Untitled Document

Review Essay
Patricia Gherovici, Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism, New York: Routledge, 2010
Patricia Gherovici and Manya Steinkoler eds., Lacan on Madness: Madness Yes You Can’t, New York: Routledge, 2015.

Daniel Wilson
Independent Scholar

Daniel Wilson lives in Montreal, where he studies and writes about psychoanalysis.  He is interested in the relationship between the history of psychoanalysis and the contemporary clinic.  He has a PhD in English Literature from Cornell University.

In Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism (2010), Patricia Gherovici considers “America’s recent fascination with sex change” (Gherovici, 5), arguing that “the democratizing of transgenderism should not be predicated on essentialist notions of normativity” and that because “transgenderism is not an illness, a sex change cannot be either a treatment or a cure” (Gherovici, 4).  At the same time that Gherovici offers a psychoanalytic interpretation of transgenderism, she argues that “transgender discourse has profoundly altered and reoriented psychoanalytic practice” ( Gherovici, xiii), and reads both the origins and history of psychoanalysis—from the question of bisexuality in Freud and Fliess, to Freud’s analyses of hysterics, the pousse-à-la-femme in Schreber and Lacan’s treatment of transsexuals—through the lens of transgenderism.  Gherovici ultimately links the question of transgenderism to Lacan’s late work on psychosis and the sinthome, arguing that a transgender identity can be read as a sinthome, a creative response to the failure of the phallic order to account for the subject.  As she writes, “The unconscious reveals that there is no stable sexual identity, only sinthomatic identities.  Man and woman are alienating positions that are regulated by a cunning phallic order.  One can remain trapped in hysterical identifications that serve the master while still looking for a new guarantee or a totalizing Other.  But there is another option:  to reinvent one’s sexuality by identifying with one’s sinthome” ( Gherovici, 247).

Lacan on Madness: Madness, Yes You Can’t! (2015), edited by Patricia Gherovici and Manya Steinkoler, contains case studies, contemporary theorizations of psychosis, and readings of madness in relation to literary creativity.  Part of the interest in reading Lacan on Madness alongside Gherovici’s work on transgenderism is that at the same time as Please Select Your Gender negotiates a specifically American fascination with transgender discourse, it also speaks to a trend in contemporary French psychoanalysis that declares that the time of the Name-of-the-Father and the phallus have passed, and that it is now the sinthome that must serve as a solution to the subject’s encounter with the void at the center of signification. As Geneviève Morel writes in her contribution to Lacan on Madness:  while “the phallus has been a universal signifier for a very long period of history” (45), “nothing can guarantee that the signifier of the phallus as emblem of sexual discourse will not be taken over by a multitude of individual sinthomatic solutions” (45).  A number of essays in Lacan on Madness speak to the theorization of psychosis in the contemporary French clinic, and reading Please Select Your Gender along with these essays suggests that, before asking after the experience and enjoyment of transsexuals, it is prudent to ask how a certain vision of “the woman” as sinthome is itself a symptom of a worrisome refusal of castration within a certain line of mainstream psychoanalysis. 

Please Select Your Gender draws heavily on Morel’s theorization of the transsexual as psychotic, and of  “the woman” as a privileged sinthome that replaces the Name-of-the-Father.  Gherovici writes that “as Geneviève Morel contends, the freedom of the psychotic resides precisely in this rejection that forgoes the phallus and the Name-of-the-Father together and that ends up requiring an invention to anchor jouissance” (Gherovici, 164).  In her Sexual Ambiguities (published in French in 2000 and in an English translation in 2011), Morel reads Lacan’s dictum that “the woman does not exist” against Lacan’s formulas of sexuation, where woman is “not-all” under the phallic function.  Morel proposes that whereas “the woman does not exist” if “the father exists,” in psychosis, where there is a “foreclosure of the Name-of-the-Father and the phallus,” Lacan’s formulation can be rewritten such that “ ‘the father does not exist’ and ‘the woman exists’”(Morel, 231). There is, as Morel writes, “an exclusive ‘rivalry,’ in the structure, between the Name-of-the-Father and the signifier ‘the’ woman” (Morel, 231).  Either the Name-of-the-Father sustains the phallus as a signifier of desire, or “the woman” can be constructed as a sinthome. 

Whereas Lacan proposes that “the woman” doesn’t exist because of a fundamental incompatibility between subjective experience and what can be articulated in language, Morel argues that it is the name of the father and the phallus that prevent “the woman” from existing.  As Lucie Cantin writes, concerning a certain structural complicity between femininity and perversion, it is “as if, in this fundamental injury that language introduces, and which overdetermines the human subject and the exile of the subject from its biological reality and the jouissance of the instinct, the stakes of castration were at once recognized and refused.  On the other hand, the ideal figure of the 'complete woman' is erected and the hatred of men directed against this figure establishes the proof of its consistence” (Cantin, 59). Gherovici argues that in the push-towards-woman that Lacan identified in Schreber's delusion, “Lacan found the lineaments for a new theory of sexual identity” ( Gherovici, 156), in that the “push-towards-woman […] makes up for the deficiencies in the Name-of-the-Father and is a correlate of his transsexual jouissance” (Gherovici, 178).  One might respond, however, that although it may very well be the case that certain transsexuals are motivated by a “push-towards-woman,” a reading of the “push-towards-woman” as not only a symptom that avoids the confrontation with castration but a discourse that alters psychoanalysis itself raises the question of whether psychoanalysis is an ethics that sustains the subject in its encounter with castration, or whether psychoanalysis will assimilate itself to the medical, sexual, religious, and social strategies that offer to protect the subject from castration.

The reading of the transsexual through Lacan’s reading of psychosis speaks to a certain expansion of psychosis as a clinical diagnostic category, one which would seem to be related to the idea of “ordinary psychosis,” which Jacques-Alain Miller developed in the 1990’s.  In “Ordinary Psychosis Revisited,” the text of a talk Miller gave in 2008, Miller recounts the development of the concept. “Because true perverts don’t really analyze themselves,” Miller writes, clinicians were faced with the question of whether a given patient was neurotic or psychotic, such that “you saw people trying for years to decide if their patient was on one side or the other.”  Miller recalls that he thus invented the idea of “ordinary psychosis” in order “to dodge the rigid binary character of our clinic—Neurosis or Psychosis.” Ordinary psychosis is therefore “an epistemic category.”  Since there are any number of psychotics who have not been “triggered” there is perhaps no way of knowing whether one is a neurotic or a psychotic.  As Jean-Claude Maleval writes, in Lacan on Madness, the analyst must thus attend to the possibility that a given patient suffers from “ordinary psychosis where the signs are discrete, since they are not medicated and remain untriggered” (107).

If the analyst’s fundamental position remained the same regardless of whether the analysand was a psychotic, a pervert, or a neurotic, there would be nothing at stake in the epistemic category of “ordinary psychosis.”  But this is not the case, as Maleval’s invaluable contribution to Lacan on Madness, “Psychoses and Contemporary Psychoanalysis,” makes clear.  Maleval traces the theorization of psychosis in the École de la Cause Freudienne since Lacan’s death.  Whereas, Maleval writes, Lacan theorized a “deregulation of jouissance” (104) in psychosis, “he did not realize the implications of this for the direction of the cure” (104), for “if one accepts the thesis that ultimately it is the invasion of jouissance that the psychotic suffers from, does it not make sense that the analysis should oppose it?” (104).  Maleval thus proposes that the analyst should help the psychotic subject “to bring order to his world” by “trying to direct the jouissance, at times limiting it by blocking the de-regulated jouissance, and at times in a positive manner by sustaining certain of the subject’s ideals” (106). The creation of “ordinary psychosis” along with this idea that the analyst could take responsibility for regulating jouissance for the subject, would seem to map a turn from an analysis that sustains a speech about jouissance to an analytic discourse that claims to protect the subject from jouissance, and which celebrates the sinthome as a protection against castration. 

This expansion of the category of psychosis—in addition to the evocation of “ordinary psychosis,” articles by Darian Leader and Russell Grigg, argue, respectively, that manic depression and melancholy should be classed with the psychoses—along with the idea that the psychotic should be protected from jouissance, emerges in a number of essays in the collection.  Guy Dana proposes that the institutional attitude of care for a psychotic should be “like that of a mother” (49).  Paul Verhaeghe writes of “new symptoms” with which “classic psychoanalytic treatment does not work” (70).  Since the problem for these new patients is often a “failed relationship with the Other” (77), Verhaeghe proposes that “the literal presence of the Other and his or her gaze is necessary” (77).  The therapist must develop “a positive therapeutic relationship” that will “make possible the transfer of representations coming from the therapist” (78).  Jean Allouch argues “one cannot actually say that the psychotic has transference, as one would say of the neurotic” (119), for while “the psychotic positions himself transferentially […] in making it known that the Other speaks to him”(119), the psychotic is “unable” to “let go” of his position as “subject supposed to know” (120).  At the same time that these articles affirm that psychotics can indeed be treated by psychoanalysis, they suggest that psychotics must be protected from the real of the unconscious. 

The two case studies in Lacan on Madness appeal to the category of ordinary psychosis. In “The Case of the Baby Diaper Man” Rolf Flor writes of “Jay” who identifies as an “adult baby” and a “diaper lover.” As a child Jay had never succeeded in becoming fully toilet trained.  As Jay’s “enuresis continued into adulthood […] the problem had become its own solution” (19).  Jay found comfort in the “paraphernalia of infancy” and began to participate in both virtual and real communities through which he “found himself able to develop a quasi-symbolic matrix that made it possible to negotiate the challenges of connecting to others” (19).  In a footnote Flor notes that while the case is not “a classical psychosis” he has “found some tools in Jacques-Alain Miller’s Ordinary Psychosis” (32).  The implicit argument would thus seem to be that Jay’s “ordinary psychosis” found its solution in the sinthomatic “quasi-symbolic matrix” of the adult baby community.  A case study by Morel, “Ilse or the Law of the Mother,” writes of Ilse, a woman who has a baby with her lesbian partner.  Morel proposes that in taking herself as a “parent,” and thus establishing a new mode of familial organization in the place of the Name-of-the-Father, Ilse “shows that one way of inventing such a sinthome” that will sustain the subject who has neither access to the Name-of-the-Father nor to the phallus “is to make use of the new forms of parenthood taking shape in our societies today” (33).  When Ilse brings an incestuous dream to her analysis, Morel writes that “while ideas of paternal incest […] could evoke the triggering of a psychosis,” in Ilse’s case it is “accompanied by a certain stabilization” (40), and that “the fact that there wasn’t the least psychotic emergence at that particular point again confirms the sinthomatic value of the solution Ilse found to the problems of generation and sexual difference” (43). Within the category of ordinary psychosis—a concept which Morel brings up in a footnote—the lack of a psychotic crisis becomes evidence of a sinthomatic solution.   

If the correct attitude towards a psychotic is to protect the subject from jouissance, and any analysand is potentially an “ordinary psychotic”—since as an “epistemic term” ordinary psychosis has to do with the analyst’s knowledge—there would seem to be a risk that the clinic would institutionalize a kind of negative transference where the analyst is given license to work against jouissance, and thus to relegate the subject to silence.  The sinthome risks appearing as an ideal beyond which an analysis cannot proceed.  The elevation of the sinthome as that which prevents the subject from falling into a crisis suggests a certain mistrust of the subject’s ability to maintain an ethical orientation towards speech in the encounter with the void that is das Ding.

In these terms, an article by Claude-Noële Pickmann is of special interest.  In “She’s Raving Mad,” Pickmann opposes the excess of femininity to the closure of the sinthome.  Whereas Pickmann writes of the sinthome as that which “allows to make up for what does not stop being written”(197), she argues that femininity—that which is “not-all” under the phallic function—“reveals that there is no order to existence, and no partner who could respond to restore order” (199).  For the feminine subject, there is no place “where what never ceases to not be written would finally be written or where subjectivation would finally hold” (199).  In similar terms Juliet Flower MacCannell’s “The Open Ego: Woolf, Joyce and the ‘Mad’ Subject” argues that Woolf reached an impasse between the “‘phallic’ order” which “positions her as a defined object in a patriarchal culture” and “a wild Nature free of all restriction, all order” which “potentially locates woman outside the shelter of phallic order, along with the pleasures of the sublime—terrifying excess” (208).  Through a reading of Joyce’s “The Dead,” MacCannell mounts a defense of a masculine ethics defined by a man’s “willingness to face death for his love” (212). In a reading of Lacan’s graph of sexuation, MacCannell writes that “the feminine requires […] a word (of love) from a barred Other” in order to “go beyond her phallic definition as an object” (219).  In “The Dead,” MacCannell argues that this willingness to face death is a gesture that functions as “the subjective support”—as a “sign of love from a barred Other”(213)—that sustains a feminine subjectivity.  Part of the strength of MacCannell’s theorization of this “word” that sustains the subject is that in MacCannell’s reading it is Joyce—who has an almost iconic status in Lacanian discussions of the sinthome as a solution to the foreclosure of the Name-of-the-Father—who proposes the gift of a signifier as a “subjective support.”  This suggests that it is in psychosis, where the subject encounters the lack in language without the support of the Name-of-the-Father, that the signifier of the effects of the signifier—the phallus—finds its necessity. 

There is no shortage of discourses that claim to be able to take responsibility for the fact of castration and for the position in jouissance that determines the singularity of the subject.  Freud writes, in “Inhibitions, Symptoms, and Anxiety” that “being of a peaceable disposition [the ego] would like to incorporate the symptom and make it part of itself.  It is from the symptom itself that the trouble comes” (100).  To take the side of the symptom is to take the side of this trouble, to sustain the subject in his or her confrontation with the real of enjoyment.  To take the side of the symptom / sinthome as a limit that cannot be gone beyond, and to try to protect the analysand from jouissance by enforcing a peace between the subject and the social link, would seem to sell the subject short. For what could be the specificity of the analyst’s offer, if not the knowledge that since there is no one else who could do it in his or her place, it is only the subject who can take responsibility for that which is at work in the body? 

A number of articles in Lacan on Madness consider madness outside of the constellation of the sinthome and ordinary psychosis that I’ve tried to outline.  An article by Nestor Braunstein proposes that it is the “responsibility of psychiatrists or psychoanalysts” to “place themselves on the psychotics’ side, to try and see things from their perspective and not from the perspective of cultural, familial, and political demands and social expectations” (96). An article by Richard Boothby gives a Lacanian reading of suicide bombers.  An article by Jasper Feyaerts and Stijn Vanheule is a useful reading of the mirror stage in Merleau-Ponty and Lacan, and Hector Yankelevich considers the relationships between narcissism, neurosis, and the mirror stage.  There are also a number of strong readings of literature and psychosis by Paola Mieli, Stephen Whitworth and Olga Cox Cameron, as well as a fascinating reading, by Manya Steinkoler, of a dense text written by a psychotic man.  


Works Cited

Cantin, Lucie. “La féminité: D’une complicité à la perversion à une éthique de l’impossible.”  Savoir: Pschanalyse et Analyse Culturelle 2, nos. 1-2. (1995):  46-85. My Translation.

Freud, Sigmund. “Inhibitions, Symptoms, and Anxiety.”  The Standard Edition of the Complete Psychological Works of Sigmund Freud.  Ed. and Trans. James Strachey.  London:  Hogarth Press, 1981.  Vol. XX.

Miller, Jacques-Alan. “Ordinary Psychosis Revisited.” (2008). Online. Available through the New Lacanian School of Psychoanalysis Archives: http://scholar.google.ca/scholar_url?url=http://www.nlscongress.org/wp-content/archivos/Ordinary-Psychosis-Revisted-J.-A.Miller.pdf&hl=en&sa=X&scisig=AAGBfm3fMFjRzgOvunT4eAqK1BHhf4FlTQ&nossl=1&oi=scholarr&ved=0ahUKEwiz2vbxl_nOAhVEGx4KHXjpA38QgAMIHSgAMAA

Morel, Geneviève.  Sexual Ambiguities. trans. Lindsay Watson. London: Karnac, 2011.


  • There are currently no refbacks.