Disjonction entre image et identité : histoire et actualité du signe du miroir

Abstract

ObjectiveThis article focuses on the “mirror sign” as an element of psychiatric semiology. Considered as a prodrome of schizophrenia during its description between 1927 and 1930, the article aims to shed light on its contemporary relevance, particularly with regard to changes in society concerning the subject's relationship to their image as well as the relationship to identity or self. MethodAfter reviewing the history of the discovery and description of this sign, in order to shed light on its origins and on some essential elements, we take up the hypothesis of a link between a failure of the Lacanian “mirror stage” (stade du miroir) and the occurrence of the sign of the mirror. Links between original description, the frequency of body image disorders in psychosis, and the consequence of the mirror stage on symbolic identity are clarified. A few clinical fragments allow us to question the unfolding hypothesis. ResultsThe mirror sign appeared at the beginning of the 20th century as a prognosis for schizophrenia. Alienists linked it to homosexuality, then considered pathological. It appears today that the clinical class of the disorders that can be referred to this sign emerges essentially from a disjunction between body image and identity. This sign can be heuristically put into perspective with the Lacanian statement unpacked in “Le stade du miroir comme formateur de la fonction du Je,” and with the hypothesis that the psychotic structure also offers subjects the possibility of non-standard symptomatic responses. The sign of the mirror and the subjective responses that result from it shed light on what it is that some subjects seeking to create, by working on their image, on their body, a new identity, to respond to an initial perceived disjunction between image and identity. DiscussionIf the sign of the mirror inspires a large number of subjective responses aimed at modifying the body to make it conform to a new identity, and thereby carrying viable neo-identity solutions, it is not experienced without some discomfort in most cases. Nothing makes it possible to predict its future, and the therapeutic action is limited to identifying this sign and supporting the possible elaborations of the subjects who aspire to produce a conjunction between image and identity. ConclusionOne hundred years after its discovery, the mirror sign, is still an extremely relevant element of psychiatric semiology. It does not necessarily constitute a prodrome of schizophrenia, but it indicates a subjective difficulty in associating image with identity. The symptomatic response of the subject does not require the validation of the clinician; it is linked to a subjective malaise, which can be welcomed, whatever the outcome of this sign.