Lacanian analysis and its schools

1. Introduction

Version followed: Lacan's technical writings in Écrits ("Variations on the standard treatment" 1955, "The direction of the treatment and the principles of its power" 1958, "On a question prior to any possible treatment of psychosis" 1958) and Seminars I–III, XI, XVII, XXIII, operationalised through Bruce Fink, A Clinical Introduction to Lacanian Psychoanalysis (1997) and Fundamentals of Psychoanalytic Technique (2007); the pass as set out in Lacan's "Proposition of 9 October 1967" and as run by the ECF/World Association of Psychoanalysis (WAP); psychosis per Lacan 1955–58 plus the WAP "ordinary psychosis" clinic (Miller, 1998/2009). Differences from the IF-EPFCL and ALI are flagged where relevant.

Plain statement: Lacanian analysis is not a manualised therapy. Lacan explicitly rejected a "standard" treatment defined by rules of frame and duration, and his schools transmit technique through personal analysis, supervision (contrôle), cartels and the pass rather than through a protocol. What follows is the technique Lacan and Fink actually describe; where I turn it into step-by-step instructions, the steps are marked [synthesis]. [source: Lacan 1955 "Variations"; Fink 2007 preface; Norton description of Fink 2007]

Core idea of change: the subject suffers from a relation to the Other's desire and to a mode of satisfaction (jouissance) that are fixed in signifiers and in an unconscious fundamental fantasy. Speaking under transference to an analyst who refuses to answer demand, understand, or advise, and who intervenes on the letter of speech (punctuation, scansion, equivocal interpretation), brings unconscious formations into play, shifts the analysand from complaint to question, and lets desire be articulated. In neurosis the analysis aims at separation from the Other's desire and a traversal of the fundamental fantasy; in Lacan's later teaching, at a new arrangement with the symptom (sinthome). Symptom relief is expected but treated as a by-product, not the target. In psychosis the aim is different: stabilisation and support of the subject's own solutions. [source: Lacan 1958 "Direction"; Lacan 1964 Seminar XI; Fink 1997 chs 1–5, 10]

2. Framework

No fixed session count exists in any primary source. The phases below are Fink's operational ordering of Lacan's terms. [source: Fink 1997 chs 2–5; Lacan 1967 "Proposition"]

Phase 1 — Preliminary interviews (entretiens préliminaires).

Goals: (a) establish the diagnostic structure (neurosis: obsession/hysteria/phobia; perversion; psychosis) because it decides the analyst's position and which techniques are safe; (b) engage the patient's desire to know, turning a complaint into a question addressed to the analyst; (c) let transference form around the analyst as "subject supposed to know"; (d) for neurotics, begin "hystericisation" (the patient starts to question their own division). [source: Fink 1997 chs 2, 6]
Format: face to face, seated; already variable-length sessions in Fink's practice; Fink argues for frequent sessions from the outset (more than once weekly) rather than building up. Length: weeks to months, open-ended. [uncertain: exact durations and frequencies vary by analyst and school; no source gives a norm]
Fink advises the analyst to say more here than later, and to "tread lightly" while structure is unclear, especially around possible psychosis. [source: Fink 1997 ch 7 via Perlego preview]
Move on when: the structure is reasonably established as neurotic (or the psychosis track is chosen); the patient brings dreams, slips and associations rather than only reports; the symptom has become an enigma whose meaning the patient expects to find in speaking to this analyst; the patient attends and pays reliably. This marks "entry into analysis." [source: Fink 1997 ch 2; criteria list is synthesis from Fink's descriptions] [synthesis]

Phase 2 — Analysis proper (neurosis, and some perversion).

Goals: free association; work on dreams, slips, fantasies; punctuation, scansion and interpretation aimed at unconscious desire; handling transference without interpreting it as here-and-now relationship; constructing the fundamental fantasy (the subject's position as object for the Other); moving from alienation to separation. [source: Fink 1997 chs 3–5; Fink 2007]
Format: couch (for neurotics, after entry); several sessions weekly; variable length; years. Payment and missed-session policy held firmly. [source: Fink 1997, 2007] [uncertain: frequency norms]
Indicators of progress: shifting signifiers in the analysand's speech, emergence of new questions, change in how the analysand positions themself toward the Other's demand and desire, reduction of repetition. [synthesis]

Phase 3 — End of analysis.

Lacan's formulations change over time: traversal of the fundamental fantasy and "subjective destitution", fall of the subject supposed to know and reduction of the analyst to the remainder (object a) (1967); later, identification with or "knowing how to do with" the symptom (1976–77); a "satisfaction" that marks the end (1976 preface to English Seminar XI). [source: Lacan 1967 "Proposition"; Lacan 1976 Preface; Fink 1997 ch 5, 10]
Criteria: not a checklist and not decided unilaterally by the analyst; the analysand reaches a point where the supposition of knowledge in the analyst drops and desire no longer waits for the Other's answer. [source: nosubject "Pass"; Lacan 1967]

Phase 4 (optional, institutional) — The pass.

For an analysand who considers their analysis ended (or has made the passage from analysand to analyst) and wants to testify to it to a School. Not a clinical phase, not a licence. Details in §4.22. [source: Lacan 1967; Wikipedia "The Pass"; nosubject "Pass"]

Parallel track — Psychosis.

Goals: avoid triggering; stabilise; support the subject's own constructions (delusional metaphor, suppléance, sinthome); regulate jouissance; preserve social links. No traversal of fantasy is aimed at. Format usually face to face; no push to free association; frequency and session length adjusted to the patient. Duration open, often long-term. [source: Lacan 1958 "Question prior"; Lacan 1955–56 Seminar III; Sauvagnat on ordinary psychosis; Fink 1997 ch 7, 2007]

School differences relevant to the framework.

WAP/ECF (Miller orientation): the pass is central and published (AE testimonies, cartel reports); strong emphasis on ordinary psychosis and on the later Lacan (sinthome, jouissance). [source: Wikipedia "The Pass"; Sauvagnat]
IF-EPFCL (Soler, split from WAP 1998): keeps the pass, governed by an international college, and explicitly criticises the WAP's centralised hierarchy. [source: nosubject IF-EPFCL] [uncertain: procedural details]
ALI (Melman, Czermak; founded 1982): strong psychiatric-hospital clinic of psychosis (patient presentations, Czermak's work) and Melman's thesis of a shift from an economy of desire to one of jouissance; training through seminars and cartels. [source: freud-lacan.com; nosubject ALI] [uncertain: whether and how ALI operates a pass was not confirmed]
Fink practises in the US outside these institutions in his clinical books; his session frequencies and use of the phone are his own choices. [uncertain]

3. Guiding principles

[source for this section: Lacan 1953 "Function and field", 1955 "Variations", 1958 "Direction", Seminar XI, Seminar XVII; Fink 1997, 2007; nosubject summary of "Direction"]

The analyst directs the treatment, never the patient's life. Decide the frame, timing and interventions; give no advice, prescriptions or life guidance.
Tactics, strategy, policy. Lacan: the analyst is freest in interpretation (tactics), less free in handling transference (strategy), and least free in their own being/want-to-be (policy). Be inventive in what you say, disciplined in where you place yourself.
The analyst pays too. With words (interpretations), with their person (lent to the transference), and with their own judgment. Expect to be used as a support, not to be met as yourself.
The unconscious is structured like a language. Listen to signifiers: exact words, repetitions, slips, homophones; not just meaning or affect.
Do not understand too quickly. Understanding closes the question; keep the analysand's speech open to what it did not mean to say (Fink's "against understanding").
Do not answer demand. Every demand (for advice, love, reassurance, explanation) is heard, not gratified, so the desire behind it can emerge. This is not deliberate frustration as technique; Lacan criticised making frustration the lever.
Refuse the imaginary axis. Avoid ego-to-ego alliance, mirroring, empathic identification or arguing with the ego; intervene on the symbolic axis (the subject's words and relation to the Other).
Subject supposed to know. Transference is the supposition that the analyst knows the meaning of the symptom; use it to keep the analysand working, and never believe it yourself.
The analyst's desire. Not to cure, educate or be loved, but that the analysis go on and that the analysand's singular desire emerge; Seminar XI calls it a desire to obtain absolute difference. Practically: watch your own wishes for the patient.
Cure comes in addition. In "Variations" therapeutic benefit is expected as a by-product; do not steer toward adaptation or normality (Fink's "non-normalising" stance).
Logical time over clock time. Session length follows the logic of what is said (Lacan 1945 "Logical time"); the end of a session is itself an intervention.
Diagnosis by structure governs technique. What helps a neurotic (equivocation, scansion on enigmatic signifiers, confrontation with the Other's desire) can trigger a psychosis.
Analyst as semblant of object a. In the discourse of the analyst (Seminar XVII), the analyst occupies the place of the cause of desire, not of master or knowledge; speak little, and enigmatically.
The only resistance is the analyst's. Lacan (Seminar II) locates stalling in the analyst's position; when stuck, examine yourself and take it to supervision first.
Payment is part of the cure. The analysand pays for sessions, including missed ones; money marks a loss that makes the analysis the analysand's own.
Do not back away from psychosis. Lacan's 1977 injunction: accept psychotic subjects, but with a different direction of treatment.
Authorisation. Lacan's 1967 principle that the analyst is authorised only by themself (later: "and by some others"); practically, no title replaces personal analysis and supervision. [uncertain: the "and by some others" addendum is from Lacan 1973–74]

4. Intervention inventory

Scope note: Lacan names principles and a few operations (punctuation, scansion, interpretation by equivocation, citation and enigma, subjective rectification); Fink turns these into practitioner technique. Numbered steps below are my operational rendering of what these authors describe and are [synthesis] unless a source is given. All example lines are illustrative unless quoted and cited.

4.1 Preliminary interviews and structural diagnosis

Purpose / when: first sessions with every new patient; decide neurosis, perversion or psychosis before using any technique that pushes on unconscious material. [source: Fink 1997 chs 2, 6–9]
Steps: (1) Sit face to face; let the patient say why they come now (the precipitating moment matters). (2) Ask about history, family, the patient's place in parents' desire, onset of symptoms, previous treatment. (3) Listen for markers of structure rather than symptoms: in neurosis, doubt, questions about desire, repression returning as slips and dreams; in psychosis, elementary phenomena (voices, certainty, neologisms, words that "mean" something enigmatic and personal, sentences broken off), lack of the dialectic of doubt, a moment of triggering when the subject met a paternal role or demand; in perversion, disavowal and a confident knowledge about jouissance. (4) Ask about past breaks, hospitalisations, medication. (5) Do not interpret deeply or use equivocation until structure is clear. (6) Explain fees, frequency, missed-session rules, variable length. [source: Fink 1997 chs 6–7; Lacan 1958 "Question prior"]
Example language (illustrative): "What made you decide to come now rather than last year?" / "You said the words 'went silent' in your head. Tell me more about that."
Watch for: certainty without doubt, a sense that the world is addressed personally to them, peculiar uses of words: slow down and adopt the psychosis track (4.20–4.21). The diagnosis is provisional and is inferred from speech, not observed directly. [source: Fink 1997 ch 6 via Perlego]

4.2 Subjective rectification (from complaint to question)

Purpose / when: early, with neurotic patients who present themselves as victims of others or of circumstances. Lacan's model is Freud's first move with Dora: asking what her own part was in the disorder she complained of. [source: Lacan 1951 "Presentation on transference"; Lacan 1958 "Direction"]
Steps: (1) Let the complaint be stated fully. (2) Pick out a point where the patient's own position, choice or satisfaction appears in what they say. (3) Return it as a question, not a judgment. (4) Do not moralise or assign blame; the point is to locate the subject as implicated, which opens the question of their desire.
Example language (illustrative): "And you, what was your part in this arrangement?" / "You said you 'always end up' with this kind of boss. End up?"
Watch for: the patient begins to wonder about themselves instead of only reporting others; slips start appearing. If they hear it as accusation and close down, you rectified too early or with an imaginary (moral) tone.

4.3 Fundamental rule and free association

Purpose / when: at entry into analysis, and whenever the patient censors.
Steps: (1) State the rule briefly: say whatever comes to mind, including what seems trivial, embarrassing or about you. (2) Do not over-explain. (3) Later, remind by questioning what was skipped rather than by restating the rule. [source: Freud's rule as taken up by Lacan 1958; Fink 2007]
Example language (illustrative): "Say whatever comes, even if it seems beside the point or impolite." / "You hesitated just then."
Watch for: patients who prepare sessions in advance or bring written notes (common in obsession): treat as material, punctuate the gap between the plan and what slips out.

4.4 Moving to the couch

Purpose / when: at entry into analysis for neurotic patients; removes the analyst's face as an imaginary support and favours speech addressed to the Other. Not used routinely with psychosis. [source: Fink 1997 ch 2; Fink 2007] [uncertain: Fink's precise timing criteria]
Steps: (1) Propose it when entry criteria (§2 Phase 1) are met. (2) Present it as what the work now requires, not as a reward. (3) Note the patient's reaction (relief, anxiety, refusal) as material.
Example language (illustrative): "From now on I'd like you to use the couch."
Watch for: strong persecutory reactions to not seeing you (reconsider structure); the patient watching you over the shoulder or narrating to you as an audience.

4.5 Listening to the letter

Purpose / when: throughout; the basic analytic act.
Steps: (1) Attend to exact words, not the gist: slips, mispronunciations, unusual expressions, repeated signifiers, homophones, ambiguous syntax, sentences left unfinished. (2) Do not fill gaps with your own understanding or theory. (3) Note signifiers that recur across sessions and those connected to parents' words. (4) Fink's training exercise: practise hearing slips in radio or TV speech, starting with topics that do not interest you so content does not capture attention. [source: Fink 2007 ch 1, via metapsychology review]
Example language: none required; listening is mostly silent.
Watch for: your own urge to empathise, explain or reassure; Fink argues empathic reactions can close down the analysand's own response. [source: Fink 2007 via metapsychology review]

4.6 Questioning

Purpose / when: to open rather than close speech; especially when the analysand glides over a word, uses a cliche, or assumes you understand.
Steps: (1) Ask about specific words and details, not general feelings. (2) Prefer open, short questions. (3) Do not ask questions that presume your understanding or whose answer you already want. (4) Feign no false naivety; ask because you genuinely do not know what this word means for this person. [source: Fink 2007 ch 2 topic "asking questions"; detail is my rendering] [synthesis]
Example language (illustrative): "What do you mean by 'decent'?" / "Which neighbour?" / "What comes to mind about 'the debt'?"
Watch for: questions that become interrogation or a demand to confess; questions that steer toward your hypothesis.

4.7 Silence and non-response to demand

Purpose / when: whenever the analysand asks for advice, judgment, reassurance, information about you, or explanation of the symptom.
Steps: (1) Hear the demand. (2) Do not gratify it and do not refuse it with hostility. (3) Return it to the analysand or simply not answer, letting the demand unfold so the desire within it appears. (4) Be aware that Lacan criticised frustration used as a technique: the point is not to frustrate but not to plug the lack with your answer. [source: Lacan 1958 "Direction"; Fink 1997 ch 1]
Example language (illustrative): "You'd like me to tell you what to do." / "What would it mean if I said yes?" / silence.
Watch for: with new or fragile patients silence can be felt as abandonment or persecution; in preliminary interviews say more. In psychosis, silence can be experienced as an enigmatic Other's intention: avoid (4.21).

4.8 Punctuation

Purpose / when: to underline a signifier or ambiguity so the analysand hears what they said beyond what they meant; used constantly, in session.
Steps: (1) Hear a word that is ambiguous, overdetermined or slipped. (2) Repeat it back alone, possibly with a questioning tone; or a minimal "Hm" at the moment of an equivocal expression; or repeat a phrase with a different stress. (3) Stop there; do not explain. (4) Let the analysand associate. [source: Lacan 1953 "Function and field" on punctuation; Fink 2007 ch 3 topic "punctuating"]
Example language (illustrative): Patient: "I just want to put it all behind me, my father..." Analyst: "Behind you, your father." / "'Mourning'?" (patient said "morning").
Watch for: the analysand laughs, pauses, corrects, or produces a new association: it is working. If they ask "what do you mean?" repeatedly, you may be punctuating too obscurely or the structure may not support it.

4.9 Scansion (ending the session; variable-length session)

Purpose / when: ending a session at a meaningful moment turns the cut itself into a punctuation: it highlights a signifier, interrupts empty speech, prevents the analysand from defusing what just emerged, and counters obsessional waiting (filling time while waiting for the master's end). Variable does not mean short; sessions can also be long. [source: Lacan 1953 "Function and field"; Fink 2007 topic "scanding"; metapsychology review]
Steps: (1) Tell the patient at the outset that sessions vary in length. (2) Listen for a point where something new, equivocal or surprising is said, or where speech turns empty and repetitive. (3) End the session right then, often by repeating the key word or simply standing. (4) Do not explain the ending. (5) Hold fees per session regardless of length, or as agreed. [steps 1, 4, 5 are synthesis]
Example language (illustrative): "'Owed.' We'll stop there." / "Let's stop here."
Watch for: the analysand returning next session with associations to the cut word (working); anger, sense of being dismissed, or pressure to say the "important thing" first (use as material, see §5). Ethical limits [synthesis]: never use the cut as punishment, to fit more paying patients, or with a patient whose structure or crisis state makes abrupt endings destabilising; inform patients clearly; check legal and insurance rules on billing for variable sessions. Historical note: Lacan's variable and very short sessions were the stated ground for the IPA's refusal to recognise his training analyses (1953–1963). [uncertain]

4.10 Equivocal (oracular) interpretation

Purpose / when: neurosis, after entry into analysis, when a signifier carries more than one sense; aims at the cause of desire rather than at giving a meaning. Lacan: interpretation works through equivocation and should be a "half-saying"; Fink calls this oracular interpretation: pointed enough to land, polyvalent enough to produce more material. [source: Lacan Seminar XVII; Lacan 1973 "L'étourdit" on equivocation; Fink 2007, Norton description; metapsychology review]
Steps: (1) Wait for a word that condenses several lines of association (homophony, double grammar, a name). (2) Say the word or a short phrase that keeps both senses alive; avoid a full sentence explaining what it means. (3) Optionally end the session on it (4.9). (4) Do not confirm or deny the analysand's reading of what you meant.
Example language (illustrative): Patient speaks of a "loan" and of being "alone": "A loan." / Patient: "I'm not a mother, I just mother everyone": "Smother?" [illustrative; English puns only work in the analysand's language]
Watch for: surprise, laughter, a new memory or dream: working. Bewilderment that persists, or the patient building a personal theory of what you "secretly mean" about them: stop; reconsider psychosis.

4.11 Interpretation as citation and enigma

Purpose / when: Lacan (Seminar XVII) describes interpretation as either a citation (quoting the analysand's own words back, so they are attributed to the speaker) or an enigma (a half-said that the analysand must decipher). Use when the analysand's own words contain the interpretation. [source: Lacan Seminar XVII]
Steps: (1) Note an earlier formulation of the analysand (same session or months before). (2) Quote it back exactly, at the moment it bears on what they now say. (3) Add nothing, or only an enigmatic minimal comment.
Example language (illustrative): "Two months ago you said: 'I'll never be my father's son.'"
Watch for: the analysand recognises it as theirs and is struck; if they hear it as your judgment, you added too much.

4.12 Working with dreams

Purpose / when: whenever the analysand brings dreams, daydreams or nightmares; dreams are a privileged route to unconscious desire. [source: Fink 2007 chapter on dreams, daydreams and fantasies, per Norton description]
Steps: (1) Let the dream be told fully; note the exact words of the account, including corrections and hesitations. (2) Ask for associations element by element, starting with what the analysand passes over or finds odd. (3) Attend to words in the dream (names, numbers, phrases) as signifiers that may be puns. (4) Ask about the day residue. (5) For anxiety dreams and nightmares, look at where the dreamer awoke: Lacan reads awakening as the point where the dreamer approaches the real of desire. (6) Do not deliver a full interpretation; punctuate or cut at a key element. [steps 2–4 follow Freud as taken up by Fink; step 5 Lacan Seminar XI on the dream of the burning child; ordering is synthesis]
Example language (illustrative): "What comes to mind about the green door?" / "You said 'and then I woke up' just when he turned round."
Watch for: associations that go somewhere unexpected; reported dreams that seem to be made "for" the analyst (transference message: note it).

4.13 Fantasies and constructing the fundamental fantasy

Purpose / when: mid-analysis; daydreams and sexual fantasies reveal the subject's position as object in relation to the Other's desire (formula $ ◇ a). The aim is to let this fundamental fantasy be constructed, not to judge or correct it. [source: Fink 1997 ch 5; Fink 2007]
Steps: (1) Invite reporting of daydreams and fantasies without embarrassment. (2) Ask for detail: who does what to whom, from where the scene is viewed, what moment is exciting. (3) Track the repeating structure across fantasies, dreams, symptoms and life choices. (4) Punctuate the subject's position in it (watcher, victim, the one who is missing). (5) Avoid naming the fantasy for the analysand in theoretical terms.
Example language (illustrative): "Where are you in this scene?" / "Again you're the one waiting outside the door."
Watch for: shame and resistance (expected); a shift from describing to questioning the position.

4.14 Handling transference

Purpose / when: throughout. Lacan treats transference as the supposition of a subject who knows, plus love addressed to that knowledge; the analyst sustains it without satisfying it. Fink cautions against routine here-and-now transference interpretation and against correcting "distorted" perceptions toward a "realistic" view via an observing ego. [source: Lacan Seminar XI; Fink 2007, via Norton description and metapsychology review]
Steps: (1) Expect love, hate and suppositions of knowledge; neither encourage nor dispel them. (2) Do not interpret transference as a relationship between two egos ("you feel toward me as toward your mother"); work with the signifiers through which it is expressed. (3) Interpret transference directly only when it stops the analysis (e.g., the analysand stops associating to please or defy you). (4) Do not self-disclose to correct the image. (5) Remember transference repeats outside sessions too. [source for 3: Fink 2007 per review] [rest synthesis]
Example language (illustrative): Patient: "You must think I'm pathetic." Analyst: "Pathetic." / when blocking: "You've stopped telling me your dreams since you decided I'm bored."
Watch for: transference becoming erotomaniac or persecutory certainty (signal of psychosis); the analysand organising life to please the analyst.

4.15 Countertransference and the analyst's own resistance

Purpose / when: whenever you feel bored, irritated, seduced, protective or eager to help. Lacan places resistance on the side of the analyst and treats countertransference as the analyst's prejudices and passions, not as a communication to be disclosed. [source: Lacan Seminar II; Lacan 1958 "Direction"; Fink 2007 on countertransference vs mainstream projective identification]
Steps: (1) Note the feeling privately. (2) Ask what demand of yours (to be loved, to cure, to know) it reflects. (3) Do not disclose it as interpretation. (4) Take it to your own analysis and to supervision (4.23).
Watch for: sessions where you talk more than usual, explain, or set homework: your own demand may be steering.

4.16 Fee, missed sessions and frame

Purpose / when: set in preliminary interviews; held throughout. Paying, including for missed sessions, makes the analysand bear a loss and marks the analysis as theirs; Lacan notes the analysand pays for a "nothing" the analyst does not even supply. [source: Lacan 1958 "Direction" via nosubject; Fink 1997 ch 2]
Steps: (1) State fee, payment rhythm and missed-session rule clearly. (2) Collect payment in person, ideally per session [uncertain: Fink's preference]. (3) Treat lateness, forgotten payments and requests for reductions as material before negotiating. (4) Adjust fee when real circumstances require; do not make it a power struggle.
Example language (illustrative): "Missed sessions are paid." / "You forgot to pay the week your brother asked you for money."
Watch for: fee becoming a battle ground for the analyst's own interests; legal requirements in your jurisdiction.

4.17 Structure-specific positioning in neurosis (hysteria, obsession)

Purpose / when: once neurosis is established; Fink describes different moves for the hysteric and the obsessional, with the general aim of "hystericising" both so they address their division to the analyst. [source: Fink 1997 ch 8]
Steps, obsession: (1) Expect the obsessional to neutralise the Other: monologue, preparedness, treating the analyst as absent or dead. (2) Make your presence and desire felt through cuts, punctuation and the occasional unexpected question. (3) Scan away from endless thinking and toward the moment of doubt. (4) Bring the analysand to put a question about desire to you rather than to themselves alone. [source: Fink 1997 ch 8; step detail synthesis]
Steps, hysteria: (1) Expect the hysteric to seek the master's knowledge and then to show its insufficiency, sustaining the Other's desire as unsatisfied. (2) Do not take the master's position or compete in knowledge. (3) Return questions about what the Other wants to her/his own desire. (4) Use enigma rather than explanation. [source: Fink 1997 ch 8; step detail synthesis]
Example language (illustrative): to an obsessional rehearsing: "You've been sure of everything for twenty minutes." / to a hysteric asking what you think she should want: "What do you suppose I want?"
Watch for: the obsessional starts arriving without a plan and with anxiety (good sign); the hysteric shifts from questioning the Other to questioning her own desire.

4.18 Positioning in perversion

Purpose / when: when disavowal is the defining mechanism. Fink describes the pervert as working to make the Other's law exist and as rarely seeking analysis with a question; the analyst aims to bring about a measure of separation and a naming of the lack, not to moralise. [source: Fink 1997 ch 9] [uncertain: technique detail is thin in the sources; Lacanian authors disagree on analysability]
Steps (synthesis): (1) Do not adopt the position of a judge or of an accomplice. (2) Listen for what brought them now (often a failure of the scenario or an external demand). (3) Punctuate points where knowledge of jouissance falters. (4) Observe legal and safeguarding duties strictly where acts harm others.
Example language (illustrative): "You're very sure of what she wanted."
Watch for: attempts to make the analyst a witness who validates or an anxious Other; seek supervision early.

4.19 Separation and traversal of the fundamental fantasy

Purpose / when: late in neurotic analyses. Not a single technique but the cumulative effect of the analyst sustaining the place of cause of desire while declining to be the Other who knows. The analysand comes to a different position toward the Other's desire; Lacan (1967) speaks of subjective destitution and of the analyst falling to the status of remainder. [source: Lacan 1964 Seminar XI; Lacan 1967 "Proposition"; Fink 1997 ch 5]
Steps (synthesis): (1) Keep interpretations aimed at the object and cause rather than at meaning. (2) Do not take the analysand's growing disappointment with you ("you don't know after all") as failure; let the supposition of knowledge fall. (3) Do not propose an ending; let the analysand arrive at it. (4) When the analysand raises ending, ask what has changed in their relation to what they were waiting for from the Other. (5) Accept the end without a ceremony of evaluation.
Example language (illustrative): "And now that you no longer expect me to tell you?"
Watch for: distinction between this and a flight into health, an angry break, or a therapeutic plateau (§5).

4.20 Psychosis: recognising triggering and ordinary psychosis

Purpose / when: preliminary interviews and throughout, to avoid triggering and to adapt technique. Lacan (1958): psychosis is foreclosure of the Name-of-the-Father; a break is triggered when the subject is called to respond from a place where that signifier is missing (e.g., becoming a father, a promotion, a sexual encounter, meeting a paternal figure). The WAP clinic adds "ordinary psychosis": no florid break, but discreet signs in three registers (Miller 2009): social (an inexplicable difficulty taking up social functions, "as if" identifications), bodily (the body felt as foreign or unhooked, needing artificial supports), subjective (emptiness, vagueness, fixed identification with an object). [source: Lacan 1958 "Question prior"; Sauvagnat, "Ordinary psychosis"]
Steps: (1) Inquire about the precipitating circumstances with paternal or sexual dimensions. (2) Listen for elementary phenomena: intrusive voices or thoughts, neologisms, words with personal enigmatic meaning, sentences broken off, certainty. (3) Look for knotting problems rather than an all-or-nothing diagnosis; signs may fluctuate (unknotting and reknotting). (4) If in doubt, act as if psychosis is possible: no couch, no equivocation, no enigmatic cuts. [source: Sauvagnat; Fink 1997 ch 7] [steps 1 and 4 synthesis]
Example language (illustrative): "When you say the word 'designated', what does it mean for you?"
Watch for: the patient saying that your words "mean something" about them, perplexity, rising certainty, new sleep loss: refer for psychiatric assessment and slow down.

4.21 Psychosis: direction of treatment

Purpose / when: once psychosis or ordinary psychosis is likely. Lacan, ironising, said analysts content themselves with being "secretaries to the insane" and then took this as a position to adopt seriously: record and witness the subject's testimony rather than interpret it. Later WAP work emphasises supporting suppléance (a substitute knot: a work, a role, a set of rules, a writing practice) and the sinthome (Lacan, Seminar XXIII on Joyce). [source: Lacan Seminar III; Lacan Seminar XXIII; Sauvagnat]
Steps: (1) Sit face to face; keep a calm, regular presence; consider regular rather than abrupt variable endings. [synthesis] (2) Do not rush to understand; let associations and the delusion unfold, as surprise openings can appear. [source: Sauvagnat] (3) Do not interpret toward the unconscious or use equivocation; ask for elaboration and record. (4) Support the patient's own solutions: help them build and maintain a delusional metaphor, a role, a writing, an activity that ties the registers. (5) Help limit the invasive jouissance of the Other: the analyst presents as a "decompleted" Other who does not know everything and does not demand; Sauvagnat notes the analyst can act as a limit to omnipotent knowledge and as an obstacle to the "push-to-the-woman". (6) Rely on the patient's partnership with their own symptom and lalangue. (7) Coordinate with psychiatry when needed. [source: Sauvagnat; step 4–5 partly synthesis]
Example language (illustrative): "Write it down for next time; I want to follow it exactly." / "I don't know what they intend. What do you make of it?" (only if the patient can tolerate the gap) / "That job gave you a frame. What happens on the days off?"
Watch for: erotomaniac or persecutory transference attaching to you: reduce enigma, be predictable, never confirm a special relation. Stabilisation signs: less invasion, a working routine, social link maintained.
School note: ALI's clinic of psychosis (Czermak) is rooted in hospital psychiatry and patient presentation; WAP's ordinary-psychosis framework is more widely used in outpatient practice. [source: nosubject ALI; Sauvagnat] [uncertain: technical differences]

4.22 The pass (institutional procedure)

Purpose / when: after an analysis the analysand considers ended, or at the passage from analysand to analyst; to transmit what happened at that juncture, which Lacan called a dark spot, and to produce knowledge for the School. Proposed in the "Proposition of 9 October 1967"; voted in at the École freudienne de Paris in 1969; in the ECF statutes since 1981; practised in WAP schools and, separately, the IF-EPFCL. Not an exam and not a licence. [source: Wikipedia "The Pass"; nosubject "Pass"]
Steps (as described): (1) The passant applies to the School's pass secretariat. (2) The passant is given two passeurs, chosen by analysts of the School (AMEs in the WAP terminology) from among their analysands judged to be themselves at the moment of the pass. (3) The passant speaks to each passeur separately, as many times as needed, about their analysis and its end. (4) The passeurs transmit the testimony separately to a jury/cartel of the pass; they are witnesses, not judges. (5) The cartel nominates the passant Analyst of the School (AE) or does not; non-nomination is stated not to reflect on the passant's analysis. (6) In the WAP, AEs give public testimonies for a fixed period (around three years) and cartels publish reports. (7) The other title, AME, is granted by the School on its own initiative to practitioners who have proven themselves, independent of the pass. [source: Wikipedia "The Pass"; nosubject "Pass"] [uncertain: passeur-selection details from Lacan 1967, not re-verified against the text]
Example language: not applicable (not a clinical intervention).
Watch for (clinical relevance): analysands may idealise the pass as a goal; treat that as material, not as an endpoint. Lacan called it an experiment and in 1978 called it a failure; schools continue it.

4.23 Supervision (contrôle) and cartels

Purpose / when: continuous, not only in training. Lacanian schools transmit technique through personal analysis, supervision and cartels (small study groups with a "plus-one") rather than manuals. [source: Lacan 1967; nosubject ALI on seminars and cartels]
Steps (synthesis): (1) Present cases to a supervisor of your choice, especially early sessions, suspected psychosis, and impasses. (2) Bring your own interventions verbatim. (3) Join a cartel to read Lacan and Fink alongside cases.
Watch for: using supervision to get recipes rather than to question your position.

4.24 Patient presentation (présentation de malades)

Purpose / when: a teaching interview in psychiatric settings, practised by Lacan at Sainte-Anne and continued in ECF/WAP sections cliniques and by ALI; used to train diagnostic listening, especially for psychosis. [source: Sauvagnat on Lacan's presentations; nosubject ALI] [uncertain: format varies by institution]
Steps: follow the host institution's protocol and consent rules; this is a training format, not an outpatient technique. No script given.
Watch for: the patient's dignity and consent; the presentation must serve the patient, not only the audience. [synthesis]

5. Handling problems

Lacan's sources say little about "problems" in the CBT sense; most of the guidance below is my synthesis from the principles in §3 and Fink's examples, and is marked so.

Stuck analysis, empty speech. Lacan (1953) distinguishes empty speech (talk about oneself as an object, chatter, reporting) from full speech (speech that changes the speaker's position). Response: shorten sessions at the start of empty stretches; punctuate a single word; ask about a detail; check whether you have become a confidant or audience (imaginary axis). Then ask yourself, per Lacan's "the only resistance is the analyst's", what you want from this patient. [source: Lacan 1953; Lacan Seminar II] [synthesis for the specific moves]
Resistance. Do not interpret resistance as the patient's opposition to you; treat it as a point where the signifying chain meets something it cannot yet say. Response: stay with the gap ("You stopped"), cut there, or wait. If you notice yourself arguing or persuading, step back. [source: Lacan Seminar II; Lacan 1958] [synthesis]
Overwhelm, anxiety surges. Lacan treats anxiety as the affect that does not deceive, signalling the approach of the object (Seminar X). Response in neurosis: do not rush to soothe; slow the pace, use fewer enigmatic interventions, and allow longer sessions. If anxiety becomes perplexity or disorganisation, consider psychosis (4.20). [source: Lacan Seminar X] [uncertain] [synthesis]
Non-adherence: lateness, missed sessions, forgotten payments. Charge missed sessions per agreement; treat as material: the act is a message. Do not lecture. Persistent absence may be acting out (see next). [source: Fink 1997 ch 2 on fees and engagement] [synthesis for detail]
Acting out and passage à l'acte. Lacan links the patient's acting out to the analyst's own failures (missed or over-hasty interpretation, the analyst's acting); acting out is a message addressed to the Other, while passage à l'acte is an exit from the scene. Response: for acting out, ask what you missed and re-establish speech; for any risk of passage à l'acte (self-harm, suicide, violence) suspend analytic neutrality, conduct a standard structured risk assessment, involve psychiatric and emergency services per your jurisdiction's protocols, and document. [source: Lacan 1958 "Direction" via nosubject; Lacan Seminar X] [synthesis for crisis response]
Ruptures: anger at a cut, feeling dismissed. Variable sessions provoke strong reactions. Response: hear the complaint, do not justify or apologise into an ego-to-ego exchange, but do not ignore it; take its words as material ("thrown out"). If the patient is new, fragile or psychotic, revise your use of cuts. If the anger reveals a patient never informed about variable sessions, correct the frame explicitly. [synthesis]
Requests for advice, homework, diagnosis, reassurance. Treat as demand (4.7). For urgent practical questions (medication, legal issues, safety) refer appropriately rather than refuse outright. [synthesis]
Patient wants a time-limited, symptom-focused therapy. Say plainly what you offer; if they need structured symptom treatment now, refer. Lacanian practice does not set treatment length in advance. [synthesis]
Flight into health and early termination. Symptom relief often comes early. Response: note it, ask what has been settled and what still questions them; do not hold the patient by force; leave the door open. [synthesis]
Idealisation or erotic transference. Neurosis: sustain without gratifying or interpreting it away (4.14). Psychosis: risk of erotomania; be predictable, reduce enigma, never accept or appear to reciprocate a special bond. [source: Lacan Seminar XI; Sauvagnat] [synthesis]
Triggering during treatment. Signs: perplexity, enigmatic meanings, new certainty, sleep loss, voices. Response: stop equivocation and scansion, sit up face to face, move to supportive and recording stance (4.21), arrange psychiatric review. [source: Fink 1997 ch 7; Lacan 1958] [synthesis for the sequence]
Hysteric's challenge to the analyst's knowledge; obsessional's stalemate. See 4.17: do not compete in knowledge with the hysteric; with the obsessional, cut through the monologue and make your desire present. [source: Fink 1997 ch 8]
Practitioner problems (not addressed by sources): (a) Working in public or insured settings with fixed session lengths: use punctuation, questioning and end-of-session placement within fixed times; disclose any variable-length policy and comply with billing law. (b) Teletherapy: punctuation and silence work differently online; agree how silences and endings are handled. (c) Informed consent: explain in plain language the method, fee and missed-session rules, variable sessions, and that symptom relief is expected but not promised. (d) Ethical limits: very short sessions, high fees, or authoritarian cuts can become exploitative; Lacan's own practice in the 1970s was criticised on this basis. Keep the frame accountable through supervision. [synthesis] [uncertain]

Sources

Sources:

Further reading (not drawn on unless listed above):

Lacan, J. (1945/2006). Logical time and the assertion of anticipated certainty. In Écrits, trans. B. Fink. Norton.
Lacan, J. (1951/2006). Presentation on transference. In Écrits.
Lacan, J. (1953/2006). The function and field of speech and language in psychoanalysis. In Écrits.
Lacan, J. (1955/2006). Variations on the standard treatment. In Écrits.
Lacan, J. (1958/2006). The direction of the treatment and the principles of its power. In Écrits.
Lacan, J. (1958/2006). On a question prior to any possible treatment of psychosis. In Écrits.
Lacan, J. Seminar II (1954–55), The Ego in Freud's Theory and in the Technique of Psychoanalysis.
Lacan, J. Seminar III (1955–56), The Psychoses.
Lacan, J. Seminar X (1962–63), Anxiety.
Lacan, J. Seminar XI (1964), The Four Fundamental Concepts of Psychoanalysis; and 1976 Preface to the English-language edition.
Lacan, J. Seminar XVII (1969–70), The Other Side of Psychoanalysis.
Lacan, J. Seminar XXIII (1975–76), The Sinthome.
Lacan, J. (1967). Proposition of 9 October 1967 on the psychoanalyst of the School (trans. R. Grigg, Analysis 6, 1995).
Fink, B. (1997). A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique. Harvard University Press.
Fink, B. (2007). Fundamentals of Psychoanalytic Technique: A Lacanian Approach for Practitioners. Norton.
Miller, J.-A. (2009). Ordinary psychosis revisited. Psychoanalytical Notebooks 19 (via Sauvagnat).
Miller, J.-A. (ed.) (1999). La psychose ordinaire: la convention d'Antibes. Agalma/Seuil (via Sauvagnat).

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