To understand the context of Lacan's work, we need to take a moment to understand Lacan's view of the (sometimes) shared reality in which analysis, psychotherapy, (and all of human interaction) takes place. Lacan describes reality as involving three registers which exist partly as a developmental scheme and partly as a description of the structure of reality. The first register is the Imaginary. The Imaginary is seen as a pre-verbal field of experience based on the visual imagery processed by the pre-Oedipal (i.e., pre-linguistic) child. Clinical manifestation of the Imaginary is seen in extreme regression, decompensation, and an inability to symbolize therapeutic interactions (e.g., failure of the "working through" in therapy, see Peterfreund, 1983). Much of the detail of what Lacan ascribes to this register was derived from Klein's work on children's development (Van Buren, 1993; Sarup, 1993, p. 24-25).
Developmentally, the Symbolic register starts with the child's acquisition of the Name of the Father. This is the point where a child translates his/her lived experience into a language-based process. More so, the Name of the Father (i.e., the Oedipal demand of no mother) acts as the first splitting element in the structure of the psyche. It is the whole "birth" into a linguistically mediated mode of experience. As such, it provides a number of problems in the experience of reality. Language alienates the subject from the Real (see below). As Sarup (1993) notes, "...all experience is symbolically mediated and has to be interpreted" (p. 25). It is in this register that most of the subject's experience occurs. It is in the Symbolic register that the (linguistic) means and methods of therapy have their impact. It is in this register that the chain of signifiers (again, a concept addressed below) exists and presents itself as symptoms and structures needing the help of the therapist. Clinically, the experience of the Symbolic can be seen as the whole of the (language-based) interaction of therapy.
The final register is the Real. It is a difficult concept to grasp and even Lacan is not always clear. Generally it is unknowable as it transcends language (i.e., the Symbolic). Following the Sausserian idea that there is a fixed, "objective" reality underlying the layers of the Symbolic register, the Real is Lacan's view of this. Clinically, it might be experienced as a felt presence, shared by therapist and patient, that there is some unspoken, shared sense of reality, which lies just beyond verbalization. Beyond a simple "consensual reality", the Real is the actual thing which underlies our many layers of symbolization Not unlike the floor beneath the carpet: we believe standing on the carpet is standing on the floor, whereas the carpet (the Symbolic) actually overlays the floor (Real).
Ultimately, the whole enterprise of therapy addresses the rift between the Symbolic and the Real. One author cryptically suggests that the Real "...is simply History itself" (Jameson, 1977). Clinically, this means that the patient has some sense of a real existence, interpreted through the Symbolic and thus presents to therapy in order to deal with the effects of being alienated (through language) from that existence. The sense of self is one derived from the continuity of experience in the Symbolic over time, underlain by the Real.
There is a deep-rooted tendency of British and North American psychoanalytic theory to describe health as revolving around an intact structure such as the ego or the self , while framing pathology as a deviation from the wholeness of this sense of coherent self or ego. Lacan's view suggests that the self is not "...a singular, coherent, and bounded entity..." but is seen as "...a loose net of contextual, contradictory, and shifting identifications..." enveloping the absence of a discreet core (Loewenstein, 1994). Horner (1995) provides a clinical example of this concept, while bridging Lacan's work with the more familiar language of object relations.
In Lacan's world view, the concepts of jouissance and desire hold particular meaning that is central to clinical work. Translation of Lacan's jouissance has been problematic in that it embodies a number of ideas which are represented by different words in English. Sheridan (the translator of The Four Fundamental Concepts of Psycho-analysis), suggested that jouissance embraced aspects of the English words enjoyment, and pleasure, but with the added element of a sexual connotation. Lacan used the term pleasure as Freud did in Beyond the Pleasure Principle (Freud, 1920), meaning a psychic energy which, when discharged, seeks the lowest level of tension. Jouissance, on the other hand, connotes a sense of building, sexual desire, and increased tension (Sheridan in Lacan, 1979, p. 281). The implication is clear: the experience and expression of jouissance, as directed to the world of objects, is driven by a sexual motive. By way of example, (and to be fair to the original concept,) this sexual aspect of jouissance captures some of the essence of words like titillate, intrigue, pique, thrill, captivate and tantalize. (See also Forrester, 1990, p. 99-100, for a similar discussion of the translation of jouissance.)
Desire also loses some essence when translated from the French. In English, this term typically refers to a psychic energy, directed towards some object, held for a finite time. Sheridan notes that the French term d‚sir connotes more of a continuous force and presence. This presence of desire acts in response to the organism's continuous state of need (e.g., the need for satisfaction of drives). When this need is mediated by language, a gap is created between the Real and the Symbolic. The act of existing in the Symbolic introduces breaks in the continuity of desire which the organism moves to fill.
Use of language, the currency of the Symbolic, implies a response from an Other. This is Lacan's concept of demand. In signifying a need, a demand is created. To speak is to require (i.e., demand) a response. To name the existence of a drive (e.g., hunger) is to demand that its aim be fulfilled. In this case, fulfilment of hunger might mean ordering a meal at a restaurant, which then exists as the response of the Other (the food signifying the acknowledgement of your hunger by the Other). The continual presence of a gap between one's need and the dynamics of demand is where we find desire. What then, if desire (the product of the dialectic of need and demand) comes into force alongside the subject's jouissance?
Milmaniene (1993) suggests that anxiety is the product of an action of the subject's desire meeting head-on the force of jouissance. In this case, desire can be seen as a defence against the full experience of jouissance, not unlike Malan's conceptualization of an anxiety resulting from the mediation of deeper impulses by defences of the ego (Malan, 1979; Jerry, 1997, 1998). Clinically then, the Lacanian psychotherapist will be presented with disorders which are framed in terms of lack of, or misplaced desire (e.g., problems of reaching out to the Other; problems of emerging into the Symbolic order such as the sexually-charged transitions of adolescence), problems of alienating demand (e.g., having the effort of reaching out to the Other fail; or, failure of the Other -e.g. the "maternal environment" in Winnicott's terms), and issues that grapple with the power and essence of jouissance, (e.g., oversexualized behaviour).
The brief Lacanian therapist uses the concept of the unconscious in a manner different from the North American psychodynamic psychotherapist. Lacan's unconscious is a complex issue. With its origins in his famous "Rome Discourse", Lacan's claim that the unconscious is structured as a language sits as a central, guiding force for the Lacanian therapist. Lest this phrase be misinterpreted, .....(sorry, more to follow...).
One of the clearest discussions of Lacan's concept of chains of signification can be found in Dor (1997a, p.131 - 134). Essentially, Lacan suggests that the development of the human subject follows the development of language. From a point rooted in the Oedipal transformation, (acquisition of the Name, or Law of the Father) the child begins the process of learning the socially mediated linguistic signs (i.e., labels) given to the world (the Symbolic register). Thus, at a simple level, the child learns that such-and-such object is a "chair". More importantly, as the child grows, he/she comes to understand that the signifier "chair" carries more connotation than simply a verbal cue related to an object. Consider the difference in meaning between a "chair" used for sitting, and a "chair" of a university department. The typical adult would understand the different meanings attached to the same signifier in this example. The psychotic however might mistake these nuances of the signifier, leading to a potentially tragic mistake in the social world. Over years of growth and development, over myriad social exchanges, and through many thought processes, each individual develops a kind of psychic structure in the Symbolic register. This psychic structure can be described as many, many chains of signification, woven like a web. A "North American" therapist might state that different experiences help to produce different personalities as a parallel idea.
The clinical implications of this concept are rich. Leavy (1993) provides an example of this work with signifying chains in the context of depression. He proposes that therapeutic change is found in the therapeutic "modification of the self as the container of previously unavailable signifying chains" as found in the free association of the therapeutic discourse. The patient who states, "I am depressed" has reduced a whole set of present symptoms, interpersonal experiences, and personal history into the single signifier "depressed". The clinical work here would be to unpack the signifier and explore what is meant by "depressed". More than the typical history and symptom-based interview, in the Lacanian frame, an exploration of "depressed" involves a deconstruction of the meaning of the term, as experienced by the patient. Central to this deconstruction are the processes of condensation (Lacan's metaphoric process), displacement (Lacan's metonymic mechanism), and the symptoms as metaphor.
If a patient's psychic structure is a certain way today because of the shape and development of his/her connections of signification, it follows that the direction of future development and psychic structure could be changed through a linguistic process (e.g., a "talking cure") of projecting new directions for the chains of signification to proceed.
not yet written... sorry...