Psychical Causality Against the Hierarchy

I. The Jacksonian Foundation: Evolution and Dissolution

To understand Henri Ey’s organo-dynamism, one must first revisit the neurologically radical work of John Hughlings Jackson. Practicing in a mid-19th-century landscape dominated by theological indivisibility, Jackson applied Spencerian evolutionary theory to cerebral architecture. He proposed that the nervous system is a sensorimotor apparatus organized into a strict hierarchy: the lowest centers (spinal and brainstem) being the most organized and automatic, and the highest centers (the prefrontal cortex) being the least organized, most complex, and most voluntary.

Jackson’s core contribution was the doctrine of Dissolution, the evolutionary reversal of development. In Jacksonian neurology, pathology is never “creative”; it is subtractive. A lesion in a superior center produces two simultaneous clinical dimensions:

Negative Symptoms: The direct result of the loss of the higher, inhibiting center (e.g., loss of volition or “apical” judgment).

Positive Symptoms: The “liberation” of lower, more primitive centers. The hallucinations of the psychotic were, for Jackson, merely the archaic, automatic activities of the lower brain no longer held in check by the evolved “superior” centers.

Henri Ey took this Jacksonian scaffolding and applied it to the psychoanalytic clinic, designating psychiatry as the field of apical dissolutions. For Ey, madness was an “energetic” failure of the highest level of mental organization.

II. The Schneider Case: Shattering the Hierarchy

Lacan’s 1946 intervention was a direct assault on this “hierarchical-organicist” comfort. He turned to the Gelb and Goldstein study of Johann Schneider, a patient whose brain injury should have, by Jacksonian logic, resulted in a discrete, partial dissolution of visual function. Instead, Schneider exhibited a global collapse of the subject’s existential world.

Schneider suffered from what Goldstein called a loss of the “abstract attitude.” He could no longer grasp a “Gestalt”: he could see the parts of a face but could not recognize his wife; he could respond to a physical stimulus but could no longer inhabit a metaphor or sustain a religious faith. This suggested to Lacan that the “apical” functions are not simply the top layer of a biological cake. Rather, the subject’s relationship to the Symbolic order (language) is what provides the very cohesion of the organism. When the symbolic function fails, the “organ” fails to constitute a world, proving that psychical causality cannot be mapped onto a vertical neurological ladder.

III. Clérambault and the Automatisme Mental

If the Jacksonian model of “liberated primitive centers” failed to explain the clinical phenomenology, Lacan looked to Gaëtan Gatian de Clérambault for a structural alternative. Clérambault’s mental automatism (automatisme mental) remains the pathognomonic core of the psychoses, yet Lacan stripped it of Clérambault’s own organicist “circuits gone haywire” explanation.

For the trained clinician, the automatism is an encounter with the Xenopathic Signifier. It is a moment where the subject’s own thought processing becomes exogenous: echoing, narrating, or mocking. Clérambault’s genius was in recognizing that the “delusional narrative” (the persecutory plot) is actually a secondary, healthy rationalization of this primary, non-thematic interference.

Lacan formalizes this as a Structural Misrecognition (méconnaissance):

The Alienation of the Res Cogitans: The subject encounters language as a parasite. The “inner voice” is no longer experienced as an extension of the self, but as a material intrusion (an object of the res extensa).

The Law of the Heart: Borrowing from Hegel’s Phenomenology of Spirit, Lacan posits that the madman seeks to “impose the law of his heart” upon a world he perceives as disordered. The “frenzy of self-conceit” in the paranoid subject is a desperate attempt to reconstruct a Symbolic universe after the primary foreclosure of the signifier.

IV. The Imago: The Biological Efficacy of the Image

Lacan’s final stroke is the introduction of the Imago as an irreducible phenomenon with genuine biological causality. He argues that the Ego is not a “perception-consciousness” system, but a visual construct formed during the “Mirror Stage.” To prove that a psychical image can trigger a biological Real, he utilizes two classic ethological examples:

The Female Pigeon: Gonadal activation and subsequent ovulation are entirely dependent on the visual perception of a conspecific. The biological drive is “switched on” by a visual Gestalt.

The Schistocerca (Locust): The morphological transition from the solitary to the gregarious (swarming) phase is triggered specifically by the larval recognition of another grasshopper’s image.

This suggests that identification is the site of psychical causality. In the psychoses, we observe a rupture in this primordial identification. The subject can no longer recognize themselves in their own mental productions; they are “captured” by an image or a language that remains fundamentally Other.

Conclusion: The Ethics of the Subject

For the psychiatrist with psychoanalytic training, Lacan’s “Psychical Causality” demands a move away from the Jacksonian view of the “broken machine.” If madness is a crisis of meaning and identification, our clinical task is not merely the suppression of “liberated” lower centers via pharmacotherapy. It is the navigation of the subject’s idiosyncratic attempt to suture their world. As Lacan warns, to treat the “organ” while ignoring the “law of the heart” is to abandon the field of psychiatry altogether.

Budapest, 2016.