Hysteria and the Psychoanalytic Act


Hysteria’s notorious history is that of the pharmakon, constantly seducing and subverting the master into the production of a knowledge destined to fall, clearing the space for a question, and this question is the beginning of psychoanalysis, the induction of the transference.  Lacan’s conception of the psychoanalytic act is this hystericizing effect which induces the transference, but also of the equally hysterical fall of the subject supposed to know that marks the end and cure of a psychoanalysis.  How can this same act both instantiate the illusion of the subject supposed to know in the person of the analyst and serve to analyze and undo this illusion?  What does hysteria still have to teach psychoanalysts about the nature of their act and of the psychoanalytic cure?  The author explores the “two acts of psychoanalysis”, hysterical disappointment, and the sinthomatic creation that is the psychoanalytic cure.

Hystory: Of Masters and Errant Wombs

The history of hysteria spans nearly four thousand years: four thousand years of the wilderness of women’s bodies and of manifest destiny, or the attempts of men to push ever further the boundaries of the frontier, four thousand years of shame, of defiance, four thousand years of theater, of desire’s sting and the “infection of the Idea” (Badiou, 2013).  Hysteria, from the Greek hystérā, womb, hysterikós, of the womb.  The womb that wanders.  As the father of Western thought, Plato, described, “The uterus was rebellious and masterful, like an animal disobedient to reason, and maddened with the sting of lust” (Plato, 1963/1973, p. 1210).  Desiring, violent, creaturely stuff.  Throughout these four thousand years, the myriad ways hysteria has been conceptualized, and all of its rapidly fluctuating symptomatic couture, it has never ceased to be associated with the porousness of the female body and masculine fascination and terror in the face of feminine desire.

Cultural history might be defined as the interdependence of master and hysteric: priest and witch, doctor and patient, artist and muse, husband and wife.  The hysteric, with her incessant questioning – the question of the woman – seeks out a master, but as Lacan (1969-70) stipulated, “a master she can reign over.”  It is through desire, and as the object of desire, that the hysteric puts the master to work in the production of knowledge, a production that is endless as it turns out, for none of that which the master produces will satisfy her (or keep her at bay).  There will be no caviar for the butcher’s beautiful wife (Freud, 1900).  The master will be castrated, that desire and the production of knowledge – the unceasing, idiotic march of cultural progress – might continue without end.



Hysteria is a pharmakon: neither and both active and/or passive, masquerading seduction and/or incessant truth-telling, conservative and/or revolutionary; it is a site of irreducible ambivalence and danger.  Derrida (1972/1981) wrote of the pharmakon:

This charm, this spellbinding virtue, this power of fascination, can be – alternately or simultaneously – beneficent or maleficent.  The pharmakon would be a substance – with all that that word can connote in terms of matter with occult virtues, cryptic depths refusing to submit their ambivalence to analysis, already paving the way for alchemy – if we didn’t have eventually to come to recognize it as antisubstance itself: that which resists any philosopheme, indefinitely exceeding its bounds as nonidentity, nonessence, nonsubstance; granting philosophy by that very fact the inexhaustible adversity of what funds it and the infinite absence of what founds it.  (p. 70)

The hysterical pharmakon, from Eve to Augustine, Dora to Lady Gaga, endlessly seducing the master with her fruits of knowledge, luring him from the safe insularity of the garden into the wilderness.  The hysteric’s desire infects the world.  Hysteria spreads: boarding school epidemics of psychic pregnancy and paralyses, recovered memories, viral memes, ataque de nervios, an endless deferral, repetition, and transformation of mimetic desiring.  The hysterical pharmakon comes as a stranger from without, from the dark continent, upsetting the orderly, bounded daylight world.  “God has no allergies” (Derrida, 1972/1981, p. 101).  With its proton pseudos, hysteria disrupts our ideals of immanent, identical being.

Above all, the hysterical pharmakon is antisubstance: matter without the indelible imprint of form.  Pure potentiality, the hysteric is always in flight, and today she has flown right out of the compendiums of medical, psychiatric, and even psychoanalytic doxa.   To the vexation of masters everywhere and at all times, the hysteric’s ego is weak: constantly acting out, she has no capacity for delay.  The catastrophe of castration having already occurred, the hysteric’s superego is lax and the reaction formations and armoring of character does not occur for her as it does for her obsessional counterpart.  Her identity is diffuse and must be gathered up and nailed in place for her.

The hysteric is that terrifying being whose matter can be, must be incarnated by form, whose womb is stung with lust and whose body can play host to demons or speak the language of 19th century medicine, allergic and allergenic, the one who can be hypnotized.  Psychoanalysis was born of Freud’s evental encounter with hysteria.  And his creation of psychoanalysis from the blah-blah of hysterics and their loquacious bodies must be repeated in each and every psychoanalysis, or, to put it somewhat differently, it is only with a hysterical question that a psychoanalysis can begin.  Where there is no discourse of the hysteric, there can be no discourse of the analyst.  Lacan (1967-1968) stated:

Questions are posed starting from the fact that there is somewhere this function, call it what you will, here it appears in all its aspects, obvious because mythical, that there is somewhere something which plays this function of the subject supposed to know.  (November 29, 1967)

And this beginning – this question addressed to a subject supposed to know – is not necessarily there at the beginning, and so it must come later.  This is the psychoanalytic act, the hystericization of the analysand and the induction to the transference.


The Act

The first effect of the psychoanalytic act is the intrication of the analyst with the analysand’s symptom: the analysand must exchange his neurosis for a transference neurosis and the analyst must allow herself to be taken up as partner-symptom. A stage is set.  With hysterical question addressed to subject supposed to know, the analysand’s symptom is split and rendered analyzable, and in this ciphering and deciphering, the unconscious, as Other, is created each time anew.  The unconscious is not some hidden depth, a reservoir or cauldron of the drives; it is created in the analytic session as an Other that produces a message that has a specific addressee (the subject supposed to know).  The symptom of the speaking-being consists of a symbolico-imaginary message and a real core of jouissance, a signifier supported by a letter (a).  In the act, the analyst lends her being to the real of the analysand’s transference-symptom, and the analysand dickers an unsatisfactory jouissance for the “harebrained lucubrations” of this Other knowledge (Lacan, 1972-1973).  This act establishes a scission within the symptom, liberating the signifier from the fixation of its jouissante core and allowing it to unfold as a chain.  This is the first effect of the act.

But let us go back before the beginning.  With the hysteric as guide, psychoanalysis had to pass through the field of hypnosis in order to be born.  Hysteria is the basic neurosis, the discourse of magisterial complaint, of symptom, of division and non-identity.  It is the hysteric that allows her ego to fade into syncope and lends her body to hypnosis.  Lacan (1967-1968) proclaimed, “The hysteric reaches the goal immediately.  The Freud she is kissing is the object a.  Everyone knows that this is what a hysteric needs especially coming out of hypnosis” (February 21, 1968).  Four years earlier, he had proposed this formula, “To define hypnosis as the confusion, at one point of the ideal signifier in which the subject is mapped with the a, is the most assured structural definition that has been advanced” (Lacan, 1963-64/1978, p. 273).  Hypnosis collapses this point of the real fixated with jouissance around which the drive circulates with, or into, a symbolico-imaginary representation that captures while simultaneously alienating the subject from the real of the drives.

The apotheosis of hypnosis is a clearing away that allows the transference-symptom – the master signifier fixated with jouissance – to emerge in pristine form.  Freud’s genius was to be the first to recognize that simply replacing one symptom with another led only to an interminable or infinite process.  The transference cannot be ignored nor can it simply be manipulated.  Freud (1916-1917) wrote:

In every other kind of suggestive treatment the transference is carefully preserved and left untouched; in analysis it is itself subjected to treatment and is dissected in all the shapes in which it appears.  At the end of an analytic treatment the transference itself must be cleaned away…  (p. 452)

The desire of the analyst, an enigmatic desire for absolute difference, must work against the collapse of the unconscious in the petrifying identification of master signifier and a.  Lacan would characterize psychoanalysis as an “upside-down hypnosis”: it is the analyst, as a, who must fall into syncope.

What does it mean that the analyst must fall?  The most obvious meaning, a formulation of the direction of the treatment and its principle of cure, is that the analyst must fall as subject supposed to know, that the analysand might separate from this alienating master.  But more will be written shortly about this cleaning away of the transference.  The first of the analyst’s falls I wish to speak of is the fall of her knowledge.  Both analysand and analyst must abandon themselves to the fall that is the psychoanalytic method: free association and evenly-suspended attention.  Analysts must approach each analysand and, indeed, every session and moment as if it was the first, entirely singular.  Psychoanalysis is a radically abductive practice, constructing from the gaps in an otherwise continuous surface, and it allows for no deduction, no movement from the general (metapsychological, technical, biographical/historical) to the specific.  In the militant epoché of psychoanalytic neutrality, the analyst must let go of the knowledge she has fought and clawed for and which she has used to plug countless holes.  Standing before the abyss of judgment, she must let fall.

But this is not all, for Freud (1912) wrote of evenly-suspended attention, “The rule for the doctor may be expressed: ‘He should withhold all conscious influences from his capacity to attend and give himself over completely to his ‘unconscious memory’” (p. 111-112).  Evenly-suspended attention is not only the already-impossible epoché of analytic neutrality; for what is Freud referring to when he encourages the analyst to “give himself over completely to his ‘unconscious memory’?  Why memory?  Lacan proposed that the memory that must be connected with in evenly-suspended attention was an experience of unconscious truth from the analyst’s own analysis re-discovered in the signifiers of the analysand and engendering the psychoanalytic act (Lacan, 1955/2006; Webster, in press).  Freud and Lacan are clear: whatever act it is that the psychoanalyst is engaged in, it is not of the order of ego-intentional action duly guided by knowledge, but is, rather, a hysterical fall into unconsciousness.  Lacan (1967-1968) described this movement:

An act of faith, I said, in the subject supposed to know and precisely by a subject who has just learned what is involved in the subject supposed to know, at least in an exemplary operation, which is that of psychoanalysis.  (February 21, 1968)

In this strange figure of a subject of knowledge acting in faith, Lacan points towards the analyst’s coming to be through her own analysis (or, rather, her coming to (un)be as function).  The analyst authorizes herself through her analysis, her own experience of the fall of the subject supposed to know.  What faith remains?  And what endures of the hysterical act if there is no master that might be its addressee?

In his Anxiety Seminar, Lacan (1962-63/2014) differentiated acting out from the passage to the act.  He likened acting out to wild transference coming in the place of a missing interpretation and insisting on it, barely ciphered or not ciphered at all, an exasperated missive.  The passage to the act, on the other hand, is an exit from the scene of the Other altogether; it is a letting oneself fall into the real.  Lacan (1967-1968) described the psychoanalytic act as an “enlightened passage to the act” (March 13, 1968).  The sense here is double.  In the act, the psychoanalyst lets herself fall away as the subject supposed to know.  But earlier still, she has already allowed herself to be taken up as the supposed subject of knowing when she has experienced firsthand and in its purest form that no such subject exists.  As Lacan (1975-1976) learned in his later study of Joyce and the sinthome, there can be no subject without a symptom, and the symptom persists even without the Other to whom it would be a response.  In l’Etourdit, Lacan explained that the hysterical symptom is not all response to the Other; it is also a response to the real (Brousse, 1997).  The psychoanalytic act, this fall into the real, might also be called the psychoanalyst’s symptom.

In Seminar 24, Lacan (1976-1977) refers to himself as a “perfect hysteric.”  Here, as elsewhere, he alludes to an hysteria without symptoms.  He meant symptoms in the common nosological sense, with or without an Other it might be a message to or from, there can be no subject without a symptom.  In analysis, the Other is deconstructed and nothing is left of the symptom as ciphering-deciphering.  But the symptom, as that which doesn’t stop not being written, persists in its absence as real.  Lacan (1967-1968) describes the act both as an “act of faith” and as an “enlightened passage to the act,” remarkably evoking simultaneously Kierkegaard’s leap and the enlightenment collapse of the Other of theistic thought.  This is the hysteria of the psychoanalyst’s act: a repetitive setting the stage and living out of her destiny to fall from it again and again.  A play in two acts.  Begin again, hysteria (see Webster, this issue).  Let fall.


Psychoanalysis in Two Acts

We have come to recognize, even to define the psychoanalytic act based on its effects: the induction to the transference and its dissolution in the fall of the subject supposed to know.  Lacan (1967-1968) is characteristically oblique in his formulations of the psychoanalytic act, especially related to the two times of the act I am proposing here.  So, confirming the act’s relation to the beginning of the psychoanalysis, he states, “We posit the psychoanalytic act as consisting in the fact of supporting the transference” (January 17, 1968).  He describes this support as an acting and as a feint, and he claims of the analysis of the transference, “If it means anything, it can only be the following: the elimination of this subject supposed to know” (November 29, 1967).  Although it is not necessarily the case from this statement that Lacan believes that the analysis of transference, as he is defining it here, is a necessary part of the act, he does make clear that the psychoanalytic act is properly aimed at the truth, which he defines as an experience of the subject’s incapacity to master knowledge.  The act would seem from these statements to comprise both this supporting via a feint and its analysis, unloosening, letting fall.

How are we to understand these two radically opposed moments that frame a psychoanalysis?  Are there multiple (at least two) types of act or, perhaps, a single act has multiple (at least two) effects?  Mieli (2011) elegantly proposed the concept of steps in the act, which are the logical punctuations that make a cut in the circularity of repetition and open a new space in the treatment, while the act itself refers to the entire unfolding of the cure.

A related strain of questions arises regarding the nature of the psychoanalytic act in relation to other fundamental psychoanalytic concepts.  Is the psychoanalytic act of the order of interpretation or is it more of the order of those reference points we have already made recourse to here, the desire of the analyst and evenly-suspended attention?  It is tempting, and quite possibly accurate to make a similar movement in responding to this latter question as that of Mieli.  There might be a similar broadening as we move from the specific tactic of interpretation (a mutative interpretation would be a step in the act), to the more general positioning of evenly-suspended attention and the desire of the analyst, to the most general or global concept of the psychoanalytic act, the entire unfolding of the cure.  I suppose this is, in large measure, a terminological question, a matter of defining terms.  It does raise the question, though, of why Lacan felt compelled, with the psychoanalytic act, to introduce a new term at all.

Something in me resists this solution, some recognition of my proclivity towards inhibition and an endless deferral as well as a persistent longing for a cataclysmic action that might release me from it, and I can’t quite give myself over to such a globalized conception of the act.  I need something different.  I fear that this movement risks purging the act of its activity, stripping it of its hysterical thrust.  The resonances of the signifier act are marvelous: its connection in Latin (agere) to drive, its theatricality and suggestion of a truth that must pass through falsity via desire, and its association with those most active and hysterical symptomatic productions – acting out, the passage to the act, and bungled actions.  And with this neglect of the activity of the act and its suggestion of a passage through falsity and error to arrive at truth, it seems to me, we also lose the distinct elements of danger and risk so fundamental to the act and its hysterical psychopomp.

In trying to think through the idea that the psychoanalytic act might have these two radically opposed effects – first the creation and support of an illusion and then that illusion’s collapse, and that this traversal to the far ends of error is the very structure of psychoanalytic truth and cure – I was reminded of a dream from early in my analysis.  In the dream, I had stuffed a cat into a burlap sack.  Inside the bag, I was attempting to strangle the cat.  The experience was visceral: I was squeezing hard and the cat was scratching, frenziedly trying to escape.  At the end of the dream, the cat did manage to tear through the bottom of the bag and free herself.  But it was the experience of aggression and murderous violence that I was disturbed by and focused on when I recounted the dream to my analyst.  I associated to a day residue of a television program I had watched in which a detective, after interviewing a serial killer, strangled a stray cat, of the danger of giving myself over to something.  I associated to sex with cat = pussy as well as its opposite, cat as a male figure as in hepcat, cool cat; and of the closure and strangulation of the bag versus the openness of the cat’s final escape.  But mostly I was unnerved by the violence of the dream and the feeling it left me with upon awakening.

Breaking his silence, which had lasted most of the session, my analyst stated simply, “The cat got out of the bag.”  I was completely surprised, and afterwards, surprised by my surprise, perhaps even slightly ashamed by it.  The shame of egoic failure, anything but master in its own house.  But more than this, I was excited by the interpretation.  I appreciated my artisanal unconscious, and, particularly, I admired that my analyst had heard this message despite my associative focus guiding us elsewhere.  Here, indeed, was a subject who knew.

And to add yet another oscillation, I didn’t actually feel a resonance with the idea of a secret coming out that the idiom implies.  Had any secret come out?  What was its content?  Half fearing that it was prophetic and half feeling disappointedly that there is always one more mystery, that this was the trouble with psychoanalysis, its endless proliferation of meaning.  Perhaps the dream was pure form without content.  All that had come out was the structure of the dream itself.  Its secret was that it contained a secret and could surprise, nothing else.

The question of phallic stopper and obsessional enclosure against hystericization and violent opening that had emerged in my associations to the dreams was not exactly a secret, but it has remained at the center of my theoretical work and the unfolding of my analysis.  Looking back at this unfolding, as encapsulated in kernel form within the dream: an initial disturbance and feeling of uncanny unease and of shame, a second moment of transference love and libidinized lucubrations of ciphering and deciphering, and a second reversal and third moment of disappointed, “is this it?  is that all?”  Such is the fate of secrets when they are exposed to the light of day.  It is not only that a cat emerging from a bag is not the pig that was promised[1], but that this etymology is so patently absurd.  Psychoanalysis is a scam (Lacan, 1977).  Hysterical disappointment is inevitable.  Is that what all the fuss has been about?  And what now?

All to bring me to this moment, to this question, this what now that might presage a passage to sinthomatic creation.  A great many things must fall.

There are inevitable risks and impossible contingency in the two acts of psychoanalysis.  Just as Freud took his bearings from his hysterical patients and invented a new science, so too must every practitioner re-invent psychoanalysis anew with each and every analysand.  And the ludicrous wager of psychoanalysis, fraught with risk, is that the cure takes its form from the illness.  So, Lacan (1967-1968) would claim that the hysteric is cured of everything except her hysteria.  And such a hysteric might come to authorize herself as a psychoanalyst, to lend herself to this beginning again, and to this letting fall.   This is also the two times of Nachträglichkeit, in an act that refuses any mastery and whose effects may not be felt until long after when it meets up with those signifiers that have mapped the destiny and truth for analysand and analyst alike.


Badiou, A.  (2013)  Rhapsody for the theatre (London: Verso Books).


Brousse, M.H.  (1997)  “Hysteria and sinthome”,  The London Society of the New Lacanian  School.  Retrieved from: https://londonsociety-nls.org.uk/MHB_h&sinthome.htm.


Derrida, J.  (1972/1981)  Dissemination.  B. Johnson, trans.  (Chicago, IL: University of Chicago Press).


Freud, S.:

–        (1900a)  “The Interpretation of Dreams”,  SE, 4.

–        (1912e)  “Recommendations to Physicians Practising Psycho-analysis”,  SE, 12pp. 109-120.

–        (1916-1917)  “Introductory Lectures on Psycho-analysis (Part III)”,  SE, 16, pp. 241-463.


Lacan, J.:

–        (1955/2006)  “Variations on the standard treatment”,  Ecrits: The first complete edition in English, pp. 269-302. B. Fink, ed. & trans. (New York: W.W. Norton & Company).

–        (1962-63/2014)  The Seminar of Jacques Lacan, Book XAnxiety. J.A. Miller, ed. & A. Price, trans.   (Cambridge UK: Polity Press).

–        (1963-64)  The seminar of Jacques Lacan, Book XI. The four fundamental concepts of psycho-analysis. J.A. Miller, ed. & A. Sheridan, trans. (New York: W.W. Norton & Company, 1977).

–        (1967-1968)  The seminar of Jacques Lacan: Book XV: The psychoanalytic act.  C. Gallagher, trans.  Unpublished manuscript.

–        (1969-70)  The seminar of Jacques Lacan, Book XVII. The other side of psychoanalysis.  J.A. Miller, ed. & R. Grigg, trans. (New York: W.W. Norton & Company, 2007).

–        (1972-1973)  The seminar of Jacques Lacan, Book XX: Encore: On feminine sexuality, the limits of love and knowledge. B. Fink, trans.  (New York: Norton, 1998).

–        (1975-76)  The seminar of Jacques Lacan: Book XXIII: Le sinthome.  C. Gallagher, trans.  Unpublished manuscript.

–        (1976-1977)  The seminar of Jacques Lacan: Book XXIV: L’insu que sait….  C. Gallagher, trans.  Unpublished manuscript in English.

–        (1977)  Remarks on hysteria.  Retrieved from: https://web.missouri.edu/~stonej/propos.pdf.


Mieli, P.  (2011)  Glancing at history.  Unpublished manuscript.  Retrieved from:



Plato  (1963/1973)  The dialogues of Plato.  E. Hamilton & H. Cairns, eds. (Princeton, NJ: Princeton University Press.)


Webster, J.  (in press)  “Variations on the standard treatment”


[1] A commonly espoused etymology of the idiom, “the cat got out of the bag,” asserts that it refers to a practice of agricultural chicanery in which a pig would be purchased but replaced in the bag with a cat of the same size.  The secret is discovered when the bag is opened and the cat gets out.


Matthew Oyer is a psychoanalyst and clinical psychologist in New York.  He completed his doctoral training at the City University of New York and his predoctoral internship at New York Psychoanalytic Society and Institute and Mount Sinai Medical Center. Matthew is particularly interested in the theoretical work of Freud, Lacan, and Bataille, and his recent research has focused on hysteria and the psychoanalytic act and the psychoanalytic cure in the treatment of the psychoses. He is a participant at Après Coup Psychoanalytic Association and Das Unbehagen: A Free Association for Psychoanalysis.

Publication Date:

August 25, 2015

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European Journal of Psychoanalysis