The Letter, Issue 21, Spring 2001, Pages 55 - 79
A STRUCTURAL DIAGNOSIS OF TOXICOMANIA
Tom De Belie
Toxicomania and the Psychoanalytic Field
The work of the analyst is sometimes described as to allow the analysand to unpack his suitcases which up to then he dragged with him full of unnecessary ballast, so that a new journey can begin with less baggage. The way in which an analyst attempts to make this possible is by presenting the analysand with a bag with a hole in it. The analysand, in unpacking his suitcases, is eager to try to fill the bag of the analyst, in order to leave him to decide which items to bring and which not. The analyst's task is to keep the bag open all the time. However, because of the hole, everything that goes in the bag, inevitably ends up on the floor. In the end, depressed by his vain attempts to involve the analyst in choosing and provided with a better overview of the contents of his luggage, the analysand decides to fill his own suitcases again, leaving the rubbish to keep company with the holed bag of the analyst.
It is not difficult to recognize in this metaphor the encounter between the discourse of the analyst and the hysteric's discourse in psychoanalytic treatment. The hysteric's discourse is the discourse into which the analysand is forced by the analytic discourse that the analyst adopts.  This is only possible when we are dealing with analytic symptoms, that is, symptoms that are governed by SI, the phallic signifier, analytic symptoms, which are to be considered as attempts at recovery within the chain of signifiers. The psychoanalysis of such a symptom is to bring a subject as near as possible to SI, using the logic of free association, so that he can reconsider choices made in the past, which make him suffer in the present by the 'hystory' he made of them. This reconsidering of the past, this rewriting of the history of the subject, is what Lacan referred to as the traversing of the fundamental fantasy and is represented by the right antipode in the analytic discourse. However, the clinic is more than analytic symptoms alone. Very often the analyst is presented with symptoms that operate outside the signifier, that are not mediated by the Name-of-the-Father. The psychotic structure, where the Name-of-the- Father is foreclosed, is to be considered as such a case. Similarly, the clinical category of actual neurosis, that can operate within the three clinical structures, is not mediated by the Symbolic. Finally, attempts at recovery that operate outside the signifier, such as toxicomania, acting- out/passage a l'acte and psychosomatic illnesses also belong to this category. Toxicomania, which can be considered as an attempt at recovery via the compulsive intake of an external substance, shortcuts the chain of signifiers and deals directly with the body of the subject. Acting out and passage a l'acte can be viewed as attempts at recovery via un-symbolized acts of the body. So too can psychosomatic illnesses be regarded as attempts at recovery via the route of the body itself. In each of these three cases an additional jouissance is administered by a particular way of dealing with the structural or an accidental trauma. A certain jouissance added to the sexual jouissance that is governed by SI. The situation described is to be regarded as posterior to the position of the subject in language. Indeed, the three structures of neurosis, psychosis and perversion with the three negations of repression, foreclosure and disavowal are the first and foremost 'answers' of the subject to the structural trauma of the entrance into the symbolic order.