Discussion on Fabiana – I
Garofalo reported the case published here in a clinical discussion group that has been taking place regularly in Rome for the past two years and which includes analysts and psychotherapists from the most diverse schools and tendencies. It’s a kind of psychoanalytical tower of Babel! So, since therapists of very different tendencies from Garofalo’s were present, he wasn’t spared any criticism. The text you’ve just read is, therefore, a later elaboration by the author, who conscientiously
took into account our objections and perplexities concerning his first report. Thus the text is a group product, so to speak. The fact that Garofalo had the courage to commit a not very successful experience into writing is, of course, admirable.
When he presented this case in the discussion group, I was struck by his argument that hysterics are not analyzable, and that Fabiana was such an example. This is an argument that can’t go unnoticed, because, as everyone knows, Freud
discovered psychoanalysis by analyzing hysterics. But in a certain sense Garofalo is right: psychoanalysis began with impossible cases! I wonder if this wasn’t Freud’s stroke of genius: wanting to deal with the most difficult cases. It is just when analysis–i.e. “talking rather than acting”–seems impossible that a creative turn may take place.
Garofalo reported the case published here in a clinical discussion group that has been taking place regularly in Rome for the past two years and which includes analysts and psychotherapists from the most diverse schools and tendencies. It’s a kind of psychoanalytical tower of Babel! So, since therapists of very different tendencies from Garofalo’s were present, he wasn’t spared any criticism. The text you’ve just read is, therefore, a later elaboration by the author, who conscientiously took into account our objections and perplexities concerning his first report. Thus the text is a group product, so to speak. The fact that Garofalo had the courage to commit a not very successful experience into writing is, of course, admirable.
When he presented this case in the discussion group, I was struck by his argument that hysterics are not analyzable, and that Fabiana was such an example. This is an argument that can’t go unnoticed, because, as everyone knows, Freud discovered psychoanalysis by analyzing hysterics. But in a certain sense Garofalo is right: psychoanalysis began with impossible cases! I wonder if this wasn’t Freud’s stroke of genius: wanting to deal with the most difficult cases. It is just when analysis–i.e. “talking rather than acting”–seems impossible that a creative turn may take place.
There’s little to learn from easy cases for one simple reason: most patients are (fortunately) malleable, that is, in the end they say and dream everything the analyst wants them to. We like patients who make us happy, and also perhaps improve, even visibly, so as not to make us suffer disappointment. This is the triumph of the
“placebo” cure, which means, “I must be liked” [by the doctor]. But, because these patients are trying to make us happy, they always confirm us in whatever we say and think: in other words, they don’t make us grow. If Freud had dealt only with jelly cases like the ones we all like, he wouldn’t have gotten any further than Breuer’s cathartic method. The hysteric, instead, resists, she doesn’t reinforce, our narcissism: she goes out of her way to tell us “you’re good at talking, but you haven’t got the faintest idea of what I’m lacking! You’re impotent”. This resistance of hysterics against the analysis-placebo makes them the litmus test for psychoanalysis: not because analysis can always tame them–like Petruccio does with Katherine in The Taming of the Shrew–but because analysts must accept the hysteric’s challenges to the bitter end. The challenges make them accomplish a qualitative leap: hysterics are basically the most interesting analysands simply because… they’re not analyzable.
I wouldn’t rule out that Fabiana’s ‘therapy’ (between inverted commas because I still don’t know what therapy’ is, in general) also had its positive effects, as Garofalo suggests. But since one should never take anything for granted or as self-evident, I ask myself: what do we consider to be positive and negative effects in an analytic relation? If one of us considers a certain effect to be positive and another absolutely not, then this opens a window on what is ideologically implicit to us: on the fact that each of us has a personal idea (often never questioned) of our task, as analysts, and in general of the task of analysis. In any case, it would be useful to focus on what did not work in sessions with Fabiana, rather than on what may have worked. It is from failure that one learns most, as Freud shows…
Now, what struck me is the fact that Garofalo agreed, without making a peep, to keep Fabiana’s unsent letters to her lover. I’m not questioning the act of accepting this safekeeping job in itself: I just wonder why he never asked “why leave them, of all people, with me?” True, as analysts we are told not to ask too many questions, but I think that in many cases questions ought to be asked. I wonder if the non-positive result of the analysis may be due just to this oft-unasked question: why…?
This reminds me of the myth of Perceval. He was on a quest to find the Grail, but he’d been taught that it’s childish to ask questions. At one point, during a banquet, he sees some very strange goings on, during which the Grail passes, right in front of him. Anyone else would have asked, “what is this thing?”, but he kept quiet. Thus he missed the Grail. There are moments, therefore, when if one wants to lay hands on the “thing”–the hysteric thing in this case—it’s necessary to ask questions.
Indeed, my teachers in clinical psychoanalysis would have said that her demand that he keep her letters was an acting out. This concept is only apparently evident, it is more problematic than one would suppose. Indeed, what acting out means is that a patient, rather than bringing something into analysis in verbal form, or something that is in any case intersubjectively elaborated, instead acts outside the setting. Acting out is therefore a symbolic act, even if it appears as a realistic action (in Fabiana’s case the realistic implication is giving these letters to someone to keep so that her husband can’t find them… but the symbolic meaning of the act goes beyond its realistic function). Some would say that Fabiana’s is more of an acting in, i.e. something “acted” not outside but inside the analytic relationship: it is an acting outside within analysis.
Now, why are analysts taught to “denounce” acting out? Because psychoanalysis is based on a very specific ethical prescription: “Don’t act, talk!” Psychoanalysis distinguishes itself from other forms of psychotherapy for this very reason. In other words, if I’m really mad at my next door neighbor, rather than act, go over to his place with a hammer and smash his head in, I instead talk about it, to my analyst, and I “work through” this rage of mine. Isn’t psychoanalysis the training that allows us to verbalize rather than act and get ourselves into trouble?
But then, doesn’t this contrast with the authenticity-ideal of psychoanalysis? In other words, is authentic desire only desire that is never acted? But if my desire really is to smash my neighbor’s head in, why should I avoid it? Couldn’t it be that acting and talking instead of smashing is a diversion that moves us away from our truth? Could it be possible that acting is always inauthentic, and that authenticity is only found in speech?
These questions actually become more complex when my desire isn’t to smash my neighbor’s head in, but rather to seduce my lovely but lonely neighbor. Would this too be acting out? Is one acting out only when one is doing inappropriate or criminal things, or also when one is doing pleasant things that others would be happy about too? May it not be that psychoanalysis has a double standard with regard to this “acting”? Does it perhaps not lapse into a sort of cognitive pedagogy that discourages our harmful actions and allows only our harmless ones? What authorizes the analyst to say “if you want to smash your neighbor’s head in, that’s a symbolic, inauthentic, act” and “if you want to seduce your willing neighbor, that’s a positive, mature, adult act”? These are all crucial questions that I shan’t discuss here, but that I always bear in mind, in practice above all.
Now, Fabiana’s acting in is particularly interesting because it asks the analyst to keep a series of unsent letters: rather than conversing with her lover, she gives the analyst the bare corpus of her writing. Here Fabiana is treating her letters not as messages but as signs: it’s rather as ‘things’ that she propounds them to the analyst. And the analyst accepts them as things, and not as messages. Not only does she not tell her lover what she wanted to say – i.e. that she wasn’t always keen on being considered just a body, that she also wanted sometimes to be a subject, or a person (I prefer the term subject to person, person to me is a little too catholic) – she doesn’t tell her analyst about her wish to leave him her letters (perhaps so he might read them, perhaps so he might think they were really to him), she acts out, she hands them over. It’s a trick with mirrors, where every act mirrors some other act that in turn mirrors another, etc.
Indeed, Fabiana had an affair with this man who openly said he only desired her body, and she is seemingly infatuated with him just because of this proclamation. In other words, Fabiana desires this man as a subject exactly because he says to her “I desire you as an object”. But, being a proper hysteric, this solution (like any solution) frustrates her: having reached the point of sexual intercourse, in the passage from desire to the enjoyment (as a Lacanian would say), she realizes that only the real body is at play, whilst she was aspiring to…? If I could answer this latest question, I would have solved the enigma of hysteria. (Or, if this question were answerable, there wouldn’t need to be hysterics.)
Unsatisfied, she writes him letters, to remind him, it would seem, that she isn’t only a body, but instead of sending him these letters–so that the message reaches its addressee–she treats her messages as real, motionless objects. In other words, she mimics her lover, who also desires her body and not her words. In fact she entrusts these letters to her analyst without ever asking him to read them and discuss them with her – which would have entailed a shift from a real act to something intersubjective – but only to guard them as objects, as mere things. And so when the analyst accepts without asking why, like Perceval, without trying to “subjectivize” them, he unwittingly behaves like her frustrating lover too – he accepts her body, but does not read her as a subject. It’s not surprising, therefore, if in the end she holds a grudge against her ex-analyst, very much the same way she once had against her lover at the end of their relationship. In my opinion both “took her literally”, i.e. as a concrete body: the lover as her sexual body, while the analyst treated her messages as if they were real body.
Garofalo rightly complains that the hysteric is incapable of “mentalizing” and communicating. But when Fabiana offered him the Grail–her letters, where the hub of her problem was likely at play–he failed to help her mentalize… So, he colluded in her acting out. Could this be called an acting in? According to my teachers, yes. He missed the opportunity to put into operation the anti-hysteric act par excellence: moving from the register of the realistic act to the act of verbal elaboration.
Fabiana performs another acting out/acting in after the end of the analytic relation, when she asks Garofalo to write her a certificate (again, something in writing!) helping her make her case. It is obviously an attempt at manipulation, in the sense that here too subjectivation is avoided and the request is for something practical, from the Greek praxis. Once again, she does not elaborate symbolically, she acts. (The analytic meaning of this request was probably to take stock of their three-year relation.) She was asking: “what do you think analysis has given me in
all this time?” But, being a good hysteric, she doesn’t ask directly: she acts. In other words, she asks Garofalo for something outside the order of subjective elaboration, or of speech, but within the order of the practical instrument, and an aggressive instrument at that, one she could use against other people. Instead of using the analyst to try to understand what went on, she tries to make of him an object, and a useless one as she already has the letter she needs from her group therapist, seemingly only in order to get him to give her a tool that could be used only for extra-analytic purposes (to gain power over other bullying men).
Faced with this other acting out, Garofalo, in contrast to the first occasion, refuses to participate. The impression, however, is that in both cases the result is the same: Fabiana doesn’t manage to work through anything, to recognize herself, or to recognize her acting as symptomatic, and symbolic.
It is true that, by keeping the letters, Garofalo established a complicity that made it possible to continue on for some more sessions. But does continuing with sessions necessarily imply that analysis is going somewhere? Personally, I’m not at all impressed when somebody tells me something like “I was in analysis ten years!” I have known people who were in analysis for years and years and got exactly nowhere. At the other end of the spectrum, some require only a few sessions to reach some turning point. Freud, for example, cured Mahler’s impotence in just one session: I don’t think this was so much due to Freud’s genius, as much as to the fact that Mahler just required one session… Basically, regarding length of treatment, there are no rules. And the rules set by so many analytic societies, which determine someone’s level of maturation according to the number of sessions they’ve have, are clearly ridiculous. The important thing about analysis is not that it will go on for a long period of time, but that there is some change in a subject’s being-in-the-world. And not just some superficial change. In fact many analyses bring to mind a quote from Tomasi di Lampedusa’s novel The Leopard: “Everything must change, in order that nothing can change!”
Now, does this recognition contrast what Garofalo writes, i.e. that for him
analytic therapy is “the recognition of the person in all [my italics] her/his development, abilities and potentials”? One would be tempted to say that in this case he didn’t fully apply his precepts. And what if instead we malignantly suggest that in this case he failed just because he tried to apply them?
Now, it just happens that the hysteric, in my opinion, wants neither to be understood nor recognized as a person: she doesn’t know what to do with recognition. As she situates her suffering in the real (of her body, her workplace, of a corrupt society, and so on…), it’s like going to a dentist with a terrible toothache and hearing the dentist say “I understand your pain, it’s just as if I feel it myself!” Wouldn’t we tell such a dentist where to get off? We don’t need him to understand our pain; we want him to fix it. So, as analysts we are called upon by hysterics to be like dentists, even though our tools aren’t quite that effective. Anyway, even if we think this toothache is a ruse… the solution isn’t in comprehending. That’s why these days so many hysterics prefer a plastic surgeon to an analyst (the analyst’s true competitor, much more than colleagues from other therapeutic schools). Maybe psychoanalysis is a third way between pure “total” comprehension and surgery, a kind of no man’s land?
Now, by “to understand” we usually mean stepping into someone else’s shoes: we put ourselves in somebody else’s place and we “understand” why they think certain things and why they react in certain ways. But the fact is that the hysteric doesn’t know which shoes she’s in. She is sometimes called histrionic because she steps in so many people’s shoes. “To understand her” always means to understand someone else, not her. Understanding her would simply mean being another hysteric, sort of like her: because, of course, on the one hand, she does say “please understand me!”, but on the other she doesn’t know what to do with this comprehension. It’s no accident that she doesn’t fall in love with a guy who claims to understand her, but with one who tells her quite plainly “I’m only after your body!” What she desires is not a man who understands her, but one who’ll grab her like a piece of meat–even though she complains when it actually happens. That’s just it: the awful thing about being a hysteric is that in the end most of her desires
actually come true… the terrible thing is that almost all your dreams come true! As an hysteric she doesn’t know what she wants, and she doesn’t know what anybody is supposed to be “understanding” about her, either: she hopes the analyst goes beyond comprehension and gives her an answer in the realm of the real, like her plastic surgeon would.
Therefore the analyst needs to find an alternate path to both hysteric collusion (sympathizing with her acting out) and comprehension. Let’s say that the analyst should rather allow in the hysteric something like a conversion–in the sense that we say a particular region has been converted to industry, or a wood has been converted to grazing. The analyst ought to be the catalyst towards conversion. Easier said than done, of course.