This book provides an introductory overview of key Lacanian psychoanalytic techniques for clinical practitioners, including listening skills, questioning patients, punctuating patient speech, dream interpretation, and understanding transference dynamics. The book examines techniques such as scansion, free association, phone analysis, and differentiating normalizing from non-normalizing analysis. The goal is to supplement existing literature on Lacanian analysis by exploring techniques through case examples and emphasizing that techniques must be tailored to individual patients and analysts.

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BOOK REVIEW
Bruce Fink (2007). Fundamentals of Psychoanalytic Technique: A Lacanian Approach for
Practitioners (New York and London: W. W. Norton & Company), ISBN 978-0-393-
70725-0
INTRODUCTION
This book is an introductory primer of psychoanalytic techniques. It is aimed mainly
at clinical practitioners but will be of use to those who are thinking about going into
analysis, training to become analysts, or are just interested in knowing what really
happens in the Lacanian clinic. Bruce Fink’s authorial intent is not to produce an
exhaustive volume of analytic techniques (assuming that can be done), but to
identify the most important techniques that he uses in his own practice as a Lacanian
analyst.1 Fink starts with a caveat; the usefulness of an analytic technique depends
on how well it is deployed in the clinic. Obviously, all analysts will try to
supplement the standard techniques of psychoanalysis with their own insights;
Fink’s intention is not to argue that his analytic techniques and insights will work for
all analysts. Nonetheless, his way of thinking about the techniques of analysis is a
good way to get started; and, as Fink reminds us at the very outset: ‘nothing works
with everyone.’ Every analyst must decide by trial-and-error what techniques work
for him and his patients. Fink also reminds us that these techniques are mainly used
in analysing neurotics and should not be used in treating psychotics (though he
takes up this challenge separately in the last chapter). Fink is conscious of the fact
that analysts usually work within the space afforded by their own schools of thought
and do not pretend to offer a model of treatment that can subsume all forms of
analysis; this is however neither possible nor necessary at the level of theory or
technique. Nonetheless an analytic technique that adds value or generates insights
can be used by an analyst of another school as well. Fink’s intent, to put it simply, is
to supplement what is available in the existing literature on analytic techniques. The
1 Readers of this book should also look up Bruce Fink (1996, 1997). A Clinical Introduction to
Lacanian Psychoanalysis (Cambridge and London: Harvard University Press).

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reason for doing so is that there is an increase in the number of analysts who
describe themselves as ‘Lacanians;’ and, furthermore, there is a discrepancy between
what is understood to be Lacanian theory by those who work with Lacanian texts
and those who work with books about Jacques Lacan. That is why (on a self-
reflective note), I alternate between reviewing books by Jacques Lacan and books on
Jacques Lacan; the reviewing strategy is an attempt to narrow the
misunderstandings that might otherwise be caused.
This difference bothers Fink not only because he is an analyst who must manage the
expectations of his patients, but also because he is a prolific translator of Lacanian
texts from the French. Each of the ten techniques that Fink identifies in this book has
a separate chapter, but he starts with listening skills.2 There is a good reason for this.
Lacanians believe that the best way to learn psychoanalysis is to start with what the
patients themselves have to teach them about the unconscious.
LACANIAN TECHNIQUES IN ANALYSIS
The clinical techniques in contention are the following: listening skills; asking
questions to keep the analysis going; learning to punctuate the discourse of the
patient; managing the process of scanding, interpreting what the patient says;
understanding the differences between dreams, daydreams, and fantasies; working-
through the transference and counter-transference; using the telephone to
supplement the analysis; deploying a non-normalizing model of analysis; and
learning to treat psychosis. In addition to explaining these techniques, Fink also
includes an afterword, bibliography, and an index to his text for readers who would
like to engage further with Lacanian psychoanalysis. What is common to many of
these skills, for Fink, is the importance of not falling prey to the imaginary. So while
all analysts start off with listening skills, they get deeply drawn into what the patient
is saying in the course of his analysis. When they do so, they should be led by the
patient’s unconscious without worrying about how much they understand at the
beginning of the analysis. The preoccupation with understanding is the wrong way
2 See, for instance, Serge Leclaire (1998). ‘On the Ear with Which One Ought to Listen,’
Psychoanalyzing: On the Order of the Unconscious and the Practice of the Letter, translated by
Peggy Kamuf (Stanford: Stanford University Press), pp. 1-16.

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to analyse a patient because it prompts the analyst to relate everything that happens
in the analysis to his own life and use himself as a model of what is right or wrong. 3
In other words, the analyst should not expect the patient to identify with him at the
end of analysis.4 This demand on the part of the analyst will bring the imaginary
dimension into the analysis making it difficult for the patient to make a transition to
the symbolic. Another important reason is that the relationship between ‘what’ the
patient is saying and ‘how’ he says it; both these dimensions matter and the analyst
should know when to invoke what is being said and when to invoke how it is being
said. The approach that is required in psychoanalysis is known as ‘free-floating
attention.’ In this approach, the analyst must not pay ‘too much attention’ or ‘too
little attention’ to any particular part of the patient’s speech because he cannot
anticipate the direction in which the patient’s unconscious will eventually direct his
speech. In other words, the analyst must resist the temptation to hear what he wants
to hear and let the patient have his say. While doing so however the patient’s
associations may not be adequate to keep the analysis going; in such cases, the
analyst must know how to ask questions that induce the desire of the patient to keep
going.
LACANIAN PUNCTUATION
The analyst must not forget that the patient does not really want to know how his
neurosis came about; nonetheless, the whole point of asking questions is to focus on
what constitutes causation in psychoanalysis; where, after all, is the patient’s
neurosis coming from? In addition to asking questions, the analyst must also
punctuate the speech of the patient. This process of punctuation involves being
attentive to sentence structure; a patient’s sentences may not be completed; it might,
for instance, ‘trail-off,’ or be ‘reconstructed’ by the patient in lieu of completing the
original sentence. The patient’s speech will also be full of disclaimers, forms of
negation, off-hand remarks, denials, and vary in emphasis in ways that may not be
related to what he is trying to say. In other words, it is not necessarily obvious as to
what the patient is saying until a certain modicum of punctuation has been
introduced by the analyst. The implications of punctuation can be taken even
further; so, for instance, the analyst might ‘scand’ the session at a point when
something significant is said by the patient. This is also known as the ‘variable
3 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.
4 See, for instance, Dylan Evans (1996). ‘End of Analysis,’ A Dictionary of Lacanian
Psychoanalysis (London and New York: Routledge), pp. 53-55.

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length session.’ This technique is used to get the patient to reflect on why the analyst
ended a session at a particular point and in order to generate insights in-between the
sessions. Fink refers to scansion as ‘an especially emphatic form of punctuation.’ It
should only be used with neurotics and not with psychotics since the latter require a
great level of empathy from the analyst. Fink points out that the analyst should try
to ‘reconstruct’ meaning with psychotics and ‘deconstruct’ meaning with neurotics
as a prelude to interpretation.
LACANIAN INTERPRETATION
The Lacanian model of interpretation then is not an attempt to understand in the
everyday sense of the term; it is rather the attempt to make a clinical intervention
(through punctuation or scansion) resonate in the patient’s unconscious. But, at the
same time, it should not become a form of ‘suggestion’ (a technique that is
acceptable in counselling, but not in analysis). That is why Lacanians avoid invoking
a ‘specific meaning’ and prefer to be ‘equivocal and polyvalent’ in their approach to
interpretation. Brevity is preferable to verbosity since it is not necessary to say a lot
in order to make an interpretation resonate in the unconscious. Another term that is
used to describe Lacanian interpretation is ‘oracular.’ What this means is that an
analyst must learn to speak like an oracle. Like Sigmund Freud, the Lacanians also take
the interpretation of dreams seriously.5 But dreams come in various forms; there are
also daydreams and fantasies that demand an analyst’s attention. The main
difference is that in conventional dreams the patient is asleep; but in daydreams and
fantasies the patient may not be asleep. The fascination with dreams is related to the
fact that (as analysts know only too well); the dream must not be ‘conflated’ with the
unconscious. But, nonetheless, it is easier to bring the repressed to the consciousness
of the patient more effectively through the interpretation of dreams than any other
method. Sigmund Freud was fond of pointing out that the best way to train to
become an analyst is to learn to interpret one’s own dreams.
THE DREAM-WORK
The formations of the dream work represent the basic mechanisms of the
unconscious. The better part of the work that goes into analysis happens within the
context of the dream. Furthermore, the layperson undergoing analysis will have to
be acquainted with the difference between the ‘manifest content’ and the ‘latent
content’ of dreams. It is only when the patient free-associates successfully with
fragments of the dream that it is possible to relate the manifest content to the
5 See Sigmund Freud (1899, 2006). Interpreting Dreams, translated by J. A. Underwood, with
an introduction by John Forrester (London: Penguin Books).

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underlying latent content in his unconscious.6 The ‘formations of the unconscious’
are also related to a theory of memory in psychoanalysis; this is because forgetting
could be symptomatic of the underlying repression in the patient’s psyche. What is
however common to dreams, daydreams, and fantasies is that they are all related to
a theory of wish-fulfilment. Needless to say, there is both a conscious and an
unconscious dimension to wishes; it is important to explore both in the analytic
situation. The importance of anxiety dreams and nightmares are also important: so,
for instance, the main task of dreams is to let the subject sleep on. However, if the
dream breaks through the barrier of repression; and it is not possible to adequately
disguise the wish-fulfilment that constitutes the dream from the dreamer, it becomes
necessary for the dreaming subject to wake up. In such instances, sleeping on is
more traumatic than waking up. The justification for working-through dreams,
daydreams, and fantasies is that it will become possible to identify ‘the fundamental
fantasy’ that constitutes the unconscious of the patient and ‘traverse’ it in analysis.
The success of the analysis depends on whether the patient was able to reconfigure
this fundamental fantasy and appreciate the forms of existential impossibility that it is
mediated by with a high level of maturity.
TRANSFERENTIAL DYNAMICS
Fink also explains the difference between the transference and the counter-
transference and the forms of analytic training that are required to manage these
manifestations of the unconscious in the Lacanian clinic. Every school of analysis has
its own model of the unconscious, but what they all share in common is the
empirical encounter with the transference in every single session of the analysis. The
transference is of great interest from both a theoretical and practical point of view.
Lacan relates transferential phenomena to ‘repetition’ and knowing how these terms
relate to teach other is an important part of knowing when the patient is projecting
and when he is just free-associating on the couch. The terms ‘transference’ and
‘repetition’ are also related to the task of ‘remembering and working-through’ since
the more the patient remembers and works-through, the less he will repeat in his
life.7 Lacan brings out the differences between the real, the imaginary, and the
symbolic to bear on his understanding of transferential phenomena like he does for
all aspects of psychoanalysis. So, just as the fundamental fantasy has to be
reconfigured at the end of analysis; likewise, the task of interpretation must attend to
6 See Jean Laplanche and Jean-Bertrand Pontalis (1973, 1988). ‘Dream-Work,’ translated by
Donald Nicholson-Smith, with an introduction by Daniel Lagache, The Language of
Psychoanalysis (London: Karnac Books), p. 125.
7 For the relationship between the terms ‘repetition’ and the ‘transference,’ see Jacques Lacan
(1973, 1979). ‘Of the Subject of Certainty,’ The Four Fundamental Concepts of Psychoanalysis,
translated by Alan Sheridan, edited by Jacques-Alain Miller (London: Penguin Books), p. 33.

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the transferential configurations at play in the analysis. That is however not
reducible to the distressing ‘affects’ suffered by the patient, but involves the
repetition of more ‘complex structures’ that are not obvious or conscious to the
patient.
FORMS OF THE TRANSFERENCE
The transference can take either the form of a positive transference or a negative
transference. The therapeutic response of the patient can again take a positive or a
negative cast. Extremely positive or negative transferences can be difficult to handle
given that the patient’s expectations might not correspond to what is possible or not
possible in analysis. The whole question of whether the analyst should refer to
transferential phenomena; or let the analysis simply run its course, is a question that
both theorists and clinical practitioners are fond of addressing. The Lacanian
approach is to let the analysis proceed to the extent it will and only address these
matters if the patient is not able to free-associate anymore. The importance of the
transference relates to the fact that the patient is most likely to ‘act-out’ repressed
conflicts when the transference is mishandled by the analyst. Lacanians also
differentiate between ‘acting-out’ and ‘passage to the act.’8 Both these dangers must
be avoided; that is why it is important for the analyst to have himself worked-
through his transference from the locus of a patient before being allowed to manage
a patient in analysis.
Fink cites Jacques-Alain Miller as arguing that a patient might suffer a negative
transference when there is a ‘lifting of the repression’ since it might be traumatic to
work-through the repressed contents of his unconscious. Learning to be an analyst
revolves around the challenges of managing the dynamics of the transference; this is
a point on which most schools of analysis will converge on. This is also the main
differentiator between those analysts who have a successful practice and those who
don’t (as opposed to how much they know about analysis).
8 For the differences between these terms, see ‘Acting-Out’ and ‘Passage to the Act’ in Dylan
Evans (1996). An Introductory Dictionary of Lacanian Psychoanalysis (London and New York:
Routledge), pp. 2-3 and pp. 136-137.

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INNOVATIONS IN ANALYSIS
Fink also explains a technique that is not commonly known; the use of the telephone
to supplement analyses if the patient or the analyst is forced to relocate and cannot
find a suitable substitute. This is a technique that Fink found himself using because
Americans have a high level of mobility; but, it is not a technique that is used
commonly outside the United States or even commonly there. I found out about this
technique for the first time in this book. The main difference between phone analysis
and having the patient on the couch is that the analyst cannot observe the patient’s
body language. That should however not be difficult for Lacanians since they are
more preoccupied with what the patient is actually willing to put into words rather
than focus on non-verbal expressions of thought and intention; this follows from
taking the idea of the ‘talking cure’ seriously. Fink has an open mind on this and
puts forth the possibility of phone analysis as an innovation; he is open to feedback
from other analysts on whether this is a practice that will catch on in the years to
come. The last of the techniques that Fink introduces before invoking psychosis in
the last chapter is the difference between ‘normalizing’ and ‘non-normalizing’ forms
of analysis. Lacanians points out that the normalizing approach is related to the
theory of adaptation in evolutionary biology. While this approach has been
incorporated into ego-psychology that is not the goal of Lacanian psychoanalysis.
That is because Lacanians do not expect the patient to identify with the analyst at the
end of the analysis since that would be to fall prey to the lure of the imaginary. It is
more important to let the patient find his own way without making any explicit
suggestions to him on what is right or wrong from an existential point of view. What
this means is that the patient will remain preoccupied with his ‘fundamental fantasy’
whether it concerns his gender or sexual identity; the patient cannot be told to stop
brooding about death or his symptoms and just get on with it.
LACAN ON PSYCHOSIS
And, finally, Fink considers how useful Lacanian psychoanalysis is in treating
psychosis and how it relates to the basic forms of the psychoses (as they appear in
the psychiatric clinic). The main symptom of psychosis is ‘paranoia’ and the danger
there is that the analyst and the patient will get drawn into the imaginary. Lacanians
do not go out of their way to treat psychotics; but there are instances where what
starts as a neurosis becomes a psychosis and they feel a sense of moral responsibility
to do something; or there are cases where they feel that they can make a difference.
As pointed out previously, most of the analytic techniques explained above are not
meant to be used for psychotics. The main Lacanian preoccupation is not whether
the psychotics’ world-view corresponds to reality as everybody understands it, but
whether or not it is possible to identify the specific causal mechanism that triggers
off a psychosis; this mechanism is known to analysts as the ‘foreclosure of the name-

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of-the-father.’ The main diagnostic tool that Lacanians use is to examine how
psychotics relate to the structure of language rather than reality. Most of the research
on psychosis is about how psychotics use language as opposed to neurotics. An
interesting finding is that psychotics cannot produce metaphors in the way neurotics
do.
CONCLUSION
Furthermore, psychotics do not have an unconscious in the way that neurotics do
and are not subject to primary repression; so, unlike neurotics, they do not have any
secrets to hide. Psychotics are subject to paranoia and do not have a sense of irony;
that is, they do not understand the sematic difference between what is said and what
is meant. Irony is the literary expression or the foregrounding of the gap between what is
said and what is meant. Psychotics also have difficulty in differentiating between
language and reality and treat words as though they were things. That is why being
attentive to the form in which patients express themselves is of great use in making a
diagnosis. The neurotic subject is more likely to believe in the locus of the symbolic
Other than the psychotic and is much more susceptible to the transference in a
clinical situation. Lacan was fond of pointing out that what the psychotic demands is
not a ‘subject presumed to know,’ but a witness to his suffering. That is why a
psychotic is less likely to attribute knowledge to the analyst in the locus of the
symbolic Other; and is more prone to hallucinations, hearing voices, and delusions
than neurotics. Any therapeutic engagement with a psychotic then is bound to be
protracted for the analyst; Lacanians should only take on psychotics with a full
knowledge of the implications of doing so.
Fink concludes his analysis of what Lacanian psychoanalysis can do for psychotics
by citing Jacques-Alain Miller who points out that ‘when faced with someone who is
insane and delusional, do not forget that you too are or were once an analysand and
that you too spoke about what does not exist.’ That is why empathy is more
important in dealing with psychotics than with neurotics and the analytic techniques
described in this book should be used carefully. And while it is important to read
books like this on and by Jacques Lacan, it is important to start by reading Sigmund

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Freud. As Jacques Lacan was fond of reminding his fellow clinicians, ‘reading Freud
in itself trains us.’ It is to that form of analytic training then that Bruce Fink has
dedicated himself as a theorist and as a practitioner of Lacanian psychoanalysis. This
book should go a long way in helping us to appreciate exactly what that type of
dedication demands in the life and career of a Lacanian psychoanalyst.
SHIVA KUMAR SRINIVASAN