GUY LE GAUFEY

IS THE ANALYST A CLINICIAN ?

Such a question could sound like a provocation in this opening of a

series of lectures about psychoanalytical clinics. I certainly won't claim that
there does not exist anything of the kind, but I will support the idea that this
strange couple of words is closer to an oxymoron than to anything else.
Something of the famous obscure light, or the deafening silence is at
stake in this expression, which has become so common nowadays that it
seems as clear as day for, apparently, everyone.

The dividing line which parts these two words is nothing other than the
question of the nature of the sign. I will try to show you that the clinical
approach rests on a semiotic politics, in profound agreement with the
classical conception of the sign, whereas psychoanalysis is much more
ambiguous about this matter. No one can say that the psychoanalytical
practice is, in one way or another, unfamiliar with the question of the sign in
its more classical aspects ; but at the same time, psychoanalysis would be
on the road to ruin if it stood in this sole approach. Why ? Because part of the
effectiveness of analysis relies on a very different road toward the making of
signification. And this is not a trifle, for the success of interpretation very
often depends on it, especially when it focuses on transference.

According to the famous definition by Charles Sanders Pierce, a sign is

something which takes place of something for somebody. This utterance
almost brought an end to a vast period of time, which began in the XVII

century, when a new semiotical order, gradually but rather rapidly, was set
 Is the Analyst a Clinician ?, p. 2

up. It encountered its bible when, in the second half of that century, Arnauld
& Nicole published their Logique de Port-Royal, ou L'Art de penser (this book
has had forty-five editions in 332 years). In this very Cartesian universe of
thought, the usual functioning of the sign involves three different and distinct
places : that of the sign, that of what this sign represents (please, note
immediately that this link between the sign and what it represents can be
broken or suspended : this is precisely the work of the hyperbolic doubt in
the Second Meditation) ; and, last but assuredly not least, that of ego for
which for whom ? this link between sign and what it represents is
relevant.

We must not rush into the idea that this third point would necessarily be
a perfect human being. This Cartesian requirement of a human presence is
more metaphysic than semiotic, and a precision coming from Pierce makes
this clear. In a letter He wrote to a certain Lady Welby on the 23 th of
December 1908, He commented his main definition in this way :

I talked about somebody as if I have to feed Cerberus,

because I despair to make understood my own conception,
which is broader.

Broader indeed, as far as Pierce later on named this third component an

interpretant, which can be the work of a sign itself. This precision is
crucial, we will better realise it a little further : the place from where the
sign is seen as taking the place of something else is not necessarily that of a
subject as a consciousness giving meaning to signs, to things and to events.

Instead of Pierce, I could have as well quoted Arnault & Nicole and their
Logique de Port-Royal : all of them describe a functioning of the sign
(whatever it may be made of) based on the same tripod : 1) the sign, 2) the
thing it represents (whatever it may be once again : an object, another sign,
a human being, a God it does not matter), and 3) the place from which the
link between sign and thing is valid.

The invention of clinical investigation in the XIX e century medicine

relied massively on this conception of the sign, insofar as such an
investigation took account of a natural property of this kind of sign : it can
be equivocal, ambiguous, dubious, questionable. That meant and still
 Is the Analyst a Clinician ?, p. 3

means that this apparent link between sign and what it represents could
at any given time be deceitful and misleading.

The clinical gaze as Foucault studied it forty years ago now is the
one which does not let itself be deceived by appearances, that is to say by
the usual precipitation in establishing the link between a sign and its
referent. According to his experience of certain species and series of signs,
thanks to his theoretical knowledge of signs and their possible causes,
protected from error by his prudence and care about the general making of
signification, the clinician is He who wants to make himself clinical in the
sense that language itself has ended up attributing to this word, that is :
detached, cold, passionless, guided only by the very search of truth.

But what is truth ? Under this perspective called Clinic, truth is

directly connected with reality, whatever it be external or internal, psychical
or physical, actual or virtual, but reality in the sense that these clinical signs
actually are the expression of it. An expression maybe tortuous, maybe
convoluted, perhaps even devious, but always sustained by the inescapable
idea of a cause : if such a reality was not actually at stake, this sign, this
collection of signs would not be here.

So much so that the clinician was and still is in a position to

exclude from his field of inquiry the sham, that is He who deliberately wants
to lie through a certain use of these clinical signs. This sham is therefore a
sort of monster for the clinician himself, but also serves as the best occasion
to put to test the clinician's capacity to separate the wheat from the chaff.

The wheat consists then in rediscovering the way to reality as the very
spring of signs themselves. If such a way turned out to be definitely cut off
by the forgery the sham is trying to make effective, the clinician is thus
defeated and must clear the ground, letting this poor sham to the sheer
destiny of chaff : to wither and to die.

Those who are even a little acquainted with the history of

psychoanalysis know that this matter of shams constituted a very strong
cleavage between Charcot and Freud, of course not at the time of their
encounter, but when Freud began to venture into the invention of
psychoanalysis. Not only were they divided over the topic of the lesion, but
 Is the Analyst a Clinician ?, p. 4

also by their different stances with respect to this specialist of shams, I

mean the hysterical patient.

At the very moment Freud agreed no to investigate any further to

establish whether or not the patient is shaming, he also differentiated his
work from this authority of reality upon which Charcot's clinic was then
based. I do not mean by this that Freud suddenly abandoned any care for any
reality. It is rather well known today that, in spite of his famous letter to
Fliess on the 21st of September 1897, He never totally let go of his prime
conception of the reality of trauma. But He subtly mixed it with something
else, and the question for us is whether this something else is a matter for
clinic investigation, or not.

This something else has borne many different names, which do not
mean the same thing at all, but all of them point to the same semiotic place :
fantasy, latent content, psychical reality, unconscious ideas, and so on If
we only look at the present psychoanalytical vocabulary, the answer to our
previous question is quite obvious : of course every item of this series is a
matter for a clinical approach ! Clinic of the fantasy, Clinic of the Real,
Clinic of transference, Clinic of dreams, anything in the
psychoanalytical field seems to be a matter for clinic !

Freud himself was the very first to give a sort of reality to each of
these items of his own invention a sort of reality, and if we simply follow
him and consider all of that as a reality, there is therefore grounds for clinic
which can study it, because the functioning of sign, in its more classical
meaning, is once again regular.

But the same Freud sang, from time to time, a quite different song. Let's
have a quick look to a certain terminal passage of, precisely, The
Interpretation of Dreams. Freud is here talking about the dream of a Roman
citizen in which this citizen murders the Emperor. Hearing of this dream, the
Emperor decides to put his subject to death, in real life. Was He right acting
this way, asks Freud ? Then He goes :

I think it is best to acquit dreams. Whether we are to

attribute reality to unconscious wishes, I cannot say. It must
 Is the Analyst a Clinician ?, p. 5

be denied, of course, to any transitional or intermediate

thoughts1.

What are they, then, these strange things to which we must deny, of
course, any reality ? Would they not, as Lacan later on designated them, be
signifiers, which precisely means a sudden loss of any link with any object ?
Thus, in the very session Lacan first introduced his definition of the subject
as represented by a signifier for another signifier 2, He also talked about
les effaons du signifiant, a sort of witticism melting the word faon,
the manner the signifier works, and the French verb effacer, to erase, to
efface something. The signifier as Lacan uses it effaces the link between
itself and the signified, letting in abeyance any link with any object.

In such a situation, the possibility of a clinic is extremely narrow, but

not absolutely non-existent. It would be sufficient to consider the signifier as
a certain type of reality to rebuild a sort of clinic. But it is not so easy and
natural. Let's take for instance the precise moment in which the Wolfman
stumbles and says Espe instead of Wespe (while He is trying to talk of a
wasp). The patient himself recognises at once his own initials (Serguei
Petrov) in his very freudian slip. But what actually happened there ?

Freud interprets on the spot this mutilation of the word as the

expression of another mutilation, the one concerning the body. He concludes
this paragraph :

The dream clearly tells that He took revenge on Grousha for

her threat of castration.

1. S. Freud, The Interpretation of Dreams, Penguin Books, 1987, p.782. In

German : Ob den unbewuten Wnschen Realitt zuzuerkennen ist, kann Ich nicht

sagen. Allen bergangs- und Zwischengedanken ist sie natrlich abzusprechen.

2 . 6th December 1961. It will first of all be necessary for us to distinguish the
signifier from the sign and for us to show in what sense the step taken is that of the

effaced thing : the different "effaons" if you will allow me to use this formula, in

which the signifier comes to birth, will give us precisely the major modes of the

manifestation of the subject.

 Is the Analyst a Clinician ?, p. 6

I am not interested here in whether or not Freud was right or not in this
interpretation, but I draw attention to the fact that his general strategy,
dividing any sign into a manifest and a latent component, always allows him
to interpret in the classical sense, that is in a way which can very easily be
regarded as clinical. From the moment He can figure out the latent content,
such content works as the reality whose manifest content is the sign. So
that a good psychoanalytical clinician would be someone who would know
the largest quantity of pre-formed latent content, or at least someone who
would be able to quickly and accurately trace back to any latent content.

Of course, it is still today a noteworthy part of the psychoanalytical

task. But if something has changed in the general scheme of interpretation,
it is mainly because this approach very often appears weak and
inappropriate insofar as latent contents have been reduced to a mere
collection of clichs. Not that most of them have become wrong ; they just
became ineffective.

Notice that this style of interpretation that Freud used in the case of
Espe (and the clinic associated to it) is exclusively based on one side of
our semiotic tripod : the one which links the sign to what it represents. But
what about the other side, the inescapable and indispensable other side
which puts on stage the actor (whatever be the name we give to it to
him?), and through which (through whom?) the very possibility of
signification passes ? Take it (him) away, and the sign is no longer a sign.

If I mentioned Peirce previously and quoted him in preference to

Arnauld & Nicole, it is because his sensibility on this point is much more in
accordance with ours than that of Les Messieurs de Port-Royal, who were
a little blinded by the new and wild light of the cogito and of its ego. Pierce is
not obsessed by any such worry about what a certain philosophic tradition
calls the transcendental subject, who roots directly, albeit in many
different manners, in the ego of the cogito. Pierce was too pragmatic, in the
Anglo-Saxon sense, to be a fan of this kind of subject who dominates the
whole world of representation. And above all, He wanted to build a semiotic
explanation of the functioning of signification outside of any resort to
psychology or to any consciousness, a concern He shared with Frege and
Russell, among others. This place where the signs finds out its signification
was definitely not to be understood through the help of the obscure light
 Is the Analyst a Clinician ?, p. 7

of consciousness, but only from within the functioning itself, without any
deus ex machina.

That is why Pierce conceived it mainly as the work of another sign,

what He rather called an interpretant. What is to be done in that place is
indeed to get the link between sign ant object, and thus, so to speak, to
interpret the sign. This is for us the very place of the clinician, not to
speak of the analyst. This is also something crucial from Pierce's standpoint
as far as, according to him, a sign is not something everyone could recognise
as such at first sight. It is on the contrary anything which calls for an
interpretation, and therefore for an interpretant. For Pierce, it is not
necessary for a sign to be actually interpreted in order to be a sign ; but it is
essential it can be. This possibility is enough to qualify a sign as such, and a
sign which would wait for eternity to meet its interpretant has to be
considered as a sign, as abstract as such a consideration can be.

The question is, then, that if the someone who produces the
interpretation is conceived as a sign at least once the interpretation has
been given , it is clear that we just have gone one step back. This sign, this
interpretant, has to be interpreted too. As a sign, it is calling for an
interpretant, and if this one comes, it will call for the same thing, and so on,
and so on

Once this infinite regression is thus clearly conceived, it generally

triggers two kinds of reaction : fear and repulsion, or interest and esteem.
Each one was very readable in Wittgenstein for instance insofar as He first
supported a system in which this regression was blocked off as a danger
(period of the Tractatus), but then later on considered it as perfectly
indispensable in the pragmatic playing of communication (Second
Wittgenstein). Pierce, for his part, was immediately and clearly in favour of
this perspective, and saw it as a very interesting property of the general
semiotic systems. He called it the vagueness linked to signification, and I
think it is worth getting closer to this property insofar as it is a consequence
of a kind of leak which does not necessarily distort or alter the meaning
itself, but which makes almost impossible any clear and definitive
individuation of the interpretant.
 Is the Analyst a Clinician ?, p. 8

This vagueness has indeed nothing to do with any flaw on the side of
the link from which the sign finds out its signification. This vagueness is only
attached by Pierce to the potentially indefinite series of interpretants. That
means immediately that it is quite impossible to encounter or to build an
ultimate signification of any sign. The fact that we commonly adopt one
signification for one sign is more a property of human beings than a property
of semiotic systems. So that this vagueness is a positive property linked to
what Pierce sometimes calls the Third Ones (in opposition to the First
Ones the signs and the Second Ones the objects). These Third
Ones disclose the fact that language cannot be conceived as a
nomenclature, the name Saussure used to designate the conception in
which all that exists is the link between signs and objects.

Armed with these very little pieces of semiotic knowledge, we can

return now to our previous question about clinics, at least insofar as we
would have learnt that, if there is still and always a lot of questions which
can feed clinical investigation about signs and their causes, there is also
something very critical about the place from where the interpretation
comes.

I do not necessarily mean by this the analyst in the analytical process.

But I do mean what Lacan called le sujet-suppos-savoir. The way He put it in
his seminars is rather intriguing : the very day He invented this formula, He
rejected it strongly and almost definitely :

[] what we are dealing with, and how this is given us since

we are psychoanalysts, is to radically subvert, to render
impossible this most radical prejudice [] which has
developed from what we called the Cartesian Investigations
into the cogito, that there has never been but a single subject
which I would pinpoint, to terminate, under this form : the
sujet-suppos-savoir3.

After that : almost three years of silence about this philosophic subject,
which is inadmissible as such in the psychoanalytical field, but which

3 . J. Lacan, The Identification, 15th of November 1961. Translation Cormac

Gallagher.
 Is the Analyst a Clinician ?, p. 9

nonetheless reappears triumphantly at the end of Seminar XI, on the 3 rd of

June 1964 exactly, and is from then on something indispensable to
understand what transference is all about :

Ds qu'il y a le sujet-suppos-savoir, il y a transfert.

As soon as there is the sujet-suppos-savoir, there is

transference.

Why ? Among a lot of reasons which we will not list now, there is at
least one which can hold our semiotic attention. The sujet-suppos-savoir
enters into play insofar as the behaviour which constitutes the symptom is
considered as a sign, that is full of meaning. Sometimes, we witness the
sudden surfacing of this supposition of meaning that is sufficient for
differentiating the Freudian symptom from the medical symptom. What does
that mean ? is then a sort of index of a symptom. At other times, we have to
work a lot to open the way for such a question without which the very engine
of transference is not on.

But we here can remember too that this required movement towards
signification and meaning participates directly of the general economy of
sign according to Pierce, as we have seen it before. Therefore this sujet-
suppos-savoir is not only an invention of a psychoanalyst who is short of
understanding transference, it is also a step towards understanding
transference in the general frame of meaning, and not only as an emotional
move, which it is as well, obviously. For the link between feelings and
meanings, and between Sex and language, is paramount to psychoanalysis,
much more than hermeneutism which emphasises mainly meanings, and
therapy which emphasises mainly feelings. So, we must not be surprised to
encounter in Lacan, especially in Radiophonie, the perfect definition of
sign according to Pierce :

Le signe suppose le quelqu'un qui il fait signe de quelque

chose4.

The sign supposes the someone to whom it indicates

something.

4 . J. Lacan, Radiophonie, in Scilicet 2/3, Le Seuil, Paris, 1970, p.56.

 Is the Analyst a Clinician ?, p. 10

This way of quoting Pierce (even without then mentioning him) clearly
places emphasis on the someone, the aforementioned Third One, the One
for whom the sign is linked to something else. But only one line further,
Lacan gives a crucial precision concerning this someone :

Appelez ce quelqu'un comme vous voudrez, ce sera toujours

une sottise5.

Name this someone as you wish, it will always be a stupidity.

How Lacan dare say that ? Is not his sujet-suppos-savoir precisely a

name for this someone ? Of course it is ! But in fact the harshness of Lacan's
judgement is nothing but an introduction to a very strange question since,
far from starting, as many people do, from the sign to reach the level of
signifiers, He rather takes the other way around :

Qu'il en soit ainsi du dpart dont le signifiant vire au signe,

o trouver maintenant le quelqu'un qu'il faut lui procurer
d'urgence ?6

The starting from which the signifier turns to the sign being
thus so, where now is the someone that must be urgently
provided to the sign ?

With all these quotations (and some others too), we can easily guess
that Lacan is moving in a field a la Pierce, using Pierce's terminology for
his own psychoanalytical aims. Which are they, then ?

They essentially try to show what the personage and the place of the
analyst are made of: not a person, neither a subject nor any consciousness
but the piercean someone urgently needed to make that signifiers may
turn to signs.

In this moment, the analyst is not so much a clinician, at least if we

understand the clinician as He who is devoted to figure out, not only the

5 . Ibid.

6 . ibid., p.66.
 Is the Analyst a Clinician ?, p. 11

signification of a sign, but through this signification, the referent of this sign
as part of some reality.

This work is undoubtedly an important part of the elucidation of

symptoms. It can be also a way of interpretation of transference as far as
transference is conceived as a mere repetition of the past. But inasmuch as
transference is NOT a repetition, this little vanishing point Pierce
encountered with the leak on the side of the interpretant can become as
important as it is in the art of perspective: nothing we can represent
properly, but something from what everything finds out its exact location.
Very often, we can notice at this spot, in the painting, the eye of a horse, or a
little window, something rather empty or hollow, but assuredly something of
no account in terms of representation, nothing we would be well advised to
interpret.

According to this point, clinical approach is irrelevant. Not only because

it would only reinforce transference instead of analysing it, but above all
because it would not respect the very nature of the sign as it lays all along
the analytical process such as Lacan tried to make it clear, and such a s
Pierce still helps us to understand.

The clinic literally caves in at the point where the analyst is required to
be, to stand and mainly not to shut his mouth but to give voice to the
silence in the midst of signification He builds or let build. That is precisely
the place where Lacan reduced him to this object (a) He invented partly to
this end, and on which I momentarily conclude.