National History Museum, Lezama Park, Buenos Aires
History beyond Trauma – whereof one cannot speak, thereof one cannot stay silent. Françoise Davoine, Jean-Max Gaudillière (transl. by Susan Fairfield). Other Press, New York, 2004
History beyond Trauma by Françoise Davoine and Jean-Max Gaudillière is a most interesting effort to establish and describe the effects of psychoanalysis in seriously disturbed patients; its outstanding hypothesis is to link psychosis with “post-traumatic stress disorders” i.e. war neuroses. The un-said: a Real unable to be surrounded by words lies unrecognised beyond symptoms and elementary phenomena; these have come to be undecipherable, unreadable, inexplicable. A corrective paraphrase of Wittgenstein’s famous aphorism is the book’s subtitle and motto: whereof one cannot speak, thereof one cannot remain silent. Thus the general programme: the different chapters develop it further through case histories as well as by allusions to American war-psychiatrists’ experience – e.g. the Salmon principles, which are extensively discussed and illustrated throughout the last chapters:
“In 1994 we were the guests of The Washington School of Psychiatry, founded by Sullivan in 1930 (…)This is how we learned that, as they were about to intervene in the war in 1917 and were wondering about the huge proportion of psychiatric casualties in the allied forces – one seventh of the fighters were discharged for disability – the Americans sent an observatory commission to Europe. Thomas W. Salmon (1917) was the consultant for the American expeditionary force… (p. 104-5)
Proximity opens up a new space of trustworthiness amid chaos.
Immediacy constructs a welcome to the return from hell.
Simplicity emphasizes the obligation to speak without jargon”. (p. 116)
Thomas W. Salmon
Across three extended sections, the authors offer their personal translation of the two first principles in praxi, and keep the last one undeveloped to exemplify their Conclusions. Bion’s group experiences with disabled soldiers are also mentioned, though only anecdotally (Bion, 1946).
A touch of European flavour is added by numerous literary references, mostly by French writers from all ages; a slight detour questions non-psychoanalytic psychiatry, i. e., the neurobiological, psychoactive-medicine trend and its subjectivity-denying orientation.
Clearly, the book’s strongest appeal lies in the case histories, a frequent condition in post-Lacanian writings, as further theoretical developments or ramifications become increasingly difficult to set up.
Notwithstanding this circumstance, some points seem to invite a close scrutiny.
The first one is therapeutic optimism regarding supposedly severe disturbances; here, the adjective points precisely to the problem elicited by the designation itself.
Does psychoanalysis cure psychosis? The question was poignantly raised in an extended article by Colette Soler (Soler, 1984) that is, in fact, yet another book review – of Marion Milner’s The Hands of the Living God. In this unending-case account, Winnicott’s disciple assures us she has rescued a young woman from schizophrenia, a strenuous effort that demanded of her and her patient no less than twenty years of analysis.
One of the main issues discussed by Soler is diagnosis. In this aspect, her critique of Milner’s outlook is extremely sharp: the American-English psychoanalyst merely receives and accepts the psychiatrist’s label worn by (or rather, set upon) the patient, and not the slightest attempt to question this established stamp appears anywhere.
Quite differently, Soler builds up a detailed structural scaffold – by means of Lacan’s innovative discourse-theory – to conclude that Milner was wrong, indeed. Notwithstanding the subtleness of this investigation, we could add that clinical phenomena could have advised Milner otherwise right from the beginning. Soler accordingly denominates Milner’s behaviour “l’insouciance diagnostique” – diagnostic carelessness. As we shall see, this brings us in proximity to Davoine and Gaudillière’s position.
Indeed, these authors reject diagnosis as such altogether, and might thus be attributed with the same “insouciance”:
“And so we are setting forth these principles here (…) They will be our guide as this book progresses, and we shall show how they work clinically and dynamically for all analysts faced with the urgency of traumas and madness. Two basic requirements are set down in advance: do not diagnose…” (p. 114)
Certainly, no one would object to being free of prejudices capable of disturbing a thoroughly neutral, abstinent receptive approach. And psychiatrists have never been so consistently inclined to gag, muzzle or stifle lost fragments of memories by means of psychoactive drug excess as in current times of the DSM hype. Nevertheless, rejecting diagnosis altogether runs into strict danger of collision with the terms the authors use for patients whose case histories they narrate, since expressions like “psychosis” or “madness” do appear after all.
The contradiction seems even more sharp if we recall not only Lacan’s lifetime activity as a psychiatrist, but his structural outlook itself. Publications by the original Lacanian school featured considerable amounts of historic descriptive texts by Clérambault, Kraepelin and others. Consistently, Soler draws an exhaustive inventory:
“The list of the lacking elements in the diagnosis may be set up: no hallucinations, no voices, no imposed words, no comments on acts; nothing that recalls the initiation of an enigmatic significance, no dissociation, no body without organs. Not a trace, then, of elementary phenomena or disturbances of language…” (Soler, 1984, p. 38)
Furthermore, many of the formulae that Lacan developed may be used, in fact, to distinguish clear differences between the Freudian categories of relationship to the Other (neurosis, psychosis, perversion). Soler firmly rejects any in-between phenomena, since
“…in matters of diagnosis, significant causality of psychosis rules out the species “fish-rabbit”; (…) if structure weighs a priori on the treatment’s aim and outline, establishing diagnosis beforehand becomes mandatory” (Soler, 1984, p. 37).
The alternative, “careless” behaviour strongly recalls former Kleinian times, where all human beings were supposed to conceal an innermost “psychotic nucleus” which, in turn, had to become the main and only goal of any therapy. As again Soler most ironically mentions, the result is that the analyst does not cure a schizophrenic patient, but the patient’s schizophrenia… In the end, the possibility remains of Lacan’s aphorism in “On a question preliminary to any treatment of psychosis” being true again: analysts cure psychosis on the condition that it actually isn’t one (Lacan, 1955-56).
We could, in fact, go over the case histories and – indeed – apply Lacan’s algebraic formulae as Soler does. However, a mere descriptive account would perhaps suffice. But let us cite one of the authors’ case histories – the patient nicknamed “Gilda”:
“After five years of analysis with you,” said Gilda. “I’ve just made a discovery. The goal of my psychosis, for twenty years, was to get me to find a feeling to bring back together the separated pieces of what I’ve been able to construct over the years…” (p. 21)
The vicinity with Milner’s “Susan” history is even more patent, as the latter complained about “having lost her soul” – as Soler keenly puts forward,
“Alas, psychiatric hospitals do not handle feminine mysteries: this one has just been electro-shocked…” (Soler, 1984, p. 31)
There is yet another finding: the authors repeatedly venture their interventions based on a heavy amount of sudden intuition:
(“Ernest”): “I am going now. I’ve decided to kill myself. It’ll look like an accident. I’ve got a paper on me that will give my body to science. It has nothing to do with you.”
(The analyst): “I consider myself responsible. It’s your sister and brother, not you, who should rest in peace in a grave” (…)
“What made the analyst so sure that she could, for a moment, play the monstrous role of the mistress of death, only to turn around, acknowledge her flaws, and claim responsibility for the announced suicide?”
While nobody – not even the toughest, most rational and exceedingly strict, rigorous analyst – would deny the weight of intuitive movements involved in any analysis, the difficulty arises when somebody asks how this could be transmitted (i.e., the Freudian Reason at play), since impulses of the heart rarely – if ever – crystallize into a theory to be conveyed and passed on to others. We are once again reminded of old Kleinian times, when analysts had to rely on their “counter-transferential feelings” rather than on the logic of the signifier. Taking for granted that a complete training analysis had comprehensively emptied the analyst of any unconscious contents, everything he/she felt and/or thought during the interview was nothing else than the patient’s “projective identification”.
Consequently, phenomena recalling the unexplained “communication between unconsciouses” repeatedly appear:
“Joseph continued (…). Then, in a sudden fury: “Why didn’t you take care of me when I was a baby?” (…) The reply to this displaced question arose the following night, in the form of a surrealistic dream of the analyst’s in which there occurred the image of an “exquisite corpse” (…) As bizarre as this might seem, he had had this dream in the place of Joseph…” (p. 174-5)
The designation “madness” being questionable or even volatile, the aforementioned point of genuine interest continues: the proximity of “traumatic neurosis” (to use Freudian terminology) or PTSD (to honour fashionable psychiatric naming trends), regarding “psychic causality”.
And here we find another difficulty. The authors cite Jonathan Shay (Shay, 1995, 2002), a former American psychoanalyst who relinquished his membership in the Association (readers familiar with the insistent Lacanian critique of American psychoanalysis that runs through the whole volume of the “Écrits” like an obsessional Leitmotiv will not have any trouble understanding his disappointment) to devote himself completely to his work with war veterans – who, as everyone knows, are a highly archetypical American commodity whose massive production increases exponentially on a daily basis. Both books by Shay are very well worth knowing, as the principles which he works upon – establishing a possible border by signifiers to the Real without a name, triggered by betrayal of the superiors or bereavement of a therapon – overlap very well with Lacanian ideas, rather than the American ego-psychology which Shay took an understandable distance from.
However, the subjects of the case histories of “war neuroses” Davoine and Gaudillière describe have not had any direct contact with combat situations. War is only present in the memories of grandparents, parents or relatives (and in those of the authors’ relatives themselves) – or (and this is the authors’ main issue) precisely in the unnoticed holes, cracks and darning that become traceable in these memories. Thus, “traumas” are – so to say – somewhat second-hand… Certainly, one might generalise the definition of “trauma” – as Freud indeed did, remembering the postulate after which sexuality includes a traumatic kernel by itself. Every psychoanalyst’s experience shows that psychic wounds may run through generations before becoming symptomatic. But does this mean we may generalise the term “war neurosis” to include any distant, far-reaching consequences of disruptions that haven’t been adequately met or worked through?
Jean.Max Gaudillière and Françoise Davoine
Bion, W. R. (1946), Experiences in Groups, Tavistock, London
Lacan, J. (1955-56) On a question preliminary to any possible treatment of psychosis. In: Écrits: A Selection (1977), trans. A. Sheridan, Norton, New York, pp. 179-221
Shay, J. (1995), Achilles in Vietnam: Combat Trauma and the Undoing of Character. Touchstone Books, Simon & Schuster, New York
Shay, J. (2002), Odysseus in America: Combat Trauma and the Trials of Homecoming. Scribner, New York
Soler, C.(1984), Une passion de transfert (A passion of Transference), Ornicar ? No. 29, Navarin Éditeur, Paris, pp. 31-57