The Lacanian Concept of Paranoia: An Historical Perspective

The Lacanian Concept of Paranoia: An Historical Perspective

This article seeks to reopen a major question raised by the Lacanian nosology of the psychoses, by looking closely at Lacan's formulations of what he never ceased referring to as "paranoia". While almost all classification systems of modern psychiatry, such as the ICD ten and the DSM five, have abandoned the specific category of paranoia, Lacan always viewed paranoia as a major category of "functional psychosis". He held that paranoia was a qualitatively different disorder than schizophrenia, and considered it to be the principal or exemplary form of psychosis. Furthermore, in the middle period of his work, Lacan thought of paranoia in much broader terms than those of the definition proposed by Kraepelin, which he revisited, point by point, developing his theory of Freud's concept of "Verwerfung" or foreclosure; the latter became the focal diagnostic criterion in his nosographic construction. Lacan's privileging of and evolving theoretical views on paranoia provide a structural approach to what he called the "resistant nucleus" of psychosis; his work serves as a counterpoint to the more descriptive neo-Kraepelinian approach of contemporary psychiatric nosology.

INTRODUCTION

This article seeks to reopen a major question raised by the Lacanian nosology of the psychoses, by looking closely at Lacan's formulations of what he never ceased referring to as "paranoia".

The need for such a reopening arises because successive editions of the principal international classification systems have ceased to use "paranoia" to delineate a unique diagnostic category, to the point that it seems destined to "fade away," nosographically speaking. Lacan, on the contrary, used the concept intensively, so much so that he considered paranoia to be the prime example of psychosis. Has Lacan's approach become outdated? Could it, on the contrary, remain of interest today, at least on the condition that certain of its subtleties are not overlooked? We shall argue for the second option.

To this end, we need to consider, jointly and separately, the centrality of the place accorded to paranoia in Lacan's work and its increasing marginalization in contemporary nosography. We shall compare the slow incorporation of paranoia into the schizophrenia group with Lacan's paradoxical consolidation of the concept of paranoia, a concept to which he frequently appealed as the exemplary form of psychosis throughout his rethinking of that problematic.