I would like to suggest, that one of the most pressing clinical problems in the field of psychoanalysis is that of female obsessional neurosis. Who would disagree if I were to allege that any woman who enters the consulting room is immediately considered—once the diagnosis of Psychosis has been discarded—a potential hysteric? Freud’s Studies on Hysteria, the cases of Dora and the Rat Man had imposed this conclusion, and our own clinical observations have tended to reinforce it. The appearance of obsessional symptoms in a woman is easily met by the analyst’s disbelief, he promptly assumes an attitude of expectancy, in which what is expected is the emergence of hysterical patterns.
It is worth noting, however, that the eight patients described by Freud in Névrose, Psychose et Perversion (a French collection of Freud’s earlier writings on neurosis, psychosis and perversion), to illustrate cases of obsessional thought and ceremonial are all women. Yet he does not comment at all on this fact! Lacan asserts on the contrary a definite relationship between structure and sex: “Let’s leave the lady there for the moment and go back to the masculine structure to take a look at the obsessional strategy” (Ecrits, 1966, p. 452). Lacan is applying the principle that the structure of the subject is not automatically defined by the symptom. As a consequence, the finding of obsessional symptoms does not necessarily justify the diagnosis of obsessional neurosis. According to Lacan, the obsessional subject is the strategist of the unconscious who gambles with death, playing tricks on the Other; this conception sets aside reference to the symptom.
Further on in Ecrits, in “Subversion of the subject and dialectic of desire”, Lacan proposes precise structural criteria to distinguish obsessionality from hysteria. Both must be seen as having their origin in fantasm, that is, the way the subject relates to the desire of the Other. The obsessional, says Lacan, “denies the desire of the Other by means of a phantasm set up to prevent the vanishing of the subject,” whereas the hysteric’s desire “sustains itself in the fantasm only by virtue of a dissatisfaction that she obtains by having the Other desire in vain.”
However this conception, which sets the symptom aside, deserves to be modified in light of Lacan’s later work. The decisive step was to shift the symptom from the register of either the Imaginary or the Symbolic to that of the Real. This new conception allowed to bring the symptom and the object of the fantasm together. Freud had provided a first indication regarding this link by explaining the symptom in terms of an underlying fantasy. His suggestion takes on a fresh meaning with Lacan’s introduction of the category of the Real. The Real in the symptom and that in the fantasm are the same, if the loss which the subject suffers in the form of the symptom repeats the lack of the Other that is enacted in the fantasm.
Thus, a woman with obsessional symptoms may also manifest the structure of obsessionality, although this relation is not self-evident and must be verified by the cure. That which has to be verified is indeed the phantasm. I shall present a clinical vignette from my practice. It’s a case about which I have not yet reached a conclusion. Is Florence really an obsessional? Michel Silvestre, to whom I reported the case, unhesitatingly supported that diagnosis. He even called it “a classical case of obsessionality!”
The obsessional thoughts which plague Florence are flagrant, although it is not so much their content which bothers her as the fact of thinking in an obsessional manner. She comes to see me because her suffering is unbearable. Behind her she has years of unsuccessful treatment with several analysts. The latest seems to have made matters worse and, thus, her demand for analysis is strictly therapeutic.
Obsessional thoughts assail her at every moment: she only has to open the directory and come across the word voisin (neighbor), and immediately she thinks “assassin” (murderer); she enters the cafeteria where she works, sees a knife, and thinks “slash” a glance at a dog food advertisement gives her the idea “tear into shreds;” and when she signs a document; the thought criminal befalls and distresses her. Her mind is constantly invaded by these intimations. She fears that one day she will just as promptly commit the act as she is now overcome by the thought.
The aetiology of this symptom is classically Freudian‑a scene of masturbation with a young male partner. Such was Florence’s first encounter with sexuality. Seized by anxiety, she told her aunt about the traumatic event. “You are cursed,” the old woman screamed at her; and she locked the young seducer into a dark room, without however punishing the girl.
In the course of the session during which she reports these events, Florence associates this traumatic memory with the appearance of her first obsessional thoughts. Her father, a butcher, was downstairs in his shop. She was upstairs, doing her homework together with her older sister. When she was sharpening a pencil, she heard the noise of the chopping-knife in the butcher shop. At this moment she had the thought slash a sexual organ.
Lacan reformulates in structural terms Freud’s observation that a traumatic masturbation memory is conducive to the later formation of obsessional ideas. The memory represents the conjunction of two determining elements in the structure of the subject, the mirror phase and the paternal metaphor. The specular encounter of the two children is disrupted by the emergence of an unexpected reality—the signification of the phallus in the form of the erect male organ. The girl has no other recourse than to turn to the 0ther who is supposed to know. The Other responds, passing on to her the signification of the phallus—Eros—along with the meaning of lack, horror, sin, crime, malediction—Thanatos. This latter meaning usually remains inaccessible to the subject, i.e. it rests unconscious. In Florence’s case, this meaning erupts through an Other who takes side with the Real. In effect, not content with representing the Law, (a concept Lacan derives from the Freudian idea of the dead primal Father), allowing the phallus to be symbolized, the aunt’s response lays bare the injunction “Enjoy!” which that symbolization represses.
Here, obsessional thoughts take on the consistency of the symptom. They are the subject’s last resort when it confronts the disclosure of absolute lack—the emergence of intolerable jouissance.The obsessional symptom represses this climactic jouissance that no living being can bear, and at the sametime provides a kind of substitute by recapitulating the tendencies of the repressed on the level of the signifier. As a rule, these tendencies are charged with obscene or criminal meaning. Henceforth the Other can reveal himself at any time as the purveyor of death and crime: the phone book an advertisement a check to be signed are as many occasions to find the Other’s knowledge coming amiss and trigger the resounding command of deadly jouissance.
Identification as well can bolster the Other’s command. Florence has assumed the morbid character traits of her father whose imposing biography provides the elements for this identification. Formerly a delinquent, he became a security guard and then a butcher. “He is a living dead,” Florence states repeatedly. All her attempts, in private and in public. to lead a “normal” life have foundered, snapped up by the destructive Other like reflections waning in a mirror.
It is striking to observe how identification and obsession work together to satisfy and, simultaneously, to neutralize the fatal appetite of the Other. Identification failed in the encounter with the boy-seducer, but then the obsessional symptom formed repressing the morbid satisfaction. In this game, the obsessional subject wears itself out and finds immobility as its last resort. As for Florence, she doesn’t go out any more; she doesn’t answer the telephone; she stops reading the newspaper. the Other could erupt anywhere any time.
Obsessional symptoms are of great clinical relevance because they disclose—perhaps more than other abnormal behavior—the connection between the symptom ans the wanting Other. The obsessional subject cannot bear the structure of the signifier, the gap inherent in the signifying chain. Any interruption of the patient’s speech, the ending of a session. or only and unexpected word—any one or all of these can throw her into a fit of anxiety.
The obsessional symptom manifests this gap in the Real. Because it has severed thought from thought, the symptom seems absurd and excentric. But since it has done so with another thought, by means of something endowed with signifying content, the original split has been mended already. The obsessional thought of the chopping-knife illustrates rather well the relationship established by Freud between the symptom and castration anxiety. The obsessional idea both conceals and exalts the castration. the little girl “slashes” the sexual organ in thought, not in act, in response to the noise of the father’s hatchet. The obsessional idea puts one thought in the place of another. The thought may occur as an alternative to masturbation—Either I masturbate, or I think of “that.”—This signifying form of Florence’s symptom invites a closer look.
The infinitives ‘slash’, ‘tear to shreds’ stand for the imperative of the drive, as if the drive sought expression in barely articulate language: repressed and maintained by the symptom, the jouissance of the symptom emerges. Since, furthermore, the obsessional thought functions by way of metonymy, it may shift endlessly, attaching itself to any object in sight: the printed word voisin, a knife, the picture of an eating dog, the sound of a hatchet. Florence sees a staircase, thinks “going down!’ (descendre), and immediately the idea “getting bumped off’ (se faire descendre) takes a hold of her. The act of thinking supersedes the content of thought.
Above all, obsession is an utterance (parole)in which the material signifier takes precedence over the [spiritual] signified; hence the affinity of obsession to the voice on which the signifier relies. The obsessional does not hear voices like the psychotic; Florence hears meaningful utterances, not mechanical commands. Nevertheless the obsessional suffers from a form of mental automatism, an internal dialogue he cannot stop and which oscillates between ratiocination and obsession. The obsession might be seen as the automatism of the thinking machine which the obsessional frequently is.
However, obsessionality has not only this signifying edge, but includes the side of the object as well. Hence, obsessional thought and obsessional ritual can be distinguished. The ritual emphasizes the meaning, whereas the obsessional idea emphasizes the act of thinking. One could even distinguish ritual as metaphoric symptom, from obsession as metonymic system. Metonymy is apt to exhibit the pressure of the drive, according to Freud the mission of the symptom.
The symptom manifests the restlessness of the drive unable to find the object that would satisfy it. The structural defect in the knowledge of the Other pointed out by Lacan is synonymous with this object that forever lost must forever be refound. Hence it appears that the pleasure principle is not the only master of the drive. The drive harbors an archaic heritage compelling it to relentlessly seek satisfaction. Freud was aware of this even before he wrote Beyond the Pleasure Principle. He first came upon this ‘beyond’ in dealing with obsessional neurosis.
According to Freud, the drive suffers repression when the first sexual encounter elicits in the subject an overly intense pleasure, a pleasure beyond pleasure, the traumatic memory of which is already an interpretation. From that time on, writes Freud in 1897 and again in 1907, the repressed drive seeks whatever representation it can find. It makes use of symbolic connections “charged with meaning,” attaching itself to “false” representations. But the affect, even though repressed, accompanies the drive all along and doesn’t allow itself to be deceived. It remains as hardy as ever and obscurely feeds the new representation, for example, in the form of a reproach. It keeps the subject under “constraint”. Constraint is one of several possible translations for the German term Zwang, as in Zwangsneurose, ‘obsessional neurosis! But the compromise achieved by the obsessional symptom “threatens constantly to break down.” Already at this stage of the Freudian theory, the affect is an index of the Real, irreducible to the signifier; it jolts the signifying arrangements between representations.
After Beyond the Pleasure Principle, Freud pinpoints a special agency — the superego — liable for the part of the drive which cannot be satisfied. Relaying the id, the superego invades the ego in the form of an imperative that must be given satisfaction. In this way, the superego accounts for the existence of an unconscious mechanism other than repression; here the affect can flow without any loss of strength.
The obsession knots the Real and the Symbolic together—the latter, in compensating the failure of representation, mending the breach come to light in the knowledge of the Other; the former, by assuming the charge of the restless drive. Is this not the meaning of Freud’s “activity of eroticized thought?”
Obsessionality is double-edged—reason enough to call it a name of the superego. The charge of jouissance that it must manage accounts for the prevalence of the Real in the obsession. This prevalence depends on the covert action of the objet a, here to be read as surplus-jouissance (plus-de-jouir.) Opposing the exigency of the drive, the Symbolic permits the intolerable satisfaction to find expression in the obsessional thought. Here the analyst rinds invaluable keys for the conduct of treatment. The obsessional idea does not ask for interpretation; to say what it means is useless or even noxious. Presented with the analyses knowledge, the subject has no option indeed but to reissue the symptom and the compulsion to think. We know the extent to which confronting the Other’s knowledge commits the subject to deny the inadequacy of this knowledge.
My bet is on transference-love… bet that through this love, the Real manifest in the symptom—the obsessions which plague Florence—will rejoin the Real that her phantasm covers over.
Translated by Gae Stratton, Paris