08 de març 2014

Psychoanalysis, Science and the Real

— “Psychoanalysis is not a science”.*
This was Jacques Lacan’s statement in 1975 in his visit to the United States, in the Massachusetts Institute of Technology[1]. He reached this conclusion after some decades of having referred psychoanalysis to the field of science, first by means of linguistics and anthropology, and later through of mathematics and logics. Sigmund Freud always thought psychoanalysis had his references in the field of natural sciences, as psychoanalysis itself had emerged as a consequence of these sciences, as a practice derived from medicine. It was in the 50’ and 60’ that Jacques Lacan linked psychoanalysis, in an epistemological break with natural sciences, to the field of structural anthropology and linguistics, using the work of Saussure and Lévi-Strauss, and sometime after to mathematics and logics. Psychoanalysis would be then a science homologue to the field and function of logics, a field that he could define as a “science of the real”. 
But Jacques Lacan added something else in his well-known Seminar during those same years —Psychoanalysis is not a science, it’s a practice that deals with something real, a real that is different from the real that science deals with.[2] Therefore, following this statement, the question may be posed: Which is the real that science deals with, and which is this other real psychoanalysis deals with? And which is the relation between them, if there is any? This will be, on the other hand, the theme of the next international Congress of the World Association of Psychoanalysis to be held in Paris this coming April, with the promising title: “A Real for the XXIth Century”. I hope to shed some light upon this question today.

Different reals

First of all, we have to distinguish two registers that can be never confused, neither in science nor in psychoanalysis: the real is not reality. In fact, even the Physics of our days underlines this distinction as necessary in order to construct its object and its practice. The progress of science itself has been founded in this distinction: the real calculated and constructed by science has nothing to do ultimately with the reality of matter. As Jacques-Alain Miller pointed out in the presentation of the Congress theme: “it has not been possible to make an equivalence between the real and the matter; with subatomic Physics, the levels of matter multiplies”. And we must say that the determinate article The in the expression ‘The matter’ doesn’t exist as a universal thing, that “The matter, like the universal article of The woman, vanishes”[3]. You know perhaps the surprising statement by Jacques Lacan in the 70’: “The Woman [as a universal] doesn’t exist”, there is only one woman, another woman, and another woman, they must be taken one by one but they never make the universal class of The woman. Well, with matter and real in science we have the same question: there is no “The matter”. The real conceived and constructed by contemporary science makes matter vanishes in bits of real, bits that have to be considered one by one.
Therefore, the new epistemology of science states that each science has its own bit of real, different from the bit of real of other sciences.  We may say then, as the Spanish scientist Javier Peteiro states —Javier Peteiro is our respected interlocutor in these questions—, that “there are different ‘reals’, that the Real in Chemistry is not the same Real dealt with in Physics, in Biology or in Anthropology.”[4] For example, the Real of Biology, life itself, is not reducible to Physics. We don’t know yet what this real called “life” is , we have today the same difficulties to define “life” as one thousand years ago. The inaugural text by the physicist Erwin Schrödinger, entitled “What is life?” preserves its enigma without a clear answer. Life is not reducible to a combinatorial of atoms, or even a combinatorial of genes that, moreover, are death matter in themselves.
On its part, psychoanalysis conceives life only as phenomena in the field of language, as that specific real that has been called “jouissance”, with the French lacanian word. (There is no accorded translation for this lacanian term, —enjoyment, pleasure, fruition…—, then the best translators as our colleague Bruce Fink, have chosen to let it in French). Life is what makes sign of a pleasure beyond the homeostasis of energy in the universe. Where there is life, there is “jouissance” and there is an imbalance of energy that introduces his opposite in the field of language, that’s to say death. And there is only life and death for a subject of language, for a being affected by this virus, by this parasite —as Lacan said— that is language. Sometimes, scientists are confronted to this real of “jouissance” of life with some anguish, when they find a sign of life that could go beyond its control and that could expand its opposite in death. Therefore, this real thing called “jouissance” is a bit of real between the real in Physics and the real in Biology.
This is an example of the place that psychoanalysis has today in the field of the sciences, “its place among the sciences” as Jacques-Alain Miller said some years ago, in a conference, originally in English, that has been recently published in the Psychoanalytical Notebooks with this title, “Psychoanalysis, its place among the sciences”[5]. “Among the sciences” does not mean out of the sciences, it doesn’t mean out of the scientific border but, on the contrary, in the inner part of science itself, in the space between a science and another science, the space in-between, so to speak. Psychoanalysis finds itself, then, just in the place where the sciences find that real that cannot be defined by their concepts, that real that Jacques Lacan introduced in the 60’ with the expression “the subject of science”. The subject of science is precisely the subject psychoanalysis deals with in its practice, it is the subject that makes sign of “jouissance”, of a real that breaks homeostasis in life, the “jouissance” that emerges in the symptom as a malaise.

When we deal with symptom, we deal with this other real that cannot be entirely defined in the scientific field. That is the reason Lacan said that  “psychoanalysis is not a science”, adding, however, that “there isn’t any therapeutic practice that constitutes a science, even medicine is not a science but an art.”[6] When your are dealing with the subject, with the subject of a symptom, with the singularity of symptom in the subject suffering, there isn’t any possible science, there is always an art that cannot be evaluated by scientific method.  We may think perhaps that Lacan had a very high idea of what constitutes a science  and that all his efforts to make psychoanalysis a science were a sort of desperate enterprise. In fact, in another class of his Seminar he repeated this statement: “Psychoanalysis, I have said and I have repeated it recently, is not a science; it has not the status of science and it can only wait for it, expect it”[7]. This would mean that psychoanalysis, —a practice that is a product, an effect of modern science—, is not a science yet, but a practice that it is in the waiting room to be a science among the others, perhaps in this XXI century. This may mean that its constitution as a new science will be sometime operative and that its inclusion in the field of sciences has to change the status of science itself.

The “one by one” method

But, in fact, why psychoanalysis cannot be considered as a science in its modern sense? Is a very simple question, a too simple question at a first glance. Scientific method, following the natural sciences since the 17th century, is founded first of all in the quantification of phenomena. Galileo’s principle is in its fundamentals: “Measure what is measurable, and make measurable what it is not”. But how we could make measurable subjective suffering? How we could make measurable the meaning of suffering and malaise, the subjective meaning of a symptom, even the meaning of an experience, a significant event in subjects life? When you take this scientific principle and you make it extensive to the entire field of subjective suffering you reach an absurd thinking. Is the absurd of questionnaires, labeled sometimes as “scientific”, with questions like this one:  “Have you felt happy in the past 7 days? Check the answer in the scale from 1 to 10.” (It’s a true example that you can find in the so called “scientific questionnaires”). No, you cannot make measurable the meaning of a subjective experience; there is a profound mistake in this extension of scientific method that reaches what is called, by scientific thinking itself, scientism. Scientism is the belief in the universal applicability of scientific method, as quantification, to all human phenomena. When you deal with a subjective experience you cannot take this principle as a guide.
But there is a more evident argument to say that psychoanalysis is not a science, following the conditions of modern scientific method. This method requires at least the condition of reproducibility of an experience or study under the same conditions and obtaining the same results. The condition of reproducibility is in fact an ideal condition, and there are a lot of scientific theories that are considered as operative in science that cannot be tested by reproducing the experience that would confirm them.
But how could you reproduce the experience of a psychoanalytical session, or a psychoanalytical interpretation? It’s completely impossible. When you deal with the subject of the unconscious, you deal with a real that cannot be reproduced. You cannot reproduce under the same conditions the unconscious formations that are the emergence of the subject of psychoanalysis; you cannot reproduce under the same conditions a dream and its interpretation, you cannot reproduce under the same conditions a parapraxis, a Freudian slip, or what is more important, you cannot reproduce the effect of a psychoanalytical interpretation itself. The interpretation that has been effective in a case of obsessional neurosis will not necessarily be effective in another case of obsessional neurosis. The psychoanalyst, following Freud’s advices, has to take every case as a whole new case, on by one. Even more, he has to put on hold all he knows about other cases in order to be able to listen to the singularity of that case, that one-off case. This is the reason why we define psychoanalytical clinics as a clinics of “one by one”, that can never be reproduced under the same conditions. Each case has its own demonstration and its own validation by its own effects in the psychoanalytical treatment.
In fact, this is also a question for many of the existing scientific practices. For example, in the field of Pharmacology there are the well-known clinical trials for a drug, the clinical trials designed as randomized, the double blind and placebo-controlled trials, the planned experiments with a trial group and a control group. But, following the remarks of some critic pharmacologists, —specially after the big fiasco in pharmaceutical industry with influenza A virus— the best clinical trial, the most effective and reliable trial is what is called “clinical trial in an only patient”[8]. It consists in the modification, in a systematic form, of the disease treatment in an only patient in a predetermined series of periods. That’s to say, you have to test a drug in an only patient, taken in his singularity, following its effects in an incomparable way, in a “one by one” way. You may say that this method is impossible to follow, too long and too expensive, but in some cases it will be without a doubt the most effective and accurate. In the case of psychoanalytical clinics, where you cannot reproduce the same experience or phenomena under the same conditions it’s the only way to verify the effectiveness of the method and the treatment.

“Truths that only one can see”

Here, I have to make a small parenthesis. A few weeks ago, when I was back in Barcelona working in the development of my speech for today, trying to explain the impossibility of making a replication of the unconscious phenomena and formations, I received, at that very moment, an e-mail from my colleague here in New York, Maria Cristina Aguirre, with a link to a very interesting article published in the New York Times, an article that talks about… replication in science, of course! It was really a surprising coincidence, perhaps an experience of that phenomenon that Lacan evokes as an “encounter with the real”, a real “Tyché”, taking the term from Aristotle, the Goddess of Fortune. It’s kind type of phenomena that interested also Jung, Freud’s dissident pupil, in his interlocution with the Nobel Price in Physics, Wolfgang Pauli. They had even written an interesting text about this phenomenon that they called “synchronicity”, the experience of two or more events without an apparent causal relation. This coincidence is nearly a synchronicity of this type, because the article deals with what is impossible to reproduce in the field of science.
 The article is entitled “New Truths That Only One Can See” and it has a number of interesting remarks about the question of replication or reproducibility at present in sciences. I quote the following paragraph:
“It has been jarring to learn in recent years that a reproducible result may actually be the rarest of birds. Replication, the ability of another lab to reproduce a finding, is the gold standard of science, reassurance that you have discovered something true. But that is getting harder all the time. With the most accessible truths already discovered, what remains are often subtle effects, some so delicate that they can be conjured up only under ideal circumstances, using highly specialized techniques.”[9] Therefore, replication is not really a common practice in present days science. This is not a secondary or a minor problem. One of the most important consequences, as a certain Dr. Ionnidis concludes after some meta-analysis of scientific publications, is that “papers reporting negative conclusions [of the most part of experiences] are more easily ignored”, and he reaches “the conclusion that most published findings are probably incorrect”. The journalist talks about the inevitable “unconscious bias” of scientists that may end in a vicious circle. That, is: the more scientists expect to find specific results and, therefore, they build their research towards that point, the more they find confirmation through replicability methods. The more they find confirmation of their experiments, the more these experiments are published, quoted, and lead the perspective of new research. As a consequence, the perspective of new and different research is set aside. From our perspective, we may say that this constitutes a good example of the massive effects of the suggestion phenomena that psychoanalysis discovers as a part of the transference.  Scientists talk about a “tacit knowledge” in their community that hides the real they are in fact researching. The discovering of a new real in science is then reserved —says the journalist— to “an experiment as unique as a Rembrandt”. Indeed, the real is always “as unique as a Rembrandt”, impossible to reproduce.
There is always something that cannot be reproduced in experience and sometimes that is the most important issue, the issue that could lead towards a true scientific advance. However, that is precisely ignored, even obliterated, in those published researches that confirm each other in a mutual consensus. This issue is precisely what could allow us to catch a bit of the real, that real that always slips from language and from research.
I will close this parenthesis I opened up a few lines above by pointing out that perhaps I may be also under the effect of that “tacit knowledge” that exists in the same manner in the psychoanalytical community, as it exists in each community of knowledge. And maybe this tacit knowledge that exists about the unconscious knowledge among us also hides the real knot, the real point of the unconscious that lays in scientific discourse. In any case, I will say that this nearly synchronicity between my speech and Maria Cristina’s message, with the link to that interesting article, is an event impossible to reproduce, impossible to repeat in a scientific method, as it was also an event impossible to preview. And, in this sense, it is also an encounter with a real, with the real psychoanalysis deals with.

The Freud’s dream in science

If we have to approach the real that makes specific psychoanalysis clinics in the field of science, it’s better to look at the unconscious formations themselves as those phenomena, so singular, that cannot be reproduced in any way. There is an original moment of this encounter with the real of the unconscious that is necessary to remember when we speak about the real, an original moment in the history of science, a moment that is an unconscious formation, a dream of Freud himself, the dream that is also in the origin of his text “The interpretation of dreams”, a text which is in fact the development of this dream. This is a well-known dream entitled “Irma’s injection dream” and it is linked to the question of feminine sexuality,of feminine “jouissance”, a question that has made present a new real in science and in clinics, a new real that cannot be represented as a complete or as a consistent form, because it escapes always to scientific knowledge.
Where is feminine jouissance? It will be always a question with its enigma preserved in the center of knowledge. And it is also the enigma that lies in the center, in the navel of Freud’s dream. It takes place during Freud’s summer holidays, a few days before his birthday, he has just written a rapport about a difficult patient, Irma, a friend of the family and whose treatment has not been successful. Irma is announced to assist at Freud’s birthday party and he doesn’t feel very comfortable with this circumstance, with Irma’s presence, that is also the presence of a symptom in the clinics of female sexuality. That night, from July 23th to 24th, in the year 1895, he has a dream that rests as a real and singular encounter between scientific knowledge and the question about feminine jouissance. I will only quote some phrases of the manifest content of the dream, when Freud meets Irma who complains in the dream that all Freudian solutions had failed to heal his symptoms. At that point, Freud writes:
“I was alarmed and looked at her. She looked pale and puffy. I thought to myself that after all I must have been missing some organic trouble. I took her to the window and looked down her throat, and she showed signs of recalcitrance, like women with artificial dentures. I thought to myself that there was really no need for her to do that. - She then opened her mouth properly and on the right I found a big white patch…”
The dream goes on, but it is in this white patch, in this white spot, —this “grossen weissen Fleck”— where the navel of the dream finds its place, the real point where all of Freud’s free associations stop at. It is in the blank page of this real, so horrible as it appears to Freud, where the chemical formula of trimethylamin appears, —“printed in heavy type”, Freud points out—, a formula of an element linked to sexuality. Trimethylamin was supposed to be a component of semen, and its formula is therefore a writing of sexuality on the blank page, on the white patch in Irma’s throat that is in then center of Freud’s anguish. There are several associations that lead Freud to the question of female sexuality, but also to the question of death.
In any case, we have in this white spot, in this blank page, the point that Freud himself describes as the navel of the dream, the most real point of the dream; we have in this image that rests in the center of Irma’s injection dream an excellent image of the real that escapes to knowledge, a real that is impossible to represent, that is even impossible to write. It is that real that, in Lacan’s expression, does not cease to not be written —with two negatives— does not cease to not be represented. When Lacan tries to formulate the real he doesn’t find a better formula that this one: the real is what does not cease to not write.
And we may conceive the structure of Freud’s discourse, all his elaboration about the unconscious knowledge, as a work-through around this blank page that remains in every field of knowledge. This is in fact the hypothesis of the unconscious, a knowledge that doesn’t know itself and that stands in every knowledge, a knowledge that is heterogeneous in the field of scientific knowledge, the supposed objective knowledge of the real.
Freud’s dream and his formalization with the symbolic laws of the unconscious knowledge emerges therefore as a real point in scientific knowledge, as a real point that was waiting to be inscribed in its field, a real point that does not cease to not be written until the moment of the formation of this dream, when something of this real unconscious ceases to not be written. When the real ceases to not be written, we have a phenomenon of Tyché, an encounter with the real, always as a contingency, never as a necessary law that would be previewed or calculated in advance.

Neuroscience’s dream

This is the real of psychoanalysis and we can now pose the following question: where is this real in our contemporary science? Is it possible to catch it, to find some representation of its impossible writing in the scientific knowledge of present days?
I propose you the reading of an actual reference in the field of neurosciences, the reading of someone that at some point was interested in Freud and that tries to represent the unconscious knowledge in the brain mapping of actual neurosciences. I am referring to Antonio Damasio, the neuroscientist, author of some best-sellers in the diffusion of science, the later one titled Self Comes to Mind: Constructing the Conscious Brain. In this work, Antonio Damasio proposes a representation, a mapping of the brain, a brain that would be in its turn a mapping of reality, even a mapping of the real. Even if he proposes the idea of mapping only as a useful abstraction, the operation of mapping the brain activity is today a very suggestive procedure widely published in all kinds of press with the coloured images of fMRI (Functional Magnetic Resonance Imaging). All the thinking activity, all the human thoughts could be represented in this brain mapping, even the unconscious thoughts, of course. Even the white patch and the writing of the trymethylamin formula in the Freud’s dream will be mapped. This is the ideal goal of neurosciences: mapping the real of human thoughts.
But the real unconscious is impossible to map, so impossible as the real itself that does not cease to not be written. The real unconscious will always be impossible to map out by a Magnetic Resonance, just as those parts in the ancient maps that were represented as a terra incognita, obscured by clouds, a non explored region where you could only read: hic sunt dracones, there are dragons here, impossible beings, but not so unreal ones. To catch dragons in the terra incognita of the real unconscious, Magnetic Resonance is absolutely useless; you have rather to try with Semantic Resonance, with the resonance that words and language produce in a human being, a talking being.
The most interesting moment in the reading of Antonio Damasio’s book is precisely the chapter dedicated to Freud and the “Freudian unconscious”. We have there the privilege of reading Damasio’s testimony of his own unconscious, as in the Freudian text of “The interpretation of dreams”. Contrary to Freud, Damasio doesn’t extract any consequences of his dreams. In fact, he says that he tries hard to remember them, but unless he writes them down, they vanish. All of them? No, not all of them. There is at least a dream that resists to vanish from the scientific mind of Damasio, “a recurrent soft nightmare” as he writes, an unconscious formation that usually comes to his mind the night before he has to make a speech. Damasio himself confesses  his uneasiness  when someone invites him to give a lecture on the topic of Freud and neuroscience: “It is the sort of assignment one should decline vigorously”, he writes. And then, here is the soft nightmare that disturbs him, with its message of the real unconscious: “The variations always had the same gist: I am late, desperately late, and something essential is missing. My shoes may have disappeared; or my five o’clock shadow is turning into a two-day beard and my shaver is nowhere to be found; or the airport has closed down with fog and I am grounded. I am tortured and sometimes embarrasses, as when (in my dream, of course) I actually walked onstage barefoot (but in an Armani suit). That is why —Damasio adds —, I never leave shoes to be shined outside a hotel room.”[10]
It’s indeed one of those dreams of repetition in which Freud found the presence of the real with its traumatic effects, in a form of a repetition that is always beyond the pleasure principle. Of course, we would need Antonio Damasio’s associations about each element of the dream to develop the semantic resonances that are weaved in the text of his unconscious. But there is something very clear in this text, something that is always missing, that the subject feels like a lack, something lost or disappeared that tortures him. The real unconscious is precisely this lack, this absence, this place impossible to represent in the map, this place where the subject Antonio Damasio is always late, desperately late, too late to say that unconscious will be always absent of the brain mapping. This is the real unconscious that does not cease to not be written, that does not ceased not  be represented, but that insists to be written in the subject’s dream. And how it insists at being represented? It insists at being represented as a lack, as an absence, as a lost, as the lack of shoes that are so present in its absence. —In Spanish we say “brillan por su ausencia”, literally, “they shine through its absence”, and there is no need to let them outside the room to be shined, it’s enough to dream of them as the lack object, as the most real object. The subject misses this object to the extent that he is always late in his meeting with the Freudian unconscious. The real unconscious are these shoes Antonio Damasio fears to loose and that does not cease not to be outside his hotel room every night before his impossible speech, his impossible meeting with the Freudian unconscious.
The shoes of Antonio Damasio are therefore a brilliant image, as any other unconscious formation, as any other symptom, to reveal the real that psychoanalysis has to deal with, the real unconscious that only the subject could decide to decipher. But, of course, to do that it would be necessary first to admit that those shoes, as a symbolic element, are an interesting object to represent the unconscious as a brain.

The red ink of the real

We can go back now to our first question about the unobvious relation between the real of science and the real of psychoanalysis. We can name this relation as the real unconscious that remains among the sciences, among the knowledge of the different sciences. It isn’t indeed an obvious relation because this real always appears as a blank page in the book of science. To make it evident, to give you a short view of this place, I haven’t found a better example than an amusing and brief story that someone called Slavoj Zizek was telling recently, here in Wall Street, to some people, perhaps without extracting the most interesting consequences. The brief story as follows:
“A guy was sent from East Germany to work in Siberia. He knew his mail would be read by censors. So he told his friends: Let’s establish a code. If the letter you get from me is written in blue ink, it is true what I said. If it is written in red ink, it is false. After a month his friends got a first letter all written in blue ink that said: everything is wonderful here. Stores are full of good food. Movie theaters show all sorts of excellent American films. Apartments are large and luxurious. The only thing you cannot buy is red ink.”
Indeed, we lack the red ink to say all the truth, and that is the reason Lacan said that we can only half-speak the truth —to translate Lacan expression “le midire de la vérité”— which is different from saying: to speak half-truths. There is a logic impossibility to say all the truth or all the real, because of the unconscious. We lack the red ink, even to say that what I am saying is false. But truth speaks by itself in what I’m saying, always beyond my conscious will.
Science is based on the belief that one can spell out and write all the real in blue ink, that one can say the truth of the knowledge that is written in the real, without any lack. However, this belief only lasts to point when one realizes that some shoes are definitely lacking, that the red ink will always be lacking in any discourse.
Therefore, I will say as a conclusion that psychoanalysis is the red ink of science, as the subject of unconscious is the red ink of scientific discourse. Both, the real unconscious and psychoanalysis itself are waiting to be written in blue ink. However, we must be careful, if  at anytime that became the case, one would get, as the most important object always lacking to the subject’s desire, only a blank page to be read, —with the semantic resonances that the language offers us in the word “read”.

* Lecture in Barnard College, New York City, February 14, 2014. I thank Howard Rose for his proofreading of this text.

[1] Published in Scilicet nº 6-7. Du Seuil, Paris 1975.
[2] “Une pratique qui joue d’un autre réel” S. XIX, p. 240.
[3] Jacques-Alain Miller, “A real for the XXIth Century”, presentation of the IX Congress of the WAP.
[4] Javier Peteiro, “Lo real sin ley de la ciencia”, contribution to the IX Congress of the Wap.
[5] Jacques-Alain Miller, in Psychoanalytical Notebooks 27, “Science and the Real”, London Society of the Nerw Lacanian School, September 2013. The conference was pronounced in 1988.
[6] In an interview in “Figaro littéraire” by Gilles Lapouge, 1st December 1996, nº 1076.
[7]La psychanalyse, je l'ai dit, je l'ai répété tout récemment, n'est pas une science. Elle n'a pas son statut de science et elle ne peut que l'attendre, l'espérer.” Le Séminaire, libre XXIV, “L’insu que sait de l’une-bévue s’aile à mourre” (inédit).
[8] We refer here to the studies of Joan-Ramon Laporte, director of the Catalan Institute of Pharmacology, “Principios básicos de investigación clínica”, AstraZeneca, Barcelona 2001.
[9] George Johnson, “New Truths Than Only One Can See”, in The New York Times, January 20, 2014.
[10] Antonio Damasio, Self Comes to Mind: Constructing the Conscious Brain, Ramdom House, New York 2012.