> Vincent Clarke wrote:
>
> Lacan contends that in people suffering from psychosis have
>> failed to integrate the structures of their particular culture properly
>>
>
>
> On this understanding of psychosis, there's no basis for judging psychotic
> perception delusional.
>
I've heard this argument before - time and again and I'll be honest: it's logically reasonable (insofar as me saying that "unicorns exist because I have an idea in my head of what a unicorn is" is logically reasonable), but it's bunk, practically speaking.
You see it's not a logical or even a philosophical problem; it's a medical problem. I'll give an analogous problem from the sphere of neurology. Say a neurologist comes across an MRI scan where someone is showing the first signs of Multiple-Scerosis. Now, the neurologist has to make a call: is this MS or is it not (it could be ADEM, for instance, or one of the other "Borderline MS" diseases) - the neurologist also has to make a call in relation to prescribing medication, which is a pretty big call. So, there's no concrete basis for judging the condition. This is because its a nosological rather than a logical judgement, based on experience and intuition rather than on pure logic - but it has major practical consequences.
Psychosis is similar. The reason (Lacanian) psychoanalysts differentiate so forcefully between psychosis and neurosis is because they have to make a call on it too - and the call they make could be the difference between psychiatric confinement and freedom. In fact once you get into that grey area of "well, you can't really differentiate between the two" you adhere to the diagnostic criteria put forward in the DSM - which leads to more confinement and an increased use of strong psychotropic drugs.
As far as psychoanalysis is concerned there is a way to tell if perception is psychotic or not (or "delusional", if you want to use that rather vague term). Its a question of:
(a) Language disturbance - is there language disturbances in the individual? Does the individual employ neologisms which he cannot explain to anyone (which he cannot make metaphors about)? Does the individual show signs of seriously disorganised speech? Etc etc.
(b) Certainty - does the individual show an absolute unwillingness to question his/her notion of reality? Are they simply not open to argument about certain things they believe? Etc etc
These are what distinguish psychotic from non-psychotic perceptions/thoughts.
>
> There's also no basis for judging anyone as psychotic since this requires
> knowledge of reality, namely, knowledge of the reality of "the structures of
> their particular culture" and of the "structure" of the person who is the
> object of the judgment. Reality, however, is an unknowable thing in itself
> where perception is determined by "structures" in this sense.
>
No, this is not the case at all. Psychoanalysts - at least most modern ones - don't claim that they have absolute knowledge of reality. What they claim is that they have specialised knowledge of what type of structures of thinking constitute psychosis and what type constitute neurosis/normality. Thus they can predict - usually with reasonable accuracy - whether someone will, in the future have a psychotic episode or not and they will cater their treatment accordingly.
>
> The only relation this can have to psychoanalysis in any reasonable sense
> is that such a psychoanalysis might be able to explain the psychopathology
> involved, a psychopathology characteristic of the "particular culture" in
> which it's widespread.
>
> I don't really understand what you're getting at here, sorry...