On Psychopathology

Date: May 4, 2020
Interviewer: Ala Akbarian Tefaghi

This interview originally published on E-mag, Evolp’s Group Evolution Psychology magazine, Second Issue: Abnormal Psychology and Evolutionary Psychology, 2021 in English and Persian. The translation and edition of the Persian version had been done by me. You can purchase the magazine and read the Persian version there.

1. What are the role of new sciences and fields of studies in psychology (e.g. Affective Neuroscience) on Classic Psychoanalysis as opposed to Freud’s Followers and other psychodynamic analytical approaches both, in theory and in the techniques.

JL Vannier: classical psychoanalysis? And why not a “vintage” psychoanalysis? The way you raise the question seems to lead to the fact that there would be an old fashioned psychoanalysis opposed to a modern one. When you read carefully Freud, more likely in the original German edition, you will find that his ideas were and still are very contemporary. I see many times young clinicians, included some in Iran, rushing to buy the latest book published on Freudian psychoanalysis without having read any or only a little few works written by Freud himself. As the late French philosopher Jean Guitton said: “to want to be in the wind [to be trendy] is to have the fate of a dead leaf.

Coming back to your question, you can find almost everything in Freud’s followers: on the one hand, it proves that Freud’s thoughts are “living”: like what I call a “living book” you can read it several times in your entire life and discover through each reading unexpected ideas. Never forget the epistemology [way of working] of Freud as he learnt it from his master Charcot while in Paris: “read and study, over and over again, day after day until suddenly, understanding arises”. On the other hand, some Freud’s followers introduced some “fresh air” in the doctrine. They “dusted” old translations and in doing so, they discovered the real meaning of some essential concepts in Freud’s mind: I think of the striking difference between “instinct” and “drive” that was completely obscured in Strachey’s translation and that is the utmost importance to understand Freud’s wavering between the confirmation and the abandoning of his seduction theory.

But many others threw simply the baby out with the bathwater: It is always surprising for me to read a twenty pages article about Freudian psychoanalysis without finding once in it the word “sexuality” –the infantile sexuality– which remains the cornerstone of the entire Freudian corpus.

Last but not least, I shall tell you my deep thought. I think that psychology and psychoanalysis have definitively distanced themselves to a point that both have little to do with each other anymore:  the “unconscious” and, moreover, the “internal foreign body”, two essential concepts both in the theory and for the clinic, leave the today psychologist perplexed, not to say irritated. The evolution of neurosciences even tries to replace the sexual drive with a theory of motivation. It reduces libido to adult sex only and this sexuality to almost nothing. The unconscious is reduced to neural circuits, awareness to information processing and Superego to social pressure. The main contribution of psychology to psychoanalysis lies however in the observation of children, in particular the development on a genetic basis of a communication between adults and children at the earliest ages. These experiments dismiss the strange analytic concept of “primary narcissism”, notwithstanding the fact that this observation relates more to self-preservation and that it lacks consideration of the asymmetry between the two protagonists on the unconscious level and therefore forgets the sexual dimension. Finally, two evolutions of psychoanalysis seem very damaging to me: the reduction [the fold down] of the sexual drive on the instinct of self-preservation and the tendency to favor in the analytic theory, since Hartmann, the “sphere of a free Ego” over the drive conflict.

2. Based on our common social and cultural stereotypes and preoccupations or ideas about the human evolution, how can we define and explain psychoanalysis’s function or its theory itself?

JL Vannier: Psychoanalysis has shaken a number of stereotypes: the most important of them was undoubtedly the popular belief, based on a strong cultural resistance, according to which the human sexuality starts only at puberty. To such an extent that Freud, in a posthumous note, wished to assert it again: “infantile sexuality is the prototype of all sexuality”. This reaffirmation is of utmost importance to answer your question: during his development, the human being experiences the sexual drive before the self-preservation instinct. Nurture comes before nature. The object of psychoanalysis is the unconscious and this unconscious, it is above all the sexual in the precise Freudian sense: the infantile sexual drive, anti-adaptive, chaotic, fragmented, and constantly looking for excitement. Unlike adult sexuality which is biologically, even genetically programmed. In this context, the treatment proposed by psychoanalysis aims for the dissolution of synthesis -and stereotypes to come back to your question- previously forged by the subject. The analytical treatment must confront the “unbound”, not as the result of any innate Id, but that of resulting from the asymmetrical relationship between the “other” adult human and the child from the first months of life.

3. If there is one day to talk about “Superior Gene” in the sense of being the kind of “better human” in evolution and their offspring, what could be the features of such human, mentally or seeing from an analytical view?

JL Vannier: to people who fantasize about “Superior Gene” or genetically superior children, I will urgently and strongly advise psychoanalysis. But let’s be a psychoanalyst right to the end: even in the presence of a cloned child, should we still, as Jean Laplanche wonders, “hang the Oedipus on biological parenting or still on the symbolic and cultural equation of father and mother”? To those of his patients who denied the Oedipus complex, Sigmund Freud used to answer: “Don’t you have a father and a mother”? Nevertheless, it would be necessary, with the cloning processes, to question otherwise the principle: “Pater incertus, mater semper certissima” [father uncertain, mother always sure].

4. Is there any possibility of a kind of existential superiority in people who go to therapy in comparison with one who never gets any kind of psychological therapies or with one who starts a therapy but leave it sooner than his case needed?

JL Vannier: “Errare humanum est, perseverare diabolicum” [to err is human but to persist is diabolical]. To define any precise purpose for psychoanalysis – like that of a possible human superiority – would be to go astray from its specificity, its method and, which is the most important, to fail precisely because you get obsessed by a goal to be achieved. The opposite to the fundamental analytic rule, the “free associations”, which is, as we know all except free in the sense that the unconscious determinism becomes more accessible by revealing new connections or significant gaps in the talk. This purpose is close to that of, always criticized by Freud, a “furor sanandi” [the rage to cure]: to pretend to cure at all costs the patients who come to see us. The will to succeed in curing a patient would lead us to let ourselves be blinded by the symptom and forget its etiology: a compromise-formation and its infantile sexual origin. It shows moreover a utilitarian vision of psychoanalysis which would make it the objective ally of the “Ego and its propensity to the synthesis of its contents, to the regrouping and the unification of its psychic processes” as Freud said.

5. All in all, are there any ratings in looking at people with different personality traits and mental conditions? 

JL Vannier: here we are! What heals is true! Psychoanalysis has become infected with a vulgar pragmatism aimed at responding, no doubt for profitable reasons, to the injunctions of the moment: to heal, quickly as a recipe for achieving hyper-consumerist happiness. What I called “fast food therapies”. To assess, to categorize, to “typologize” are characteristics of the psychology which are, in my opinion, infiltrated with a psychic resistance in order to reassure the human being: belonging to a category sutures the unbinding process of the sexual drive. We have many examples of this need for reassurance with the profusion of communitarianism, not to say ghettoization as the groups are closed to each others, in all areas. One of the reasons for this communitarianism lies in the inability of the human being to assume his destiny: instead, he prefers to drown in the mass an individuality that has become too heavy to carry on. Despite all of Freud’s repeated assertions on this subject, we still encounter opposition to the fact that the difference between normal and pathological is a matter of degree and not that of essence. For Freud, and one of his latest article of 1938 confirms it: “it is scientifically impracticable to draw a dividing line between the psychic norm and the abnormality”.

6. Psychoanalytic speaking, are Anti-socials perverts or not? So what are they? If we know Anti-socials as ones with less chance for survival and reproduction among others “normal” people, why are they still here in our societies and they survive till these days? Could we talk about “Abnormal Psychology” by talking about malfunctions and disturbances of their relationships with “Les Autres”?

JL Vannier: You seem to forget that in psychoanalysis, perversion is a psychic structure without any moralizing overtone like the one prevalent in the media. In his very famous 1905 work “Three Essays on the Theory of Sexuality”, Freud asserts about perversions the following: “the tendency to perversion is not something rare and particular, but is a part of the so-called normal constitution” of the human being. Before Freud, Krafft-Ebing and his “Psychopathia Sexualis” of 1893 had listed all the sexual oddities of which the fertile imagination of human was capable. There is little doubt that Freud was inspired by Krafft-Ebing to write the first chapter of his “Three Essays” entitled “sexual aberrations”. By the way, Hans Sachs signed in the “Internationale Zeitschrift für Psychoanalyse” (1923) a very interesting contribution where he underlines: “neuroses, just like perversions, testify to a search for pleasure obtained on the natural route of partial drives, but, foiling the repression, the partial drive can find in perversion a form that we can say familiar of satisfaction”. Lacan praised this article in one of his seminar in 1958.

The idea of anti-social is more contemporary and has been often mentioned by an author like Donald Wood Winnicott: according to him, the anti-social tendency “represents the SOS or the cry of the heart of the child who, at one stage or another, has been robbed [deprived] of the contribution of the environment which should have been his at an age when he missed it.” In his posthumous work devoted to him “Home is where we start from”, he specifies: “In the anti-social tendency, the child is moved by the need to go back, to the time preceding the state of deprivation”.

7. Generally speaking of the current paradigm of Clinical Psychology, and talking about psychologists working with patients having bolder roles in each therapy session, what’s the philosophy of doing talking therapies in this way and this condition? What’s the philosophy behind the different therapeutic settings in psychodynamics and especially insisting on being neutral as a therapist in Classical Psychoanalysis?

JL Vannier: for once, I will try to answer your question with a clinical case. In most French universities and for historical reasons linked to the various psychoanalytic convulsions, the departments of psychology are hold – not to say vampirized – by the users of CBT. This is the case in Nice. However, it often happens that students who follow this course come to experience psychoanalysis on my couch in order to complete their education. Such is the case of a student in the 3rd year of psychology. She came in fact for a specific symptom: a urinary tract infection happens every time she has sexual intercourse with her regular partner, despite the fact that the couple’s blood tests are perfectly normal. It is during a single session that the girl links –“binds” would be more accurate with the psychic register– her infectious symptoms to the fact that she is the third child after her mother experienced two previous miscarriages in advanced pregnancies. “I have two ghosts in me, she explains, and I shouldn’t be there”. Full of guilt, she bursted into tears but she immediately resumes by invoking arguments drawn from her cognitive knowledge. Only after a few seconds, she started to cry again. The same scenario – crying, pulling herself together, and crying again – happened for a while. I did not interfere at all. She experienced on herself the difference between psychotherapy and psychoanalysis, the difference between what Ernest Jones named in 1908 “rationalization” and a kind of abreaction fighting against her resistance. Soon after, her urinary tract infections, which she worried about after having sex, completely disappeared.

8. In Classical Psychoanalysis, how far, while knowing our life’s history and working on our wounds during our ways, could we leave our resistance and so, cure our mental and social damages and traumas?

JL Vannier:  It would be a mistake to believe that to tell your story is enough to get rid of the symptoms. In the previous clinical case, psychoanalysis allowed the young girl to realize much more important psychic reshuffles than those happening with her abreaction which, in fact, belongs to the primary analytic technique. Contrary to what the philosopher Paul Ricoeur proposes, psychoanalysis is not a simple “narrative identity”. It is not a hermeneutics which would consist in discovering a treasure, hidden since always deep in your unconscious. Hence the verb “to bind” that I pointed out in this short clinic case. And for a precise reason: the repression. “Original repression is only the first and founding moment of a process which lasts a lifetime” according to Jean Laplanche. The sexuality literally breaks in the child from outside, from the adults who proffers to this child, through the most daily innocent attitude (milking, nursing…) verbal, non-verbal and even behavioral signifiers which are pregnant with unconscious sexual significations. A thorn in the flesh. This primal seduction, which Freud apparently renounces in 1897 in his famous letter to Fliess dated September 21 before reintroducing it later on, especially in his “Three essays” of 1905, include enigmatic – because infiltrated by the repressed infantile sexuality of the adult himself – messages which have to be “translated” by the “infans” [Latin]. The part of the translation of those messages which the latter is unable to achieve, the translation waste, is repressed and creates the unconscious. Which does not mean that the unconscious is simply the “other” in me: because between the intromission of the “other” in me and the creation, as a result, of this “internal foreign body”, the operation of repression dislocates then reconfigures the elements of this lived experience. Repression changes the very essence – Freud mentions“reminiscence” and not a simple memory – of what has been repressed: a loss that will never be compensated for by a total come-back.

9. What’s the importance of superstitious thoughts and beliefs, tales, myths, and symbols which are our cultural traditional elements coming from our fathers and ancestors?

JL Vannier: You mix a lot of different things in your question. To answer a little schematically, I would say: psychoanalysis uses the expression of symbols in its clinical practice, questions myths in its theoretical research and is wary of the superstitions which it associates with beliefs of early childhood according to a Freudian approach on the phylogenesis and the evolution of the human being.

Religious superstitions are more interesting for the study of psychoses than for those of neuroses. During my stay in Lebanon, I had the opportunity to study this aspect while participating in weekly presentations of patients at the psychiatric hospital of Beirut. It was striking to hear those patients explaining that they had met prophetic figures belonging to the three monotheisms, or even discussed with Lebanese saints. The scenario or the characters who feed the delusions of many psychotics often matches with prevailing ideas or surrounding religious cultures.

Myths and other legends – the classification is, I admit, a little arbitrary – like that fundamental one of Oedipus, are in my opinion operations of reclaim and actualization, and, probably linked for the legend of Oedipus, attempts to explain the enigmas of sexuality. I offer as evidence the fact that the Oedipus complex only aims, in many articles of Freud, at highlighting and resolving two other imperatives: castration and prohibition of incest. This is especially the case for children’s questions about sexuality like in “On the Sexual Theory of Children” (1908). In a small letter sent to Dr. Moritz Fürst “The Sexual Enlightenment of Children”, Freud even uses it as a possible way for children to solve their question: “where are children coming from”?

Symbolization, as psychoanalysis understands it, brings together two representations. It substitutes one representation to another one or, according to Ernest Jones who wrote a theoretical essay about it, is a “mode of indirect representation”. It however carries a drawback noted in clinic by Jean Laplanche: “when the symbolization speaks, the free associations keep silent”.

10. Could you tell us about your own experience in Iran and its culture, the atmosphere, and all “beauty and beasts” you see and feel in your previous trips and business trips?

JL Vannier: Surprisingly, Iranians are always intrigued by someone who loves their country! And are curious [foosool?] to discover the reasons. I will tell you three things. I got to know Iran at the early 1990s through holidays in Tehran and in Chaloos on the Caspian Sea, then trips to Isfahan -nesfe djahan!- , Ahvaz and Bandar-Abbas. Then I returned to Iran in 2015 invited to a psychiatric congress on adolescent addictions. I recognized absolutely nothing of the country and remembered this Freudian assertion of the “Three Essays”: “the lost object – the first sexual object – “is not to be found but to be found again”! Then, what fascinates me in Iran is the extreme sophistication of Iranian culture and people. A kind of heightened sense of aesthetics which is not the reverse of a vacuum but which reflects on the contrary, to my opinion, a drive overflow: I remember the first words learned in Persian: the difference between “biroon” (outside) and “andaroon” (inside). Each scene in the Iranian everyday life, the tiniest, the most insignificant, is for the inhabitants an opportunity to have fun or joke about it. Finally, and through a process that we know well in psychoanalysis -Lacan even quotes the apostle Paul on this specific subject in his writings!-, it is the prohibition that reveals the sexual desire: with the arrival of the Islamic revolution, many things were banned. Though, everything in the smallest details of the daily life and attitude of the Iranians becomes a subtle and disguised expression of this desire: the sensual glance pierces under the headscarf, the teasing smile through the “tahrish” beard!

11. Could you explain the differences in therapeutic sessions with Iranian patients and French patients or other patients you see them from different backgrounds and for different cultures in Nice, France, or elsewhere?

JL Vannier: At the beginning of each psychoanalytic session, we must remember this guideline: each case is a specific one and the counter must be reset to zero. It is obviously essential to feel and assess the cultural influences and to question their possible result on the transference. This should be a subtle balance between the necessary courtesy and the impossible neurotic bonus.

12. Do you have any experience in long-distance/online therapies and supervising and how you see this phenomenon? What are their costs and benefits? 

JL Vannier: this debate has been taking place among psychoanalysts since the appearance of secure applications that offer free long distance calls. If the session on the couch seems in theory irreplaceable, it is also necessary to respond to requests from foreign patients or frequent travelers who wish to maintain a regular rhythm of sessions. I have been myself practicing these online therapies with WhatsApp for a while and I must admit that I am quite “amazed” with the positive results. I now refuse to use Skype because the reciprocal vision interferes, in my opinion, with the acoustic abilities of an evenly-suspended attention.

**You can send me your questions about this interview or your own queries and questions on “Psychoanalysis and Psychopathology” via email in English by choosing “other” as the subject, and wait for professor Jean-Luc Vannier’s answer.**