The metaphorical, the metonymical and the psychotic aspects of obsessive symptomatology

Translations of summary

This paper is an attempt to suggest an integrative formulation of obsessive symptomatology, based on the integration of Lacanian and object‐relations points of view. This formulation manifests a singular interaction between three aspects of obsessive symptomatology, which I call “the metaphorical aspect”, “the metonymical aspect” and “the psychotic aspect”, and which are intertwined with a varying degree of dominance. The singular interaction between them has crucial influence on the capacity for symbolization and reflection, and therefore has immense implications concerning analytical work. The theoretical formulation will be followed by a detailed analytical illustration.

Métaphore, métonymie et aspects psychotiques de la symptomatologie obsessionnelle

Dans cet article, l'auteur propose une formulation de la symptomatologie obsessionnelle qui intégrerait la théorie lacanienne et celle des relations d'objet. Cette formulation permet de mettre en évidence une interaction singulière entre trois aspects de la symptomatologie obsessionnelle ‐ « l'aspect métaphorique », « l'aspect métonymique » et « l'aspect psychotique » ‐ qui s'enchevêtrent et varient suivant le degré de prédominance de chacun de ces trois pôles. Dans la mesure où l'interaction singulière entre ces trois aspects exerce une influence cruciale sur la capacité de symbolisation et [pde réflexion, elle entraîne des conséquences considérables sur le travail analytique. Une vignette clinique détaillée viendra illustrer cette formulation théorique.

Der metaphorische, der metonymische und der psychotische aspekt der zwangssymptomatik

Dieser Beitrag ist der Versuch einer integrativen Formulierung der Zwangssymptomatik auf der Grundlage einer Integration lacanianischer und objektbeziehungstheoretischer Auffassungen. Diese Formulierung geht von einer außergewöhnlichen Interaktion zwischen drei Aspekten der Zwangssymptomatik aus, die ich als „metaphorischen Aspekt”, als „metonymischen Aspekt” bzw. als „psychotischen Aspekt” bezeichne. Sie sind miteinander verflochten und treten abwechselnd mal mehr, mal weniger stark hervor. Ihre unverwechselbare Interaktion übt einen entscheidenden Einfluss auf die Symbolisierungs‐ und Reflexionsfähigkeit aus und ist deshalb für die analytische Arbeit immens folgenreich. Der theoretischen Formulierung schließt sich ein detailliertes analytisches Fallbeispiel an.

Gli aspetti metaforici, quelli metonimici e quelli psicotici della sintomatologia ossessiva

Questo articolo cerca di proporre una formulazione integrativa della sintomatologia ossessiva, basata sull'integrazione della prospettiva lacaniana con quella delle relazioni d'oggetto. Tale formulazione mostra una particolare interazione tra tre aspetti della sintomatologia ossessiva che definisco “l'aspetto metaforico”, “l'aspetto metonimico” e “l'aspetto psicotico”, che si intrecciano con vari gradi di dominanza reciproca. La particolare interazione tra questi aspetti ha un'influenza cruciale sulle capacità sublimatorie e riflessive e consequentemente ha importanti implicazioni per il lavoro analitico. All'esposizione della formulazione teoretica verrà fatto seguito con una dettagliata illustrazione clinica.

Los aspectos metafóricos, metonímicos y psicóticos de la sintomatología obsesiva

Este trabajo intenta sugerir una formulación integradora de la sintomatología obsesiva basada en la combinación de las perspectivas lacaniana y de relaciones de objeto. Dicha formulación supone una interacción singular entre tres aspectos de la sintomatología obsesiva que la autora ha llamado “aspecto metafórico”, “aspecto metonímico” y “aspecto psicótico”. Estos se interrelacionan con distintos grados de predominio de cada uno. La interacción específica que se produzca ejercerá una influencia crucial en la capacidad de simbolización y de reflexión y, por ello, tendrá implicancias fundamentales para la tarea analítica. La formulación teórica va seguida de una ejemplificación clínica detallada.

Key words:

• obsessive symptomatology
• psychosis
• metaphor
• metonymy
• excess

Notes

1. Lacan's concept of the Real refers to that which is outside language and that resists symbolization absolutely.

2. In ‘A question prior to any possible treatment of psychosis’ (1958) Lacan writes about the notion of ‘forclusion’ in the context of psychosis. Repression and forclusion differ in that while the first aims to remove a thought or an image from consciousness, the latter removes it from the unconscious. In other words, while forclusion casts the materials out of the unconscious, repression strives to fix them there. While repression is part of normal psychic functioning – though under certain conditions it has neurotic outcomes that impair functioning – forclusion consists of a violent rejection of psychic reality and its implications are catastrophic. It leads to psychosis rather than neurosis.

3. Joyce McDougall (1999, p. 62) mentions a patient who presented an ideal figure: saintly, maternal, someone who treated all of humanity with generosity and love. This figure, however, concealed another, very different one: diabolical, wild and full of hate towards children. The patient used complicated compulsive rituals in order to keep control of this hidden figure. McDougall presents an episode in which the patient complimented her on the flowers on her table and then fell silent. When McDougall asked her to continue, she said that it suddenly occurred to her that McDougall may have been too old to have children and that that's why she grew flowers instead. McDougall draws attention to the aggression concealed by the compliment, the hatred behind the manifested admiration.

4. I chose the name Ophelia (a fictional character in the play Hamlet) since the original name of my patient is also a name that holds the association of life fighting against death.

5. As analysis progressed, though, and in a way that I understand as a significant achievement – the wish to be hospitalized turned from being the wish to anesthetize her thinking to being an expression of the wish to gain back the laws of reality and thinking: to reconstruct a space in which hierarchies and differentiations were maintained.