Folie, première et seconde mort

Abstract

AimsThe author sets out to show that catering for madness, conceived as psychic death, requires the framework which, in other branches of medicine, configures the caregiver's implication in favour of life to be broadened. MethodsAn in-depth analysis of the ideas of the French psychiatrist Georges Lantéri-Laura is presented, in particular those set out in his Essai sur la discordance dans la psychiatrie contemporaine (in collaboration with Martine Gros, 1992). He refers to the nineteenth century French psychiatrist Philippe Chaslin, who supported the idea that in psychiatry the boundaries between health and illness, like those between psychic life and death, need to be envisaged in a broader perspective, giving central importance to the subjective experience of the individual presenting symptoms. The present paper details the proposal by Jacques Lacan, on the subject of the stages described by Sophocles in Antigone's progress towards death, of distinguishing first death, second death, and the “zone between two deaths”. It describes this model, along with illustrations from literature. For instance, in Heinrich von Kleist's Prince of Homburg, the hero, rather than a life without honour, prefers to enter immortality by the heroic acceptation of his punishment. We underline how this radical option can be accompanied by the experience of an ultimate triumph, transcending the value that the individual attaches to life. ResultsThis leads on to an approach to madness returning to what was known as “alienation”. This concept, reappraised as an upraising (or uprising) of the subject, forms the question that is worth asking of the subject, that of his freedom (Henry Ey, Jacques Lacan). We stress the approach letting people know that the tragic hero expresses by his detachment from life, and his conviction that there is a life after existence has gone, because the being of the person said to be departed remains present in what remains of his acts. DiscussionThis critical reflection leads us to a new conception of grief and mourning. We need to think beyond the stage of mourning or grieving described by Freud, as this process could replace the investment in a departed object by investment in a substitute object. Like Philippe Ariès, we consider that the most important, most invested objects remain, and should remain, irreplaceable. The person mourning should adopt an attitude of respect that allows the figure of the departed to continue towards his destiny in the remembrance of the survivors. This analysis of mourning, integrating the destiny of the image of the departed person, is a head-on criticism of the present trend in society of reducing, masking or denying death, and its essential consequences on the identity of mourners. ConclusionsThe Hindu thought, with the principle of Nirvana, is an encouragement to fully accept the encroachment of death on life, and life on death, which Lacan studied in Œdipus at Colonus. We recall the case of the Papin sisters, and its literary echoes, showing that the uprising against death merits consideration in a wider perspective. Likewise, we can recall the regrettable tradition in psychiatric asylums of burying patients in nameless tombs.