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Jonathan Foiles LCSW
Jonathan Foiles LCSW

What a French Psychoanalyst Can Teach Us About Trauma

Jacques Lacan taught me how to listen to Robert.

In my first post I described the beginning of my work with Robert, a trauma survivor who believed that he was truly an African prince who had been kidnapped at birth by African Americans.

Blatterhin/Wikimedia Commons
Source: Blatterhin/Wikimedia Commons

Jacques Lacan is not a name that comes up often when treating survivors of trauma, but he should be. A leading French psychoanalyst who proposed a return to Freud, he gave yearly seminars in Paris from 1953 to 1981 in which he expounded upon his ideas. His writing is elliptical and dense with theoretical formulations rendered in his own idiosyncratic vocabulary. While Lacan was a practicing psychoanalyst, in the United States his work initially received greater acclaim among critical theorists and other academicians. That has begun to change recently thanks to the work of a few insightful interpreters.

During my fellowship at the Chicago Center for Psychoanalysis, a colleague recommended Annie Rogers’ The Unsayable to me in light of my work with trauma survivors. Rogers, a clinical psychologist who treats children who have experienced trauma, writes movingly of her own traumatic childhood as well as her work, focusing in particular on her treatment of a girl she calls Ellen. Ellen was repeatedly molested by a next door neighbor as a child, and when she first presents for treatment she cannot speak of it, cannot speak of much at all. Through the course of their work Rogers helps her find her voice, rendered most beautifully through her cello. Rogers dives into Lacan’s work through the course of Ellen’s treatment and finds in him a way to help Ellen make sense of herself and move forward.

Lacan’s most fundamental concept is that we are born into language, and it is language which structures both our conscious and unconscious thoughts. Language shapes the way that we experience and make sense of our world: “it is the world of words that creates the world of things.” In a sense this immersion in language can be traumatic; even those who have not experienced trauma per se are marked by the inability to fully articulate their hidden wishes and desires. Lacan taught Rogers a new way of listening to Ellen, one in which she paid attention to the ways in which her unconscious leaked out of her conscious through various signifiers: slips of the tongue, repeating words or phrases, dreams.

Lacan believes that all people share one of three fundamental psychological structures: the neurotic, the pervert, and the psychotic (the terms are deeply dated, but bear with me). For Lacan, fathers and father figures play an important role in the infant’s development in that they prevent the infant and the mother from becoming completely enmeshed and introduce the outside world which helps the infant develop their own subjectivity. For those with a psychotic structure, this fails to happen; they remain undifferentiated and unaccustomed to the world at large because it has not impinged upon them with its demands and its ways of making meaning. Those with a psychotic structure are placed outside of language, of meaning itself, and attempt to form their own meaning. The goal of treatment, then, is to help the patient develop their own sense of meaning and way of understanding the world. As Lacanian psychoanalyst Bruce Fink says, “delusional activity, when it is allowed to run its course rather than being silenced by a therapist’s intervention, eventually leads -- and this process may well take years -- to the construction of what Lacan calls a ‘delusional metaphor,’ a new starting point on the basis of which the psychotic establishes the meaning of the world and everything in it.”

Encountering the work of Lacan through his able interpreters Annie Rogers and Bruce Fink caused a radical shift in my work with Robert. I now see my earlier efforts in his treatment as an attempt to make sense of Robert’s story based upon my own preconceived notions. These efforts proved to be largely futile because we did not share the same language. Lacan’s thoughts on psychosis caused me to interpret less and to listen more.

By listening more I grew to a better understanding of Robert’s story. When he talked about witnessing his captors kill and eat children, I heard not only the terror in his account but also the unsayable of wondering how people related to him could seek to ‘consume’ him whole. When he described them taping rats to his body and forcing him to go to school, I heard the shame of being dirty, of being in need of basic parental care, and being ignored. When faced with caregivers such as these, it makes sense that Robert could think that they couldn’t possibly be related to him and that there was someone out there who had given him a name and a birthright. I also heard Robert’s attempts to make sense of his story, to have it recognized by someone else. In the last few months of our work together, he was engaged in a search to obtain his correct birth certificate that would prove he was who he said he was. I helped him describe why this search was so important to him, and by suggesting that his search may not end in success for any number of reasons, I guided him through alternative responses as he realized his life had meaning and worth even if his search wasn’t fruitful.

Kaique Rocha/Pexels
Source: Kaique Rocha/Pexels

Robert’s symptoms began to decline over the course of our work together. He used breathing techniques and meditation to reduce his arousal. He began sleeping better. Although his beliefs about African Americans did not really go away, he began to talk about them much less frequently as he felt safe and less threatened by the presence of others. After a few years our work together had to end due to insurance issues, an unfortunate reality of community mental health. In one of our last sessions he described a recent walk through a park near his house. There was nothing remarkable about the day or time, but as he meandered through he suddenly felt present to his life in a way that he had not before. He sat down on a bench and spent hours there, listening to the ambient noise, feeling the sun upon his skin, enjoying the greenery. In itself this may not seem remarkable, but as we processed this both of us realized that he had finally become present to his experience in the moment in a way that he never had before. He had created his own way of being in the world, and that made him feel safe to stop and enjoy the sunshine.


Rogers, A. (2006). The Unsayable: The Hidden Language of Trauma. New York, NY: Ballantine Books.

Fink, B. (1997). A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique. Cambridge, MA: Harvard University Press.

About the Author
Jonathan Foiles LCSW

Jonathan Foiles, LCSW, is a therapist who works at a community mental health clinic in Chicago.

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