4inquiries (4inquiries) wrote in psychoanalysts,

Lakoff on Drug Therapy

From “The Lacan Ward: Pharmacology and Subjectivity in Buenos Aires” (2003):

Given that Lacanians are opposed to drug therapy, we might expect never to see a Lacanian analysis on medicated psychotics. However, the development of anti-psychotics in the 1950s proved that drugs could make psychotics accessible to psychoanalytic intervention for the purposes of stabilizing their fictitious worlds. What happens when Lacanians encountered such new candidates for analysis? Lakoff tells us of just such a case during the ‘80s and ‘90s at the public Hospital Romero in Buenos Aires, Argentina.

At the Hospital Romero there was a twenty-bed “women’s ward” called the “Lacan ward,” complete with a computer to look up a fully indexed copy of Lacan’s seminars (86). At this time Lacanian psychoanalysis was popular in public hospitals and counseling centers. Argentinian lacanismo might have been a fad, or perhaps “the turn in the mental health community toward Lacan’s hermetic philosophical system had been complicit with the military dictatorship’s efforts to depoliticize the mental health field - that Lacanianism’s detachment from social problems allowed it to survive the ‘dirty war’ period” (85). Or perhaps psychologists flocked to the Lacan’s anti-drug doctrine as a rebellion against the Argentinian Psychoanalytic Association’s restriction of analytic practice to medical doctors. In any case “when the Faculty of Psychology reopened in 1983 after the fall of the dictatorship, they [the Lacanians] were well placed to lead the institution” (85).

Because the Lacanians administered medication to facilitate analysis at the same time that they were disapproved of medicating patients, “their formal status as physicians often came into tension with their professional identity as [Lacanian] psychoanalysts” (86). The Lacanians’ management of this split identity “was accomplished through a strict distinction between the work of the doctor and that of the analyst” (87). In other words there had to be a disavowal of the anti-psychotic medication therapy by the Lacanian psychoanalysts, “Medication, as the means for managing symptoms so that subjectivity could be investigated, played a crucial but unspoken part in sustaining this distinction” (87). For an example of this disavowal, Romero staff doctor Norberto Gomez “did not agree with the erasure of subjectivity” effected by drugs he administered (88). Thus we can conclude that the analytical Order had a hole in it - marked by psychosis as an impasse of analysis - the Lacanian analyst disavows this hole by shoring it up with a fetish, medicine or the medical order in general, “The ironic use of medication - to sustain subjectivity rather than to transform pathology - made the hospital a place where one could remain an analyst, despite the exigencies of the medical order” (98). The disavowal of the importance of medicine for the psychoanalytic order is a desire to recover the lost, imaginary satisfaction of being a total, pure psychoanalyst. But there is no pure or absolute psychoanalysis.

Even when patients showed sufficient improvement for release, determining the agent of improvement (drugs or therapy) could prove impossible. Lac-an, Lak-off, Lac-an, Lak-off.
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