The Impasse of Diagnosis

It is not uncommon today to meet a person in a psychoanalytic context who desires a diagnosis. And indeed, some people spend a lot of time and earn large sums of money by providing subjects with the signifiers of diagnoses. One can say that “Diagnosis” is a name of an industry and, wherever there is an industry, there are desiring subjects willing to pay.

However, I believe that those who call themselves psychoanalysts should take the desire for diagnosis with a grain of salt and always remain prudent when asked for one. Basically, the question of diagnosis in psychoanalysis has not to do with the subject’s identifications with a particular signifier but with the direction of the treatment. In other words, in terms of diagnosis, psychoanalysts must always ask themselves how does a diagnostic criteria assist in the direction of the treatment, rather than just providing the subject with a signifier to identify with. From this a universal lesson might be learned—that is, a lesson for the “psy” universe—that a diagnosis has nothing to do with the therapeutic process if it does not facilitate the direction of the treatment.

Sometimes signifiers are privileged in as much as they are disproportionately important for the subject. They receive their privileged position because they come as an answer to those aspects of discourse where libidinal elements cause a fundamental distortion: where one’s particular mode of enjoyment remains undetermined for instance. There is a great pleasure in taking up these signifiers on oneself, and every cultural time provides different ones—today “narcissism” is very popular for instance. However, these signifiers, with which one identifies, are not only a source of localized pleasure but are also dead ends, constantly bringing the subject’s discourse to a halt. This is true especially in terms of the work in psychoanalysis. In this sense, in psychoanalysis one aims to diffuse these signifiers—or, more precisely, to “dialectize” them—in order to turn these dead ends into new pathways. After all, psychoanalysis is not about identifying with a signifier/your analyst but about confronting the constitutive disharmony that is the subject, and only then considering alternative possibilities for subjectivization.