Why Psychosis Is Not So Crazy / Lacan, Language, and Madness as Possibility with Stijn Vanheule

·55 min·5 clips

Lacan sees psychosis as an invasion of intimate space by a fundamental strangeness, not just a mismatch with reality.

The episode features an interview with Stijn Vanheule, a professor of clinical psychology and psychoanalysis at Ghent University and a Lacanian analyst. He discusses his book 'Why Psychosis Is Not So Crazy', published in 2024 by Other Press, which is written to be accessible to non-specialists like families and caregivers. Vanheule explains his motivation for writing the book: to impact how psychosis is treated clinically and perceived socially, moving beyond academic audiences. He critiques contemporary mental health care's focus on psychosis as a biological disease, arguing it minimizes listening to patients' experiences. Vanheule notes that antipsychotic medication is effective for only about 25% of patients, often causing side effects like numbed consciousness. He contrasts the psychiatric definition of psychosis—based on hallucinations, delusions, and behavioral changes—with the Lacanian perspective, which emphasizes the subjective experience of being invaded by a fundamental strangeness. Vanheule explains that psychosis often arises during life changes, such as between ages 15 and 25, due to triggering events. He delves into Lacanian theory, describing the three registers of mental life: the real (destabilizing intrusions), the symbolic (language and codes), and the imaginary (meaning-making). In psychosis, the symbolic system fails, leading to a confrontation with the real. Vanheule discusses how psychosis threatens subjectivity, as the 'other' (symbolic system) goes mad, causing feelings of disappearance and anxiety. He distinguishes neurotic identities, which involve distance and flux, from psychotic identifications, where people cannot separate from roles like being Christ. Vanheule links psychosis to sociological factors, such as stigma against minority groups, and cultural trends like irony and cynicism, which undermine symbolic systems. He advocates for psychoanalytic approaches that foster encounters and social bonds, rather than dismissing psychotic speech as nonsense. The conversation touches on artists like Yayoi Kusama and Annie Rogers, who use psychotic experiences creatively, showing psychosis can be an innovative force. Vanheule concludes that Lacan saw madness as expressing human freedom, though it is difficult to live with, and emphasizes the possibility of recovery and integration.

As heard by us

A humane, demanding conversation about psychosis, language, and meanings that can fail under pressure.

Psychosis is framed here as a confrontation with what Lacan calls the real, where ordinary meanings, language, and familiar signifiers can lose their grip.

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Want a Lacanian route into psychosis that keeps human warmth, hope, and recovery in view?

Read the full recommendation in PlayNext →

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