BUENOS AIRES' UNIVERSITY

Faculty of Psychology

Bachelor's Thesis Project in Psychology:

“The presentation of patients before and after Lacan”

Student: Alan Couce LU: 37 113 990-0

Email: alancouce@psi.uba.ar

Thesis Tutor: Dr. Fabián L. Allegro

May 2015
Introduction
The project of student Alan Couce (LU 37 113 990-0) for the Bachelor's Thesis in
Psychology of the Faculty of Psychology of the University of Buenos Aires with the purpose
of introducing the topic, the objectives pursued and the research methodology. Likewise,
the theoretical framework of reference and an introduction to the state of the art of the
issue to be discussed are presented.
The preparation of the thesis will take place during the first quarter of 2015, estimating
that it will be completed by the end of May of this year. The tutor in charge of it is Dr.
Fabián Allegro.
Issue
The thesis has been titled “The presentation of patients before and after Lacan” in
reference to its theme, which consists of a comparative analysis of the presentation of
patients between the use of the device in the medical paradigm of classical psychiatry and
the implementation of the same by psychoanalysis. The treatment of the topic focuses on
De Clérambault and Lacan, and then reflects on the presentations of current patients.
The selected topic is relevant at different levels. In principle, it concerns the personal level
since it allows the integration of varied learning at the same time as it is linked to the
theory, practice and teaching of essential knowledge of Psychology. Also, a contribution is
developed to the conceptualization of that particular practice where patients,
psychoanalysts and students meet. Finally, reflection on this aspect of the training of
psychologists oriented toward psychoanalysis or possible future mental health agents in
the clinical setting is of special relevance.
Theoretical framework
The comparative analysis will take place between the patient presentations of De
Clérambault, representative of classical psychiatry, and those of Lacan, who learns from
the aforementioned psychiatrist, to understand the current use of this device. This task is
guided by the theoretical conception of psychoanalysis, as well as with the help of the
theories developed by Foucault.
The knowledge developed by this last author can help, as he characterizes the theory
(Foucault, 1985), as a toolbox. This means that they can serve as instruments in the light
of which power struggles, situations and practices can be read, reflecting at times from a
historical dimension. In this way, we appeal to the genealogical analysis in The Birth of the
Clinic (Foucault, 1986) where the history of the clinic in France is analyzed, which forms
the framework for the presentations of patients to be treated. Also, other concepts of the
author will be taken for the analysis of the discourses of power and the practices they
support.
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 From psychoanalytic theory, fundamental concepts from classic texts by Freud and Lacan
stand out, necessary to understand the presentations of patients that the latter develops
throughout his teaching. Reading the changes that are introduced in the device in question
allows a better understanding of its current use, which makes possible an analysis of a
case from this theoretical orientation.
State of the art
The topic presents a history of various approaches that provide multiple perspectives on
the issue to be addressed. In this way, a reading of the works on the topic was carried out,
a brief review of which is presented below.
As first sources, there are some transcriptions of presentations of patients by both De
Clérambault (1995) and Lacan (1976) where they take resources from them to teach their
teaching, reflecting on their own practices.
A round table debate is also presented (Clastres et al., 1985) where the use of the device
and certain theoretical considerations of the topic are discussed, highlighting both Lacan's
presentations and the experiences of his disciples.
Furthermore, Miller (1987) addresses the present topic by referring to Lacan's
presentations and attesting to his participation in them. His text provides knowledge about
Lacan's use of the device, the author's theoretical reflections and references to conceptual
developments by De Clérambault.
Jorge Jinkis (1987), for his part, published an article with a critical stance on the use that
Lacan's successors made of the device, and then ended up carrying out an analysis based
on a presentation of patients by the aforementioned French psychoanalyst.
More currently, María Laura Valcarce develops a systematic investigation of the topic,
relating various issues to the presentations of patients such as the aspect of teaching in the
clinic, the changes that Lacan introduces to this practice, the issue of diagnosis and others
in various articles (2009, 2010, 2011, 2012, 2014). Goals
The general objective is to achieve a better understanding of the presentation of patients
for psychoanalysis and the analysis of a case based on the changes that Lacan
inaugurated in this practice.
The specific objectives involve:

• Comparatively analyze the presentations of patients by De Clèrembault and those of

Lacan.
• Distinguish the changes in the device that Lacan introduces with what they imply.
• Articulate with a current case based on this analysis.
Work methodology

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The action plan proposed for this thesis is presented below, organized into sections.
Method
A qualitative method will be used, which is the most relevant for the current research where
we work with a case study. The object of this research cannot be quantified or reduced to
operationalizable variables, which makes a quantitative approach to the problem
impossible. The reason for this is that theory attempts to rescue the uniqueness of the case
by case. Although the entire investigation is presented in a linear sequence, its actual
process presents movements where as the matter is understood in greater depth, the data
will be built and integrated with the theory (Ynoub, 2010).
Hypothesis
The work in a case of patient presentation is oriented towards the divergence between the
clinic of looking and the clinic of listening. While the first involves the display supported by
gaze, the second proposes reading the patient's text from listening. The working
hypothesis is that the use that psychoanalysis makes of the device is situated in this
second orientation.
Research design
The research presents an exploratory design, since it is a topic that has not yet been
studied much. At the same time, it is the researcher's first approach to the issue. It is
expected to achieve a broad perspective of the problem to be treated that can then be
taken up in future works. In this way, questions related to the main topic arise, such as
whether it is possible to explore the phenomenon of transference in the presentation of
patients in order to recognize it or not as a psychoanalytic device. Attempting an
exhaustive answer to this point exceeds the purpose of this analysis, although it is well
worth reflecting on this important question for future research.
Case study
For this research, we will work with the study of a case of patient presentation in the
psychoanalytic use of the device within the clinical setting. A record of the case will be
presented based on the reconstruction of the case made by the researcher after his
participation as part of the assistance in the device.
Source of obtaining the case
The case is opportunely taken advantage of as one possible among the presentations of
patients who were attended both within the framework of the Hospital Practices of the
subject Philosophical Problems in Psychology as well as by the Professional Practice of
the Clinical Area: Emergency Clinic.
Discussion
As the moment of integration between theoretical and empirical components (Ynoub,
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2010), this stage aims to establish an articulation between the theory and the case
presented with a view to responding to the working hypothesis and the research objectives.
Conclusion
For closure and integration, a few words are dedicated to conclude the result of the
elaboration of the work where both a new understanding of the research object that calls us
together is expected, as well as the opening to new questions that relaunch the cycle for
future research (Ynoub, 2010).
Basic general bibliography
Bercherie, P. (1986) The foundations of the clinic . Buenos Aires: Manantial.
Bercherie, P. (2004) Presentation. In G. g. de Clérambault, Mental Automatism:
paranoia (pp. 9-24). Buenos Aires: Polemos.
Clastres, G.; Gorog, F.; Gorog, J.J. Laurent, E. Schreiber, F.; Silvestre, D. (1985) Patient
presentations: good use and false problems. In: Psychosis and Psychoanalysis (pp.
39 - 54). Buenos Aires: Manantial.
Clavreul, J. (1983) The medical order . Barcelona: Slang.
De Clérambault, G. g. (1995) Mental automatism: paranoia . Buenos Aires: Polemos.
Foucault, M. (1968) Words and things . Buenos Aires: 21st Century.
Foucault, M. (1985) Powers and Strategies. In A Dialogue on Power and Other
Conversations (pp. 73-86). Alianza Ed., Madrid: Alianza Editorial.
Foucault, M. (1986) The birth of the clinic . Madrid: 21st century.
Foucault, M. (1989) Monitor and punish. Birth of the prison , Buenos Aires: 21st century.
Foucault, M. (2003) Psychiatric power . Buenos Aires: Economic Culture Fund.
Freud, S. (1911) Psychoanalytic remarks on a case of paranoia (Dementia paranoides)
described autobiographically (Schreber Case). In Complete Works (volume XII),
Buenos Aires: Amorrortu.
Jinkis, J. (1987) Notes on the “presentation of patients”. Conjectural , 14, 49 – 67.
Miller, J.A. (1987). Lessons from the presentation of patients. In Mathematics I (pp.155
168). Buenos Aires: Manantial.
Moron, P., Girard, M., Maurel, H. & Tisseron, S. (1993) Clérambault, teacher of Lacan.
Buenos Aires: New Vision.
Lacan, J. (1955/6). The Seminar. Book III. The Psychoses . Buenos Aires: Paidós.
Lacan, J. (1958) From a preliminary question to any possible treatment in psychosis. In
Writings 2 (pp. 513-564). Buenos Aires: 21st Century.
Lacan, J. (1964). The Seminar. Book XI. The four fundamental concepts of psychoanalysis
. Buenos Aires: Paidós.
Lacan, J. (1976). “A Lacanian psychosis” Case presentation. In The analysis . Barcelona:
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 Correo/Paradiso.
Valcarce, ML (2009) The device of the presentation of patients and the teaching of the
Clinic. I International Congress of Research and Professional Practice in
Psychology, XVI Research Conference and V Meeting of Mercosur Psychology
Researchers. Univ. from Buenos Aires, Bs. Ace.
Valcarce, ML (2010) The introduction of the analyst's desire in the presentations of
patients: a Lacanian finding. II International Congress of Research and Professional
Practice in Psychology, XVII Research Conferences and VI Meeting of Mercosur
Psychology Researchers. Univ. from Buenos Aires, Bs. Ace.
Valcarce, M. L. (2011). Lacan and psychosis: consequences of the presentations of
patients in their teaching. III International Congress of Research and Professional
Practice in Psychology XVIII Research Conferences and VII Meeting of Psychology
Researchers of Mercosur. Univ. from Buenos Aires, Bs. Ace.
Valcarce, M. L. (2012). The place of assistance in Lacan's presentations of patients and its
relationship with Freudian witz. IV International Congress of Research and
Professional Practice in Psychology XIX Research Conferences VIII Meeting of
Psychology Researchers of Mercosur. Univ. from Buenos Aires, Bs. Ace.
Valcarce, M. L. (2014). The notion of diagnosis in psychoanalysis in light of the
presentation device of patients. VI International Congress of Research and
Professional Practice in Psychology XXI Research Conferences Tenth Meeting of
Psychology Researchers of Mercosur. Univ. from Buenos Aires, Bs. Ace.
Ynoub, R. (2010) Science as social practice: bases for situating the examination of the
scientific research process in its full sense . Unpublished.