5. Symbolic Landscapes of Psychotic Thought

The notion that psychotic thought may be viewed as a form of symbolic meaning has been with us for over a century (Jung). This idea holds out a particular hope for our being able to understand what otherwise appears radically deranged.

Depth psychologists have understood delusion as providing all of: wishfulfilling compensation for radical injuries to self worth (Jung), a binding for psychotic terror and disintegration through a pseudo-thinkable structure (Leader), the articulation of the consequences of radical projection and splitting (Bell), the symbolising of the psychotic process using worldly physical emblems (Sass) for inner psychological alterations, or symbolising wishes in disguised form (Sechehaye). Several of these non-competing understandings of delusion invoke a notion of symbolisation.

Théodore Flournoy

The psychological literature is confusing in two ways. First it often helps itself to a notion of 'symbol' and 'symbolisation' without explaining what this amounts to. (Kleinians are the partial exceptions to this rule.) Second we find within it very different-seeming appreciations of psychotic thought. On the one hand, Jungians consider the psychotic mind to be rich with symbolism, and the psychotic process to be one of self-healing (metanoia) in which a bewildering proliferation of symbols spontaneously emerge (Flournoy) as the psyche attempts to re-form in more integrated fashion (Perry). The therapeutic task is to help this process emerge and to re-attach the symbols with the missing affect. On the other hand, Kleinians talk of the psychotic mind as one in which symbolisation has failed, and view delusion as a prime example of such a failure in symbolisation (Segal).

Hanna Segal: the boss

So what is this symbolisation which takes place without the subject's intention or knowledge? One (cognitive-psychological) suggestion has it that delusions are a result of metaphorical thought which has later been mistaken for non-metaphorical thought (Rhodes & Jakes). An apparent advantage of this theory is that it seems to allow us to understand psychological symbolism, and to grasp the symbolic meanings of psychotic thought, using nothing more than our ordinary conception of metaphor. Yet difficulties for the theory include the facts: that delusions often appear to crystallise without any prior metaphorical thought; that the delusional person, in the ambit of his or her delusion, appears to precisely have lost the capacity for something worth calling metaphoric thought (Segal); and that what makes a thought metaphoric is in part the thinker's acknowledgement and intention. Psychotic symbolisation appears importantly different in form from non-psychotic metaphor, and this means we must look elsewhere for our very understanding of what here is meant by a symbol.

Here's a brief summary of the most cogent Freudian position (Petocz):

We should distinguish between conventional symbolism which is designed to refer or communicate, and non-conventional symbolism (psychological/psychoanalytic/non-discursive symbolism) which is produced via displacement. That is to say, an intolerable drive-based wish is repressed and a defensive substitute takes its place. The substitute is partially gratifying of the wish - it is a 'compromise formation'. Such symbols include mnemic symbols but also: stretches of behaviour including elaborate rituals, dreams, neurotic symptoms, myths, fairy tales, compulsions.

It's tempting, if ultimately inadvisable, to ask how such self-deception via symbol formation is possible. For even if we were confident that the concept of 'repression' did not fall foul of Sartre's objection of self-contradiction (we must know what we wish in order to repress it and prevent ourselves from knowing it), we may still ask how we can gain gratification from a mere symbolic substitute. A typical solution is to split the psyche: one part taking the symbol for the symbolised (and hence able to be satisfied by symbolic gratification), another part acknowledging it for what it is (Petocz). Yet what is it for a mind to be thus split? Another solution is to attribute the knowledge, will and drive here not to a person in two minds but to separate neurological states of the person (Hopkins). Yet what is it for a brain to be a thinker, willer, or representer? Might not such solutions cause more problems than they solve?

The concept of symbolism is closely related to that of wish-fulfilment. (The symbol is the substitute activity or object which 'fulfils' the repressed wish.) Here is Freud's account of the latter, replete with his characteristic reifications of actions, wishes and feelings into the psychic processes and impulses, excitations, forces, impacts, operations, internal stimuli, mnemic images, cathexes, of a 'psychical apparatus':

cigars: smaller than pipes

A hungry baby screams or kicks helplessly... the excitation arising from the internal need is not due to a force producing a momentaryimpact but to one which is in continuous operation. A change can only come about if in some way or other (in the case of the baby, through outside help) an 'experience of satisfaction' can be achieved which puts an end to the internal stimulus. An essential component of this experience of satisfaction is a particular perception (that of nourishment, in our example) the mnemic image of which remains associated thence forward with the memory trace of the excitation produced by the need. As a result of the link that has thus been established, next time this need arises a psychical impulse will at once emerge which will seek to re-cathect the mnemic image of the perception and to re-evoke the perception itself, that is to say, to re-establish the situation of the original satisfaction. An impulse of this kind is what we call a wish; the re-appearance of the perception is the fulfilment of the wish; and the shortest path to the fulfilment of the wish is a path leading direct from the excitation produced by the need to a complete cathexis of the perception. Nothing prevents us from assuming that there was a primitive state of the psychical apparatus in which this path was actually traversed, that is, in which wishing ended in hallucinating. Thus, the aim of the first psychical activity was to produce a ‘perceptual identity’ - a repetition of the perception which was linked with the satisfaction of the need.

Such reifications create an appearance of explanatory scientific theory. Yet the appearance is cast into doubt when we ask, what Freud's account takes for granted without providing, i) what are the criteria (constituting markers) for the repressed wish, ii) what licenses the suggestion that it is the repressed wish which gives rise to the symbol (might they not e.g. be effects of a common cause?), and iii) what licenses the suggestion that it is the symbol which 'fulfils' the wish? We're lulled into thinking we have such criteria because we tacitly imagine that the repressed wish enjoys the kind of being of a physical state individuated spatiotemporally. To invoke 'inference to the best explanation' as the model for our ascriptions of such wishes, displacements and symbols would, for example, be to put the epistemic cart before the conceptual horse: what we want to know is rather, first, how such an explanation could so much as get off the ground - 'what, exactly, is being inferred?' being our question. We can readily see just how tempting, yet futile, it is to concoct a hybrid psycho-mechanical array of concepts, especially when contemporary philosophy of mind has its own consilient set of reifying concoctions (inner representational states and cognitive processes) from which to draw.

I suggested above that it's tempting but ultimately inadvisable to ask how self-deception via symbol formation is possible. Rather than answer the question we may instead attempt its dissolution - to show how it only appears to be a good question:

1. First, symbols do not really satisfy wishes - instead they palliate them (Hopkins, Pataki). (Compare Wittgenstein on the different ways an apple and a punch in the stomach may remove a desire for an apple: only the former satisfies the desire.) 
2. Second, an unconscious wish is a half-formed thing, not a fully-formed thing shunted off an inner stage. Because of this we don't need to see a symbol as produced from such a wish via a mechanism of displacement. The very wish in question did not yet itself have the wherewithal, as it were, to flower in a fully-formed way. The primary process mechanisms are but theorists' fictions, detailing the fictional vicissitudes of fictional desires. 
3. Third, symbols are not produced intentionally, even though their production is motivated. Motivation or drive is the tropistic form of animate life; intention by contrast invokes what an agent gives by way of reasons.
4. Fourth, the creative drive of symbolisation is rooted deep in our nature (Langer). If we lack the ego capacity to form certain reality-oriented thoughts, or if we have become psychotic (our thoughts no longer being classifiable as either imaginary or real, and thereby losing part of what is essential to thought as such), then (barring schizophrenic drive disassemblage) psychological symbol production is inevitable. 
5. Lacking such ego capacity is the normal human condition when it comes to the more mysterious and terrifying aspects of our lives.

Psychoanalytic thinking on symbolisation has three particular strengths:

1. It allows us to decode psychotic thought. But this 'decoding' is not into what lies intact yet buried beneath, but rather into what could - and hopefully, with careful therapeutic handling, will - arrive by way of thought and feeling. (It is not that we have to decipher a message to discover its original form; rather we have to help the message be written for the first time.)
2. It understands the drive to reality contact which, unless we are dealing with those rather scarce manifestly tractable domains of emotional life, will typically give rise to symbolisation, as a vital function for any mind which we could call alive.
3. It provides a rationale not only for art therapies, artistic production for individuals and for a culture, but also for that very intriguing form of therapy, never properly taken up, called 'symbolic realisation' (Sechehaye) in which the therapist supports and responds in kind, rather than interprets, the psychotic patient's symbolisations.

Reading

Francisco Balbuena (2014). The pioneering work of Marguerite Sechehaye into the psychotherapy of psychosis: A critical review. Swiss Archives of Neurology and Psychiatry, 165, 6, 167-174.

Gregory Bateson (1956/1972). Towards a theory of schizophrenia. In Bateson's Steps to an Ecology of Mind. pp. 173-198. Originally: Bateson, G.. Jackson, D. D., Haley, J., & Weakland, J. (1956). Behavioral Sci., 1251-264.

Carl Jung (1906/1909/1936). The Psychology of Dementia Praecox. Nervous and Mental Disease Publishing Company.

Carl Jung (1912/1916/1952/1956/1967). Symbols of Transformation. (Originally Psychology of the Unconscious.) Collected Works vol 5. Routledge / Princeton University Press.

Sigmund Freud (1900). The Interpretation of Dreams.

Jim Hopkins (2016). Free energy and virtual reality in neuroscience and psychoanalysis: A complexity theory of dreaming and mental disorder. Frontiers in Psychology.

Darian Leader (2012). What is Madness? Penguin.

Maurice Merleau-Ponty (1968). The Visible and the Invisible. Northwestern University Press.

Tamas Pataki (2014). Wish-fulfilment in Philosophy and Psychoanalysis. Routledge.

Agnes Petocz (1999). Freud, Psychoanalysis and Symbolism. Cambridge University Press. ch 10.

John Rhodes and Simon Jakes (2004). The contribution of metaphor and metonymy to delusions. Psychology and Psychotherapy: Theory, Research and Practice, 77, 1-17.

Josef Parnas and Louis Sass (2008). Varieties of "phenomenology": on description, understanding, and explanation in psychiatry. In Kenneth S. Kendler & Josef Parnas (eds.), Philosophical Issues in Psychiatry: Explanation, Phenomenology, and Nosology. Johns Hopkins University Press.

Harold Searles (1962/1965). The differentiation between concrete and metaphorical thinking in the recovering schizophrenic patient. Journal of the American Psychoanalytical Association, 10, 22-49. Also in Collected Papers on Schizophrenia and Related Subjects.

Marguerite Sechehaye (1951). Symbolic Realization: A New Method of Psychotherapy Applied to a Case of Schizophrenia. Princeton University Press.

Marguerite Sechehaye (1951). Autobiography of a Schizophrenic Girl. Grune & Stratton.

Marguerite Sechehaye (1956). A New Psychotherapy in Schizophrenia. Grune & Stratton

Hanna Segal (1957). Notes on symbol formation. International Journal of Psychoanalysis, 38, 391-397.