Fragments of the other: a psychoanalytic approach to the ego in schizophrenia

Abstract

This article describes psychoanalytic research carried out with schizophrenic patients. The aspects of the clinical case are paradigmatic for understanding the splitting of ego in schizophrenia and the triggering of psychosis. There will be a brief historical discussion of the concept of schizophrenia, and of the differences between the ideas developed by Eugen Bleuler and Emil Krapaelin. We compare the diverse authors’ ideas to illuminate today's discussion on clinical methodology and the relationship between psychiatric and psychoanalysis. We link up Bleuler's proposition concerning the splitting of the ego in schizophrenia and his broader conception of psychopathology with more recent psychoanalytic explanation of the disintegration, in psychosis, of all imaginary organization of the ego, as proposed in Jacques Lacan's theory. Clinical vignettes are also discussed in the light of Lacan's psychoanalytical lecture on a Marguerite Duras novel, in order to elucidate the phenomenon of transitivism, a key concept in this case. The article suggests a direction for the psychoanalytic treatment of schizophrenia based on the analyst's position, compared with Duras's character Jacques Hold, who, as a narrator of part of Duras's plot, allows the book's subject to articulate her desire.