Le premier moment de la psychose chez de Clérambault et chez Lacan

Abstract

The first moment of psychosis according to de Clérambault and Lacan. The question of elementary phenomena as the primum movens od psychosis is a recurring theme in the history of psychiatry. Many authors, especially the classical authors of the nineteenth and twentieth centuries, have introduced new ideas about the first moment of the illness. Esquirol was the first to delimit the hallucinatory phenomenon and fix a definition. Until that time (1838), hallucination was a labile, vaguely accepted term. His follower, Jean-Pierre Falret, gave a written description from his master. Other authors play a fundamental role in the study of this phenomenon. Out of all these authors, though, two stood out noticeably: Gaëtan Gatian de Clérambault (1872–1934) and Jacques Lacan (1901–1981), the first with his ‘mental automatism’ and the second because of his ‘elementary phenomenon’. Clérambault's mental automatism and Lacan's elementary phenomenon are one and the same phenomenon. In fact, both recognize in psychosis a first moment, not yet hallucination, but rather suspension of thought. This initial movement sets in when a heterogeneous element (a foreign body) disturbs the subject. De Clérambault called this element the initial disturbance or ‘small mental automatism’; Lacan called it the ‘name of the Father’. Hallucination is the subject's first response to fill in the emptiness produced in its symbolization by this intrusive element. For de Clérambault, its most frequent form is noise, for Lacan, ‘insult’, which one notices particularly in the form of an injury of a sexual nature, even if the patient conceals it when spoken to about it.