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Journal of the GIEP כתב עת של ה-

Et Lacan 4: Psychoanalysis and Medicine

Call for Papers

In the first lesson of Seminar XI[1], in the context of the effort to situate psychoanalysis in relation to science, Lacan mentions "the daughter who does not speak." Psychoanalysis, he states, directs its interest at getting her to speak rather than at explaining why she does not do so. And medicine? Will it speak where the silence of science reigns?

In a lecture entitled "Medicine and Science: How to Manage With the Subject?"[2] given in Strasbourg on June 2006, to an audience of physicians, by François Leguil highlights a direction taken by medicine which Freud had pointed out as early as 1890[3]: its scientifization. This direction leaves by the wayside something that psychoanalysis places at the center: the subjectivity of the patient. The scientifization of medicine hence makes psychoanalysis medicine's remainder object. Yet it is from this locus of the remainder that psychoanalysis can speak to medicine.

Leguil refers to the various ways in which Freud uses the term "physician": sometimes as a synonym for the term "psychoanalyst" and sometimes as a distinct term. This is because Freud considers the physician with respect to his function rather than his diploma. This function originates in what was given to the physician by "the magic of words," and it has to do with the warranty given by the physician to the suffering that goes beyond the domain of science.

It is no other than the rise of science, says Lacan[4], that subverted the position of the physician. This position must be examined in relation to demand. "It is in the register of the response to the patient's demand," Lacan says in a 1966 lecture on the place of psychoanalysis in medicine, "that the survival of the physician's position as such stands a chance." "What I indicate in speaking in the position the psychoanalyst might take," Lacan adds, "is that nowadays it is the only position starting from which the physician might preserve the originality which had always been proper to his own position, the position of he who must respond to the demand for knowledge."[5]

How might the physician position himself with respect to the demand for knowledge when faced with the question: "doctor, what is wrong with me?" that materializes the patient's suffering? Even in the era of science, physicians still have a space in which to locate themselves vis-à-vis the patient's demand: a space that is in the dimension of language, a space made of words and the spaces of silence among them. Given the psychoanalytic discovery regarding the power of this dimension, its ability to cause changes in symptoms, how might the physician's reply include what Eric Laurent calls "symbolic efficacy"[6]: language use not limited to universalist, statistical data but grounded in the patient's own phrasing of his suffering which, without his knowing anything about this, ciphers his unconscious truth[7]? Can physicians today be concerned with what the patient "says, cries out, stutters or mumbles?"[8] Can the medical operation of a contemporary physician involve the calculation of the subject's phrasing of his demand?

Lacan draws a distinction between the body as perceived by medicine in the era of science and the body of jouissance.[9] The body of scientificized medicine is the body placed in MRI's, the body photographed, calibrated and inserted into statistical charts. The body of jouissance is the irreducible particularity of the patient's suffering. The jouissante body, says Lacan, is accessible to the physician only via the dimension of pain. The photographed and calibrated body veils and excludes the body of jouissance. What clinical savoir faire, then, is necessary to the contemporary physician so that he might reinsert the body of jouissance into the discursive frame of medicine? How might we understand Lacan's statement in his 1966 lecture on psychoanalysis and medicine according to which "the direction of jouissance is the very direction wherein medicine's ethical dimension is to be found?"[10]

And the psychoanalyst? Is his position so assured? It is not so difficult to locate the risk involved in the assimilation of psychoanalysis into capitalistic-scientific discourse as much as in its detachment from this discourse. The psychoanalyst is no more immune than the physician to the challenges stemming from scientific innovations and the technological possibilities ensuing from them. This is seen in contemporary developments such as neuro-psychoanalysis or treatment via video conferences and other media on the one hand and a nostalgia for a historical version of the Name of the Father on the other.

Et Lacan, the journal of the GIEP, wishes to dedicate its next issue to these questions. This issue will be bilingual: Hebrew and English.
We invite members of the NLS to contribute papers on issues outlined in this argument.
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Articles, in either English or French, should be sent to Omri Bichovski no later than the end of September to the following email address:

bicho@netvision.net.il

The Et Lacan editorial cartel.
Omri Bichovski, Ilana Rabin, Shirly Sharon zisser, Einat Semel, Nehama Guesser. Anne-Lysy Stevens (plus un)



[1] Lacan J., The Four FundamentalCconcepts of Ppsychoanalysis, Trans. Alan .Sheridan. New York: Norton, 1994, p.11

[2] Leguil, F. "La médecine et la science : comment compter avec le sujet ?" Ornicar? Digital 304, 2006.

[3] Freud, S. "Psychical (or Mental) Treatment." (1890a). The Standard Edition of the Complete Psychological Works of Sigmund Freud. Trans. James Strachey et al. London: Vintage, 2001. Vol. 7, pp. 283-302

[4] Lacan, J. "La place de la psychanalyse dans la médecine." Cahiers du collège de Médecine 1966, pp. 761-774.
[5] Ibid.
[6] Laurent ,E. "Evidence-Based Medicine"
[7] Lacan, J. "La place de la psychanalyse dans la médecine." Op. cit
[8] Miller, J.-A. The Pathology of Democracy. Op. cit.
[9] Lacan, J. "La place de la psychanalyse dans la médecine." Cahiers du collège de Médecine 1966, pp. 761-774.
[10] Ibid.