Lacan’s goal of analysis: Le Sinthome

Freudian psychoanalysis started as a therapeutic treatment meant to remove pathological symptoms. Moreover, it was Freud’s ambition to install a causal treatment, by which the symptoms would be removed in a permanent way. His initial enthusiasm about psychoanalysis as psychotherapy gave way to a more pessimistic view at the end of his career. Finally, he considered the analytic process as “interminable,” thus turning psychoanalysis into an impossible profession. In the meantime, he had elaborated a whole new theory on psychopathology. Since Freud’s discovery of the unconscious, pathological processes are explained on the basis of defense, in which repression takes the prominent place. After Freud, it was more or less forgotten that repression in itself is already a secondary moment within the dynamics of the pathogenesis. Indeed, repression is an elaboration of the defence process against the drive. Right from the beginning of his theory, Freud recognized a twofold structure within the symptom: on the one hand, the drive, on the other, the psyche. In Lacanian terms: the Real and the Symbolic. This is clearly present in Freud’s first case study, that of Dora. In this study, Freud does not add to his theory of defense, which had already been elaborated in his two papers on the psychoneuroses of defense (Freud, 1894, 1896). It can be said that the core of this case study resides precisely in this twofold structure, as he focuses on the Real, drive-related element, what he terms as the “Somatisches Entgegenkommen”. 1 Later, in his Three Essays, this will be called the fixation of the drive. From this point of view, Dora’s conversion symptoms can be studied from two perspectives: a Symbolic one, that is, the signifiers or psychical representations that are repressed, and a Real one, related to the drive, in this case the oral drive. Freud will confirm this hybrid composition of the symptom in all his later case studies. Little Hans’s phobia is built upon and against oral, anal, and scopic drives; the obsessions of the Rat-man go back to the scopic and the anal drive; and the same holds for the Wolf-man’s phobia and conversion symptoms (Freud, 1909a, 1909b, 1918b).