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.

Keywords:

• schizophrenia
• psychoanalysis
• psychopathology
• transitivism
• ego and Jacques Lacan's theory

Notes

¹Postdoctoral research entitled O imaginário na esquizofrenia: o fenômeno do transitivismo (“The imaginary in schizophrenia: The phenomenon of transitivism”), carried out by author in conjunction with the Laboratory of Fundamental Psychopathology at the Department of Medical Psychology and Psychiatry at the State University at Campinas (UNICAMP), Brazil.

²One of his songs is Crazy Beauty [Maluco Beleza], which, quite significantly, Julio memorized many years previously.

³The expression in Portuguese is “Eles tiram o meu são,” the word “são” meaning either “they are” or “sane,” depending on the context.

Additional information

Notes on contributors

Luciane Loss Jardim

Luciane Loss Jardim, PhD, fellow researcher of the Laboratory of Fundamental Psychopathology at the Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp); member psychoanalyst of the Psychoanalitic Association of Porto Alegre (APPOA), Porto Alegre, Brazil

Mario Eduardo Costa Pereira

Mario Eduardo da Costa Pereira, MD, PhD, professor of psychopathology, Faculty of Psychology, University of Marseille, France

Claudia Maria de Souza Palma

Claudia Maria de Sousa Palma, PhD, psychoanalyst; professor of psychology of the University of Santa Maria (UFSM), Brazil