First European Congress of Psychoanalysis
Does Mental Health exist ?
A large number of psychoanalysts work in institutions that operate under the label of Mental Health. In effect the analyst is affected by a clinic of ravages linked to the discourse of the Other, which Freud designated as ‘discontent in the civilisation’. However, when an analyst occupies the place of the Mental Health worker, he is engaged in a constant and necessary debate about that concept since there is an antinomy between the notion of Mental Health and psychoanalysis.
Where Mental Health is put at the service of public order, psychoanalysis tries to work out a place for each one's own ‘craziness’. Where Mental Health tries to standardise desire to put the subject in step with the common ideals, psychoanalysis supports a claim of the right to the ‘not like everyone else’. Where Mental Health carries a trace of charity, psychoanalysis, according to Lacan, ‘decharitises’ [‘décharite’]and relieves the subject from the will of ‘the Other who wishes your good’. In effect, rather than vowing to put up with the world’s misery, the analyst comes to incarnate the cause of desire for the subject of the unconscious.
But why to put the very existence of Mental Health into question?
It is that the turns that have taken on the use of the term for a few decades are correlate to a disturbing dilution of the ‘psy’ clinic. Formerly, the confrontation between disciplines involved in the Mental Health was a source of a rigorous debate the co-ordinates of the scientific foundations of which were determined. The protagonists of this debate have not ceased to refine their clinical observations in order to found their arguments.
Today this debate is extinct. States have turned Mental Health into their affair; it is the political and economic co-ordination of their actions which is at the foreground. The figures representing the Other of Mental Health push towards a consensus there where formerly a debate of the scholars took place. Thus, in order to avoid teeth gnashing the DSM thinks itself to be ‘atheoretical’, and its drafting is measured on the scale of statistical norm and public opinion. Certain universities try to dilute the clinic of psychical suffering in the woolliness of ‘bio-psycho-social’. The definition of the Mental Health by the WHO in terms of ‘promotion of well-being’ and of ‘prevention of mental disorders’ extends its effects to everyone without any distinctions.
This consensus created an epistemic mist that moves Mental Health away from the real of the clinic. The idea of a mental disorder as objectifiable and curable moves away from the study of the symptom that combines the singular jouissance of the subject and its truth. The reference to ‘well-being’ is only a reduction of the virtues formerly promoted by the wisdoms to a hygienism that pretends to be scientific.
In this field, the woolliness is not without effects. Evaluation based on questionnaires is a parasite in the clinical encounter moved by speech and transference. The psychiatric nosography is transformed into a continuum that erases the differences between acute psychical suffering and the simple human condition. The market of psychotropic drugs doubtless benefits from this globalisation of the application field of Mental Health, becoming an ideal to attain. The cognitive-behavioural therapies, which snap at the subject of the unconscious, try to make an impact in the name of great efficacy demonstrated ‘scientifically’. We find ourselves faced with a clinical doctrine that claims that the ‘mental disorder’ is for everyone, while the unconscious is for no one. It follows that the cases presenting an acute suffering with a risk of passage to the act are often overlooked.
In Europe many practitioners resist this movement of dilution and keep on the psychoanalytical orientation. All measures are good in order to submit them to the epistemic and ethical liquidity that is set up: the call to the legislator and to the ‘scientific’ studies in order to discredit their formations and practices, and if this is not enough, denigration and even defamation.
As adherents of Lacanian psychoanalysis, we are among these practitioners. We do not give up either on our orientation or on the clinical rigour it requires. But we deplore the ravages committed in the name of Mental Health which deprived us of some serious interlocutors. Therefore, we do not claim a consensus, we claim a debate. Our question is: what does Mental Health mean today? And moreover: does it exist?
Director of PIPOL 5
EuroFederation of Psychoanalysis
(Translation: Bogdan Wolf)
 J.-A. Miller, Santé mentale et ordre publicin Mental No 3, January, 1997.
 J.-A. Miller, Choses de finesse en psychanalyse, Seminar course, 19 November 2008.
 J. Lacan, Television, trans. D. Hollier, R. Kraus, A. Michelson, WW. Norton&Co, 1990.
 A. Aflalo, L’assassinant manqué de la psychanalyse, Nantes, Cécile Defaut, 2009.