More paraphrastic notes from Fink's book on the clinical practice of Lacanian psychoanalysis.
1. A person usually comes to analysis in times of crisis, when their symptoms bring them into some kind of conflict with others around them, or intensify to the degree they become unendurable. It is when the satisfaction the symptoms provide begin to waver that they seek external help.
At the same time, there is a satisfaction in the very dissatisfaction to which the symptoms have led - a jouissance, to use Lacan's words, in which pleasure is mixed with pain (there is pleasure in pain and pain in pleasure). Analysis is sought, Fink says, when jouissance breaks down - when the effects of the symptom, understood as the sole source of the person's obtaining enjoyment, have become unendurable.
Initially at least, the patient may simply be looking merely for a way of retrieving that wavering source of jouissance, of seeking the quick fix they believe analysis might provide. As such, the patient - or analysand, to use Lacan's word, the '-and' ending implying that it is the patient who must be prepared to do the analytical work - is often unprepared for what analysis will call for. It is the analyst's role to maintain the force of this calling, even against the analysand's explicit wishes - for who would want give up the sole source of their enjoyment?
There must therefore be a discipline to the analysis, which the analyst must rigorously maintain without becoming, for all that, a disciplinary figure (a parent, a judge). It must be what Lacan calls the desire of the analyst to maintain the session, for the patient to talk, to fantasise, to associate. But what does this mean?
The analyst's desire is focused solely on the process of analysis - it is not concerned wanting the best for the patient - for him or her to achieve career advancement, or to find a suitable life-partner. Desire, likewise, has nothing to do with what the analyst wants the patient to say, or the plans the analyst might have for the patient's development. The analyst's desire must remain enigmatic, free floating, holding back from prompting the analysand in any particular direction.
2. Initially, the analyst must broadly determine the kind of patient the analysand is by way of a mixture of direct questioning and allowing the patient to talk and associate, the clinical category into which the patient might fall. The analyst will also seek to crystallise the dissatisfaction of the patient into a particular psychosomatic symptom, leading the analysand to understand how his or her problems may be susceptible to a talking cure.
These 'preliminary interviews' may last for as long as a year, over which the analyst will begin to lose, for the patient, the sense of being an individual like any other. Slowly, the analyst becomes akin to an actor or a placeholder, and analysis can pass from a face to face meeting to one in which the analysand is put on the couch.
In these initial sessions, the analyst should offer only punctuations of the analysand's speech, suggesting through specific interjections - emphasising particular words, interjecting a 'huh!' every now and again, and of course focusing on slips of the tongue, garbled speech and other ambiguities - how another account of what the patient is saying might be possible. This is not yet rigorously diagnostical work, but allows the patient to become aware that there is another layer of meanings to his or her unconscious formations. The patient, too, should become interested in his or her own slips of the tongue and double entendres as such formations.
The analyst, then, draws the patient's attention to certain points at which unconscious desire surfaces, thereby allowing the patient to think about them and to associate to them. This may require the analyst carries out an interruption or scansion of the session, whereby the patient's attention is focused upon what gives a clue to a hitherto unavowed source of jouissance. The analyst may call for the session may end on such a note, rather than letting the patient carry on speaking.
Above all, the analyst cannot let the patient chatter aimlessly, but must keep him or her off balance, for it is only when what they say becomes enigmatic to them - when they begin to place their faith in those moments in which the play of the unconscious reveals itself that their desire can be said to be engaged in analysis. Only, that is, when they begin to wonder about the significance of their slips, fantasies, dreams and garbled speech that analysis becomes as Lacan puts it 'dialecticisable'. Now the patient has given up the impatient demand for a cure and has truly entered analysis.
Note here the active role of the analysand in the sessions: he or she is not looking to the analyst as a source of authority. It is the analysand's unconscious that is, in Lacan's phrase, the subject supposed to know in the sessions: at the same time, this subject is projected by the analysand onto the analyst, who agrees in his or her role as actor or placeholder to stand in for the unconscious. The analyst has become, in Lacan's words, the Other - a blank and anonymous stand-in, a mirror or a projective screen for the analysand.
3. It is in terms of the analysand's relationship to this stand-in that we can understand the role of Lacan's notions of the imaginary, the symbolic and the real.
Initially, the analysand will have what Lacan calls an imaginary relationship to the analyst. What does this mean? The relationship is dominated by the self-image of the analysand and the image he or she has of the analyst. The imaginary stage, Fink notes, is marked by rivalry as the analysand measures him- or herself against the image of the analyst: who is better? who is inferior? The analyst must be careful not to respond to this imaginary relationship, maintaining his or her position until rivalry subsides.
The analysand will then characteristically move on to a symbolic relationship to the analyst, relating to him or her as to an authority figure who is able to deliver judgements of various kinds, whether approving or disapproving. To the analysand, the analyst cannot help but embody certain values by dint of the way he or she dresses, by his or her accent, by the decorative features of office in which the sessions take place and so on. But once again, despite this, the analyst must strive to become no one in particular, that is, Other with regard to the analysand, rejecting the interpretations of the patient in his or her transferences.
Freud came to call transference the developing relationship of the patient with the analyst over the course of a treatment. Specific kinds of transference characterise the imaginary and symbolic relationships to the analyst - rivalry (insofar as the analyst seems to be like him or her) and the desire to be judged (the analyst as Other, as judge or parent), respectively. But with respect to the real relationship, the analyst is understood to be the cause of the dreams, fantasies and slips of the analysand - that is, his or her unconscious formations. The analyst thereby becomes what for Lacan is a 'real' object for the analysand, which is to be indicated by the expression 'object a'.
In this position, the presence of the analyst becomes far more troubling for the patient under analysis, showing up in the unconscious formations themselves. The patient may now exhibit what is called negative transference with respect to the analyst. This is not to be avoided and may even be necessary: analysis, at this point, is not a pleasant process, since the analyst as Other must allow himself to stand in for people and events that the analysand must confront in the analytic session. For it is not enough for the analysand to merely talk through his or her issues with respect to those people and events; the analysand must also experience the affect they originally aroused (even if this affect was diffused and not experienced as such at the time of the events themselves).
Crucially, then, transference also involves a transfer of affect associated with those people and events in the past into the analytic sessions. Analysis depends upon the projection onto the analyst of those emotions felt towards the people and events in question. Only at this point, for Lacan, can analysis really progress. In Fink's words, the analyst can now work 'to reestablish connections between the content (thought and feeling) and the persons, situations, and relationships that initially gave rise to it'. The analyst can uncover the real of those connections as it is brought to signification by the analysand.
The analyst, then, must allow him or herself to stand in for people, events or relationships that were productive of what can be determined as the patient's symptom. He or she must become Other to the patient to the extent the analyst can bear a kind of transference that might be called substitutive. The analysand, too, might be said to become Other for him or herself in talking and associating to particular polyvalent interpretations the analyst might proffer. A process that will lead to the unconscious (the patient's Other, if I understand correctly) to be projected upon the analyst as Other.
Only in this way can analysis touch upon the real, as it understood as a connection or link between two events that has been repressed and can now be restored. Only now can the real, understood as trauma, be put into words, that is, symbolised, such that the an analytic cure to the distressing effects of the patient's symptom might be found.