedand coming to termswith the
problems of life . What happens now is the opposite: culture
increasingly forces external solutions onto the subject.
Loose also takes up the question of dual-diagnosis, stating, from a psy-

choanalytic point of view, there is no addiction without dual diagnosis
because addiction will always have to be situated within a neurotic,
psychotic, or perverse structure, and he differentiates the role of drugs
within psychotic vs. neurotic structure, stating:
In neurosis and perversion the administration in addiction is a

matter of the supplying or dispensing of an extra jouissance: an
attempt to suspend the limits that reality or language puts on
pleasure. In psychosis the administration with the effects of drugs
and alcohol concerns the management or mastery of an unbearable
jouissance and it functions as a substitute for language precisely
because language cannot function properly for the subject with a
psychotic structure.
Klurfan (Chapter Nine) also offers an extensive theorization on the role

of drugs within the neurotic vs. the psychotic structure. In addition
to this diagnostic structural distinction, Loose also situates addiction
in regards to actual neurosis. Finally, throughout his argument Loose
explores addiction via economic terms and ends his essay with an expo-
sition on how Joyce may shed light on our understanding of what Loose
calls administration.
Fabian Naparsteks framing essay (Chapter Two) follows drug use
and drug-dependence, which he calls toxicomania, throughout his-
tory and across various cultures. Naparstek locates three historical peri-
ods in particular and focuses on Western society from Freuds time to
our own. Naparstek describes how the role of drugs, particularly as
they relate to partying, has changed with the vicissitudes in culture.
He discusses the partying subject as they are connected to culture and a
group mentality, particularly in relation to guilt and to what is happen-
ing with object a. He argues that in our culture at the moment, object a
is replacing the signifier (the Name-of-the-Father in particular). He also
xxx INTRODUCTION
maps the subjects changing relationship to jouissance and consumption,

particularly consumption as our access to jouissance. Within his analy-
sis he follows the changing role of object a within this dynamic, all the
while exploring the impact on sexuality, including the role and effects
of drugs such as Viagra. Like Loose, Naparstek demands a specificity,
particularly when discussing the relationship between consumption,
the specific form of toxicomania, and neurosis vs. psychosis. He articu-
lates, for example, that in psychosis, drugs do not have a breaking
function but a tying one. Thus the difference in direction of treatment
for psychotics and neurotics must be carefully examined.
Like Naparstek, Liliana Kruszel (Chapter Fourteen) also relates
addictions to our changing times, particularly to the discourse of cap-
italism and to sexual identity. Her essay also brings our attention to
cultural specificity. She uses the Broadway musical and film Rent as
a window into our culture, particularly as to how the subject is posi-
tioned symbolically in these times.
Alexine Fleck (Chapter Eight) switches the camera angle on addic-
tion with her close reading of an anthropological/ethnographic text.
Revisiting an incident from an ethnographic study of addiction, Fleck
asks how the researcher is implicated in the child prostitution that is
consequent to a crack addiction. Clearly, as residing in the position of
the gaze, the scene described by the ethnographer is deeply entwined
with its witness, and the jouissance implicated resides at the heart of
the subjective calculations that mark the sexual and drug exchanges
observed by the ethnographer.
As a great number of our authors are clinicians in addition to theo-
reticians, many presented clinical case material to back up their points.
For example, Maria-Cristina Aguirre (Chapter Thirteen) uses clinical
vignettes to explore the connection between the symptoms of bulimia,
anxiety, and the question of speech and feminine jouissance. Maria
Lopez (Chapter Fourteen) offers an artistic turn of interpretation as she
comments upon Aguirres paper. Patricia Gherovicis (Chapter Seven)
case study also offers a sophisticated look at the connection between
bulimia and addiction. Cristina Laurita (Chapter Ten) presents a case of
a subject with an obsessional neurotic structure with features of perver-
sion that traces the role of the drive in addiction. The case focuses on
the connection between the subjects familial history, particularly his
relationships to his mother and father as they relate to his drug use.
INTRODUCTION xxxi
In addition to outlining Freuds and Lacans positions on addictions,

and illustrated by clinical vignettes, Thomas Svolos (Chapter Five)
situates addictions in relation to the New Symptoms, especially in
terms of the variegated functions of addictions within a cultural and
subjective logic. Despite the confluence between the New Symptoms
and contemporary cultural configurations in the West, Svolos reminds
us that we must still approach each patient in their singularity. He does,
however, note, like Loose, an evolving articulation of new modalities of
clinical interventions, including splicing and nomination, based on the
logic of a talking cure but aimed towards different elements.
Taking both a philosophical yet distinctly clinical turn, Michael
Miller (Chapter Twelve) critiques the medical-disease model that is so
prevalent in our current theory and treatment of addictions. He out-
lines the costs associated with this behavioural approach. He locates
Lacan alongside Freud and Kierkegaard as helpful places to turn for a
psychoanalytic option. In situating addiction in human nature, Miller
states, we might call addiction a Neurotic-Existential Given. Miller
uses the example of Kierkegaards Repetition to illustrate his points (the
addict in this story is addicted to a woman, or rather to a particular feel-
ing of coming down that he gets from his complex interactions with
her) and to bring Kierkegaard and Lacan into dialogue. He uses Kierke-
gaards story to explore the existential, Oedipal, and phallic natures of
addiction and ultimately to explain his notion that addicts are addicted
to redemption, which Miller relates to the potential success of 12-step
programmes and the Alcoholics Anonymous (AA) culture. He ends his
article with a plea for why psychoanalysis may offer something differ-
ent to the addictnot least of all, a place to speak.
The Lacanian perspective always pays attention to speech. Rolf
Flors (Chapter Three) case study shows a remarkable condensation
of a subjective impasse with the materiality of the signifier, the role
of a nose (nos and knows) in the subjective history and symptoms of
a client whose addiction remained hidden from Flor for some time.
The Lacanian analyst and author Bruce Fink (Chapter Four) offers his
astute commentary on Flors case. A number of authorssee chapters
by Loose (Chapter One), Klurfan (Chapter Nine), and Meyer (Chapter
Sixteen), as well as work by Braunstein (1996), Melman (1999), and van
den Hoven (2002)point out the term a-diction1, and how a-diction
negates the linguistic act. (Klurfan also adds that addiction points to
xxxii INTRODUCTION
an addition of jouissance.) Kelly and Malone (Chapter Eleven) argue

that addiction in particular calls us to use the later Lacanwhere
theoretically the move is from an emphasis on the role of the symbolic
to that of the real, and from the subjects relationship to language to the
subjects relationship to jouissance. However, this does not necessarily
imply that addiction erases the subjects relationship to speech. From
the clinical case discussed by Kelly, the authors note that, it has been
my experience that my patients are not dealing with a-diction, or with
an attempt to bypass speech, but instead, as this case illustrates, with
ad-diction as an attempt towards speech. Even the drug itself holds
open a placea choice over the worst. Kelly and Malones theoretical
exploration is tied down to the specifics of the case history as they trace
how a specific incident happens in the therapy that moves the real into
the symbolic; indeed, the authors remark on a writing that occurs in
the therapy that serves to symbolize a trauma and create a social link.
This should again remind us, as noted by Naparstek, Svolos, and many
others, that addiction is not a simple strategy and cannot be reduced
simply to a shortcut to jouissance.
In trying to think about what addiction can demonstrate to clinicians,
Gherovici (Chapter Sevevn) discusses the holophrase and how her
bulimic analysand moved from maintaining the Other through a sacri-
fice of her own body to a less destructive relationship to the limit of the
Other and castration. Regarding this, Gherovici runs through the logic
of the signifying process in the creation of the subject and addresses
how we can see the function of addiction (here being bulimic is seen in
terms of addiction):
If we assume that these two steps are necessary in subjective

constitution, we could argue that it is possible to find analysands
who have undergone the first step (alienation) which implies a
refusal of jouissance but who cannot draw from castration another
jouissance (separation). In my clinical experience with people like
Linda, one is led to believe that these analysands seem to have
assumed subjective castration but have yet to attain the type of
jouissance one reaches by way of what Lacan calls the inverted
scale of the Law of desire (Lacan, 2006, p. 324). At times the fail-
ure of this second stage of subjective constitution has devastating
consequences: bulimia can be one example of the painful return of
a deadly jouissance that needs to be refused.
INTRODUCTION xxxiii
Our book finishes with a brief afterward by Thomas Svolos that, upon
further pondering the events at the conference, takes up the question of
ethics in the practice of psychoanalysis and how this ethic is inherently
tied to the work of speech. Indeed, not losing the role of speech, and the
specificity of speech within psychoanalytic encounters, surfaced time
and again in the speech of our conference participants and in the chap-
ters they have prepared for this book.
For those interested in the topic of addictions, those interested in
Lacanian psychoanalysis, and of course, those interested in how the
two intersect, we invite you to peruse a now text artifact of our confer-
ence and what were many interesting deliberations, speech acts, and
conversations.
Endnote
1. A-diction is a term that was introduced by N. Braunstein. (1992). La
Jouissance: Un Concept Lacanien. Paris: Point Hors Ligne. p. 257. One can
also consult Braunstein (1996).
References
American Psychiatric Association. (2000). Diagnostic and Statistical Manual
of Mental Disorders (Revised 4th Ed.). Washington, DC: Author.
Braunstein, N. (1992). La Jouissance: Un Concept Lacanien. (Jouissance:
A Lacanian Concept.) Paris: Point Hors Ligne.
Braunstein, N. (1996). Drug A-diction. Journal of the Psychoanalysis of Culture
and Society, 1: 167170.
De Rick, A. (2002). Freuds differential categories of actual neurosis and
psychoneuroses as a diagnostic tool in the field of addiction. Paper pre-
sented at Fifth Conference of the European Opiate Addiction Treatment
Association (EUROPAD), Oslo, Norway.
Glover, E. (1932). On the aetiology of drug addiction. In: D. S. Yalisove (Ed.),
Essential Papers on Addiction (pp. 2451). New York: New York University
Press, 1997.
Jacobs, D. F. (1986). A general theory of addictions: a new theoretical model.
In: D. S. Yalisove (Ed.), Essential Papers on Addiction (pp. 166183). New
York: New York University Press, 1997.
Lacan, J. (2006). Response to Jean Hyppolites commentary on Freuds
Vernienung, 1956. In: crits: The First Complete Edition in English
(pp. 318333). Trans. B. Fink in collaboration with H. Fink and R. Grigg.
New York: W. W. Norton.
xxxiv INTRODUCTION
Laurent, E. (1998). From saying to doing in the clinic of drug addiction and
alcoholism. Almanac of Psychoanalysis, 1: 129140.
Loose, R. (2002). The Subject of Addiction. London: Karnac.
Melman, C. (1999). Addiction. The Letter, 16: 18.
Naparstek, F. (2002) Toxicomania of yesterday and today. Psychoanalytical
Notebooks, 9: 151162.
Rad, S. (1933). The psychoanalysis of pharmacothymia. In: D. S. Yalisove
(Ed.), Essential Papers on Addiction (pp. 5271). New York: New York
University Press, 1997.
van den Hoven, G. (2002). Toxicomania in context. Psychoanalytical Notebook,
9: 163170.
Wurmser, L. (1974). Psychoanalytic considerations of the etiology of com-
pulsive drug use. In: D. S. Yalisove (Ed.), Essential Papers on Addiction
(pp. 87108). New York: New York University Press, 1997.
Yalisove, D. (Ed.). (1997). Essential Papers on Addiction. New York: New York
University Press.
Zinberg, N. E. (1975). Addiction and ego function. In: D. S. Yalisove (Ed.),
Essential Papers on Addiction (pp. 147165). New York: New York Univer-
sity Press, 1997.
CHAPTER ONE
Modern symptoms and their effects

as forms of administration: a challenge
to the concept of dual diagnosis
and to treatment
Rik Loose
Introduction
Considered from a psychoanalytic point of view there is no such thing
as an expertise in addiction, but to pay special attention to addiction is
important, because it is arguably a paradigmatic expression of the suf-
fering of the modern subject and, moreover, it is a crucial problem for
psychoanalysis.
It is important to investigate the effect of the symptom and dual
diagnosis from within a psychoanalytic framework for at least the fol-
lowing four reasons:
1. Freuds confrontation with the effect of the symptom is what pushed

him into the direction of psychoanalysis, which he developed, fail-
ing to incorporate that effect to some extent. Freud in his very early
work on cocaine made a very interesting discovery: he realized that
cocaine does not affect everyone in the same way (Freud, 1885).
There appears to be a variable within the subject which determines
what the effect of drugs will be on someone, something which in turn
implies that Freud began to locate the cause of any problems with
drugs within the subject. In fact, the discovery made him decide that
1
2 L A CA N A N D A D D I C T I O N
cocaine was not going to be a useful pharmacological instrument

and instead he became interested in studying that variable within
the subject, that is, he became interested in the constitution of the
human psyche.
2. Dual diagnosis was Freuds starting point regarding addiction.
Freuds first diagnostic distinction was between the psychoneuroses
(the neuro-psychoses of defence as he called them at the time) and the
actual neuroses. He connected the actual neuroses to addiction and
subsequently excluded both from his clinic, because he felt that both
actual neurosis and addiction do not manifest analysable symptoms.
One of the implications of this surely must be that psychoanalysis
has a crucial problem.
3. Dual diagnosis is a major concern at the moment for psychiatry,
psychopathology, and addiction research. The question here is what
contribution psychoanalysis can make.
4. As we will see, approaching dual diagnosis from a psychoanalytic
perspective cannot evade the question of the effect of the symptom
or drug. This question goes right to the heart of the suffering of the
modern subject.
Psychoanalysis in modern times cannot afford not to question itself

regarding its theory and technique because it is a well-known fact that
the various addictions are an increasing problem worldwide, which in
itself is a strong indication that addiction is related to a changing culture
and thus to a change in the response of the human subject to their discon-
tent in civilization. This discontent, and indeed the subjects response to
it, has since Freud always been a concern for psychoanalysis.
Lacan does not refer much to addiction at all. However, at one
point in the 1960s he remarks that the legislators of medical practice
move medicine into the direction of jouissance (Lacan, 1966, p. 767).
He argues that addiction is following the path of medical science and
is becoming increasingly dependent on effects we have on the body.
Medical legislators, he continues, impose two duties: 1. a control-
led use of drugs; and 2. the medical use of jouissance. These remarks
have important implications. He implies that (psychiatric) medicine is
becoming increasingly dependent on the effects of drugs and that in
turn implies the possibility that an addictive use of drugs, which can
be a consequence of this medical dependency, is officially or medically
sanctioned and encouraged. It is indeed in this period that tranquilizers
M O D E R N S Y M P TO M S A N D T H E I R E F F E C T S A S F O R M S O F A D M I N I S T R AT I O N 3
and other drugs began to acquire a newly elevated status in our culture.
Therefore it should not surprise us that addiction would become such a
pervasive presence in our society a decade or two later.
Concerning the first duty, namely, that the people who determine
laws and policies regarding medical practice and research impose a
controlled use of drugs, we can say that we can now legitimately rely
on drugs as a solution outside ourselves to resolve most human trou-
bles and woes. And indeed, where jouissance and external solutions get
out of hand and become a painful experience, we have a solution at
hand that falls perfectly within the parameters of aforementioned med-
ical legislation: we have recourse to the kinds of drugs to control this
excess of which methadone is a perfect example. The use of methadone
is nothing more than a drug solution to a drug problem. Is this not the
same as trying to extinguish a fire with petrol?
Concerning the second duty, we can say that jouissance and pleasure
have indeed become a duty in our culture. We have to enjoy ourselves,
because we have at our disposal and in abundance all the products
(such as alcohol and drugs) and gadgets with which to do it. Of course,
some of these gadgets and products have existed for a long time. The
difference is that previously our enjoyment of them was to some extent
curtailed. Now we find ourselves in the opposite situation, which finds
its expression in the following credo: No one needs to be short of any-
thing unless you want to lose out. In other words, there is nothing that
sells more than the promise of total enjoyment and the fear of not being
part of that experience.
It can be argued that the push to find solutions outside oneself for
ones problems and discontents, as well as the duty of enjoyment in
recent times, fuel the addictification of our society. However, from a
psychoanalytic point of view, it is important to state that addiction can
never be clinically understood at a general level, that is to say, without
knowing how drugs affect people and indeed without knowing why
and how these effects relate to other forms of suffering.
In his research on cocaine, which Freud conducted from 1884 to 1887
and which resulted in a series of papers, he came to the conclusion that
cocaine has only an indirect effect on people. Freud (1885, p. 104) was
struck by two facts in his findings, namely, that cocaine has an optimum
effect when the condition of the subject is poor (depressed mood) and
that it has a diminished effect when the condition is cheerful and effi-
cient (good mood). This implies that certain psychic conditions such
as feeling well have the same effect as cocaine. As I wrote earlier, the
decisive factor regarding the effect of cocaine is something in the psyche
of the user. That means that, according to Freud, cocaine has an indirect
effect via a psychic variable and there is no direct effect on the body.
Already then he had come to the conclusion that the cause of addiction
is to be sought within the subjectpersons who already in the grip of
one demon are so weak in will power, so susceptible, that they would
misuse, and indeed have misused, any stimulant held out to them
(Freud, 1887, p. 173) and not in the drug. In other words, a variable in
the subject determines what the effect of drugs will be on someone.
There are obviously generic aspects to the effects of drugs, for exam-
ple, we all know that heroin, cocaine, hallucinogenics, cannabis, and
alcohol each have a particular set of effects. But to believe that all peo-
ple are affected in the same way by the same drug is a myth that is
sustained in order to justify (funded) research that stakes everything
onto the object (drug) in order to avoid the complexities of its relation-
ship to subjectivity (the subject). It is my contention that addicts are not
addicted to drugs, but are addicted to an effect they get out of drugs: a
subject-specific-effect. This is an effect that non-addicts do not get out
of drugs. I have attempted to find a mechanism that can contribute to
helping to understand how symptoms and drugs affect people differ-
ently. I call this mechanism administration. I will later explain why
I call it that and I will also explain how it can contribute to an under-
standing of addiction in relation to various forms of human suffering.
At the very end of the first lecture from The Seminar, Book XXI,
The Non-Dupes Err/The Names of the Father, Lacan says the following:
It is necessary to be a dupe, namely to stick to the structure (Lacan,
19731974, lecture from 13/11/73). Before that, he said in the same lec-
ture that the non-dupes are those that refuse to be captured by the space
of the speaking-being (Ibid.). There are of course several ways of being
non-duped. One of the ways is the way of the wayfarer. For those who
consider life to be no more than a journeywho consider the period
between birth and death to be nothing more than the way towards a
promised landstructure will not stick. This kind of life, Lacan sug-
gests, is that of the viator (Ibid.). Viator is a very interesting word in the
context of addiction. A viator is someone who travels; someone who
roams the lands. However, there is an old Latin meaning to the word
and that is that the viator is a civil servant of the court: someone who is
an administrator to the magistrate of the court, that is to say, someone
who is in the service of someone else. I will return to this within the
context of my argument that administration in modernity is less in the
service of the Other than it was previously.
In the same context, Lacan says that between birth and death we find
structure. However, that is of course only half the story: between life
and death we also encounter life in its vital aspect, namely in the form
of the jouissance of the living body. This jouissance of the living body
becomes, to a greater or lesser extent, entangled with structure during
life. The encounter between jouissance and structure will always imply
that the subject is duped in terms of jouissance. Another way of avoid-
ing being duped is by overriding the entanglement between jouissance
and the body via the toxic route of the body with drugs. In other words,
addicts err by not sticking to structure: they skid over it via the use of
drugs and alcohol, which turns them (as addicts) into slaves or admin-
istrators of jouissance.
I use the following formula for addiction: addiction is a choice for
jouissance that is administered independently of the structure that deter-
mines the social bond with other people. With this definition I am not
implying that the social bond with other people does not play a role in
the aetiology and experience of addiction. Rather what I want to empha-
size here is the fact that the effect that addicts pursue is something that
takes place to a large degree independently of the Other. Consider as a
counter-example sex and humour. These are also pleasure-producing
activities. For both you need respectively the Other as sexual partner
and the Other in the sense of language. The field of language and mean-
ing, as the basis for the social bond with other people, is indeed the field
without which humour would not be possible. Humour plays with
sense and non-sense and is therefore utterly dependent on language
and meaning. Even behavioural and practical jokes cant escape the fact
that they need the interaction between sense and non-sense and there-
fore the overall framework that determines this, namely, language.
However, there is jouissance that manages to bypass the Other.
Addicts predominantly produce non-phallic jouissance. In this context it
might be interesting to mention that Freud made a connection between
masturbation and addiction (Freud, 1985, p. 187). Freud argued that
masturbation is a shortcut between desire and satisfaction and that
as such it is something that allows the subject to bypass the external
world (Nunberg & Federn, 1962, pp. 239240). Thus both masturbation
and addiction can produce pleasure for the subject in a manner that is
independent of the Other. However, Freud was not entirely right when
he wrote to Fliess that masturbation is the prototype of all other addic-
tions. The masturbator, unlike the addict, is fondly engaged with his
phallus; he produces the kind of jouissance with it that is indeed phallic
in nature. Lacan referred to this as the jouissance of the idiot (Lacan,
1998, p. 81). The jouissance of addiction is not necessarily the jouissance
of the idiot or the masturbator. The masturbator is just hooked to his
organ and produces the limit to jouissance rhythmically with it all the
time, whilst the jouissance pursued by the addict will eventually spell
total disaster. That is why masturbation is not really a general problem,
unlike addiction.
Having said that Freud was not entirely right, we should add that
things have changed in recent times regarding our pursuits of pleasure
and comfort. Fabin Naparstek argues that in Freuds time drug use
is one answer among others to our Discontent in Civilization. In fact,
Naparstek recognizes three historical moments in the use of drug: in a
first period, drug use was not a pathology, or at least it was not consid-
ered to be a pathology as such; in a second period, a period that includes
Freuds time, drug use became a solution for dealing with discontent in
civilization and it was only considered to be one solution among many
others; whilst in the third period one can speak of a generalized toxico-
mania (Naparstek, 2002, p. 161).
In a certain sense, Freuds work anticipated this third time. In Jokes
and Their Relation to the Unconscious he implied a connection between
speech/language, addiction, and pleasure. He indicated that he prefers
jokes to a state of high spirits (Freud, 1905c, p. 127). High spirits is some-
thing that happens to the subject, whilst joking is an act that takes place
with or within the field of the Other (as we mentioned before). Joking
implies other people and takes place within the realm of language. It is
a form of diction. To keep things within the realm of language is cru-
cial for the ethics of psychoanalytic practice. Addiction is the opposite
from the linguistic act. It uses the toxic route of the body and it can pro-
vide pleasure much more effectively and instantaneously. This could
lead us to the conclusion that we should be worried and pessimistic
about the future of addiction. There are signs that the battle against
addiction is already lost. In fact from a psychoanalytic point of view
our only hope is to treat the addicted subjects one by one. However,
the extraordinary and immediate efficaciousness of drugs allow us
to understand that (at least) some addictions function as short-circuit
solutions. Hence, it wouldnt go too far to say that addiction implies

a problematic relationship to the social bond.
The social bond and identity

It is often said that society has a tendency to exclude or reject people
who are addicted, especially those with dual diagnosis problems. It
seems to me, however, that it would not be very fruitful to make society
entirely responsible for addiction and dual diagnosis problems. Addicts
also carry responsibility, precisely because they made a choice, and this
choice implies a decision at the level of the subject: the addicted sub-
ject decided to take a shortcut via the toxic route of the body and, as
such, avoid the less immediate, and thus less satisfactory, detour via
the social bond.
Therefore the creation and maintenance of a space of transference
(a subjectOther space) within society is absolutely essential, not
just because addiction is not on the wane but especially because we
are increasingly confronted with a culture in which the immediacy
of jouissance is forced on us. A dire consequence of this is that there is
increasingly less space for dissatisfaction, desire, and the social bond. In
other words, more and more we are being dominated by an enjoyment-
and-consumption culture in which we should be feeling satisfied (after
all havent all conditions for satisfaction been met?) but in which the
not-feeling-so-good becomes increasingly unbearable.
The philosopher Gilles Lipovetsky (2005) has produced an interesting
book on this topic, entitled Hypermodern Times. He writes that a second
modernity has come into being, a period characterized by deregulation
and globalization and one which essentially rests on three elements: the
market, technocratic efficiency, and the individual (Lipovetsky, 2005,
pp. 3132). It could indeed well be that this blind modernization and
technocratic commodity nihilism is a process that spins around and
around in a vacuum, without aim or meaning (Ibid., p. 34). If that is
the case we find here a cultural manifestation of the acephalous aspect
of the death-drive. Lipovetsky further argues that pleasure has been
turned into a dictatorship, but what really should worry us is the way in
which peoples personalities have become fragile (Ibid., p. 55). There is
a weakening of the regulative power of collective institutions (Ibid.).
We are in some sense witnessing the destabilization of an increasingly
volatile subject with the rising tide of psychosomatic symptoms,
depression, anxiety, suicide, eating disorders, panic attacks, addiction,

self-harm, a growing sense of inadequacy, and self-depreciation (Ibid.).
In some ways you could say that the previous system of defence
is breaking down, which means that the subject finds themselves
deprived of the social structures that endowed them with something
that enabled them to face up to lifes difficulties (Ibid., p. 56). Deregula-
tion is accompanied by mood swings and a growth in the number of
psychological disturbances (Ibid.). People are increasingly experiencing
subjective exhaustion. What people are looking for, above all, in con-
sumption is a feeling, an intense emotional pleasure, which is depend-
ent less on their status than on the very experience of the pleasure of
novelty (Ibid., pp. 8485).
Indeed, the more we suffer the discontent emanating from our right
to enjoy ourselves in todays culture, the more we begin to resolve this
discontent with symptoms that produce a pleasure or jouissance effect.
This is the kind of culture that becomes less demanding of its subjects
in terms of making them responsible for finding subjective solutions
to suffering in ways that are singular. These singular solutions are the
kinds of solutions that need to be discovered by the subject through
being confrontedand coming to termswith the problems of life.
What happens now is the opposite: culture increasingly forces external
solutions onto the subject. One of the consequences is that this subject
becomes more and more dependent on these external solutions and this
heralds the addictification of our society.
Lacan (1972, p. 48) indicated in a lecture that in the modern world
the discourse of capitalism has become dominant. Developments in sci-
ence and the market economy and the emergence of liberal democracy
have contributed to this movement. The law that unites people by pro-
hibiting, distributing, and regulating jouissance has been replaced by
the ideal of individual freedom; an ideal which is characterized by the
pursuit to acquire as much jouissance as one can and indeed by sell-
ing as much of it as is possible to others. In other words, the discourse
of capitalism superimposes itself on the discourse of the master. What
we should take notice ofand this will be elaborated on lateris that
there are different desires at stake in the two discourses: the discourse
of the master is an attempt that represents the desire for unification and
for the social bond, whilst the discourse of capitalism represents the
desire for individualism and thus to do without the social bond. That
is hugely important for understanding the function of addiction in our

modern culture.
Many drug-cultures are sub-cultures. These sub-cultures are not just
produced by the centrifugal role that drugs play in the lives of these
subjects but also by a need within these subjects that existed prior to
the onset of addiction. An identity is formed from the very beginning of
our existence via our confrontation (as subject) with the images, desires,
aspirations, and words of others (the Other). The causation of our suf-
fering and our psychopathology are determined byand functions
ofthis identity formation. Freud has made abundantly clear through-
out his work, and more specifically in Civilization and its Discontents,
that nobody can avoid suffering and indeed that nobody can acquire a
trouble-free identity (Freud, 1930a). On the basis of these remarks about
identity two consequences can be outlined. First, diagnosis and treat-
ment require a consideration of the transference relationship, because
if addiction is related to identity and (thus) to the subjectOther rela-
tionship, it makes sense to make the subjectOther relationship of the
transference the privileged aspect of therapy with addicts. Second, dual
diagnosis (co-morbidity) as a concept is problematic for clinical practice
in two specific ways. I will continue with an exploration of these two
specific ways of the second consequence below, however, it is impor-
tant to mention the first consequence, because the transference, as the
very vehicle for change, is often excluded from official addiction policy
and treatment.
The problem of dual diagnosis

Concerning co-morbidity, the authors of a study on dual diagnosis in
Ireland wrote that there is absolutely no consensus on what dual diag-
nosis is: it is addiction and another disorder (MacGabhann, et al., 2004).
There appears to be hardly any agreement on what dual diagnosis actu-
ally is, nor what it is meant to be doing. Regarding the problem of dual
diagnosis, the European Monitoring Centre for Drugs and Drug Addic-
tion wrote in their Annual Report: Existing research about the causal
relations between psychiatric and substance disorders is inconclusive.
The symptoms of mental disorder and addiction problems interact and
mutually influence each other (European Monitoring Centre for Drugs
and Drug Addiction, 2004, p. 94).
The problem referred to in this quote is sometimes described as the

chicken and egg discussion. The question of what came first is based
on a false premise and that is that all truth can be reduced to a general
cause-and-effect relationship. The implication of the application of a
simple cause-and-effect logic to the problem of dual diagnosis is that
certain pathologies would lead to certain addictions and vice versa. This
is a complete illusion because we do not encounter this in the clinic.
Avoiding here the very elaborate and complex epistemological dis-
cussion of the problem of causation within general psychopathology,
it can be clinically observed that there is no straightforward uniform
relationship between psychopathology and addiction in the sense, for
instance, that a specific pathology would be prone to cause specific
addictions and that a specific addiction would be prone to cause spe-
cific psychopathologies. This is not to exclude the fact that, no matter
what, addiction will always cause certain physical and mental prob-
lems, which in itself is an argument against the concept of dual diagno-
sis, because addiction will always have other injurious consequences.
It is a well-known fact that co-morbidity is very difficult to diagnose.
The reasons usually given for this are that the clinical picture of addic-
tion often hides the underlying psychopathology and that the symp-
toms of addiction and intoxication mimic certain psychiatric symptoms
which makes them in many cases indistinguishable from the latter. No
doubt this is true, but there is another element that makes the whole
area of dual diagnosis even more problematic and complex.
We can enter the complexity of this problem by asking the following
question: is the meeting between psychopathology and addiction within
the dual diagnosis patient purely accidental? A positive response to this
question would conveniently side-step what Freud discovered in his
work on cocaine and that is, as mentioned earlier, that drugs (and alco-
hol) are profoundly ambiguous in both their function forand their
effect onthe subject. Drugs can affect people differently and can affect
the same person differently at different times. De Quincey wrote in a
footnote to the Confessions of an English Opium Eater something simi-
lar to Freud more than half a century later: the varieties of effect pro-
duced by opium on different constitutions are infinite (De Quincey,
1821, p. 92). In other words, the suggestion is that the effect of drugs is
dependent on the constitution of the subject, which surely must include
their identity and indeed their body. The crucial question here is: how
do we know this is the case?
Before returning to this question it is important to be more specific

about the cause-and-effect relationship within addiction in order to
show that the accidental has no place in this area. It can hardly be
denied that the cause of addiction has something to do with the effects
of drugs on the subject. Without an effect someone would not become
addicted. This logically implies that addicts seek an effect, namely, the
kind of effect that hooks them to the drug: these are the effects that
they become dependent on. The cause of addiction is related to the
effects of drugs and these effects are specific to the addicted subject
in the sense that non-addicts would not get these effects out of drugs.
Again, addiction is caused by a specific effect that only addicts get out
of drugs.
The implication of this is complex in terms of understanding the
problem of the addiction to drugs, because there is neither just the
cause of the effect (the constitution of the subject) nor just the effect
of the cause (of addiction). There is always both and something else
which concerns the relationship between cause and effect. What is that
something else that causes the specific effect of drugs and the desire
for it? The cause of the effect that ultimately causes addiction is the sub-
ject, namely, that which represents the relay between the cause and a
subject-specific-effect. If this is the case, this idea will have implications,
because it implies that the cause of addiction cannot be known a priori
to the therapeutic encounter with addicts. In other words, it is only the
addicted subject who can articulate something about this cause.
With the idea of articulation we have arrived at the question that
is still left unanswered: how do we know that the effects of drugs are
dependent on the constitution of the subject? One is only ever able to
know something about how the effects of drugs cause addiction by lis-
tening to how subjects speak about their drug-taking and how these
drugs affect them. Effects of drugs and alcohol do not exist independ-
ently of the subject and subjective structure.
However, it is of crucial importance to mention here that the effects
of drugs do not exist independently of culture either. Anthropological
research has established that we obtain particular and different effects
from the same drug in other cultures or indeed in the same culture at
different times, which echoes at a cultural level what Freud discovered
in his work on cocaine. Any practice of drug use in any culture entails
an approach to the real through the real and the drug effect that ensues
is dependent on the symbolic frame in which the approach of the real by
the real takes place (Naparstek, 2002, pp. 153154). We will see that it is
important not just to consider this symbolic frame in its cultural dimen-
sion but also in its radically particular subjective dimension. However,
one way or another, drugs and alcohol do not produce any knowledge
regarding their effects: only subjects do. That is why one should not
stake everything on the object (drug) in addiction and in dual diagnosis
research, but one should also include in this research the subjectobject
relationship.
* * *
Ultimately, the only way out of the impasse of the chicken and egg
discussion regarding dual diagnosis and addiction is by making the
relationship or link between cause and effect speak. In doing so, one
quickly realizes that very little in life and addiction is accidental or left
to chance: the particular constitution of the subject is the cause of the
subject-specific-effect that makes the subject addicted to drugs. The link
between the two (or more) pathological aspects of dual diagnosis is the
subject and he or she (as subject) makes choices based on their desire
and their jouissance. Choices made by the subject regarding addiction
and other psychopathologies are by no means unrelated to the ques-
tion of the identity of the subject. Considering, as indicated before, that
identities are always more or less particular and open to change, dual
diagnosis classification systems that are truly effective in the clinic will
forever remain only a mirage on the horizon, unless, of course, we find
a way of incorporating the subject into our diagnostic system.
The administration of the subject

The importance of the subjectOther relationship for the development
of the individual and the question of the identity of the subject (which
is intimately related to the subjectOther relationship) form a serious
problem for the concept of dual diagnosis in addiction. The notions of
the subjectOther relationship and the identity of the subject under-
mine the idea of a classification system that works for the domain of
addiction treatment. However, it is important not to lose sight of the
reason why the concept of dual diagnosis was developed and why
it is now such an important part of policy concerned with treating
addiction. It was developed because different (psycho)pathologies do
exist within the one subject and dual diagnosis has become a pressing
problem. However, it should also be mentioned that the increased used

of psychopharmacology in psychiatry has led to the realization that the
medicinal use of drugs in cases of mental suffering and illness can cause
addiction and thus dual diagnosis patients.
Despite the problems with dual diagnosis, it is my contention that
the concept of dual diagnosis is still useful because it will have an
important impact on the general field of addiction treatment. It is my
hope that the positive impact of the concept of dual diagnosis will out-
weigh the negative problems as outlined above. The positive aspect of
dual diagnosis is that it introduces the idea that addiction is actually a
complex problem rather than a simple and straightforward one. The
uniform manifestation and representation of addiction have been able
to hide the subjective and social complexities involved and that has
at least until recentlyjustified a superficial treatment policy and a
specialization programme that require minimal financial and training
investment.
If dual diagnosis is able to evoke our interest in addiction as a com-
plex problem that (amongst other aspects) involves serious psychologi-
cal problems, then perhaps the time has come to introduce the possibility
of a diagnosis that includes the subject and their clinical structure.
Earlier on I defined addiction as: a choice for jouissance that is admin-
istered independently of the social bond with other people. There
I briefly explored the particular relationship of independence between
the subject who is addicted and the Other. Here I want to emphasize the
concept of administration (of jouissance) in this definition and propose
that this concept might be helpful in outlining the beginnings of a sys-
tem of differential diagnosis of addiction that includes the subject. Why
not indeed take the subject as ones starting point and not the uniform
effects of drugs and alcohol?
Considered from a psychoanalytic point of view, there is no addiction
without dual diagnosis because addiction will always have to be situ-
ated within a neurotic, psychotic, or perverse structure. Furthermore,
Freud very early on had come to the conclusion that some addictions
should be related to what he called actual neurosis. With this he intro-
duces the idea that there is a toxicity which is not situated in the drug
or alcohol, but which can be situated in the body and the psyche, and
indeed perhaps even within the domain of relationships. In connection
with the actual neuroses he implies that the energies or drives of the
body can become toxic substances when these, for a variety of reasons,
cannot be psychically processed or symbolically represented. In this

way this toxicity can lead to depression (neurasthenia) or anxiety/panic
(anxiety neurosis).
For Freud actual neurosis distinguishes itself within psychopathol-
ogy via the absence of psychologically structured symptoms. Anxiety
neurosis, neurasthenic forms of depression, and especially addictions,
are only some of the clinical phenomena one encounters here. These are
sometimes wrongly referred to as modern symptoms but their frequency
is indeed on the increase. In Freuds conception of actual neurosis one
does not encounter analysable symptoms because, as mentioned before,
what characterizes it is a lack of psychic processing. The subject can-
not mediate their suffering via (symbolically structured) psychological
symptoms. It is rather the case that they suffer in a direct way and often
from their body. The reason for this is that the lack of psychic process-
ing has consequences for the constitution of the subject, not just in the
sense of psyche, but also as body. Here we encounter the connections
between addiction, anxiety, depression, and a toxicity of the body.
The anxiety referred to here is not Freuds castration anxiety, nor is it
the anxiety from the beginning of Lacans Seminar X where he indicates
that anxiety is related to the desire of the Other (Lacan, 1962a). These are
anxieties that have an object, although that object can be the desire of
the Other. The anxiety referred to here rather concerns the anxiety from
the latter part of that seminar, namely, the certainty of anxiety when it
is related to the real of jouissance, that is to say, when anxiety functions
as defence against absolute helplessness at birth (Miller, 2005, p. 83).
This anxiety concerns the jouissance of the real drives. A clinical con-
sequence of this new theory of anxiety is that anxiety will need to be
crossed-over or stepped-over via desire (Lacan, 1962b). This is the
work of analysis that can take place when anxiety is present but only
on two conditions: 1. the analyst has to replace drugs and alcohol as the
object of transference and anxiety; and 2. the analyst does not use their
anxiety by lending it to the patient which means that he [sic] has to
deny his analysands his own anxiety (Jonckheere, 2005, p. 129).
Regarding the latter condition, it should be mentioned that there
are many and subtle ways in which the analyst can lend their anx-
iety to the analysand. An obvious example is to present analysands or
addicts with general knowledge, explanations, or ideal solutions (all of
which can function as defences against anxiety). Freud already warned
against this kind of solution (Freud, 1919a, p. 164). Most addicts are
very susceptible to these ideals. Mostly they search for an ideal solution
to the problem of living life. Indeed, life for some is absurd, or a matter
of deep suffering; it can be a question of having to live with a lack,
or indeed of having to live with a too much, or, indeed, it can be a
question of how to live a life that is permeated with the presence of
death. Or to put these questions into Lacanian terms, how does one
live in a symbolic that is permeated with the real? These questions are
pushed to the forefront in a direct and acute way by addiction. Drugs
and alcohol can provide addicts with the illusion that there is an ideal
solution in existence. It makes no real difference what kind of ideal it is,
as long as it works. As such we can drop one ideal and replace it with
another. We can sacrifice anything as long as compensation is avail-
able. Participation in human life demands enormous sacrifices from the
subject. We pay with anxiety. However, the installation of the ego-ideal
can cater for the necessary compensation for anxiety or loss. In other
words, these ideals compensate for the loss of libidinal satisfaction that
is demanded by the Other (of culture). This demand of the Other is dif-
ficult to negotiate for the subject. Freud wrote: If more is demanded of
a man [sic], a revolt will be produced in him or a neurosis, or he will be
made unhappy (Freud, 1930a, p. 143).
In that case the identification withor the dependence onan ideal,
an ideology, or a masterful figure can function as a remedy for the defi-
ciency in happiness and loss of pleasure. In this context I propose the
following formula of addiction: addiction is the process which ensues
when the incarnation or representation of the ideal becomes a con-
sumable object that appears on the empty place or in the lack that was
caused by the loss of satisfaction which was demanded by the Other. It
is possible to apply this formula to other typical human causes: if the
representative of the ideal for the subject is another person, we have
a hypnotic relationship; if the representative is an idea, or system of
ideas, we have a (scientific) ideology; and if the representative is the
incarnation of the final truth, we have religion. It is relevant to mention
these three other areas because they all play, in various ways, combina-
tions, and degrees, a role in the (history of the) treatment of addiction
and the imagination of addicts.
Addicts can abstain very well. There is always an ideal or master
available. Every request for a master seems to lead to an erection of
one or two. The difference between the general functioning of the ideal
and active addiction is that in active addiction the ideal is not a support
foror a scaffolding ofjouissance, but has become jouissance itself.

The question here is: can the analyst abstain from moving into a mas-
ter position as a tendency to want to collaborate with the quest for an
ego-ideal as a defence against anxiety which is provoked by the con-
frontation with the real jouissance of addiction? Only know-how with
ones jouissance and anxiety will allow one to abstain from taking up a
master position and that is the opposite from lending ones anxiety
and jouissance to someone else.
I have tried to find a mechanism that can relate addiction to the dif-
ferent clinical structures and pathologies of the subject. I proposed the
concept of administration. I worked with addicted people for some
years in a hospital setting and I still do in my clinical practice. There
was something that struck me in their speech: they seemed to refer to
what can only be described as an economy. It is not always obvious,
but it is certainly an undercurrent in their discourse. I thought that this
economic undercurrent reflected a particular relationship to jouissance:
addicts seemed to be concerned with a management or distribution
of jouissance. Administration is an economic term that has an interest-
ing etymology and history. It stems from to minister or to serve.
In terms of how jouissance is ministered to or served, administration as
a concept correlates with the clinical structures of the subject and with
actual neurosis.
Neurotic, psychotic, or perverse subjects administer their enjoy-
ment (jouissance) in different ways and indeed for different reasons. In
neurosis and perversion the administration in addiction is a matter of
the supplying or dispensing of an extra jouissance: an attempt to sus-
pend the limits that reality or language puts on pleasure. In psychosis
the administration with the effects of drugs and alcohol concerns the
management or mastery of an unbearable jouissance and it functions as
a substitute for language precisely because language cannot function
properly for the subject with a psychotic structure. The Name-of-the-
Father is foreclosed for psychotic subjects and they are forced to live
with an invading jouissance. Addiction in this structure functions as an
effect that can neutralize the invading jouissance, which is a function
that otherwise would have been executed by language. The administra-
tion with the effects of drugs and alcohol in actual neurosis concerns the
regulation or governing of the body because in actual neurosis patients
suffer indeed predominantly from their bodies. The constitution of the
body in this clinical condition is a problematic affair essentially because
the lack of psychic processing (or symbolization) hinders the translation

and transformation from the primordial organism (that we are born as)
into the body that we eventually will have. A consequence of this is that
many of these patients experience a very problematic jouissance (usually
in the form of pain, anxiety, and/or physical exhaustion) at the level of
their bodies. Addiction here functions as a kind of floodgate mecha-
nism that regulates the kind of problematic jouissance produced in this
condition.
The different methods of administration determine what the effects
of drugs will be for the individual addicts. It is therefore always impor-
tant in our work with addicted people to get them to articulate how
they experience the effects of drugs. However, it is important to realize
as well that the effect of drugs is not just determined by the clinical
structure of the subject and its corresponding mechanism of admin-
istration: the effects of drugs are not just determined by the more or
less universal aspect of the clinical structure but are also determined by
something that is radically particular.
I propose the hypothesis that the effects of drugs are co-determined
by the particular interactions between the subject and the Other prior
to the constitution of the clinical structure of the subject. In this very
first phase of life the body is already being affected by the signifying
behaviours and actions (or lack of them) of the (m)Other. The subject
will indeed psychically experience the effects of this signifying mate-
rial and these will also contribute to the formation of the identity of the
subject, which includes a relationship of the subject to the body. This
area of theory (and research) concerns the interface between language
and the real of biology. The formation and constitution of the body
in this early phase of life will determine how the subject will experi-
ence the effects of drugs. Some of these effects will no doubt lead to
addiction.
The crucial aspect of this theory for the treatment of addiction is
that all causation and determination of addiction is situated within the
subjectOther relationship and that fact alone justifies the claim that the
transference (as a therapeutic subjectOther relationship) is the most
privileged vehicle for change within the addicted subject. Until now we
have only provided a justification for the functions of the transference
and speech for the treatment of an addicted subject, however, it is also
important that we consider the function of interpretation in the treat-
ment of the addicted subject of modernity.
Having arrived at this point, I would like to explore some of the ideas
put forward a bit further along three different lines. First, the effect of
the symptom will be explored via Lacans work on the Irish writer James
Joyce. Second, a brief historical reflection on administration will be pre-
sented as a concept that concerns regulation and governance and it will
be explored how this concept can contribute to an understanding of the
way that we deal with our suffering today. Third, the function of inter-
pretation in the treatment of the modern subject will be considered.
Joyces administration
Why look at Joyce when we are concerned with addiction? It was men-
tioned earlier that Freud excluded the actual neuroses and addiction
from psychoanalytic practice. The reason for that was that Freud inter-
preted the psychoanalytic symptom within the realm of signifiers as
they acquired their status and function within that realm. The Freudian
symptom is the correlate of the symbolic order and thus the correlate
of truth and meaning. I think that it is possible to argue that in Seminar
XXII RSI (Real, Symbolic, Imaginary). Lacan succeeded in giving the
Name-of-the-Father a lower status in which it is only equal to other
structuring possibilities in the life of a human subject. All three orders
(real, symbolic, and imaginary) acquire an equal status of importance
in RSI and it seems to me that this implies that Lacan had become inter-
ested in the emergence of modern symptoms in the sense that these are
symptoms to function to a lesser extent in relation toor withinthe
field of the Other.
It is Millers opinion that when Lacan gives the symptom its new
name (the sinthome) in his next seminar on Joyce that he separates symp-
tom from truth and connects symptom to jouissance (Miller, 2007, p. 77).
He also argues that this is not unrelated to the introduction of Lacans
concept of Lalangue towards the end of Seminar XX (Encore). Lalangue
is not concerned with meaning or communication but demonstrates
that, in the first instance, signifying material is related to jouissance and
that, only in the second instance, language, being derived from that
first instance, functions as a vehicle for meaning and communication
(Miller, 2007, p. 77). We can put this differently: Lalangue is pre-Oedipal
and language is Oedipal.
The Freudian symptom is an Oedipal symptom and in that context
it should be considered as an unconscious appeal to the Other for
interpretation, meaning, and, therefore, truth. The symptom of the

modern subject is first and foremost jouissance or rather something that
produces jouissance. That was the function of Joyces writing; it produced
a jouissance effect for him. Lacans interpretation of Joyce and his work
introduced a new way of thinking about the modern functioning of
symptoms and at the same time it was an invitation to respond to it
differently. In other words, it created an opportunity to bring the actual
neuroses and addiction back to psychoanalytic practice. That is not to say,
as we will see, that the modern symptoms are sinthomes. We have to make
a distinction. I call the modern symptoms external solutions or effect-
producing symptoms. However, what modern symptoms and sinthomes
have in common is that both function or operate, at least to some extent,
against the social bond. That is why it is crucial to look at Joyce. Joyce
wrote for his own jouissance and for making a name for himself; he did
not write in order to relate toor communicate withothers.
Why approach jouissance with an economic concept? Economic terms
are helpful because, as Lacan suggests in Seminar XVII, they can con-
tribute to the setting up of this other field of energetics, namely, the
energetics of jouissance (Lacan, 2006, p. 81). In the beginning of Ulysses
Stephen Dedalus, James Joyces literary alter-ego in the book, says that
he is the servant of two masters, an English one and an Italian one (p. 31).
In fact he alludes to a third master and it could be Irelands ego that
Joyce tried to escape via exile. It is clear from the context that Stephen
does not want to serve two masters, never mind three. However, the
dilemma is that, one way or another, the human subject always serves
two masters: language and jouissance. In life one has to strike a balance
between these. In this context administration is nothing but accountancy,
that is to say, a balancing of the books of jouissance with the ciphering of
language. Administration here is a form of writing jouissance. I think that
Joyce indeed wrote his jouissance. Of course there is nothing new about
this connection between writing and jouissance.
However, what is interesting about the relationship between
jouissance, Joyces writing as sinthome, and the symptom in general, is
the connection between the effect of the symptom and its cause. It is
important to pay attention to the cause-and-effect relationship regard-
ing the symptom because the effect of the symptom does not get much
emphasis in psychoanalysis. In relation to this, J.-A. Miller says the
following: At the end of it there is a clinic that revolves on a defini-
tion I believe has been neglected from the symptom, thus fundamental,
that it must be addressed. It is the one of the symptom as event of the

body, which appears at least once in Lacan (Miller, 2001a, p. 23). A lit-
tle later he says: If the symptom is drive satisfaction, if it is jouissance
as conditioned by life under the form of the body, that implies that the
living body prevails in every symptom (Ibid.).
Joyces writing produced a jouissance for him; a jouissance that was
entirely his own, that is to say, it was administered independently of the
Other and was therefore masturbatory in nature. It is well known that
Joyce laughed his way through the writing of Finnegans Wake (Harari,
2002, p. 81). What is at stake here is the effect of Joyces writing as the
cause of a symptom that does not stop to write itself. In other words,
writing for Joyce produced a subject-of-Joyce-specific-effect. This is the
question that we touched upon earlier: what is the cause of the effect
that in turn is the cause of the symptom? To answer this we need to
return to the concept of administration.
In an interview with Arthur Power, Joyce suggests that his art is
emotional writing and that emotion dictated the course and detail
of Ulysses (Power, 1974, p. 109). For him emotional writing goes deeper
than intellectual writing and he adds that it is not important what you
write but how you write (Lacan, 19751976). In the very beginning of
Seminar XXIII, Lacan surmises from the Joyces neologism lelangue that
his writing caused a kind of elation or mania that resembled his last
book. Elation is an emotion, but I am not so sure what Joyces expression
emotional writing actually means. Perhaps the concept of administra-
tion and a reconsideration of Freuds concept of actual neurosis might
help us out here.
Freud argued that actual neurosis is caused by a deficiency in the
psyche that prevents psychic processing of energies in the body, which,
subsequently, become toxic. Essentially actual neurosis can be consid-
ered to be a deficiency in the presentation of signifying material by the
Other to the baby or infant which ultimately leads to a lack of identity
and a problematic relationship to the body. I propose here that Freuds
psychic deficiency concerns a particular form of foreclosure that is dif-
ferent than the mechanism for the constitution of psychosis.
In Seminar XXIII Lacan hints at the possibility of another form of
foreclosurea more radical onebesides the one of the Name-of-the-
Father (which he considers to be more lightweight) (Lacan, 1975
1976a). If that is the case, and if, as Freud suggests, psychic deficiency in
actual neurosis is more primordial than hysteria and the neuropsychoses
of defence, then actual neurosis can indeed be a dominant factor within

the three clinical structures of the subject.
Lacan strongly suggests in Seminar XXIII that the sinthome is related
to the mechanism of foreclosure. This leads to the following question:
is the sinthome a particular form of administrating jouissance with the
symptom? Lacans concept of the sinthome can perhaps apply to both
the foreclosure of psychosis and the foreclosure of something less light-
weight as two different ways of administrating jouissance. Towards the
end of Seminar XXIII Lacan suggests that Joyces sinthome is his writing
and Joyce is so totally identified with it that you can conclude that it is
his ego. In this context Lacan discusses the incident from A Portrait of
an Artist as a Young Man when Stephen is attacked and after which he
experiences a peculiar sensation of the loss of his ego. Lacan interprets
this as Stephens lack of ego having repercussions for his experience of
his body (Lacan, 19751976b). This raises two related questions:
1. Is Joyces sinthome related in some way to a problematicperhaps

actual neuroticrelationship with his body?
2. What form of administration is involved in Joyces writing?
How writing functioned for Joyce cannot be considered separately from

the universality of his cultural and political background, nor can it be
considered separately from the more or less universal aspect of his clini-
cal structure. However, if Joyces writing related to a more radical
foreclosure than the one of the Name-of-the-Father, we must agree with
Lacan that the nature of Joyces sinthome is radically particular. To this
we can now add that this implies that also the effect of his sinthome
was radically particular for Joyce. This more radical foreclosure relates
to the specificities of the very early subjectOther relationship which
includes the domain of Lalangue: the rhythms of touch, the body, and
particular childrearing practices that all contribute to a style of suffer-
ing. This suffering can express itself via the body (or in an actual neu-
rotic way) if the Other is not engaged at the level of their desire and thus
with their signifiers.
It is relevant to mention that the encounter with Lalangue is always
more or less traumatic. Lalangue or the signifying material of the Other
makes the human being sick. Our bodies are always a little bit sick and
we are always to some extent traumatized. In relation to this, Miller sug-
gests that the fundamental traumatic event is initially more related to
language (which leaves traces of effect on the body) and only at a later
point to seduction, menace of castration, loss of love, and so on (Miller,
2001b, p. 27). The question for all human beings is ultimately: how do
we do something with this basic fact or what can we invent in order to
deal with this situation? We all need to fabricate a little stool (escabeau)
in order to survive (Miller, 2007a, p. 100). What Joyce showed Lacan is
to what extent a sinthome can compensate for a deep disturbance.
Its not clear whether Joyce was psychotic, neurotic, or perverse.
I dont think that Lacan committed himself entirely on this point. How-
ever, it is possible to say that his writing administers his jouissance econ-
omy. The question as to how it does that is difficult to answer, but Joyce
gave us a strong clue in A Portrait of the Artist as a Young Man. This is
how Stephen tried to cope with his state of mind when he is walking
with his father in Cork and he temporarily lost touch with reality after
being repulsed by his fathers voice: He slowly repeated to himself:
I am Stephen Dedalus, I am walking beside my father whose name is
Simon Dedalus. We are in Cork, in Ireland. Cork is a city. Our room is in
the Victoria Hotel. Victoria and Stephen and Simon. Simon and Stephen
and Victoria. Names (Joyce, 1916, p. 343). This is not speech. This is
writing, a writing of names, writing that nominates. In other words, it is
like a form of accountancy. However, what is more fundamental than all
of that is that it is rhythm. A particular rhythm of language is involved.
The predominant presence of rhythm in this passage appears to indi-
cate that Joyces administration is first and foremost a matter of regula-
tion and governing, because that is exactly the function of rhythm in
music. (I suggested earlier that regulation or governing is the function
of administration in actual neurosis, whilst to dispense or supply and
management or mastery as a substitute are respectively the functions of
administration in neurosis/perversion and psychosis.) In other words,
this is an indication that Joyce suffered, at least partially, in an actual
neurotic way or indeed in a way that is related to the aforementioned
foreclosure that is more radical than the one of the Name-of-the-Father.
That is to say, he suffered more from his body than he did via symboli-
cally structured symptoms and indeed when Joyce didnt write he suf-
fered from all kinds of physical and somatic phenomena, accompanied
by deep depressions, especially after the births of his children.
Rhythm is fundamental to speech and language. In that sense rhythm
is a more or less universal human phenomenon, but the irregularities,
punctuations, gaps, irruptions, and syncopations that characterize
the particular baby(m)Other relationships determine the radically

singular aspect of the subject. My hypothesis is that these singular
phenomena are the ultimate cause of the Joyce-specific-effects of his
sinthome. Rhythm plays a role in the regulation or governing of the real
and it has a function in the subject that is intimately related to the acqui-
sition of the signifier via the intermediary stage of proto-conversation.
This is nothing new because Colwyn Trevarthen noted that already in
1967 the Russian physiologist Bernstein stated that rhythm is a bio-
mechanical necessity (Trevarthen, 19992000, p. 8). However, what is
crucial here is that the functioning of the signifier will always carry the
imprint of the primordial singular aspects of the rhythm between child
and (m)Other. It seems that Freud and Lacan were aware of the impor-
tance of these primordial subjectOther interactions.
In Seminar III Lacan says that Freud constantly pointed out that for
memory and historization to be there one needs a prior organization of
language; one already has to have signifying material to make anything
signify at all (Lacan, 1993, p. 156). It is my contention that this signifying
material, which includes specific rhythms and radical particularities, pro-
duces the subject-specific-effects of the sinthome, predominantly because
of the effect that they have on the constitution of the body. The signifying
material does not only have an effect on how the subject comes to fit into
language but also on how the subject comes to fit into their body. The
suits of language and the body are not tailor-made but ready-made and
are therefore never perfectly fitting. Again, that is why the encounter of
the subject with this signifying material of the Other is always traumatic
and indeed more for some than for others. In Joyces case the fabric was
very ill-fitting and for that reason he needed a suppletion, his stoolhis
sinthomewith the very same fabricand to great effect.
In the same seminar, Lacan says that psychoanalysts are not excused
from reading psychologists (Lacan, 1993, p. 152). Indeed, perhaps psy-
choanalysts should read the works of Colwyn Trevarthen, especially
an article called Musicality and the intrinsic motive pulse: evidence
from human psychobiology and infant communication (Trevarthen,
19992000). What Trevarthen experimentally proves is that language
develops out of rhythmic interaction between mother and baby and
that this is something that starts immediately after birth, indeed lit-
erally within the first days of life. He also demonstrates that rhythm
and language are a co-construction; it is a dance that the mother
directs but in which the child is by no means passive. Nevertheless,
the mothers engagement plays a crucial role and that means that her
desire, jouissance, and signifiers are the music and rhythm to this dance.
In his seminar on Joyce, Lacan alludes to this function of dance. He
says there that it is absolutely remarkable that the body doesnt benefit
more from dance and that this would allow us to write condensation as
condancation (Lacan, 19751976).
Trevarthen shows that motheresethe speech, sound, and rhythm she
directs at her babyis a universal phenomenon. Trevarthen is a psy-
chologist and would be looking for general knowledge and universal
laws. However, I would argue that already here at this level of primor-
dial organization we encounter the singular aspects of the particular
child(m)Other interactions. What may perhaps be more fruitfulat
least from a psychoanalytic point of viewis to concentrate on the
irregularities, the particularities, the peculiarities, and the things that
dont work in order to understand the underlying (causative) nature
of psychopathology. In the last period of his work Lacan became less
interested in language as a system, that is to say, as something that has a
consistency or order, and more interested in language creating a hole in
the real and how this affects the experience of the body. In other words,
he became more interested in the encounter between the signifier and
jouissance and the primordial trauma or hole this encounter creates for
the subject, all of which form an essential aspect of Lacans seminar on
Joyce. As mentioned above, all these singularities, irregularities, and
traumatisms have an effect on the constitution of the body of the subject
and on how this body is experienced by him or her. The experience of
the body referred to here includes how the effect of the sinthome and the
effect of drugs on the body are experienced by the subject.
According to Lacan, Joyces father taught him nothing and thus
he was hardly there for him. Perhaps that is why his fathers voice
repulsed him so much: his fathers voiceits rhythm and sound
hardly played a role in the constitution of his life and body; for Joyce it
remained a voice in the real. Stephens derealization or panic attack in
Portrait was triggered by a repulsion of his fathers voice. It is well
documented that Joyce did not come from a background that contained
the rhythm and sound of parental engagement. Perhaps that is why
rhythm and sound returned in his writing to a degree that this writing
moved away from sense, but in a way that allowed him to regulate his
mood and body, and indeed even produce an effect of excitement or
elation.
The particular effect of Joyces writing caused him not to stop it

and the cause of this effect of his sinthome is situated in the singular
way in which rhythm and engagement were lacking in his early life.
In a way we could say that Joyce was lucky; his sinthome could have
been undermined by Joyce-specific-effects of alcohol. And there are
indications that he was very susceptible to these effects. Joyce was a
dipsomaniac.
Administration in historical perspective

Having arrived at this point I would like to return to the concept of
administration and consider it within a historical perspective in order
to discern its modern-day function and in order to demonstrate that
the addictions or jouissance-effect producing external solutions are the
paradigmatic ways of suffering of our time.
In Seminar XX Lacan says that it is clearly the essence of the
lawto divide up, distribute, or reattribute everything that counts
as jouissance (Lacan, 1998). If that is the function of the law than we
may consider administrationwhich since Jeremy Bentham is noth-
ing but the machinery that the law requires in terms of its execution
and implementation in particular instancesto be the function of psy-
chopathology. That is to say that the formations of the unconscious
including unconscious fantasyadminister and regulate jouissance in
the subject. It is important to mention that administration, at least in
this form, is ultimately dependent on the law of the symbolic order and
is therefore symbolically structured. In the very same seminar Lacan
refers to the imperative of jouissance which characterizes the cultural
superego of our time (Lacan, 1998, p. 3). What is implied here by Lacan
is that the power of the function of the law of the symbolic order is
being diminished in favour of the law of jouissance.
The question we should ask ourselves now is the following: what
happens to the administration of jouissancewhich is ultimately a
jouissance of the bodywhen the administrative machinery is forced to
function increasingly on its own as a result of the decline of the func-
tion of the symbolic law? This is a legitimate question because in the
discourse of capitalism the function of the law has been replaced by
the function of freedom. From the perspective of this ideology we have
all become individual free agents who operate at a distance from oth-
ers and indeed the law that mediates between us and others and who,
paradoxically, become increasingly dependent on objects of jouissance.

One way of answering this question is by saying that the kind of admin-
istration that functions increasingly independently of the Other becomes
an administration of the jouissance of the body with the real of jouissance
itself. Indeed, more and more, we have recourse to objects of jouissance
with which we can regulate jouissance. There is no doubt in my mind
that this leads to an increase in addictions to drugs and alcohol, which
are predominantly administrations inand ofthe real.
In psychopathologyand via psychopathologyjouissance is lim-
ited, curtailed, and distributed. Psychopathology is dependent on the
symbolic law and on the administration that serves as an executive
support for the functioning of that law. Essentially, administration here
concerns the administration by the subject of the state of being duped
in terms of gaining full access to jouissance and that is indeed a mat-
ter of managing, governing, serving, and regulating the little we can
have of it. This is administration linked to desire and it is the kind of
administration that is an echo of the great administrative machinery
that came into being at the very beginning of the enlightenment (or
even just before that) in the 16th century. This period saw an extension
of royal activity (expansion of trade, creation of royal standing armies,
royal monopolizing of justice, relationships with foreign powers, and so
on) and this required administrative machinery (Dunsire, 1973, p. 53).
This machinery was to guarantee the sovereignty of the king in a period
when feudalism was in its final stages and religious dispersion began to
develop via the movements of Reformation and Counter-Reformation.
Government or state centralization came into being and, in order to be
able to serve the king in a proper manner, administration saw the light
of day which meant, amongst other things, that the subjects of the king
had to pay a price in terms of certain pleasures and goods they could
enjoy.
In the 18th century, with the advent of industry and the nation state,
we encounter a change in the administration machinery. Administration
does not serve an absolute authority anymore but is now made depend-
ent on the public law. Administration has become a matter of distribut-
ing and regulating the goods and pleasures in society. Administration
here serves society or the common law of the state, but it is an adminis-
tration that was still very much in the service of desire. The price to be
paid by the subjects of the state is still the one of being duped in terms
of having access to jouissance: You cant have it all. It is not for noth-
ing that Freud introduced psychoanalysis into this Victorian period.
The dominance of the law and prohibition established the conditions

for repression and the rule of free-association brought the possibilities
and (perhaps) illusions of relief.
In the recent shift in our culturea shift that appears to coincide
with a more direct (or bodily) way of sufferingwe see the emergence
of the predominance of a different form of administration. It is a form
of administration that functions increasingly at a distance from the
symbolic law and one which is related to the attempt of the subject not
to be duped in terms of jouissance. Lacan makes the same point when
he suggests that the discourse of capitalism implies the foreclosure of
sexuality and thus castration. The administration in capitalist discourse
is not the administration of desire, lack, and ordinary limited pleasure,
but it is the administration that belongs to the real of jouissance. It is the
administration of the viator, that is to say, the administration of the one
who skids over structure and is in the service of the law of jouissance.
The cause of the separation between the law and the administration
of the subject must be related to western culture favouring jouissance
over desire. The shift towards an administration that is divorced from
the law indicates that, to a lesser degree, we may have become serv-
ants to language and, to a greater degree, servants to jouissance. Most
are obsessed with their little jouissance and most function in segregated
ways from others. Marie-Helene Brousse demonstrates that the dis-
course of capitalism (the global market) produces segregation (Brousse,
2006, p. 261). The unmediated and bodily (or actual neurotic) way of
suffering is a direct consequence of this shift in balance. One of the con-
sequences of an administrative machinery that functions increasingly at
a distance from the lawa law which in itself is now also increasingly
distant from those whose actions it was intended to regulateis the
emergence of symptoms in the real such as addictions, self-harm, eating
disorders, and so on.
So what could possibly happen to the law in this situation? Without
administrative machinery that supports the law, the law can become
something that can be enjoyed as an object itself. Is the jouissance of the
law not the precise definition of fundamentalism? Fundamentalism is
not unimportant in the history of addiction treatment. The way of the
addict is to be the viator of structure with jouissance, or to be in the serv-
ice of the latter because the former hardly exists. Speech and the trans-
ference should be able to provide another way somewhere in-between
being nailed down by the jouissance of the law and being adrift in the
law of jouissance.
It is perhaps not without a certain amount of irony that we should

notice that the more we are encouraged to pursue jouissanceand
indeed we pursue it more than everthe more we begin to treat the
human conflict that emanates from this pursuit precisely with the kinds
of methods that disconnect symptoms and behaviours from jouissance
(such as cognitive behavioural therapy).
Modern symptoms and the function of interpretation

Lacan was familiar with every detail of Freuds work. This begs the ques-
tion of why he hardly ever refers to Freuds notion of the actual neuroses.
It would have made sense for Lacan to have done so, especially within
the context of the last period of his thinking when he was concerned
with the nature of the symptom and its connection to the jouissance of
the real. In his thinking in this period the symptom or sinthome, as solu-
tions, bring the real into play by connecting it to the other two orders.
Indeed, the realas something that is related to the imaginary and the
symbolic, but which, despite these relationships, cannot be represented
by themis the cause of suffering (anxiety). For Freud, the suffering of
actual neurosis was caused by a lack of psychic representation of ener-
gies and drives of the body. Consequently one could say that Freud and
Lacan are more or less arguing the same thing here. However, there
is, of course, also a crucial difference: whereas Freud excluded actual
neurosis from his clinic, Lacan elaborated his concept of the real and his
theory of psychosis in such a way that the real became the (extimate)
object of psychoanalytic practice.
In 2006 Guy Trobas published an interesting article entitled Depres-
sion of Repression & Modern Symptoms. The impetus for his arti-
cle can be worded with the following question: does the pressure of
jouissance in our modern era cause the depression of repression? We
mentioned before that the modern symptoms are not symptoms in the
strict Freudian sense, that is to say, symptoms as a return due to the
repression of signifiers. This is a return that, besides the usual conflict,
also causes a certain amount of satisfaction. However, we know that
there are pathologies without (symbolically structured) symptoms,
such as the actual neuroses. Moreover, inhibitions are not symptoms
and yet we know from Freud that, like symptoms, they relate to anxiety.
They are a way of dealing with it or indeed a way of diminishing it.
Trobas suggests that inhibition can replace the formation of symptoms
and that inhibition supposes an imaginary treatment of jouissance and
castration, whereas the Freudian symptom is related to a symbolic way

of treating the latter (a treatment that would not deprive the object of
the world of their libidinal cathexis [Trobas, 2006, p. 91]). This leads
to the following question: is the symbolic aspect of the symptom being
diminished in favour of the imaginary aspect of inhibition in our mod-
ern way of suffering?
Perhaps it is possible to say that, indeed, we are replacing a sym-
bolic, and thus a more or less particular way of dealing with jouissance,
with a largely imaginary way. This is a way that relies on mass solu-
tions to the problems that emanate from jouissance and are as such
solutions produced externally to the subject. Trobas (2006) appears to
suggest that the imaginary inhibition of jouissance produces depres-
sion whilst the repression of the signifier (or the symbolic) relates to
anxiety. If that is the case, it can be argued that inhibition causes the
foreclosure of the repression of the signifier which can be considered to
be the second form of foreclosure that Lacan referred to in his seminar
on Joyce. The mass inhibition of jouissance, and thus of anxiety, pro-
duces depression or depressive states. In other words, in that situation
repression is less able to carve up jouissance by limiting it through the
creation of discrete units of jouissance otherwise known as pleasure.
The limitation of jouissance leaves room for more to be desired and this
situation can cause anxiety when we reach some of these limits in our
experience. In the case of the depression of repression the imaginary
massively suppresses anxiety, but this can result in violent eruptions of
jouissance when at certain moments this function of suppression fails.
However, when it more or less succeeds, it will lead to generalized
states of depression.
Lacan suggested in Television that the subject can become bored or
morose because he or she rejects repression and thus the unconscious
(Lacan, 1987, p. 34). Increasingly, the modern subject is not prepared
to take responsibility for his or her unconscious. This means that the
subject avoids the know-how of knowledge with jouissance. There
is a decrease of know-how with ones symptoms and an increasing
dependence on external (mass) solutions that are imaginary in nature,
which inhibit anxiety, and which tend to cause depressive states. One
of my analysands had come to me complaining of anxiety. Later he
became depressed. It transpired that he had started taking a cocktail of
anti-anxiety drugs. In this sense drugs (and alcohol) are an imaginary
solution with real effects, which in this case meant a shift from anxiety
to depression.
I predict that we will be increasingly confronted with the following

situation in our clinical work. The Freudian symptom, which functions
largely within the coherence of a signifying chain or structure and,
which, within itself, contains a dynamic between a universal aspect and
a particular aspect, will slowly but surely separate out into and make
way for two aspects: on the one side we will be confronted with the uni-
versal imaginary of external solutions, which includes solutions with
or within the body, whilst on the other we will be confronted with the
radically particular invention or artifice of the sinthome which to some
extent allows the real to become bearable for the subject. The more we
are threatened to be swallowed by the real the more these latter two
solutions (aspects) will come to the fore.
Interpretation and the effect of the modern symptom

This leads us finally to the question of interpretation. How do we
intervene with those patients who suffer fromor indeed withan
overabundance of jouissance? I am referring to what can be called the
too much or not enough conditions such as eating disorders, self-
harm, substance abuse, and other forms of addictions. How should
we intervene in the symptomatology of the modern subject (of which
the substance abuser is a paradigmatic example)? The modern addict
is alone with their jouissance. They do not want to know about their
unconscious. How do we get the addict to become interested in their
unconscious? First of all, as mentioned before, we have to establish a
transference relationship, because if it is possible to conclude from Freud
that all psychopathology ultimately stems from the subjectOther rela-
tionship, it makes sense to utilize the subjectOther relationship of the
transference in clinical work. However, this is not sufficient. Often we
are dealing with acute situations and indeed with people who are not
necessarily interested in the long-term working-through process of a
transference relationship. We will have to intervene more directly with
words or signifiers. This leads to the following question? Can weor
even should weintervene with interpretations when a transference
relationship has not yet been established? This in turn leads to a second
question: are there interpretations that can lead to the installation of the
transference?
First I want to propose a basic requirement for intervention that
we touched upon earlier. When we intervene with substance abusers
it is crucial to avoid the ideal of sense and the sense of the ideal.
Hidden behind the pathology we often find that substance abusers are
knowledge-seekers; they seek a positive answer to the lack in the Other.
That is why they like to share themselves around an ideal. They want
to make too much sense out of life and this need for a fixed signifier
signified relationship forms a heavy burden in their lives. The problem
is that this burden is hidden by the jouissance effect of the pathology.
If it is important to avoid the ideal of sense, I think it is crucial to
mention that there is a most peculiar twist involved here: we need to
install the search for sense or knowledge at the very beginning of a
treatment in order to undo it again at a later stage via interpretations in
the transference. This requires further explanation. For Lacan the signi-
fier is material that is capable of transcending itself. Speech can evoke
something real; statements are real matter, not just names that refer
only to other names. Words can nominate something outside their own
realm and, for instance, affect the jouissance of the body.
In Seminar XXIV, Lacan (1977) says that we are all glued to sense
and he expresses the hope for a signifier that has no sense and which,
as such, is able to open up to the real. When we intervene with sub-
stance abusers we have to make sure that our words open up to the
real in order to curtail or stabilize the jouissance of the Other. Neither
sense nor ideals are able to do that. Lacan says in the same seminar: All
discourse has a hypnotic effect. All discourse has effects of suggestion.
Discourse always induces sleep, unless one does not understand; then
it wakes one up (Lacan, 1977a).
Discourse and substance abuse have something in common: they
put the subject to sleep. Is there an intervention that can awaken this
drowsy subject? From a reading of the last lecture from Seminar XXII,
I have drawn the conclusion that Lacan was trying to find a different
way of intervening with those analysands (or patients) for whom the
regulatory function of the symbolic was in decline, that is, patients who
tend to become overwhelmed by jouissance or an imaginary need for it
(Lacan, 19741975). On the basis of a reading of this lecture it is possible
to say that Lacan implies that people have become less susceptible to the
law-inducing function of the Name-of-the-Father that regulates jouissance
by keeping it at bay. Instead he suggests that there are different modes
of the Name-of-the-Father. The father is no longer a figure who nomi-
nates, but has in fact been nominated, or at least is one of the things that
has been nominated. Nomination is everything or anything that allows
a knotting of the real, the symbolic, and the imaginary. The element that
is able to knot the three orders becomes the sinthome in his next semi-
nar. It seems to me that this theoretical development in Lacans work
implies the possibility of considering the existence of different ways of
administrating jouissance in an era when the law and desire have been
rendered more or less impotent, that is to say, in an era in which the
subject is encouraged to cheat on their desire.
Lacan refers to three different forms of nomination and thus three
different ways of establishing an effect in the jouissance economy of
the subject: imaginary nomination, symbolic nomination, and
real nomination. He correlates these to Freuds trinity of inhibi-
tion, symptoms, and anxiety. Inhibition is a nomination from the
imaginary; symptom is a nomination from the symbolic; and anxiety a
nomination from the real (Lacan, 19741975). In Seminar XXIII Lacan
offers the possibility of thinking that Joyce lacked the consistency of the
imaginary with the result that the real and the symbolic could not be tied
together. He lacked what this consistency establishes, namely, an ego and
a consistent relationship to the body (Lacan, 19751976). Subsequently
what happened in the case of Joyce was that his ego was replaced with
the imaginary nomination of his writing. The symptom, as a symbolically
structured formation of the unconscious, administrates jouissance and, as
symbolic nomination, brings forward the function of the symbolic by tying
it to the real and the imaginary, as such allowing it to limit jouissance.
If anxiety is real nomination it is an indication of the presence of the object
a in the subject. Pierre Skriabine (2004) argues that Melanie Kleins inter-
vention in the case of Little Dick was an act of real nomination. Dick was
four years of age and lived to some extent in the real, but he experienced
life without a trace of anxiety. In other words, the object a had not been
established yet in his case. Lacan indicates that the real, the symbolic,
and the imaginary were present in him but only in a very undifferenti-
ated and basic form (Lacan, 1988, pp. 6870, 8184).
What did Melanie Klein do in this case? She introduces Little Dick to
his unconscious via an anxiety-inducing interpretation (or act) (Lacan,
1988). The effect of Kleins interpretation was to make Dick sensitive to
the presence of the Other, especially to the Other within himself. Anxiety
establishes repression and as such it can evoke a desire to make sense
of it via the Other (within himself). Inhibition has the opposite effect: it
diminishes anxiety, it depresses repression, and it depletes a desire that
is related to the Other.
It is an ethical imperative that we find a way of awakening substance

abusers at the very beginning of their treatment. The way to do this is
by aiming at a particular conflict within them. This conflict may be an
indication of the location of the object a. An interpretation that aims
at this conflict will evoke anxiety and that in turn may evoke a desire
in patients for knowledge and sense. Via the real nomination of anxiety
a belief in the sense of the symptom can be restored and, when this
happens, the transference has been installed. From here on a different
kind of interpretation can be employed in order to lessen the burdening
weight of sense on the subject. These latter interpretations (those that
take place within the transference) imply various ways of exploding
sense. However, the very first interpretations should be ones that estab-
lish a mark in the real: they should create a moment in which anxiety
causes a desire for sense and a belief in knowledge. Consequently, an
administrative relationship to jouissance has been created that is medi-
ated by the social bond with the Other. In this sense you could say that
now the love of the transference can do its work. To quote Gabriela van
den Hoven: Love is a way to put the object a in the Other. To have a
question about it is to try to produce some knowledge and first of all
to take the Other into account (van den Hoven, 2002, p. 170). That is
when analysis has a chance.
Conclusion: a clinical fragment

I conclude with a very brief fragment of the case of a female patient
of a therapist whom I supervise. This patient came for consultation
without making an appointment. She just knocked on the door. The
therapist works with students in one of the universities. Her patient is
a drama student. The patient said that she had been very depressed in
the past and she had been prescribed medication for this. Eventually
her depression lifted. Now she is in a relationship but things are turn-
ing sour. She feels that the relationship between her and her boyfriend
will fall apart. She worries that she may become depressed again. She
says that her parents were both drug addicts. Her father is still an active
user. She never felt much part of her parents life. Rejection, exclusion,
failure, and lack of success are very much part of her discourse. This
is understandable when one knows that her parents chose jouissance
over desire and thus over desire for her. She displayed a curious lit-
tle habit. From the very first session onwards she asks her therapist
whether she can plug in her mobile phone to charge it. The therapist
allows her to do this and consequently the patient charges her phone
at every subsequent session. I mentioned the following to her therapist:
This is a very interesting act and perhaps she demands from the Other,
you, her parents, her friends, and so on, to be recharged. The therapist
then told me that her patient panics when she does not have access to
her mobile phone. When she feels down or depressed she needs to be
able to talk to her friends immediately and then she is full of enthusiasm
again. I said to the therapist that, considering that she has only a couple
of sessions left (sessions were limited in this particular situation), she
could, when the opportunity presents itself, make an interpretation by
saying, for instance, that the patient needs others to charge her. After
the supervision session it suddenly occurred to me that an opportu-
nity had been missed. When the patient was next to ask if she could
charge her phone, the therapist should have been prepared to say: NO!
The depression of her patient is related to an unmediated dependence
on the Other. Her relationship to the Other is less determined by the
linguistically structured social bond with the Other than it is based on
a (nearly) visceral and unlimited dependence on an object. This NO!
would have functioned as a limit, as something that separates heror
extracts herfrom her jouissance and thus it would have functioned as
something that provokes anxiety. After all, as Lacan suggests, one can
only move from jouissance to desire via anxiety (Lacan, 19621963b).
Has psychoanalysis not taught us that one has to be able to say
NO!, especially in a world where everything is possible and where the
can-do and I do because I can mentality reigns supreme? More than
ever, psychoanalysis should not give in to the general push for adapta-
tion via positive thinking.
References
Beira, M. (2006). Personal communication.
Brousse, M.-H. (2006). Common markets and segregation. In: J. Clemens &
R. Grigg (Eds.), Jacques Lacan and the Other Side of Psychoanalysis
(pp. 254262). Durham: Duke University Press.
De Quincey, T. (1821). Confessions of an English Opium Eater. London:
Penguin Classics. [Reprinted: 1986.]
Dunsire, A. (1973). Administration: The Word and the Science. London: Martin
Robertson & Co.
European Monitoring Centre for Drugs and Drug Addiction. (2004). Annual
Report 2004: The State of the Drugs Problem in the European Union and
Norway. Luxemburg: Office for Official Publications of the European
Communities.
Fink, B. (2006). Personal communication.
Freud, S. (1885). Contribution to the knowledge of the effect of cocaine.
In: R. Byck (Ed.), Cocaine Papers (pp. 96104). New York: Stonehill, 1974.
Freud, S. (1887). Craving for and fear of cocaine. In: R. Byck (Ed.), Cocaine
Papers (pp. 169176). New York: Stonehill, 1974.
Freud, S. (1905c). Jokes and Their Relation to the Unconscious. In: S.E., 8.
London: The Hogarth Press.
Freud, S. (1919a). Lines of Advance in Psycho-Analytic Therapy. In: S.E., 17.
London: The Hogarth Press
Freud, S. (1930a). Civilization and its Discontents. In: S.E., 21. London:
The Hogarth Press
Freud, S. (1985). The Complete Letters of Sigmund Freud to Wilhelm Fliess
18871904, J. Masson (ed.), Cambridge: Harvard University Press,
1985.
Harari, R. (2002). How Joyce Made His Name: A Reading of the Final Lacan,
(Trans.) L. Thurston. New York: The Other Press.
Hardt, M. & Negri, T. (2000). Empire. Cambridge: Harvard University
Press.
Hoven, van den, G. (2002). Toxicomania in Context. Psychoanalytical Note-
books, 9: pp. 163170.
Jonckheere, L. (2005). Van een remedie tegen de angst naar een mogelijke
overschrijding van de angst (Of a remedy against anxiety to a possible
crossing-over of anxiety). iNWiT, 1: 108137.
Joyce, J. (1916). A portrait of the artist as a young man. In: H. Levin (Ed.),
James Joyce: A James Joyce Reader (pp. 243526). London: Penguin Books,
1993.
Joyce, J. (1922). Ulysses. London: Everymans Library. [Reprinted: 1992.]
Lacan, J. (19621963a). The Seminar, Book X, Anxiety, C. Gallagher (Trans.),
unpublished, lecture, 14 November 1962.
Lacan, J. (19621963b). The Seminar, Book X, Anxiety, C. Gallagher (Trans.),
unpublished, lecture, 13 March 1963.
Lacan, J. (1966). La place de la psychanalyse dans la medecine (The place of
psychoanalysis in medicine). Cahier du College de Medecine, 12: 761774.
Lacan, J. (1972). Du discours psychanalytique (On psychoanalytic dis-
course). In: Lacan in Italia 19531978: En Italie Lacan (pp. 3355). Milan:
La Salamandra.
Lacan, J. (19731974). The Seminar, Book XXI, The Non-Dupes Err/The Names
of the Father, (Trans. C. Gallagher), unpublished, lecture 13 November
1973.
Lacan, J. (19741975). The Seminar Book XXII, RSI. C. Gallagher (Trans.).
Unpublished, lecture 13 May 1975.
Lacan, J. (19751976a). The Seminar, Book XXIII, Joyce and The Sinthome.
C. Gallagher (Trans.). Unpublished, lecture 18 November 1975.
Lacan, J. (19751976b). The Seminar, Book XXIII, Joyce and The Sinthome.
C. Gallagher (Trans.). Unpublished, lecture 11 May 1976.
Lacan, J. (1977a). The Seminar, Livre XXIV, LInsu que sait de lune bevue saiile
a mourre, D. Collins (Trans.). Unpublished, lecture 14 April 1977.
Lacan, J. (1977b). The Seminar, Livre XXIV, LInsu que sait de lune bevue saiile
a mourre, D. Collins (Trans.). Unpublished, lecture 17 May 1977.
Lacan, J. (1987). Television. D. Hollier, R. Krauss and A. Michelson (Trans.),
October 40, pp. 550.
Lacan, J. (1988). The seminar of Jacques Lacan, Book I: Freuds Papers on
Technique, 19531954. (J. A. Miller Ed. & J. Forrester Trans.) New York:
W. W. Norton.
Lacan, J. (1993). The Seminar, Book III, The Psychoses, text established by
J.-A. Miller , R. Grigg (trans.). London: Routledge.
Lacan, J. (1998). The Seminary, Book XX: Encore, 1972-1973. Trans. Bruce
Fink. New York: W. W. Norton.
Lacan, J. (2006). The Seminar, Book XVII, The Other Side of Psychoanalysis,
19691970, text established by J.-A. Miller, R. Grigg (trans.), New York:
W. W. Norton.
Lipovetsky, G. (2005). Hypermodern Times. Cambridge: Polity Press.
Loose, R. (2002). The Subject of Addiction: Psychoanalysis and the Administra-
tion of Enjoyment. London: Karnac.
MacGabhann, L., Scheele, A., Dunne, T., Gallagher, P., MacNeela, P.,
Moore, G., Philbin, M. (2004) (Eds.), Mental Health and Addiction Services
and the Management of Dual Diagnosis in Ireland. Dublin: National Advi-
sory Committee on Drugs.
Miller, J.-A. (2001a). Lacanian biology and the event of the body. Lacanian
Ink, 18: 629.
Miller, J.-A. (2001b). The symptom and the body event. Lacanian Ink, 19:
447.
Miller, J.-A. (2005). Inleiding tot de Lezing van Lacans Seminarie X over de
Angst: Aan deze Zijde van het Verlangen (Introduction to the Reading
of Lacans Seminar X on Anxiety: On this Side of Desire). (Trans. H. Van
Hoorde). iNWiT, 1: 8184.
Miller, J.-A. (2007a). De Misslag, Sexueel (The Mishit, Sexual). iNWiT, 2/3:
89101.
Miller, J.-A. (2007b). Resonanties (Resonances). iNWiT, 2/3: 7488.

Naparstek, F. (2002). Toxicomania of yesterday and today. Psychoanalytical
Nunberg, H. & Federn, E. (1962). Minutes of the Vienna Psychoanalytic
Society, I, 19061908. New York: International Universities Press.
Power, A. (1974). Conversations with James Joyce. Dublin: The Lilliput Press.
[Reprinted: 1999].
Skriabine, P. (2004). The clinic of the Borromean knot. In: E. Ragland and D.
Milanovic (Eds.), E. Ragland and V. Voruz (Trans.). Lacan: Topologically
Speaking (pp. 249267). New York: Other Press.
Trevarthen, C. (19992000). Musicality and the intrinsic motive pulse:
evidence from human psychobiology and infant communication. In:
Rhythms, Musical Narrative, and the Origins of Human Communication.
Musicae Scientae, Special Issue, 19992000. Liege: European Society for
the Cognitive Sciences of Music, pp. 155215.
Trobas, G. (2006). Depression of repression & modern symptoms. Psycho-
analytical Notebooks, 15: 595.
CHAPTER TWO
New uses of drugs

Fabin Naparstek
F
irst of all, I would like to thank the Affiliated Psychoanalytic
Workgroups (APW) and mainly Kareen Malone and Yael
Goldman Baldwin. I know how hard they have worked to make
this possible. Im very glad to have the possibility of sharing my work
with you.
I decided to focus on new forms of drug use, thus the title of my
presentation. The different uses of drugs is a topic that we have been
studying for a while in TyA Buenos Aires (the workgroup I lead in Bue-
nos Aires) and also in the International TyA network. Indeed, this was
the topic I discussed in Paris in 2002 at the workshop of TyA in the XIIth
International Encounter of the Freudian Field, and, later on, during the
same year, in the presentation I gave in the United Kingdom named
Toxicomania of yesterday and today (Naparstek, 2002).
Today, I would like to go further in discussing drug use. Ill share
with you some of my thoughts and research experiences on the topic
with the hope that we can establish a venue for exchanging and devel-
oping ideas on the subject.
When I talk about drug uses, I refer to the ways in which the subject
relates to drugs. These kinds of relationship have evolved and changed
39
with time. Although drug consumption is not a new or modern

phenomenon, toxicomania and alcoholism, as such, have been only
recently formulated.
In fact, I would argue that, whereas drug consumption is not new,
its definition as an addictive problem, in its present meaning, has been
found only recently.
In my book (Naparstek et al., 2005), I attempted to trace the different
uses of drugs throughout history and within different cultural contexts.
Most of us are familiar with the use of drugs in ancient Greece and with
the debates around it, or the use made by aborigines in different parts of
the world, or the central role played by opium in China and in various
eastern religions. Even in the Old and New Testaments, we find refer-
ence to the use of drugs.
I will not delve into these historical examples. However, my main
point is that addiction, toxicomania, and drug-dependence (whichever
term you may choose) have been recognized as such only in the last 150
years. However, the history of drug use is wider and older than that of
toxicomania and alcoholism.
What do I mean by toxicomania and alcoholism? I refer to them
as a particular sort, among others, of relationship an individual has
with a certain substance.
As Escohotado argues in his thesis History of Drugs: Unless we were
addressing communities that live in Arctic areas, with no vegetation
at all, there are no human groups that have not displayed some use of
psychoactive drugs (Escohotado, 1998, p. 23).
I mean, except for those places where no substances grow, there is a
relationship between the subject and certain substances that provoke
different organic effects. In fact, as I have already said, toxicomania and
alcoholism, as such, have only been recognized during the last century
and half.
Based on this perspective, I suggested in an earlier presentation
(Naparstek, 2002), to distinguish among three different historical peri-
ods of drug use in Western societies. In the first, the use of drugs was
not presented as a pathology. In the second, starting at the end of the
nineteenth century and the beginning of the twentieth, drugs started to
generate some dependency. This is the time that Freud wrote his Civi-
lization and its Discontents (Freud, 1930a). Finally, there is the third and
contemporary period, on which I shall focus today.
NEW USES OF DRUGS 41
First of all, Id like to talk about the difference between the period in
which Freud wrote and ours. In doing so, I try to analyse the changes
produced in addictive practices and then, departing from Freud and
Lacans writings, try to distinguish which clinical tools can be relevant
today to our understanding of toxicomania.
Within this framework of discussion, Id like to compare two types
of partying; on the one hand the old one, and, on the other, the current
one. Why focus on partying? Because, I believe, partying is central in
the lives of youngsters and in their use of drugs. Parties provide the
setting in which young people usually meet, express themselves, and
consume substances, among other things.
The first topic Id like to emphasize is that which stems from the con-
cept of culture as developed by Freud in his Totem and Taboo (Freud,
1913a), where partying plays a key role.
In Freuds discussion on the constitutive myth of culture, he points
out several features relevant to my discussion. Freud talks about the
existence of the primitive horde in which a proto-father possessed all
women. The children kill him and establish culture by creating a pact
for a social contract. It is understood that such agreement is symbolic.
The pact is symbolic, as it represents the entrance to language. It is not
enough by just killing the hordes male that culture is created. Further-
more, a pact happens to be necessary where there is a renunciation of
keeping the whole jouissance previously enjoyed by the proto-father.
Such whole jouissance must be lost. The pact is fundamentally based
on renouncing and distributing. This is Freuds main idea: there is
no culture without renunciation. Because of this total loss, some of
this jouissance can be distributed. The war loot (if I can refer to it this
way) is distributed negatively, however. That is to say, this is not an
equal socialist distribution. This is a distribution in which it has to
be assured that no one will get a full share. Nobody enjoys the old and
whole jouissance. Everybody has to give up something. It doesnt matter
whether someone gets ten women or none, what matters is that it has
to be made sure that at least one woman is not delivered. This dynamic
is deduced from what Freud calls the totemic party: once a year, an
animalrepresenting the fatheris killed, eaten up, and an encounter
characterized as necessary and mandatory is held (Freud, 1913a). At
this point, it is important to mention the two main characteristics of the
totemic party: a limited but mandatory excess. The excess implies
that whatever is forbidden during regular times is allowed during

party time. Therefore, whereas in regular times it is forbidden to touch
the totem, in party times it is eaten. All the laws that rule society can be
broken during the party.
Such a mandatory condition originated from the blood pact and
is specially connected to guilt. In this way, it is assured that everybody
will feel guilt in breaking the law. Unfortunately, this motive is closely
linked with the Argentinean collective experience. During the time of
military rule, there was an implicit blood pact according to which every
member of the military had to kill someone to be equally responsible
(and guilty) in the massacre party. In any case, this is a party in which
the crowd, the collective, prevails over the singular. Therefore, culture
is established upon a renunciation on the one hand (repression, inhibi-
tion, neurosis, religion, family, state, ideals, etc.) and an excess on the
other.
However, there is also a surplus that cannot be digested. After all,
there is a recurrent attempt to eat up the father every year time and
again. This means that there is a bone that is not entirely digested or
swallowed. This bone is unruly, it cannot be subjected to the rule of
law, but from time to time it needs its place. This is the logic that leads
Freud to talk about the Super Ego. Freud develops the idea that the
more virtuous the individual, the more is demanded by the Super Ego.
According to Freud, it was preferable that these parties would take
place from time to time and that people would have their little excesses
and law breaking. It is better to give such little excesses their place than
try to leave them out completely. According to Lacans formula, what is
rejected (foreclosed) comes back in the Real each time:
Scheme:
1) jouissance Law: Dead father
/-----------/-------------------------------------------------------------/Culture
Therefore, the jouissance is left aside the law, as a clandestine jouissance.

Psychosis shows the devastating effects very clearly when the jouissance
is not clandestine and pervades or invades all through.
In some indigenous tribesas demonstrated in earlier work
(Naparstek, 2002)the drug was part of the culture, especially in these
parties. Anthropologists showed that drug consumption ratifies the
pact with the father, with the authority, and revalidates the culture
within the party.
The drug, in this way, is at the service of the religious ritual and of
culture; for example, some rituals enable the individual to become a
member of a group. In this case, the consumption is limited and regu-
lated in compliance with the ruling of such rituals (Furst, 1980).
Back to the present, and what once was limited in time and space,
has now expanded over everything. This is a consequence of what is
often called the fall of authority and ideals. Such fall of ideals is accom-
panied by a push-to-jouissance, as shown by Eric Laurent in Lacanian
Compass (Laurent, 2006).
Nowadays, we live a push-to-enjoyment, a push-through-
consumption, a kind of perpetual and permanent party, boundless,
without renouncement, where the Impossible is Nothing (as Adi-
das advertise). What once was marginal has now become protagonist.
When we talk about hypermodernityas explained by Lipovetzky
(2005)we imply taking modernity to its extreme. Lipovetzkys idea
points out that at a certain moment the right to enjoy was highlighted,
and therefore we now live in an era in which the constant struggle over
the right to enjoy has become a push-to-jouissance. We cannot say
that we are in post-modernity, he argues, as the term post means
change, and we are, rather, standing on the edge of the same.
Taking modernity to its own limits, the world is divided up between
pushing-to-jouissance and depression, one of the prevailing pathologies
of contemporary society. That is, what previously was a limited obliga-
tion to participate in the party, has today become a push-to-jouissance
through consumption, so the one who is not able to consume becomes
depressed. The division used to be between order and small occa-
sional disorders. Now, the consumer is bound to obtain an unbounded
jouissance, which doesnt allow depression. Therefore, today the world
is divided between consumption and its abstinence.
The so-called globalization makes us believe that each and all of us
can equally enjoy the same things in any and all parts of the world.
Ethnic strifeas anticipated by Lacanrepresents a way of resist-
ance to globalization, an attempt to retain the singularity and particu-
larity jeopardized by globalization.
Now, I would like to step forward. What once was a lateral surplus,
has now become central. There is a cult for the surplus, a kind of culture
that worships the surplus, or we can say object a.
We can take the surplus in two different ways: on one hand, as a kind
of waste that has to be thrown away, and, on the other, as a motivat-
ing factor encouraging work. The latter is a fertile surplus associated
with what Freud called the diurnal surplus. Its a surplus that causes
work and requires processing. However, nowadays there is a cult of the
surplus as a waste. Waste belongs to human nature itself, and it is what
remains from every symbolic operation.
Im not sure whether in the United States it is a common practice,
but in Argentina the so-called JUNTADITO or MEZCLADITO (a slang
neologism which would translate as GATHERED or MIXED) happens
at the end of youngsters parties. Its a mixture of all the leftovers of
what they have drunk all night long. They put them all together into
just one glass and then drink it. By consuming the JUNTADITO, they
attempt to dissipate any remains of the party.
The point is that whoever drinks this surplus, identifies himself or
herself with it and ends up in the street thrown away as well as the
waste of civilization (that is, they become the waste itself). Its about
the promotion of object a as a compass of civilizationas Miller asserts
(Miller, 2004).
Its this promotion that changes the hypermodern subject into a dis-
inhibited one. As Miller proposes: The dictatorship of object a makes
marriages blow off, families break apart and bodies change (surgery,
diet, anorexia, etc.) (Miller, 2004).
Accordingly, Eric Laurent points out that besides the jouissance of the
overdose, there is the alloverdose (Laurent, 2004, p. 7). He said that
it is the experience of the All regarding jouissance. The overdose takes
place whenever there is a limit to pass over.
However, Laurent develops the idea of how, at present, there is a
generalized search for total jouissance without any surplus.
Lacan states that it was about the rise of object a to the zenith of
civilization (Lacan, 1977, pp. 2526). This is what Miller wrote as: a>I
(Laurent, 2004, p. 3). That is, the prevalence of object a over the signi-
fier, over the ideals, over the Name-of-the-Father. What Miller explains
is that the object a questions the Name-of-the-Father. Thats why he
named the last lesson of the Seminar Anxiety From the object a to the
Names of the father.
Object a is what doesnt allow (isnt allowed?) to be named, what
remains out of the nominative function of the Name-of-the-Father,
questioning it. Indeed, it questions the universal father.
Miller states: Object a puts the unity of the Name of the Father in
doubt (Miller, 2003).
Push-to-jouissance. Dictatorship of a Name-of-the-Father. fanaticism

/-----------------------------------------------------------------/-----------------------/
At present, there is a party consumption: ecstasy, alcohol, cocaine, crack,

psycho-stimulants, etc. They are all drugs that respond to a euphoric
demand. Heroine consumption, a psychedelic drug intended to elimi-
nate anguish, to abstract oneself from the world, and finally to destroy
sexuality, is different. Also marijuana could perform as a tranquilizer.
Likewise, such new kinds of consumption take us to a sexuality
under influence, to a strengthened sexuality, because they reach the
sexual act after the party, after the burst, deadly ruined.
Disc Jockeys parties are an example of sexuality under ecstasy effects.
Moreover, nowadays Viagra is a mass consumption substance, mostly
for young people. What was once presented as a drug directed at the
elderly has become a mass usage substance. At this point an attempt to
ignore the phallic limit is clearly seen, not only as a symbolic limit, but
as an organic one.
There is a kind of consumption that returns to sexuality, whereas in
the past it was intended to be left aside. But its about a maniacal sexu-
ality. (Ill come back to this.) This mass consumption leaves subjects
increasingly alone. As a matter of fact, both globalized jouissance and
globalized loneliness are in place. Lasting and strong relationships hap-
pen to be the most difficult thing to achieve, thus altering encounters
between sexes.
Therefore, in my opinion, what Freud proposed in his text Civiliza-
tion and its Discontents, cannot be sustained nowadays. I understand
that the Freudian time and ours are so different that, as a result, coor-
dinates have changed. In Freuds time, toxicomania was one isolated
symptom among others. Freud presents things as a menu of chances
where solutions la carte may be found. I mean, the key point is the
inherent discontent in each culture and then a set of possibilities to pal-
liate such discontent; narcotic usage is a crutchas Freud saysamong
others (love, religions, sublimation, etc.).
There is a current trend oriented to a unique and globalized answer,
and it is about the same jouissance, in the mode of one-ness, for everyone,
trying to sweep away all differences. Such a trend seems to be different

from the one pointed out by Freud in his Civilization and its Discontents.
Im trying to place a period according to Freuds text and time when
narcotic consumption starts to outline as another way of facing the Real
and, indeed, as an isolated symptom. That was a time when ideals stood
out, and there was a preponderance for the Name-of-the-Father. Thats
why a drug took the placein some alcoholic casesas a possible part-
ner. At that time, toxicomania seems to be the answer aside others, as
something localized or punctual.
Anyway, what that period shows is how the alcoholic is tied to con-
sumption through certain ideal links, through their creed, even the
groups. That is, the man who meets with others to drink alcoholsetting
up linksas a way to clean out his love sorrows. In Buenos Aires, we
call him the romantic alcoholic.
At the same time, we have another moment that answers to such a
period, called by Miller, the inexistence of the Other Miller (2002).
It is about the generalized toxicomania (Sinatra, 2008, p. 48), as a
globalized and unique way. Its the time of general consumption as
a supposed and unique answer to discontent; so, things are divided
between consumers and the depressed. I mean, those who cant enjoy
according to the market rules, get depressed.
So, as such cultural coordinates regarding drugs have been identi-
fied, Ill step ahead to frame how we think, following the Lacanian ori-
entation, toxicomania in neurosis and in psychosis. Later on, Ill come
back to this current pathology way. But now, lets talk about toxicoma-
nia in neurosis and psychosis.
Toxicomania-orientation in neurosis
Within the field of neurosis, there is a Freudian version of the relation-
ship between the individual and a drug. When I say Freudian and
Lacanian version, it doesnt mean they gave a seminar, a course, or
wrote a paper about toxicomania. You wont find that. It doesnt exist
or, at least, I havent found that in any place. What we do find are refer-
ences, and we make a version out of them, a Freudian and a Lacanian
version. I myself take a position about this. And, of course, Im not the
only one. There are lots of psychoanalysts that work on that matter.
Both versions haveto mean intimate relationship. Theres an inti-
mate connection between them, but for sure with a Lacanian version we
are going one step up from a Freudian version.
You know that there are a lot of references in Freud about narcotic
usage; for example, Letter 79 brings up such issues, and includes
the following quote (as featuring in the chapter by Tom Svolos):
masturbation is the one major habit, the primal addiction, and that it
is only as a substitute and replacement for it that the other addictions
for alcohol, morphine, tobacco, etc. come into existence (Freud,
1950a, p. 272). This is a whole thesis. Ill write it this way:
Addictions
Masturbation
The problem is what people substitute for this first and original addic-
tion: masturbation. Masturbation is the common addiction for every-
body. In this way, we can say that everybody is an addict. Everybody
has a period with this main addiction. So, the problem is as we go to
substitute another addiction or with love, sublimation, symptom, etc.
with masturbation.
Love/Sublimation/etc
Masturbation
Well, he defines masturbation as a primary addiction, and he says that
the other ones would be secondary to this. They are masturbation sub-
stitutes, therefore, addictions (in the plural). It means that there is a
substitution of these other addictions for masturbation. To me, this is
the strongest thesis in Freud on the issue.
In Lacantoday I want to focus specially on his versionthere is
an indication that it is not about addictions, but it is about the drug
itself andto meit is a strong thesis in Lacan that takes the Freudian
thesis. Of course, thats the way I read it. Lacan never says hes taking
this Freudian thesis. He says the following: Drug is what allows the
breaking of the marriage between the body and little pee pee (Lacan,
1976, p. 268). Little pee pee is a reference to Little Hans. The point in
Lacan is how to examine this breaking with the phallus.
So, quoting Lacan, When someone considers himself a male, thats
because he has a little tailmeaning penis, etymologicallybut
something else is necessary. And he adds: Phallus is the joining of
that parasite, that little tail, with the function of the word (Lacan,
1975). Actually, Lacan sustains that in order to accede to the other sex, it
is necessary to pay the price for the little difference that gets cheatingly
to the Real through the organ (Lacan, 1971), adding: an organ is only
an instrument because of the signifier (Lacan, 1971). Notice the differ-
ence between an organ and an instrument. An organ becomes an instru-
ment only in the connection with the signifier.
We can write it like this:
Word
( -------- ) Phallus
organ
By Signifier
organ -------------------> instrument
On this point, Lacan goes further and proposes that the transsexual
doesnt want to know anything about the signifier, or about the organ
itself, making a mistake, a common mistake, in Lacans words, of
refusing to signify the phallus by sexual speech (Lacan, 1994, p. 278).
Therefore, the mistake is trying to push symbolic sexual speech into
the Real through surgery. There is a common mistake in confusing the
Real of the organ with its articulation with signifieras an instrument.
And that is pathetically shown in the transsexuals example.
Regarding this common mistake and its consequences, I think its
worth clarifying the differences between organ and instrument,
between penis and phallus. For example, Lacan wonders why angst
appears in Little Hans. Thats where he locates real penis irruption
(Lacan, 1994, p. 278). Im not examining Hanss case but I think its very
useful thinking about this reference to real penis irruption. On the one
hand, Lacan points out that the phallus was Hanss centre of the world,
and suddenly something changes and Hanss penis becomes something
real: His penis starts moving and the kid starts masturbation . This
is just the observable. Therefore, we should wonder if theres a relation-
ship between this elementreal penis irruptionand what appears in
that moment: angst (Lacan, 1994, p. 278). Id underline the independ-
ence of penis in the expression penis starts moving. Lacan points out a
penis that becomes independent, which moves itself, shakes itself. Its
also indicated that it is a drive in the most elemental way. That means
in Hans, what should be the knotted phallus, irrupts as real, of course,
with its driving face, and produces angst. It is in that moment that the
phallus is not enough to hold the real penis. The phallus cant make
firmly the joint.
Everyone believesfrom the egothat the phallus can be managed
at ones sole discretion. Its a narcissistic belief strongly tied to the imag-
inary register. Thats how we find people who suddenly realize that the
phallus doesnt obey their will, but unconscious laws, in its symbolic
face. These subjects canin some casesmake a symptom out of that.
But, regarding Hans, we underline how the penisand not the
phallusbecomes independent. And in this sense, it becomes inde-
pendent from not only ego and will, but also from the rhetoric of the
Unconscious.
The real penis is not narcissistically tied to the ego, nor to metaphor
and metonymy of the Unconscious. Thats why the penis should be
held by the symbolic and imaginary phallus, so the equations could be
made. So, Lacan observes that the Symbolic order, as different from
the Real, gets into the Real order like a fence in the field, introducing
an original dimension. This is the point in this case, Hans (Lacan,
1994, p. 278). Lacan is referring essentially to the fathers function, law,
and castration, all of the elements that set some kind of order into the
Real of the bodyrepresented in this case by the real penis. The Real
penis is drive, driving organism, or as he will call it later: real jouis-
sance (Lacan, 1994, p. 278).
By Signifier
organ -------------------> instrument
Real jouissance
Drive in the most elemental way
Thats why the definition which opens The Signification of the

PhallusLacans writingshows strongly how the symptom is ana-
lysable, as far it is tied to castration, to the phallus: the castration
complex is the tie in the dynamic structure of the symptom, in an
analytical sense of the term, we mean, of what it is analyzable (Lacan,
1988, p. 665). Although there is something in the symptom that is reluc-
tant to being caught by the phallic tie quoted above.
Out of this path, we have also some consequences for psychosis,
and I would say in a special way. With these same terms, Lacan
comments: The devastating aspect, especially in paranoia, of the first

complete orgasmic sensation (Lacan, 1994, p. 278). And also, the dif-
ficulty of integrating the real penis in psychosis, because of the foreclos-
ure of the symbolic father (Lacan, 1994, p. 278). This reminds us of the
appearancein Schreberof the frequent nocturnal ejaculations. And
following our path, we could say, they respond neither to the will, nor
to unconscious determination.
Weve thoroughly commented about the difficulty of the psychotic
subject with integrating the organ into a symbolic net, and putting it in
some order.
Returning to such orientation, Miller points out that it is crucial to
define the jouissance of the toxicomaniac, and he stresses, as we have
just stated, that there is a jouissance that does not go through the Other.
He adds that this is the sexual Other. Out of this formulation, he warns
us about the fact that not going through the sexual Other does not neces-
sarily entail leaving the sexual jouissance apart, or let us say, the phallus.
He gives the example of a male homosexual who looks for the same
in the other, instead of the differentbut it is still a phallic jouissance.
He gives another example: the act of masturbation may imply not the
break, but the marriage, with the little pee peewhat Lacan called the
bachelor.
But, for Miller, while the jouissance that is found in toxicomania
does not entail going through the Other, it does not go through phallic
jouissance either. According to Millers point of view, the specificity of
the toxicomaniacs jouissance enables avoiding setting forth the sexual
problem.
I have presented a clinical case in which consumption was so much
oriented to be not at the service of breaking the phallus, but rather to
remaining married to it, to using drugs with the purpose of keeping
masturbation. However, what Miller argues, following Lacan, is that the
true toxicomaniac is the one who breaks with sex. Something patheti-
cally described by clinical work (already given in London). Now, lets
move on with toxicomanias in psychosis.
Toxicomania in psychosis
In the workgroups held in Paris in 2002, it was very clear in differ-
ent presentationsfrom different parts of the worldthat people who
usually work with toxicomania are finding more and more psychotic
subjects. At first, we dont ask why. Lets take it as a fact. I have two
options in mind: either there are effectively more psychotics that use
drugs (in the way we think of toxicomania); or, for some reason, we
are more aware to make a diagnosis of psychosis in some subjects. Can
you follow the matter? In fact, maybe some time ago, we wouldnt
have made a diagnosis of psychosis in lots of these same cases. Well,
these are the reasons, from my point of view, that justify bringing this
topic.
Then, in Eric Laurents article, of 1994, he defines the thesis of the
break, calling it break formation. Its very interesting because he
makes a game between symptom formation and breaking forma-
tion, following Freudian terms. Its the idea that drugs allow breaking
with the phallus; as I have just explained. Therefore, its not a com-
promise formationas symptombut a breaking formation. Besides,
it lets us think about the mania included in the term toxicomaniain
breaking with the phallus. Mania is exactly on the opposite side of the
phallus, since the phallus implies limit par excellence.
In a brief summary of Laurents ideas, he proposes the following:
that mentioned thesis of breaking does not fit psychosis, it fits only neu-
rosis becausefollowing an impeccable logicin psychosis, the break
is at the beginning. Otherwise, it shows how, in some psychotics, the
use of drugs doesnt represent a toxicomania but a monomania (fol-
lowing Esquirols term, from classical psychiatry). Laurent points out
that in some psychotics, the link they establish with drugs lets them
locate jouissance, lots of times. Thats exactly opposite to the mentioned
breaking thesis. Its demonstrated that the phallus locates jouissance and
when theres a breaking with it, a dislocated jouissance is found.
I want to focus on monomanias, as far as I used to understand it as
a logical deduction, but a little time ago I realized that it was actually
a clinical indication. I started to find some subjects that use only one
drug, which has a specific function in the structure and responds to this
clinical indication of monomanias.
We have certain toxicomanias of the sort I take it all (not always
far off being literal). If theres no heroin, theres water, if not, cocaine,
or whatever. We have seen lots of cases that show this taking it all;
but there are other cases that involve only one drug in a manic way. So,
its still mania but a limited one. Some cases could be revised because
its an interesting clinical indication to test: differentiating toxicomanias

from monomanias.
In London, I discussed a subject who sought my advice on his toxi-
comaniahe tells me that he performs a systematic use of drugs, once
a week, and that this fact does not prevent him from carrying out his
professional activity with certain success. After a long period of inter-
views, he notes that in that moment of drug use, he performs a practice:
he transvestites into a woman. He justifies as well that his preferred
drugcocaineproduces an effect that makes his penis retract, as far
as the point of making it almost disappear. All the matter was what to
do at that momentwhen he started having an uncontainable sensa-
tion within the bodywhat to do with that thing that was there (that
is how he used to describe his own penis, with that sensation of strange-
ness). This state was named with a neologism like numb moment. If
this moment was not stopped quickly, it led him to hear all kinds of
unbearable voices. Cocaineand a masturbatory practicehelped him
reduce, at that numb moment, that organ for which he had no symbolic
element to be transformed into a jouissance instrument. In this case, the
whole thing was trying to keep this intimate practice reduced, both in
a time and space dimension. This practice helped him command an
unbearable invasion of jouissance.
Another subject comes to see me arguing that he has an addiction to
sexuality and Viagra. He has a mania of having sex with prostitutes and
consuming Viagra. At that moment, he presented a systematic daily
sexual intercourse with prostitutes. After a short time, he could explain
that in fact it was not about sexual desire, but a need. He tells that when
he was a teenager he used to have erections with no sense at all. This
could happen at any moment without any sexual reference or stimuli
of any kind. He would have erections over and over again when, for
instance, listening to some music, or when speaking with someone. He
points out that such erections appeared out of the blue and turned
out to be unbearable. For many years, he suffered from such unbear-
able invasions of jouissance, which came along together with voices and
other psychotic phenomena (which took him to drug consumption with
several passages to the act), until he came across Viagra. Before com-
ing across Viagra, he was not able to have sexual intercourse because
he lacked any desire, although he wanted to be like everybody else.
With Viagra, he managed to have sexual intercourse, to be like other
men, but at the same time he began to regulate his erections. The organ
began to respond to the pills. At present, once in a while, he has some

isolated erections (as he calls them); he now grounds them on his
high sexual activity. He holds long-term sexual intercourses, which
adapt to the pills effect. In this case, Viagra helped not only to heal his
impotence but also to regularize an organ that did not respond to any
law; as the patient said, Being able to have a controlled sexuality. The
treatment was oriented to make the subject be able to, together with his
sexual mania, hold such a stabilization that enabled him to lead a life
just like everybody else, without the voices and phenomena destabi-
lizing him.
These two little clinical vignettes show very clearly that the whole
thing for these young men was what to do with an organ that did not
let itself get tied. In the first case, we can see the problem he could have
without his addictive practice, as far as it was useful to command, peri-
odically, an unbearable and uncontrollable irruption of jouissance. It
remains to be determined how, in psychosis, with a limited practice as
the one mentioned above, drugs do not have a breaking function but a
tying one. Indeed, the clinic of the break formation is applicable to
neurosis, but not to psychosis.
Moreover, if we increasingly find a greater number of psychotic sub-
jects within the toxicomania field, we will be forced to look for more
and new answers.
Besides, its clear that in these kinds of cases the direction of the treat-
ment doesnt necessarily involve giving up drug consumption.
Regarding the cases Ive just exposed, the treatment was oriented
to keeping such direction, a kind of limited consumption that would
enable them to keep stabilized.
As a conclusion
It happens to be obvious that science has very properly understood
the relationship between the phallus and the organ. Viagra is aimed at
performing exactly in the connection point between both. What used
to stand for a phallic symptom in the pastin the joint between the
word and the little tail in question and which Ive already explained
and was analysable in sexual male disordersnowadays could be
resolved by separating the organ from its link to the signifier. Its about
an organ that starts to respond only to sciences gadget and not to
unconsciousness.
Now, we can write it like this:
Pill (science)
Drug (Viagra) ---------------------- // Breaking with word
organ
It is different when the phallus is the joint between word and the
organ:
Word
( -------- ) Phallus
organ
The drug tries to make sexuality work, regardless of the word. There-
fore, it may be understood why partying drugsas Viagra is called
in Argentinaare not only used for sexual dysfunctions. What now
surprises laboratories had already been announced by Lacan a long
time ago.
If sexuality doesnt have any other way of working but through
dysfunctionsuch dysfunction produced by the languagepartying
drugs offer everybody the chance of a promised sexuality without
unconsciousness, a sexuality without dysfunctions. A kind of sexuality
that may certainly be named sexuality under the influence or rather a
manic sexuality, without any limit, I mean, without phallic limit. This
is the reason why youngsters use them, regardless of the fact that they
may have a specific sexual dysfunction.
As Marta Rajtman, a clinic sexologist, states: Its a noble drug, fan-
tastic, similar to contraceptive pills which allow women to be the own-
ers of their bodies. Nowadays, men take possession of theirs. In my
opinion its the best drug of last century (Rajtman, 2005).
Indeed, that seems to be the paradigm of this time: a time that encour-
ages partying consumption by means of drugs that are at the service of
a maniac euphoria.
As Ive just said, ecstasy, cocaine, psycho-stimulants, etc. are drugs
that encourage endless partying where Impossible is Nothing. A time
featured by overcoming limits and believing in the power of beating
them. This is clearly different from the previous time when drugs were
aimed at removing people from sexuality and relieving their anguish.

Heroine, old alcohol, marijuana, hallucination drugs seem to be old
models of current refined drugs.
If the old break from the phallus was introduced as a way to get away
from sexuality, thus leaving the old toxicomanic out of it, nowadays, it
is possible to break off the phallus and keep an unlimited sexuality, or
rather the illusion of it. Hypermodernity has taken an old aspiration of
modernity to the extreme: breaking off from the phallus, but not from
sexuality.
However, Mariano H., 41 years old, tells us that Viagra worked for
him as the gunpowder: fire is needed to explode. Thats the way he
has found to describe how the organ taken up by the drug is not tied
to desire.
In order to meet with the other sex, another condiment is needed.
At the same time a patient, who consults for an erection dysfunction,
decides to take the pill soon after his therapy does not resolve his prob-
lem. However, he draws a similar conclusion to Marianos. In his opin-
ion, the pill has not worked his sexual impotence out. The pill enabled
him to have sexual intercourse with a woman who does not complain
anymore about his lack of erection; but he wonders whats going on
in his marriage where he is unable to have sexual desires, whereas it
doesnt happen in extra-marital relationships.
Thus, he registers his impotence in the face of certain authoritarian
women for whom he has no answers.
Esteban L., 39 years old, shows us something similar. The pill doesnt
work in extra-marital relationships, but it does inside his marriage.
However, he points out something else: the time it worked, happened
to be unbearable for him. He saw how his organ moved by itself.
Its like in the case of Little Hans whose real penis swings or in
the case of a psychotic subject who argued that his penis and the
word used to be separately out there, which also turns out to be
unbearable.
As a result, we can see how such time gets increasingly closer to
madness in the strictest sense of the term.
If the old drug pattern enabled the heart to get drunk and to move
away from negative encounters with the Other sex, it is clear that the
current improved pattern is oriented to not leaving sexuality, even
under the condition of losing the phallus as a means of sexual inter-
course, desire, and love.
In the past, consumption was at the service of covering losses (for

example, drinking alcohol on a broken heart); whereas, at present, con-
sumption is based on the assumption that nothing is lost. The para-
digm of current consumption calls for what Lacan named the common
mistake made by transsexuals, a drunk jouissance, the same one for
everybody without any singularity regarding how each one faces their
sexual problem. It fosters sex with an unknown Other and leaves sub-
jects increasingly lonely, thus foreclosing them.
Unless the symptom as real can appear like a stick in the wheel
and show that impotence grants the benefit of making the subject
rise again, then this is where psychoanalysis finds its place in culture
with a therapeutic pattern that recognizes the limits themselves of
subjectivity.
References
Escohotado, A. (1998). Historia general de las drogas 1. [General History of
Drugs.] Madrid: Alianza Editorial.
Freud, S. (1913a). Totem and taboo. In S.E., XIII. London: The Hogarth
Press.
Freud, S. (1930a). Civilization and its discontents. In S.E., 21. London: The
Hogarth Press.
Freud, S. (1950a). Extracts from the Fliess letters. In S.E., I. London: The
Hogarth Press.
Furst, P. (Ed.). (1980). Alucingenos y cultura. [Hallucinigens and Culture.]
Mxico: Fondo de cultura econmica.
Lacan, J. (19621963). The Seminar, Book XI, Anxiety. Trans. C. Gallagher.
Unpublished, lecture 13 March 1963.
Lacan, J. (1971) Seminario XIX, Ou pire. [Or Worse.] Clase del 8 de diciembre
de 1971. Indito.
Lacan, J. (1975) Seminario XXIII, Le Sinthome. Clase del 18 de Noviembre de
1975. Indito.
Lacan, J. (1976). Intervention in the Journes des cartels de lcole freud-
ienne de Paris. Lettre de lcole freudienne, 18: 263270.
Lacan, J. (1977). Psicoanlisis, Radiofona y Televisin. [Psychoanalysis, Radio-
phone, and Television.] Barcelona: Anagrama.
Lacan, J. (1988). La significacin del falo. [The Signification of the Phallus.]
Escritos 2. Buenos Aires: Siglo XXI Editores.
Lacan, J. (1994). Seminario IV, La relacin de Objeto. [The Relation with the
Object.] Barcelona: Paids.
Laurent, E. (1994). Tres observaciones sobre la toxicomana. [Three

observations about toxicomania.] Sujeto, Goce y Modernidad, II: 1521.
Buenos Aires: Atuel TyA.
Laurent, E. (2004). La societ du symptone. [The Society of the Symptom.]
Quarto 79, revue de lEcole de la Cause Freudienne, 9. Bruxelles, Belgique.
Laurent, E. (2006). The name of the father: psychoanalysis and democracy.
Lacanian Compass: Psychoanalytic Newsletter of Lacanian Orientation, 1(7).
Electronic publication.
Lipovetsky, G. (2005). Hypermodern Times. Cambridge: Polity Press.
Miller, J.-A. (2002). A contribution of the schizophrenic to the psychoana-
lytic clinic (originally published as La clinique dironie). The Symptom, 2.
Available at: http:///www.lacan.com/contributionf/htm, accessed 9
June 2011.
Miller, J.-A. (2003). Curso de Orientacin Lacaniana. Clase 17, 4/2003.
Indito.
Miller, J-A. (2004). Keynote presentation at the Conferencia Comandatuba,
Ilha de Comandatuba, Brasil.
Naparstek, F. et al. (Eds.) (2005). Introduccin a la clnica con toxicomanas y
alcoholismo. [Introduction to the Clinic of Toxicomania and Alcoholism.]
Buenos Aires: Grama Ediciones.
Rajtman, M. (2005). Diario Clarn, July, 24, 2005. Buenos Aires, Argentina.
Sinatra, E. (2008). La toxicomana generalizada. [Generalized Toxicomania.]
Mas all de las drogas. Bolivia: Plural.
CHAPTER THREE
Knows nos nose

Rolf Flor
I define a nose as followsentreating only beforehand, and

beseeching my readers, both male and female, of what age,
complexion, and condition so ever, for the love of God and their
own souls, to guard against the temptations and suggestions of the
devil, and suffer him by no art or wile to put any other ideas into
their minds, than what I put into my definitionFor by the word
Nose, throughout all this long chapter of noses, and in every other
part of my work, where the word Nose occursI declare, by that
word I mean a nose, and nothing more, or less.
(Sterne, 1962, p. 172)
Addiction in a therapeutic clinic

Under the guidance of policy makers and researchers, the contempo-
rary trend is to see addiction as a medical health issue. This direction is
encapsulated by the slogan addiction is a disease. It might be nice to
believe that this means that the contemporary therapeutic clinic has
evolved with regard to addiction from a stance of pre-scientific moral-
ism or neglect to a medical activity founded in scientific knowledge and
guided by professional civility. Certainly it has become more common
59
for addiction to be treated in mental health settings by specialists in

substance abuse intervention. A closer inspection yields many disap-
pointments about our putative progress.
The optimal therapy for persons with an addiction remains a mystery.
Rather than finding tributaries of clinical experience leading to deeper
rivers of knowledgethe empiricist fantasy of scientific progress, or
ever more coherence in locating addictions on a conceptual mapping of
psychopathologythe rationalist fantasy of a comprehensive science,
prescribed treatment options seem without either of these moorings.
Since the effectiveness of any therapy has not been convincingly
established, the professional therapist can depend on a certain free-
dom of choice in clinical practice. This does not imply that an ethos of
pluralism or tolerance has taken over. Behavioural, pharmacological,
and psychosocial interventions contest for dominance in a social con-
text. And experience in the clinic suggests that non-clinical forces have
much to say about how therapeutic eclecticism is managed. Many of
the current options for the treatment of addictions in the therapeutic
clinic arose or were developed as public health mandates aimed at the
eradication of perceived epidemics. Treatment is funded in a social setting
where drug tsars are deputized in a war on drugs. And costs must
be reduced, which turns out to be the way that performance is meas-
ured in this war. In other words, the treatment of addiction is framed
within the context of social impact.
The addicted subject, it should be noted, may have little interest in
being the focus of treatment. They may have very legitimate concerns
about speaking to anyone about their addiction, lest they find them-
selves in the crosshairs of the war. Other subjects may of course also
have little interest in being the focus of treatment. Here begins what
strikes me as a cautionary tale.
Jack1
Although Jack had been in treatment at our clinic for several years,
only his psychiatrist had remained constant. He had seen three previ-
ous therapists. This is not unusual in community health settings. Jack
was placed on my caseload because his earlier therapist had left the
clinic. He told me that he had seen this therapist for the past six months.
He said: She helped me with my self-esteem. We have been working at
that for a while and she definitely helped.2
KNOWS NOS NOSE 61
I asked him what had definitely helped his self-esteem?

I have problems with my wife because of my diagnosis. We argue
because she puts me down for my problem. I have also been diagnosed
bipolar, but nothing has helped me as much as the (methylphenidate).
That changed my life. Lithium just made me sick, so I definitely have
attention deficit. Before I was never able to stay on top of things and
with the medicine I can. I used to think I was stupid, now I realize that
I was just ADHD [Attention Deficit Hyperactivity Disorder]. My wife
doesnt want me to be on my medicine. Grace [his former therapist]
helped me accept the fact that I have this chemical imbalance. Its not
my fault.
Clearly he wanted me to know his diagnosis and what had alleviated
this condition. He managed to cycle back several times to both.
Jacks words throughout these early sessions followed each other
evenly, somewhat quickly, and often without emphasis. His manner of
speaking struck me as odd, having a scripted sound. Possibly this
was the result of his having been moved from therapist to therapist.
In that sense, there had been several rehearsals for our meeting.
As we started the first session, his speech felt like a relief to me. I saw
Jack after another patient, one who was much more reticent to speak,
where long silences left me longing for more words. Nevertheless,
after a certain point, the way that Jack filled the session began to make
me anxious. Upon reflection I realized that anxiety struck me when
I noticed that he would get ever so slightly louder whenever I tried to
say something.
He continued to spontaneously tell me about his treatment history.
My mother completely understands my problem, because she is a
psychiatrist. She has always said that I have ADHD. She would never
entertain any doubts about his diagnosis. One time when I was in high
school3 someone tried to convince her I was manic-depressive. She dis-
missed the idea.
As I learned a little later, she never had any doubts, as he described
her. She was always calm, cool and collected. She has to be calm:
shes a psychiatrist, all the time. I tried to jump in with a question-
ing quotation: All the time? He just ploughed on. Nothing seems
to ruffle her. Even when she told the family about her girlfriend, she
just announced it. As if it did not matter at all to anyone else that she
was now a lesbian . Like it was nothing to talk about . Actually,
I dont think she ever really announced it. We never spoke about it.
Well we spoke about it, my brother and I, but she never did. I never
heard her use the word lesbian. Not that I care, I have friends who are
that way, but it just makes me feel a little queasy. I know its probably
just a chemical thing like everything else.
He watched me with a steady gaze as he spoke, seemingly looking
for reactions, but never leaving room for change of speaker moments.
He seemed to play both parts in our dialogue. I needed to speak quickly
or louder in order to get a word in anywhere; even then I was not sure
that he had attended to what I had said. This is not the first time that
someone had spilled their thoughts out quickly during a first session,
but usually they recognize what they are doing at some point. Jack filled
our time almost seamlessly. When I ended the first session, he had no
objection. He simply got up and quickly said, See you next week.
Usually thats my line.
Analytic therapy?
As my introductory words have suggested, I am disillusioned about
the contemporary clinic. My doubt and dissatisfaction extends beyond
the treatment of addiction in community mental health: the intrusion
of politics, the desperation of eclecticism, and the dominance of reduc-
tive biology are pervasive. Long before I met Jack, in fact long before
I had begun to practice, I had developed an interest in the work of
Lacan because it seems to point to a richer and more vigorous alter-
native. Nevertheless, having done much of my training in community
mental health settings, I have elected to stay and see what is to be done.
Specifically, I wondered, and continue to wonder, what Lacan can bring
to the work done in community clinics.
These clinics have their own rules. Reading the notes from previous
therapists it was clear that Jack had agreed to see a therapist because
the agency had a policy against providing psychiatry without therapy.
When I asked him what he wished to get from therapy he joked that
it was a good way to get an hour or two away from his family. I told
myself that anytime someone comes to speak to someone, an analysis
may begin if the listener brings the unconscious to that listening. Par-
enthetically, one thing he certainly did not say to me was that he had an
addiction, much less that he wished to do anything about it.
As I listened to Jack with my studies and my own experience in analy-
sis in mind, I was occupied with other difficulties. Without a crisis or con-
frontation to motivate him, Jack was coming to see me without expressing
KNOWS NOS NOSE 63
any demand for treatment whatsoever on his part, and certainly not
analytic treatment. There were complaints lodged in his discourse, but
his tone and pace suggested that they were no more important than any-
thing else he had to say. Nevertheless, having taken it as a goal to try to
think and work through the tensions and contradictions of applying
Lacan, I sat with Jack once a weeklistening from a place which I hoped
could be different from any place Jack had been listened to before. I chose
to do this even though listening itself, more so than with any previous
patients, eventually took on an anxiety-provoking quality for me.
After a brief period of time of gathering family history, I turned my
attention to the process of orienting the patient to talk therapy. I did
encourage him to speak everything that came to mind without censor-
ship. This had a perfunctory quality for me, given that he seemed to
have no difficulty doing something like that already.4 During a momen-
tary lull in an early session I asked him about his dreams, fantasies,
etc. He did not take me up on that for a little while. Second, in keeping
with what I think Lacan has said about the centrality of language, its
acquisition and its impact, I wondered how Jack may have been caught
in the mechanism of signification and what choices he may have made
along the way. Certainly language seemed to grab a hold of Jack some-
where. As I understand him, Lacan explored how the assumption of
subjectivityan attempt to address the fundamental question of who
or what one isironically depends on losing a certain amount of the
immediacy of just being as one ventures into the terrain of meaning.
A particular gap or crack opens when language herniates the wall of
interior experience and starts to affect that experience. I began try-
ing to assess how Jack personally lived through that crack.5 What was
Jacks way with language?
In short, to put things in more technical terms, I introduced him to
the fundamental rule as best I could, while trying to diagnose him,
however provisionally.
The former, as I have said, did not seem so difficult; the latter became
increasingly more complicated for me.
Interviewing for history

Our early sessions, as I have already mentioned, covered his family history.
Jack was the older of two boys. His mother, as already mentioned, was a
psychiatrist. She didnt think much of Jacks father. His father worked
with his hands. It was evident to Jack that his mother felt superior to his
father in every way. Jack rarely spoke about his father. He remembered
his father and mother fighting loudly on many nights. Shortly before the
parents separated, he heard an argument in which his mother called his
father a fucking cunt. At the time he remembered being afraid until
she yelled those words, thereafter things became silent. He chuckled in
the session as he repeated the phrase fucking cunt. How, he asked
bemusedly, is a cunt going to fuck? It makes no sense.
His parents divorced when he was 8.
When Jack was 9, his mother began to date a woman, without
acknowledging (or for that matter, hiding) that she had begun a lesbian
relationship. Although his mother and her girlfriend owned separate
homes, they alternated sleeping on weekends in each others homes for
many years. The girlfriend of Jacks mother otherwise interacted very
little with Jack and the rest of the family. One memory he had was of
his mothers bedroom door swinging open on a warm summer Sunday.
His mother and her girlfriend were entwined in a position that he could
not identify because a sheet covered them and there just seemed to be
feet sticking out everywhere. He watched for some time listening to
their whispers and noises. One of them sneezed and they both laughed
uproariously. He pulled the door shut quietly when he heard his brother
coming up behind him.
He felt popular in school, but neither he nor his mother was satisfied
with his school achievements. Many sessions were filled with material
and associations to school. Several dreams revolved around his playing
the class clown. Stories about school frequently involved disciplining
by teachers because of his inability to repress jokes and comments. Jack
acknowledged smoking pot, drinking alcohol, and snorting cocaine
with his brother in his teen years. He did not like the pot, liked the
alcohol at times, but felt the cocaine helped him with his school work.
Referencing a book that he had bought about ADHD, he referred to this
as probably self-medicating.
Jack also had his first sexual experience in his teen years with an older
woman. This happened shortly before being hospitalized for losing it.
He said that he threatened someone with a knife, and was acting all
crazy, so they locked me up. The hazy details of that event suggest that
a relationship was the presumptive cause of losing it. But he also sug-
gested that to a certain extent there was a sexual problem at the heart
of itperhaps the same one that affected his current relationship. Jack
was not having sex with his wife often enough to satisfy her, because he
KNOWS NOS NOSE 65
could not stand the state he would fall into after orgasm. He reported
that his sexual experiences, after a very brief period of enjoyment (prob-
ably limited to masturbation in his teen years), were not enjoyable. He
found himself completely lifeless and dysthymic after every orgasm.
My dick, he said, is all shrivelled. Everything, he said with a note-
worthy turn of phrase, smells like failure. Perhaps this was a problem
for him, but one would not know it from what Jack said. He never even
suggested that something about this could or would change. Sex, he
said during that same session, is overrated. He repeated this later.
Masturbation, preferably without his wife present, could be okay at
times. His wife would frequently engage him to perform oral sex on
her, which he said he did not mind so much. She complained, how-
ever, because he would talk to her while going down on her about the
things that he needed to do (pay bills, etc.). She said that made it hard
for her to enjoy herself and it made her feel even worse about their not
having intercourse. This made him feel guilty. Yet the argument about
his talking during these intimacies happened repeatedly.
The dream of Jacks son

Jack usually hit the ground running from the moment he arrived for
his sessions; however Jack was frequently late for his appointments.
Several months after our first session, two weeks after I had reminded
him that I was interested in hearing his dreams, and one week after
I pointed out that his tardiness was interfering in his treatment, he
brought the following:
I had a dream that I was on my way here, but I was lost, so I knew
I was going to be late. I knew you would understand, but I felt stupid.
I have never been able to trust men. I am always worried they will be
angry at me. I know youre not the type to get angry, but still . I felt
stupid because I just couldnt stay focused on the road, and that always
happens when I dont take my medicine. I saw my son (Jason). He was
wearing his football uniform, standing next to his coach. His coach was
waving at me to pull over, and I could see as I pulled to the side of the
road, my son was holding his helmet. The helmet looked very dented.
Jasons uniform was ripped in places and he had blood all over him.
Blood was running from his nose like a motherfucker.
After a pause he added, I was proud of him because I knew the
other kid must have looked a lot worse.
Jacks associations to the dream were to his brother and the fights
they had when he was growing up.
We fought over everything until we were in our teens. It was not
unusual for my mother to have to pull us apart. It happened so often
that she didnt even get worked-up over it. The only time she actu-
ally got angry was when I accidentally hit my brother with a bat in the
face. She yelled at me, screaming Why cant you pay attention? What
is wrong with you?
Coming back to this material at a later time he added that he now
understood why she let that get to her; someone had explained to him
that if the bat had pushed his brothers nose into his skull his brother
could die, a danger of which his mother was presumably aware.
I vigorously encouraged him to associate to the dream, even
thoughor perhaps becausefor the first time in our sessions his words
seemed to leave room for me. He actually seemed to be thinking rather
than reading from a script. Perhaps analytic treatment was beginning to
take hold? Perhaps Jack was entering the work of treatment?
That got me thinking harder about what it could be that shaped his
particular way of feeling lifes bite. From the ways in which he was
afraid of not remaining present, of fading or drifting-off, he seemed to
me to struggle with how to be more vital. If I were to get a word in edge-
wise, he just might come to a full stop. The way in which he seemed to
cling to vitality was in remaining alert. In short I found myself conclud-
ing that his particular way of pushing away lifes bite was to never let
down his guard and notice that it had one, or alternatively, whenever he
noticed one, to not feel it. This is the kind of constraint that I have come to
associate with what Freud described as Zwangsneurose (Freud, 1909d).
Remembering that Lacan had argued that obsessionas a character-
istic primal way of managing the lack that comes with languagewas
really something of a dialect of hysteria, my thoughts turned ever more
frequently to the question: how can analysis work for Jack?6 If he did
have even an inkling of engaging in an analysis, which granted would
not be the way he would put things, how should I be his analyst?
Dr. V. and the real Jack

One day, soon after the dream about his son, I arrived in my office to find
a series of phone messages waiting for me. The first was from Jack. In a
surprisingly petulant tone, Jack said Dr. V was being a fucking cunt
KNOWS NOS NOSE 67
about this. If she was going to cut him off he was going to lose
his job, and he was going to hold her responsible. Then he hung up.
The second call was again from Jack. Slightly calmer, he acknowledged
that I may not know what he was talking about. While on a trip to see
his brother, his medication had accidentally dropped into the toilet.
It wouldnt be a big deal, but he needed to drive his truck the next
day and since he was prescribed methylphenidate for his ADHD, if he
were to drive without his medication he could lose his licence. Could I
please speak with Dr. V and straighten things out? He was very sorry
for getting angry with her, but she needed to understand that his live-
lihood depended on this! The third call was from Dr. V. She said that
this was the third time in little more than a year that Jack had needed
to get another prescription. The bottle had been lost, stolen, and now
flushed. He had called urgently requesting a refill but she no longer
felt comfortable prescribing because she was beginning to suspect that
he was abusing his methylphenidate. She would be willing to see him
to consider alternative medication, but she would no longer prescribe
amphetamines. The fourth call from Jack said that he would be in that
morning to see me because we had to straighten this out.
A little later that morning, Jack was in my office with an empty, water-
stained pill bottle. After pushing me in a variety of ways to do my part
to get his medication refilled, Jack sat in my office for the very first time
in complete and utter silence. The minutes ticked by. Demoralized, he
finally asked about other options. Stopping any and all medication was
not an option. After a telephone conversation with Dr. V, Jack accepted
the idea that he would take a referral to see one of our psychiatrists
who prescribed specifically within the agencys substance abuse pro-
gramme. From what he said, it was clear that he hoped the other doctor
(another woman) would realize that Dr. Vs concerns were unfounded.
When Jack arrived for his next session, on time for a change, he started
with the first of a series of surprising revelations. He described the irony
of it all as in the past he had abused his medication. He admitted that
he had taken too much just for fun back then. Nobody had noticed. Back
then it would have made sense to call him on it, but not now! Session
after session included new information about the question of addic-
tion. When he noticed that he started needing it more to get the same
effect for his everyday life he resolved not to abuse my medication.
I could have taken my sons methylphenidate, but I would never do
that. Is that what Dr. V would have preferred? At one point he had in
fact been addicted to cocaine. I weaned myself off because I did not
want to lose my job. They do random drug screens for truck driving.
In the meantime, Jack had gone to see the substance abuse psychia-
trist who at first offered him medication from other classes of drugs
(mood stabilizers, anti-psychotics, antidepressants). After very brief tri-
als, Jack inevitably reported reasons (side effects, insufficient treatment
of his primary complaint, etc.) for stopping these medications. Finally,
the new doctor was willing to prescribe what Jack thought of as a time
release version of his methylphenidate, which was purportedly not as
prone for abuse or dependence.
Gradually, Jack tried to settle back into the pattern that existed before
the methylphenidate crisis. He was again regularly late for his appoint-
ments, stubbing out a cigarette as he walked in the door, clutching a
giant coffee. I again found myself anxious that I could not be heard.
Once more I needed to raise my voice or repeat myself in order to punc-
tuate anything that struck me as an unconscious formation. He again
ended our sessions with See you next week.
Finally, following a series of sessions where he had arrived late, and
with a great deal of effort on my part, I pointed out the pattern. For the
rest of that session, and for many of the following, he tried several dif-
ferent ways to get me to say that I accepted that the problems which led
to his being late were out of (his) control because it was ultimately
due to his inability to concentrate, his chemical imbalance. His associa-
tions in one of these sessions led him to a memory of his mother from his
early childhood. Standing one day in his mothers office, a room that he
was not welcome to go into in their home, he was touching some of her
papers. She walked in and coldly looked at him. After a pause, in which
she stared angrily at him, she finally said, If you are going to be nosy,
there will be hell to pay.7 I punctuated the word nosy because of the
way that he pronounced it, with a strange elongation. He became irritated
with my saying the word back to him in a questioning way. What was I
getting at? I said it sounded as if he had started to say noisy. What the
hell is wrong with me that I need to focus on every little slip? Am I trying
to bring him down? Do I need to interrupt him, even when he is trying to
share a painful and personal memory with that kind of crap?
One big bloody nose

Jack was late for his next session, cheerful, and irrepressible. Again,
I found myself anxious.
KNOWS NOS NOSE 69
Two sessions later, Jacks wife called to say that he needed to go to

the doctor and that he would probably miss this appointment. She was
calling for him, something she had never done before, because accord-
ing to her he did not want me to think that he was avoiding me. The
following session he explained that he had gotten a nose bleed, leaving
him in his words one big bloody nose. He said that this was not the
first time that had happened, but the bleeding wouldnt stop this time.
With the word nose ringing in my ears, I started to feel like we
had reached something profoundly worth pursuing. I remembered
his dream about his son. I remembered the sneeze in his mothers bed.
I remembered the way that his brother could die. I remembered the
way his dick smelled like failure.
Perhaps noting my change of expression, without even a pause or
change in tone, he launched into an explanation for his bloody nose.
The organization of his explanation reminded me of what I remem-
ber of Swifts A Modest Proposal. What starts out as gentle observation,
gradually, almost imperceptibly, grows to a horrific conclusion. Some-
times, like, it tickles when I put things up my nose. I always used to
do that. I would stick pencils in my nose. Even now, when I get bored,
I will go to the medicine cabinet and use nasal spray.
From this tickle, ripples seemed to form, like a pebble thrown into
a still lake.
He had stuck things up his nose since he was a very small child.
It made him feel funny, made him feel alert. When he was taking
a test in school, if he couldnt think of an answer on a test, he would
push the pencils eraser against his nasal membrane. Sometimes that
helped him find the answer. He would hide this, but sometimes he
would also purposefully put two pencils in his nose, one in each nos-
tril: It cracked people up. One time when he got sick his mother gave
him nasal spray, and she cleaned out his nose with a saline solution.
He remembered needing to hide an erection. Cocaine provided, as he
put it, a concentrated high. This was too expensive in school, but his
mother had arranged for him to get methylphenidate, and from another
student he had learned to crush and snort methylphenidate.
I am not altogether clear as to why he was willing to provide this
information. Perhaps it was my bemused look when he first mentioned
the pencils up his nose, the moment when I realized that a cipher may
have been written for Jack on his nasal membrane. Perhaps he thought
the episodic assertions he threw in about this being a problem from the
past kept him safe from my questioning his current abuse. (More than
once he mentioned the toxicology screens which his work randomly

imposed on him; I wouldnt be so stupid as to risk my job.) Perhaps
he just wanted to prevent me from interrupting his flow.
After he relayed the story of a previous serious nose bleed, which
sounded quite painful, he laughed. I asked, What makes you laugh?
He laughed nervously some more, telling me about how I too had
never noticed things. Apparently, on many occasions before a session,
Jack would sit in his truck on the far side of the parking lot snorting a
crushed methylphenidate.
I asked why he would do this.

He told me he would never do this again.
I repeated my question.
He told me not to be angry.
I asked him if I seemed angry.
He said, No . And you shouldnt be . I did it for you.
Trying not to show just how perplexed this answer left me, I asked
him, How so?
That way I am focused.
He missed his next session. I called to ask him to make it up. He could
not or would not arrange anything before our next scheduled date.
He missed that session. His wife called to tell me that he had lost his
insurance, because he had been out of work.
Jack never mentioned to me that he was out of work.
After not responding to any of my outreach efforts, I closed his case.
Afterwards
I frequently find myself reflecting back on my experience with Jack and
his nose. Questions and lessons float by. Was Jack leading me around by
the nose? Or did Jack let me know about his nose because at some level
he had already jumped ship? Was he hoping that I would find a way
to stop him? Or did he tell me more than he could bear my knowing?
Jacks nose, like what Freud noticed about sexuality, perhaps like addic-
tion itself, has the iceberg quality: the part you see is a small fraction
of the whole. I am grateful for this insight. It enriches my listening to
others, just like the above questions motivate curiosity.
KNOWS NOS NOSE 71
But does Jack have any reason to appreciate his experience in

treatment? I have no reason to believe that his addiction was curbed
by his treatment. In other words, I assume that Jack continues to get his
methylphenidate or whatever he is currently using as nose candy. If
he is no longer working, perhaps he could fall back on the illicit drugs
which had succeeded in the past. Sadly, I remember his alluding to a
friend who had offered him heroin, which he knew was safer to snort
than to shoot.
My readings and experience lead me to expect that most patients
have incorporated the fact that the world says no to them in some sense.
In a psychoanalytic vein, one could say that most people have learned
to live with castration.8 Jack lived his life to be a nose; he seems to have
turned his no into nose. Chemicals, both real and imagined, went
into his nose so that he could remain alive and moving and energetic.
But could they be symbolic for him? Could he personalize his addiction
in some sense? Could talking about noses become a point of departure
in future work?
Once one begins to live with no, one uses words to try to name
what seems lost with no. Words can offer a compensation for the no
that is so painful to know. But Jacks subjectivity seems to be centred on
the nasal membrane itself, a place where the inside meets the outside, a
place where the life of thought meets the fear of death, but not a place
where words function easily.
Endnotes
1. All names in the text are pseudonyms.
2. Quotations are taken from sessions. In addition to some changes neces-
sary to protect confidentiality, the punctuations are added. This obscures
the fact that Jacks sentences often seemed to have neither beginnings
nor ends, running on without pause for large chunks of time. Several of
the places where I have inserted periods were actually punctuated by a
barely intoned and.
3. High School is a secondary stage of education in the USA.
4. This is not to say that just because someone speaks non-stop that
this person does not censor what they say. Sometimes speaking a lot
is exactly the best way to censor something else that one does not
wish to say. For an introduction to the fundamental rule see S. Freud.
(1913c).
5. Lacan, drawing on Freud, finds logical reasons for a few typical ways
for this to happen. See B. Fink. (1997). A Clinical Introduction to Lacanian
Psychoanalysis: Theory and Technique. Cambridge: Harvard University
Press, pp. 7579. Lacan, drawing on Freud, finds logical reasons for a
few typical ways for this to happen.
6. For examples and explanations about obsessional neurosis a la Lacan
see B. Fink. (1997) pp. 112145 or D. Nobus. (2000). Jacques Lacan and
the Freudian Practice of Psychoanalysis. Philadelphia, PA: Routledge,
pp. 2734.
7. In hindsight, having read this material many times, I am ever more
struck by how foundational this sentence may have been for Jack.
8. Assuming that Jack had in some way learned to live with castrationa
reasonable hypothesisit seems also reasonable to ask when and how
this happened. Jacks mother herself may have performed this opera-
tion with a single sentence: If you are going to be nosy, there will be
hell to pay.
References
Fink, B. (1997). A Clinical Introduction to Lacanian Psychoanalysis: Theory and
Technique. Cambridge: Harvard University Press.
Freud, S. (1909d). Notes upon a Case of Obsessional Neurosis. In: S.E.,
10: 155249.
Freud, S. (1913c). On Beginning the Treatment. In: S.E., 13: 121144.
Nobus, D. (2000). Jacques Lacan and the Freudian Practice of Psychoanalysis.
Philadelphia, PA: Routledge.
Sterne, L. (1962). The Life and Opinions of Tristram Shandy. New York: Holt,
Rinehart & Winston.
CHAPTER FOUR
Brief comments on Rolf Flors

case presentation
Bruce Fink
I
want to thank Rolf for his fine presentation of a short but rich case
in which he allows us to see things which had probably escaped
Jacks previous therapists. Indeed, one wonders to what degree Jack
had succeeded in simply leading them around by the nose. There is
a curious Fliessian character to the case, although instead of the nose
being mapped point by point to the rest of the body (as Fliess suggests),
the nose itself seems to be the essential erogenous zone here, bringing
renewed meaning to Freuds comments about (the rubbing of) mucous
membranes! The nose is the organ that does not fail Jack, we might
say, whereas his penis doesthe latter becomes all shrivelled, he feels
lifeless, and everything smells like failure. Isnt he attesting to what
I have called the fallibility of phallic jouissance (Fink, 2002, p. 37)?
The nose, on the other hand, might perhaps be understood here as
the infallible or unfailing erogenous zone, the cunt that can always be
tickled, even if it is unclear to him how it can fuck (that being reserved
for the penis or baseball bat?). The nose serves here, it seems, as a
kind of ambiguous, polyvalent sexual organ (or amboceptor) (Lacan
2006, pp. 271, 772), which is protruding but can have things inserted
into it, which can be blownthat is, have things ejected from itand
be sprayed or snorted into, and which can bleed like a vagina or sneeze
73
like a penis? (For another example of such an ambiguous sexual

organ, see Fink 2003).
If the nose can be said to provide some sort of reliable Other
jouissance, a jouissance beyond the fallible phallus (the nose nevertheless
being a sort of phallic symbol), it curiously allowed him to function bet-
ter at work and, he felt, in therapy: stimulating it the right way made
him focused and helped him find the answers on tests. And let us not
forget that it could lead to death, if one hit it the wrong waynot la
petite mort, but la grande.
Does his nose provide a substitute jouissance or rather a supplemen-
tal jouissance? That is the questionor at least one of them. Another
question is that of diagnosis, which does not seem overly clear to me
thus far.
Jacks choice of drugs he could put up his nose seems to have encoun-
tered a nosy (or noisy) Eros-in-waiting, a zone stimulated for him by his
mother, a zone involved in sneezing, which is after all what one does
in bed with a woman, in his experience, a zone that can lend itself to
identifications with both men and women.
In his work life, Jack was ever striving to keep his nose clean, but he
kept getting it up his nose, as P. G. Wodehouse was wont to say. Did
Jack lose his job as it were deliberately after telling Rolf about his snort-
ing methylphenidate before sessions, after first articulating that he had
enlisted the Other jouissance in the service of his phallic jouissancethat
is, in the service of the work of therapy (as he had done with cocaine in
high school to help with his school work)? That is the question Ill raise
here at the end of my brief comments on the case.
References
Fink, B. (2002). Knowledge and jouissance. In: B. Fink & S. Barnard (Eds.),
Reading Seminar XX: Lacans Major Work on Love, Knowledge, and Feminine
Sexuality (pp. 2145). Albany: SUNY Press.
Fink, B. (2003). The use of Lacanian psychoanalysis in a case of fetichism.
Clinical Case Studies II, 1: 5069.
Lacan, J. (2006). In crits: The First Complete Edition in English. Trans. B. Fink
in collaboration with H. Fink and R. Grigg. New York: W. W. Norton.
CHAPTER FIVE
Introducing the New Symptoms

Thomas Svolos
To attach to or detach from the Phallus

There is a very curious relationship between what Freud and what
Lacan had to say about addictions. Freud makes a few comments on
addictions in his work, most of them a gloss in one form or another
of his comments to Wilhelm Fleiss in a letter of 22 December 1897, in
which he states that masturbation is the one major habit, the primary
addiction, and it is only as a substitute and replacement for it that the
other addictionsto alcohol, morphine and tobacco, and the like
come into existence (Freud, 1985, p. 287). Lacan had fewer things to
say about addictions, but perhaps his most well-known comment was
delivered in 1975, as an aside, at a meeting of the cole, when Lacan
noted that there is no other definition of drugs than that which allows
one to break the marriage, the relationship, with the Phallus (Lacan,
1976). With Freud, addictions are a means of maintaining a relationship
with the Phallusin this masturbatory sense, without the connection
to the Other, a short circuit to jouissance; for Lacan, addictions are a
way of obtaining jouissance, but, instead of obtaining this through the
Phallus, he speaks of obtaining it by breaking a connection with the
Phallus.
75
My first thesis is that this divergence indicates a different place for

the Phallus with regard to castration and its relationship to jouissance.
For Freud, castration (of the mother or the child) for the male is linked
to a perceived threat of the loss of ones Phallus, further linked to a
perceived paternal injunction. Integration into the social bond is fur-
ther, for Freud, linked to a certain perceived renunciation of enjoyment
achieved through the mechanism of paternal identification and the
pursuit of a jouissance regulated, in a sense, through that identification.
Addictions, in this model, short-circuit the path to satisfaction, taking
the subject out of the social bond in a mode of direct satisfaction, akin
to masturbation. Now, Lacan doesfor example, in Seminar Vrework
this Freudian proposition, rewrite it, importing linguistics and partially
reformulating this structure of castration and Oedipus with his notion
of the Name-of-the-Father. And, in that sense, one can certainly eas-
ily read Lacans comments in 1975 about breaking the relation with
the Phallus in addictions as breaking the relation with the social order,
disconnecting from the Otheras regulated by the Symbolic Phallus
(Lacan, 1976).
I would suggest, however, that we read this comment of Lacans
in the light of his later comments on the Phallus, in particular those
which Jacques-Alain Miller has recently drawn our attention to within
Seminar X. Miller notes that in this Seminar we see the return of the
Phallus, not only as Symbolic, but as organ. In this context, Miller
notes: The negative minus phi is, in fact, no longer a symbol of castra-
tion, but designates an anatomical property of the male organ which
is completely the opposite of its imaginarization as power, since it is
a matter of the detumescence which strikes this organ at the moment
of its jouissance (Miller, 2004, p.83). This formulation on the Phal-
lus, which Miller notes is not at all present in Freud, puts Lacans
comments into a completely different perspective, one in which as a
body part, the Phallus does not represent an auto-erotic jouissance, as
with Freud, but rather a body part which contains the death of jou-
issance at the very moment of its achievement as the very principle
of the Phallus itself. This change in perspective on the Phallus from
Freud reprises Lacans general rejection of Freuds auto-erotic Phal-
lus and replaces it with the allo-erotic Phallus Lacan identifies in the
Little Hans case, where the boy is confronted not with the Phallus as
a source of satisfaction, but as a parasitic foreign object affecting him
in ways that he does not understand, sexuality appearing here in its
I N T R O D U C I N G T H E N E W S Y M P TO M S 77
traumatic character, fundamentally disruptive, and opaque to Hans

understanding.
We see here, then, a divergencefor Freud, addiction is an attach-
ment to the Phallus as a means to obtain satisfaction by somehow avoid-
ing the law or the passage through the social bond. For Lacan, however,
addiction correlates with an escape from the Phallus in this other sense,
addiction as a jouissance, correlated with an escape from what Lacan
calls the affliction of the speaking being with sexuality itself. In one
case, the speaking being avoids the Law; in the other, the subject avoids
the affliction of sexuality.
From malaise to addiction

With regard to history, however, its easy enough to note thatthe few
comments such as those noted above notwithstandingFreud and
Lacan had relatively little to say about addictions, and they were hardly
alone in this respect within the greater psy field. Amidst all the psy lit-
erature on neurosis and psychosis and the suffering of the timesay a
half-century or century agoall the discontent or malaise, to adopt the
French translation, which Freud alludes to, addiction does not figure
prominently. Something that is somewhat surprising given the verita-
ble ubiquity of addictions todaynot only in the terms of the public
debate on the various epidemics of drugs; not only in the proliferation
of the new addiction diagnosessuch as alcoholism and drugs, but
also, say, pathological gambling, self-cutting, anorexia, and bulimia;
and not only in the very ways in which patients themselves frame their
treatment demands today; but also at the level of political discourse.
In 1979, our last period of soaring energy prices, President Jimmy Carter
delivered a now-infamous speech in which he enumerated the psychic,
spiritual, and social suffering of the American people and their relation
to the energy crisisthe Malaise Speech, which ruined his political
fortunes. In contrast, in our current energy crisisalso a time of some
discontent in the American political arenawe have just heard Presi-
dent George Bush declare that America is addicted to oil and that
the best way to break this addiction is through technology.
In addition to its ubiquity, however, I think it is important to recog-
nize thatin the broader psy field beyond psychoanalysisaddiction
is the new template for diagnosis itself. Diagnosis in psychiatry and
psychology has gone from the Realist diagnosis of classical psychiatry
from Pinel through Kraepelin; through a phase of Modernist diagnosis,

in which psychic structure and psychopathology were singularly rede-
fined by Behaviourists such as Skinner (with Stimulus-Response and
Operant Conditioning) and Wolpe (the generalization of phobia for
all diagnosis itself); to a period of Postmodernism, in which we have
the DSM (Diagnostic and Statistical Manual of Mental Disorders)a het-
erogeneous, superficial, sprawling systemthat includes everything
from the Realist diagnostic categories to a whole series of new mono-
symptomatic diagnoses, all of which are fundamentally structured as
addictions. These diagnosesreferred to as the New Symptoms or
Contemporary Symptoms in the Lacanian literatureare often config-
ured as addictions elsewhere.
Not every addiction is a New Symptom

While addictions may be a new phenomenon, a new social construct,
we might say, it is certainly clear that drugs and alcohol have been
around a long, long time. What has changed, however, is how they
are often configured in psychic structure. As Fabin Naparstek has
pointed out, the use can vary quite dramatically as a function of social
organization, varied social structures, in different historical settings
(Naparstek, 2002). Thus, in aboriginal cultures of the past and of
today, people will take drugs and experience much of the same physi-
ological impact as anyone else using the drug, but the drug use in such
cultures is often quite ritualized and, even more importantly, serves a
function to support the social structure, bolster the Other or support
the function of the Name-of-the-Father in that social structure. This
stands in contrast to some typical forms of drug use in our time, in
the era of the New Symptoms, in which no such support of the Name-
of-the-Father is in play and in which the relationship of the drug use
to forms of jouissance must be articulated. Here, Naparstek describes
various patterns of drug usea drug use through which a jouissance
is obtained, but within a Phallic limit, under some sort of Phallic con-
trol; also, a drug use which enables subjects to break from the Phallus,
in the sense of the Lacan quote from 1975, and avoid the Phallus or
the issue of sexuality; or, a drug use that enables one to confront the
Other sex, such as performance-enhancing drugs; and, a form of drug
use in the psychotic in which the drug is used to limit an excessive
jouissance.
This is not to say, however, that dimensions of this aboriginal use of

drugs and alcohol are not present today. As Naparstek rightly empha-
sizes, each subject must be approached in his singularity. I will give
a brief clinical vignette. A successful female professional sees me for
help with addictions, one to benzodiazepine drugs and alcohol, for
which she had received some treatment through a drug treatment pro-
gramme using a 12-step approach, which left her unsatisfied that any-
thing had been resolved (and which had led also to the development
of another so-called addiction to shopping, less harmful to her, but no
less troubling). It quickly became apparent that she was not using drugs
to escape or avoid sexuality or to exit the symbolic order or the social
bond. Rather, she was using drugs to prop up the Other, to enable her
to participate in various social and professional functions, and to enable
her to live up to a certain paternal semblant which she admired. In this
sense, her use of drugs enabled her continued participation in her social
milieu and supported both her identification (a vertical identification)
with that milieu and with her father, who she also modelled herself
after in this regard. Now, this drug use was at times ritualized (in the
very socially validated consumption of alcohol), but waswith regard
to the drugs themselvesalso private. I think that such formulations
of drug and alcohol useas a support of the Other and the Name-of-
the-Father, evoking the observations of Naparstek on ritual drug use in
aboriginal cultureare not necessarily rare, and that we must be care-
ful to not necessarily assume, in this sense, that every addiction is a
New Symptom.
The New Sinthomes

That said, I do believe that this phenomenon of the New Symptoms or
the Contemporary Symptoms exists, and I think that it might be use-
ful to try to trace out some reference points about this from the work
of psychoanalysts of the World Association of Psychoanalysis in their
elaboration of these concepts. First, I would draw attention to the col-
laborative work of Jacques-Alain Miller and ric Laurent in the Sem-
inar on The Other Who Doesnt Exist and His Ethical Committees
(Laurent & Miller, 1997). There are two points I want to extract from
this Seminar. The first is that eponymous thesis regarding the Other.
If there was an Other which existed, we can say that this is the Other of
Freud and of the early Lacan. An Other marked by completeness and by
consistency, secured in an operation of capitonage by the Name-of-the-

Father. A key demarcation point in Lacan is in the late 1950s and early
1960s when, roughly corollary with his pluralization of the Names-of-
the-Father in the incomplete Seminarthe decentring of a single point
de caption to secure the OtherLacan introduces a barred and lacking
Other. The consequences of this for the clinic are immense, with a bear-
ing on the notion of the symptom and on our technique relative to the
symptom. With a consistent and complete OtherSymbolic Other
we have a practice of interpretation, of symbolic interpretation, and the
symptom as unconscious formation can be decoded against this back-
drop. The symptoms status is thus largely symbolic. However, with an
incomplete Other of this era, Lacan takes a step in the direction of what
he will elaborate in Seminar XXIII on Joyce, in which the symptom is
reconstituted as a sinthome, and we move from a focus on the interpre-
tation of the truth of the symptom on the basis of a language secured
by this intact Other to a reduction or distillation of the jouissance of the
sinthome through Lalangue, as Jacques-Alain Miller developed last year
in his Seminar Pices detaches. It is this sinthomatic dimension which
makes the New Symptoms the New Symptoms, which we certainly
see in the clinic, in the way in which these symptoms are resistantin
many waysto interpretation: a point to which I will return, but which
is important as a way of defining the logic of what makes the New
Symptoms.
There is a second point that I want to extract from The Other Who
Doesnt Existthe shift that Laurent and Miller observe from vertical
identificationthe identification with the paternal imago in its varied
forms as enumerated by Freud in Group Psychology and the Analysis of
the Ego that forms the basis for primary identificationsto horizontal
identifications, identifications of members of a group with one another,
as opposed to with a leader. In Civilization and its Discontents, Freud
identifies this horizontal identification as a specific feature of American
civilization (Freud, 1930a). This sharp observation has many ramifica-
tions, including its impact on the very formation of Lacanian psycho-
analysis and its institutions in the United States, where the levelling
aspect of American equality identified by de Tocquevillewith its
horizontal identificationsis a more challenging terrain to the devel-
opment of psychoanalysis with its focus on singularityin contrast to
any identificationthan the hierarchical, vertically identified, social
structures of Europe, more conducive to the establishment of the psy-
choanalytic transference (Svolos, 2005). But, more important in the
context of this issue of the New Symptoms, is the way in which we

can see horizontal identifications in play. For example, this is evident at
the level of the symptoms themselveswhere it is not at all unusual to
see analysands adopting symptoms that they hear about from friends,
or from internet searches. This phenomenon, especially true in adoles-
cents and young adults, is based on a wilful, conscious modelling, very
different from the unconscious hysterical identifications identified by
Freud, such as in the passage in The Interpretation of Dreams where he
gives the vignette of the hospitalized woman with spasms whose symp-
tom will be copied by other women in the same hospital ward (Freud,
1900a). That mechanism of hysterical identification passes through an
unconscious process in which an Other is invoked, often with some fig-
ure securing the Other, as the very backdrop for the processthe doctor
himself, we might hypothesize, in Freuds vignette. These new hori-
zontal identifications, in contrast, have no such backdropthe Other
doesnt exist, as has been posited. Thus, we see the very phenomenolog-
ical presentations of the symptoms themselves organized via a mecha-
nism of horizontal identification, which is itself responsible for the very
mono-symptomaticity of the treatment demands that we see addressed
to us. But, there is yet another dimension to this, in that the response
of the greater psy field to these demands itself replicates this structure,
delivering treatments themselves that further solidify the imaginary
identifications in play. The most obvious examples of this are the var-
ied 12-step treatment programmes such as Alcoholics Anonymous
all organized around the fundamental assertion of the participant that
I am an addictan alcoholic, a drug addict, a gambler, whatever. The
whole logic of the treatment is based on that fundamental identifica-
tion and a kind of management of that identification based on ones
lateral, horizontal bonds with otherssuch as sponsorswith the
precise same identification: a form of generalized pseudo-nomination.
Everything about the structure of the 12-step programmes, from the
system of sponsorship, to the organization of meetings, to the institu-
tional framework of the groups themselves, is notable as well for an
anti-hierarchical, anti-vertical, organization and associated polemics.
From the Discourse of the Master to the Discourse

of the Capitalist
Now, a second point in the work of the WAP: Domenico Cosenza, in
a very recent article (Cosenza, 2005), formulates the symptom as the
juncture between the clinic and politics, where the psychoanalytic

symptom ishere he quotes Miller (Miller, 1997, p. 193)the very
definition of the social bond. Cosenza continues with a periodization,
a shift from the Freudian orientation to the Lacanian orientation that
can be read within the form of the symptom itself. The Freudian poli-
tics of the symptom is organized around the Name-of-the-Fathera
unique, universal politics, which defines the social bond for all subjects
and is at the heart of the clinic. The subjects entry in societyinto the
field of the Otheris linked to an irrecoupable loss of jouissance that
forms the basis for symptom formation. For Cosenza, the key to the
politics of the New Symptoms can be found in a reworking of symp-
tomatic politics to be found in Lacans rewriting of the social bond in
our current era of advanced capitalism, or postmodernism. In particu-
lar, he draws upon a fifth discourse, first elaborated by Lacan in Milan
in 1972 (Lacan, 1972)the Discourse of the Capitalistwhich appears
only about a dozen times in Lacans work, from 1972 to 1975, as best
as I can tell. Lacan himselfwho had little to say about itindicates
that this Discourse is a variant of the Discourse of the Master, formed
through the inversion of the Master Signifier and the Subject in the Dis-
course of the Master, putting the Subject in the position of agent and the
S1 in the position of truth. The other salient feature in the representa-
tion of it is that the vectorsthe arrowsshift as well, the vector at the
top, labelled impossibility, is not present, and the arrow from Subject to
S1 in the Milan representation is reversed, giving a set of four arrows:
from Subject to S1 to S2 to object a back to Subject. Cosenza highlights
this last, emphasizing the effacement of the dimension of the impos-
sible andgiven the revised vector schematica permanent recycling
of the object. He notes the precariousness of the limit-setting function of
the symbolic and the amplification of the pousse au jouir, which he links
in the New Symptoms to a fetishistic attachment to some objectsthe
so-called substances of addictionbased on unconscious partial drive
functions.
I find this reading of relation of the so-called addictive substances to
New Symptoms to political formations compelling and want to elabo-
rate on it with attention to a different aspect of this Fifth Discoursethe
inversion of places that puts the Subject in the position of agency
which captures an important dimension of addictions, namely that the
very name addict or alcoholic or gambler somehow as a second-
ary label misses a subjective dimension in play in its emphasis on the
object itself, rather than on the Subject, Subject as consumer of objects.

This subjective dimension is certainly rightly recognized in the political
domainsay in the society of consumerism; in economicswhere con-
sumption drives the economy; and even in the ideological shifts in health
care, the shift from the authoritarian doctor as master to patient-driven
health care. Well, let us ourselves observe the fact that the Subjectas
a lacking beingis in the position of agent here as well, a fact clearly
recognized in the clinical domain by thosepsychoanalysts or not
who treat so-called addicts, where frequently different drugs or alcohol
will succeed one another as the object of addiction, or, whereeven
outside of psychoanalytic discourse completelyadherents to Alco-
holics Anonymous will describe the dry drunkwhere the object of
addiction is not pursued, but the subjective structure remains intact. In
the clinical vignette I gave earlier, when the woman discards the use of
substances, she replaced it with shoppingpreserving a type of subject
position, with interchangeable objects.
But, unlike the Discourse of the Hystericin the Freudian formula-
tion, say, where beneath the layers of symbolic interpretation one finds
some irreducible partial drive elementwhere the object a is below the
bar in the position of a truth separated from the Subject, the genius of
Lacans manipulation here is that, in the Discourse of the Capitalist,
beneath the bar, the truth of the Subject is the Master Signifier itself
here not the Name-of-the-Fatherbut the signifier putting discourse
to work, as a demand, to enjoy, to consume. Not the Master Signifier
as a Master in the Hegelian Sense, but in an unconscious, superegoic
dimension. We might say here that we have a Master Signifier without
a Name-of-the-Father, which, coming from a different theoretical elabo-
ration, is also precisely the point Marie-Hlne Brousse arrives at in one
of her recent articles (Brousse, 2005) where she draws the further con-
clusion that without the Name-of-the-Father to organize the fiction, the
fantasy, of sexual relations, it is the objects of the Marketsupported by
this Father-less Master Signifierthat structures jouissance today.
to the Discourse of the Analyst

As a final reference to the work of the WAP in this direction, I want
to return to Jacques-Alain Miller, and in particular to a talk he gave
two years ago in Comandatuba (Miller, 2005). In response to a series
of presentations asserting the disinhibited and rudderless status of
contemporary subjects, Miller asserts that, in fact, it is the object a that

represents the boussole, the compass, or point of orientation for postmod-
ern discourseimposing itself on the Subject, lifting inhibitions, giving
the matheme a, vector, then Subject. This leads the Subject to produce
some evaluation, an S1, the countable One of evaluation, whichin the
discourse structure of Lacanis thus placed under the bar of the Sub-
ject. The fourth place is occupied by knowledge itself, as perspectival
semblant in the place of truthgiving postmodern discourse precisely
the structure of the Discourse of the Analyst. This radical hypothesis,
interestingly, is not without support in Lacans work itself: in 1973, at
another conference in Milan, Lacan remarked that there is a correla-
tion in style between capitalist civilization and the extension of the
Discourse of the Analyst (Lacan, 1973). Miller supports this stunning
proposition with the observation that Lacan gave the Unconscious, and
Society from Antiquity to today, the structure of the Discourse of the
Masteragainst which psychoanalysis efficacy in interpretation and
effects itself correlated with the fact that it was the opposite, the flip side
of the Masters Discourse. But, what now, if contemporary discourse
has the structure of the Discourse of the Analyst?
Lets work this proposition further. First, it certainly allows us to
account for a type of loss of efficacy in psychoanalysis, or at least in
classic psychoanalytic interpretation. The practice of the golden age
of Freudian interpretationbringing light to an Unconscious of which
subjects were blindly unawarejust doesnt work now, in a setting in
which, we could say, capitalism haswith the acceptance of subjects
reached into the Unconscious, what Fred Jameson refers to, along with
Nature, as one of the final precapitalist enclaves, now colonized by
multinational capital (Jameson, 1991, p. 49). Or, put differently, without
the strong repressive apparatus, with the waning of the paternal imago
that Lacan noted as far back as 1938 (Lacan, 1938), the Unconscious
itselforganized on the structure of the Discourse of the Master
may not even be a useful way of figuring psychic structure. Without
an Unconscious, or at least the Freudian one, the loss of interpretive
efficacy makes sense, in that the Discourse of the Analyst works on
the Discourse of the Master and, without an Unconscious structured
in such a way, perhaps Analytic Discourse is in a more precarious
situation.
Miller notes, however, that there is a difference between postmod-
ern civilization and analytic discourse, in that the various elements are
separated in postmodern discoursenot articulated with one another

as they are in the Discourse of the Analyst proper.
These two pointsfirst, the loss, in a sense, or the transfiguration, of
the Discourse of the Master in the formation of an Unconscious against
which to work; and, second, the fragmented, disconnected character of
postmodern discourse, lead themselves to the basis for an approach to
the New Symptoms.
Rectification
I think that its important to specify the nature of the challenge to psy-
choanalysis of the New Symptoms. One of these is certainly related to
a loss of efficacy in interpretation. The shift from the symptom to the
sinthome conveys some of the dimensions of a theorization of this shift
and an outline of a response to itthe move from interpretation of
truth to a distillation of jouissance. One dimension sometimes evoked
in this regard is the opaque character of the jouissance inherent in the
symptoms, named autistic in some settings. I agree wholeheartedly
with Fabin Naparstek that we do not want to limit the forms in which
we conceptualize the jouissance manifested in the New Symptoms.
It may be an autistic jouissance to be obtained without reference to the
Other or to the Lacanian phallus, a type of non-sexualized jouissance;
or, a jouissance linked to the Phallus, the masturbatory jouissance of the
male position; or, a jouissance articulated with the Other in the mode of
feminine jouissanceand the varied presentations of drug use as acting
out often can be articulated in such a way; or, again not to be forgotten,
a drug use linked to the Other in support of the Name-of-the-Father.
Finally, there is the place of drugs in psychosis, where addictions may
well serve as a means of containing jouissance, and the occasionally
seen phenomenon of the eruption of an overt psychosis after a per-
son stops using drugs or alcohol certainly indicates the importance of
precision in diagnosis and prudence in the pursuit of treatment for
addictions.
That said, I want to give a vignetteto illustrate some ways of
responding to these challengeswhich we can make sense of with
respect to these theoretical formulationsthe shift from the Discourse
of the Master and the fragmentation. A woman comes to my office with
the common complaint regarding her addiction to some serious drugs.
However, it becomes clear in our preliminary sessions that her use of
drugs is not so monolithic, but instead takes three forms. In the first,
she uses very modest doses of different drugs to help her get through
the daynot, say, to prop up the Name-of-the-Father, or to integrate
her socially, but rather to negate or efface her moods (the small ups
and downs of daily life), especially the sense of lack of control, or of
stable identity, which Miller labels as essential elements of the femi-
nine clinic of non-identity, or the being of nothing (Miller, 1999). This
is a very interesting use of drugsone that many people search for in
prescription pharmaceuticals that they get from psychiatrists. Her sec-
ond use of drugs is to give her access to men, to enable her sexuality,
whichdrawing on the table of sexuation in Seminar XX, we could call
her phallic vector, jouissance directed to the Phallus. The third use is a
use of drugs she described as leading to a kind of pleasurably painful
immobilitydepression she initially labelled itbut really a certain
type of, for lack of a better way of putting it, lounging around the house.
This third use isagain with Lacanthe vector leading to the Signi-
fier of the lack in the Other, which only becomes clear through a series
of connections, junctions, made that linked this behaviour to a similar
behaviour on the part of her mothera real Millerian femme postichea
dominant Other for this analysandwho only demonstrated her lack in
a similar lounging behaviour. This final articulation was especially fruit-
ful in the caseshaking up ready-made horizontal identifications with
her substance, fortified by Alcoholics Anonymous treatmentthrough
a series of links that brought this into play. This operation is similar to
what Lacan namedin a session of Seminar XXIII (Lacan, 2005) brought
to my attention in a text of Mauricio Tarrabs (Tarrab, 2005)splicing.
I brought together disparate, fragmented, separate elements of this ana-
lysands discourse and called into question her solid, objective iden-
tification. This operation is not effected through the introduction of a
new word, an interpretation, a suturing that requires the addition of a
stitch, but by pulling pieces together, a procedure whose efficacy may
be formulated in the context of the fragmentation that Miller proposes
in postmodern discourse. In the face of the fragmentation, splicing
serves the purpose, not of solidifying knowledge, but of introducing an
enigma. This notion of enigmawhich Marie-Hlne Brousse high-
lights in the paper above as an especially important task with regard
to the New Symptomshas, of course, always been a critical task in
preliminary sessions: a calling into question of identifications. It is espe-
cially important in the context of today, where these identifications are
held onto quite stronglysupported by the various groups such as

Alcoholics Anonymousthe ethical committees that stand in for the
weakened Other.
A final vignette details another response to the challenge. Again,
a woman presents with trouble with a drug, again mediated through
Alcoholics Anonymous treatment with significant emphasis on an
inability to control use of the drug. Here, again, I intervened, but in a
different way, relatively quickly naming the use of the drug as a device,
a device that enabled her to do things. This intervention, a nomina-
tion, had an effect, inducing an enigma by turning upside-down her
formulation about her usefrom a use of drugs out of control to a use
of drugs as a device to controlleading to a sense of curiosity about
why she chose to do that, introducing the subjective dimension. In the
text cited above, Mauricio Tarrab talks about this type of interven-
tion as a cutting up of a certain functioning of jouissance, not through
decipheringinterpretationbut by nomination, a nomination he
identifies as being closer to the traumatic Father than the Symbolic
Father. Here, I venture that this naming, we might say, not only intro-
duces an enigma, but, through a kind of symbolic mandate, reorders
psychic structure in a way to set the analytic process in motion, intro-
ducing a bit of the Discourse of the Master against which the Discourse
of the Analyst can play.
In both of these interventionssplicing and nominationwe are
looking at two forms of rectification, of the establishment of the prop-
erly psychoanalytic symptom, and the shift from preliminary sessions
to psychoanalysis. All of which makes sense, for with analysands and
patients with addictions or any of these New Symptoms, the challenge
is not the end of the treatment but beginning the treatment.
References
Brousse, M.-H. (2005). Vers une nouvelle clinique psychanalytique.
[Towards a new psychoanalytic clinic.] Mental, 15: 2840.
Cosenza, D. (2005). La psychanalyse et les transformations contemporaines
du symptme. [Psychoanalysis and the contemporary transformations
of the symptom.] Mental, 16: 5764.
Freud, S. (1900a). The Interpretation of Dreams. S.E., 4.
Freud, S. (1930a). Civilization and its Discontents. S.E., 21.
Freud, S. (1985). The Complete Letters of Sigmund Freud to Wilhelm Fliess,
18871904. Cambridge: Harvard University Press.
Jameson, F. (1991). Postmodernism; or, the Cultural Logic of Late Capitalism.

Durham: Duke University Press.
Lacan, J. (1972). Du discourse psychanalytique [Psychoanalytic discourse]:
discours de Jacques Lacan lUniversit de Milan le 12 mai 1972, paru
dans louvrage bilingue. In: Lacan in Italia 19531978: En Italie Lacan
(pp. 3255). Milan: La Salamandra, 1978.
Lacan, J. (1973). La psychanalyse dans sa reference au rapport sexuel
[Psychoanalysis and its reference to the sexual relationship]: confrence
donne au muse de la science et de la technique de Milan, le 3 fvrier
1973: parue dans louvrage bilingue. In: Lacan in Italia 19531978:
En Italie Lacan (pp. 5877). Milan: La Salamandra, 1978.
Lacan, J. (1976). Intervention in the Journes des cartels de lcole
freudienne de Paris. Lettre de lcole freudienne, 18: 263270.
Lacan, J. (1998). Le Sminaire, Livre V, Les formations de linconscient 19571958.
[The formations of the unconscious.] Paris: ditions du Seuil.
Lacan, J. (2001). Les complexes familiaux dans la formation du lindividu.
[The family complexes in the formation of the individual.] Autres crits.
Paris: ditions du Seuil.
Lacan, J. (2005). Le Sminaire, livre XXIII, Le sinthome 19751976. Paris: di-
tions du Seuil.
Laurent, E. & Miller, J.-A. (1997). LAutre qui nexiste pas et ses comits
dthique. [The Other who doesnt exist and his ethical committees.]
La Cause Freudienne, 35: 720.
Miller, J.-A. (1997). In: IRMA [Instance de reflxionsur le mathme analyt-
ique, collective authored]. La Conversation dArcochon. [The Conversation
of Arcochon.] Paris: La Seuil.
Miller, J.-A. (1999). Of semblants in the relations between sexes. Psychoana-
lytical Notebooks, 3: 926.
Miller, J.-A. (2004). Introduction la lecture du Sminaire de Langoisse de
Jacques Lacan. [Introduction to the reading of the Seminar on Anxiety of
Jacques Lacan.] La Cause Freudienne, 58: 61100.
Miller, J.-A. (2005). Une fantasie. [A Fantasy.] Mental, 15: 927.
Svolos, T. (2005). Lacan in the US. Agence Lacanienne de presse, [Press release]
Nouvelle srie, n 78Paris, le mardi 12 avril, 2005.
Tarrab, M. (2005). Produire de nouveaux symptoms. [To produce new
symptoms.] Quarto 85: 4851.
CHAPTER SIX
Comments on Introducing
the New Symptoms
Fabin Naparstek
T
here are many issues to point out about the interesting and clear
work made by Tom Svolos; I am going to highlight a couple of
issues, although many other interesting things may be devel-
oped. I am going to begin my comment with one of the subtitles setting
up Svolos work: Not every addiction is a New Symptom.
I like such a distinction very much, and I could actually use it as
the title of my next conference paper. As a matter of fact, one of the
features involved in the new symptoms is that singularity is left aside.
Svolos describes it very clearly and also shows how these new symp-
toms make the subject take a horizontal identification where singular-
ity is lost. If we dont try to separate each symptom together with its
singularity from the so-called new symptoms, we would be encourag-
ing such indiscrimination. As Svolos also shows very clearly, psychoa-
nalysis has always been the flip side of one Discourse. At one time, it
was the flip side of the Masters Discourse. Tom Svolos wonders what
we should do when, at present, the prevailing discourse is the one of
capitalism or the analysts instead of the Masters (with the fragmenta-
tion features described by Miller that Tom reminds us about). In my
opinion, one first answer to Svolos question would be not to foster the
indiscriminate symptoms of this time. As Svolos argues, it is better to
89
search for the singularity of each symptom rather than sticking to the
only one explanation which sustains that addiction is a new symptom.
Svolos first case clearly shows such an issue. It is about a woman
who held a ritualized consumption that enabled her to sustain the
Name-of-the-Father. But he also shows very thoroughly the conse-
quences produced by a treatment that suppresses all symptoms in
a sudden manner. Such a woman turns to Alcoholics Anonymous,
and it is observed that ultimately such treatments are aimed at keep-
ing the subjects consumption within the market patterns. She begins
with a toxicomanic addiction (alcohol and benzodiazepines), does not
resolve it, and on top of that, ends up with a shopping addiction. It is a
paradigmatic case that makes us think about A.A or N.As behaviourist
therapies.
When Woody Allen finishes one of his movies, he tells us the fol-
lowing: he once turned to his psychoanalyst setting forth a problem.
Woody Allen tells his psychoanalyst that his brother is crazy, that he
thinks he is a light bulb. The psychoanalyst proposes that Woody Allen
bring his brother to a session and finally Woody Allen answers that, if
he did so, he would have no light.
From the very beginning, Freud clearly understood such features of
the symptom. The symptom implies a jouissance that the subject holds
to, and which is not resolved through will or behaviour. We must under-
line that Freud was the first therapist who carried out short therapies.
Freuds first therapies lasted a short time. In this hypermodern world,
this first Freud may be recognized easily. But Freud immediately real-
ized that healing would not be possible by only removing the symp-
tom. According to Freud, when one removes a symptom, one has the
capacity of creating another. This is an issue to take into account regard-
ing the trend of the evaluation. At the moment of evaluating whether
the subject is healed, what do we take into account? Do we take into
account the moment in which the symptom disappeared, or rather if it
was replaced by another one of the same kind (a very common thing in
the clinic of toxicomania), or the moment in which the nucleus of the
symptom is touched? Freud was very strict about this issue. We have to
touch the nucleus of the symptom. We do not direct therapies with the
purpose of replacing one symptom with another; for example, in Doras
case, to replace her cough by aphonia. Replacement or substitution ther-
apies are not new; they have been in place for a long time. For example,
it is public knowledge that the discovery of heroin was thought as an
C O M M E N T S O N I N T R O D U C I N G T H E N E W S Y M P TO M S 91
antidote to morphine. There are records on how morphine addicts were

prescribed heroin in order to give up morphine. We all know where
these individuals ended up. Within the field of toxicomania, I agree
with certain replacement therapies; I am not against them when, for
instance, drugs like methadone are prescribed with the purpose of giv-
ing up heroin. But they are not enough; they are helpful for the subject
for certain moments, and to take them out of their behaviour risk, but, if
such replacement is considered itself to be the therapy, there I see a mis-
representation. It is worth calling it just the way it is; when it is intended
to sustain that the symptom has disappeared, but it is actually replaced
by another one, that is a misrepresentation. Since the very beginning,
Freud was courageous enough to argue that such short therapies did
not resolve the problem: they did not touch the nucleus of the symp-
tom. Svolos shows how, at present, such therapies, where the consum-
ing subjects position remains intact, can be sustained. Likewise, Svolos
shows that, in order to touch the nucleus of the symptom, it is necessary
to dive into the singularity of each case.
At this point, I would also like to remark how Svolos provides a
very precise indication of the direction of the treatment of such sub-
jects. I will sum it up by quoting what he named as the distillation
of the jouissance. I like this way of naming the treatment-orientation
in our field of toxicomania. To me it is a great way of figuring out our
orientation in the treatment of toxicomanias: distillation of the jouis-
sance. Such a formula shows clearly the difference of our orientation
with the tendency nowadays of recycling the object (an issue I will
develop deeper in my conference). He distinguishes a clear attempt
of the time oriented to recycling the object (an issue I will develop
more thoroughly in my paper); but instead, he sets forth the formula
of distillation of the jouissance. I am very interested in this formula,
because it assumes a process that leaves a surplus. It is about a process
where not all the jouissance can be reduced. Something different can be
made with jouissance; however, there is always something that remains.
There is something that is impossible to be reduced. The other cases he
shares with us show a clear need to reintroduce the impossible in such
pathologies. And I fully agree with Svolos that our challenge should
not only be oriented to finishing a treatment, but to beginning it. I have
worked in several settings, and I have ended up arguing that for many
subjects the beginning of the psychoanalytic treatment itselfstrictly
speakingimplied the exit from toxicomania. But in any case, what
turns out to be very clear is that the beginning of the treatment through
the analytical device introduces the impossible, thus yielding subjective
effects. And the subject is precisely in the opposite position to that of
toxicomaniacs.
To sum up, I would like to ask Tom Svolos two particular questions:
1. I was really interested in your distinction between Freud and Lacan

regarding addiction. I was wondering whether you might go fur-
ther in it. I would like to know, whether, in your opinion, Lacan
takes Freuds arguments and goes further into them or instead, is
his approach grounded on a dramatically different basis? In other
words, I am asking you about the relationship of both arguments.
2. Regarding psychosis: I have seen many psychotics who, in
Alcoholics Anonymous, achieved certain compensation. In such
cases, I managed to sustain an analytical treatment together with
their concurrence to such places. I have been especially careful in
not opposing them in such cases. I would like to know whether you
have had any experience in this regard and whether you might think
of any further development of this phenomenon.
CHAPTER SEVEN
Bulimia: between phobia and addiction

Patricia Gherovici
E
ating makes me feel good. Its getting what I want. I put food
in and throw up. I can eat continuously and stay empty. Its
the best of each thing. I get to eat all the time. I look good and
nobody notices. I shut down everything around me. This is how a
female analysand in her twenties, whom I will call Linda, talks about
her eating to an extent not normal. She says: I think I have to fight
this impulse. I feel like Im an addict. If it is pleasurable to eat, it has to
be bad food. I either have no desire for food; it doesnt even exist. Or
I could eat a ridiculous amount, like a whole pizza. I want to explore
some questions brought on by my work with Linda, and a first question
would be: is bulimia a phobia or an addiction? In order to provide an
answer, let us look at the whole family history.
Linda, an African-American woman, initially came to see me com-
plaining of severe problems with her mother. She did not seem to need
to share until well into her treatment that at the time she would, at
least once a week, spend a whole night binging and purging; Linda
just wanted to talk about her mother. She loved her to death but, as
she would put it, did not really feel a connection. She also wanted to
slow down and find out why she felt disoriented, displaced. Show-
ing similarities with other analysands suffering from eating disorders
93
whom I have treated, Linda did not appear like the classic hysteric
who is supported in her armature by the love for the father1and who
parades that love as a badge or armour. She seemed quite far from
the paradigmatic obsessional who sustains the gaze of the mother in
an arrogant parade. Linda seemed not to have found in the primor-
dial Other a privileged place. Hence she would take risks, date the
wrong people, or trust too much. In short, she behaved as if she had
nothing to lose, as if she was someone whom the big Other could lose
or waste without any remorse. I observed this feature in several cases
of analysands with bulimia. In fact, for her, the question: What am I for
the Other? was a burning enigma that could not be easily answered. It
seemed that she could not find in the Other an interval between signi-
fiers, a lack in which she could find an object a with which she would
identify.
One often sees young children playing games of hide-and-seek. In
hiding, their main purpose is to verify whether they lack for the Other
or not. Does anyone notice that they are missing? One sees the intense
joy that children experience in the game as they are looked for; they
thus become aware that they can be missed by the Other. The outcome
would be devastating if a child hides away somewhere and no one
tries to find them. In my clinical experience, I have found that some
analysands, like Linda, recall with vivid detail instances in which their
mother forgot them. For Linda, once it was in a department store
her mother did her shopping and then drove off, leaving Linda behind.
She also remembered occasions in which her mother forgot to pick her
up from child care after school. What is important here it is not so much
the incidents themselves as the fact that these analysands remember
them so poignantly, and never erase the consequent feelings of desola-
tion and abandonment.
A case like Lindas offers an example of a failure happening at a cru-
cial moment of her subjective constitution (Lacan, 19761977). Let us
recall that in alienation the subject disappears in aphanisis under the
Others signifiers. On a second stage, responding to the Others demand,
the subject will find in the intervals of the signifying chain a place to
come into being.2 It is as if Linda was asking: What do you want? Can
you lose me? Can I be the object of your lack? And the devastating
answer is: You do not lack for me, you do not represent my lack; I do not
miss you. It is crucial that the Other would offer this interval, this lack,
this nothing to locate there, an object to which the subject will identify.
BULIMIA: BETWEEN PHOBIA AND ADDICTION 95
What the subject fills is not the lack that she encounters in the Other but
the lack that results from the constitutive loss of one of the parts of her
being, when it turns out that she feels as if she was made of two parts.
The subject operates here with her own loss. Only then will the subject
invent a phantasmatic mask covering the first moment of alienation. In
that case, the subject will go from disappearing to being lost.
This passage from disappearing object to lost object is a necessary
passage that allows subjects to mourn what they were for the Other.
This can be summed up in our clinical work as an elaboration of mourn-
ing in which one finds the matrix for subsequent mourning. I would
argue that for Linda this very matrix was failing, that her life was an
endless chain of responses, seemingly accidental ones, which were vain
attempts to inscribe a loss not yet symbolized. This calls up Lacans
Seminar on Anxiety, in which he says that we mourn people whose lack
we had embodied (Lacan, 19621963). In the work of mourning, what
has to be understood is how we make the other lack in order to rep-
resent their lack. Only then can we mourn the one whose desire we
caused. Since love is to give what one does not have, in the situation
of the loss of the love object, what we do not have comes back to us. In
mourning, there is a signifying reorganization that attempts to border
the hole left in the Real by the disappearance of the object. Then, and
only then, can the subject restart the process of desire.
Since she was a teenager, Linda binged and purged regularly. She
would interrupt romantic dinners and run to the restroom to throw up
and return soon after to the table doing her best to hide what had hap-
pened before. Her deception would succeed because she actually would
feel much better. Before having sex, she would take a shower, put her
fingers into her throat and throw up, in a ritual she felt was purify-
ing and that readied for the encounter. Her bulimia had an appeasing
effect in moments when she admittedly felt anxious for no clear rea-
son. For Linda, bulimia operated as a regulatory strategy: it was meant
to reconstruct a subject in front of the failure in the paternal function.
I had to understand why Linda would refuse food and employ her
refusal as if it were a desire. For this, I needed to know more about
her childhood and her relationship to her m(O)ther. Paradoxically,
Linda was her mothers confidant: regularly, her mother would ask
Linda for advice, and she professed adoration for her only child. How-
ever, Linda was still unsure of her mothers true feelings for her. The
mother would alternate between calling her daughter on the phone
several times a day, getting angry if Linda did not respond to the call
immediately, and unexpected weeks of silence with unreturned phone
calls in which Linda would not know anything about her whereabouts.
Very often Lindas mother would arrange meetings with her daughter
but then, without any warning, fail to show up at the agreed place
not providing any reasons for her absence afterwards. Waiting for her
mother during those failed encounters created an intense anxiety for
Linda. Ultimately that left her feeling clueless as to what she was for her
mother. Can we speculate that if her mother felt no need to let her know
that she was not coming to see her as planned, it was because she was
not seen as a separate object? Most likely, Linda was not fully separated
from a mother who treated her as an extension of her body, and not
even a privileged one at that.
Such a mother fits the image introduced by Lacan in Seminar XVII,
when he gives a disquieting shape to emblematize the mothers desire:
an open crocodile mouth inside which a child is trapped (Lacan,
19701971). In this allegory of the devouring Other, there is only one
limit to maternal cannibalismthe Name-of-the-Father, which functions
as the stick preventing the mouth from closing. As with many cases of
analysands with eating disorders, the Real plays a prevalent role, and
yet we can assure that Lindas situation was not a case of psychosis
the Name-of-the-Father was operating. Yet, initially, her neurosis was
not one of transference. A second step was still missing, which is what
we may call the passage from disappeared to lost; a passage that is the
condition for the establishment of transference neurosis.
Let me put it another way, and use the term holophrase (Lacan,
1964, p. 237), a notion that Lacan borrows from linguistics where holo-
phrase refers to the earliest stage in a childs language acquisition: a
one-word utterance is used to express meaning which, in more mature
speech, would normally be being expressed in a more complex gram-
matical structure such as a phrase or sentence. An example of how a
single word may represent an entire thought is when a baby says Boo
to mean read me a book. Another example is FIRE!, where a single
word could be functioning as subject, address, compliment, and ref-
erent, putting into motion lexical elements and complex functions of
grammar (Laurent, 2002).
Lacan uses holophrase to indicate when the interval between S1
(Master Signifier) and S2 (signifying chain, knowledge) has not
been clearly established and the first couple of signifiers solidify.
The term holophrase functions as a verb in a new Lacanian

neologism (Stevens, 1986). The holophrase can be found operating
in several clinical manifestations: psychosomatic disorders, mental
retardation, and psychosis. This solidification in the matheme S1/S2
relates to the topology of alienation and separation, that is to say to
the rapport of the subject to the field of the Other and to the lack in
the Other. The object at stake in the holophrase is not the object a,
object cause of desire, but an object that is Real in so far as it depends
on the hazards of the Others presence/absence. For instance, Linda
told me that her parents were very unhappy when she was born; they
were so absorbed in themselves and their conflicts that she felt that
they could not really care for her. They divorced before she was six
years of age. Her mother, however, described her as a very happy
baby. According to her mother, Linda knew instinctively how to be
happy and did not require much attention. Linda believed that they
were too busy with their problems to pay her any attention. There-
fore, for Linda, separation was a more difficult issue when the very
union was questioned. Linda argued that she had very few memories
of her mother during her childhood because in fact she was not much
around. The Other seemed unable to oscillate between a measure of
presence and absence. Here absence could not provide any security
to presencepresence was overwhelming and then absence itself
devastating.
As I have observed in structurally analogous cases, for Linda nei-
ther repression nor the return of the repressed seemed to be available:
there were no formations of the unconscious, but pure suffering in the
Real of the body by way of psychosomatic illnesses. For instance, Linda
suffered from eczema and asthma; she complained that whenever she
felt unable to breathe, or that she was being smothered by something
heavy, as she would say, her mother was around. All her history sug-
gests a strong alliance of Linda with her mother; her father appeared
absent, ill at ease as a parent, playing a peripheral role. However, Linda
suddenly and impulsively left her mother and moved in with her father
who had just re-married. Linda reacted to the separation from her
mother by acting out (failing in school, dating much older men, getting
drunk, using drugs, being sexually active, sneaking out of the house,
etc.). The best way to describe Lindas adolescent acting-outs is locat-
ing them in a particular zone of relation, one that Lacan calls the zone
of acting out (Lacan, 2006a, pp. 328333). This notion of acting-out is
useful; it describes the subjects performance of a scene for the gaze of

the Other.
Acting-out is also understood as transference without analysis; it is a
showing addressed to the Other and tries to inscribe an object a. Lacan
defines acting-out as the showing of an object and passage to the act as
an attempt to restore the subject who has been barred by the presence
of an object. He explains that Freuds famous patient Doras paradoxi-
cal complicity in the continuation of her fathers extra-marital affair is
an acting-out (as an attempt to make the objectwhich is outside
appear in a scene). But the fatidic declaration of the cuckold husband
and her suitor, Herr K., blurting out that he gets nothing from his wife,
precipitates a passage to the act (as a withdrawal from the stagingthe
subject identified to the object drops from the scene). Doras answer to
his confession is a slap that changes the story forever (Lacan, 19621963,
pp. 136137). Dora denounces the affair and stops participating in the
saga. The consequences of Doras passage to the act are less severe than
in the case of the Young Homosexual Woman, who attempts suicide,
but they are regulated by a similar pattern. This pattern is similar to one
presented in Seminar IV and follows Freuds text Inhibition, Symp-
tom, and Anxiety. This is schematized in a table that presents modali-
ties of action organized around anxiety. At the extreme of the vector
of difficulty, embarrassment appears in the presence of an object; the
movement at stake is that the subject is barred, producing a passage to
the act as the last resource against anxiety. Lindas acting out is a way of
finding in the Other the path to desire while regulating jouissance.
Linda became very oppositional and was fighting with her mother
all the time. Unable to deal with the maternal demand, while strug-
gling to assume her own femininity as a young woman, she decided
to move to New York with her father, hoping she would be better off
with him. But her mothers willingness to accept her decision to leave
at such a difficult juncture as she was trying to separate from her, was
devastating for Linda. One could claim that her mother let her fall,
dropped her, or we could even say, dumped her, and responded to
the daughters acting out with a parallel passage lacte. To better grasp
the dynamics at play here, we need to remember that Lacan departed
from Freud when he affirmed that anxiety was not without an object.
He was talking about the specific status of object a, which precisely
allows for such a formulation. If we keep in mind that anxiety appears
when the object a is revealed, we may define a passage to the act as the
result of an encounter with a, that is to say an encounter not filtered by

desire, deprived of the cover of the fantasy. What causes anxiety is the
fear of vanishing in the face of the certainty of the jouissance attributed
to the Other. Lacan establishes a clear distinction between acting-out
and passage to the act (Lacan, 19621963, p. 144). While both are strate-
gies deployed against anxiety, in the acting-out the subject remains in
the scene, whereas in the passage to the act, the subject leaves the scene
altogether. The acting-out is addressed to the Other, while the passage
to the act is a flight from the Other into the dimension of the real. It is
an exit from the symbolic network. It is a dissolution of the social bond.
The passage to the act is not a message addressed to anyone. It implies a
disintegration of the subject who for a moment becomes a pure object a,
a leftover of signification.
Upon her arrival to her fathers New York home, Linda developed
a severe bulimia and to her consternation nobody (stepmother, father,
and new siblings) seemed to notice that she was often leaving the din-
ner table to go to throw up in the bathroom and only made apprecia-
tive comments about the lost pounds. What we could gather is that she
had created in her body the lack that she could not locate in the Other.
While Linda obsessively counted her lost pounds, she seemed not to
count (or lack) for the Other, and in consequence her responses would
all be played out in the field of the Real. If love is to give what one
does not have, Linda gave to that nothing the value of an object. She
wanted to stay empty while shutting down everything around her.
Her description of her bulimic episodes calls up a state of aphanisis; she
disappeared as a subject, she became the blind spot not noticed by any-
one, as I gather from the poignant description of what happened to her
when she binged and purged: Eating makes me feel good. Its getting
what I want. I put food in and throw up. I can eat continuously and stay
empty. Its the best of each thing. I get to eat all the time. I look good and
nobody notices. I shut down everything around me.
In The Direction of the Treatment and the Principles of its Power,
Lacan links eating disorders, in his case example, anorexia, to desire
and its rejection. It is the child who is most lovingly fed who refuses
food and employs his [sic] refusal as if it were a desire (anorexia ner-
vosa). Lacan understands anorexia as a strategy of separation from
the Other because the Others demand is suffocating lack, preventing
desire; in anorexia nothing is taken as an object when food smothers the
possibility of hunger. For Linda, staying empty and shut[ting] down
everything around me, makes up for desire. Lacan asks, Ultimately,

by refusing to satisfy the mothers demand, isnt the child requiring the
mother to have a desire outside of him [sic], because that is the pathway
to desire that he lacks? (Lacan, 2006b, p. 524)
In Seminar XI, The Four Fundamental Concepts of Psychoanalysis Lacan
introduces the terms alienation and separation as two operations
fundamental to the constitution of a subject (Lacan, 1964, pp. 203215).
The human offspring is born into the verbal world, into the field of the
Other, in a state of total dependence on the Other that Freud describes
as a state of helplessness (Hilflosigkeit). It is this extreme dependence
upon an other, Freud notes, that creates human communication and
moral values (Freud, 1950a). The biological incompleteness and insuffi-
ciency of the newborn makes them bound to an other, creating a tie that
is both ontological and existential.3 The required response and codifica-
tion of the Other transforms needs into demands. As Lacan observes,
this deviation of humans needs is due to the fact that the human being
speaks:
to the extent that his [sic] needs are subjected to demand, they
come back to him in alienated form. This is not the effect of his
real dependence but rather of needs being put into signifying form
as such, and of the fact that it is from the Others locus that this
message is emitted. What is thus alienated in needs constitutes an
Urverdraengung [primal repression], as it cannot, hypothetically, be
articulated in demand.
(Lacan, 2006c, p. 579)
For Lacan, alienation is linked to the structural division of the speak-

ing subject. As speaking beings subjected to language, we are split
by our entry into the symbolic register. This splitting concerns a choice
between meaning, which is produced by the signifier and is found in
the Other, and the being of the subject. As in Lacans example of the rob-
ber saying, Your money or your life! the choice is in fact impossible.4
By choosing meaning, the being of the subject disappears, which is a
phenomenon described by Lacan using Ernest Jones concept of aph-
anisis. By choosing being, the subject may fall into non-meaning.
The process of structural alienation places the subject between a rock
and a hard place: between the rock of pure being without sense or
meaningpresumably an unbearable stateand the loss of being for

the sake of meaning.
Lacan gives to alienation a primordial, necessary, and causal func-
tion in the formation of subjectivity. This conceptualization of aliena-
tion is linked to symbolic castration.
After alienation, a second operation takes place, which Lacan out-
lines in the context of the realization of the subject in the field of the
Other as an encounter with the signifier; this he calls separation.
In an exploration of the meaning of the term separation, Lacan
derives the meanings to defend oneself, to resist, but also, to
adorn oneself, to dress oneself, and finally, se parere, to engender
oneself. Essentially, however, separation is a response of the sub-
ject to the intimation that the Other makes to him [sic] by his dis-
course (Lacan, 1964, p. 214). The subject thereby becomes aware of
the desire of the Other, but cannot yet experience it as desire, and
instead presents itself in all its impenetrable mystery as a lack. In the
intervals of the discourse of the Other, there emerges in the experience
of the child something that is radically mappable, namely, He [sic] is
saying this to me, but what does he want? (Lacan, 1964, p. 214). The
subject answers with the production of a lack of their own, the most
convenient one being to offer themselves as lack, that is, to offer their
own disappearance as an active test of what it is that comes from the
Other. Lacan sees in this interaction between child and adult the seed
of eating disorders. While alienation relates to a division within the
subject and to the opposition between meaning and being, separation
is tied to a lack, a very specific lack, the lack that needs to be recog-
nized in the Other. One lack is superimposed upon the other (Lacan,
1964, p. 215) and a link between desire of the subject and desire of the
Other is created.
Separation means the recognition of a gap both in the Other and in
the subject; this is a splitting of the phallic object that acknowledges a
limit. The subject becomes aware of the Others desire and wonders
what they amount to. Thus, the subject perceives the point of lack in
the Other with which they may identify as object, that is, with which
they may identify with the lack apprehended in the Other. The first
object the subject proposes as the lost object, or lack, is in themselves:
can they (the Other) lose me? This is the fantasy of ones own death or
disappearance (like anorexia, in which the subject follows the course of
the death drive producing the lack in the Other). The child seeks out the
space in the (m)Other where they are lacking, in order to be object of

their desire. This is an intersubjective phenomenon. Intersubjectivity is
marked by deprivation and lack and by recognition of desire.5
I will go faster in my account of the case and mention briefly Lacans
understanding of the phobic object in terms of Freudian phallic signi-
fication, when he defines the phobic object as an all-purpose signi-
fier making up for the Others lack (Lacan, 2006b, p. 510). Any phobic
object is a symptomatic object, which, as Freud (1926d) contends in
Inhibition, Symptom and Anxiety, is created by castration anxiety
and its signification is to be understood in phallic terms. Conforming
to Lacans interpretation of Little Hanss mother in Seminar IV, Lindas
mother appears as a big open mouth, the mouth of an unsatisfied
mother ready to devour her. This devouring image is for Lacan one of
the elementary forms of phobic presentations and can give an answer to
the enigma of the desire of the Other (Lacan, 19571958). I believe that
this image played an important role in her bulimia. Linda was herself
cannibalistic, like any baby who cannibalizes her mother. But it was
the unmitigated cannibalism of her mother which prevented her from
modulating her own. When she binged, she would vomit in a bag. This
element of her ritual is important because it forced her to have to handle
and dispose of the homogenous mass of food purged. The global mass
she had to manipulate and flush down the toilet was a prototype of
an object a, a piece of her body that fell, and that she needed to make
appear in the Real. It was a dejected object a, which in a repeated passage
lacte, was constituted and dropped, over and over again, but that all
the while also served to eliminate her as a subject from the scene. With-
out a subject, there is no room for desire, and therefore her statement,
I feel like Im an addict. If it is pleasurable to eat, it has to be bad food.
I either have no desire for food; it doesnt even exist. Or I could eat a
ridiculous amount, like a whole pizza.
Bulimia was a difficult element in Lindas analysis, a resisting symp-
tom. During her work with me, she was able to stop throwing up and
her physical symptoms (asthma, eczema) became much less severe.
She also exhibited some phobic features in intimate relationships. The
bulimia, however, would reappear briefly like a fort-da game when her
mother would take distance from her as if her mothers absence could
not yet guarantee presence. Linda used bulimia as a way to elude the
traumatic reality of a failing desire (her fathers) which could not func-
tion as a metaphor for her mothers desire. Bulimia neutralized feelings
for Linda. For instance, if she was unhappy about something, she
would binge, throw up, and then shutdown everything around me.
Like in other similar cases of bulimia I have worked with, the bingeing
and purging were instances of extreme jouissance. Linda described them
as automatic acts meant to feel empty, feel nothing, or to have a
lack of feeling. I will use this very resisting symptom that introduces,
however, a lack, to have a lack of feeling in order to try to understand
how the exclusionary jouissance of the Other remains a powerful force
that seemed to prevent her from having access to her mothers desire,
a desire which remained enigmatic. The refractory bulimia suggested a
prevalence of the oral stageshe needed to throw up in order not to be
eaten up, not to be devoured by the Other. However, this representation
of an open mouth was in fact the devouring open hole left in the Other
by the introduction of the castration complex. Often a phobia appears
as a variation of the phallic signification that compensates for a failure
in the paternal metaphor, whereas bulimia as addiction can be under-
stood as turning ones back to phallic signification. In this case, Lindas
phobic features had the function of introducing a phallic signification;
they helped Linda find the others lack and the remainder of phallic
significationthe object a.
Lacan argues in 1957 that phobia is the result of a failure in the pater-
nal function (Lacan, 19561957). A phobia appears to make up for the
Name-of-the-Father when symbolic castration is not carried out cor-
rectly. One could even say that phobia is like an emergency repair kit
that allows things to keep running, lending a spare signifier when the
Name-of-the-Father falters. The bumpy road to castration provides
benefits for the subject. As Lacan observes, castration is not like the for-
mulations put forward by a famous little boy, known in the analytic lit-
erature as Freuds Little Hans (Lacan, 1967). Castration, as Bruce Fink
defines it, has to do with the fact that at a certain point, we are required
to give up some jouissance (Fink, 1997, p. 99). And this renunciation of
jouissance concerns both men and women and is closely related to the
processes of separation and alienation. What happens after that sacri-
fice? The jouissance that is lost may be found elsewhere; it can be recov-
ered. Lacan, in the closing of a 1975 symposium at his school, remarked
how difficult it is for us, as speaking beings, to get the perksto draw
from castration a jouissance. Castration and desire can liberate us from
anxiety.6 Castration can lead us towards an investment in the body
of the Other that symbolizes the lack in our own body, but this can
only happen after the processes of alienation and separation have been
fulfilled. If we assume that these two steps are necessary in subjective
constitution, we could argue that it is possible to find analysands who
have undergone the first step (alienation) which implies a refusal of jou-
issance but who cannot draw from castration another jouissance (sepa-
ration). In my clinical experience with people like Linda, one is led to
believe that these analysands seem to have assumed subjective castra-
tion but have yet to attain the type of jouissance one reaches by way of
what Lacan calls the inverted scale of the Law of desire (Lacan, 2006a,
p. 324). At times the failure of this second stage of subjective constitu-
tion has devastating consequences: bulimia can be one example of the
painful return of a deadly jouissance that needs to be refused.
When Freuds Little Hans discovers that his whole being is attached
to the Wiwimacher, or weeweemaker, and that in order to break away
from such a doomed union with the precious weeweemaker, he enters
a marriage of convenience, and says, I do, to some Others body, or
to something else, and thus manages to move on to some other object
in order to escape such a primary but fatal bond. In the process, he
develops a phobia to horses. Of course, this process has parallels in the
evolution of the little girl, who may also find a way out of the bond to
the mother by producing a symptom, a phobia, or something else, like
bulimia, in our clinical example.
Nestor Braunstein contends that the success of drugs derives from
their ability to mitigate the elementary marriage to the weeweemaker,
and quoting Lacan, he goes on to note that, there is no other definition
of drug than this oneit is what allows one to break the marriage with
the weeweemaker (Braunstein, 1992, p. 214). Braunstein says that for
both men and women drugs are the partner that comes after the divorce
with the phallic order, after the break-up with the admission of lack. He
calls this second marriage, a marriage that is a promise of a paradise
in which all is calm, order, luxury, pleasure, and sensual gratifications
where one substitutes for the Other an object that is without desires or
whims, an object that will never betray, and in relation to which the only
problem is procuring it as a commodity. Braunstein stresses the fact that
addiction is a method by which the subject subtracts themselves from
the process of symbolic exchange that is the result of a decision, a choice.
It is something that permits a kind of experimental connection with
jouissance and that produces a short-circuit in the relation to the Other
and to the Others desire. It is a path that offers the subject a certain
guidance, a more or less regulated production of separation from the

effects of alienation produced by the signifier (a concept I will develop
soon). This separation can be complete; that is, it can be absolute refusal
of the alienation produced by the signifier (Braunstein, 1992, p. 238).
Drugs and what he calls, drug a-diction, or toxicomania, are
placed in the same order of response as suicide, which he calls the
most noisy way of slamming the door on the Other, and this is thus
his proposition:
Separation, understood as an operation that is opposed to aliena-

tion is the key here as well as in suicide. Except that now the clamor
is just a vague rumor, the banging the door is replaced by slipping
away. The overweening becomes humble, the spectacular becomes
secret, and pride becomes shame. A difference becomes instantly
apparent, there is no real death but a pretense of death, a kind of
attenuated death that doesnt claim the body with an arrogant scorn
but rather degrades it and shows it in the misery of its bondages.
(Braunstein, 1992, pp. 239240)
Braunstein underlines the paradox of a subject who tries to do without

the Other while using a method offered by the same Other the subject
claims to be separating from. In fact this separation is the product of
industry, something that is trafficked, something that is proposed and
offered by the Other in commerce, which can satisfy the demand for a
radical separation of the I think in favour of an attenuated I am that
is beyond all thought (Braunstein, 1992, pp. 238239).
I want to explore in this paper one of the possible effects of the opera-
tion of alienation of the signifier as revealed in cases like Lindas. These
are cases that I would place in a zone of in-between as my title notes,
in-between phobia and addiction, or in-between alienation and separa-
tion. For cases like Lindas, bulimia was first a strategy allowing her to
do without the Other. Then it also became an attempt at creating a lack
in her mother, a lack that was created retroactively. Let us return to her
own words: Eating makes me feel good. Its getting what I want. I put
food in and throw up. I can eat continuously and stay empty. And,
Its the best of each thing. I get to eat all the time. I look good and
nobody notices. I shutdown everything around me. She first filled up
the lack, the emptiness created by bingeing; when she purged, she
emptied and thus she carved it out, creating it. Through bingeing
and purging she created a distance between her and the threatening
desire of her mother that she experienced as that which shut(s) down
everything around me.
In her analysis, Linda achieved the difficult separation from the nar-
cissistic trap of her mothers love, a love that went from the same to
the same. Lindas mother would endlessly describe how she and her
daughter were alike. However crucial men were in Lindas universe,
they did not seem to register as true holders of the phallus. Obviously,
her mother seemed to be quite at ease in a quasi-phallic position. The
way Linda was always hiding her achievements, almost discarding
whatever she would produce, betrayed that she needed to feel that she
was like a failure herself, so as not to compete with a mother experi-
enced as a terrifying opponent. Her mother had failed to open the way
to a discourse beyond her, a discourse that would point towards desire.
Linda preferred to see herself as a failure rather than confront her own
hatred, a hatred which she experienced as coming from the Other and
also completely lethal. Her bulimia attempted at cutting a hole, creating
a lack in her mothers jouissancethe Other was not complete, but when
she was throwing up, Linda was swallowed by a jouissance beyond cas-
tration. Linda could not find in her mothers discourse room for a father
for which she was searching. She needed to hold onto her jouissance to
make sure that rejection was guaranteed, so that the enigma of sexual
difference could remain solvable on the mothers side. Her fantasy cov-
ered over the fact that the Other of desire is effaced behind the Other of
the demand. In analysis, she had in fact addressed the enigma of sex-
ual difference, which brought her back to the fact that she needed first
to believe that the Other desired her, even when that desire remained
opaque for her. Her asthma was caused by situations of loss brought
by a sadness so extreme that she could not bear it, which may sug-
gest a melancholic disposition. Unable to feel sad, unable to let go, she
remained in a melancholic state in which she felt betrayed by the Other,
since the Other desired without her.
Linda had, like many hysterics, a fallen father. In terms of Lacans
sexuation formulas, such love for the father suggests also a virile iden-
tification with an impotent, fallen father. She had a mother who knew
no boundaries, no limitations, and who lived out the fantasy of an ideal
absence of castration (one could say a mother who seems to represent
the left side or men of the formulas of sexuation; they are fully defined
by the phallic function). This was a mother who talked too much, who
treated her as a partner, and who seemed not to have fully accepted cas-
tration. Her mother controlled her as if she were her own law, calling up
the primal father who exists outside symbolic castration. In Freudian
theory, the father of the primal horde and the phallic mother are both
conceived as all-enjoying and lacking nothing. In Lacanian theory,
the Woman and the pre-jouissant (laws violent progenitor) occupy
this position of plenitude beyond division. As these figures possess
or embody the phallus in the form of unlimited jouissance, they seem
beyond gender in the usual sense; they appear not to be subjected to
sexual division.
I will conclude by returning to Lacans statement in Subversion
of the Subject: Castration means that jouissance has to be refused in
order to be attained on the inverse scale of the Law of desire (Lacan,
2006d, p. 700). This sends us back to the dialectics of alienation and
separation. Two stages can be outlined, first the renunciation to jouis-
sance (or alienation), and then the renunciation to the pleasure derived
from the Others demand ($ <> D) when jouissance is attained as the
inverse of the Law of desire (separation--$ <> a). The fundamental ques-
tion that brings a subject to the point of separation is: what am I for the
Others desire? Psychoanalysis is the process by which we can begin to
answer that question. Eventually Linda stopped being bulimic when
her jouissance no longer expressed itself outside speech in an obstinate
rejection but was inscribed in a rapport with the Other. The solution
she found was to stress the process of making food: cooking became a
hobby for her and eventually developed into a profitable professional
activity. It all started with tremendous pleasure. One holiday season she
announced that she had found the perfect gift for her family and friends:
Mondel Brodts, a hard almond cookie much like biscotti. A delicious
treat. Great with coffee or tea, she quipped. The details of the recipe
are revealing. The baking of the cookie requires two steps. First, the
dough is shaped into logs that are baked for 20 minutes and removed
from the oven and cooled completely. Then, the logs are cut in slices
and returned to the oven for a second baking, until toasted. It does not
seem too far-fetched to see in this an allegory of the two-stage proc-
ess with an intermediary cut that she had managed to bring to bear on
her life. By baking, cutting, and re-baking she was able to introduce
difference and let the object emerge as independent and divisible. Linda
no longer needed her bulimia to ward off the threat of a swallowing
Other. Cooking replaced the phobic object, which shows that the fear
of being eaten was overcome and that food wasnt an addictive sub-
stance any more. She would now delight in cooking for others. The
addictive cycle of bingeing had been controlled by a double process
that contained repetition, while marking it off with a symbolic cutting
operation. Linda later found an outlet for her creative energies when
she became an artist whose main medium was chocolate sculpture. Her
symptom had become a Lacanian sinthome.
Endnotes
1. Fragments of this case appear in Please Select Your Gender: From the Inven-
tion of Hysteria to the Democratizing of Transgenderism (Routledge: New
York and London, 2010, pp. 196208). This is a revised and expanded
version.
2. For alienation and psychoanalytic technique, see Lacan, J. (2006).
Position of the Unconscious. In: crits: The First Complete Edition in
English (pp. 713716). Trans. B. Fink in collaboration with H. Fink and
R. Grigg. New York: W. W. Norton.
3. For more on Henri Wallons studies of the dialectic of self and other in
relation to the newborns helplessness see Tran-Thong. (1967). Stades
et concepts de stade dedevelopment de lenfant dans la psychologie contempo-
raine, pp. 184185. Paris: Vrin.
4. Lacan explains that if one was to choose money, one may lose both.
If one chooses life over money, one will have a life without money, that
is, deprived of something. Lacan, J. (1981). Seminar XI, The Four Funda-
mental Concepts of Psychoanalysis. (J. A. Miller, Ed.).Trans. Alan Sheridan.
5. For a helpful and very detailed discussion of alienation and separation
see Fink, 1997, pp. 83125.
6. In Inhibition, Symptom and Anxiety, Freuds theory of anxiety turns a cor-
ner and anxiety is no longer considered the result of repression. In this
19251926 text, anxiety no longer appears as a result of repression but
as its cause. And the reason for that anxiety is to be found in an external
factor, the threat of castration.
References
Fink, B. (1997). The Lacanian Subject: Between Language and Jouissance.
Princeton, NJ: Princeton University Press.
Freud, S. (1926d). Inhibitions, symptoms, and anxiety. S. E., 20: 75166.

London: Hogarth Press.
Freud, S. (1950a). Project for a Scientific Psychology. S. E., 1: 281391.
London: Hogarth.
Gherovici, P. (2010). Please select Your Gender: From the Invention of Hysteria to
the Democratizing of Transgenderism, New York and London: Routledge.
Lacan, J. (1967). Le Sminaire, Livre XV: Lacte psychanalytique. Lecture 12
April, 1967. Unpublished.
Lacan, J. (19701971). Le Sminaire, Livre XVII, Lenvers de la psychanalyse
(J. A. Miller, Ed.). Paris: ditions du Seuil.
Lacan, J. (19761977). Le sminaire, Livre XXIV: Linsu que sait de lune bvue
saile mourre. Ornicar? 12/13, 1977. Seminar Linsu.
Lacan, J. (1981). Seminar XI, The Four Fundamental Concepts of Psychoanalysis.
(J. A. Miller, Ed.). Trans. Alan Sheridan. New York: W. W. Norton.
Lacan, J. (1994). Le Sminaire, Livre IV, La relation dobjet et les structures
freudiennes 19561957. (J. A. Miller Ed.). Paris : ditions du Seuil.
Lacan, J. (1998). Le sminaire, Livre V: Les formations de linconscient 19571958.
(J. A. Miller Ed.). Paris: Seuil.
Lacan, J. (2004). Le Sminaire, Livre X, Langoise. (J. A. Miller, Ed.). Paris:
ditions du Seuil.
Lacan, J. (2006a). Response to Jean Hyppolites commentary on Freuds
Vernienung, 1956. In: crits: The First Complete Edition in English
Lacan, J. (2006b). The direction of the treatment and the principles of its
power, 1958. In: crits: The First Complete Edition in English (pp. 489542).
Trans. B. Fink in collaboration with H. Fink and R. Grigg. New York:
W. W. Norton.
Lacan, J. (2006c). The signification of the phallus, 1958. In: crits: The First
Complete Edition in English (pp. 575584). Trans. B. Fink in collaboration
with H. Fink and R. Grigg. New York: W. W. Norton.
Lacan, J. (2006d). The subversion of the subject and the dialectic of desire
in the Freudian unconscious, 1960. In: crits: The First Complete Edition in
English. Trans. B. Fink in collaboration with H. Fink and R. Grigg. New
York: W. W. Norton.
Laurent, E. (2002). Institution of the phantasm, phantasms of the institution.
Courtil Papers: www.ch-freudien-be.org/Papers/Txt/Laurent-fc4.pdf,
accessed on 2/11/08.
Stevens, A. (1986). Remarques sur lusage du terme holophrase dans
lenseignement de Jacques Lacan (D.E.A). Unpublished manuscript.
CHAPTER EIGHT
Two people in a room: ethnographers,

unruly subjects, and the pleasures
of addiction
Alexine Fleck
I
n the provocatively titled anthology, Crack Pipe as Pimp, various
ethnographers describe the sex-for-crack phenomenon surfacing
in the more general crack-using population. James Inciardi (1993)
opens his taxonomy of crack-using locales and risk behaviours, entitled
Kingrats, Chicken Heads, Slow Necks, Freaks, and Blood Suckers,
with a particularly disturbing scene. I impose it on you to illustrate an
argument I hope to make in this article:
Upon entering a room in the rear of the crack house (what I later
learned was called a freak room), I observed what appeared to
be the gang rape of an unconscious child. Emaciated, seemingly
comatose, and likely no older than 14 years of age, she was lying
spread-eagled on a filthy mattress while four men in succession
had vaginal intercourse with her. After they had finished and left
the room, however, it became readily clear that it had not been for-
cible rape at all. She opened her eyes and looked about to see if
anyone was waiting. When she realized that our purpose there was
111
not for sex, she wiped her groin with a ragged beach towel, covered
herself with half of a tattered sheet affecting a somewhat peculiar
sense of modesty, and rolled over in an attempt to sleep.
(Inciardi, 1993, pp. 3940)
Inciardi later learns that this unconscious child is the house girl,
who provides sexual favours in exchange for food, shelter, and crack.
His description of what he saw, however, is not retroactively modified
by this new realization. Rather, he positions his reader to witness the
event as he did. Welike Inciardiare, of course, horrified, outraged.
A gang rape of an unconscious child? A child who is unhealthy, dirty,
emaciated? As he gathers more information about the scene, Inciardi
needs to modify his original description of the event as a gang rape. Yet
he finds no real term for what hes seen, so he must resort to a second
negative: not a gang rape and not a forcible rape, but somehow a rape
all the same. How else could he explain this girls situation? How else
can he put the blame where it belongs: at the feet of men who would use
a girl in such a manner.
Inciardis description precludes any different responses to the scene,
refuses history or context, reducing it to its two main actors: the girl
and the man having sex with the girl. But there were other people in the
room. Inciardi could not have gained entrance to such a scene without a
guide, and he makes reference to the other peoplepresumably men
who were not participating in the sexual activity when he notes that the
girl realized that our purpose there was not for sex. Inciardis use of
the passive voice also masks the identity of the person who named the
space the freak room and this person most likely had a different sense
of the events happening there. By looking, by naming what he sees, by
using this girl as a shocking case study, Inciardi is more aligned with the
men looking and so am Iand so are you now. Our relationship to this
girl is filtered through Inciardis gaze, which raises the question of how
we look and how our look is guidedhow we witness suffering, abuse,
violence and, possibly, some troubling pleasure when our subjects are
unruly and fail to conform to rigid binary roles of victimvictimizer,
goodbad, innocentguilty, and usthem. And it raises the question of
what we do with what we see.
Merleau-Ponty (1964, p. 134) notes that, as with touching, looking
inscribes us into the scene, since he [sic] who looks must not himself be
TWO PEOPLE IN A ROOM 113
foreign to the world he looks at. There is no real outside from which to
look upon the other; we are always, in his formulation, apart from and
a part of what we see. Attending to the way that Inciardi represents the
scene before him extends the frame from two people in a room to two
people in a room that has become a stage with an implicated audience.
Once suffering has become your subject, Elizabeth Spelman (1997,
p. 153) notes, it is impossible not to send a messageperhaps a quite
complicated oneabout its meaning. We create taxonomies of suffer-
ing, rank its significance, use it metaphorically, to talk about ourselves
or to instruct others in how some suffering is instructive or worthy
of more than cursory recognition, implying that other suffering is not
(Spelman, 1997, p. 5). When Inciardis perception of the scene he has
just witnessed shifts, the girls suffering is refigured and the possibility
of pleasure, so dearly purchased, emerges as a spectre in our imagina-
tion. Its difficult to realize that for some, pleasure might simply be the
cessation of pain, or a sad choice from among bad options. Its likewise
difficult to realize that pleasure can be derived despiteor because
ofthe suffering of others.
In The Body in Pain, Elaine Scarry (1985) theorizes a primal torture
scenario in which there are two people in a room, one in pain and one
not. The impassable gulf between them is why one can inflict unbear-
able pain on the other in the name of nation or security or freedom.
[T]o have great pain is to have certainty, she writes, to hear that
another person has pain is to have doubt. In this way, pain foregrounds
the split between ones sense of ones own reality and the reality of
other persons (Scarry, 1985, p. 4). That gap exists in the scene Inciardi
describes as well; it is what enables him to read the scene one way and
then anotherfirst as a rape and then as something elsesomething
even more horrifying, it seems. Initially, he sees someone suffering at
the hands of another and, as Scarry (1985, p. 4) points out, the fact of suf-
fering makes clear where the lines of moral responsibility are drawn.
They must be starkly drawn, for the sake of political mobilization, to
illustrate the power inequality that makes possible a room in which one
person suffers and another person inflicts suffering. As any feminist
worth her salt would remind us, the girls sexual violation is an act of
power, usually used by men to reinforce patriarchal power relations.
As such, it is always embedded in larger structures of inequality, of
which it is symptomatic. Rape is an act of violence and control, one with
clear (and often gendered) boundaries between victim and perpetrator,
innocent and guilty. Rape resembles Scarrys formulation of torture, an

act of stupidity in which the pain of one person (and the non-pain of the
other) ultimately work to buttress what feminists hope is a crumbling
patriarchal regimes fiction of power. Yet, Scarry (1985, p. 35; emphasis
in original) notes, as soon as the focus of attention shifts to the verbal
aspect of torture, those lines [begin] to waver and change their shape
in the direction of accommodating and crediting the torturers, who
are only seeking information. Those lines waver as well in the scene
Inciardi describes, threatening our sense of rape, trauma, responsibility,
and justice. Although the scene enacts a version of the feminist formula-
tion of rapethe symptom of a culture in which men enact and repro-
duce their power through sexual violence and subjugationit also
undercuts such a critique when the girl barters her sexuality for drugs,
housing, and food. She has what the men want and by choosing to sell
it, she potentially reinforces her original sexual self-ownership.
Hegels (1807) lord and bondsman enact a similar power struggle
and potential reversal: the bondsman is willing to reflect the subjectiv-
ity of the lord because hes not willing to put his life on the line. But, in
the process, he develops a more real connection with the material world
and, in doing so, supersedes the subjectivity of the lord. And in a sense,
Hegels hypothetical pair are really just another two people in a room.
If we witness the original struggle, the master subjugates the slave; if
we focus on subsequent material production, as Marxists do, we see the
slaves subjugation as the precondition for genuine existence.
What strikes me about Hegeland, by association, about Inciardi and
Scarryis that there are only two people in the room: lord and bonds-
man, man having sex with girl, torturer and tortured. Yet wealigned
through the gaze of the authorare never to identify with either of
these two people. We are positioned with the obscured third, the one
who witnesses, theorizes, documents. The authors direct our gaze and
shape our understanding, as Inciardi does in his unfolding description
of the scene in the freak room. But describing this scene as a rape
obscures another way of looking at itas a transaction: an exchange of
sex for something the girl values more than sexin this case a place to
sleep, something to eat and, of course, crack.
I think this is the horror for Inciardi, the something else to which
I referred earlier. In the second half of his quotation, his descriptive
tone shifts. The girl pulls a sheet over her naked bodya gesture in
keeping with someone who has just been raped, or the child that she
is, perhaps, but in sharp contrast, some might think, to the degrading
way in which she has just prostituted herself. Inciardi calls this gesture
a somewhat peculiar sense of modesty, however, and his use of the
word peculiar suggests the girls new status in his thinkingnot a
victim but a whoreone who has ceded her body to anyone for crack
and whose choice permeates her very being such that modesty, with-
holding her body or self from any man, is rendered peculiar.
Can this girl be both victim and whore? Can she prostitute herself
and then want to withhold her body from others? Can a child even
make such choices? Can she allow violent sexual touching and then
resist the invisible, yet almost physical, contact of the gaze? Inciardis
disturbing description of a young crack prostitute, a chicken head
according to the title of his article, cant offer conceptual space for the
complicated volition that distinguishes between victim and whorefor
the fact that she can choose to sell her sexuality for drugs, food, and
shelter, and still retain elements of herself by covering her body in the
presence of a stranger.
In an appendix to another anthology, Women and Crack-Cocaine,
Inciardi (1983) returns to this girl in order to illustrate the ethical quan-
daries faced by drug researchers. Inciardi introduces her in exactly the
same waythe text is identical to the one portion cited aboveand
then asks what a researcher should do in a situation like this? He lists
possibilities before addressing the reader directly: What? What would
you do? He describes his initial reaction as highly repressed outrage
but confesses he did nothing after his guide quietly threatened his life
and pointed out that the girl would most likely be punishedprobably
with rapeif Inciardi did anything. In the ensuing months, Inciardi
gets to know the girl, who he calls Leona. He learns more details, con-
firming some suspicions and complicating others: she is a minor; she
covered herself out of shame; she didnt want to leave the crack house
for a variety of reasons. Inciardi tries to help the girl, who cant quit
using crack, gets tangled up in the legal system, contracts HIV (human
immunodeficiency virus) and disappears, at least from Inciardis view.
Although he doesnt admit it in the more formal article in which I origi-
nally found this passage, Inciardi does eventually shed his more purely
observational role, trying to alter the scene after the fact. He tampers
with the subject of research because she is a subject and because, by
looking and initially doing nothing, he is paradoxically implicated in
the scene.
This returns me to the girls somewhat peculiar gesturepulling

half a tattered sheet around her and attempting to sleep. The girl in the
room never says a word, but the gesture communicates her boundaries
all the same. Her actions speak to (or for) those others who are witnessed
or watched, the subjectsor objectsof expert discourse, case
studies, unruly subjects who are narrated into someone elses theories,
even as they resist or complicate those theories. They experience our
gaze more accurately than we can ever understand what it is to be in
that skin upon which our vision alights. If, following Merleau-Ponty
(1964), we think of vision as a variant of palpation in which the gaze
reaches out and lands on the skin of another, then perhaps some ways
of looking are as invasive, or more invasive, than the unwanted or semi-
negotiated intimate touch of a stranger.
There is pleasure in places we dont want it to be, particularly when
our (unruly) subject is addiction, one way to term the desire that brings
that girl to that increasingly crowded room and the forces that keep
her there. Part of the paradox of addiction involves its strange alchemy
of pleasure and pain. Indeed, even before the word addiction was
used to describe the concept we know today, De Quincey (1821) used
pleasure and pain to describe his experience with opium through-
out Confessions of an English Opium Eater. And even then, pleasure and
pain were inextricably interconnecteddespite De Quinceys efforts
to divide his narrative into a pre-lapsarian, pleasurable Before and a
fallen, painful Afterthere is pain even in his earliest descriptions and
pleasure in the later ones. Drug users pleasures and pains can look
senseless, uselessan experience without truth, Derrida (1989, p. 8)
has said. But if we think of drug users as active agents, making choices
we might or might not make, choosing their stigmatized pleasures
sometimes at great cost, we can start to think of the girl in the freak
room as someone who chose from the options available to her and
whose choice illustrates the volition that reflects her subjectivity as well
as the nature of injustice.
Drug users are unruly subjects, unwilling to conform to the ways
that we (or at least I) want to understand the world. They have an
important but troubling lesson for us. They expose the rigid distinc-
tions between victim and victimizer, innocent and guilty, helpless and
powerful, passive and active, as necessary, if inaccurate, fictions. We
need these fictions for moral clarity and political mobilization, but in
some intellectually safe rooms, we need to think about those who
dont fitor exceedthose distinctions. We cant let the freak room

exist outside of human culture or we will never know what drug use
and addiction can tell us about ourselves and others.
References
De Quincey, T. (1821). Confessions of an English Opium Eater. New York:
Penguin Books, 1971.
Derrida, J. (1989). The rhetoric of drugs: an interview. Differences: A Journal
of Feminist Cultural Criticism, 5(1): 225, 1993.
Hegel, G. W. H. (1807). Phenomenology of Spirit. Trans. A. V. Miller. Oxford:
Oxford University Press, 1977.
Inciardi, J. A. (1983). Appendix A: some considerations of the methods,
dangers, and ethics of crack-house research. In: (Eds.) D. Lockwood &
A. E. Pottieger Women and Crack-Cocaine (pp. 147158). New York:
MacMillan Publishing Company.
Inciardi, J. A. (1993). Kingrats, chicken heads, slow necks, freaks, and blood
suckers: a glimpse at the Miami sex-for-crack market. In: (Ed.) Mitchell
S. Ratner, Crack Pipe as Pimp: An Ethnographic Investigation of Sex-for-Crack
Exchanges (pp. 3767). New York: Lexington Books.
Merleau-Ponty, M. (1964). The Visible and the Invisible. Trans. C. Lefort.
Evanston: Northwestern University Press, 1968.
Scarry, E. (1985). The Body in Pain: The Making and Unmaking of the World.
New York: Oxford University Press.
Spelman, E. V. (1997). Fruits of Sorrow: Framing Our Attention to Suffering.
Boston: Beacon Press.
CHAPTER NINE
Toxicomanic passion for an object:

the sexual relation exists
Gustavo Klurfan
Setting
I have been practicing in a Community Mental Health (as it is called)
Clinic in the barrio of North Philadelphia for almost four years, most
recently as clinical supervisor. North Philadelphia is one of the hot-spot
scenarios of drug dealers, users, and sellers. One out of three patients
upon admission has, or has had, problems with substances such as alco-
hol, cocaine, or heroin. Upon our acceptance of a patient with an addic-
tion, we must immediately refer them to our Drug and Alcohol (D&A)
programme, which is adjacent to the clinic. The patient must undergo
both treatments because they are considered to have dual diagnosis or
co-occurring disorders (as if, for the Managed Care system, someones
mental health and their trouble with substances are completely sepa-
rate dimensions of the subject). As I will discuss throughout the paper,
a psychoanalytic approach to addiction is much different than this tra-
ditional mental health one.
In the D&A programme that belongs to our private, non-profit insti-
tution, the group therapy sessions are conducted by a counsellor. The
patients are taught that they are sick and cannot ever be cured of their
119
illnesseven if they succeed in quitting the substance entirely. They

are also told that there is a Superior Power who will help them to
quit. From my point of view, such language creates an obstacle in the
psychoanalytic path, an indelible mark of identification with being an
addict: I am an addict, and I will never be cured even if I stay clean.
This goes in a direction opposite to that of a psychoanalytic cure, in
which the subject is driven to the point of finally abandoning such iden-
tifications, allowing desire to emerge. Every attempt to move the sub-
ject from this fixed signifier that names their being represents a drastic
fall from an ideal. We have to be very careful with the transference, of
course, because we have to manage this stabilizing identification with
the jouissance of the symptom, which is incarnated in the subject. This
allows the subject to go from I am an addict to I have an addiction
that I can rid myself of, a phallic signification that can be exchanged
with multiple others, creating the possibility for the subject to question
their implication in the symptom.
Another obstacle in our D&A programme (from a psychoanalytic
viewpoint) is that the patients are treated as children rather than as
adults responsible for their acts. On one occasion, for example, the D&A
counsellor of one of my patientswho was in a crisisentered my office
while the patient was in session with me and, seeing the patient crying,
hugged her and said, Dont worry, remember that youll always be
my little child and I love you so much. The patient stopped crying
instantly, an infantile smile replacing her tears.
Psychoanalysis and addiction

It is a tradition in psychoanalytic literature to think that a patient with
an addiction cannot be analysed; although this is often true, I think that
there are important exceptions.
There are many patients who come to the clinic where I practice only
for the intake session. Through an extensive bio-psychosocial interview
they are confronted with their past history or reminded of the roles they
played in the lives of their significant others, which alone sometimes
triggers the abandonment of treatment.
Indeed, each time I begin treating an addict I have the sensationor
the prejudicethat they will not continue in longer term treatment.
This is not only a result of my clinical experience with patients pre-
senting themselves with their lies and deceptionsall framed by the
TOX I C O M A N I C PA S S I O N F O R A N O B J E C T 121
medico-legal discourse which constitutes them as guilty, irresponsible,

criminal, and sickbut also is a product of the limited number of refer-
ences in Lacan and Freud about cases of addiction.
I wish to present two different ways that a subject can relate to the
object of their addiction, to describe the corresponding structural posi-
tions of the subject, and finally to correlate these two categories within
the classic psychiatric nomenclature. Two clinical vignettes will be
presented to show their differences and relationships. I will also cor-
relate Lacans (1950, p. 108) and Henri Eys (p. 1978) use of the term
psychopath to one of the types of addicted patients.
In addition, my questions are about the status of the object of addic-
tion and its association to the subject and the role of the Other. How
does a subject become so fixed to a particular object? Does this fixation
allow the possibility of a psychoanalytic transference? Can we consider
addiction as a symptom, from a psychoanalytic point of view? What
leads to the excessive use of the object: is it the emergence of anxiety,
or is it the immediate demand of the partial drives? How is it that I see
certain cases of addiction presented as perversion? From the Lacanian
psychoanalytic perspective, a perversion should be considered in only
structural terms: a position of the subject in relation to the Other and the
object. Is addiction a perversion?
The few references in Lacan and Freud to the problem of addiction
warrant our tracing them in order to open up ideas for a possible psy-
choanalytic discourse in this domain. In a letter to Fliess, Freud writes
that masturbation is the one great habit that is a primary addictions,
and the other addictions, for example alcohol, morphine, tobacco, etc.,
only enter life as a substitute and replacement for it (Freud, 1954,
p. 238). This autoerotic satisfaction that pushes the Other away is a
feature typical of the addict since they do not need anothers body to
obtain satisfaction.
Freud also compares the addicts relation to alcohol and to a love
object.
Consider the relation of a drinker to wine . Has one ever heard

of the drinker being obliged constantly to change his [sic] drink
because he soon grows tired of keeping to the same one? On the
contrary, habit constantly tightens the bond between a man and the
kind of wine he drinks . If we listen to what our great alcohol-
ics say about their relation to wine it sounds like a model
of a happy marriage. Why is the relation of the lover to his sexual

object so very different?
(Freud, 1912d, p. 188)
The encounter with this object provokes ecstasy, a kind of orgasm that
veils a structural lack: it conceals the fact that there is no complementa-
rity between the sexes, that there is no complete jouissance. In some cases
the object of addiction, in fact, provokes a sense of complete independ-
ence from the Other, which invites the question: is this omnipotence
the one which prevents the formation of a conflict that would allow a
demand about the symptom to be addressed to the analyst?
In thinking about the specificity of addiction, it struck me that the
French psychiatrist Henri Ey, a very close colleague of Lacans, includes
both drug addicts (toxicmanos; Fr. toxicomanes) and sexual perverts
under the classification of psychopaths. In general, psychopathy is
a term that entails some transgression of the law, a necessary element
that must be present according to Eys criteria. Some rejection of the
symbolic order is implied even in the ordinary use of psychopath,
which the American Heritage College Dictionary, for example, defines as
a person with an antisocial personality disorder, manifested in aggres-
sive, perverted or criminal behavior without empathy or remorse
(American Heritage College Dictionary, 2004, p. 1125).
Addiction and psychopathy also share a relation to the drive; Ey says
that the behavior of the toxicmano constitutes a perversion that com-
pletely satisfies his [sic] need (Ey, 1978, p. 351). He associates it with
certain behaviours that are such perversions since they both share
the regression to a partial pleasure. For Ey, in these cases the behav-
ior emerges directly from the drives. The anxiety is completely avoided,
and there is no conflict or guilt which would arise from a symbolic elab-
oration. The act emerges directly from the drives as a consequence of a
strong and early fixation (Ey, 1978, p. 331).
In a presentation given at a conference in 1950, Lacan agrees with
Ey: Assuredly, there is a high correlation between many perversions
and the subjects who are sent for criminological examinations, but
this correlation can only be evaluated psychoanalytically as a function
of fixation of an object, developmental stagnation, the impact of ego
structure, and neurotic repressions in each individual case (Lacan,
1950, p. 121). Here Lacan makes a clear diagnostic recommendation,
matching psychopathy with perversion. But where would this place

addiction?
The signifier addiction condenses two others: not only add, or a plus,
but also a/diction, a privation, a silence, what is not said. It is a signifier
that denotes the cut with the symbolic order and the silence of the death
drive. The addiction is the subjects choice of an object that is experi-
enced as almost pure jouissance, and constitutes a strategy to extract
himself from the Other. On the one hand, there is the plus of jouissance;
on the other, the subtraction of desire. Again, can we specify the rela-
tion of desire and jouissance with greater precision around the question
of addiction?
* * *
The Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition (DSM-IV) distinguishes between two types of substance use
disorders: a) dependence is characterized by a persistent desire or
unsuccessful efforts to cut down or control substance use; and b) abuse
features recurrent substance-related legal problems (e.g., arrests for
substance-related disorderly conduct) (American Psychiatric Associa-
tion, 2005, p. 199).
I find a correspondence between dependence and neurotic structure,
on the one hand, and between abuse and perverse structure, on the
other. Dependence implies a link with the Other, by way of submission.
Conflict and guilt regarding the addiction may be experienced as a
symptom; as a result, the subject may question their use of the object
and thus address a demand to the analyst. With abuse, however, there is
a sense of omnipotence in regard to the knowledge of what jouissance is,
and the addiction is never experienced as a symptom.
Clinical vignettes
I will present two cases: that of a patient addicted to gambling, the
other of one addicted to alcohol, both of whom share what psychiatry
calls lack of control of the impulses. These two vignettes will help
illuminate the way that addiction may play out differently in relation-
ship to a subjects structure. Some may question my choice of a patient
whose addiction is gambling (the first case of Manuel). Although
not specifically classified as an addiction in the DSM-IV, pathologi-
cal gambling is considered a disorder of the control of the impulses
(American Psychiatric Association, 2005, p. 663), along with pyromania,

kleptomania, and trichotillomania. (We see the word mania in all
of them: a compulsive, repetitive, uncontrolled way of relating to an
object.)
In Civilization and its Discontents Freud compares the manic with
the addict: we know at least one pathological state, mania, in which
a condition similar to intoxication arises without the administration
of any intoxicating drug (Freud, 1930a, p. 78). In this text, Freud also
emphasizes the independence from the external world caused by such
drugsand behaviours (we might add)situating them as one of sev-
eral ways to deal with suffering.
* * *
Manuel, a patient in his fifties, lives alone and completely isolated from
his sisters and daughter, who live in another country. More than 20 years
ago he had a brief but intense relationship with a separated woman
five years older than himself. After a few months of dating, the woman
got pregnant. They lived together for a few months and then separated
before their daughter was born, in 1982. He was never involved in rais-
ing his daughter and only met her a few times. He last saw her when
she was 10 years old. Then he travelled and worked in several countries
and only had contact with her by phone. In 2000, he called one of his
sisters, who told him that their mother had died several months ear-
lier. Immediately, he called his daughter and got into an argument with
her because she had never visited her aunts and refused to even then.
He has not talked to either his sisters or his daughter since.
Manuel has a job and a decent income, but he spends every cent
gambling in Atlantic City, where he sometimes plays cards for 24 or
more hours in a row. He presents himself naming his being: Im an
inveterate gambler. He comes to treatment not because of the gam-
bling, however, but because of the aforementioned radical cut with his
sisters and daughter. This is not normal, I want to change it, he says.
Another facet of his initial demand is that he would like to gain some
discipline so he can become a professional gambler. He finds that he
cannot stop even after he has reached the limit of losses at which a pro-
fessional in his position would cease playing.
On the day of his first appointment he arrives half an hour early.
He arrives half an hour late for the next one. When I raised this as an
issue, he explained: I am not interested in using a watch. However, in

subsequent sessions he always asks me if he is on time or late. He also
does not use a phone, owning neither a mobile nor a home phone: he
refuses to use either of these two universals that rule social encounters.
At the same time, however, he acknowledges their importance, even as
he challenges it with his continuous acting-out. Here we see the logic of
transgression as a constant provocation of the law, in Jel Dors terms,
a defiance that is typical of the perverse subject (Dor, 2001, p. 134).
The patient talks about himself in a melancholic way, saying he
humiliates himself when he plays cards. The object becomes an object
of degradation. The patient tells me that he is a masochist. He does
not show any trace of delusions or hallucinations that would suggest
psychosis.
He says of his dead mother that she has a sense of humour like me.
He mentions other ways in which we are pretty similar, continuing
in the present tense as if she were still alive. This denotes identification
with his mother, and a denial of the most extreme form of castration
her death. I can also trace a strong identification with his maternal
grandfather, who gambled away a fortune. The signifier of the Name-
of-the-Father seems to be transmitted through the maternal line.
I live like a savage, Manuel says. I dont own a thing. Calling
oneself a savage is a significant way to speak of oneself and may
mark his relationship to law and its mediating function in relationship
to (his) nature. Lvi-Strauss states that the prohibition of incest is the
universal law that is the fundamental step because of which, by which,
but above all in which, the transition from nature to culture is accom-
plished (Lvi-Strauss, 1949, pp. 2425). Lacan situates the psychopath
(psychopathe) on this meeting point of nature and culture (Lacan,
1950, p. 111). Positioned at the very edge of the passage, I think that
psychopaths show the existence of the law, its transgression, and the
self-punishment for the crime. We could say that the drive is reduced
to the category of instinct, with its fixed object almost on the border of
nature and culture.
The two Freudian myths of the prohibition of incest are, of course,
Oedipus the King and Totem and Taboo. In both there is a crime. In the
first one, there is self-punishment for the crime of having enjoyed the
mother; in the second, the crime of the father for having enjoyed all
women.
Manuel has a recurrent and compulsive thought that he killed some-

one in the past; when I inquire about it, he inadvertently associates it
with a dream about his dead fatherbut avoids giving any details. My
father believed that I was bad, that I was very destructive. Once he said
of me: Tiene que ser delincuente. In Spanish, this ambiguous statement
has a double meaning: either he is a criminal by nature, or he will one
day become a criminal. Manuel repeats in the sessions that he is not a
criminal, that he actually did not kill anyone.
For Freud, the masochistic pervert likes to be treated as a way-
ward and dependent child. Manuel says, Everyone calls me
Manuelito, treating me as a four-year-old child. My father was good
at everything, I am a disaster, and I belong to my mothers family.
Identified with the maternal phallus and disavowing/repudiating
her castration, Manuel seeks out self-punishment for the crime
through the losses and debts he incurs gambling. The card game, in
which hands are dealt to the player, replaces the games the hands
play with the genitals in onanism, the resemblance of the enjoyment
of the mother.
In his book Structure and Perversions, Joel Dor (2001) says that the
defiance of the law typical of the perverse subject is an expression of
the trap in which the child is situated by their mother: on the one hand
she seduces the child by calling for transgression of the law of incest;
and, on the other, she recognizes the father as the representative of the
law. But there is a failure on the fathers part to make use of his sym-
bolic power. The pervert is trapped in a movement towards a version of
the father (pre-version), which is elicited only to be eluded. The mother
is an accomplice. Thus, the pervert will always need an accomplice to
ensure their jouissance.
Instead of love, Manuel has a dysfunctional passion for gambling,
a kind of crazy and uncontrollable love that the subject exhibits to the
other for their jouissance. The patient expresses their relation to the phal-
lus: The gambling has me, I dont have a thing. He has no phallus; his
whole body is identified with the maternal phallus. The object has him,
as was the case with the mother of his daughter: I was attached to her
as if to hot iron (hierro caliente). He was fused to an older woman as if
he were her phallus.
I want to be sincere with you: I reject women. Its been ten years
since Ive had sex, he tells me, but goes on to say, contradicting himself,
I only have sex with easy women for one night. This is the opposite of
the The Woman idealized by the neurotic. He rejects the non-castrated

The Woman and he probably has sex only with prostitutes. Does he
consider prostitutes women?
Manuel subjects himself to long periods of fasting (sometimes for as
long as 15 days) after losing large amounts of money. He doesnt give
a shit (to use the vernacular) about the money he loses gambling, but
on the other hand, he avoids eatingand thus having to shit. We see
here the circuit of the drives: alienation by shitting money and sepa-
ration by fasting.
An interesting parallel exists between this case and what Freud
describes in his essay on Dostoyevsky. Describing the period when the
writer was obsessed with a mania for gambling, which no one could
regard as anything but an unmistakable fit of pathological passion
(Freud, 1928b, p. 190), Freud asserts that Dostoyevsky knew that the
chief thing was the gambling for its own sake for him, gambling
[Freud thinks] was a method of self-punishment (Freud, 1928b,
pp. 178179). Freud gives equal significance to the authors choosing of
violent, murderous and egoistic characters, his possible confession to
a sexual assault of a young girl, and his passion for gambling (Freud,
1928b, p. 190). In addition to characterizing the authors personality as
an instinctual character (p. 179), he describes the writer as a criminal
(p. 178), who sublimated his destructive drives, as a sadist (p. 178),
in the way that he treated his readers and others, and as a masochist.
Freud describes this attack of pathological passion for gambling as a
kind of defence against onanism, theorized as the primary addiction
(as noted above).
With Manuel, gambling is an object that functions as a fetish of, or a
substitute for, the maternal phallus. There is a fixation on this object. It
seems that he cannot love. (Indeed, he tells me that he rejects every-
one.) There is fixation, but not the choice of an object.
In our sessions, he constantly exhibits his knowledge of jouissance
when he attempts to teach me, in detail, the rules of the different kinds
of card games. On one occasion he reveals, smiling: Once I lost $30,000.
Everyone was amazed. And: Sometimes I go to work with $40,000 in
my pocket. He shows no regret or anxiety when reporting either of
these; I think he is trying to use me as a witness, attempting to fascinate
me with his adventures. There is no demand to get rid of the addic-
tion; in fact he is quite explicit about this: Im not here to stop my
gambling.
After some months of therapy during which he associates on the

causes of his severance from his family, he buys a cell phone one day
and calls his daughter, finally speaking with her after those many years.
Never did the issue of gambling enter the transference beyond the point
of exhibition of his jouissance.
* * *
Carlos is a patient in his 30s who, on and off, experiences periods of
alcohol dependence. He has been in several detoxification programmes.
He describes his wife, with whom he lives, as being a mother, a friend
and a wife for me. Here we have the idealized woman characteristic of
the obsessional neurotic.
He has been extremely depressed, and has begun drinking heav-
ily again, when he starts treatment with me following three months of
missed sessions with his former therapist (at the same clinic). When
I was first assigned a caseload at the clinic, Carlos was on my list. I had
to call him three times before he finally came for the first session. From
the beginning he describes how upset with himself he is for consuming
beer after beer in bars with friends until late at night, afterwards wak-
ing up in the morning depressed and guilty. He is very identified with
his alcoholic father, after whom he is named.
After five or six sessions, he starts to historicize his symptom and
to take responsibility for his choosing beer as a refuge. Previously,
each traumatic episode with his sister and mother triggered beer inges-
tion and the vicious cycle of guilt and escape to this refuge from the
jouissance of the Other. In other words, we can say that the beer takes on
the value of a phobic object.
Carlos can be positioned in the category of alcohol dependence
since he has had repeated, frustrating attempts to control the ingestion.
The beer-as-shelter functions here as phallic signification that can be
exchanged with others, in his case with periods of 12 to 14 daily hours
of work in construction. Here we have a displacement, maybe in the
order of sublimation of his death drive, and also a different meaning for
the phallus. This value of the object as a substitute for the phallus, or
as making up for the Name-of-the-Father, allows the exchange among
objects and the possibility of constituting a love object for the transfer-
ence. This triggers the circuit of desire instead of the one of jouissance.
There is an explicit demand to get rid of the addiction: I want to be
out of this. It is ruining my life. Carlos actually managed to sustain
transference for more than three years, during which he stopped

drinking alcohol for a period of almost 12 months.
Conclusions
I think that the object of addiction can be structurally positioned as a
phobic object or as a fetish (although not exclusively one of these two
only). When phobic, the function of the object is to avoid anxiety, and
it becomes a refuge (as in the case of Carlos) to protect oneself from
the omnipotencejouissance of the Other. Thus, the subject becomes
dependent.
When fetishistic, as in the case of Manuel, the subject abuses the
object, feels omnipotent over it, and shows the Other his knowledge
of jouissance. For the perverted subject, the addiction is not felt to be a
symptom. There is no guilt, no conflict for the use of the substance or
the activity.
According to Freud, the analysis must not provide a substitute sat-
isfaction for the drives (an alternative jouissance). The abusive addict
seeks an immediate satisfaction, which is obtained with the object as
pure experience of jouissance; any delay, introduced by interventions
that lead to the displacement along the signifier chain, will prevent this
immediate satisfaction. This is why, from my point of view, it is very
difficult to establish transference with patients who abuse their object.
Where are the Symbolic and Imaginary dimensions of the transference,
if the Real reappears compulsively behind the mute and non-mediated
mask of this AddObject?
I propose two series: perversion/fixation/abuse/manic passion (as
in the case of Manuel) vs. neurosis/choice/dependence/love (as in the
case of Carlos). If we consider the dependence/phobic neurotic side of
addiction, the submission to the Other in this case allows a question for
the Others desire, the aim for a love object of the transference, and the
creation of a psychoanalytic symptom as a question to be addressed
to the analyst. We can consider the addiction as a symptom if the sub-
ject can formulate a question about their choice and if the Other can be
included as an enigma for the subjects desire.
On the other hand, if the Other is used as a witness for the demon-
stration of knowledge of the enjoyment of a fixed and perfect object,
only the circuit of the death drive will show its effects. If the dependent
neurotic, through his relation to the Phallus, presents a demand for the
lack of complementarity between the sexes, the abusive pervert shows

that the sexual relation is the relation to the object of their passion; in
other words, that the sexual relation exists.
Can the pathological passion for an object be transformed into love
for it? Is this knowledge about jouissance able to be transformed in a
question about desire? Is pathological passion a manic certainty com-
parable to psychosis, or can it be displaced along the signifier chain?
I think that the answer to each of these questions is no. However,
I believe that there is a privileged place for psychoanalysis in the field of
addiction if it can restore to the subject the responsibility for the choos-
ing of the addiction, instead of labelling it with guilt and the associated
punishment, which are always present in the medico-legal domain.
References
American Heritage College Dictionary (2004). 4th edn. Boston: Houghton
Mifflin Co.
American Psychiatric Association (2005). The Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition. Washington D.C.: American
Psychiatric Publishing, Inc.
Dor, J. (2001). Structure and Perversions. New York: Other Press.
Ey, H. (1978). Tratado de Psiquiatra, 8a Edicin. Masson SA: Barcelona.
Freud, S. (1912d). On the universal tendency to debasement in the sphere of
love. In S.E., 11. London: Hogarth.
Freud, S. (1928b). Dostoevsky and parricide. In S.E., 21. London: Hogarth.
Freud, S. (1930a). Civilization and its discontents. In S.E., 21. London:
Hogarth.
Freud, S. (1954). The Origins of Psychoanalysis. Letters to Wilhelm Fliess,
18871902. New York: Basic books, Inc.
Lacan, J. (2006). A theoretical introduction to the functions of psychoanal-
ysis in criminology, 1950. In: crits: The first complete edition in English
Lvi-Strauss, C. (1969). The Elementary Structures of Kinship. Boston: Beacon
Press.
CHAPTER TEN
The colour of emptiness: addiction

and the drive
Cristina Laurita
I
n On Freuds Trieb and the Psychoanalysts Desire, Lacan makes
a brief reference to the drives color of emptiness (couleur de vide)
(Lacan 2006b, p. 722). Although he does not unpack the multiple
meanings suggested by this concept, I will focus in particular on how, as
Lacan reminds us, beg inning in Seminar XI, the jouissance of the drive is
attributable to its circling around an object beyond which is a semblant
of emptiness. That is, there is always a gap between the objects of the
drive and the lost satisfactionlost because of the intervention of the
signifierfor which the subsequent objects stand in as always insuf-
ficient replacements. Insofar as it is irreparably lost, that place of sat-
isfaction is always empty, and the drives attempts to recuperate some
jouissance take on the colour of emptiness.
Accordingly, the drives satisfaction is not necessarily about the phe-
nomenal object itself, and has more to do with the particular position
that the various drive objects occupy and thus how they are implicated
in the drives circuit. It is also important to keep this in mind when we
think about addictions, in that the drive satisfaction of an addiction is
often about much more than the drug object in and of itself. Indeed,
as I hope to demonstrate through the presentation of a case of obses-
sional neurosis with perverse features, an addiction or symptom has a
131
real core, around which there is a symbolic structure. Freud describes

this as being like the grain of sand around which an oyster forms its
pearl (Freud, 1953, p. 83). Finding ways to work with the symbolic
structure around the real of the drive is crucial if the analytic process is
to have an effect on the real of the drive through the symbolic medium
of speech.
The patient, whom I will refer to as Phil, was in his early thirties
when I began working with him. In spite of his age, he had not yet grad-
uated college and had a rather low-level, low-paying job. Phil explained
that he felt his difficulties with drugs kept him from finishing college.
Indeed, over the years he had made at least six separate attempts to
pursue university studies in various schools across the country, but
these attempts inevitably lasted for no more than a few months each.
What is more, his attempts always failed in the same way: his drug use
would become so problematic as to eclipse his studies, and he would
usually wind up getting kicked out of the educational institution. Phil
told me that he kept trying to complete college because that was what
people did but I did not get the impression that he was actually trying
to learn anything, enrich his life, or reap the rewards or pride that might
go along with receiving a degree; indeed, Phil did not desire symbolic
achievements. He even asserted that his inability to complete a college
degree was his way of keeping adulthood at bay. Phil told me that
rather than pursuing an adult life in which he had a well-paying job,
complete with a wife, family, and white picket fence, he had always
been much more interested in drugs, marijuana in particular.
From the first session, Phil identified himself as an addict. He stated
that he was addicted to marijuana and that he was coming to therapy
because he wanted to quit smoking. He explained that over the years
his drug use had fluctuated, but that his smoking was now out of con-
trol. Phil told me that he smoked quite a bit of marijuana every night,
even though he didnt want to. That is, at the end of the day, although
he claimed that he wanted to resist the urge to smoke, he felt he could
never resist it, in spite of his best efforts. He always found himself in the
same predicament of giving in to the urge, always magnetically drawn
to a situation he supposedly wished to, but felt he could not, resist.
Referring to his drug use, he stated: It has to be stopped. (Note the
passive formIt has to be stoppedas opposed to something like
I have to stop smoking.) As I would soon find out, Phil often put
THE COLOUR OF EMPTINESS 133
himself in situations in which it was in fact someone else who might

become responsible for putting a stop to his drug use.
What is more, Phil reported two rather different styles of drug use,
and it was a very specific experience associated with one extreme of
drug use that he wanted to end. That is, he told me that sometimes he
would smoke marijuana and have the sense that he was still in control
of his drug use, even though he felt that the amount of marijuana he
smoked was excessive. Other times, however, he felt his smoking was
at a point at which he was no longer in control, and it was this latter
type of drug experience that became the object of his complaint. Indeed,
Phil said that he was seeking treatment because something about the
smoking in which he was no longer in control had become just too
much and, in his account, caused a great deal of suffering. Phil came
to treatment in the midst of a jouissance crisis.
Phil told me that for him the highest highs of smoking actually
became anxiety-inducing. He described a viscous feeling, like dark
syrup, oozing throughout him, which accompanied these highest
highs and made him feel suffocated. He described this experience
of being overwhelmed by a diffuse and nebulous darkness rather poeti-
cally, noting, The darkness comes over me, seeps throughout every pore of my
being, like little dark cloud fingers slowly creeping through my body, taking
over, possessing me entirely: body, mind, and soul. Phil claimed that this
drug experience, associated with darkness overtaking him, had become
so problematic that he felt that it was urgent that it be stopped immedi-
ately, stating, Its killing me. Marijuana is generally not considered to
be one of the most addictive substances, much less a drug that kills, and
so one way in which I understood Phils claim that it was killing him
was that it was killing desire itself. Lack was lacking.
In fact, from the very start of our work, lack seemed to be precisely
what Phil was seeking out. During the first session in particular, it
became clear that Phil was hoping that I would put an end to his drug
use. Indeed, he told me that prior to coming to the clinic where I was
working he had assumed that being in treatment would mean that he
would be required to stop using drugs. When I told him that that was
not a requirement, and that I would leave that choice to him, he was
disappointed, and stated that he felt he wouldnt be able to give it
up unless someone else forced him to do so. He told me that he was
going to try to quit cold turkey, but that if he couldnt handle that yet,
he would at least commit himself to not smoking on the nights prior to

our sessions.
Phils demand for a separation from the drug was certainly not the
same as a demand for analysis, and so I made an intervention during the
first session in an attempt to incite desire and curiositythat is, to try to
create the initial conditions for beginning analytic work. I told Phil that
I would not agree to work with him if his only goal was simply to stop
smoking. Instead, I told him, I wanted the two of us to work together
to explore the various facets of what might be involved in, or underly-
ing, his drug use as well as other aspects of his life. I asked him to agree
to speakand to speak not only about his issues with marijuana, but
also about his dreams, fantasies, relationships, and so on. I thus asked
him to trade demand for desire and speech. I opened up the idea that
there might be more to his smoking than meets the eye and said to Phil,
Id like us to explore it together, and he agreed. This agreement, to
explore it, thus became the foundation of our work.
My intervention stemmed from my belief that a simple and instanta-
neous separation from the drug, even if this could in fact be maintained
by him, would not automatically be equivalent to a modification of his
position in relation to desire and jouissance and would be more like a
short-circuiting of the goals of sustained analytic work. The particular
way in which I formulated this intervention, asking Phil to agree that
we would try to explore it, was deliberately ambiguous, touching
perhaps on the way in which it might have been as yet unsymbol-
ized, and drawing together snippets of his own discourse during that
first session. When Phil spoke of his drug use and noted, Its killing
me, and It has to be stopped, I didnt assume that it was necessar-
ily marijuana itself. Instead, I suspended judgement and left room for
the various possible meanings of it to emerge more fully throughout
our work. What was it that was killing him? What was it that had to be
stopped? My initial assumptions about Phils issues with his marijuana
use (in line with my understanding of symptoms of any sort) were that
his substance use was over-determined and that the particularities of
his history had an important role in constructing his modes of jouissance.
Accordingly, we set out to learn more about it by exploring historical
determinants, following his signifying chains, and so on.
The first clue came with his first slip of the tongue, when instead of
saying marijuana, he said mamajuana. Not surprisingly, I asked
Phil to tell me about his mother.
Over the next few months of sessions, Phil spoke in great detail about
how he and his mother had always been extremely close, and that their
close bond began when she was pregnant with him. Phil attributed
this early bond during the pregnancy to the fact that one thing made
his mothers pregnancy with him different from her pregnancy with
his older brother (Phils only sibling): she smoked cigarettes while she
was pregnant with Phil. He explained that his mother had always been
a chain smoker, but that when she was pregnant with his brother,
she was able to quit cold turkey, as he put it. Note that this is also
the wording he used during the first session to describe how he himself
wanted to quit smoking marijuana, which, as we shall see, begins to
suggest an interesting connection between his smoking marijuana and
his mothers smoking cigarettes.
During another session, Phil spoke about two topics in particular:
his mothers smoking when she was pregnant with him and also the
fact that he had recently been feeling even more overwhelmed while
smoking marijuana. Phil recounted that his grandparents (who were in
the habit of telling their grandchildren numerous stories about the fam-
ilys history) told him stories about his mothers inability to stop smok-
ing while she was pregnant with him, but that these stories were never
accompanied by any reason or explanation. That is, his grandparents
always told him something brief, Phil recalled, such as, With you, she
just couldnt stop it. She just couldnt stop it? I echoed. Then he cor-
rected himself and said, Well, I meant to say that my grandparents
said, She just couldnt stop. Sticking close to the specificity of what
he had said, I said to Phil, But you said, She just couldnt stop it, and
during our first session you said, It has to be stopped, and Its killing
me I then ended the session, saying, Lets stop there for today.
My impression was that Phil seemed to feel that there was something
limitless about his mothers smoking as well as his own, and that some-
thing about the absence of limits in both of these areas was contributing
to his suffering. During the session following the one just described,
Phil reported that a great sense of relief had set in for him following
where we ended the session. Throughout the therapy, he had described
going through life always with a dark cloud looming right over his
head, which he felt was a mix of anxiety, depression, and a sense of
impending doom. (We can see how that dark cloud also calls to mind
marijuana or cigarette smoke as well as Phils description of the little
dark cloud fingers that he felt seized him when he smoked.) Phil said
that, after that session, that cloud seemed to be a bit farther away, and
he felt that he suddenly had much more room to breathe.
Perhaps my intervention, in splicing together pieces of his discourse
and scanding the session as I did, might have hit the real and also had
something of an anxiety-relieving, limiting function.1 Indeed, my sense
was that something about linking those comments of Phils (She just
couldnt stop it; It has to be stopped; and Its killing me) and then
ending the session, allowed those words to resonate. I hoped also to
create something of a limit precisely where he was speaking of the suf-
fering that the absence of limits brought himto demonstrate, beyond
the creation of a meaning effect, that what was supposedly killing him
could be mitigated, that there was something that could be done about
it. Perhaps this intervention also began to open up a space through
which a process of symbolization could unfolda space similar to
the gap that he felt had suddenly emerged between him and the dark
cloud.
Although the connections between Phils and his mothers smoking
had already begun to emerge, their multiple resonances became even
more amplified after that session. Since Phils grandparents had not
articulated why his mother couldnt stop it, Phil began to construct
his own explanations. Indeed, Phils interpretation of his mothers sup-
posed inability to stop smoking while she was pregnant with him (in
contrast to her decision to quit while she was pregnant with his brother)
was that he must have occupied a unique role of being, paradoxically,
very strongly loved and yet also very strongly hated.
First, as for the idea that he was very strongly loved, Phil speculated
that the fact that his mother smoked with him and not with his brother
made him special, made their relationship oddly privileged from the
start, and reified their very tight bond even then. Phil told me he imag-
ined how he must have been such a happy baby in the womb, as he
pictured himself being encircled by his mothers cigarette smoke. He
would often joke around when he referred to this during sessions, say-
ing that being in a smoky womb must have been quite trippy, likening
it to being high at a party and losing oneself in the drugs and music.
Its like when youre dancing around and youre so buzzed and
immersed in the drugs and the music that everything melds into one
you cant tell the difference between you, the music, and the drugs.
His mothers inability to quit smoking took on the value of love in that
Phil imagined that his mothers smoke was a liminal entity that unified
them, or made them one, just as in the party situation he described.
That is, he imagined that the smoke could permeate all borders, not-
ing, It went from her mouth to all around me. Phil also seemed quite
fascinated with the idea that he could have been smoking in the womb,
for all intents and purposes, and that that liminal smoke could have
seeped into him and become one with his very being. According to
these descriptions, we can see a sort of imagined absence of separation
or differentiation between Phil, his mother, and the smoke.
For Phil, union with his mother through the smoke seemed to be
evidence of his mothers love, but also of her hatred. That is, precisely
because she couldnt stop it and smoked so much during the preg-
nancy with Phil, he wound up being a significantly, and in fact dan-
gerously, underweight baby. Apparently Phil was born prematurely,
was quite frail, and almost died. He commented from time to time that
surely his mother must have been aware of the harmful effects of smok-
ing during pregnancy. The conclusion Phil seemed to reach was that his
mothers intense love/hate for him, manifested in her smoking while
she was pregnant with him, was quite literally almost lethal.
Although Phil felt that his mothers smoking was evidence of her
love and her hatred, we can see how jouissance was also a factor. That
is, she couldnt stop smoking because she enjoyed it so much, and was
hooked. Since he imagined that the smoke became continuous with
him in the womb, Phil logically aligned himself with the substance his
mother enjoyedif she enjoyed the smoke, and he was unified with
the smoke, then she enjoyed him. Further, according to what Phil imag-
ined of the trippy womb environment, smoke was associated not
only with his mothers enjoyment but also his own, and in ways that
exceeded limits.
Even in the womb, then, Phils relationship with his mother was
marked by jouissance. He recalled having a number of intense expe-
riences with his mother, particularly when his father was away. As a
result of the sort of work he was in, his father was almost always out
of town on business, and even when he was home, he and Phil rarely
communicated at all. When his father was travelling, Phils relationship
with his mother would become more highly charged, especially when
they would watch horror films together, as they often did. Phil seemed
to have the sense that when his father was away, his mother turned
towards him for something, although he didnt know what. That is,
particularly when his father was gone, his mother seemed to be lacking
or unsatisfied in some way, which generated anxiety in Phil.
Phil said that their relationship would generally be too close
closer than an ordinary parentchild relationship and that as they sat
in the darkness of their living room watching horror films together, they
would often engage in intimate touching. There was a rather excited
gleam in his eyes as he told me that thinking about it made him feel
dirty. He commented that his mother supposedly made him cuddle
with her to comfort her as they watched frightening movies, but that
he felt this was also a way of satisfying her while his father was away,
explaining, During those times, it was like I had to be her substitute
husband. No one was there to set limits to their contact, and he further
explained that during their physical intimacy while watching the horror
films, his body seemed to become hers. Phil said that eventually, by the
time he was about 12 years of age, he had the vague sense that the way
they touched each other during those movies was probably wrong, and
that although he still participated, his entire body would go stiff in her
arms. Phil filled his mothers lack with himself; he was her phallus.
We can already see a number of points of connection emerging
between three elements: his mother, darkness, and jouissance. First, lets
recall Phils description of the darkness he feels overtakes him during
the highest highs (the jouissance) of smoking: The darkness comes
over me, seeps throughout every pore of my being, like little dark
cloud fingers slowly creeping through my body, taking over, possess-
ing me entirely: body, mind, and soul. Note the resonance between
that description of a drug-related high associated with darkness
(marijuana/mamajuana smoke) and the enjoyment he imagined he
got from being unified with his mother in the dark and smoky womb.
Further, the jouissance associated with the excitement of his intimate
embraces with his mother in the dark while they watched horror films
(which are also inherently frightening and exciting) recalls his descrip-
tion of the darkness that overcomes him when he smokes marijuana.
His mothers nicotine-stained fingers that touched him in the dark seem
to be expressed also in his account of marijuana use in which dark
cloud fingersfingers simultaneously associated with darkness and
smokepossessed him.
Another event in which darkness, jouissance, and Phils mother were
featured was a primal scene. Phil told me that as a child he often had
trouble falling asleep due to what he referred to as a terrible fear of the

dark (again, his eyes glimmered with perhaps unrecognized excite-
ment as he told me this). In spite of having a nightlight in his room, he
was often unable to fall asleep, imagining, for instance, that someone
was under his bed, waiting to cut off any limbs that might be dangling
down. When Phil became particularly afraid, he would drag his com-
forter into his parents bedroom and sleep on their floor. Sometimes he
entered announced and sometimes he entered unannounced. On one
such unannounced visit, as he snuck in under the cover of darkness, he
found himself puzzled by the sounds he was hearing as he was curled
up in a little ball on his parents floor. Not knowing what to make of the
sounds, he remained silent and motionless, hoping that no one would
notice that he was there. As his mother then got out of bed to walk to
the bathroom, Phil saw her naked bodyeverything and nothing
before she put on her robe. He said he was able to decipher the outlines
of her breasts, but that what he saw of her pubic area was darkness.
He added, It was like I saw it, but I didnt see it. It was weird. Phils
report of seeing everything and nothing can be heard a bit differ-
ently: Everything there was to see but no thing. That scene related to
Phils long-standing fear of the dark but also may have contributed to
his developing a specific attraction to women with dark features.
In fact, Phil was attracted only to women who had dark features. The
condition for finding women sexually exciting was that, physically,
something about them had to be dark, such as having dark hair, eyes,
or skin. Dark features were required, but he also claimed to be drawn to
characteristics such as a dark mood or dark sense of humour. Neverthe-
less, those were bonuses, mere icing on the cake, while dark physical
features were necessary. Moreover, Phil felt that finding a woman who
had a combination of dark physical features and also something like a
dark sense of humour was like hitting the jackpot! In this manner, his
finding darkness compelling in women took on a rather fetishistic char-
acter. Lets recall that even for Freud, the libido object often has more
to do with the signifier than just a tangible object in the world. As he
discussed in his Fetishism essay, the example of the fetish of Glanz auf
der Nase (shining on the nose, glance at the nose) is grounded in a lin-
guistic transformation, via an error of translation (Freud, 1927, p. 311).
Nevertheless, although having dark features was necessary in order for
women to be sexually exciting, Phils relationships with women never
lasted very long. Indeed, although Phil seemed to find a great amount
of jouissance in these relationships, he would eventually try to push

them to break up with him. For instance, he would frequently get into
quite vituperative arguments with one of his previous girlfriends, who,
to Phils delight, had dark skin, eyes, and hair. I could really push her
buttons, and she mine, he said with a combination of acrimony and
zeal. During their arguments, which he said were always about every-
thing and nothing (recall that, interestingly, that was also what he said
he saw of his mothers naked body in the darkness), he would become
so charged up that he felt he was always about to explode or black
out. Phil also told me that during the peaks of their arguments he
would deliberately say something that he knew would set her off, and
that with each subsequent argument, he would say something more
hurtful than the previous time. I really got off on those arguments.
I was totally addicted to her, to the fights, he added.
We might speculate that what he was seeking out in pushing limits
with various girlfriends during such recurring fights was not so much
the high he got from the fighting itself but rather trying to get them to
lay down the law, so to speak, to say no to his verbal abuse and enact a
sort of mini-castration by breaking up with him. If that were applicable
to what Phil was doing with the womengetting them to lay down
the lawthat might have been more indicative of a perverse structure.
However, although Phil pushed the womens buttons, he was usually
the one who ended the relationships. Perhaps, then, through his repeat-
edly breaking up with women with dark features, Phil was trying to act
as his own Name-of-the-Father and set limits on the maternal figure (the
women being associated with his mother). Phil was repeatedly trying
to re-enact or prop up the paternal metaphor, through his relationship
patterns and his drug use. While I considered Phil to be structurally
neuroticthe Name-of-the-Father was instated for himhe had traces
of perversion, as I have been describing. That may have been attributa-
ble to the Name-of-the-Father having being imposed in a fragile way
perhaps through things like getting the impression that no father was
around to separate him from his mothers intimate touches as they
watched horror films in the darksuch that what he lived out through
the cycles of using drugs and trying to get caught by the police involved
attempts to reassure himself of the Name-of-the-Father.
Something about castration seemed also to be related to Phils long-
standing fear of the dark. It was a long-standing fear indeed, in that
Phils childhood anxiety about the dark never seemed to resolve itself
even in his early thirties, he still claimed to be afraid. For instance,
he described walking down a dark hallway on the way to the bathroom

in the middle of the night and freezing in terror as he was startled by
an unidentified noise, which he later concluded was just the shifting of
dishes in the kitchen sink. He also described being absolutely unwilling
to ever enter a dark room. Instead, he would put his back up against
the wall as he stood outside the room, slowly reach his arm around the
corner, then flip the light switch on, and quickly jump back to be sure
that nothing that may have been hiding in the darkness could come and
get him.
When I inquired as to what he imagined might be lurking in the
darkness waiting to come and get him, he said he often imagined that
there might be someone or something waiting there, like the charac-
ters from the horror films he used to watch with his mother during his
childhood. He referred to them as slasher films. We might recognize
in all of this a wish to find someone who might exhibit characteristics
he wished his father could have had, such as an ability to set limits to
the jouissance with his mother, encountered in those intimate embraces
in the dark. This resonated with the notion that he might find someone
like a character from the slasher films, especially insofar as many hor-
ror films involve violence to women by men.
Seeking out someone who might be able to set limits to jouissance
was something of a pattern in Phils life. Indeed, even with his drug
use, he seemed to seek someone who might enact castration. When Phil
reached what he found to be the anxiety-inducing highest highs of
his drug use, he sought to put an end to the experience, to limit the
excessive jouissance. That is, Phil described the sequence in which his
experience of smoking was satisfying and tolerable, but then suddenly
became so excessive that it was utterly intolerable as: I enjoyed it,
then it enjoyed me. It was such moments, which always seemed to
take him by surprise, which he associated with the feeling of darkness
possessing him. At such instances, Phil would always repeat the same
sequence of events: he would leave his apartment, go to something like
a convenience store, and commit petty theft. Eventually he admitted
that in going out while he was high (he felt he always behaved in such
a way that it would be obvious to onlookers that he had been using high
doses of drugs) and stealing things like a pack of gum or a newspaper,
he was trying to get caught. He fantasized that if he did that, some-
one might catch him and reprimand him for his drug use. Getting
himself caught seemed also to be a way to fundamentally get himself
recognized. In fact, he often entertained masochistic fantasies about the
police finding him and throwing him in jailthat is, ultimately setting
limits to what he experienced as an overwhelming, seemingly limitless
jouissance.
These frequent fantasies of being caught and punished by the police
always involved a very particular element that came up in several of
Phils fantasies, dreams, and, as we will see, his creative writing: a yel-
low light. For instance, whenever he told me about how he imagined
that he would be caught and reprimanded by the police for his drug use,
he would speak of how they might have bright yellow flashlights. For
instance, he reported a dream in which he was smoking in a dark base-
ment and then was startled out of his drug haze by what he described
as police outside a basement window, shining the yellow light of their
flashlights into the basement. (It is important to note also that Phil
would actually only smoke in the dark, lending further relevance to the
manifold associations between darkness and his jouissance.) The yellow
light cutting into darkness also showed up in a number of poems he
wrote, particularly ones about the rhythmic flashing of the yellow light
of a lighthouse. The yellow light in these examples seems to have taken
on the value of that which might make a cut in jouissance, and set limits
to it, perhaps in the style of a paternal functionthat is, to cut through
and delimit the overwhelming darkness.
Yellow also seemed to have struck a chord with Phil as he told me
during one session about his favourite song, entitled Yellow. He told
me that what he loved about the song was not so much the song itself
but rather the idea behind it. He explained that he had once seen a VH1
programme [American music video cable television channel] about the
band that sung it and found out that the songwriter wrote the entire
song with gaps in itunfinished lines of lyrics, having the sense that
there was something fundamentally missing from it, but he couldnt
complete it, couldnt come up with the right word to end each unfin-
ished line. As the story goes, the songwriter was sitting at a desk, strug-
gling to figure out what was missing from the song, and at that moment
he looked over and noticed the phone book next to him: the Yellow
Pages. He then decided to insert the word yellow into each of the
incomplete portions of the lyrics, and to make Yellow the title of the
song, to boot. Phil told me that this delighted him because there was
absolutely no inherent meaning to the word yellow or why it was
in the song, but that it was simply added to the song to complete it.
He called it an example of pure creativity.
What makes Phils preoccupation with yellow even more striking has
to do with a way in which it is connected with a name associated with
both his father and himself, in their native tongue. As such, something
about yellow might have functioned as a sort of signifier that could
establish for Phil an albeit fragile place within a paternal lineage, in that
it was associated with both his father and himself. For Phil, yellow
became associated with desire and a name of his father, while dark
became associated with jouissance and his mother. Perhaps, then,
yellow represented something akin to a signifier acting as support of
castration, something like a version of a Name-of-the-Father.
Furthermore, both yellow and dark came together in the struc-
ture of Phils addictions and drive satisfactions. This was so in that Phil
sought to limit the excessive jouissance that for him was often associated
with darkness of various sorts, with indications of yellow or light.
For instance, the incestuous jouissance associated with his mothers
caresses in the dark and the feeling of dark cloud fingers possessing
him or dark syrup oozing throughout him during his highest highs
of smoking marijuana became limited, in fantasy or action, through
manoeuvres like trying to get caught by the police, whom he associated
with the yellow light of their flashlights. Even the highly charged argu-
ments with women with dark features, during which he would become
so angry that he felt he would black out, were a way he tried to get
limits set, by pushing the women to break up with him.
A number of Phils artistic productions also reflected an attempt
to symbolize something about dark and yellow. For instance,
the flashing yellow light of a lighthouse became a recurring theme
throughout many of the poems he wrote. The yellow light of the light-
house calls to mind many of the other representations of yellow, such
as the yellow light of police flashlights. Such representations suggest
the symbolization of an invocation to the Other, a wish to re-enact the
paternal function, tantamount to asking for someone to be able to shine
a light into the darkness of jouissance with his mother during the horror
films, and set limits to it, creating breathing room and a space wherein
his own desire might come to the fore. The repetition of the coming and
going of the beam of the lighthouse even calls to mind the coming and
going of Phils father, his frequent travelling, throughout Phils child-
hood. Like his writing of poetry, the analytic work, through a process
that includes opening up a space of symbolization, creates an effect
of sublimation. Over the course of our work, Phils anxiety and drug
use reduced significantly. Indeed, speech can bring a bit of light to

darkness.
It seems particularly fitting to conclude by referring to Freuds exam-
ple of a child who was afraid of the dark and said, If someone speaks,
it gets lighter (Freud, 19161917, p. 407). And although the child in
Freuds example longs for his mother, the light Phil longed for seemed
instead to be associated with a father, perhaps a reassurance of the
Name-of-the-Father. Accordingly, the jouissance or drive satisfaction at
work in Phils addiction took on its colour from, and fell somewhere
in the gap between, the play of dark and light, and indeed in the
alternation between them.
Endnote
1. To scand is the verb form of scansion. Scansionstemming from
the French verb scander, which means to scanis a way in which
the analyst can punctuate something or make a kind of cut, such as
by ending a session on a particular note that the analyst hopes will
resonate for the patient and have an impact (often an impact beyond
meaning). Scansion can also be implemented in such a way as to also
have an impact on the drive: it is insofar as the analyst intervenes by
scanding the patients discourse that an adjustment occurs in the pulsa-
tion of the rim through which the being that resides just shy of it must
flow (Lacan, 2006b, p. 716).
References
Freud, S. (1905e). Fragment of an Analysis of a Case of Hysteria. S.E. 7,.
London: Hogarth.
Freud, S. (19161917). Introductory Lectures on Psycho-Analysis. S.E., 16:
392411. London: Hogarth.
Freud, S. (1927e). Fetishism. S.E., 21. London: Hogarth.
Lacan, J. (2006a). On Freuds Trieb and the psychoanalysts desire,
1964. In: crits: The First Complete Edition in English. Trans. B. Fink in
collaboration with H. Fink and R. Grigg. New York: W. W. Norton.
Lacan, J. (2006b). Position of the unconscious. 1969. In: crits: The First
Complete Edition in English. Trans. B. Fink in collaboration with H. Fink
and R. Grigg. New York: W. W. Norton.
CHAPTER ELEVEN
Leverage of the letter

in the emergence of desire:
a case of addiction
Shannon Kelly and Kareen Malone
Introduction
This paper examines how one might think about a subject with the
specific identification, symptom, behaviour, or strategy of addiction.
The ideas that we bring to bear are related to the current Lacanian liter-
ature on the topic of addiction as well as the manner in which Shannon
Kelly, as Samanthas addiction counsellor, participates in and sustains
the possibility of something happening clinically that impacts on the
subject of the unconscious. Addiction is particularly interesting in that
the subjects position as a response to the real and as a being who is
condemned to the effects of jouissance may be much more foregrounded
than in other cases where the symptom is not simultaneously so custom-
made and mass-produced to maintain some remnant of jouissance.
If a subjects relation to drugs is figural in a case, one might think
carefully about the relation to the real and its effects as jouissance. One
sees just this sort of focus in many formulations of Lacanian work
with addicts.1 It might also follow that one could draw upon Lacans
thoughts as he pushed his own theoretical formulations of the real
and of psychoanalysis as a practice that must know what to do with
jouissance. In other words, the clinic where one works with addicts may
145
be an opportunity to create a knowledge that, as a clinical practice,

draws on the later Lacan as a source to articulate the ends of analysis
within certain formulations. More specifically, drugs may function not
only as a modality where one simply maintains a certain relationship to
jouissance but also designates a brake on jouissance that must be deci-
phered differently than through the complex of signifier, prohibition,
and fantasy (Brousse, 2005).
In this case, a subject who struggles with addiction or dependence,
that is, who says that they cannot function without some drug, has
entered a treatment which asks them to speak and assume responsibil-
ity for their history. They now bring the function of addiction as it is
intrinsic to their strategies and structure into relation with the working
of speech.
The temptations of addiction

Drugs dont talk and it is assumed that the body that uses them con-
spires in this silence. For our part, we are only to say no to drugs
trying to set up a certain sort of relationshipone that is laughable
in todays pharmacologically saturated world. In these contradictory
contexts, drug addiction may represent a way in which the subject,
unable to treat the real with the signifier for reasons that have reached
structural proportions, instead has resort to another medium, drugs as
administration of jouissance. In the instance of addiction one is faced
with persons who use various substances that alter the bodys chemis-
try; there seems to be a sort of direct hit, a kind of cheating in the game
of jouissance. Addiction is particularly tricky to theorize both as some X
and within the clinic in that it entails a certain relationship to jouissance.
A relationship which does not submerge or create a unique subjective
structure but which nonetheless seems to offer its own singular solution
to the difficulty of ones symbolic castration and the field of the Other
in the course of desire.
Addiction as a subjective strategy seems to treat the real with the
realas Fabin Naparstek (2002) has noted. It seems to substitute a
qualitative difference in the body and organize it; it is a practice whose
symbolic coordinates are supplied by a culture of medicine, a discourse
of marginalization, a subculture of certain ethics and aesthetics, but it
does not easily refer us to a set of symbols rendered qua unconscious
L E V E R AG E O F T H E L E T T E R I N T H E E M E R G E N C E O F D E S I R E 147
fantasy, even as it operates as an object of desire for the addict (De Belie,
2001).
In response to the specificity of the subjective strategy of drug
use/addiction, some Lacanian analysts have spoken of addiction as a
disengagement from phallic jouissance, from the Other, of getting pleas-
ure without going through the detour of the Other or the Other sex
and characterize addicts as somehow less troubled by the difficulties
of desirewhich would mean the desire of the Other. Many of these
observations are tied in with the self-administration of jouissance that
is associated with drug injection or ingestion. So that this action of the
chemicals, as particular as it may be, and as much as it has been cultur-
ally symbolized, becomes linked with the a as a place without signifi-
ers. The body functions as an object a in the view of Nstor Braunstein
(1996). Thus the addiction does in a way treat the real with the real
(Naparstek, 2002), sometimes at great expense to the subject. Sometimes
the operation of the real on the real is similarly apprehended in terms of
the failure of the signifier but associated with the place from which the
fathers word fails or where language shows its inconsistency. Fabin
Naparstek (2002) has discussed this aspect in various cultural contexts.
It is suggested that addiction attains an illusion that the object is not
lost. Rik Loose defines toxicomania as the search by the subject for an
object which can be administered at will, which would satisfy desire
and regulate or keep jouissance at an ideal level . The desire of the
Other is problematic for addicts; indeed as we have seen, they choose
to avoid desire, through seeking this total satisfaction which would
annihilate it and instead they take the side of jouissance (Loose, 2002,
p. 174). Charles Melman (1999) notes that drugs are objects that act as
if they were the original object, thus leading to a lessening interest in
sex and the desire which derives from lack, as governed by the phallic
signifier. Nstor Braunstein remarks that addicts will exert their will
in the form of the body a simple machine without desire . The
body in this without diction is the place of a jouissance without a subject,
outside of discourse and rejecting the social bond (Braunstein, 1996,
p. 169). One can see that this treatment of the real with the real becomes
increasingly stark in its characterization.
Drugs play a gambit with the death drive; they are also chemicals that
affect the body and seem to bring the subject who seeks them a degree
of jouissance which becomes determinative for their life. Jouissance is
not of course biological and thus there are no direct chemical effects on
jouissance but jouissance does require a body. What a body is or the clarifi-
cation of this body is important; a body and its enjoying entail a number
of layers of articulation or overlap, from its inscription through a let-
ter (R), to its imaginary wrapping (I), to its clothes of identification (S)
(Soler, 1995).
In the particular case study to be discussed below, the cousin of
Shannons patient implicates her younger cousin in her secret alcoholic
binges conjoining violence, affection, and alcohol by giving the child a
drink while she witnesses her cousins alternating ferocious/amorous
behaviour. The cousin buys silence with drugs. The drugs enter as a
commodity/object/mark in this exchange between cousins. One need
not know what the meaning of this exchange may be, but it is a conjec-
tural game between the two. Like the Queens letter, the unknown bit
of jouissance remains sealed even as it is exchanged, although it will set
the stage for a sort of logic (Lacan, 2006). This is true of writing, and
of any inter-subjective logic, known mainly in its effects (Lacan, 2006).
That there is a dosing, a relationship to an object that directly affects
the body, is clearwe see the cultural shift induced by medicine, for
example. What is not quite as clear is how that bodily manipulation and
the drug qua object inserts itself in the interdependencies that frame
the subjects debt to the Other in its relationship to repression and the
signifier.
In some cases of addiction, our culture has decided that there is
little or nothing that can or needs to be said: we substitute one drug
for another; addiction thus seems to be a practice at the limit of the
signifier. One might think of this impasse as some unconscious repu-
diation of the phallus and the signifier (qua Other). One would see this
repudiation not just in the addictive behaviour but in the clinic, in dif-
ficulties in association, in acting out, etc. Surely, this is an issue one
faces in the clinic and with addicts. But we will look at the function of
writing and letters in the case presented below. For us, it is a question
of what the patient was doing with her writingas a subjective strat-
egy that would position her and function to transform her relationship
to her history and the death drive. Writing can be read, and it is an
assumption that analysis can make the unconscious a reader (Lacan,
19711972).
The particular complexities of addiction turn our attention to think-
ing through treatment in the terms of the real as found in jouissances
effects and repetitiontowards that which is impossible to symbolize.

In the context of this case, accounts of addictive strategies suggested in
earlier paragraphs are supplemented by a focus on writing and the let-
ter. The object a is a prototypic letteras both position/function and as
a correlative to an inscription that creates the real of the subject (as well
as the failure of the Other). The repetition that is inherent to the letter
imposes a space that creates the subject whose trajectory draws along
the path of identification or through the Other to a and desire. With this
aim of desire, work with addiction requires an attention to the logic of
the subject in its effects in order to move towards the ethics of speak-
ing. One might consider whether the addict treats the impossible with a
practice that entails a positioning of the subject and a relationship to the
Other. Nonetheless, the clinic of addiction may not have, at its disposal,
the usual sort of strategies in the elaboration of unconscious knowl-
edge. Rather this clinic may need to focus more on the bare bones logic
and the inscription of the body, writing, and the letter as propaedeutic
to the place of elaboration. In the case presented by Shannon below, the
letter links and doubles back to create a place of address and thus knots
a moment whereby a subjective assumption is possible.
The case of Samantha

I used to have this idea that the practice of psychotherapy, or the practice
of the talking cure, was a relatively calm interaction. The emergence
of various affects or anxiety on the part of the patient notwithstanding,
I imagined that, for the most part, two people sat in a room together and
while one could certainly say that something was happening, it was
an occurrence that was contained within the limits of a kind of verbal
interaction. The work occurs through the act of speaking.
In my work with addicts this could not be farther from the truth.
The relative calm turns out to be merely the eye of the storm and
speech occurs not as the initial vehicle of therapeutic work but rather as
the result of seemingly endless attempts to contain a series of acts that
are substitutes for speech and move them into the work of the session.
Rather than the luxury of the prototypical consulting room, I often
find myself somehow in the scene without any symbolic coordinates
with which to situate myself.
Although there is a manner of understanding the phenomena of
acting out as erasing the letter, what I will attempt to articulate in
the example below is a different type of acting outone where the

purpose is not to destroy the letter, but precisely to produce it. In other
words, it has been my experience that my patients are not dealing with
a-diction, or with an attempt to bypass speech, but instead, as this
case illustrates, with ad-diction as an attempt towards speech. Even
the drug itself holds open a placea choice over the worst.
In the case I will present, the patient, who I will call Samantha, suf-
fers from an addiction to heroin, which was the problem that prompted
her entrance into treatment. The entirety of my time with this patient has
been in the capacity of an addiction counsellor at an outpatient metha-
done clinic; although it will be important to note that I assumed the role
of director of this clinic shortly after I began working with Samantha.
She had been admitted to treatment with us for heroin dependence, and
had reported six years of intravenous heroin abuse. She says that she
became addicted to the feeling of euphoria and to the sense she would
get from the drug that everything would be okay. As part of her treat-
ment, Samantha was prescribed methadone, which she receives daily at
our facility and was required to attend individual and group counsel-
ling weekly.
In terms of her history, Samantha told me during our first meeting
that she had been in counselling intermittently since early adolescence.
She had begun a course of therapy for depression and anxiety as an
adolescent and then in her early thirties for anger management. When
speaking to me about her previous therapists, Samantha indicated that
she would seek counselling when she began to feel as though she would
lose everything in her life, but was prone to quit as soon as she felt
better. Despite her history of psychotherapy, until the time she entered
treatment at our facility, Samantha had never spoken about her use of
and addiction to heroin.
She stated at the beginning of her treatment with me that she knew
that her childhood was the source of her addiction as well as the source
of many of her other problems, but that she had always found it easier
to try to forget than to focus on remembering. She said, Sometimes
I can see that the pain I feel comes from my childhood and its just
always been easier to handle all of those feelings with smack instead
of really feeling them. The childhood that continues to cause her tre-
mendous pain was marked by a series of transgressions made by family
membersmost literally in terms of severe physical abuse by an older
female cousin that began at the age of 6 and continued until the age of
15but also in terms of the multiple failures of her parents and other
guardians to provide her with a safe and stable home.
Samantha was raised by a maternal aunt, with whom she lived from
the age of 6 until she left home at 19 to attend college. She explains that
her parents, who were both addicts, were found to be unable to provide
her with a safe home and she was removed by the state and placed
with her aunt and two cousins. She rarely speaks of her parents and on
those occasions when she does, one is left with the impression that the
environment of her early childhood was primarily one of neglect. Local
authorities began an investigation of her parents after it was discovered
that they had failed to enrol her in school. She indicates that she was
removed from her parents custody after the caseworker came to her
house to find that they had left her home alone. Samantha did not know
where her parents had gone or when they would return. She tells me
that she tried to explain to the people who took [her] away that her
parents always came back, but that she was unable to say anything that
would change their minds about removing her. Samantha saw her par-
ents only one time after she was placed with her aunt, when they came
to tell her that they were moving away.
She describes the aunt with whom she spent the remainder of her
childhood as being very harsh and controlling and not very affection-
ate with either Samantha or her own children. She was deeply reli-
gious and often condemning of what would otherwise be considered
typical behaviour for young children. According to Samantha, her aunt
expected her children and her niece to live according to Gods law and
she placed herself in charge of monitoring the familys moral character.
She further describes her aunt as one who is somehow above the very
law that she so arduously enforces. She is well known in her small com-
munity for her church activity and religious conviction. Yet, she is often
prone to utilizing her position as a religious woman to get out of or
around the usual consequences one encounters with breaking the law.
Samantha indicates that her older cousinDawntook the major-
ity of her mothers verbal/emotional abuse and in response, Samantha
says, would take it out on the younger children whenever her mother
was not around. Samantha describes Dawn, who was nine years her
senior, as terribly manipulative and explicitly violent, prone to physical
assaults with little or no warning. Dawn was an alcoholic, and, begin-
ning shortly after Samantha came to live there, would routinely take
Samantha and her younger sister to an abandoned home adjacent to
their property where Dawn would become extremely intoxicated and

would alternate between severely violent outbursts and overly affection-
ate behaviour. Samanthas way of making sense of her cousins actions
was to come to understand her role as that of protector of her younger
cousin, but there was a ritual in place as well that forced Samantha to
be simultaneously complicit with her cousins behaviour in addition to
protecting her from it. In order to ensure that Samantha didnt speak
to her aunt about her behaviour, her cousin would force her to drink.
By doing so, Samanthas cousin successfully positioned her in a place
where she believed that it was impossible to speak. Samantha knew
that she should tell her aunt about Dawns drunken attacks on herself
and her younger cousin, but she also knew that she had taken a drink,
too, so that whatever she did tell her aunt would be suspect because of
her involvement.
In a complete reversal of her childhood home, Samantha has made a
home of her ownwhat she calls her sanctuarywith her own child.
She takes very seriously her role as mother and spends a great deal
of time and energy thinking about how to break the cycle and pro-
vide a loving home for her little girl. According to her, [her] daughter
is [her] life and fucking with [her] daughter is the same as fucking
with [her]. According to Samantha, her daughter is the only thing she
couldnt live without and she believes that the loss of her daughter
would literally cost her life.
Samantha told me during our first meeting that she regularly wrote
in journals in order to get everything out of her head and consist-
ently her writing, as well as her need to write, have served an essential
function in her treatment as that which provides her an initial position
from which to eventually speak. She says, I just write whatevers in
my head to get it out I never read what I write. I dont know why,
because I keep them.2 Sometimes I think I should burn all of them. In
case I die. Because I dont want anyone else to read them eitherthey
would know too much about me.
The introduction of writing into our work together, however, came
up more out of a necessity on my part rather than an appeal to her pre-
disposition to the activity. It became clear during the first few weeks
after she began treatment that Samantha had little ability to observe
some of the more implicit aspects of professional courtesy. More days
than not she would burst into my office unannounced, throw herself
down in one of the chairs in my office, and begin telling me about
some injusticeleaving me sufficiently disoriented and usually totally

unclear about what it was in her story that she found so pressing.
About a month after our first meeting, I gave her my email address
and explained that it would be more often the case that I did not have
time to meet with her outside of her scheduled session, but that if she
wanted, she could email me her thoughts to read and we could talk
about what she had written during her sessions.
Over the course of the next several months it became apparent that
writing, either in the form of emails or handwritten letters, would play
an important role in our work together. Very early on it became evident
that there was something of a repetition in her utilization of writing that,
together with her consistent need to act out, functioned in a way that
allowed her to speak. It also became evident early on that my position
in relation to her would involve a dimension in addition to my role as
one who listens. This additional dimension was a manner in which she
used me, and one that is extremely difficult for me to describe as it was
somehow simultaneously a way of pulling me onto the scene while at
the same time positioning me in terms of the Other for whom the scene
is staged. It reminds me of a passage from Seminar X where Lacan,
speaking about acting-out in relation to the transference, says:
[O]ne of the questions to be posed, is, concerning the organization of

transferenceI mean the organization, the action of transference
that one of the ways of posing the question is to ask how one can
domesticate the wild transference, how one gets the wild elephant
into the enclosure or how one can get the horse into the ring, where
one makes him turn round, in the circus.
(Lacan, 19621963, p. 11)
During the first several months of treatment, Samantha spent the

majority of the time of her sessions talking to me about other peo-
ples problems and the things that she did to help people get their
lives together. Her descriptions of the various interventions she made
with friends, and sometimes even with strangers, seemed to be the
only manner in which she was able to tell me anything about her-
self. During this time, however, she was in a certain way incapable
of exploring her role in relation to these events. What she produced
in terms of material in the sessions was of limited immediate value
despite the fact that her speech did not appear to be scripted. Instead,
she seemed to speak without any sense of what she was intending to
tell me, a fact that made her decidedly anxious, although I had never
asked her to free associate.
Despite the fact that she was unable to produce much in the way of
knowledge during her sessions, there was a manner in which Samantha
began to produce something of a logic through an interesting repeti-
tion of events involving her acting-out, her writing, and her speech.
The relationship between these three things was consistent. First, she
would respond to some perceived insult or threat on the part of a staff
member as though it were intended to cause her some immediate harm.
During this time I would routinely be called out of my office to inter-
vene or calm her down. Usually within a day or two I would get an
email or a letter that, although sometimes mentioning the most recent
incident at the clinic, would be primarily related to some other event
or thought involving her family. She would then come to her session to
speak about something that was, for her, not at all related to either the
instance of acting-out or the writing.
Let me trace the logic through an example: there was an instance
in the dosing area in our clinic when Samantha was asked by one of
the nurses to leave her purse outside. This is a well-known rule and
should not have been at all surprising to Samantha. Samantha refused,
apparently meaning to be funny, and consequently the nurse refused to
dose her. At this point Samantha apparently exploded. From inside my
office I could hear her begin screaming, You Stupid Mother-Fucker,
it was a damn joke! I spoke with her briefly to calm her down and
asked her to see me the following day. The next morning I received
an email. The beginning mentioned the episode with the nurse, but
only to say that she had no respect for her. The remainder of the four-
page email was reminiscence about her aunts response to her when
she had finally decided to tell her about the abuse she was suffering
from Dawn. Her aunts response was, Sometimes kids play rough,
something Samantha interpreted as evidence of her aunts unwilling-
ness to listen to her story. During her next session, she did not speak
about either the altercation with the nurse or the email she had writ-
ten. Instead, she spoke about being angry and fighting to protect her-
self. At the end of the session she said that her first physical fight had
occurred because a friend had accused her of stealing. She told me
that she didnt remember the actual fight, but that something came
over her when she heard those words and she reacted by physically
attacking the woman.
All of these instancesthe acting-out/the writing/and her speech
seemed to bear no relation to one another for Samantha, although one
could see some obvious associative element emerging between the
threean uncontrollable rage resulting from an experience of not being
heard produces a writing that describes a more fundamental deafness
on the part of the Other after which follows a speaking about the expe-
rience of rage in terms of its initial emergence.
Several months into her treatment, there was a slight movement in
this structuration of acting-out/writing/speaking following an unin-
tended intervention on my part involving a report I was forced to sub-
mit to Samanthas parole officer. She was on parole after having served
six months of a one-year term for possession of heroin. The terms of her
parole required her attendance in, and successful completion of, a drug
treatment programme. Each month I was required to submit a report to
her parole officer indicating the extent of her participation and progress
towards recovery. In these reports I would have to indicate the number
of days she attended the programme for medication and prescribed
counselling. At the time of this particular report, Samantha had been
arrested on a different charge and had missed several days at the clinic
while in jail. Her parole officer was unaware of the new charge and, as
it was a violation of her parole, if he found out he would be forced to
place her back in prison. Samantha was aware that I would have to send
my monthly report to the parole officer and that in it I would have to
explain why she had missed days in her treatment. Knowing that I did
not want to send the report, Samantha asked me to conceal the missed
days for her, but I refused, telling her that I had no choice. I have to fol-
low the law, whether or not I want to. She was arrested for violating her
parole and spent three months in the local jail to complete her initial
sentence. She ultimately returned to treatment after spending several
weeks angry with me. She returned when she discovered that I had
written the judge a letter on her behalf indicating that while I did not
think that she should be allowed to forgo the consequences associated
with her actions, the consequence of additional jail time in this instance
would interfere with her continued treatment, and perhaps in this case
he could consider alternatives to incarceration.
Following this somewhat unplanned intervention, a certain change
occurred in both our working relationship as well as in the manner in
which Samanthas writing functioned in relation to both her continued

acting-out and her speech within her sessions. Whereas previously her
writing had centred on questioning and explaining her aunts failure
to hear what she needed to tell her, at this time it began to focus on
questions she had about herself as well as about her future. Also at this
time, the focus of her speech within her sessions moved from a focus on
explaining other peoples problems to a consistent questioning of other
peoples motives and desires in relation to her, although it remained to
her largely unconnected to her writing or her instances of acting-out.
And, much to my surprise, her acting-out moved from a focus on other
staff members to a decided and sometimes violent focus on me. The
literal succession of acting/writing/speaking remained the same, only
the focus, or perhaps intent, changed.
During this time, she would often burst into my office saying, So
maybe you can explain this to me and proceed to accuse me of var-
ious trespasses against either herself or other patients. (It is perhaps
important to mention that I was never able to obtain any kind of warn-
ing prior to these accusations. The only repetitious element was that
each violation was made by me in my role as director rather than as
her counsellor. More often than not she would become enraged over
something that would have never previously struck me as anything
other than ordinary.) On occasion, her anger was fairly easily assuaged
with an explanation for my actions, however more often than not she
would be highly unsatisfied with any attempt at explanation and would
remain angry for an indefinite period of time, during which she would
alternatively continue to demand explanations or walk by my office
talking loudly about how I didnt care about my patients, how I was
only interested in policies rather than people, etc. My sole interest dur-
ing this time was in moving these events, which were occurring outside
of her sessions, to the scheduled session.
Similar to the manner in which a sudden shift occurred following my
letter to the judge earlier in her treatment, there was an abrupt change
during one of the instances where she was angry with me over a situ-
ation involving another patient. In this particular instance, she became
infuriated after discovering that we had reported a patient for child
abuse. The patient, who already had three children in state custody,
consequently lost her youngest child. Samantha immediately decided
that we had purposefully meant to hurt this other patient and was, for
several weeks, inconsolable. This was a particularly difficult situation
for her because, due to strict confidentiality regulations in substance

abuse treatment, I could not respond to her need to understand why,
which she interpreted as an indication of my guilt. It was a particularly
difficult situation for me because her behaviour quickly escalated from
what I now think of as the more normal confrontations in my office
to a much more deliberate assault. Beginning with Samantha walking
through the hallways of the clinic shouting about the bitch who thinks
she can destroy peoples lives for fun her manifest anger with me
seemed to increase daily over a period of weeks, until its culmination
in a furious outburst outside my office where she beat on my window
screaming, I trusted you and look what you did. It took about an
hour for another staff member to calm her down. I am not clear about
what precisely occurred between Samantha and the other staff mem-
ber, however the following morning I received an email containing
an apology and an explanation for her behaviour: the situation with
the other patient made her feel like there were things she couldnt say
to me because I might repeat her words, which, for the other patient
meant a loss of her children. For Samantha, even the thought of losing
her daughter was more than she could bear. [Her] daughter is [her]
life. How could I have assured her that she could say anything to me,
when there were things she might say which would have such fatal
consequences?
As was typical, she was unable to speak directly about her messages
or about the scene outside my window during her session. What was
not typical was that these writingsspecifically the email providing
a reasonwas a way of articulating a knowledge about an episode of
acting-out. So that, for the first time, she was able to write the scene
or write about the scene. And it seemed that through that writing, she
was able to formulate the question that would ultimately allow her to
speak about what had been written. In her writing, she provides a rea-
son for her actionsshe felt as though she couldnt speak to me because
I might repeat her words3and shortly after she produces a question:
How do you say what cant be said?
Following this emergence of the question, there was (finally) a shift
in our work to the sessions, rather than in the hallways or parking lot of
the clinic, which became focused on two things. The first was the sud-
den emergence of a symptomshe suddenly became unable to write,
not only in her journals but also letters, e-mails, etc. She told me that she
could not write because she didnt know where to start. The second
focus was again the question, How do you say what cant be said?
This was a question initially posed regarding the physical abuse and
neglect she suffered in her childhood, the details of which she had not
yet ever written or spoken. It has since emerged as a somewhat more
fundamental question for her insofar as the cant in her statement
refers not only to what is difficult for her to describe to another person,
but also to what is impossible in speech as well as what she has never
been allowed to speak. This question and the symptom of being unable
to write occupied our work for approximately 5 months, at which point
Samantha was able to make an association that linked the two by con-
necting an action of hers with an event that had never been spoken.
She told me during one of her sessions that she had remembered,
after a friend had asked her, why it was that she never wears the
colour red. This came as a surprise to her because although she has
always avoided wearing that colour it had never occurred to her that
there may be a reason and she was quite shocked that the reason she
discovered was related to her history. She was unable to tell me why
during the session, she only mentioned the fact, and then went on to
explain to me that she had figured out why it was so hard to say certain
thingsBecause once you say it, theres nothing you can do. The fol-
lowing day she brought me a letter. When she handed it to me she said
that she had finally been able to write something, but I didnt have to
read it right away. She just wanted to give it to me to have if I wanted
to read it.
In the letter she had written a description of one memory of a par-
ticularly brutal scene involving her cousin, Dawn, who, after beating
Samantha to the point where she could no longer stand or speak, stood
over her and smiled. Samantha remembers looking at Dawns face
and seeing both the smile and her own blood on her cousins face. She
recalled very vividly how red her blood looked and further recalled
having the thoughtshe wears it well. This was a phrase she had
often heard her mother use when she was a small child, but had not
really understood what it meant. The letter was addressed to no one
and had no opening or closingseeming more like one of her journal
entries than a typical letter to me. Prior to this letter, however, she had
never before written or spoken the details of her abuse, only referencing
it as getting slapped around.
During her next session, I told her I had read her letter and that
when she wanted to talk about it, I would listen. She responded by
talking about the process of writing rather than by talking about what
she had written. She explained to me again that she writes in journals
to get everything out of her headand that during the time when
she couldnt write, she felt like she was being forced to hold on to more
thoughts than she had room for. And thats why she didnt know where
to start. Her friends question, however, prompted a realization, which
provided her with a place to start writing. And, she said, Once I got the
first sentence out, the rest of the letter practically wrote itself!
I received a call from Samantha a few hours following her session.
She was calling, she told me, because she wanted to schedule another
session. Because she thought that it was important for her to talk about
her abuse in counselling rather than just writing it down where no
one will ever read it. She was calling because she wanted to say what
cant be said.
I understood her articulation of this new process of her writing as
being also an initial way of articulating a shift in her relation to the
desire of the Other; however what I also found interesting about the
series of events was the change that occurred within the structure of
the writing act itself. Whereas previously her letters to me were always
addressed to me and served to promote my knowledge rather than
hers, this letter was not addressed to anyone. Instead, it was a descrip-
tion of a historical event that read more like proserecreating a scene in
an almost tactile manner. What was also distinct about this writing was
that it was produced following the association red/blood and that,
for the first time, linked acting, writing, and speaking with Samanthas
history. There was an association made in the symbolic that referred
to a trauma that had always remained both unwrittenin the sense of
impossibleas well as unspoken, and I believe that it was the writing
that was subsequently produced in this moment that moved the letter
in a way that eventually allowed for the trauma to begin to be spoken.
Conclusion
The unconscious is a matter of grammar. It also has a little to do, a lot
to do, everything to do with repetition, namely the aspect that is quite
contrary to what a dictionary is used for (Lacan, 19711972, p. 14).
In the movement of this case, the patient writes a letter that is not
addressed to anyone, really. It is a writing that allows for the articula-
tion of a signifier and thus a place where a fantasy may be constructed.
This was not a smooth path but one marked by a logic in the process of
writing and speech, a movement to bring that logic into the session; a
symptom appears which is the process of writing itself, which may now
be addressed to the Other. Outside the drama of reproaches aimed at
Shannon and the Law about the treatment of herself and others, there is
the subjects attempt to link her repetitive acts to writing and to speak-
ing: a structural link is being created.
If addiction possesses some specificity which affects the subjects
position in relation to speech, action, and structure, we may see, as has
been suggested in some accounts, the failure of the signifier to refer
to an Other in which the neurotic subject takes refuge. Thus certain
strategies in relation to the lack in being and of the Other may not be
as evident; the operation of fantasy and a particular playing out in the
field of sexuality. But in this case, we may also gain some insight into
the field of logical effects qua written that interlink the operation of
the letter, the repetition that founds the unconscious, with its scrap of
knowledge and the further elaboration or lucubration that becomes
the knowledge with which one can work. These elements which cap-
ture Lacans attention in the later seminars may appear more figural
because the usual parade of meaning, the production of knowledge
and the strategies towards lack, are not so in evidence. We dont have
the same sort of symbolic construction/elaboration and phallic signi-
fication, perhaps.
Drug use does appear to allow a staging of subjective structure
through the body. But that body itself has been constituted through the
letter and apparently is operating in an economy that entails the Other.
In a study of classical conditioning, researchers found that heroin
addicts who were fed their medications along with placebos through
an intravenous drip did not develop a tolerance for lower levels of dos-
age while those who shot themselves up did develop tolerance for the
drug and had to increase the dosage to maintain the effects. Since psy-
chiatrists define an addictive drug by its supposedly intrinsic property
of leading to a need for higher doses, which suggests that it is a practice
of the subject in sustaining a relation to the object that creates some-
thing we can call addiction.
Even as we see that the drug can function as object or the drugged
body as object, one is not simply faced with a subjective strategy of
obtaining down-and-dirty jouissance of which the rest of us are deprived.
There is another dimension, tied as closely to the real: its function in
maintaining a repetition. The a and this repetition are intimately tied.

Fantasy linksmore or lessthe $ (split subject) and the a, and more
elementally, we can write a link between the letter to the phallic signi-
fier which then turns to the Other of meaning and is put in relation to
the a that sustains that Other (Voruz, 2002).
In this case, heroin and methadone do probably function as an obsta-
cle to articulating ones fantasy, but they also set out a locus called the
Other as suggested by the empirical study noted above. They are a
response to the performative force of the Master signifier. We may say
that what can not be grasped through signification can be grasped by
logic (Pickman, 2004, p. 20). There is some escape from being purely
the signified of the Others signifiers. Thus, there is the possibility of
a subjective position that entails a position towards the Other, which
can be assumed. This Other is sustained through drugs as well as other
practices and stray words, as well as being created through psycho-
analytic praxis. But, in the case of drugs, the subject is asked to not
elaborateto not say more. In this instance, addiction is approached
from another angle, from the angle of repetition, writing, and logic
from the other angle of the trail from S1 s to fantasy.
The addicts path may lead us to connect the most fundamental articula-
tion of the structure of our praxis (its logic) to current subjective difficulties
that a contemporary clinic might encounter. This means understanding
how formalization is an effort to better understand the subject from the
perspective of the real. We finish with a quotation from Marie-Hlne
Brousse: It is therefore no longer the at least one of the father or the
One of the phallic signifier that gives its orientation to the analysis, for the
latter also requires that this trace of the anchoring point of S1 on the body
be isolated through its repetitions and, in the process, dissociated from
object a (Brousse, 1999, p. 158). In this case, unlike Brousses observation,
which is about pushing the analysis with a neurotic, the issue seems to be
worked between a writing and the effects of drugs as jouissance, a move-
ment that moves from a traumatic contingent to its writing as necessity
and hopefully back to its contingent, if extremely difficult, assumption.
Endnotes
1. For example, see C. Melman. (1999). Addiction. The Letter, 16: 18 and
also T. De Belie. (2001). A Structural Diagnosis of Toxicomania. The
Letter, 21: 5579.
2. She has saved every journal entry since age eightseveral hundred at
the present time.
3. It should also be noted that this can also be read in terms of her emerg-
ing anxiety about my ability to hear what she says, which was noticed
by her originally in terms of my repeating certain words or phrases.
References
Braunstein, N. (1996). Drug a-diction. Journal for the Psychoanalysis of Culture
and Society, 1, 167170.
Brousse, M.-H. (1999). Sexual position and the end of analysis. Psychoanalytic
Brousse, M.-H., (2005). Toward a new psychoanalytic practice. Lacanian
Praxis: International Quarterly of Applied Psychoanalysis, (Online May, 1):
2227.
De Belie, T. (2001). A structural diagnosis of toxicomania. The Letter, 21:
5579.
Lacan, J. (19621963). The Seminar of Jacques Lacan, Book X, Anxiety. Seminar
of 23 January 1963. Trans. C. Gallagher. Private circulation only.
Lacan, J. (19711972). The Seminar of Jacques Lacan, Book XIV, The Knowledge
of the Psychoanalyst. Trans. C. Gallagher. Private circulation only.
Lacan, J. (1998). The Seminar of Jacques Lacan, Book XX, On feminine sexuality.
Trans. B. Fink. New York: W. W. Norton.
Lacan, J. (2006). The seminar on the purloined letter. In: crits: The First
Complete Edition in English (p. 650). Trans. B. Fink in collaboration with
H. Fink and R. Grigg. New York: W. W. Norton.
Loose, R. (2002). The Subject of Addiction. London: Karnac.
Melman, C. (1999). Addiction. The Letter, 16: 18.
Naparstek, F. (2002). Toxicomania of yesterday and today. Psychoanalytic
Pickman, Noel. (2004). Examining the clinic of the not all. The Letter, 30.
1930.
Soler, C. (1995). The body in the teaching of Lacan. Journal for the Centre of
Freudian Analysis and Research, 6: 639.
Voruz, V. (2002). Acephallic litter as phallic letter. In: L. Thurston (Ed.), Re-
Inventing the Symptom (pp. 111140). New York: Other Books.
CHAPTER TWELVE
Lost objects: repetition in Kierkegaard,

Lacan, and the clinic
Michael Miller
Addiction as prior to neurosis

How can we meaningfully and usefully conceptualize addiction within
a psychoanalytic framework? Increasingly, and as is the case with most
other behavioural disorders, the discourse surrounding addiction
has become one firmly, even perhaps defensively, attached to the rheto-
ric of disease. Socially useful as this trend is for the re-thinking of a
traditionally racist, classist, and overly punitive approach to the sub-
stance user, it may also carry some cost. One facet of that cost may be
that when we subscribe too unreflectively to a medical disease model
which drives our case conceptualization and treatment of addiction,
we sacrifice our understanding of the more subtle, human, meaning-
laden dimensions of the symptom. Sometimes we trade them in for, at
best, a mass-marketed vocabulary which we apply to the experience of
the patient and those around them, arming ourselves and our patients
with terms such as enabler, co-dependent, and A.C.O.A. (Adult
Children of Alcoholics), terms which do little to enrich our understand-
ing of the human, experiential, meaningful dimension of the set of phe-
nomena we refer to as addiction. I suggest that we let the medical
163
model rest for the moment, attempting instead to grapple with the
uncertainties involved in a psychoanalytic and philosophical discus-
sion of addictions.
To this end, we recall Freud, who mentions in Dora that [O]f all
the clinical pictures which we meet with in clinical medicine, it is the
phenomena of intoxication and abstinence in connection with the use
of certain chronic poisons that most closely resemble the psychoneu-
roses (Freud, 1905e, p. 112). This comment of Freuds is noteworthy
for a number of reasons. First, and perhaps most immediately, it prob-
lematizes our ever-more dogged determination to conceptualize addic-
tions as a simply neurobiological disease. On further reflection, we are
reminded that neurotic symptoms provide satisfactions similar to those
provided by intoxicating and addictive substances. Yet most salient for
the purposes of our current discussion is that Freud is not singling out
one neurosis. Rather than stopping at characterizing this or that neu-
rotic structure as bearing a singular similarity to that of the addict (who
in mainstream American psychotherapeutic thinking is often assigned
their own diagnostic category, or is assigned to the oddly named pop-
ulation of those with dual diagnoses), we might alternatively take
Freud to be saying that every neurotic is also a kind of junkie.
In fact, it makes sense to picture addiction as diagnostically non-
specificexperience quickly shows us that smokers, alcoholics, and
cocaine addicts know no allegiance to one category of psychoana-
lytic or Diagnostic and Statistical Manual of Mental Disorders diagnosis
(American Psychiatric Association, 2000)hence the dual diagnosis
tag. However, perhaps we should not be too quick to conceptualize
addiction as another incidental symptom which, like any other, serves
the aims of signification created by the given neurotic structure. To do
so would be to beg the question of how we might understand Freuds
comparison between the phenomena of intoxication and abstinence in
connection with the use of certain chronic poisons and the neuroses in
general. Why make substance use (instead of, for example, nail-biting,
delusional thinking, or chronic stomach problems) the object of such a
comparison?
One possible answer might be that addiction reveals something
of the structure of the neurotic symptom. That is, we find that both
addictive behaviours and the more classical psychological symptoms
tend to be repeated. Not only repeated, but repeated at high costeven
the ultimate costto the subject and those around them. The student
LOST OBJECTS 165
of Freud will also be quick to note that we become dependent upon

our symptoms for the epinosic and paranosic gains that they provide
(Freud, 19161917). Further, we note with Lacan that, generally speak-
ing, the symptom is itself a repetition of sorts, a repetition of a prior
signification by way of metaphor and metonymy (Lacan, 2006b). But
even beyond these resemblances, might there be something more pro-
found in Freuds comparison? It is possible to read Freud as intimat-
ing that addiction is suitably conceptualized neither as a diagnostic
category, nor an incidental symptom occurring within such a category,
but something prior to both, something that structures the neuroses,
perversions, and phobias, as well as their symptoms themselves, thus
making addiction a necessary condition to the development of neurosis.
For Lacanian psychoanalysis, neurosis, perversion, and phobia (here-
after referred to as neurosis for the sake of brevity and in keeping with
Freuds usage, above) are the rule rather than the exception, as most of
us are neurotic by virtue of our relationship to the symbolic order. Tak-
ing the neurotic relationship to language and Law to be a predominant,
even if not universal, condition of human beings, we see addiction take
on a new characteristic. Addiction becomes in this sense a fundamental
aspect of most human existencea more or less existential condition
(if one can speak meaningfully about a condition being more or less
existential, which I would suggest is probably the best we can do by
way of general existential declarations). All neurotic human beings, by
way of our relationship to language, are arguably addicts in a way onto-
logically prior to having settled into a particular neurotic structure. We
pick our particular poisons, in the form of substances or substitute sat-
isfactions, later in life, but our addictive character is part and parcel of
the structure of neurosis. We might call addiction a Neurotic-Existential
Given.
This sentiment finds some resonance with Kierkegaard, who, writing
as Constantine Constantius, intimates as much in Repetition. Constantius
boldly asserts that life itself is a repetition, asking us, Who would wish
to be a tablet upon which time writes every instant a new inscription?
(Kierkegaard, 1843, p. 34) and declaring that [t]he world endures, and
it endures for the fact that it is a repetition. We might add to this that
this is the case precisely because it is a neurotics world.
This paper will attempt to demonstrate more clearly the meaning
of this claim, as well as to explore some of its theoretical and clinical
ramifications, bringing Lacan and Kierkegaard into dialogue with each
other, as well as with some aspects of our current clinical culture around
the notion of addiction.
The Oedipal nature of addiction: resuscitating the symbolic

The addict in Kierkegaards story is the young, passionate male friend
of our much more conservative, staid narrator and self-described psy-
chological observer, Constantius. The two men share a common interest
in the possibility of repetition, a concept which, although it seems
ill-defined at the outset, becomes clearer as the text progresses, and will
hopefully become clearer as this discussion continues.
I call the young man an addict because, although he is not at the
mercy of some particular substance per se, he has been infatuated for
some time with a woman. He finds out one day that she returns his
feelings, and shows up in Constantius home shortly thereafter. We can
easily see in this scene that he is intoxicated by the situation he has found
himself in, if not by the woman herself. Constantius, the dispassionate
observer, describes the young man at the height of his passion: His
eyes filled with tears, he flung himself down on a chair and repeated
[the following] verse again and again:
To my arm-chair there comes a dream

From the springtime of youth,
A longing intense
For thee, thou sun amongst women
(Kierkegaard, 1843, p. 38)
The young mans desire and melancholy here are beyond what Con-
stantius deems normal. Yes, he is in love, but in a way that threatens
to destroy him. The destructive nature of this love, of which we so far
know so little, may stand out to the reader of Freud as having some-
thing to do with the nature of its object. A sun amongst women trans-
ported by a dream of longing from the springtime of youth seems to
sound a fairly clear Oedipal note.
From that perspective, it makes sense to us that Kierkegaard would be
concerned with repetition here. The young mans love seeks, in the first
place, to repeat the long lost experience of his sun amongst women.
Like an addict, he desires this repetition at any cost, and already it is
threatening to destroy him, as Constantius can see. The young mans
LOST OBJECTS 167
desire to repeathis longing for this larger-than-life womanis an

Oedipal, transgressive desire. He has, in bringing this desire close to
fruition, nearly stepped outside of what Kierkegaard (1843, p. 132) calls
the Universal, seeking to become the exception to the Oedipal rule.
We might draw a connection here between Kierkegaards Universal
and Lacans notion of the symbolic order, or the Law. (see, for example,
Lacan 2002).
In this same vein, parts of Kierkegaards discussion of repetition seem
to prefigure, or at least resonate with, Lacans description of the effect of
Oedipalization upon the subject. For Lacan, we know the pre-Oedipal
is the prehistoric, the unspeakable, the vital, the real. Oedipalization as
symbolization results in the death of the real body (Lacan, 2006b,
p. 719). Similarly, Kierkegaard tells us that it must be true that ones
life is over at the first instant (Kierkegaard, 1843, p. 40). For Lacan, the
subject who is created by the instance of the letter is born to a dead,
symbolized, body. To synthesize these ideas: ones life is over at the first
instant, the instant of language.
But like the split subject of Lacanian psychoanalysis, Kierkegaards
young man is plagued/blessed by some desire or drive to transcend
or transgress the law, in order to regain what is thought to have been
lost. Although life is over at the first instant, Kierkegaard tells us also
that there must be vitality enough to kill this death and transform it
into life (Kierkegaard, 1843, p. 40). For Lacan, this vitality resides in
the parts of us that resist signification (the real) but also perhaps in the
cleverness of the speaking subject, who produces their tabooed signifi-
cations by way of the symptom. In Kierkegaard, we find this logically
impossible vitality in the fact that there are individuals within the soci-
ety, and parts within the individual, which place themselves in relation
to the universal as the exception.
Since we are imagining addiction as an existential psychological con-
dition, reflection on our own experience might enhance our discussion:
do we not attempt to bring the real into this dead body, to amplify unsym-
bolized experience, to cultivate indescribable joy, as Kierkegaard calls
it, even if only to write poetry about it later? Are we not a culture, as
Lacan aptly pointed out on a number of occasions, increasingly obsessed
with avoiding the symbolic stamp upon experience, with achieving
some uncomplicated feeling-state? This search for re-animation of the
symbolized body is aided sometimes with a substance, sometimes
with a symptom (and perhaps sometimes with religious practice, the
relevance of which cannot be completely overlooked in a discussion of

Kierkegaard, and which calls for a more extensive discussion in this
context). Kierkegaards young man uses his tragicomic love affair.
The addictive substance here is presumably the young mans encoun-
ter with his dream from the springtime of youth; what better meta-
phor for killing death with vitality than springtime? This dream from
lifes springtime can be read as the fantasy of charging the universal with
the exceptional or the vital; in Lacans terms, infusing the symbolic with
the real (see, for example, Lacan, 1988, p. 68). It is also, of course, the
tabooed desire for the mother. Both meanings imply transgressions of
the paternal Law.
We see the impossibility of this task of synthesis of the real and the
symbolic, as does the young man. He quickly comes to feel that he must
choose between his relationship with the woman and his relationship
with poetry and ideasbetween the real and the word. Try though he
might, he cannot maintain relations with the symbolic and the real at
the same time. One must give way to the other.
So perhaps the addictive object provides (or attempts to provide)
a nodal point that extends one arm into this realm of Kierkegaardian
vitality or the Lacanian real, and another into the Lacanian symbolic
or the Kierkegaardian universal, in an (impossible?) attempt to pre-
vent the loss of either one, thus lending oneself to a poetic exist-
ence. The poetor perhaps the addictis thereby in conflict with the
whole of existence even as they exemplify an existential predicament
(Kierkegaard, 1843, p. 133).
Coming down
The young man at last finds his wish for a repetition fulfilled, but in a
way that leaves the reader puzzled. At the end of this work, he receives
the news that his love interest has married another man, and this news
relieves, elates, and indeed intoxicates him. He declares in his last letter
to Constantius: I am again myself, here I have the repetition, I under-
stand everything, and existence seems to me more beautiful than ever
(Kierkegaard, 1843, p. 125; emphasis added).
From his first appearance in this story, the young man has not been
able to endure the fact that his love interest returns his feelings, which
has resulted in a prolonged agony lasting until the moment he receives
news of her marriage. He comes back to himself again only when she
LOST OBJECTS 169
rejects him; only when he is assured that his is a self which another
would not pick up from the road; only when he is no longer in danger
of having his transgressive desires realized; of having the real swal-
low up the symbolic as a result of his Oedipal, existential contravention
The young man is in the end restored to his original position, free
of the (substitute) mothers desire, and once again ensconced in the
Law, in the universal, symbolic order. He is free to sing (or write, as
it were) the praises of the risks he took to return to himself, the flirta-
tions he made with the real, without endangering his position for the
moment:
Long life to the high flight of thought, to moral danger in the service
of the idea! Hail to the danger of battle! Hail to the solemn exulta-
tion of victory! Hail to the dance in the vortex of the infinite! Hail to
the breaking wave which covers me in the abyss! Hail to the break-
ing wave which hurls me above the stars!
(Kierkegaard, 1843, p. 127)
But before this redemption of sorts could occur (allowing him to praise
the risks he had taken) the young man had by necessity to stand against
that universal order, to seek the transgression of the law, as we men-
tioned. This Christian trope of redemption, that Heaven loves one sin-
ner more than ninety and nine just persons is a familiar one in the
writings of Kierkegaard, one which it might suit our purposes to exam-
ine more closely (Kierkegaard, 1843, p. 133).
What was at first intoxicating to the young man? His desire for the
young woman. This desire, however, sets in motion a process by which
he is quickly cast into the position Kierkegaard refers to as the excep-
tion to the Universal. I have suggested that his love affair would be
transgressive (casting him as the exception) inasmuch as it would pur-
sue the impossibility of charging the symbolic with the real, and enact an
Oedipal fantasy by making him desirable to a mother figure. But once in
this position of the exception, the young man finds himself unwilling to
forego his position vis a vis language and the symbolic, which is after all
his tie to universal humanity. Kierkegaard describes this dilemma aptly,
and in concert with our (and, of course, Lacans) thoughts concerning
the real and the symbolic: It is as difficult as putting a man to death
and leaving him alive (Kierkegaard, 1843, p. 133). From a Lacanian
angle, we might jettison the simile and say that it is putting a man to
death and leaving him alive.
The young mans pain, his alienation from both the exceptional
and the universal (or from both the real and the universal) continues
to grow even as he waits for his repetition, finally becoming nearly
unbearable.
Yet this untenable position is the very thing that allows for the young
mans salvation, which comes in the form of the repetition. The fact
that he still wishes for an existence within the universal, that he is not
convinced that he has any right to be outside of the law, that he sees his
exception-hood as completely unjustified, makes him what Kierkegaard
calls a justified exception, the kind of sinner that is loved by heaven
and redeemable. In Kierkegaards words, existence absolves him at the
instant when he would as it were annihilate himself. His soul now gains
a religious tone (Kierkegaard, 1843, p. 135).
In the end, the young man gets his repetition, at the same time that
he receives a sort of absolution (although we may be right to wonder
about the legitimacy of the latter). Yet this repetition, the event that
delivers him from his unbearable neurotic pain, is not the victory of his
relationship with the woman, but the victory of the law, the universal.
The woman has married another man, and the young man sees this as
signifying the repetition that he has been seeking. It may indeed be so,
but it is not, as we might have expected, the repetition of the idealized
relation with the mother or the repetition of the experience of the real
body unencumbered by the bonds of signification. Rather, it is the repeti-
tion of the loss of these things. The woman is lost to another man. She has
been made off-limits and the young man has been made undesirable,
once again the subject of the symbolic order of the fathers no. This
self which another would not pick up from the road I possess again
I suggest that it is this moment to which the young man is addicted,
and not, as we might have thought, the rush of the transgression.
He is addicted, not to the intoxicant per se, but to coming down.
From the position of sobriety, wherein he is sure that he is once again
undesirable and safely insulated by language against the vortex of
the real, he can immediately feel titillated again by the possibility that he
might again become lost to the symbolic, thereby repeating the process
of redemption, and so forth.
LOST OBJECTS 171
The addict we see in psychotherapy is rarely interested in quitting

their substance when they are sober. The desire to quit the substance, to
get clean or dry, is often at its peak when they are drunk or high.
Conventional wisdom tells us that they are addicted to their high; but
perhaps they are in fact addicted to coming down, to withdrawal, just
as the young man finds the repetition he truly desires in the re-experi-
encing of the loss of that sun amongst women.
This is admittedly a counter-intuitive view. But if we entertain it for a
moment, it may speak to our current ways of constructing and address-
ing addiction, for example, the popularity of Alcoholics Anonymous
and its variations. That is, if addicts (and therefore all neurotics) are
addicted to redemption, as I suggest they are, what better substitute for
coming down time and again can there be but to turn to a group which
defines itself passionately in relation to a codified set of rules specifi-
cally for the purpose of redemption? These rules can then be manifested
via a sponsor (a sort of mouthpiece for the paternal No!, albeit an
imaginary one) even when tempted to transgress. The addict is allowed
the redemptive feeling of coming down and returning to the law when-
ever they want it, day or night, and no substance is necessary.
The entire 12-step programme is in fact organized around a pro-
nounced theme of redemption via submission to authority (the Law/
the universal) which encompasses not only the rules of the group,
but extends to God himself. The second of the 12 steps, for example,
declares that the addict must come to believe that a power greater than
himself [sic] could restore him to sanity (Alcoholics Anonymous, 2011,
p. 59). This is precisely where Kierkegaards young man comes to find
his satisfaction, his restoration to sanity, his repetition: the invocation
of a higher power. This is the moment he arguably experiences his
greatest high: She is married, he writes, to whom I do not know, for
when I read it in the paper it was as though I had a touch of apoplexy
The phallic nature of longing: our desire makes us desirable

Also relevant to our discussion here is the concept of the phallus. With
Lacan, I use the term to designate the signifier of the lack/desire in the
Other (Lacan, 2006a). The young mans dream of his sun amongst
women is surely a dream of being desirable to the ultimate object of
ones own desire, of decidedly wielding the phallus, to the extent that
not even the law can contain the dreamer any longer.
But Lacan tells us that the phallus must remain latent, that it can
play its role only when veiled . [T]he demon of shame springs
forth at the very moment the phallus is unveiled in the ancient mys-
teries (Lacan, 2006a, p. 277). Likewise, when Kierkegaards young
man becomes phallic to the forbidden womanwhen she wants
him backhe is immediately unable to endure it, and is engulfed in
shame. Constantius tells us that at the very first instant [the young
man] ha[d] become an old man with respect to the whole relationship
(Kierkegaard, 1843, p. 39). This is because her desire for him runs con-
trary to the function his addiction plays. His addiction to his desire to
be with her and transgress the law signifies the lack in the Other (taking
the Other as the Law), inasmuch as the Law does not allow for the fulfil-
ment of his intense longing, the completion of his broken subjectivity.
That is, his desire for her is itself phallic.
Indeed, Kierkegaard makes no secret of the fact that the young
mans desire itself makes him desirable, lending him a phallic quality.
It seduces even Constantius:
The soulful expression in his eyes, almost tempted mea certain
toss of the head, a wantonness in his utterances, convinced me that
he had a profound nature which possessed more than one regis-
ter . He himself glowed with love. As a grape when it is at the
point of perfection becomes transparent and clear, while the juice
bubbles through its fine veins, as the husk of a fruit breaks when
the fruit ripens to all its fullness, so did love break forth almost vis-
ibly in his being. I could hardly forbear to snatch a sidewise glance
at him now and then, almost as though I were in love with him; for
such a youth is as alluring a sight as a young girl.
(Kierkegaard, 1843, pp. 3738)
Might it be that the culture of Alcoholics Anonymous functions, in addi-

tion to and in concert with the perpetuation of coming down, to ensure
the so-called recovering addict (or the addict to recovery) their phal-
lus of desire? They are after all placed in relation to the group and to the
sponsor much as the young man is placed in relation to Constantius:
he is there to be witnessed in his desire, in his phallic incompleteness,
his beautiful lack. This situation is possibly reinforced by the rule in
LOST OBJECTS 173
Alcoholics Anonymous that the new recruit is not allowed to become

romantically involved with anyone during his novitiate.
When the young woman returns the young mans feelings, she is
pointing out that she, too, has a lack and a desire (she desires him); this
in turn indicates that the young man may now be the party lacking
can his desire (which is his phallus) compete with hers? He immedi-
ately turns away from her: the demon of shame has now sprung
forth and he is instantly castrated again, since the phallus must remain
latent in order to remain phallic. Nor can he stand to tell her that he has
outgrown her, since [t]his indeed would be the same as telling her
that she was an incomplete being, a move that may at first seem to
reinforce that he has the phallus, but in fact does precisely the contrary
inasmuch as incompleteness is the phallic element herehe would thus
be reinforcing her phallic stance and castrating himself (Kierkegaard,
1843, p. 41). As soon as the young man has wielded the phallus, he has
lost it.
There is no solution, then, except that he let another man claim her, to
re-instate the Law of her inaccessibility and make him once again unde-
sirable, giving him back his desire, thereby giving him back the veiled
phallus, as well as the phallic power of the word with which he can sing
the mysteries of his dangerous excursions into the vortex.
Substances, on the other hand, never desire us back, nor do they
repay our efforts to repeat the first high they provided. They keep
us desirous and phallic. The repetition they provide, however, is that
we always come down, coming back to our desire. We can always count
on the relief of coming back to ourselves after the storm of the sub-
stance has subsided. We then find, in Kierkegaards words, that the
chalice of inebriation is again held out to the addict as soon as they have
recovered from their last encounter with the intoxicant (Kierkegaard,
1843, p. 127).
Conclusion: some clinical implications

I have attempted to gather some thoughts here on the existential,
Oedipal, and Phallic natures of addiction in light of the work of
Kierkegaard and Lacan. They may be useful inasmuch as they speak
to the diagnostic non-specificity of addiction: we see in Kierkegaards
young man a bit of the obsessives impossible desire as well as the
hysterics unsatisfied desire, and indeed we see echoes of the perverts
need to reinstate the paternal function as well. They may also be useful
in understanding some salient features in addiction, which shed light
not only on the condition of addicts, but upon the structure of symp-
toms themselves across a variety of diagnostic categories. Because the
majority of us function, in Lacans view, in relation to the symbolic
order, and our pathos is played out along those lines, we may benefit
by an understanding of our neurotic patients (and indeed ourselves) as
addicts in a way ontologically prior to their (our) neuroses.
While this paper has offered an alternate take on the concept of
addiction and the mechanisms of the 12-step groups, I have admittedly
neglected more specific clinical discussion. Id therefore like to com-
ment briefly on what implications it might have for psychological treat-
ment that the patient, who according to my comments here may be an
addict regardless of his substance intake, asks us to witness his desire
in the same way that Kierkegaards young man needs Constantius to
witness his?
Perhaps this is one sign that analytic therapy or analysis is indicated
for addiction, although maybe not as the exclusive mode of treatment
the addict is predisposed to use his lack phallically, and thus to attract
and make use of the analysts desire that he speak more about it. Yet the
clinician must be cautious as always about how we bear witness to this
lack; Constantius was perhaps wise to resist too much identification
with the young man, confining himself to the role of an observer (in
fact, at times only a reader of the text that the young man produces
in his letters) rather than a participant in the subjects predicament,
despite impulses to the contrary. Had he been entirely seduced by the
young mans phallic desire, and acted upon the remarkable attraction
he felt for him, he would have lost the young man, just as the lady had.
But the young man continues to write to Constantius, the disciplined
observer, throughout the ordeal. This relationship illustrates that our
structure as existential addicts provides a predisposition for analytic
therapy, but the clinician must be aware of the phallic function of desire
in order for any treatment to continue successfully.
What about the patient who continues his love affair with a sub-
stance during a course of psychotherapy, and who might seem never
to make any therapeutic progress? We might say that he keeps him-
self dangerously close to the real, preventing him from symbolizing
any loss whatsoever, and thereby from making use of the impetus to
LOST OBJECTS 175
speak that the addicts phallic desire can provide. In a word, he is too
satisfied to speak. He is truly castrated, not having the not-having that
will attract the clinician to him and provide his repetition. When the cli-
nician refers this client to a 12-step programme, perhaps the most ben-
eficial effect is that it reawakens the patients phallic desire by forcing
him to come down, and reignites the patients potential as a seducer of
the group, as he wields his powerful, beautiful loss. Perhaps only when
the group, like the young woman in Repetition, becomes too interested
in the patient (a process which need not be defined in terms of linear
time) can he then return to the therapist as a Constantius-like observer
to engage once again the phallic politics of the desire to synthesize the
real and the symbolic.
But the clinician must be sure to continue to keep the patient speak-
ing (just as Constantius kept the young man writing his letters) rather
than becoming yet another purveyor of words and concepts which,
becoming nothing other than the stuff of imaginary identification, do
no justice to the pathos of addiction. The patient can buy into stultifying
identifications which explain away his condition via any number of
cultural venues. But it is precisely the capacity of the clinician to offer
something other than the efficient cures the patient can get from 12-step
groups, daytime talk shows, and medical-model jargon, that can make
them effective.
References
Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th edn. New York:
A. A. World Services.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual
of Mental Disorders, 4th edn. Washington, DC: American Psychiatric
Association.
Freud, S. (1905e). Fragment of an Analysis of a Case of Hysteria. S.E. 7,.
London: Hogarth.
Freud, S. (19161917). Introductory Lectures on Psycho-Analysis. S.E., 16:
392411. London: Hogarth.
Kierkegaard, S. (1843). Repetition: An Essay in Experimental Psychology.
(W. Lowrie Ed. & Trans.) New York: Harper and Row. [Reprinted: 1964.]
Lacan, J. (1988). The Seminar of Jacques Lacan, Book I: Freuds Papers on
Technique, 19531954. (J. A. Miller Ed. & J. Forrester Trans.) New York:
W. W. Norton.
Lacan, J. (2002). The instance of the letter in the unconscious, 1957. In:
crits: The First Complete Edition in English (pp. 138168). Trans. B. Fink in
collaboration with H. Fink and R. Grigg. New York: W. W. Norton.
Lacan, J. (2006a). The signification of the phallus, 1958. In: crits: The First
Lacan, J. (2006b). Position of the unconscious, 1960. In: crits: The First
CHAPTER THIRTEEN
Bulimia, anxiety,
and the demand of the Other
Maria-Cristina Aguirre
T
he purpose of this paper is to interrogate the connection between
bulimia and anxiety. Through several short clinical vignettes, we
will examine the connection between anxiety and the demand of
the Other.
Andrea is as beautiful as she is thin; she is brilliant but her life is a
mess. She defines herself as different, radically different. The first time
she saw me she told me, Im not like you. How can she know what
Im like at first glance? She has other needs, she says, she cannot keep
in place; she has to move constantly, but it is always too late. What she
wants is what was there before, if only she had made a decision other
than the one that she did. She is constantly regretting what could have
been. It is easy here to perceive the signs of the hysterics desire. Maybe.
Andrea is not my patient. I met her briefly through a friend of her fam-
ily who is trying to help her get her act together and get treatment.
As Andrea is incapable of keeping appointments, they are looking for
an institution to help her: first to stabilize her and afterwards to con-
tinue treatment. On a previous hospitalization she jumped from a sec-
ond floor window and broke her back: I wanted to get out. There
is a certain ambivalence in her treatment of her body, which she both
worships and punishes, submitting to extenuating hours of exercise
177
that leaves her exhausted. There is that quality of the mortification of

the body which is often encountered in the clinic of anorexia. From her
childhood the friend of the family told me that Andrea was left alone for
long hours in her crib while her mother went out with Andreas older
sister to luncheons or tea parties. The anxiety that inhabits Andrea is as
touching as it is pathetic. There is an enormous demand to the Other to
take care of her while at the same time she sabotages any help given.
* * *
I have known Stephanie since her childhood. She was adored and pam-
pered by her mother. At the age of five, two major events produced a
psychic catastrophe: the birth of a brother and the separation (and then
divorce) of her parents. She began complaining of stomach-aches. When
I asked her to make a drawing and show me where it hurt, she drew
a little girl and pointed at the heart as the place of her pain. She had sor-
row for the loss of her parents as a couple and the loss of her mothers
undivided attention; her pain in her heart had been transposed through
the signifiers into a symptom in her body: avoir mal au coeur, which,
in French, means to have nausea. She didnt complain of nausea but
of stomach-aches. Instead of seeing an analyst, her parents took her to
an orthophonistes in response to her general malaise and difficulties in
school. As the name implies, orthophonistes in France are specialists
of the language, like Speech Therapists; they help children who have
problems reading and/or writing.
The expression mal au coeur/nausea emerged when she did the
drawing for me. I advised the parents to send her to a psychoanalyst
but they chose to send her to an orthophoniste. Ironically, Stephanie
didnt need a correction of language but rather a place to express her
dismay. It was not the orthophonistes she needed in order to say well
(le bien dire) but a psychoanalyst, as Lacan says. During adolescence,
she became anorexic with binging and purging, and underwent sev-
eral treatments and hospitalizations. Like Andrea, she was never my
patient. In both cases we can advance with caution the hypothesis that
they felt ejected, excluded from the place in the Other, and that their
symptom is a loud call to what could have been.
As Lacan teaches us, the demand to the Other is a demand of love,
beyond the oral satisfaction; it is the proof that the Other loves you. The
Lacanian version of anorexia in The Direction of the Treatment and
the Principles of its Power is that it is they who are nourished with
B U L I M I A , A N X I E T Y, A N D T H E D E M A N D O F T H E OT H E R 179
the most love that rejects food and plays with their rejection as a desire
(Lacan, 2006).
Massimo Recalcati (2004) has dedicated ten years to the research
and treatment of anorexia and bulimia. He claims that anorexia is a
manoeuvre of separation of the subject from the Other, there where the
Other of the demand seems to suffocate any lack. It fills the subject with
their suffocating meal, without giving them a sign of love.
Recalcati explores a logic of the symptom of anorexia, that is, a symp-
tom that can be part of different structures. He sees in the melancholic
version of anorexic a strong connection between rejected desire and the
pure jouissance of the death drive. To quote:
Desire as waste is found on the first plane in the melancholic oscil-

lation of anorexia. Desire is rejected and annulled in the pure jouis-
sance of the death drive, in a parasite and latent jouissance. The
subject does not defend through the rejection his [sic] subjectivity
but finds himself degraded to an object-waste: mummification, de-
vitalization, delusion of identity . The anorexic incarnates a wall
that tries to oppose to the wall of language: wall against wall. It is
the stubborn character of contemporary anorexia, outside dialectic,
radically narcissistic.
(Recalcati, 2004, p. 17)
The subject doesnt defend itself through the rejection of their subjectiv-
ity but nonetheless finds themselves degraded to an object remainder
with its sequel that Recalcati recounts of mummification and devitaliza-
tion. Anorexia, says Recaltati, incarnates a wall that tries to oppose the
wall of language: wall against wall. This is the obstinate character, out
of the dialectic, radically narcissist of the contemporary anorexia.
The DSM-IV (Diagnostic and Standard Manual of Mental Disorders, 4th
edition) is not very helpful for understanding the dynamic of anorexia
and bulimia, as in both types we can have binging and purging. The
difference resides mainly in that in anorexia the individual refuses to
maintain a minimally normal body weight. This characteristic is not
present in the bulimia type of the eating disorders.
The psychoanalytical approach is not through the disorder, but
addressing anorexia and bulimia as a subjective position. The distinc-
tive trait of anorexia-bulimia, says Recalcati, is passion: a passion of
the subject, one caused by an object-substance (food) that occupies the

place of the object-cause (of desire), not totally symbolizable either
when it leads the subject to continuous rejection (anorexia) or when the
subject appropriates it in an infinite and voracious way (bulimia). But
this passion, says this author, is a passion for emptiness. In both cases
it leads the subject to reach for and maintain the emptiness, because the
abolition of the emptiness will be an abolition of the subject themselves.
The emptiness is the condition for the existence of the desire, next to
the lack.
Anorexia-bulimia shows the function of the object a; they are beyond
the pleasure principle: to eat until you explode or to reject food until
dying of hunger are subjective positions that are better understood
from the angle of jouissance, that which is beyond the pleasure principle
and the reality principle. It is a very fine and delicate elaboration of the
dynamic between anxiety and the Demand of the Other that can serve
us as a compass in this field.
Sophie cannot say no to the Other, or better put, the only way to
say no is through binging and purging. When something upsets her,
a demand of the Other to whom she cannot say no, she eats and then
vomits. During early adolescence she had a period of anorexia and
a suicidal attempt that required hospitalization in an institution spe-
cialized in the treatment of anorexia. The modality of treatment was
based on behaviour modification, rewards, and punishments according
to weight gain or loss. The passage through this institution gave her
the tools to dupe the Other. Sophie needs desperately to create a space
between her and the Other, whose presence is perceived as invasive and
overwhelming. Any movement from the analyst perceived by her as
a demand raises the alarm, but fortunately she has been able to address
this question in analysis.
What is the connection between anxiety, the incapacity to say
no, and binging and purging? Lacan (19621963), in Seminar
X LAngoisse, describes how the subject, when confronted with the
desire of the Other, can feel like being in front of a praying mantis
(Mantis religiosa) that thinks you are its partner.
The bulimic attack is triggered by a confrontation with the Other.
When the subject is confronted with the enigma of the desire of the
Other, questions arise in the subject, such as, What does the Other
want? From me? What am I for the Other? and it produces anxiety. The
demand of the Other also produces anxiety. The subject, incapable of
finding support in the Other, confronted to their own void, which is

an inescapable and structural void, proceeds in the bulimic attack, in
a compulsive way, to ingurgitate objects (food normally, but it may be
some other thing, even knowledge) in search for the object that will
quell the hunger, that will calm the anxiety, but of course that object
does not exist: it is lost and it has been lost forever. Bulimia is described
as eating anything in excess; there is a compulsion, the subject is beside
themselves. There is a push to incorporate, to fill a void. But there is also
the incapability of facing the loss. We select what we eat, we choose,
and in that choice there is necessarily loss. For Sophie it has become
apparent that her periods of binging and purging have a certain con-
notation of cheating.
Eating in excess and then vomiting is a jouissance and a way to avoid
castration; the subject avoids paying the price of weight gain that nor-
mally accompanies excess eating. It is becoming clearer in her treatment
lately that what she eats are signifiers, signifiers related to her family
fiction, which she has to deconstruct and reconstruct in analysis. This
connection with the symptom and signifiers is what Lacans teachings
have contributed to the understanding of contemporary symptoms,
which is impossible to understand from the point of view of the behav-
iour only, as current treatments pretend.
Recalcati (2004) says that when the bulimic eats, they are not eating
food but that which is not edible, that of which food is a simulacrum.
They eat the thing. The object lost forever of the first satisfaction. They
eat the void, a void non-edible, and precisely because of this it causes
the oral drive as a push to an infinite devouring. This is exactly the pure
structure of the drive as a turning around the void. This is what the
bulimic shows.
Bulimia is obscene. It shows the real of jouissance, the drive aims to
be satisfied, aims to eat not food but the void as a cavity, as a residue
impossible to eatof the Thing. The bulimic blames the Other as being
the cause of their sorrow. They would transform into a living skeleton
to make the Other pay for it, to blackmail their will, to extort the Other
from whose love they felt deprived, that Other that threw them out of
their table.
In a very interesting paper, Pierre Naveau (2005) discusses the case
of a bulimic subject. There, where the anorexic poses the question
of desire, the bulimic questions jouissance, or the flesh of jouissance.
In Naveaus case, Celia is angry, about being what she is: a woman.
When she vomits, it is her anger that she throws up. Through vomiting
she spits in the Others face. The Other being language, life, history.
Naveau isolates a repetitive sequence in Celia. She eats, she sees herself
in the mirror, and she vomits. Throwing up what she has swallowed,
Celia wants to transform the too-much into nothing, showing in that
way the anorexic root of bulimia.
Naveau proposes that the symptom of Celias is linked to speech and
a certain style of speech. Celia can talk non-stop, but about her parents
she has nothing to say, nothing to complain about. She is angry, but
doesnt speak the cause. Pierre Naveau poses that what she keeps silent
about concerns the object she is for the Other. Celia is anxious before
and after a meal. Naveau talks about the obscenity of the act of eating.
Food becomes something of a real. Lets follow him in this sequence.
He poses that anorexia and bulimia turn around a hole and, because of
this hole, around the rawness of the real. Disgust is essential; to vomit is
the only obscenity that can answer to that other obscenity which is the
fact to eat excessively, to gulp.
The link of the symptom of bulimia to anxiety leads us to put the
accent on the primordial repression and on the relation of the subject
to what cannot be said. For Naveau that is the knot of the dialectic
between anorexia and bulimia: what is not said, or what cannot be said;
the too-much covers the nothing which arises from the reduction of
speech. She eats too much and she talks too much, she is prey to the
excess both in relationship to food and to speech.
The bulimic crisis is an attempt to deal with the lack of saying, to stuff
words in the throat and to spit them out, in so far as these words are
unpronounceable. This attempt fails, because, when one eats, one doesnt
know what one really eats. As suggested by Naveau, one eats all sorts of
things: objects, people, situations, family ravages, political crises, popu-
lar riots, personal wars, and Shakespearean dramas (Naveau, 2005). The
object cannot be said, nor can sexual difference be said. The woman is not
a signifier that can be articulated; it is something that is unsaid.
Pierre Naveaus thesis leads to an intimate connection between
bulimia and the Other sex. The bulimic crisis is the passage lacte
that enhances the subjective division provoked by the traumatizm of
such a silence imposed by the impossible. Through what the subject
swallows and throws up, the bulimic crisis is a brutal way to put a gag
on the mouth. When the too-much is the object that one eats, one pre-
vents oneself from speaking. Celia feels discomfort in her body every
time she eats. Here Naveau refers to Lacan when he says that the drive
divides the subject and the desire.
If bulimia is often considered as incurable, Naveau says, it is on the
level of alienation that we must understand this, what is incurable is
the subjective division. The anxiety that leads to eating provokes a cer-
tainty. Naveau proposes that the bulimic crisis is a way to tear off from
anxiety the certainty of that piece of real that is the bone stuck in the
throat.
I find this connection between the symptom of bulimia and anxi-
ety, and the question of speech and feminine jouissance, particularly
interesting. In this case, it is Celia herself who uses the word jouissance
related to throwing up. The passage between a being where she feels
heavy to one where she feels light, gives her an intense satisfaction; it is
the condition to fall asleep.
She feels emptiness; she eats, looks at herself in the mirror, and
throws up. This is her partner-symptom according to the expression of
Jacques-Alain Miller. This sequence imposes itself on her in an implac-
able and cruel way. She feels guilty and she feels ashamed of herself.
Naveau talks about making visible, through vomiting, the excess, the
too-much, which is inside of her; it is an operation that consists of
giving an image to this object: a real consistence to this too-much.
Jennifer speaks of her loneliness and her difficulty in making friends
and having a partner. She is thin and has problems with keeping regu-
lar schedules for meals. She reports an episode of weight loss when
she was 19 years old. She started losing weight, not intentionally, she
says, but because of her schedule. Even though friends and acquaint-
ances noticed her severe weight loss, her parents didnt take any notice,
nor did they take any action. She regrets that this happened and says
that she wished they had done something about it. When somebody
doesnt feel well, they want immediate relief.
Jennifers relationship with her parents is distant. During her child-
hood she was severely punished physically; once her father hit her with
a belt and the buckle came very close to her eye and she had to miss
school for several days. She describes or perceives her parents as being
very strong, set in their ways, and not open to dialogue. What strikes
me in Jennifer is her helplessness. Jennifer is incapable of standing up
to the Other. In a certain way, the demand of the Other is overwhelm-
ing and leaves no place to welcome the subject. It is as if the subject
has been exiled from a place in the Other. She says that if she doesnt
say it correctly then she cannot speak. Left alone in their abandonment,
they use their body. Jennifer has many questions about being a woman
and the relations between man and woman. Questions that went
unanswered by the Other.
In a recent Seminar, Jacques-Alain Miller (19992000) follows Lacans
lead on anxiety and shows how anxiety is, above all, the effect of the
divided subject. The object a is the cause of desire, the para-anxiety.
The remedy of anxiety is desire. As Lacan teaches us, the desire of the
Other provokes anxiety in the subject, the desire of the Other supposes
that the Other has a lack, that the Other is moved by the desire to fill
that lack. That desire is then addressed to me and it can be that I am
what is lacking in the Other and if there is something I dont know, it is
what I am in the desire of the Other, I dont know how I can satisfy or
dissatisfy them. The enigma of the desire of the Other is the enigma of
my own status as object a, cause of the enigmatic desire. There is a way
to solve the problem, says Miller: to assume joyfully, happily, to be what
the Other desires, to be the cause of their desire. It is the erotomaniac
solution. This is what Lacan describes as a great form of love.
In another article, Recaltati (2005) outlines the principles for the treat-
ment of the mono-symptoms. He shows how Lacan understood how
the discourse of capitalism rules the postmodern era. The disciplinary
society guided by the function of the master-signifier and the institu-
tions that incarnated it, such as the Church, the Army, the University,
Jail, and so on, has given way to the uncontested affirmation without
moral limits of the power of the market. This exclusion of the Other that
we find in all the contemporary forms of the symptom, says Recaltati,
show us how the drifting of the clinic of the symptom goes hand in
hand with a kind of degradation of the social aspect of compromise
between drive exigency and the symbolic law of the Other. The new
symptoms are not like those of the beginning of the last century in rela-
tion to the unconscious passion of desire, as were those of the hysterics,
but they signal the divorce between the subject and the desire. What
makes one suffer is the feeling of inexistence, of unreality, of anonym-
ity, the perception of an unstoppable void that the capitalist discourse
proposes falsely to fill. The challenge, says Recalcati, is to define a new
politic: how to extract the subject of the unconscious out of the swamp
of gadgets-objects.
Lacan, in a press conference in Rome in 1974, as Recalcati reminds
us, had already indicated that the future of psychoanalysis depends
on what will happen to the real. Lacan foresaw how the development
of science and the advances of technology would have an impact on
the subject, proposing objects and gadgets to fill this intolerable void
inherent to our condition of speaking beings. These gadgets present
themselves as being a must that one should have in order to attain the
promise/lure of happiness and immediate satisfaction. The consumer
society can thus be compared to the bulimic logic: the urgent need to
consume more and more and to then end up throwing it all outthe
waste and debris of civilization.
We can see that the modalities of treatment proposed in the market
today tend to privilege the way of the gadget-objects. It is up to us to
see if it is possible to maintain a clinic where subjectivity and desire are
the priority.
References
Lacan, J. (2004). Seminar X, LAngoisse. Paris: Editions du Seuil.
Lacan, J. (2006). The direction of the treatment and the principles of its
power, 1958. In: crits: The First Complete Edition in English (pp. 489542).
Trans., B. Fink in collaboration with H. Fink and R. Grigg. New York:
W. W. Norton.
Miller, J.-A. (19992000). Lacanian Orientation. Unpublished seminar.
Miller, J.-A. (2004). Los usos del lapso, 19992000. Buenos Aires: Paidos.
Naveau, P. (2005). Langoisse dans lanorexie feminine. La Cause Freudienne,
59: 3744.
Recalcati, M. (2004). La ultima cena: anorexia y bulimia. Buenos Aires:
Ediciones del Cifrado.
Recalcati, M. (2005). Lignes pour une clinique des monosymptomes.
La Cause Freudienne, 61: 8397.
CHAPTER FOURTEEN
Response: Bulimia, anxiety,

and the demand of the Other
Maria J. Lopez
T
he connection between these three dimensions: bulimia, anxiety,
and the demand of the Other has been clearly elaborated by Maria
Cristina Aguirre, both in theory and through clinical examples.
Nevertheless, these new symptoms of modernity pose an enigma and
leave open many questions.
In her book Figures of Lightness, Gabriella Ripa (1999) suggests that
there has been a passage from the structure of the hystericwhich
intrigued Freudto the clinical practice of anorexia. The rise of anorexia
itself suggests a structural change with regards to our civilization.
I am particularly interested in the underlying structure supporting
these symptoms of modernity. In a time when the roles of women are
no longer specific and clear, when the question of femininity (or the
question of what it means to be or to become a woman) takes on new
perspectives, and when the discourse of the time is pointing towards
a collapse of the paternal function, we cannot avoid questioning the
structure behind these new forms of the symptom. Are these bulimic/
anorexic women the modern hysterics?
Massimo Recalcati (2005) suggests, in light of Lacan (1977), that
the clinic of the so-called new forms of the symptomdrug addic-
tion, anorexia, depressionmakes evident the incidence of a closed,
187
untriggered, or compensated psychosis. Through these modalities the

subject defers, maintains him or herself, on this side of the hole of psy-
chosis without falling into it.
What can be said about Andreas structure when there are signs of
hysteric desire as well as a very serious passage lacte when she jumps
from a second floor window and breaks her back? And what could we
postulate in terms of Celias structure, a woman with such an adverse
reaction to her own reflection in the mirror?
Maria Cristina Aguirre cites Recalcati as saying that the bulimic
blames the Other as being a cause of her sorrow, transforming herself
into a living skeleton in order to castigate and make the Other pay. This
brings an image to mind, that of Alberto Giacomettis sculptures, as
well as the very perceptive words of art historian Laurie Schneider-
Adams (2000) who observes that Giacomettis obsession with existence
and non-existence is evident in the fact that he moulds his sculptures
as thin as possible without collapsing them. Ironically, the thinner they
become, the more their presence is felt by confronting the observer with
their potential disappearance. His sculptures as such evoke existential
angst, transporting the viewer to the very threshold of being.
References
Lacan, J. (1977). On a question preliminary to any possible treatment of
psychosis. In: crits: A Selection. (Trans. A. Sheridan) New York: W. W.
Norton.
Recalcati, M. (2005). The empty subject. Lacanian Ink, 26: 73101.
Ripa, G. (1999). Figures of Lightness: Anorexia, Bulimia, and Psychoanalysis.
London: Jessica Kingsley Publishers.
Schneider-Adams, L. (2000). History of Western Art. New York: McGraw-
Hill.
CHAPTER FIFTEEN
Addictions, sexual identity,

and our times
Liliana Kruszel
I
f we agree with Lacan that the analyst has to be involved with the
subjectivity of their times, and if we agree with him that the uncon-
scious has two aspects to itthe structural and as such out of time,
and the other related to civilization and therefore connected to what is
current in itwhat would then be the relationship between our time,
addictions, and a third articulation, sexual identity?
In other words, can we think of addictions and sexual identity as
symptomatic responses to civilization and its discontent?
Around the 1970s and from then on, there has been a gradual but
inexorable decline of the authority of the Other. The advance of technol-
ogy and science had an enormous impact that I will describe in detail
in a moment that accounts for that decline. Lacan predicted that decline
earlier on, in 1938, in his text The Family (see later version, Lacan, 1978).
With that decline came the proliferation of symptoms and multiple psy-
choanalytic orientations.
Philosophers of those years, such as Rorty and Jameson, theo-
rized this time as being governed by the inconsistency of the Other
(Jameson, 1998, pp. 45).
Miller and Laurent had defined it as the the epoch of the Other that
does not exist (Miller, 1997, p. 30) following Lacans expression that
189
the sexual relationship does not exist. They interpreted the proliferation
of Ethical Committees to discuss ethical matters as an effect of the
decline of the Other of culture that had provided in the past, more sym-
bolic tools and the authority to regulate social norms.
Drugs were used in the 1960s and 1970s, in the same way as artistic
expressions as a way to manifest the ideology of liberation and rebel-
lion against the Other, an Other that was consistent with the figure of
the leader or whomever occupied the place of the ideals.
Drugs were in the series of objects used to defy the Other, just like the
object of art, the way people dressed, or their long hair.
Today we find a change in the use of drugs, not as a protest against
the father figure, the consistent Other, a liberating sensation from the
burden of the ideals incarnated by this consistent Other, but a form of a
break from the phallic jouissance, a jouissance that in the best of cases
allows for social connection, and replacing the social partenaire with
the object drug, the new partenaire of jouissance.
Even though Lacan went back to Freud and in that sense went back
to the belief in the Name-of-the-Father, it is also true that he later on
demonstrated its nature as pure semblance (Lacan, 1987, p. 9).
Lacans original addition to psychoanalysis is that there is no
longer just one signifier (the Name-of-the-Father) that regulates jouis-
sance, but rather what we see today is the proliferation of the Names-
of-the-Father. This is in accordance with the Inconsistency of the
Other and the many different ways in which these different names
regulate jouissance in our culture (Lacan, 1987, p. 20).
Lets remember for a moment that the Names-of-the-Father intro-
duces the law that allows a subject to be a part of our culture. Its prolif-
eration results in subjects who are in life a little disoriented, who dont
believe in the Other, or in a social order, and they are cynical about it
because they lack a semblance of the Other in which to believe. This
proliferation of isolated signifiers doesnt allow for the formation of
social ties because they are not articulated to a symbolic chain. They are
not tied to a master social objective or ideal; they are private signifiers.
Among its many effects, this decline of the Other produces the hesi-
tation of ideals as they refer to the ideal model of sexual identity, the
phallic semblance for the feminine masquerade and the masculine
imposture.
If we refer to Lacans matheme of the ideal I(A), we see that it is
referred to a consistent Other without the bar. However, when the Other
A D D I C T I O N S , S E X U A L I D E N T I T Y, A N D O U R T I M E S 191
becomes inconsistent, the signifiers of our culture become isolated, not

articulated to the Other (Lacan, 1982, p. 109).
Ideals provide the symbolic-imaginary semblance for being a woman
and a man, and a shared modality of enjoyment. Ideals are therefore a
way of making social ties. If we speculate that the common ideals are
gone, then the core, around which ties are now established, is consti-
tuted by something other than the old ideals. What takes the place of
ideals is the object petit a, plus of enjoyment (surplus enjoyment). We
are now faced with what was hidden behind the ideals, which relegated
that plus de jouissance in the name of more noble social ideals. This is the
characteristic of our times.
For Freud, the subject was divided between the ideals and the
demands of the drive. The object petit a, with its correlation to the
objects of consumption in our culture, that took the place of the ideals.
To say it in a more simple way, now people get together not around
the same ideals but around the same way of enjoying. This phenom-
enon has an intimate correlation with the Lacanian concept of superego,
whose imperative is the order to enjoy, an imperative absolutely in
accordance with our time.
The imperative now is not to live in accordance with collective ide-
als, but to enjoy more and better, to consume objects of pleasure, to
travel, to be successful, to do it on your own outside the recognition of
society. These new forms of fraternities leave all others outside, para-
doxically causing segregation. Groups congregate around their activ-
ity of enjoyment or even pathology. There are groups of overeaters,
groups of drug addictions, etc., and only those who share that modality
of enjoyment can understand, for example, who they are, and what
they experience, and therefore they can only be treated by profession-
als who understand their modality of enjoyment, for example. That is
just one of the ramifications of this cultural phenomenon.
A good example of this phenomenon I think is depicted by the Broad-
way musical Rent that was translated into a movie of the same name.
Young artists cannot pay the rent of properties owned by corporations,
a metaphor in itself of the socio-economic structure. The group is com-
posed of heterosexuals, homosexuals, bisexuals, drag queens, and les-
bians, and drug addictions are used as coping strategies, by some, for
this disorientation produced by the multiplicity of signifiers. We find
subjects, who are well portrayed by the play, who do not recognize their
link to the past, and therefore who are fearful of the future.
The plays dramatic end situates the fear around sex, addictions, and
its mortal relationship with AIDS (Acquired Immune Deficiency Syn-
drome), and death. Privacy and individualism have a positive meaning,
and the concept of personal realization and recognition is outside of the
social context.
A new trend of addictions, which is in tune with this cultural coordi-
nate, seems to take place. In the 19902000 period, the city of Miami has
seen an increase of 2,500% in the consumption of heroin, outnumbering
other cities in the country that participated in the Community Epidemi-
ology Work Group that took place in December of 2001 as sponsored by
the National Institute of Health. Heroin was traditionally more expen-
sive than cocaine; today they have a comparable price. Originally her-
oin was brought by the Italian mafia activities and the so-called French
Connection that exported it from Southeast Asia. However, currently
heroin is brought from South America, via the Miami Airport which
has become the largest gateway for the importation of heroin into the
United States. Overdose by heroin is now more common than death
from cocaine usage. Cocaine and heroin produce completely different
effects in their consumers. While cocaine helps form social ties, heroin
isolates its users from others and makes the consumer fall asleep. If we
consider that the price of both drugs is similar, then it becomes a mat-
ter of subjective choice. This implies that its users are only interested in
enjoying the effects of the drug by themselves and not with others.
The contemporary individualists seem to choose heroin as an
election of jouissance (Kruszel & Tenebaum, 2002). The idea of regu-
lating and making it legal, as once was considered, would not make a
change because subjects today dont use it to challenge the Other, as
a transgression, or to make a statement. Today drugs are used either
to have a subjective consistency, for example, in naming oneself as a
drug addict, or in order to function as a veil for castration, and in
this latter example, drugs serve as a medium in the encounter with the
sexual other. That is to say, that when confronted with the impossibil-
ity to respond symbolically to sexuality, there is a response given by
the drug, a response of happiness, which closes the possibility to form
symptoms. Lets remember for a moment that a symptom is a compro-
mise solution found when a subject is confronted with the sexual rela-
tion that does not exist.
Where can we situate the consistent and the inconsistent Other in
the sexuation formulas that Lacan develops in Seminar XX Encore?
A D D I C T I O N S , S E X U A L I D E N T I T Y, A N D O U R T I M E S 193
(Lacan, 1982, p. 95) Can we situate these two forms of the Other in the
same place? The consistent Other we should find on the left side of the
formula, under the logic of the universal, the all-phallic, where there
is at least one, the exception, that reassures the rest of the group of
being castrated. Perhaps we can think of this place as the place where
leadership can arise promoting changes against the universal.
In the Cultural Turn by Fredric Jameson (1998), we find reflec-
tions that are interesting to take into account. The author distin-
guishes between post-modern pastiche and modern parody
(p. 6). Lets say that parody is from Freuds time, and the pastiche
would be a reflection of the post-modern times. Being a parody, an
imitation, an imitative style, parody needs the norm from which
the parody will take its style. Everybody will dress or speak in a cer-
tain way; somebody, an exception, will be the role model from whom
everyone will copy. Our time, however, is one of fragmentation of the
discourse, without reference to any particular norm, a time of not-
all that allows only pastiches in terms of Jameson, an irony with-
out humour.
The Other that does not exist, the inconsistent Other of our time, can
be located on the other side of the formula, under the feminine logic of
not-all, where there is no exception, but instead globalization. A not-all
generalized. I am not going to develop here the implications that this
has with respect to many different areas of our culture but will under-
line the effect of feminization and the points of disconnection from the
phallic logic.
As examples we can cite that this is the time of womens rights, and
their right over their bodies, intimately related with the legislation over
the cases of sexual harassment, and the topic of abortion, to mention
just a few. Eric Laurent underlines that this is the first time in history
that the feminine position becomes independent from the maternal
position (see Miller, 1997, p. 15).
In prior times there was an ideal type for each sex that expressed
how each one connected with the phallic semblance, feminine
masquerade, and masculine imposture. However, we learn through
Lacans teachings that identifications to the ideal male or female type
are not enough to account for jouissance (Lacan, 1982, pp. 137139). Even
though they show to be insufficient, their value lies in being a symbolic
and imaginary treatment for the absence of a programme as to how the
sexes relate. What happens when there is a lack of those symbolic and
imaginary veils that cover the inexistence of the sexual relation? What
other treatment does the subject have available when confronted with
that aspect of the Real?
We find a whole spectrum of pathologies of the act in the form of
subjects that come out of the social link, such as anorexia, bulimia, and
the addictions. What we find is that instead of symptoms that are a
compromise solution, drug abuse and other addictions comes into play
as a form of separation. Drugs seem to liberate subjects of their anxi-
ety related to castration, looking to maintain an illusion of wholeness
(Lacan, 1982, p. 137139).
Now, if we agree that precisely because there is no given sexuality by
biology nor by sexual identifications, that means that for any subject,
being a woman or a man will be a subjective construction.
In summary, in this epoch of the inexistence of the Other, subjects are
alone without symbolic tools to confront the proposals of civilization
and to relate to the other sex.
Endnote
1. For those who dont know, these are music bonds.
References
Jameson, F. (1999). El giro cultural: Escritos seleccionados sobre el
posmodernismo, 19831998 [The Cultural Turn: Selected Writings on the
Postmodern 19831998] (Traduccin de Horacio Pons). Buenos Aires:
Manantial.
Kruszel, L. & Tenebaum, K. (2002). Pharmakon. Paris: Publication of Champ
Freudien.
Lacan, J. (1978). La Familia. Buenos Aires: Argonauta.
Lacan, J. (1982). Seminario XX, Aun [Seminar XX, Encore]. Buenos Aires:
Paidos.
Lacan, J. (1987). Seminario XI, Cuatro conceptos fundamentales del Psicoanlisis
[Seminar XI, Four fundamental concepts of psychoanalysis]. Buenos Aires:
Paidos.
Miller, J. A. (1997). El otro que no existe y sus comits de tica (The Other
that doesnt exist and its ethical committees). Buenos Aires: Paidos.
CHAPTER SIXTEEN
Speech, language, and savoir

in the Lacanian clinic of addiction
Christopher Meyer
A
s my title for todays presentation suggests, my talk is oriented
in terms of what psychoanalysts after Lacan offer to the clinic
of addiction In order to define my terms, I refer to the Lacanian
clinic as an instance of analytic action, in which the analytic act is
guided by Lacans return to Freud. The analytic act aims at creating a
space for the subject of the unconscious to emerge. An elucidation of
how speech, language, and knowledge, or savoir, serve as fundamental
reference points in the Lacanian clinic is necessary if we are to approach
the unique problems that appear at the level of speecha speech of the
subjectin the clinic of addiction.
Reviewing the terms in the title, speech concerns the subjects
truth insofar as he or she is a subject of the unconscious, subjected to the
Others jouissance, and to the absent, or missing Other of the address.
Language concerns the field of the unconscious itself as it is defined
by four terms constitutive of the address: the subject of the address, the
Other to whom and through whom the subjects speech passes, the sig-
nifier and its defect, and jouissance, or the excess that is introduced and
inscribed into the very being of the subject, disrupting the logic of the
biological organism. The third term in my title, savoir, concerns the
unconscious knowledge elaborated in the cure under the constraint of
195
the analysts desire-to-know. Such a knowledge concerns the position

of the subject confronted with the death drive, the defect of the signi-
fier, and the absence of the Other of the addressthe absence of any
other capable of silencing and saving the being of the subject from
the work of death drive that sets adrift the speaking being from the
rails of instinct that might assure a way to an object of satisfaction. No
bio-psycho-social model suffices in the Lacanian clinic of addiction
because it neglects what is fundamentally at stakea subject-of-desire,
and a speaking being, forestalled before the phallus in a refusal, or inca-
pacity, to pass through the Other of the address.
Two questions guide my paper today: what does the Lacanian clinic
offer to the addict, or to the clinic of addiction, and what does the addict
offer to psychoanalysis?
The Lacanian clinic of addiction offers the same wager as it does
to the clinic of perversion, psychosis, or neurosis for that matterthe
analysts desire-to-know offers a space for speech to the subject of
language, subjected as they are to the Others jouissance. It thereby
offers a space and time in which a subjects truth, which can only be
half-spoken, emerges in the signifiers the letters of the body select in
response to the Others absence. As for the addict, he or she confronts
us with a specific strategy and savoir for avoiding speech insofar as it
concerns passing through the absent Other of the address. Psychoa-
nalysis supposes a subject where addiction presents itself, while the
mechanism of addiction proposes itself as a defence and a refusal to
submit to the laws of speech and language according to which any
speech must pass through the Other of the address. The addicts
savoir, or what Jacques-Alain Miller refers to as the addicts negative
savoir in his closing remarks to a conference on drug addiction and
its therapies, concerns the status of the Other in our contemporary
societies, and the ruses whereby its lack and absence can be avoided
(Miller, 1989, p. 134).
We must look to the literature of addiction and drugs in order to
orient the stakes of language and the Other in Western industrial soci-
eties with the rise of modernity. If mysticism arises with the advent
of Gods disappearance and absence from the world, a literature of
addiction appears as a kind of parallel universe, oriented likewise
through the Others absence, but with something else at stake. For
mysticism, the Others absence gives rise to speech and poetry that
also evokes an other jouissance introduced into the very being of the
mystic.
SPEECH, LANGUAGE, AND SAVOIR IN THE LACANIAN CLINIC OF ADDICTION 197
The objects cause of desire that fall from this Other, and around
which the drives circulate, mobilize the letters of the body to select
signifiers evoking the jouissance of the Other. And even as speech and
poetry appear, they falter before the ineffable transcendence they evoke
yet fail to capture with the signifier. As Michel de Certeau has argued
in his work on mysticism, the place of this absence becomes a locus of
speech, and its texts define a treatment of the Christian tradition (de
Certeau, 1986, p. 81; emphasis in original).
The title to an inaugural work in the literature of drugs, Baudelaires
Artificial Paradises, is suggestive due to what the modern industrial-
ized state offers its citizens in the wake of Gods disappearance from
the world (Baudelaire, 1966). Although the mystics poetry and speech
evoke the absence of God from the world, resulting in a kind of nega-
tive theology, their work takes into account and thereby treats the effects
of this absence, or lack, on the body constituted out of the letter. The
mystics body is a libidinal field giving testimony to a jouissance beyond
the phallus, for by striving to evoke the excess introduced into their
body by the Others absence from the world, the mystic pursues some-
thing beyond the signifier, or what as psychoanalysts we refer to as the
signifiers lack or defect. But the historical and cultural context in
which the mystics project took place has shifted radically, and in this
void where God had been appear substances, products, and objects of
commerce brought to the marketplace from far away. When they appear
in the marketplace, they are removed from the cultural and habitual
practices that controlled them through ritual, rite, and exchange. It is
precisely because they are no longer controlled by the laws of sym-
bolic practice and exchange whence they came that we refer to drugs as
controlled substancesthey are controlled precisely because they are
removed from the symbolic frame that controls them in their original
social-cultural context. Beyond this control they are substances to be
enjoyed, whether lawfully or not.
As the lead singer to the rock band Janes Addiction declares, there
Aint no wrong now aint no right, only pleasure and pain (Janes
Addiction, 1990). This line, however crude, is evocative in its assertive-
ness and certitude regarding the field opened up with the dawning of
modernity. It therefore orients my consideration of the field we confront
in the question of addiction. It is a field where the void left by Gods
absence from the world is supplanted and supplemented by an array
of experiences offered in the marketplace. Are you experienced? asks
Jimi Hendrix, while the reply I am resonates with a new cartography
(should we say cartesianography?) of being that is oriented by the wares

offered and sampled by consumers of the global marketplace (Hendrix,
1967). If wealth is the property of the wealthy, as Lacan stressed in his
17th seminar, then our ownership society promises each and every
subject of consumption a portion of the soup of jouissance in which we
are all awash with the problematics of the wealthy who Lacan defines
as never having to pay (Lacan, 1991, p. 94). Those who contribute
to the literature of addiction, writers, and poets such as Baudelaire,
Burroughs, Fitzgerald, or the rock band Janes Addiction, testify to an
aesthetics anchored in a relation to the object that supplants the Others
absencean aesthetics evoking their experience of the body on and off
drugs, or a being-on-drugs.
The literature of addiction gives voice to the subject of drugs, but
too often this extra step, which accesses the invocatory drive through
the work of speech and writing, is drowned out by drugs. The French
author Henri Michaux writes in Misrable miracle, that to enjoy a drug
one must enjoy being a subject (Michaux, 2002, p. 7). But what kind
of subject is at stake in this enjoyment? It is important to distinguish
this subject from the subject that psychoanalysis locates as a subject of
desire, subjected to the jouissance of the Other.
If psychoanalysis wishes to consider the problem of addiction as
it presents itself in our contemporary societies, it must begin by con-
sidering the fundamental relationship that subjective truth and savoir
have to the structure of the address and differentiate the addicts
relation to the Other as one in which this address is not risked. The
subjects truth concerns the subjects encounter with the absence
of the Other and the Others jouissance, with his or her relationship
to that death found in the Other, and to the impasses of the sexual
relationship.
The question of the subject as Michaux posits it is suggestive in that
in the place of the subject of psychoanalysis the addict presents society,
the Other, the clinic, and the analyst, with a body, the body of habit
whose time is calculated as a refusal of the uncanny time at stake in the
analytic experience, and in terms of which the analysts cut in the ses-
sion works. Unlike the mystic, or the feminine body, which confronts
us with a jouissance beyond the phallus, the addicts body is posed not
beyond the phallus, but before it. It is glimpsed in what Lacan called
the idiots jouissance, and is articulated by Freud as falling on the side
of masturbatory jouissance when he writes in a letter to Fliess that the
insight has dawned on me that masturbation is the one major habit, the
primary addiction, and it is only as a substitute and replacement for it
that the other addictionsto alcohol, morphine, tobacco, and the like
come into existence (Freud, 1995, p. 287).
The advent of the Other introduces the speaking being into the
dimension of timethe time of expectation and anticipation, and the
possibility that the Other can refuse or abuse the subjects request/
demand. However, the address to the Other concerns a temporality that
is beyond the subjects calculation. This incalculable time is the time of
the Other, and the uncanny incalculable nature of its visitation and rup-
ture breaks into the time repression constructs through the egos dis-
course. The drugged body, or the body of the habit, is given over to the
time of the habita time that defends against the constant and insistent
time of the drive, and the uncanny visitation of the incalculable Other.
Unlike the subject of desire whose question is risked and evoked
in the analytic experience and which bears upon subjective structure,
the addict has no question to address to the Other. The addict replaces
a question and a request whose non-satisfaction is fundamental to the
address, with a quest for a specific object that the Other produces. How-
ever, it is important to separate the mechanism of addiction from the
role that subjective structure plays in the analytic cure. Addiction is a
social symptom rather than a psychoanalytic one. By this, I mean to say
that as a symptom it masks a more fundamental symptom concerning
subjective structureor what is truly for the addict a want-to-be.
Unlike the question upon which Lacan hinged every analysis, the
addicts question is not What do I want from the Other and what does
the Other want from me? Instead, it might be formally stated as Is
the Other holding or not, and what is their price? Or perhaps it could
be put more accurately as Are you holding? given that this question
already supposes an other capable of satisfying the addicts request.
According to such a logic, the other who is holding is not attached to a
semblance of being or not an envelope of the object cause of desire,
but rather functions as a relay for semblance which takes itself as object
(Lacan, 1998, p. 92).
It is not only the Other of the address whose position must be inter-
rogated when we are concerned with the addicts plight. We must also
consider the object. The object at stake in addiction is not the disap-
pearing object cause of desire referred to by Lacanians as the object petit
athe object of fantasy around which the drive circulates, and whose
disappearance and lack constitutes the want-to-be that is the subjects

desire. We say that the drive that erupts and circulates around the object
a passes through the Other, and it is this passage that creates desire. In
the case of the addict, we encounter what Jacques-Alain Miller refers
to an as an object cause of jouissance so that we speak less of the sub-
ject of speech and language, and instead of a subject of jouissance
(Miller, 1989, p. 134). Here the want-to-be is truly wanting, as the addict
chooses being over the uncertain time of the Other and the signifier
whose defect is apparent in that one is always missing from the signify-
ing chain (S S S 1).
Given this impasse in which the subject identifies with the object
cause of jouissance, it is a clinical fact that subjects appear in a variety of
cultural spaces and institutions referring to themselves as addicts. It
is also a fact that referring to themselves in this way is often an impor-
tant step in their recovery. They appear here and there according to a
variety of motiveson their own volition, because the courts sent them,
to appease a loved ones demand that they get help, etc. Given this fact,
I want to return to a question I rose earlier and that bears upon the
direction of the treatment in the clinic of addiction when psychoanaly-
sis is at stake: what does psychoanalysis have to offer the addict, and
more specifically, what does the analyst have to offer the addict? I could
have put this otherwise, and removed the have to read something
like, What does analysis offer, or the analyst offer? This would be
better spoken, and more parsimonious, but for the moment I want to
consider this question of having because it is at stake in the demand
the addict makes upon the Other of the address.
Is the analytic Other (the absent Other) holding anything for the
addict? Or isnt the analysts desire sustaining the place of one Other
who is holding out on the addict as the analyst empties the place
of the Other of the address and supports that place with a desire for
the savoir that is on the side of the subject? Put differently, what hap-
pens when the addicts demand for a fix from the Other encounters a
desire-to-know rather than a rush to answer their demand?
Analysis offers a place and time to speak about the work of the death
drive, and about the habit as defence against this work, as well as its fail-
ure to place a limit upon the excess. It offers the subject a place to construct
a savoir regarding their relation to the Other, its absence and defect, to
jouissance, the symptom, and to the relationship the symptom has to the
real of sex, which can only be approached through fantasy. In the session,
the analysand encounters an other scene and an other time than the
time of habit. Linked as it is to an economy of need, the time of the habit
leaves little room for uncertainty or doubt. The addict knows what they
need and when they need it, but this is the negative savoir or negative
knowledge Miller speaks of in addiction (Miller, 1989, p. 134). It negates
a savoir on the Others absence by substituting and short-circuiting the
axis of the address with a demand for substance rather than a demand
for love. On the other hand, the time of the Other in the analytic act of
the transference is untimely, incalculable, and unpredictable. The subject
cannot speak of what will happen there ahead of time.
Our first impasse in the question of addiction concerns how to
approach the addicts defence against this passage into the uncertain
time of the Other. Be it through a fundamental protest, refusal, defense,
repression, disavowal, or foreclosure, the drugged body offers itself
in the place of the subject. Considering an analytic stance towards the
addict, Jacques-Alain Miller suggests that in the end, it would be nec-
essary that the analyst be a dealer of the drug of speech (Miller, 1989,
p. 134). Accordingly, the addicts demand for a substance that settles
and subdues the excess ravaging their being receives signifiers instead
of drugs.
Millers is a compelling metaphor, but it should be added that words
do not function like drugs in the analytic cure. In fact, it is in the analytic
cure that the subject confronts repeatedly the signifiers failure to ade-
quately silence the anguish of the work of the excess in the body that is
itself an effect of language. The analytic act must aim at making a place
for this other body (the real of the body, and the body of the drives) to
speak even as the self-identified addict is on or off drugs. By emptying
the place of the Other of demand, and by supporting the place of the
Others absence, the analysts desire sustains a space where the real
of the body might speak as the letters of the body choose signifiers to
evoke the excessthis will be the direction of the treatment.
If the addict is to enter into analysis, they will be confronted with the
challenge of making a body out of language. In welcoming the addict,
the analytic clinic must attend to the ways in which the excess carves a
body out of the living organism that is dis-organ-ized by the introduc-
tion of language into the living system. It must be aware of the ways in
which the body created by the habit seeks to silence an anguish that is
suffered and sustained by the subjects subjection to the stakes of lan-
guage, to the reality of sex, the drive, and to the absence of any Other
capable of offering a fix. It returns the analysand to the fundamental

axis of the address where risking speech, and an address, necessarily
leads the subject to confront the inconsistency of their social being as
the habit is kicked and the object cause of jouissance is mourned.
Directing a treatment: a vignette

I want to turn now to a vignette from a treatment I conducted with a
man on methadone maintenance. Some years before I began working
with this man, I had had an internship in a methadone clinic where
I had the opportunity to provide therapeutic services. As I began
working with the opioid dependent clients who used the clinic where
I then worked, I was confronted with questions regarding the effects
my action would have in its relationship to the overall treatment team
and approach. I knew that my position differed from the nursing staff,
the medical director, acupuncturist, and others who worked there, and
that unlike those other treatment providers, the room in which I held
my sessions was a space where those on my caseload could speak,
and my action would be directed towards sustaining the presence of
an absent Other (the Other of the address) in order to problematize
the presence of an object we provided our clientsthe dose. The fact
that the clinic offered and had the power to withhold something from
someone, created a specific nexus in which need and demand were
clearly in play. However, what of desire, given that an ontic object,
the dose, was given or withheld according to whether or not the client
could satisfy minimal behavioural criteria that included not looking
intoxicated, and not becoming disruptive while waiting in line for a
dose? This question guided my action while I worked there. Guided
by this question, I presented each subject with the possibility of risking
an address while they chose to wean themselves from or maintain a
dose that it was up to them to inform our medical doctor was holding
them or not.
The collegue who referred M to me was aware of my experience
working in that prior setting. When he came to his first session, M. com-
plained of suffering neck pains. He immediately told me he wanted to
raise his dose to what he referred to as his ideal dose.
It had taken him an hour from the methadone clinic to my office. For
the four days before the intial consultation, he stayed in, and was iso-
lated at, home. Having recently broken up with his long-term girlfriend
with whom he had lived for ten years, he had not talked to her since a
recent get-together with friends.
He complained he and his ex were growing apart. He felt sad that
she seemed happy in her new life without him and that she no longer
called. When she did call, it was only to ask him to return the keys to
her condominium because she was worried he might walk in on her
unannounced. He explained how they had fought at the get-together
and that it was after their fight she asked for her keys.
Do you remember your dreams? I asked. M said that he did, and
that he had had one just last night. He spoke the dream whose contents
I restated by selecting four words and closing, or cutting the session on
those four words.
M. left his keys on the table next to his chair. Befuddled, he returned
minutes later to pick them up.
M begins the second session with the words, The pain is still there.
The pain had all started at the get-together, he said, when an older lady
started talking to him, and he thought that she was being vaguely sex-
ual. He had thought to himself, Get this lady off of me. He went on to
talk about his girlfriends sexual advances towards him at the party
advances he thought were artificial because she was drunk. Because she
was intoxicated, he had had to take her back to her home, and found
himself being her caretaker just as he had been his mums. Now he was
angry at her because she had run out on him so she could have her own
place and drink. She had chosen alcohol over him, and now he was
angry and depressed.
I asked about the keys he left in my office, or his bungled action in
our initial session. M. said he did not know what to say to that.
M. went on to associate to his life at home with his mother who drank
heavily at home behind closed doors.
A letter is at stake: the neck

I selected these two opening sessions in order to isolate a letter of M.s
body that emerges in the initial session to function as the hinge between
what Miller calls the addicts non-savoir, and the savoir that will be
elaborated in an analytic treatment. This letter, the neck, is what
M. knows how to treat with his request/demand for an increased dose
of methadone. However, already in session two, the letter articulates
itself in a demand for cure, get this lady off of me, whose signification
will arrive later in the treatment as M elaborates the death drive he

encountered in his mother, or what in psychaoanalysis we refer to
as the originary fantasy. The originary fantasy concerns the subjects
encounter with the jouissance of the Other, or the subjects experience
as subjected to the capricious and limitless demand of an Other that
threatens to erase, obliterate, or kill the human being. At the level of
fantasy, it was this same encounter with the death drive in his mother
that M. imagines led to his fathers death, or killed his father.
The question in the first session concerns his ex-girlfriend and the
keys to her condominium. With his bungled action, M. momentarily
leaves his keys with the analyst and his unconscious thereby makes its
entrance into the treatment. At the time, I took this bungled action as
an invitation, or as an opening for speech, and for a specific hearing. By
leaving the keys, was he at once refusing to return them to his girlfriend
and depositing them with the analyst so that he could continue to walk
in on her, or was he offering them to the analyst who wanted to know
what was behind the door while M. spoke of his position in relation
to the closing door of his girlfiends home and the room in which his
mother drank herself into a stupor? As the treatment progressed, my
desire-to-know supported Ms ability to speak about what he encoun-
tered in his mothers neck pain (the frequent object of her complaint),
and in the room where his ex-girlfriend chooses alcohol, or another
man, over M.
Later on in the treatment, an altercation with a stranger in the
supermarket triggered what M. referred to as a nightmare that
prompted a recollection of being molested as a teenager by an older
man. The man had begun the molest by rubbing, and then choking him
by, the neck.
This time the letter, the neck, selects signifiers that treat a trauma, the
molest that M. says made him question his sexuality in the year
that followed. However, as a letter, it is also captured in a symptom,
asthma, which has a logic in the subjective history of trauma that is
M.s. M.s initial question concerns why he chooses this kind of woman
(his girlfriend) where he sees a death drive at work in the body, and the
originary fantasy might be formally expressed, or given what Freud
called its symptomatic sense(Freud, 19161917) in the following
phrase which serves as a formulation of the fantasy: When she was
around it was as difficult to breathe as when that guy waschoking me
by the neck.
By the end of this treatment, M. had tapered his dose to a much

lower one and continued to work on the question of his relationship to
death drive in the woman, and to his discovery of its effects in the body
of his father. M. returned to work in a way he found satisfying, and he
had negotiated a more satisfactory relationship with his ex-girlfriend;
he tried to no longer rely on her for financial support because, as he put
it, its become clear to me that nothing is for free.
I offer this vignette as an example of one experience conducted
within the context of a specific modality to the treatment of addiction.
What strikes me now is the way in which this modality is at once sug-
gestive given the problematics of the case (M. seems to be weaning
himself from the mothers penis concurrently with his weaning from
methadone), and outside of the stakes of speech, language, and savoir
that are in play in the treatment itself. There is a difference between the
modality of treatment in this specific clinic of addiction, and analytic
treatment itself. While on methadone, M.s unconscious finds a space
for speech, and a strategy for articulating the letters of the body the
drive mobilizes and opiate addiction strives to manage. The question of
the body off drugs is itself a topic that deserves attention, because what-
ever savoir M. discovers in his articulation of letter to signifier, will be
challenged by the experience of the body off methadone if he chose to
taper off completely.
As Lacanians, I suggest we stubbornly maintain a position of want-
ing-to-know what it is we face in the field of the addictions, and this
especially when it comes to the modalities of treatment, be they absti-
nence-based, harm reduction, opioid replacement, or the now popular
stages of change modality proposed by James Prochaska and Carlo
DiClemente (DiClemente, Nocross, and Prochaska, 1995). The analytic
act is not a modality, but rather an ethical stance and response in the
face of the demand that creates the conditions for the appearance of
the subject of speech. The importance of such an act cannot be under-
estimated today for as Eric Laurent argues, what we encounter in the
drug object is the fact that the object is a semblance and that the true
object of jouissance is death (Laurent, 1998, p. 138).
I have suggested that this object is itself related to two bodieson
the one hand, there is the body of the habit, while, on the other, analytic
experience confronts us with the body as it is carved out by language
and invested with the excess, or jouissance, that language introduces
into the logic of the organism, littered as it is with the letter. If the body
of the habit is a refusal or a way of handling and managing this excess,

in what is a not-at-all in the phallic field, then we must be aware that
it is this place that will require articulation in speech in order to create
a symbolic space and time in which the subject can live with the Other
and its body, and with others in their alterity. The analyst will confront
this non-savoir that knows how to manage with drugs with a desire-
to-know that offers the subject a space and a time for speech, and the
elaboration of a savoir.
Ultimately, we cannot ask or expect society to make a space for psy-
choanalysis, nor can we expect current modalities of treatment to do
so. We are in this sense faced with the same situation that Freud was
at the time of the invention of psychoanalysis: how to make a way for
the subject? This is the question that Freud faced with the hysteric, that
troubling patient whom medical science could not help or cure. It is
the question Lacan challenges us with as we return with him to Freud
to confront the clinical challenges that are ours today as each subject
arrives with a singular savoir.
References
Baudelaire, C. (1966). Les Paradis artificiels. Paris: Garnier-Flammarion.
de Certeau, M. (1986). Mystic speech. In: Heterologies: Discourse on the Other
(pp. 80100) Minneapolis: University of Minneapolis Press.
Diclemente, C., Norcross, J. & Prochaska, J. (1995). Changing for Good. New
York: Avon Books.
Freud, S. (19161917). Introductory Lectures on Psycho-Analysis, Lecture
XVII, The Sense of Symptoms. S.E. 16,. London: Hogarth.
Freud, S. (1995). The Complete Letters of Sigmund Freud to Wilhelm Fliess,
18871904. Cambridge: Harvard University Press.
Janes Addiction. (1990). Aint No Right. Ritual de lo Habitual [CD].
Warner Bros.
Jimi Hendrix. (1967). Are You Experienced? Are You Experienced [CD].
Reprise Records.
Lacan, J. (1991). Le Sminaire, livre XVII, Lenvers de la psychanalyse. Paris:
ditions du Seuil.
Lacan, J. (1998). The Seminar of Jacques Lacan, Book XX, Encore. (Trans. and
with notes by B. Fink.) New York: W. W. Norton.
Michaux, H. (2002). Miserable Miracle. Mescaline. New York: New York
Review Books.
Miller, J-A. (1989). Clture. Le toxicomanie et ses thrapeutes. Paris:
Navarin diteur.
CHAPTER SEVENTEEN
Response to Christopher Meyer

Kareen Malone
I
am so delighted that Christopher Meyer has contributed to this
volume. In years past, he and I have worked together as partici-
pants in the seminars led by GIFRIC (Groupe Interdisciplinaire freud-
ien de resserches et dinterventions cliniques et culturelles), the group led
by Willy Apollon, Danielle Bergeron, and Lucie Cantin and known
for their work with psychotics. There are traces of GRIFICs work in
Christophers wide-ranging and excellent paper. The paper presents a
portion of a case, addresses the ethics of the clinic in relation to addiction,
and interrogates the place of addiction in terms of its social operation
within a cultural moment. Christopher refers to this cultural moment
as spanning the dawning of modernity and entailing a relationship
to jouissance in which one, as one of the wealthy or pretend wealthy,
do not pay for it (Lacan, 2007, p. 84). Capitalist discourse is organized
so that there is a separateness of each subject in relation to the social
link but sameness, where the subject as a divided subject presents its
symptom which is then mollified by drugs or through a scientific nor-
mative discourse. There is idiot jouissance, suggested by the contempo-
rary passion for (displayed) privacy coupled with consumption as the
foundation of the social link (J(O)). Keep buying as President Bush
said to worried Americans following September 11. The alterity and
207
difference that is both sustained and made possible by the social link
seems usurped by private pleasures and normative mandates. In capi-
talist discourse S1 is the place of truth, suggesting that we might think
about how this identity is forged or fixed. In other chapters in this vol-
ume the evocation of the term holophrase and discussions of inscrip-
tion and the letter turn us to the fetish-like petrification of identity, kept
away from the pull of the signifier through drugs and goods. Certainly
addiction turns us to these thoughts.
As well, Christophers essay speaks of the aesthetics of addiction, its
intimacy with other positions such as the mystical in its relationship to
the death drive, and what he calls the absent other, the position he
evokes also for the process of analysis. If the mystical response to the
absent Other may create poetry, although I am not sure that it always
does, the addict offers, instead of evocation, a covering over, a mask-
ing by medication. Still, Christopher recognizes the place of aesthetics
in drug addiction; it is a close call with many authors in the romantic
tradition and with even those who make their fiction out of addiction.
He refers in this to reflections on the negative theology of the mystics
and similarly refers to the addicts addiction as a savoir, a negative
savoir and as a strategy. Here a question emerged for me about the tie
between this negative theology and the negative savoir of the addict.
How does this tie work in your essay, a link between this aesthetics of
the drug and the erasure of the signifier through being drugged? I think
that regarding this question, there is another, related to a clarification.
There is a distinction that works well in your essay, between the addict
as being before the phallus and the mystic as being beyond the phal-
lus. But I am interested in how this before is meant, as structurally
antecedent or more in terms of ones being before the law. Articulating
this before is important to articulating the relation of the phallic posi-
tion to non-phallic positions, maybe mystics or perhaps cheaters on an
inverse scale of the law of desire. I am not sure. Lacans quotation
on the law of desire is preceded by his observations on these strategies
towards jouissance:
Anyone who really wants to come to terms with this Other has
open to him [sic] the path of experiencing not the Others demand,
but its will. And there to either realize himself as an object, turning
himself into the mummy of some Buddhist initiation, or satisfy the
will to castrate himself in the Other, which leads to the supreme
R E S P O N S E TO C H R I S TO P H E R M E Y E R 209
narcissism of the Lost Cause (the latter being the path of Greek
tragedy, which Claudel rediscovers in a Christianity of despair).
(Lacan, 1960, p. 311)
Although we are always dealing with an ethics of speaking in the clinic

which usually implicates a phallic denominator, changes in concepts
as well as changes in culture (such as pluralization of the Name-of-
the-Father) may implicate how we understand a subjects strategies
towards the Others will.
The case vignette of M unfolds around questions that are raised in
Christophers earlier observations about the position of the Other as the
Other of the address and matters of the letter in relationship to what he
calls the absent Other. Perhaps all neurotics at least want a fix from the
Other or to be fixed (petrified, the wager pre-determined, neutered, cas-
trated, cured). Thus there is an abstinence to which Christopher refers
which marks the ethics of psychoanalysis in a general way. The ques-
tion of setting of a certain structure, a point of address, which aims to
evoke a savoir by emptying out the place of the Other is general. In this
case, or the case of addiction, this positioning aims to offset the ways
in which the habit works against an encounter with the alterity of the
Other as a locus of uncertain time and knowledge. The speaker sug-
gests that analysis aims at making another place for the real of the body,
as letters of the body open the analysis to its work of speech that aims
to an ethical assumption of the anguish and difficulty of our singularity
in the face of symbolic castration.
The case hinges on Ms back. The patient asks for a drug to sooth
his backan ideal doseand then leaves his keys in Christophers
office, a gesture that indicates, perhaps, a lack, a desire; it is certainly an
instance of a bungled action. The two parallel paths in the treatment are
tied through the signifier/letter back and the many layers of signi-
fiers, associations, and memories that emerge in relation to Ms back.
The articulation of these letters of the body to signifiers and a history
dislodge the drug as a sort of semblance with its ideal dose (although
methadone is an instrument of jouissance and works as a real object)
and make place for an articulation of Ms relation to the jouissance of the
Other, his relation to limit, and his fantasy as that emerges in the history
with his mother, with his wife, and with an older man. A lineage here is
established through the elaboration of back and back pain, which ties it
to his drug use. It enters into the signifying chain through the subjects
history, the evocation of an ideal, and the economy of jouissance (and of
sexuality).
I would like to hear Christophers further thoughts as to how back
functions as letter or a letter of the body; the letter being thought of as
the material part of the signifier, a formalization of speech, and that
around which the body coalesces as a repetition or mark of difference
itself. Also I must ask how the parallel universes intersect: between the
changes in dosing (the body of the habit) and the increasing desire for
speech. For it seems that the case brings the two together well. But it is
still of interest to me how one may think of conjoining the analytic act
where subjective truth is evoked with the regimen of dosing where the
Other has a fix and where the subjective strategy indicates quite pre-
cisely anyones difficulty of that encounter with a traumatic jouissance
as it is transformed into a subjective assumption of one speaking.
References
Lacan, J. (2006a). The subversion of the subject and the dialectic of desire,
1960. In: crits: The First Complete Edition in English (pp. 671702). Trans.
B. Fink in collaboration with H. Fink and R. Grigg. New York: W. W.
Norton.
Lacan, J. (2006b). The Seminar, Book XVII, The Other Side of Psychoanalysis,
19691970, text established by J.-A. Miller, R. Grigg (trans.), New York:
W. W. Norton.
AFTERWORD
The contribution of addictions

to the ethics of psychoanalysis
Thomas Svolos
Towards the end of the Conference of the Affiliated Psychoanalytic

Workgroups on the theme of Addictions, Dany Nobus asked a ques-
tion regarding the ethics of the practice of psychoanalysis relative to
analysands with addictions. This question did not get addressed or dis-
cussed to the extent that it deserved, and I think it is a very important
one worth serious consideration.
We may certainly read this question in one way, as a question of how
we ought to proceed with patients with addictions, a question of our
obligations with such patients. I do not wish to pursue such a deon-
tological perspective, however, but wish to tackle this question from a
different perspective, namely, one in which we may examine the effect
of our encounters with analysands with addictions on psychoanalysis
and its ethics.
Regarding the very issue of ethics, I would here reduce ethics to a
very simple and well-known Lacanian propositionto be well-spoken.
In other words, we identify the ethical position in our practice in our
speech, in the manner in which we engage analysands with speech.
I would further add that if the question of ethics is one of the ethics
of psychoanalysis, we can be more precise and add that it is a ques-
tion of the relationship between our speech and the possibility of the
211
212 AFTERWORD
formation of a social bond between us and our analysands in the form

of the Discourse of the Analyst. The psychoanalytic ethic is thus linked
precisely to the Discourse of the Analyst, as a form of speech on our part
to be inscribed within such a discourse. For psychoanalysis and ethics,
it is thus not only to be well-spoken, but to be well-spoken within a cer-
tain discoursenot, say, to be well-spoken within the Discourse of the
Master, or Hysteric, or University.
Now, of course, we may speak in other ways and with other goals
in mind, such as perhaps in cases where we intervene to preserve the
safety of an analysand. Such interventions may be very important, but
they are not specifically psychoanalytic in their formulation.
With regard to this issue of speech, the practice in the Lacanian orien-
tation has been historically marked by two special modes of engagement.
The first is scansion, the cut of the session, the interruption of the flow
of speech of an analysis. This point was of course of such importance to
Lacanwe might even say an ethical position he held to so strongly
that the International Psychological Association (IPA) excommunicated
him from his position of training psychoanalyst because of it.
The second feature of the Lacanian practice of speech is the oracular
interpretation, less controversial, but no less important to Lacan. The
words of the psychoanalyst do not deliver a meaning, but are an act
that may have effects of meaning, depending on how the analysand
incorporates them into their discourse.
I would suggest that these forms of speechscansion and
interpretationcan, when used adroitly, be understood as ethical,
when well-spoken, in the Discourse of the Analyst.
In our encounters with analysands with some forms of addictions,
in particular with the New Symptom in any of its phenomenological
forms, however, these forms of analytic speech are often inadequate
in the establishment and maintenance of the Discourse of the Analyst.
Now, of course, for the patient with psychosis this is not an issue, in
some ways, as we are not in such cases seeking to establish such a social
bond, such a form of Discourse, but with the neurotic subject, it is a dif-
ferent matter.
In discussion of matters such as nomination, splicing, or any of the
other forms in which we work in our interventions with analysands
with the New Symptoms, then, I think it is important to put these inter-
ventions into this context of a situation where interpretation and scan-
sion do not work, in which these forms of the speech of the analyst fail
AFTERWORD 213
to bring about or to sustain the Discourse of the Analyst. Nomination

and splicing are, in this context, new forms of speech, new forms of
interventions on the part of the analyst, brought into play to bring about
the Discourse of the Analyst.
And, put into this context, I would say that they represent a form of a
new ethical responsea new form of being well-spokenthat we have
learned from our analysands with the New Symptoms. Our analysands
are, in this sense, our teachers, in that we are forced now to improvise
some new forms of speech in response to the exigencies of the cases
today. This is nothing new: in encountering different analysands in the
1920s, Freud himself modified his technique in the face of failures of
the masterful interpretations that defined his earliest cases. And it is in
this context that our patients with the New Symptoms are contribut-
ing to a new ethics of psychoanalysis, to new forms of the well-spoken
intervention.
Let me add, finally, that this is not a matter of applying new theories
to our cases, but rather one in which our work with analysands forces
us to re-evaluate the very ways in which we theorize our workfrom
diagnosis; to psychic structure; to the formations and relations of the
imaginary, symbolic, and real; and to the ways in which we intervene
in treatment.
INDEX
A.C.O.A. (Adult Children of floodgate mechanism 17

Alcoholics) 163 formula for 5
addictification 3, 8 Freuds confrontation 1
ADHD (Attention Deficit from malaise to 7778
Hyperactivity Disorder) 61, 64, 67 in therapeutic clinic 5960
addiction 165, 189194 interpretation and effect of
administration of the subject modern symptom 3033
1218 introducing new symptoms
analytic therapy 62 7587
and drive 131144 leverage of letter in emergence
as prior to neurosis 163 of desire 145161
case 145161 love/sublimation 47
conceptualize within masturbation 5
psychoanalytic framework 163 modern symptoms and the
Conference of the Affiliated function of interpretation
Psychoanalytic Workgroups 211 2830
contribution to ethics of Neurotic-Existential Given 165
psychoanalysis 211213 Oedipal nature of 166
diagnostic non-specificity of 173 phallic desire 175
disease 59 pleasures of 111117
dual diagnosis problems 7 psychoanalysis 120123
214
INDEX 215
psychopathy 122 of 179

resuscitating the symbolic antisocial personality disorder 122
166168 anxiety 32, 177185
Samanthas case 149159 response 187188
temptations of 146149 anxiety neurosis 14
to shopping 79 anxiety-provoking quality 63
two people in a room 111117 Apollon, Willy 207
administration 1, 45, 16, 1922, 26, A Portrait of an Artist as a Young Man
124, 146 2122
discourse of capitalism 27
in historical perspective 2528 Baldwin, Yael Goldman 39
jouissance 32 Baudelaires Artificial Paradises 197
of the subject 1218 behavioural disorders 163
predominance of 27 Bergeron, Danielle 207
administrative machinery 2527 Bernstein 23
Affiliated Psychoanalytic big bloody nose 6870
Workgroups (APW) 39, 211 binary roles 112
Aguirre, Maria-Cristina 177, 187188 bio-psycho-social model 196
AIDS (Acquired Immune Deficiency Braunstein, Nestor 104105, 147
Syndrome) 192 Brodts, Mondel 107
alcohol 35, 1016, 26, 29, 4547, Brousse, Marie-Helene 27, 83, 86, 161
5556, 64, 75, 7879, 8183, 8587, Buenos Aires 39, 46
90, 92, 119, 121, 123, 128129, 148, bulimia 181
151, 164, 199, 203204 anxiety 177185
alcoholics anonymous 81, 83, 8687, between phobia and addiction
9092, 171173 93108
functions 172 Naveaus case, Celia 181
alcoholism 40, 77 real of jouissance 181
alienation 9495, 97, 100105, response 187188
107108, 127, 170, 183 Bush, George 77
Allen, Woody 90
allo-erotic Phallus 76 cannabis 4
American Heritage College Dictionary Cantin, Lucie 207
122 Carlos 128129
American Psychiatric Association Carter, Jimmy, (President) 77
123124, 164 castration and desire 103
A Modest Proposal 69 cause-and-effect relationship 1011, 19
analysands 14, 29, 31, 81, 87, 9394, 96, Certeau, Michel de 197
104, 211213 chemical imbalance 6168
analysts desire-to-know 196 child(m)other interactions 24
Andrea 177178, 188 Civilization and its Discontents 9, 40,
anorexia-bulimia, distinctive trait 4546, 80, 124
216 INDEX
cocaine 14, 1011, 45, 5152, 54, 64, Dor, Joel 126
6869, 74, 115, 119, 164, 192 drug a-diction 105
cocktail of anti-anxiety drugs 29 Drug and Alcohol (D&A)
colour of emptiness 131144 programme 119120
Phil 131140 drugs, new uses 3956
Community Epidemiology Work DSM (Diagnostic and Statistical
Group 192 Manual of Mental Disorders) 78
Community Mental Health 119 dual diagnosis 12, 710, 1213, 119,
co-morbidity 910 164
complete orgasmic sensation 50 positive aspect of 13
condancation 24 problem of 912
Conference of the Affiliated
Psychoanalytic Workgroups 211 eating disorders 8, 27, 30, 93, 96, 99,
Confessions of an English Opium 101, 179
Eater 10 Esteban L. 55
constant provocation of the law 125 ethnographers 111117
Constantine Constantius 165 European Monitoring Centre for
Contemporary Symptoms in the Drugs and Drug Addiction 9
Lacanian literature 78 Ey, Henri, psychopath 121
co-occurring disorders 119
Crack Pipe as Pimp 111 fall of authority and ideals 43
feminine masquerade 190
Dedalus, Simon 19, 22 ferocious/amorous behaviour 148
demand of other 177185 Fetishism 139
response 187188 feudalism 26
De Quincey, T. 116 Fink, B. 7274, 103, 108
desire makes us desirable Fleck, Alexine 111
171173 Fleiss, Wilhelm 75
detoxification programmes 128 Flor, Rolf 59
Diagnostic and Statistical Manual of brief comments on case
Mental Disorders, Fourth Edition presentation 7374
(DSM-IV) 123, 164, 179 case presentation 5971
DiClemente, Carlo 205 Fliessian character to case 73
Discontent in Civilization 6 freak room 11112, 114, 116117
discourse Freud, S. 1, 6, 72, 75, 77, 132, 139,
of analyst 8385, 87, 212213 164
of capitalist 8183 actual neurosis 14
of hysteric 83 addiction 165
of marginalization 146 breaking formation 51
discourse of master 8, 8185, 87, 212 castration anxiety 14
discourse of capitalist 8183 Civilization and its Discontents
Domenico Cosenza 81 9, 4546, 80, 124
INDEX 217
Dora 98 hallucinogenics 4
Dostoyevsky 127 Hegelian sense 83
every neurotic is also a kind of helplessness 14, 100, 108, 183
junkie 164 Hendrix, Jimi 197
first diagnostic distinction 2 heroin 4, 45, 55, 71, 9091, 119, 150,
helplessness 100 155, 161, 192
in Group Psychology and the Herr K. 98
Analysis of the Ego 80 History of Drugs 40
Inhibition, Symptom, and HIV (human immunodeficiency
Anxiety 98 virus) 115
Jokes and Their Relation to the human psyche 2
Unconscious 6 Hypermodern Times 7
Little Hans 4749, 55, 7677, hypermodernity 43, 55
102, 104
narcotic usage 47 imaginary nomination 32
notion of actual neuroses 28 Inciardi, James 111115
problem of addiction 121 description precludes 112
psychoanalysis into this Victorian gaze 112
period 26 use of the passive voice 112
symptom formation 51 Women and Crack-Cocaine 115
symptoms for epinosic and instantaneous separation 134
paranosic gains 165 International Psychological
The Interpretation of Dreams 81 Association (IPA) 212
Totem and Taboo 41 International TyA network 39
totemic party 41 intersubjectivity 102
Trieb and the Psychoanalysts
Desire 131 Jameson, Fred 84
trinity of inhibition 32 cultural turn 193
trouble-free identity 9 Janes Addiction 197
Zwangsneurose 66 Jones, Ernest 100
Freudian formulation 83 jouissance 56, 8, 1314, 1620, 22,
Freudian sense 28 2428, 34, 41, 5051, 74, 104,
Freudian symptom 18, 30 122123, 126129, 140, 142143,
Oedipal symptom 18 148, 181
administrating 32
generalized toxicomania 6, 46 administration of 146
Gherovici, Patricia 93 administrative relationship
GIFRIC (Groupe Interdisciplinaire to 33
freudien de resserches et angle of 180
dinterventions cliniques et certainty of 99
culturelles) 207 clandestine 42
globalization 7, 43, 193 colour of emptiness 131
218 INDEX
crisis 133 Kierkegaard, repetition in 163175

darkness of 143 Kierkegaardian universal 168
distillation of 85, 91 discussion of repetition 167
down-and-dirty 160 resonance with 165
economy of subject 32 story about addiction 166
effect of the pathology 31 Universal and Lacans notion of
effects and repetition 149 the symbolic order 167
election of 192 young man 167168, 171174
functioning of 87 Klein, Melanie
game of 146 case of Little Dick 32
idiots 198, 207 kleptomania 124
invasions of 52 Klurfan, Gustavo 119
know-how of knowledge with knows nos nose 5971
29 Kruszel, Liliana 189, 192
limit 32
masturbatory 198 Lacan, J. 2, 4748, 72, 75, 77, 84, 97,
modes of 134 160, 187
mothers 106 alienation 100
Name-of-the-Father regulation 31 description of the effect of
object cause of 200202 Oedipalization 167
of death drive 179 diagnostic recommendation 122
of symptom 120 discourse of capitalism 27
Others 195198, 204 eating disorders 99
overabundance of 30 interpretation of Joyce 19
phallic 74, 147, 190 problem of addiction 121
place of 147 psychopath 121
self-administration of 147 relation to the transference 153
speech and feminine 183 repetition in 163175
unbearable invasion of 5253 return to Freud 195
jouissance-effect producing external seminar on Joyce 24
solutions 25 Seminar X 14, 153
Joyce, James 18 Seminar XI, The Four
administration 18 Fundamental Concepts of
case the fabric 23 Psychoanalysis 100
emotional writing 20 Seminar XVII 1920
Finnegans Wake 20 Seminar XX 25
neologism lelangue 20 Seminar XX Encore 192
sinthome 21 Seminar XXIII 32
subject-of-Joyce-specific-effect Seminar XXIII 86
20 Seminar XXIV 31
Joyce-specific-effects of alcohol 25 Subversion of the Subject 107
JUNTADITO 44 symbolic phallus 76
INDEX 219
the bachelor 50 maniac euphoria 54

The Non-Dupes Err/ The Names of manic sexuality 54
the Father 4 Manuel 124, 127
the phallus 171 Mariano H. 55
zone of acting out 97 masochistic fantasies 141
Lacanian master signifier 161
angle 170 masturbation 6, 7576, 121, 199
Compass 43 and addiction 5, 47, 65
concept of superego 191 maternal cannibalism 96
literature on addiction 145 Melman, Charles 147
neurosis 165 methadone 3
orientation 212 methylphenidate 68
perversion 165 Meyer, Christopher 195
practice of speech 212 response to 207210
psychoanalysis 165167 Michaux, Henri 198
real 168 Miller, J.-A. 19, 21, 44, 50, 79, 8283,
sinthome 108 183184, 196, 201, 203
version of anorexia 178 compelling metaphor 201
Lacanian clinic of addiction jouissance 51
195196 Seminar X 76
directing a treatment 202203 Miller, Michael 163
speech, language, and savoir in modern symptoms 1, 14, 1819
195206 function of interpretation 2830
Lalangue 18, 2122 interpretation and effect of 3033
Laurent, Eric 43, 51, 79, 205 monomania 5152
break formation 51 clinical indication of 51
Laurita, Cristina 131 multinational capital 84
Law of desire 107
libidinal satisfaction 15 Name-of-the-Father 16, 18, 2022, 31,
Linda 94, 99 4446, 76, 78, 80, 8286, 90, 96,
bulimia 105 103, 125, 128, 140, 143144, 190
phobic features 103 falters 103
staying empty 99 in social structure 78
Lipovetsky, Gilles 7 pluralization of 80
longing, phallic nature of Naparstek, Fabin 6, 12, 3940, 42,
171173 7879, 89, 146147
Loose, Rik 1, 147 National Institute of Health 192
Lopez, Maria J. 187 Naveau, Pierre
lost objects 163175 case, Celia 181182
case, Jennifer 183
Malone, Kareen 39, 207 Celias structure 188
managed care system 119 thesis 182
220 INDEX
negative knowledge 201 artistic productions 143

negative savoir 201 childhood anxiety 140
neologism 52 preoccupation 143
neuro-psychoses of defence 21 relationship 137139
neuroses 2, 13, 1819, 28, 164165, 174 phallic
toxicomania-orientation 46 element 173
neurotic symptom, structure 164 function 107
new symptom 7587 incompleteness 172173
addictive substances to 82 jouissance 50
comments on 89 natures of addiction 173
discourse of the analyst 8385 stance 173
discourse of the master 8183 phobia and addiction 93108
horizontal identifications 81 pill (science) 54
new sinthomes 7981 pleasure-producing activities 5
not every addiction 7879 political mobilization 116
politics of 82 postmodernism 78
rectification 8587 Power, Arthur 20
to fetishistic attachment 82 pre-scientific moralism 59
Nobus, D. 72, 211 primordial organism 17
non-dupes 4 Prochaska, James 205
numb moment 52 pseudo-nomination 81
psychiatric nomenclature 121
obsessional neurotic 128 psychiatric symptoms 10
Oedipal fantasy 169 psychiatry 2, 13, 51, 62, 77, 123
Oedipalization 167 diagnosis in 77
Oedipus the King and Totem and Taboo psychopharmacology in 13
125 psychic processing 14, 17, 20
orthophonistes 178 psychoanalysis 12, 56, 196
Other encounters 200 ethics of 211213
Other of the address 200 future of 184
Others absence 200201 into Victorian period 26
theoretical formulations of 145
paradox of addiction 116 psychoanalytic
parentchild relationship 138 cure 120
penis starts moving 48 discourse 83
performance-enhancing drugs 78 interpretation 84
perversion 122123 practice 28
Lacanian psychoanalytic praxis 161
perspective 121 treatment 91
Phil 131144 psychological
addictions and drive satisfactions classical symptoms 164
143 disturbances 8
anxiety and drug 143 psychoneuroses 2, 164
INDEX 221
psychopathology 2, 26 sexual
and addiction 10 desires 55
conceptual mapping of 60 dysfunctions 54
psychic structure 78 favours 112
psychosis 28, 92, 130 identity and our times 189194
break formation 53 intercourses 53, 55
diagnosis of 51 jouissance 50
toxicomanias in 5053 other 50
psychosomatic disorders 97 relation exists 119130
psychosomatic illnesses 97 sexuality 27, 45, 5255, 70, 7679, 86,
psychotherapy 114115, 160, 192, 194, 204, 210
course of 174 or drugs 115
history of 150 without dysfunctions 54
pushing-to-jouissance 43, 45 sexuation in Seminar XX 86
pyromania 124 sexuation, formulas of 106
Shannon and the Law 160
Rajtman, Marta 54 Shannons patient 148
real jouissance 49 silence of death drive 123
real Millerian 86 sinthomes 19, 21, 28, 32
real nomination 3233 invention or artifice of 30
real penis irruption 48 new 7981
driving organism 49 subject-specific-effects of 23
Recalcati, Massimo 179, 187188 Skriabine, Pierre 32
recovering addict 172 social bond and identity 79
recurrent substance-related legal socialist distribution 41
problems 123 speech, language, and savoir in
Reformation and Counter- 195206
Reformation 26 Spelman, Elizabeth 113
repetition in Kierkegaard, Lacan, Stephanie 178
and clinic 163175 stomach-aches 178
Ripa, Gabriella Stimulus-Response and Operant
Figures of Lightness 187 Conditioning 78
Royal monopolizing of justice 26 Structure and Perversions 126
subjectother relationship 12, 17, 21,
Samanthas addiction counsellor 145 23, 30
Samanthas case 149159 subject-specific-effect 11
scansion 144 substance use disorders 123
Scarry, Elaine substances of addiction 82
formulation of torture 114 super ego 42
The Body in Pain 113 superior power 120
self-ownership 114 Svolos, Thomas 75, 89, 92, 211
separation 27, 97, 99101, 103107, Not every addiction is a New
127, 134, 137, 178179, 194 Symptom 89
222 INDEX
symbolic transgression 125

and imaginary phallus 49 series 150
imaginary semblance 191 Trevarthen, Colwyn 23
nomination 32 trichotillomania 124
order 123 Trobas, Guy 2829
Phallus 76 TyA Buenos Aires 39
Tarrab, Mauricio 8687 Ulysses 1920

The Non-Dupes Err/ The Names of the unconscious 159
Father 4 determination 50
therapeutic eclecticism 60 etonymy of 49
Totem and Taboo 125 knowledge 195
toxicomania 6, 3940 passion of desire 184
clinic of 90 repudiation of phallus 148
from monomanias 52 unconsciousness 54
jouissance 50 unruly subjects 111117
understanding of 41
toxicomanic passion for an object viator 4
119130
transference 153 World Association of Psychoanalysis
interpretations in 31 (WAP) 79, 83
psychoanalytic 80
relationship 9, 30 Young Homosexual Woman case 98
subjectother relationship 9, 30
symbolic and imaginary Zwangsneurose 66
dimensions of 129
wild 153

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LACAN AND ADDICTION

LACAN AND ADDICTION

All rights reserved. No part of this publication may be reproduced, stored in

British Library Cataloguing in Publication Data

A C.I.P. for this book is available from the British Library

Typeset by Vikatan Publishing Solutions (P) Ltd., Chennai, India

Printed in Great Britain

ABOUT THE EDITORS AND CONTRIBUTORS xiii

The editors would like to thank a number of persons who were of

Maria-Cristina Aguirre, Ph.D., is a Lacanian psychoanalyst and

ethnography, and drug addiction. While completing her Ph.D., she

Psychoanalytic Approach to the Treatment of Addictions. She maintains

Fabin Naparstek is an adjunct professor at the University of Buenos

Viewing addictions through

In 2006, Lacanians from North America, South America, and Europe,

render it not just a disease to be managed but rather a significant form

Themes and ideas from this text

(Michael Miller, Chapter Twelve; emphasis in original)

A number of authors included here have worked in mental health

number of reservations about the nature of contemporary approaches to

The Lacanian clinic of addiction offers the same wager as it does to

As Meyers passage suggests, and as is particularly evident with

by Zinberg (1975), an addicts relationship to a clinic is consumed with

II. Culture, psychoanalysis, object a, and addiction

[Jacques-Alain] Miller asserts that, in fact, it is the object a that

III. Addiction, the Other, and the social link

While we can see some similarities between various psychoanalytic

With Freud, addictions are a means of maintaining a relationship

Likewise, moving towards appropriate behaviours and cognition is a

IV: Other clinical implications: diagnosis, from jouissance to speech

[Chapter Nine]). Our authors outline what is presupposed and entailed

of subjective structure over the jouissance effects, registered in the body.

The first thing that drug addiction teaches psychoanalysis is that

(Laurent, 1998, p. 138)

more and more we are being dominated by an enjoyment-and-con-

terms of making them responsible for finding subjective solutions

Loose also takes up the question of dual-diagnosis, stating, from a psy-

In neurosis and perversion the administration in addiction is a

Klurfan (Chapter Nine) also offers an extensive theorization on the role

maps the subjects changing relationship to jouissance and consumption,

In addition to outlining Freuds and Lacans positions on addictions,

an addition of jouissance.) Kelly and Malone (Chapter Eleven) argue

If we assume that these two steps are necessary in subjective

Modern symptoms and their effects

1. Freuds confrontation with the effect of the symptom is what pushed

cocaine was not going to be a useful pharmacological instrument

Psychoanalysis in modern times cannot afford not to question itself

solutions. Hence, it wouldnt go too far to say that addiction implies

The social bond and identity

depression, anxiety, suicide, eating disorders, panic attacks, addiction,

is hugely important for understanding the function of addiction in our

The problem of dual diagnosis

The problem referred to in this quote is sometimes described as the

Before returning to this question it is important to be more specific

The administration of the subject

problem. However, it should also be mentioned that the increased used

cannot be psychically processed or symbolically represented. In this

foror a scaffolding ofjouissance, but has become jouissance itself.

the lack of psychic processing (or symbolization) hinders the translation

interpretation, meaning, and, therefore, truth. The symptom of the

that it must be addressed. It is the one of the symptom as event of the

of defence, then actual neurosis can indeed be a dominant factor within

1. Is Joyces sinthome related in some way to a problematicperhaps