The Madness of Diagnosis or is Everyone Mad? Clinical Structures in Lacanian Psychoanalysis as a Model in Opposition to Psychiatric Diagnosis

Abstract

The article aims to present the Freudian and Lacanian approaches to diagnosis. First, I will present Freud’s unique perception of mental health and diagnosis. Most importantly, however, I will focus on discussing how Lacan, who adopts Freud’s depathologising attitude towards mental suffering, develops the concept of clinical structure. I will consider whether it can be an alternative to psychiatric nosology in counselling, which currently relies on the ICD and DSM classifications. I will explain how the Lacanian approach to naming symptoms reflects the complexity and, in particular, the uniqueness of suffering, which makes it a subject-oriented one. I will also trace the cultural and biopolitical reasons why the framework of the American Psychiatric Association has been adopted as the standard of diagnosis in psychiatry and psychotherapy, while Lacanian ‘minimalist’ diagnosis without labels is not popular. Finally, I will consider the concept of ‘neurodiversity’ from the perspective of Lacanian psychoanalysis with references to Leon Brenner’s publication ‘Autistic Subject: On the Threshold of Language’.