I

Jacques Lacans Structuralist Criticism of Karl Jaspers Phenomenological

Psychiatry: Concerning the Comprehensibility and Treatment of Delusional
Disorders

Abstract
The validity of psychiatric diagnostic constructs remains suspect, a problem compounded
in the case of differential diagnoses (DDx), which imply multiple and concurrent
disorders. Can one have more than one mental disorder? Can such a supposed coexisting
differentiation be real? Whereas disorders vary by context, kind, and manifest
symptomsKarl Jaspers, in his General Psychopathology, usefully called attention to a
necessary penetrative discernment into the reducible qualities of a disordered state.
Though, according to Jacques Lacan, Jaspers argued comprehensibility to a fault.
Deciphering the problem of psychiatric comprehension, this essay will focus in on
Lacans medical thesis commentary on Jaspers phenomenological psychopathology..
Here we highlight important differences between phenomenological and structural
theories of understanding. Where Jasperian phenomenology suffers by only being able to
study theories, in acknowledging that beliefs and delusions cannot be clearly
distinguished, Lacan will propose a restorative method of listening to delusions
psychoanalytically. 1

1 A version of this paper was introduced to the Karl Jaspers Society of North America at
the December 15, 2014 joint meeting with the Eastern Division of the American
Philosophical Association in Philadelphia, PA, and was delivered by the author on March
20, 2015 at the 19th Congress of the International Society for the Psychological and
Social Treatments of Psychosis (ISPS) at the Cooper Union in New York, NY. Special
thank you to Professor Marc De Kesel for his assistance with this manuscript.

2
Keywords: Karl Jaspers, Jacques Lacan, General Psychopathology, Thesis,
Phenomenology, Structuralism, Psychosis, Delusions, Understanding, Meaningful
Connections

Introduction
All conferences are organized around a dialogue, for instance, seeking to merge
biological and psychological conceptions of the treatment of psychosis. All cases that we
hear about at such conferences deal with the work that goes on between the clinician and
the patient, tracing the methodological approach which should be taken to provide
suffering individuals, those who suffer in states of madness, with some corrective
solution. In doing so the participants at such a conference will have been contrasting on
the one hand, biological treatments which aim to provide therapies which target neuronal
and nervous system functioning, and on the other, dialogical a approaches which address
the subject in their symptomology. Now, adopting a thesis which states that biological
change should come secondary to the primary social experience of psychosis disorders,
of making sense in dialogue, this discussion paper will elaborate upon an important
change which took place in theorizing about the psychotic experience in the works of
Karl Jaspers and Jacques Lacanand thus directing new questions at our philosophical
enterprise of reasoning.
This discussion paper will draw your attention to the meeting between therapist
and patient, and how this interaction should address and work with the hallucinations and
verbal disorganizations associated with a psychotic break and later reconstitution of a
functional subjectivity in a social milieu. The most difficult aspect of presenting a thesis

3
like this is that my understanding of Jaspers and Lacans system of psychopathology
cannot have come through any formal psychological or psychiatric training program in
the English speaking world, and quite possibly any other. My research has come to me
from my work in political organization, as an advocate in legal disputes on worker rights,
and in my pursuit of answers to questions on the seemingly irreconcilable nature of
people to do exactly that which is most harmful to their interests, and to deny their
obvious blunders right through to the graveI had to understand, and so my insights
come to me through anthropology, a clinical psychoanalytic practice, and budding study
of philosophy. Rather than provide a properly critical investigation of power, politics, and
culture, today, most research conducted in the name of psychotherapy or psychology is
conducted in a narrow bio-medical, or in the best of cases, the bio-psycho-social
conception of mental illness, and so for the most part there is no credible attempt being
made at hearing the individual patient in their suffering outside of psychoanalytic circles.
So we come to the matter of psychopathology in similar circumstances which Jaspers
must have come to the issue, where responding to Emil Kreplian style biological
conceptions of mental illness identification, specification, and classification, we too are
located in a somewhat obtuse situation, where for the most part, more knowledge
available to researchers of any discipline interested in the subject of human psychology,
and trouble with subjectivity, are faced with an avalanche of information about the truth,
but no reasonable way in which to make sense of comprehend the overload of
information.
What the therapeutic establishment has increasingly resorted to is various kinds of
quantification formulae for using bio-statistics to attempt to find meaningful statistical

4
inferences that can shed light on why it is that time and time again, the same kinds of
proofs are invalidated, and time and time again, the treatment of mental disorders with
one kind of treatment or another prove ineffective2. The bio-psycho-social model
attempts to correct to apparent lack of technical or overall perspectival wherewithal in
coming to an overall understanding of the comprehension of the individual who suffers
so to properly and most effectively intervene. This is certainly the project of Jaspers
General Psychopathology3, and it is the project being continued in psychiatric and
psychological diagnostic protocols which aim for greater complexity, greater sensitivity
of scales, and a more profoundly accurate characterization of the details of some
psychopathologyand the only way through, it seems, is as Jaspers puts it, whereby
practitioners should be so well read, perhaps as well read as a world class philosopher, in
the humanities, physical and natural sciences, and the full range of psychiatric literature
from the 19th century on, to be able to make the most effective and comprehensive
characterization of, and thus planning an intervention for, the treatment of a mental
disorder.
However, let this survey of the problem not be read as a rejection of the scientific
project. No doubt, the scientific method of doubt and hypothesis testing is our only way,
within the always modern enterprise of reason, through to the other side, but we must
avoid understanding too much (Lacan), and taking on the delusions of modernity. We
cannot at the same time loose sight of the fact that religion and science are one in the

2 Hejazi, 2013, Determinate Signification and the Neurobiology of Reality Processing

(http://www.sfu.ca/humanities-institute/?p=4021). Here I discuss the problem of treatment
resistance and neuroscientific knowledge in greater detail.

3 Jaspers, Karl. General Psychopathology. Translated by J. Hoenig and L. Hamilton.

Manchester: Manchester University Press, 1963.

5
same, that belief and doubt work in tandem, and thus science is our modern placeholder
for a certain establishment of an ideal, so ever too quickly science is confused with a kind
of rejection of reason in the first place. This will be Lacans project, taking up from
Jaspers own, to advance the most important and prime topic in psychiatry, that of
delusional disorders, or psychosis.
If we, like Jaspers and Lacan, take up the topic of delusions, we must be clear
with ourselves that we too are delusional, and that the distinction between a mad person,
and the sane, is purely evaluative and contextual. As one can appreciate, irresponsible
capitalism, targeted killings for peace, feigning ignorance at torture, in a so-called, free
and democratic society, being on par with childhood certainties like a belief in Santa
Clause, will leave us embarrassingly short of the target I wish for us to make through the
course of this discussion: that we are just as superstitious, errant, and shortsighted as ever,
with the only exception being the knowledge we were able to come through by virtue of
testing of hypotheses, and being able to let go of ideas which we proved to be
inconsequential. Yet in psychiatry, and modern psychology, this capacity of moving
through indefensible knowledge seems to be most impaired. It is in these disciplines that
deal exactly with an issue as vague and seemingly indecipherable as problems with
subjectivity, where few theses are proven founded, and totally dubious assertions are
almost never let go ofunless some protest movement emerges to shame the treatment
establishment, that like pious Sigmund Freud, we will claim privileged insight into a
particular myth, without a hint of being able to truly test our assumptions as such.
Moreover, in this presentation, as in all presentations where we will attend to the
function and field of language, we need little in the way of observable statistics or

6
diagrams. So often now, it seems, in the fields of psychiatry and psychology, texts books
make reference to scans of brains, and certain demographics, as if the truth were to be
found in the statistical calculations of a computer which determined certain blood flow
passages to be correlated with a certain function, as certain flows of factors among people
is indicative of what goes on for a suffering individual. The scope and span of the
psychiatric and psychological subject has become profoundly vast in its breadth and
scope, whereas what we will find through the course of this text, is that the elementary
phenomena, what we are to distinguish through a certain kind of listening, will be purely
individual, and certainly cannot be scanned other than by attention to the speech of
another.
Thus and moreover in the same way, we will strive to illustrate, by a progressive
movement of intellectual work, by three authors, Emile Kreiplin, Karl Jaspers, and
Jacques Lacan, how one proper phenomenon, the phenomenon of a delusional disorder,
can be worked with and through in three different ways. Rather than distinguishing
between supposed kinds of psychosis, we will deal with the project of speaking about
assumed normality, for the issue of content normality is exactly the cross-roads upon
which the subject matter of hand, of delusions, must take us toand to no other. What
this means is that no other arbitrary correlates, of delusions and age, or delusions and
race, or delusions and brain scan identifiers, will suffice to locate ourselves on the
primary issue of shared and social reality, and thus on the same point of focus, which
Jaspers would have us attend, the issue of comprehensibility. Our purpose will be to, like
Jaspers and Lacan, advance us through, down the historical tradjectory, from exorcisms

7
of possessions, to the bio-psycho-social construct method, to the post-structuralfor a
new way of dealing with social difficulties of many kinds.
A Brief Genealogy of Delusional Disorders
While we know that Hipocritus in 400 BC and later Galen, in the fourth century,
among other classics identified a disorder of the mind as a problem with the constitution
of a subject with their brain (Hysteria, as a movement of the uterus), and later medieval
authors found mental disorder at the level of bad fluids (melancholia)4, the change from
between Jaspers to Lacan marks a much more radical alteration in our theory of
knowledge. This change marks the difference from the pre-modern conception of the
madness of a derivative of some good and evil contest, where a shaman or spiritual leader
would provide an explanation to the confessions of the subject, to the modern conception
of the individual as a locus of control, being given responsibility for the functioning of
their personal biological and psychological apparatus. This change is between psychiatric
knowledge about the treatment of a mental illness, between the pathogen and the body
and what the subject says and experiences about their disorder, and the psychoanalytic
conception, derived from the works of Sigmund Freud, as a problem of responses, as a
human capacity to represent and be representedand thus Freud, and later Lacan, mark
an important turn in scienceto a new kind of science, as a way of understanding the
way that the actions in the clinic will act upon an individual.
We might trace this psychoanalytic intellectual trajectory in a somewhat different
manner, from Parmenides (Who spoke about a=a, setting out the subject basis of some
4 Taylor, Michael, and Vaidya, Nutan Atre. Descriptive Psychopathology. The Signs and
Symptoms of Behavioral Disorders. Cambridge, Cambridge University Press, 2009.
Print.

8
supposision), to Descartes (Who set for the doubting I, who thinks, I think, therefore), to
Hegel (Locating all knowledge along a historical and contextual axes), to Freud (Who
locates the thinking and thus speaking being). The links between Jaspers and Lacan are
important to our conference discussion for this will lead us to deal with the mechanical
factors which are derived from the underlying biological distinctions which we can refer
to psychosis, and more importantly define the function which operations in
communication and social relating to one-another which will order our knowledge about
the causes and factors of the psychotic condition. In this paper I want to introduce a
problematic factor in our reasoning, as professionals and researchers in the field of
psychiatry, who are working with issues that relate to the mental well being of another, of
a patient who has come to us with a problem with their subjectivity, their mental health.
This problematic factor, which I will call prequation, is given where in the
construction of our ideas about what is going on with another, between ourselves and our
patients, we preliminarily equate the event of a psychotic hallucination nor break, with
the psychosis, as though the label for the disorder, a formula for identifying classes of
disorders, leave us, very quickly to an all to hasty status of knowing, of comfortably
attributing signs to some underlying pathogenic process, and thereby dismissing very
important factors which can be worked into a formulation and treatment process. In the
rest of this paper I will elaborate how a hasty equation process takes place in our
perception of our patients, and through elaborating the distinction between Jaspers and
Lacan, between phenomenology and structuralism, point us towards how our researches
into the complexities and difficulties associated with psychosis can be more readily
supported, treated, and essentially overcome.

9
Contemporary Attempts at Understanding Delusional Disorders
The American Psychiatric Association, since the first edition of their Diagnostic
and Statistical Manual of Mental Disorders (DSM)5, has allowed for the identification
and designation of both specified and unspecified disorder types, as well as multiple
differential diagnoses. Can one be mentally ill in more than one way? Does pathology not
need to be verified with a qualified yes or no? The authors of diagnostic manuals will
evoke the notion of necessary openness to allow for changes to be made to their
categories, to ease the communication of what cannot be found within any already
compiled manual, and to leave the door open to new possible applications of formulae.
Paul E. Mullen writes in A Modest Proposal for Another Phenomenological Approach to
Psychopathology6 , We have been left with classificatory systems which impose reified
categories increasingly at variance with clinical reality and increasingly divorced from
the data generated by scientific enquiry. (113). In todays psychologized social world
one can readily hear people talk about having a mental illness, having two or more
mental illnesses, or, undergoing recovery. A November 27th, 2014, article in The
Guardian7 suggests that people need to be treating their delusions and hallucinations, as
though delusions and hallucinations were not a part of normal perception. Karl Jaspers
writes in his General Psychopathology, that, Delusion is a primary phenomenon and the
first thing we have to do is to get it into a proper focus. The experience within which
delusion takes place is that of experiencing and thinking that something is real. (1963,
5 American Psychiatric Association. Diagnostic and statistical manual of mental disorders. First
edition. Washington: American Psychiatric Publishing, 1952.
6 Mullen, Paul E. (2007). A Modest Proposal for Another Phenomenological Approach

to Psychopathology. Schizophrenia Bulletin, 33(1): 113-121.

7 Freeman, Daniel. And Freeman, Jason. Delusions and hallucinations may be the keys that unlock psychosis The
Guardian, November 27, 2014: http://www.theguardian.com/science/blog/2014/nov/27/delusions-hallucinationspsychosis-schizophrenia

10
93). Jacques Lacan, following on Jaspers, will later write that the structure of scientific
truth is that of paranoia (2006, 724). There can be no clear Archimedean point of view
outside of a fixed system of belief and understandingwhat for Lacan is a point of
impossibility. No matter what efforts are made, all clinicians and researchers, are bound
to the same infrastructure of made-up thinking.
Paranoia and psychotic paranoia have a prevalent position in psychiatry and
psychological research. We normally have a narrow conception of the mad person as
someone who exudes obvious delusional phenomena and other atypical bodily
symptoms. Commentators on this norm, Sarah Troub, Thomas Lepourtre, and Benjamin
Levy, writing in Jaspers, Freud, Lacan: la question de la comprehhension en
psychpathologie89, state that the delusional character of any idea is its appearance in a
higher order of truth, an order of delusions, which necessarily places understanding
within the limits of the human capacity for knowledge (9). The problem of understanding
and the search for the specific features of understandability is a common theme in the
study of psychopathology. The problem of understanding has been addressed by
psychiatry; the issue of comprehensibility marks the significant role of psychiatry in the
process of the determination of truth for the society as a wholegiven in the historical
transition of psychiatry from the church to the government hospital10, and predictably, on
to the private clinic.

8 Translated as: the question of comprehension in psychopathology

9 Troub, Sarah, Lepourte, Thomas, and Levy, Benjamin. Jaspers, Freud, Lacan: la

question de la comprehhension en psychpathologie. PSN 3(2): 7-31 (2013).

10 Foucault, Michel. The Birth of Biopolitics. Lectures at the College de France, 197879. Edited by Michel Senellart. Translated by Graham Burchell. New York: Palgrave
Macmillan. Print.

11
For Troub, Lepourttre, and Levey, the primary delusional experience is the
source of radical incomprehensibility (12). According to Jaspers there can be an
emotional interpenetration (13) that can be undergone to investigate the nature of a
given encounter that the subject makes due to their delusional core. Jaspers will state that
what makes psychosis delusions important, though not altogether understandable, nor
consequentially linked to an inner causal factor, is the manner in which, as Matthias
Bormuth11 writes that for Jaspers, no science could fully fathom in either
psychopathological or existential terms (5) of what is really going on within a psychotic
process. Jacques Lacans scholarly career interestingly takes from Jaspers works on the
way in which meaningful life events underlie the formation of symptomology. Lacan
later departs from Jaspers with respect to the knowability of the formative substrate, as he
develops his theorizing about the nature of understandability in general. Substantiating
the totalizing approach, Stijn Vanheule 12 discusses how Lacan contests Jaspers assertion
that whereas most mental phenomena are rationally and empathically understandable for
psychologists, delusions are not (2011, 98)rather, Lacan will demonstrate how an
analysis challenges mainstream capacities of knowledge as a process of reaching a point
of verifiable certainty, but that certainty is a factor in all systems of knowledge.
French historian, Elisabeth Roudinesco writes, in her biography of Jacques
Lacan13, that in General Psychopathology Jaspers highlights the clinical differentiation
within psychiatric thought between "practices of meaning and sciences of causation". In
11 Bormuth, Mathias. Life Conduct in Modern Times, Carl Jaspers and Psychoanalysis.

Philosophy and Medicine, Volume 89 Co-Editor, Stuart F. Spicker. Doredrecht:

Springer, 2006.
12 Vanheule, Stijn. The Subject of Psychosis: A Lacanian Perspective. London: Palgrave
Macmillan, 2011.

13 Roudinesco, Elisabeth. "Jacques Lacan". New York: Columbia University Press, 1994.

12
this conception, the comprehensible followed on events via underlying factors and in the
explicable there is an element of the incomprehensible, so "one must resort to a logic
different from that of reaction to facts. The voices heard by someone suffering from
hallucinations, the persecutions imagined by a paranoid person, belong to the realm of the
explicable because of a causal concatenation." Roudinesco notes "how helpful Lacan
found such a notion in constructing a science of personality. The idea allowed him to
assign more importance to a formal logic of causality than to a mere comprehension of
meaning" (46).
Karl Jaspers
Mathias Bormuth writes in Life Conduct in Modern Times, Karl Jaspers and
Psychoanalysis, 2006, that Jaspers epoch-making methodological systematics in General
Psychopathology challenges what Bormuth says Jaspers referred to as a reprehensible
philosophy (2), namely Freuds deterministic psychoanalytic formulations, on the basis of
an important mindset difference which he endeavored to promote through his philosophy.
According to Bormuth, Jaspers was endeavoring to establish the life conduct of the
individual as an appeal against mass psychology. Jaspers assumed a three-step
psychopathological method. The first step involved rational and static understanding
of isolated psychic phenomena; the second, constituted genetically associative
understanding; and the third, the classification of symptoms according to ideotypical
disease entities. (14). Observation includes exploration of the patient, and having the
patient draw up written material. Jaspers adopts Webers methodological concept of the
ideotype but does not exhaust its epistemological substance; for Jaspers, the construct
merely acts as a relative paradigm used to recognize and classify symptomatic and

13
motivational connections in the case of mental disorders. (15). Thus differentiating
between understanding and valid science. There are layers and there are dispositions that
relate to the psychopathological core. In postulating an infinite horizon of causal
connections, Jaspers contends that explaining causality principally forms the core of
pathogenesis whereas the understandable connections merely constitute a peripheral
asset with no decisive effect. (16)
In his essay, The Phenomenological Approach in Psychopathology14, first
published in 1912, Jaspers states that it is normal to distinguish between the subjective
and the objective. Included in the subjective, for Jaspers, is anything that cannot be
observed as coming from the subject other than through their words, inclusive of mental
processes and how any subject organizes themselves. Jaspers argues that, According to
this, only the objective symptoms offer certainty; they alone form a basis for scientific
study, whereas subjective symptoms, though we cannot easily do without them for our
preliminary assessments, are considered to be quite unreliable for making final judgments
and unfruitful for the purpose of any further scientific investigation (1313). Jaspers
continues:
There is no doubt that objective psychology produces results which are more
obvious, more convincing, and easier for everyone to grasp than does subjective
psychology the difference in degree of certainty is simply quantitative, when it
comes to the kind of certainty, the difference is qualitative and fundamental. This is
so because subjective psychology always aims at the final realization of the
concepts and ideas which form the inner representation of psychic processes,
14 Jaspers, Karl. The Phenomenological Approach in Psychopathology. British Journal
of Psychiatry 114, 1313-1323 (1968).

14
whereas objective psychology finds its ultimate aim in observation in undisputed
fields such as sense-perception and the rational concepts of thought and by such
means as graphs and statistics. (1314).

Jaspers says of the qualitative research activity above, that it is the preliminary work of
representing, defining, and classifying psychic phenomena, pursued as an independent
activity, which constitutes phenomenology an end in itself. This end, Jaspers writes, is
a search for irreducible phenomena, through the others self description as a means,
not the object where by means of analogies one can identify, observe, and reach the
completely empathically inaccessible (1318). For Jaspers, what his method will be able
to reach is that which is completely objectively unverifiable, though functionally
affective.
In postulating an infinite horizon of causal connections, Jaspers in his General
Psychopathology, 1963, writes that explaining causality principally forms the core of
pathogenesis (16). For Jaspers there are:
Endogenous and exogenous causesThe basic phenomenon of life is its self-realization in an environment which it
molds from its own inner resources, on which it depends and by which it is in its
own turn molded. In so far as we divide the whole unity of life into outer and inner
world and both are broken down into factors, we attribute the phenomena of life
either to causal factors of the outer world, which we call exogenous, or to those of
the inner world, which we call endogenous; against the outer influences we set the
inner disposition. As life always consists in the interplay of inner and outer, no

15
phenomenon can be exclusively endogenous. Inversely, all exogenous influences
unfold their characteristic effects within an organism, and the particular fashion of
this will always appear as an essential factor. (454).
Jacques Lacan
In his published medical thesis15, De la psychoses paranoaque dans ses rapports
avec le la personnalit16, 1932, Lacan drew upon Jaspers Phenomenology and the
structure of psychic disorganization in psychoses. In this earlier period in his writing
Lacan assumes that at the core psychotic outbreaks are constituted by relations of the
subject to vital situations (77). Vanheule, in his The Subject of Psychosis: A Lacanian
Perspective, 2011, writes that such vital situations, all psychogenic (11), relate to sexual
and professional problems that go beyond a breaking point, touching the psychotic
subject in a profound way(10), at an ethical level (11). At this point these events find
their integration into the psychic makeup of the person and become comprehensible
developments related to how the person regards himself or herself, leading to tensions
that emerge from their situation and environment. Therefore, for Lacan, following on
Jaspers, clinical analysis depends on the application of all ones capacity of sympathy
(11, Vanheule citing Lacan, 224).
In his thesis Lacan writes that to understand the desire of jealousy for example,
you must guard against imputing that it is a sickness, jealousy of another woman, a
deductive or inductive construction more or less rational, but understand that its mental
structure forces it to identify itself to its rival, when she evokes it, and to feel that this
substitutes for her. In other words, the mental stereotypes are considered in this theory as
15 Lacan, Jacques. De la psychose paranoaque dans ses rapports avec la personnalit.

De Doctorate ed Medicine de Jacques Lacan. Seuil, Franois a Paris, 1932.

16 Translated as: Addressing Personality in Paranoid Psychosis.

16
compensation mechanisms, not of the affective order, but of the phenomenological
order17. Numerous clinical facts were in such a way interpreted in a brilliant way by
Minkowski.18 Thus according to Lacan, there is something that is directed by jealousy,
jealousy regarded as an emergent phenomenon, but the causal meaningful connections
underlying this emergence cannot be logically followed to a particular causal factor as
such. In this way Lacan both adopts and critiques Jaspers philosophy.
Lacan goes on, We believe that all distinctions between the structures or forms of the
mental life and the contents that fill it, rest on uncertain and fragile metaphysical
hypotheses. This distinction resembles certain beings imposed by the organic psychoses
and irrationalities, but these present a deep psychic disorganization with no psychogenic
link to and indeed I say, like the very good remark by Jaspers, he [the psychotic subject]
does not act from a true psychosis.1920
In the psychoses, it is possible to settle the question of whether the structure of the
symptom is not determined by the essential experience it appears to stem from; in other
words, the content and form cannot be arbitrarily dissociated, such that essential trauma
in psychoses will not be resolved. (132). Thus in this earlier text Lacan challenges
Jaspers position on the irreconcilably arbitrary nature of the delusion, and states that in
fact the delusion is both of consequence and is derivable from some contingent necessary
underlying factor for the individual in their contexts and situationsthe self, the I.

17 Husserl, Edmund. Phantasy, Images Consciousness, and Memory (1898-1925).

Translated by John B. Brough. Dordrecht: Springer, 2005.

18 A quote from Lacan on Minkowski, Jalousie pathologiques sur on fond dautomatisme mental. A.M.P., June
1929, 24-48.
19 Hence the emptiness of the objections to psychogenic research we hear everyday, the vanity of which is
demonstrated by the isolation of an entity, like general paralisis, for example. These are lazy objections.
20 I.e. not an actual derangement.

17
In Lacans later seminar on The Psychosis, 1955-1956, he writes that under a
very clear meaning under the name of [a] relation of understanding, Jaspers has made
the pivot of all so-called general psychopathology21. For Lacan, It consists in thinking
that some things are self-evident, that, for example, when someone is sad its because he
doesnt have what his heart desires. Nothing could be more false says Lacan, there
are people who have all their heart desires and are still sad. Sadness is a passion of quite
another color. (6). In this, contrary to his assertion given in his medical thesis, as
Vanheule notes, Lacan grew more critical of his dissertation, he criticized
comprehension-based approaches (2011, 11).
In France, Lacan notes, a paranoiac was a nasty person, an intolerant one, a badhumored type, proud, mistrustful, irritable, and who overestimated himself. (4). In this
context, Lacan notes that Genil-Perrinss work on the perverse structure of character
pointed to the fact that sometimes the paranoiac goes beyond the limits and falls into
that frightful madness, the unbounded exaggeration of his unfortunate character All the
formal references to an organic base, to temperament for example, don't change a thing it's really a psychological genesis. Something is defined and assessed at a certain level,
and its development follows uninterrupted with an autonomous coherence that is selfsufficient in its own field. (5). For Lacan it is false to assume that psychoanalysis
restores meaning to the chain of phenomena, or to understand the patient. This, Lacan
says, is a pure mirage.
Lacan uses the example of a child receiving a smack, however he notes, while the
child might cry, its not at all obligatory that he should cry. He gives an example of a
21 See Karl Jaspers, "Meaningful Connections," "Verstandliche Zusammenhange,"chap. 5 of his General
Psychopathology.

18
child who asks if the smack was a pat or a slap, if the latter response is given as a reply
then the child would cry, following on the rules of convention, and if it was a pat he
would be delighted (6). For Lacan, in Jaspers chapter on Meaningful Connections, in
General Psychopathology understanding is evoked within its meaningful relational
consequence. However, in understanding the underlying factors, as soon as one attempts
to apprehend the source, it becomes elusive. Lacan, therefore, will hold that there is no
psychogenesis in this meta-realm of understanding given by the field and function of
psychoanalysis, and even if there is a psychogenesis of sorts, it is not one to which
psychoanalysis can be beholden. He states, If that is what psychogenesis is, there is
precisely nothing that could be further from psychoanalysis in its whole development, its
entire inspiration and its mainspring, in everything it has contributed, everything it has
been able to confirm for us in anything we have established. For Lacan a way of
expressing things that goes much further is to say that the psychological is, if we try to
grasp it as firmly as possible, the ethological, that is, the whole of the biological
individuals behavior in relation to his natural environment. This he calls the order of
real relations, an objectifiable thing, a field with quite adequately defined boundaries.
(7).
Lacan posits that Everything that in human behavior belongs to the psychological order
is subject to such profound anomalies and constantly presents such obvious paradoxes
that the problem arises of knowing what needs to be introduced in order for a cat to find
its kittens. For Lacan, the problem cannot be solved by a mere immediacy of experience,
for this is no better placed to arrest or captivate us than to any other science. In no way
is it the measure of the development that we must ultimately reach. For Lacan, Freud

19
brings resources into play that are beyond immediate experience and cannot be grasped
in any tangible fashion. (8)22.
Discussion
A number of authors have commented on how the DSM unspecified categorical
and differential diagnostic approaches follow a phenomenological approach to research
and reasoning. Jaspers, in The Phenomenological Approach in Psychopathology writes
that, subjective psychology always aims at the final realization of the concepts and
ideas which form the inner representation of psychic processes, whereas objective
psychology finds its ultimate aim in observation in undisputed fields such as senseperception and the rational contents of thought and by such means as graphs and
statistics. (1314) Thus for Jaspers, Without doubt, the first step towards scientific
comprehension must be the sorting out, defining, differentiating and describing of
specific psychic phenomena, which are thereby actualized and are regularly described in
specific terms. (1316). According to Jaspers, this is a search for an irreducible
phenomenon, such as a colour, that is subtly differentiated, fitting contexts and
experiences. The immediate grasp of these differences can be reached through an
empathic process and route (1317).
Mullen (2007) writes that the interest in phenomenology may be undergoing a
revival, with an approach among clinicians, as well as researchers, which privileges the
specific questions and the proper categorization of the patients response. However,
under the current situation there seems to be a sacrifice of ambiguity for clarity, where
validity has been sacrificed on the alter of reliability, where, the better you know a

22 Here Lacan is referring to the psychoanalytic oeuvre, inclusive of free-associations, the frame, and an encounter
with resistances and neurotic wish fulfillments (etc.).

20
patient the better information about them seems to fit (113). The escalating size of the
disorder manuals is rooted in phenomenology, as the authors welcome new and added
classification types. However, the disorder manuals also lead to the creation of an
authoritative structure that becomes the source of an error. Such bowdlerization and
concretization ends the possibility of the scientific enquiries they were intended to usher
in. The right questions and answers are learned, and the disorder types have reified
certain conceptions of how a certain disorder is (114), rather than the other way around,
which would be scientificthe struggle to grasp the nature of experiences prior to their
being lost in futile debates about the meanings and definitions of the words used by
others to describe those experiences. (115).
John Mills in Lacan on Paranoiac Knowledge23, writes that, Lost in its
alienation, the Lacanian subject24 discovers itself in the imaginary, recovered through the
mediation of the other, giving itself meaning through the symbolic, struggling on the
threshold of the real. (36). Jacques-Alain Miller, in The invention of delusion25, writes
that Delusion and elementary phenomenon constitute a binomial (1) between the
elementary starting point of an understanding and the consideration of an outcome, a
starting point, as in the case of a delusion. Miller notes that a subject differentiates itself
within a discourse, whereby a delusion itself is an accentuation of what is carried
within (2). For Miller, delusion has a psychical cause because it requires an intellectual
effort to explain this curious, strange and disturbing intrusion. (4) It is in Lacans

23 Mills, Jon. (2003). Lacan on paranoiac knowledge. Psychoanalityc Psychology, 20(1), 3051.
24 The divided subject as conceived of by Jacques Lacan.

25 Miller, Jacques-Alan. (2009). The invention of delusion. Translated by G.S.

Marshall. International Lacanian Review, 5: 1-29.

21
medical thesis that, for Miller, Lacan introduces the notion of an elementary
phenomenon emphasizing its causal quality rather than it being a specific part of the
personality. However, as we have seen, the personality (taken as an ego) is not in the
subject, but is arranged in the symbolic order, outside of the subject, outward into the
intersubjective, emergent from a matter of course. This allows the comparison of a
structure given as long as there is a structure of a subject in reality.
Miller uses the example of an ability of a person to summarize an extended story
with a brief reference to its structure (8). This is an elaboration of the delusion, given as a
signifier, given for another signifier, in a formation that is given through the unconscious
(given through differentiation of myself and what I am not). For Miller there is an
element given that structures the experience of the subject in their reality (11). The
delusion is an articulation, the structure of which is that of a language. For Lacan, there is
an organization given by alterations in meaning. This process is psychologically
structural, always being identified in a constitutive role as an appearance of unity. In both
instances, within a delusion and a neurosis, there is always a return of a hallucination;
and in all cases this manifestation is an interpretation. The hallucination returns in
neurosis in what cannot be verbalized, and the hallucination returns in the form of
psychosis as a delusion within the speech of the subject, of something they are certain of
(13).
Conclusion
Where for Jaspers the psychosis can be dismissed as partially unknowable, Lacan finds
all aspects of a psychotics delusions to be meaningful. This, Lacan will postulate as
proof of some knowledge that has no access to conscious awareness as suchsituating

22
the ego in a space, in a setting, which determines it within a discursive environment,
divided as such. This gap in knowledge is anchored in a being, given in its topological
spatial determination. The being, in locating itself, believes in truths out of a paranoiac
position that needs to know, resolved by delusions constituted within systems of magic,
religion and science26. In this way, Lacan reintroduces the role of the name of the father,
the role of a master discourse, into science, into truth, for neurotics only seem to doubt,
and certainty is a sign of a delusion.

26 Lacan, Jacques. Ecrits: a Selection. Translated by Bruce Fink. New York: W.W.
Norton & Company, Inc., 2006. (Page 724)