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BOOK REVIEW
Bruce Fink (1997). A Clinical Introduction to Lacanian Psychoanalysis: Theory and
Technique (Cambridge and London: Harvard University Press).
INTRODUCTION
Bruce Fink is a well-known Lacanian analyst in the United States; he was trained at
the Ecole de la Cause Freudienne at the University of Paris VIII at Sainte Denis
during the period 1983-89. Fink draws mainly upon the teaching of Jacques-Alain
Miller and Colette Soler in this book; Fink has attended Miller’s weekly seminar in
psychoanalysis in Paris (which provides an orientation to the Lacanian field) for a
number of years. Fink has also translated a number of Lacanian texts including his
Écrits and seminars. I emphasize this at the outset because as Jacques Lacan was
fond of pointing out, his main preoccupation was with training the next generation
of analysts. Fink is both a theorist and a practitioner of Lacanian psychoanalysis at
Pittsburgh where he teaches at Duquesne University; so, appreciating Fink’s own
professional background will help the reader to identify his authorial intent more
clearly. As Fink points out in the preface to this book, the clinical dimensions of
Lacanian theory are not well-known; his intent in writing a comprehensive
introduction to Lacanian psychoanalysis is to ‘rectify that situation.’ This book will
be useful to both Lacanians and clinicians from other orientations who want an
exposure to the work of Jacques Lacan either because they want to become
Lacanians or because they want to learn from him. Fink has therefore written a book
that explains both the theory and practice of Lacanian psychoanalysis; he does not
hesitate to talk about the controversies that attend to the Lacanian clinic either.
THE AUTHORIAL INTENT
This book will also be useful to scholars in the humanities who want to think about
the differences between using Lacan to read literary texts and using Lacan in a
clinical situation. Fink’s straight-forward approach to Lacan will make it possible for
even those without any previous exposure to read Lacan for the first time. In

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addition to his exposition of Lacanian theory and practice, Fink provides elaborate
notes, an index, and a thematic bibliography. These are extremely useful tools that
will serve the reader well even after he has read this book and wants to get more
closely involved with the Lacanian field. There are three main parts in the text. The
first part is titled ‘Desire and Analytic Technique’ and consists of five chapters; the
second part is titled ‘Diagnosis and the Positioning of the Analyst’ and consists of
four chapters; the third part is titled ‘Psychoanalytic Technique Beyond Desire,’ and
consists of one chapter. The main topics covered in the first part include the theory
of desire; the role that desire plays in keeping an analysis going; the right way to
engage patients in analysis (depending on whether they are neurotic, psychotic or
phobic); the transferential dynamics of the relationship between the analyst and the
patient; the forms of interpretation that can be termed ‘psychoanalytic’; and the
dialectical model of desire. The topics covered in the second part explain what is at
stake in the Lacanian approach to diagnosis and what the differences are between
psychosis, neurosis, and the perversions. The main thematic concern in the third part
is to differentiate between a theory of desire and a theory of jouissance. In the
afterword, Fink emphasizes the need to both hold on to and critique a structuralist
approach to psychoanalysis; he refers to this approach as ‘Gödelian structuralism.’
Understanding the limits of structuralism then is not an attempt to do away with the
notion of structure altogether; it is instead to be conceived as a way of identifying its
theoretical limits. Lacan had a long career as a clinician; the period of Lacan’s work
that Fink is describing here relates to the work done in the 1960s and 1970s.
THE LACANIAN SYMPTOM
The first question that Fink poses in this book is about how the patient relates to his
symptoms. What is it that the patient really wants in analysis? Is it really the case
that he wants to be relieved of his symptoms? Or, is it rather the case that the
symptom has ceased to be a source of ‘substitute satisfaction?’ Furthermore, what is
the difference between the patient who wants to just be relieved of his symptoms as
opposed to a patient who wants a full-fledged analysis? If the patient wants the
latter, then, it means he is responsive in the way that relates to the desire of the
analyst. In any case, whether or not the analyst can relieve the patient of his
symptoms depends on whether it is possible to relate the relationship between the
patient’s symptoms and the underlying fantasy that constitutes the structure of his
neurosis as such. The main difference then between psychoanalysis and less intense
forms of psychotherapy is that analysts do not think that it is worth intervening at
the level of the symptom since the affective charge of the symptom can be displaced
onto other symptoms. In other words, symptoms are interconnected; the meaning
that can be attributed to a symptom depends on whether it emerges in the context of
a neurosis, psychosis or a perversion. Furthermore, even within a neurosis, the same

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symptom might occur both within hysteria and obsessional states. It is therefore
important not to take a reductive approach to the interpretation of symptoms; the
theoretical safeguards in place require that a theory of the symptom should be
accompanied by a theory of fantasy and a theory of clinical structure. That is the first
lesson that non-Lacanian practitioners will get out of this book. Lacanian clinicians
do not ask patients to fill out a form in order to situate them within a diagnostic
model or do a frequency analysis of a symptom that will take the symptom out of
the context in which it appears for a patient. Furthermore, they prefer to interrupt
the symptom rather than interpret the symptom; this process of interrupting the
symptom is known technically as ‘scanding’; or, more informally, as ‘punctuation.’
PRECIPITATING THE FANTASY
The basic technique that is used for ‘precipitating the fantasy’ that accompanies the
symptom is the use of the variable session where the patient cannot use fillers to
spend the duration of the analytic hour on the couch since he cannot anticipate how
long a session will last. When the analyst ends a session, he tries to do so in a way
that will prompt the patient to ask why the analyst chose to cut the session in the
way in which he did. A great deal of Lacanian analysis happens then ‘in-between
sessions’ and not within the duration of a particular session. The variable session
ensures that the patient does not take a ‘routine’ approach to analysis; and works on
it in a way that is worthy of the effort. If an analyst takes the variable approach
seriously, it will affect all aspects of how he engages with the patient including the
patient’s propensity to make a demand, how regular he is in attending sessions,
making payments, and whether he expects the analyst to re-schedule his sessions at
short notice. It also has implications for the Lacanian model of interpretation since
an oracular approach is more likely to resonate in the patient’s unconscious between
sessions than a reductive approach. The patient begins to really engage in the
analysis mainly when he wonders who is speaking through him or for whom he is
saying what he is saying on the couch. The patient must then come to terms with the
fact that things are not what he thought them to be; there is a lot more to his
unconscious than he thought to be the case when the analysis began. That is what
the dialectical approach to psychoanalysis is all about; it is experienced by the
patient as a loss of the fixation that constituted the structure of his propensity to
make a demand; the patient is now able to think through possibilities which he had
hitherto denied himself in the attempt to remain consistent.
SUBJECT PRESUMED TO KNOW
Another important aspect of Lacanian interpretation is the need to avoid making
suggestions and get the patient to take responsibility for his decisions; needless to
say, patients must not take important decisions while in analysis. This may not

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always be possible given the length of the treatment; that is why analysts must be
careful not to tell the patient what he must do in any given situation since
psychoanalysis is not a form of counselling. The motor force of analysis is however
the transferential assumption that the analyst is the ‘subject presumed to know’ the
truth of the patient’s desire. If the patient’s free-associations are based on this
assumption, he is said to have a positive transference; if that is not the case, the
patient is said to be having a negative transference. The analyst must also watch out
for forms of therapeutic reaction; excessively positive or negative therapeutic
reactions might lead the patient to drop out of analysis in the near future. The
patient might either decide that he does not need analysis because he finds that his
symptoms are less painful than before or because his expectations are more than can
be addressed through analysis; Lacan elsewhere refers to this as the ‘demand for
happiness.’1 What the patient may not know is that analysis cannot make him
happy; it can at best reduce a situation of ‘neurotic misery to common unhappiness.’
The success of the analysis also depends on whether the patient can accept an
asymmetrical relationship with the analyst; the patient must come to terms with the
fact that he is in a relationship like no other. The analyst ceases to be just another
person and soon begins to embody the locus of the symbolic Other. In other words,
analysis is not based on the social model of reciprocity where friends do favours for
each other.
SUBJECTIFICATION IN ANALYSIS
The strength to persist in the analysis is a lot more than the patient may realize given
that he is not used to asymmetrical relationships in the context of everyday life. This
is symbolized by the fact that the patient has to do all the talking; and everything
that the patient says to the analyst has implications for the state of the transference.
How the patient relates to the analyst is itself an indication of how he relates to the
symbolic. The patient must resist the temptation to locate the analyst in the locus of
the Imaginary that constitutes relations between rivals. The aim of the analysis then
can be defined as a modification of how the subject relates to the symbolic order as
such. This requires a patient working-through of any number of projections and
counter-projections that constitute the transference and the counter-transference in
the analytic situation. It is important to remember that unlike an analytic
interpretation of a text, the clinical interpretation is not meant to be easily
understood; it is supposed to resonate in the patient’s unconscious. Fink cites Lacan
as saying that ‘an interpretation whose effects one understands is not a
1 See Jacques Lacan (1992). ‘The Demand for Happiness and the Promise of Analysis,’ The
Seminar of Jacques Lacan: 1959-1960, The Ethics of Psychoanalysis, translated by Dennis Porter,
edited by Jacques-Alain Miller (Tavistock/Routledge), pp. 291-301.

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psychoanalytic interpretation.’2 This does not mean that an interpretation cannot be
understood; what it really means is ‘that an interpretation plays off ambiguities in its
very formulation.’ The trajectory of analysis is, as Miller puts it, ‘to drain the real
into the symbolic’ – i.e. to get the patient to work-through the affects that might have
coagulated into the symptom and ‘subjectify’ the desire of the Other.
‘Subjectification’ is the process whereby the opposition between the desire of the
subject and the desire of the Other is deconstructed in analysis; the patient takes
responsibility for his desire even though it arises in the locus of the Other. The main
challenge here is to realize that desire is not reducible to a particular object; the main
object of desire is desire itself; or, to put it simply, desire is self-reflexive.
THE TRAJECTORY OF ANALYSIS
Fink also explains that the existential task that must be taken up by the subject is to
not only relate himself to the desire of the Other; but to work through, and separate
from the desire of the Other if there is a form of libidinal ‘fixation’ that serves as the
cause of the neurosis. This fixation is at the root of the ‘fundamental fantasy’; the
purpose of analysis to reconfigure this fundamental fantasy. If this can be done, the
analysis is defined as ‘terminable’ and the patient will eventually get around to
‘separating’ from the analyst. Fink also differentiates between the trajectories of
analyses based on whether the patient is being treated for a neurosis, psychosis, or a
phobia and identifies the causal mechanisms (repression, foreclosure, and
disavowal) that are responsible for it. In order to illustrate the role played by these
mechanisms and to give the reader a feel for the phenomenology of the Lacanian
clinic, Fink includes case studies from his own clinic and those of his supervisees.
Fink also describes symptoms like hallucinations, linguistic disturbances, the
psychotic’s inability to generate metaphors, the function of doubts in the neuroses,
and the pathological consequences that ensue when the symbolic is unable to
‘overwrite the imaginary.’ The Lacanian interpretation of the Oedipus complex in
the neuroses and psychosis is also explained; the main differences in pathological
states is situated in terms of Lacanian terms like ‘the-name-of-the-father,’ the no of
the father, the function of paternal triangulation, etc.
TRAVERSING THE FANTASY
The fixation of the subject’s fundamental fantasy within the context of the Oedipus
complex is common to both Lacanian and other forms of psychoanalysis though the
exact interpretation varies according to the schema in use. Other psychic
2 See also Bruce Fink’s recent work on this theme. Bruce Fink (2014). Against Understanding:
Commentary and Critique in a Lacanian Key, Vols. 1 & 2 (London and New York: Routledge).
For an introduction to the work of Bruce Fink, see Shiva Kumar Srinivasan, ‘What is the
Lacanian Field?’ Contemporary Psychoanalysis, Vol. 51, No. 1, 2015, pp. 155-175.

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mechanisms of interest include the role of interrupted sentences, the use of
neologisms, the lure of imaginary relations, the capacity to process jouissance,
feminization of the subject, etc. Fink also includes a number of cases including those
that illustrate the basic mechanisms in the neuroses and psychosis and differentiates
at length between hysteria and obsessional neurosis in terms of their fantasy
structure, relationship to the desire of the Other, jouissance, and the existential
questions on gender, sexuality, life, and death that animate them. Fink also situates
them within the context of Lacanian discourse theory which comprises those of the
hysteric, the analyst, the master, and the university. In addition to the neuroses, and
psychosis, Fink also analyses the structure of phobia and the perversions. The main
existential states at stake in these analyses are alienation, being, having, and
separation; the differences between sadism and masochism and how these
perversions relate to jouissance and the moral law. The end of analysis is defined as
traversing the fundamental fantasy where the patient de-supposes the analyst from
the locus of the subject presumed to know and experiences an emptying of his own
subjectivity; these are mechanisms that are not commonly known, understood, or
appreciated in most forms of psychoanalysis. This phase of traversing the fantasy is
also known as the death of death; the patient has to work-through the relationship
between sexuality and death and come to terms with the fact that sexuality has
hitherto functioned in his unconscious as a mask of death.3 And, finally, the subject
must make a transition from desire to jouissance; this is just another way of saying
that the final trajectory of analysis demands the ability to make a transition from the
Other to the Thing (i.e. from the realm of the possible to that of the impossible).
SHIVA KUMAR SRINIVASAN
3 See, for instance, Dylan Evans (1996). ‘End of Analysis,’ A Dictionary of Lacanian
Psychoanalysis (London and New York: Routledge), pp. 53-55.