An Interview with Raul Moncayo, Ph.D. on Lacanian Psychoanalysis
In this edition of the Wise Counsel Podcast, Dr. Van Nuys interviews Raul Moncayo, Ph.D. on the topic of Lacanian Psychoanalysis, which is a further development of the original Freudian psychoanalysis as reimagined by Jacques Lacan, a French Psychoanalyst writing in the middle of the 20th century.
Editor's Note: Psychoanalysis is a field known for complex theories of human nature that make prominent use of 'terms of art' or jargon. Many people are familiar with some of these jargon terms, as used by Freud, such as "ego", the "unconscious", and "repression". Lacan used these terms too, but also popularized many new ones that will be entirely unfamiliar to most listeners. During this interview, Dr. Moncayo speaks quickly at times and does not attempt to carefully define all of these terms. Thus, some parts of the interview may be difficult to follow for listeners who are not already familiar with Lacan and his terminology. Please do make the attempt to listen, however, because there are many wonderful ideas being expressed here concerning how identity and self-concept develops, and how psychological and psychiatric problems that affect identity can be resolved. There is also much useful information here about the history of psychoanalysis as it has developed in "Continental" circles (e.g., in non-English speaking Europe and Latin America). I (Mark Dombeck, Ph.D.), though not a psychoanalyst, will here (below) do my best to translate the valuable ideas contained in this interview into English that a regular person can understand. If any listeners out there are Lacanian experts and wish to refine or refute my translations, I encourage them to leave comments to that effect below.
Raul Moncayo, Ph.D. was born in Chile to an American mother and a Chilean Father. He was first introduced to Psychology and Psychoanalysis while attending university in Buenos Aires, Argentina, a city known for being a world center of psychoanalysis. After graduating university, he worked in Geneva for the United Nations, and then studied with the renown psychiatrist R.D. Laing in London before ultimately relocating to the San Francisco Bay Area where he begin working as a therapist doing group psychotherapy with Schizophrenic patients on an inpatient unit. Subsequently, he did graduate work at the psychoanalytically inclined Wright Institute in Berkeley, CA. He has continued to live and work in the San Francisco area, and presently works for the Mission Mental Health public health clinic in that city.
Dr. Moncayo laments the current American approach to treating psychiatric illnesses, and the dismissal of the psychoanalytic psychotherapy approach by the American medical and psychotherapy communities. He notes that while psychoanalysis is still alive and well within university humanities departments where it has become an important part of literary analysis, it is in dramatic decline as a therapy modality. Psychiatrists are not taught about the great psychoanalytic psychiatrists of the past, but instead learn only medicine and biology, and are encouraged to reduce mental disorders to simple brain disorders. In the process, the human aspects of these disorders are ignored and marginalized.
Dr. Moncayo believes that the American psychiatric establishment has been corrupted by big business interests, especially the pharmaceutical industry which seeks to dominate treatments for all mental illnesses to the exclusion of alternative non-pharmaceutical remedies, but also the health care industry which seeks to make treatment as efficient as possible, and in so doing, makes it all but impossible to fund treatments of any duration or depth (such as psychoanalysis). One of the roots of this problem is, he believes, the American preference for the empirical (e.g., scientific research) over the theoretical (e.g., intellectual and philosophical models of how things work), the general disdain for intellectuals that is widespread in American society, and the general lack of patience with difficult material that the average American seems (to him) to display. He believes that scientific studies used to justify the widespread use of psychiatric medications are biased so that they overestimate the actual efficacy of those medications. Case studies and consumer reports should become a part of the analysis process used to justify treatments (in addition to scientific research) as these methods more accurately represent clinical outcomes and clinical experience.
Dr. Van Nuys asks Dr. Moncayo how Lacan's version of psychoanalysis differed from Freud's psychoanalysis. Dr. Moncayo replies that by Lacan's time, mainstream Freudian psychoanalysis had become something post-Freudian; something far more rigid and protracted than Freud's original vision. Lacan saw himself as returning to a more pure and original Freudian approach to therapy practice. He did this by feeling free to break the rules. Where the so-called Freudian analysts saw patients for 50 minute hours, four times a week, Lacan felt free to see patients less or more frequently than that, and to adjust the time of sessions on-the-fly as he saw fit, either shortening them or extending them as he felt benefited the therapy. For this heresy, Lacan was expelled from the Freudian Paris Psychoanalysis Society. This doesn't seem to have phased him much as he simply founded a new group with himself at the center and gathered disciples around himself.
Lacan also tried to be more holistic in his approach to psychoanalysis than was fashionable in the post-Freudian' mainstream. Freud's original psychoanalysis emphasized the ego which in psychoanalytic terms is considered a masculine function because it has to do with the development of identity in the public sphere in relationship with the demands of society, and society demands are considered masculine (although the figures making the demands are not necessarily male). However, many psychoanalysts in Lacan's time had retreated from this original emphasis towards another development called object relations, as exemplified by the writings of Melanie Kline, which emphasized a developmentally earlier time frame in the life of patients, infancy and the earliest relationships with mother figures. Object relations is consequently considered to be feminine, although the people fulfilling the care giving role might not actually be female. Lacan seems to have seen his approach as a return to the original masculine Freudian ego psychology, and possibly as a protest or criticism against the object relations approach. Moncayo suggests that object relations therapists can become "breast-like" in that they may come to be a purely supportive presence, and Lacan wanted to be more confrontive with his patients and thus more masculine.
Masculinity and femininity are important Lacanian concepts, and it is important to note that these terms as used here don't have their conventional meanings. Masculine does not mean male. Instead, it means that which makes demands upon the patient, forcing him or her to differentiate himself from a developmentally early undifferentiated or fused identity state. Feminine doesn't mean female. instead, it means that which supports the infant patient in a mother-like way. Infants are believed to be initially unable to differentiate themselves from their caregivers, and this early state of undifferentiated identity is seen as a fusion with the feminine, which it is the masculine's role to cleave or cut so that an independent sense of identity can emerge in the patient. The masculine forces in the world (e.g., the demands of society) derive their ability to break up the early fusion between infant and "mother" by means of the "phallus" which, in characteristic psychoanalytic doublespeak does not actually refer to a penis. Instead, the phallus is a term that refers to power and authority and potency - that which enables someone to compel or force another do to something. Anxiety around "castration" is also described in the Lacan vision, and this does not refer to a literal cutting off of a literal penis, but instead, to the awareness that one has something powerful to lose.
Moncayo asserts that Lacan did not exclusively promote masculine psychology over feminine, but instead tried to show how both aspects of development (the infantile feminine identity fusion with caregiver, and the masculine emergence of an independent self) were interdependent things which required one another for either to exist. Penis envy offers a good example of how this is so. In the traditional Freudian view, boys have a phallus and are afraid of losing it, while girls don't have one, and wish they did. In the Lacanian view, girls and boys both have phallus mojo but in different, inverted ways. Apparently, boys experience their real physical penis and represent it in their imaginations, and because they have imagined it, they become aware that they could lose it, causing a castration fear (a fear of being made powerless). Girls lack of an actual penis causing them to become aware of what they don't have, which causes them to represent the lack of the thing, which, causes them to know what the thing is, and thus they learn about and gain access to phallus mojo in that imaginal route. I'm not sure this makes sense, but I kind of get it. Here, Lacan is playing with language, showing, in a sense, how the ability to create a language symbol to represent a thing gives people access to a form of power over that thing (and also a vulnerability to losing that thing), and how that language symbol "handle" can be arrived at either by way of a direct representation of a thing (e.g., a penis/phallus), or by an inversion of a representation of a lack of that thing. That part makes sense (and this playfulness with 'things being there because they are not there' sort of thing seems to be a constant aspect of Lacan's work), but the incessant sexualization of this whole symbolic process seems quite unnecessary and counterproductive to my (American) mind. I don't see why involving penises in a discussion of the development of a mature and autonomous self-concept helps clarify things.
As should be clear by now, one of Lacan's major contributions to psychoanalysis was his borrowing of concepts from Linguistics and integration of those language concepts into psychoanalysis. Moncayo asserts that Lacan's vision helps make clear how the mind and the sense of identity or ego that develops within the mind is shaped by the powers and limitations of language. Language involves the process of creating a symbol that exists in the imagination and associating that symbol with something that exists in the world, and then communicating this association to other people so that both people can talk about the symbol as shorthand for referring to the thing in the world itself and there is no need to go literally point at that thing. Language allows people to get a handle on and begin to manipulate things that they would otherwise be unaware of, such as the contents of their thoughts or which are otherwise intangible abstractions such as "freedom" and "liberty". However, just as the map of a place is not the same thing as the experience of actually being in that place, the use of language to represent a thing is not the same thing as that thing. Thus, Lacan divided experience into three parts: the real, the symbolic and the imaginary.
I'm probably going to define the distinctions between imaginary, symbolic and real incorrectly, but here goes anyway. Someone who knows better than I, please correct my mistakes. The imaginary is that which people can perceive. It is the realm of mental images and impressions. These things are not directly manipulable because in order to manipulate something mentally, it is first necessary to create a symbol to represent that thing. The symbolic realm is the realm of language, as language is system of symbols that people agree on having shared meanings. The things that are perceived in the imaginary realm (the perception realm), and which are later symbolized with language in the symbolic realm are things that exist in the "real" world. This appears to be Lacan's way of acknowledging and even emphasizing that the world is always ultimately somewhat mysterious and unknowable or inexpressible - that language takes us a long way beyond simple awareness of something, but language is not capable of representing the full thing that has been perceived. This is true of language used to describe a person's own emotions, and it is true of language used to describe the physical world. The real is what remains at the limits of what words and images can convey. Both images and words ultimately lack the power to represent actual real experience.
Moncayo asserts that the drive to symbolize things (to create language and images in the symbolic realm that represent perceptions in the imaginal realm) is triggered by the "symbolic intervention of the father". Keeping in mind that the "father" is not a literal man, but rather the agents of society (the super-ego forces to use Freud's way of thinking about it), he appears to be suggesting that social demands such as mom and dad's work schedule and the lack of daycare, and the like (and in cases of abuse, situations and absences that are far more demanding) cause infants to become frustrated and that this frustration is what drives them out of the initial state of identity fusion and into a differentiated identity state where they can begin to appreciate themselves as a distinct person among many. This development of subjective identity thus occurs as a result of the infant becoming aware of social rules and demands. This knowledge is incompatible with fusion and causes the fusion to break down and the birth of the independent differentiated sense of identity characteristic of older children and (with further development) of adults.
Lacan used language concepts to improve the process of doing therapy. He encouraged therapists to pay careful attention to various kinds of language, spoken, written and body language too (for instance, the appearance of body language suggesting that something has been suppressed). Lacan also encouraged therapists to try to differentiate between language that was connected to and expressive of unconscious desires and idle chatter that contained no real useful content. In this, he is not different than many other varieties of teachers of psychotherapy. You always want to teach students of therapy to develop their "bullshit detector" so as to know when someone is avoiding things or not connected to things and when they are connected and the work of addressing those things can proceed.
Dr. Van Nuys notes that Dr. Moncayo is interested in Zen Buddhist thought and asks about the relationship between Lacan and Zen. Dr. Moncayo responds that both Zen and Lacan were interested in the nature of the ego, and specifically the way that the ego is limited and incomplete and ultimately an illusion. He describes a paper he wrote recently that referenced the Zen idea of the "finger pointing at the moon". Here the finger is the symbol for the real thing. We (our egos) pay attention to the symbol but miss (and are incapable of fully appreciating by our very nature) that which has been symbolized. Lacan's vision for his therapy was that both analyst (therapist) and analysand (patient) would ultimately be able to experience a sort of constructive breakdown of ego functioning (e.g., the process of making and using symbols to represent things) which would allow each to "get out of their own way" and better appreciate things as they actually exist (I suppose). Lacan used fancy terms for this: "subjective destitution" in reference to the client, and "benevolent depersonalization" for the therapist.
Dr. Van Nuys wonders out loud whether it is possible to do Lacanian psychotherapy in the context of truly short term psychotherapy such as is potentially reimbursable via modern health care systems. Lacan's therapy ran for years, and modern therapy needs to run for months at most. Dr. Moncayo responds that basically you can do a briefer form of Lacanian psychotherapy with less disturbed, more functional patients and it works well, but that severely disturbed patients (e.g., such as those with severe personality disorders, or chronic, psychotic disorders) simply require long term treatment. Such severe patients can be treated via shorter psychoanalysis, but the result will be that the treatment effect will be shallower, and less resistant to relapse.
Dr. Van Nuys winds up the interview by asking Dr. Moncayo about the San Francisco based Lacanian School of Psychoanalysis where he is a training analyst. This school takes 2-3 students each year, who must enter already being licensed to do psychotherapy within their fields. There are about four years of coursework, and as well students must also participate in their own multi-year psychoanalysis with a supervising analyst, and as well, provide psychoanalysis to patients themselves under supervision. The school is careful to separate supervision and teaching roles so as to avoid conflicts of interest that have plagued other psychoanalytic institutes. People who are interested in Lacan and his ideas or the idea of themselves becoming a Lacanian psychoanalyst are encouraged to contact the school at the website address provided below.
- More information about Jacques Lacan and his approach to psychoanalysis and psychotherapy can be found at the Lacan School website available online at http://www.lacanschool.org . This website organizes entry points for the Lacan School of Psychoanalysis, the mailing list for the San Francisco Society for Lacanian Studies, The society's online journal, "The Other", and links to additional relevant resources.
- Training in the Lacanian approach to psychoanalysis and psychotherapy is available through the Lacanian School of Psychoanalysis, located in the San Francisco Bay Area.
- Dr. Moncayo's book, Evolving Lacanian Perspectives for Clinical Psychoanalysis: On Narcissism, Sexuation, and the Phases/Faces of Analysis in Contemporary Culture, is available through Amazon.com.
- It occurs to me (Mark Dombeck, Ph.D.) that much of Lacan's writings are concerned with identity development. People who are interested in explainations of identity development might also wish to read (and listen to) my essays on another difficult to understand author, Robert Kegan, who provides a neo-piagetian model for undersanding this interesting subject. There is much in common being described in both of these perspectives although the authors come at the problem from very different angles and have dissimilar backgrounds. As has been the case here, I also try to translate Kegan into plain English there.
About Raul Moncayo, Ph.D.
Raul Moncayo, Ph.D. is training director for Mission Mental Health, San Francisco under the Department of Public Health. He is a member of the Research Faculty at Alliant University (formerly The California School of Professional Psychology] and a Training Analyst at the Lacanian School of Psychoanalysis in Berkeley, California. He also has a private practice in which he provides Psychoanalytic psychotherapy, consultation, and supervision.
Please note: If you liked this interview and want to hear more from Dr. Moncayo, check out his second interview with Dr Van Nuys as part of the Shrink Rap Radio interview series located here.
Carfeul delineation of roles at the LSP? - - Aug 13th 2009
It is interesting to me that the caveat about clear delineation of roles is a value to the LSP, considering that the members of this school very flagarantly announce how they do NOT hold such clincial boundaries and in practice, wildly reproduce the problematic of conflcited interest or dual realtionship.
I am both surprised and pleased to hear this from Dr. Moncayo, but he should check in with the rest of his community to see if this is the perspective that is being circulated by other members.
Amazing! - Cecy Marin Psy.D - Mar 26th 2009
I had the pleasure (and luck) of being trained by Dr. Raul Moncayo at Mission Mental Health.. This interview is brilliant and should be continued. Lacanian theory has never made more sense; this has been the best explanation and "brief" introduction of this theory.
Congrats on the book Raul!
Dr. Maoncayo - younghee,lowrie - Feb 2nd 2009
Thank you so much for the interview and information. It is rare and wonderful to hear someoned break down Lacan so easily. It is also very inspiring that Dr. Moncayo uses Lacan in a public clinic. I would look forward to an interview from a Bionian. thanks again, Younghee
Best Dr. Dave Podcast Interview Ever !!!! - honeyrococo - Jan 23rd 2009
This was great! I could listen to Raul Moncayo all day long. I really hope you interview him in long-format for Shrink Rap Radio. More than once. So refreshing and substantive and smart!! I love Latino Continental Lacanian Americans!
Corrections and Clarifications - Raul Moncayo, Ph.D. - Jan 20th 2009
I found a number of mistakes and inaccuracies on how you describe and represent my ideas and those of Lacan.
By continental I did not mean continental Europe but continental America although the reference to continental Europe may also be inadvertently or indirectly correct.
I went to London to study with Laing and his followers but decided not to stay there. I met Michael Thompson who told me about similar efforts being carried out in the Bay Area. In my work with schizophrenics I did mostly individual and family not group therapy.
Wright Institute is psychoanalytically inclined but was also in the tradition of the Frankfurt school of critical theory.
I am Training Director for Mission Mental Health but also have a private practice of psychoanalysis in Berkeley. Luckily you do mention this at the end.
Freud’s original psychoanalysis did not emphasize the ego but the unconscious so this is incorrect. The ego is not masculine so this is also incorrect and I believe I don’t say this anywhere in the interview.
What I said was that Freud focused more on Oedipal structure which is organized around the father, whereas object relations focuses more the preoedipal which is organized around the mother.
Lacan says that the preoedipal is the first phase of Oedipal structure and therefore not outside of it. Lacan is not trying to be more masculine but in scanding or cutting the sessions he is articulating something of the paternal function that brings oedipal structure proper as well as the problem of sexual difference to the foreground of the treatment.
The function of the father is not so much to create independence but to facilitate the access to culture and what Lacan calls the symbolic order. The phallus does not primarily reflect power and authority but rather is a signifier of the mother’s desire, of that which the mother wants from the father and that the father appears to have. Within the imaginary register the father appears as having the phallus and the mother and child do not, whereas within the Symbolic register, and in actuality, the father does not have the symbolic phallus either, since its function is simply to produce difference and cultural exchange as such. The symbolic father is also subject to the function of symbolic castration by which all subjects become subjects of a culture. Castration represents the renunciations that culture imposes on the individual as well as how culture organizes the differences between the sexes. Loss of the imaginary phallus and failure in Oedipus is a necessary precondition of success within the culture and in relationships.
Because girls loose the imaginary phallus at the point of entry into oedipal structure (they don’t have what the father has), and if they accept this form of imaginary castration, then they have an easier time accepting social rules and the rules of language, and they therefore have access to the symbolic phallus, which now functions, yes as power and authority and as what is desirable to have within the culture. They are also able to desire and receive the imaginary phallus in a sexual relationship to a man (who could be a female with a dildo in some cases).
The boy thinks he has the imaginary phallus that the father has but then has to loose it. Otherwise he could win the oedipal struggle and stay stuck with his mother for life or to a narcissistic fixation to his imaginary phallus. The boy becomes a man in culture by loosing the imaginary phallus that his father is supposed to have and this gives him access to the symbolic phallus in culture and to his own now legitimized imaginary phallus in relationship to another women not his mother.
It is not that we are using an arbitrary sexualization of things to clarify anything but rather unconscious phenomena are being conceptualized that are actually discovered and revealed within the intimacy and confidentiality of the analytical situation. Sexual difference within Oedipal structure reveals how men and women are made in culture in relationship to the symbolization of the mother’s desire and the function of the father. It also helps explain how human sexuality is made within culture as an unconscious process and not simply as gender roles that are ideologically mandated by the culture.
Regarding Zen, the finger at first is not the real thing, the moon is the real thing that the signifier is pointing to. But in a second moment, or a different reading of Zen, the moon is also in the finger/signifier, or the Real is also within the symbolic, as the language of the unconscious, or as a special use of language to point to the unconscious or to what is beyond language.
You are reducing the subject to the ego, and Lacan to masculine identity formation, as if we were exercising our freedom or individual agency in making symbols to represent things. To the contrary, symbols make and represent us, and this is what constitutes a subject. However, when we become aware of this, that we are metaphors, then the agency of the ego is deconstructed, and the subject becomes an empty place within the symbolic (culture, language, tec.) which then yes has the power to transform the autonomy/agency of the symbolic structure.
With regards to the public clinic or treatment financed by private insurance, milder disorders can be treated with shorter forms of Lacanian analysis but this is a second best form of treatment given that people will remain prone to relapses in the long run. Yes severe disorders require long term treatment but given economic limitations, not only of the cost of treatment, but of the number of people that need to be treated, long term treatment consists of less frequent sessions that make the treatment even longer and the treatment is shallower and less resistant to relapse, as you say. Although "second best" practices should not be disguised as "best practices", they are certainly so much better than nothing.
Thanks - Dioni - Jan 16th 2009
Hi again Dr. Van Nuys,
Thank you for following through with that request! I really enjoyed the interview and I'm looking forward to reading Dr. Moncayo's book. I can also recommend to your listeners Bruce Fink's 'A Clinical Introduction to Lacanian Psychoanalysis'. I've read several books on Lacan and dabbled in a few of his well-known Seminars, but I haven't found anything as appropriate for the absolute beginner as that particular book by Dr. Fink. It's very accessible and presupposes no detailed knowledge of Western intellectual history. Thanks again for a great interview. I realize it takes two to tango (as I'm sure Dr. Moncayo knows from his time in Buenos Aires) and your questions were not only good ones, but also delivered with good timing.
Greeting from Boston!
Dioni (by the way, I'm a 'he'!)