From No Subject - Encyclopedia of Psychoanalysis
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The full title of the doctoral thesis that signaled Jacques Lacan's entry into psychiatry was De la psychose paranoïaque dans ses rapports avec la personnalité (On paranoiac psychosis as it relates to the personality). The work was dated September 7, 1932, when Lacan was thirty-one years old.

The case of Aimee

An important moment in the history of surrealism is the convergence of the concern for language and the interest in psychoanalysis and psychiatry. The surrealists argued that the pathological is not meaningless and that it is a mode of expression which has its own validity. It is possible that Lacan's famous slogan 'the unconscious is structured like a language' may owe much to the surrealists' attention to the linguistic expression of psychic phenomena. It has been suggested that some surrealist texts prefigure aspects of Lacanian theory. Indeed, it could be argued that the surrealists were the first to realise that psychoanalysis is essentially a question of language. They fully understood why the method introduced by Freud and Breuer was given the name 'the talking cure' by Anna 0., one of Breuer's patients. Besides language, the surrealists were interested in certain aspects of femininity. 'Woman-as-victim' is a common theme in surrealist art.

Lacan's first articles were published between 1926 and 1933 while he was training as a psychiatrist. During this time he studied many patients suffering from delusions and became interested in their disorders of language. His research convinced him that no psychical phenomenon could arise completely independently of the subject's personality. The major work of this period was his doctoral thesis: 'Paranoid psychosis and its relation to the personality' (1932), which included a study of a female psychotic whom he called Aimee. While not a psychoanalyst, Lacan used some analytical concepts in his account of his patient at a time when Freud was not well known in France. Lacan's thesis was one of the first attempts in France to interpret a psychosis in terms of the total history of the patient.

Aimee was a thirty-eight-year-old railway clerk who inexplicably attacked one of the best-known actresses in Paris, wounding her with a knife as she entered the theatre one evening. Aimee consistently maintained that the actress, and others, had been spreading slander about her. She had never met her alleged persecutors. Aimee had literary ambitions, but her novels and poems had been repeatedly rejected by one publisher after another.

It was the unusual nature of her writings which first led Lacan to take an interest in her case. In his view, Aimee attacked an ideal image of woman who enjoys social freedom and power, the very type of woman she hoped to become by pursuing a literary career. The dominating woman she envied, and who became her persecutor, was initially embodied by her sister and then by a close woman friend to whom Aimee once admitted: 'I feel that I am masculine.' Aimee's condition, then, was rooted in a problem of identification, in a confusion of self and other. She wished to be a rich, influential novelist, and attacked the incarnation of her ambition: an actress who represented her ego-ideal. In Lacan's view Aimee was clearly suffering from delusions of being persecuted. A remarkable feature of Aimee's delusions was that when she was found guilty before the law and imprisoned, the delusions disappeared. The wish behind her delusions was one of unconscious self-punishment, probably in order to deal with her guilt feelings. Her psychosis was 'self-punishment paranoia'. This was one of Freud's concepts and referred to those who are criminals from a sense of guilt. Freud described how certain criminal acts give relief to subjects who suffer from oppressive feelings of guilt before the crime. He also wrote how children can quite often be naughty on purpose to provoke punishment, and then are quiet and settled after the punishment.

Lacan's observations led him to the conclusion that Aimee's assault on the actress was in fact a means of punishing herself by attacking her ideal. Lacan's comments rely heavily on Freud's argument that paranoia is in part a defense against homosexuality, a process of disavowal (a refusal to acknowledge) which gives rise to the delusion of persecution and to the identification of the loved one with the persecutor. In this case, and another which Lacan discusses concerning the Papin sisters, self and other merge all too easily and gender becomes uncertain.

Aimee was not only a patient of Lacan's, but was also a cause celebrity for the surrealists. Lacan's thesis included a selection of Aimee's copious writings, which were produced at the height of her psychosis and which virtually stopped when it abated. The literary qualities of Aimee's work were much appreciated and discussed by members of the surrealist movement of which Lacan was a part.