depression-paintingw300h235It is not unusual to hear Lacanians snicker when references to Guattari come up, joking about how the La Borde clinic eventually resorted to giving its patients insulin shots. I’ve certainly made jokes like this in the past. It is almost a requirement within Lacanian circles. The subtext of this joke is that schizoanalysis had failed and that they could only have recourse to chemical straight jackets in treating their patients. I do not know the details of La Borde’s insulin treatments, but if this is a particularly stupid joke then this is because it is both reductive, suggesting that this is all that was taking place at La Borde, and because it assumes that treatment with psychotropics is inherently a failure. With respect to this latter point, what is reflected is a sort of idealistic, anti-materialist tendency within the theory community that would like to disavow the body and anything neurological, instead treating the signifier as the only legitimate approach to treatment.

As many who read this blog know, I spent about seven or eight years in Lacanian psychoanalysis with one of the foremost analysts in the United States. In addition to this, I myself practiced for about four or five years and underwent a training analysis as well. I certainly got a lot out of my analysis in terms of general self-knowledge, though I don’t know that this analysis had much in the way of efficacy where symptoms were concerned.

I’m hesitant to write this post and almost a bit embarrassed by what I’m about to say, but about a year or so ago I was overcome by a very serious depression. Despite the fact that things were going well, that I was getting all sorts of requests for work, that I was getting recognition, that my classes were going well, and all the rest, I was in a very black place. Suicidal fantasies would plague my thoughts. It was not that I was contemplating or planning killing myself. Rather it was as if certain images, fantasies, would flash through my mind, giving me thoughts of driving into oncoming traffic or of slipping downstairs in the middle of the night to slit my throat with my butcher’s knife. My thoughts became extremely persecutory, perpetually telling me how awful I am as a person, how my work is rotten, how I’m trapped in my life, and all the rest. I was no longer able to take pleasure in anything, nor concentrate on anything. I no longer enjoyed cooking. Movies and televisions shows were unable to capture my interests. All books seemed bland and without interest. It was a very black time.

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At a certain point I simply couldn’t stand to live like this any longer and realized that I had to do something about my state. Going back into analysis was out of the question for economic reasons. And besides, analysis had never had a marked effect on affects pertaining to anxiety and depression (though I am aware that talk therapy can have a profound effect on some for depression). In light of this I decided to take the leap, visit my physician, and see about anti-depressants.

As somehow who has argued passionately from a Lacanian perspective about the evils of psychotropic drugs, I am ashamed to publicly make this admission. However, in the year since I’ve been taking these drugs, the changes have been profound. Within a couple of weeks of taking these pills, the suicidal ideation had entirely disappeared. It was a strange sort of disappearance, where everything changes and you don’t even notice the change, having forgotten what things were like before. My temperament became much more calm and less erratic in terms of angry outbursts towards friends. My interests came back and I found myself cooking again, writing again, reading again. The persecutory thoughts disappeared. It was really a remarkable change.

From a Lacanian point of view, this sort of change cannot but be perplexing. At the heart of the Lacanian theory we are told that affects and symptoms are structured by the signifier. “The unconscious is structured like a language,” we are told. The symptom is thus a sort of mute speech. It disappears when we bring it to real speech. Our compulsion to repeat arises from our constitutive alienation in language that produces an irreducible gap that can never be filled. Our symptoms and repetition, moreover, are intersubjectively structured as messages, as it were, to the Other.

Yet here, in this drug, there was no signifier, no Other, no language, but a simple chemical transformation. Had I gone to analysis to treat this depression I would have talked a good deal about the thoughts I was having, I would have produced signifiers, and my thought process would have seemed absolutely convincing. Yet chemically my brain would have remained the same (though it’s important to remember that speech, thought, and activity can actually change neurochemistry). The Lacanian might say that the drugs have simply clothed, dulled, or disguised my symptoms, hiding my unconscious. Yet I don’t think so. There has been a basic shift in thought and affect that isn’t simply a matter of signifiers. We find analogous phenomena with other substances. When you are suffering from nicotine withdrawal, the angry thoughts you’re having are absolutely convincing, seem justified, and seem completely disconnected from the absence of nicotine in your system. Yet when you smoke that cigarette, these thoughts and affects disappear like so much mist. Likewise, when I drink chardonnay, and drink wine or beer generally, I tend to become extremely affectionate and warm towards others. There is a shift in my entire thought process.

It seems to me that these sorts of phenomena pose a significant challenge to the Lacanian hypothesis of symptoms structured by the signifier. Of even deeper concern, it seems to me that phenomena like this, speaking as they do to neurochemistry rather than the signifier, pose a significant challenge to the Freudo-Lacanian concept of the compulsion to repeat and the death drive. Freud discovers the compulsion to repeat towards the end of his career, when he finds that there’s a limit to interpretation and its ability to dissolve symptoms. What if this limit has nothing to do with the signifier or language, and everything to do with certain neurochemical structures in certain patients?

My point is not that we should ignore language, talk, “the subject”, signs, etc. My point is that if we adopt a Lacanian approach to treatment we are very likely to miss these other factors. Indeed, it is not unusual to hear Lacanians dismissing those patients that say they benefited from these things, that they don’t think their particular symptom is structured around the signifier, and even hinting that they’ve been duped by the pharmaceutical industry and by neo-liberal capitalism, in a way that is morally culpable for not recognizing their status as a desiring subject. I know I certainly made these sorts of arguments, much to my regret, to my dear friend Melanie, and I made them persuasively. For that, Mel, I’m sorry. I should have listened to your arguments with a more open ear at the time and I should have not been surprised when you expressed such shock and anger when I told you that I had made this decision.

When the patient in analysis protests that nothing is happening– and I’ve known analyses that have lasted 20 years –the analyst guilts them, suggesting that they are not working and that they haven’t delved deep enough yet. In other words, since it is held a priori that the subject has a particular structure, since any sort of empiricism or alternative is ignored, it must always be the patient that is mistaken or duped, not the theory. It is never, in other words, that the treatment is not working, but rather that the patient hasn’t gone far enough. We then, on top of everything else, told that the aim of analysis is “ethical”, that it is not improvement or a better standard of living, that we’re falling into bourgeois, neo-liberal ideals of “happiness, and that we should hope to become pure desiring subject through analysis, not happy subjects. And we are given a heroic ethos about how we are the ones against the system in pursuing this. What strange animals us humans are, that we can believe such things and be persuaded by them.

Again, I am not suggesting that drugs are the answer (they really effect everyone differently– pot, for example, makes me miserable, but others seem to like it a lot) or that we should ignore our personal histories, signs, culture, etc. No, not at all. I think Guattari had the right idea in proposing a model in which we strove to think the intersection of regimes of signs, the biological body, economics, nature, etc… A highly complex ecological, networked model. The problem lies in dogmatic theoretical orientations that, ironically, suffer from Zizek’s definition of metaphysics: any orientation of thought that raises a part of the whole to the explanatory principle of all other elements in the whole. Certainly this is the case with Lacanian psychoanalysis.