The Psychoanalysis of AIDS

Author(s): Tim Dean

Source: October , Winter, 1993, Vol. 63 (Winter, 1993), pp. 83-116
Published by: The MIT Press

Stable URL: https://www.jstor.org/stable/778866

REFERENCES
Linked references are available on JSTOR for this article:
https://www.jstor.org/stable/778866?seq=1&cid=pdf-
reference#references_tab_contents
You may need to log in to JSTOR to access the linked references.

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide
range of content in a trusted digital archive. We use information technology and tools to increase productivity and
facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected].

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at
https://about.jstor.org/terms

The MIT Press is collaborating with JSTOR to digitize, preserve and extend access to October

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS*

TIM DEAN

Would it not be better to give death the place

in reality and in our thoughts which is its
due, and to give a little more prominence to
the unconscious attitude towards death which
we have hitherto so carefully suppressed?

-Sigmund Freud, "Thoughts for the

Times on War and Death," 1915

The Scope of AIDS

Twice as many Americans were killed by AIDS in the first nine years of
the epidemic (June 1981 to June 1990) as were claimed as casualties in the nine
years (1964-73) of the Vietnam War. As I write this in the summer of 1991,
after a full decade of the epidemic, over 110,000 Americans have died as a
consequence of AIDS, and at least one million more are thought to be infected
with HIV. Within another year it is expected that the number of American
AIDS deaths will be almost double last year's figure. These statistics, including
the projection that in less than another decade from now forty million people
worldwide will be infected with HIV, achieve the philosophical status of Kant's
mathematical sublime: they are so extensive as to be unthinkable. What can
psychoanalysis, which works on the human subject in his or her particularity,
say or do in the face of such epidemic dimensions?
Because psychoanalysis addresses itself to the subject of speech, it recog-
nizes that every body, including the sick body, is caught in a network of signifiers,
a network that mortifies all bodies by precluding access to either one's own
jouissance or any knowledge of the body outside of symbolic structures. Thus

* This paper has benefited from suggestions made by Dan Buccino, Chris Lane, Tova Perl-
mutter, Suzanne Yang, and especially from Jason Friedman's close attention.

OCTOBER 63, Winter 1993. C 1993

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 84 OCTOBER

insofar as AID
body, it also
renders AIDS
makes AIDS a
tion is that n
of psychic pr
investigation
ical question o
Yet AIDS is
cannot remain
proceeds from
-as has largely
construction
Beyond the ef
to diagnose m
to AIDS, this
homosexual d
subject of th
associated wi
internal sourc
the politically
sition is fram
distinct from
themselves,"
phenomena of
gay people an
while also rev
cursivity for

The

My first the
acknowledging
AIDS) insofar
real of the so
as the discour
repressed as s
is encountere

1. See Cindy Pa
Desire: Pornograp
the essays collect
MIT Press, 1988).

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 85

a society that refuses to admit a signifie

according to the structure by which we
approach the paradoxical formulation
spection, by considering what is at sta
society on the basis of a psychoanalytica
Although any psychoanalysis of society
the analogical relation is far more compl
by the conservative reduction of the soc
alytical unit such as the family, the ind
may suppose that psychic elements and
although never directly or homologica
politics, neither the psychic nor the so
because neither one wholly or unidirecti
for psychoanalysis to gain conceptual lev
portant to acknowledge the epistemologi
ysis and to insist, along with Jacquelin
cannot "continue to be analyzed as if it w
as if it operated outside the range of the
The initial model through which I pro
to AIDS is that of the Lacanian theory o
1959 icrit on the topic, Lacan makes pro
analogy," for the concept of social psych
seems pertinent in relation to AIDS be
characterizes psychosis as a defense aga
such post-Freudian orthodoxy that Lacan
the extent that his "On a Question Prelim
Psychosis" follows Ida Macalpine's relegat
logical level of causal determinant to t
(190).5 The designation of homosexuality
of psychosis is not necessarily to be con
this designation is concomitant with Lac
away from the facile understanding o
reality defined in practice as heterose

2. See Joan Copjec, "Cutting Up," in Between Fe

(New York: Routledge, 1989), pp. 227-46, for a c
psychic and social as linked by the Lacanian real an
3. Jacqueline Rose, "Margaret Thatcher and Ruth
4. Jacques Lacan, "On a Question Preliminary to
A Selection, trans. Alan Sheridan (New York: Norto
give pagination in main text.
5. I am using the term "symptom" here in the s
the classically Freudian sense, which understands
been translated into a nonlinguistic register. This
Lacan's later 1970s concept (see note 11 below).

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 86 OCTOBER

against homo
relation of m
adaptive psy
patible with
authorize the
compatibility
of an adequat
(216). Social
heterosexual,
subject is lack
the-Father. C
a reality from
psychosis is
sufficient distance has not been obtained.6
Psychosis names a primordial disturbance of the subject's relation to lan-
guage such that the paternal metaphor, which signifies castration, does not
become part of the subject's symbolic universe because it is foreclosed from the
Other and therefore from the unconscious. Lacan summarizes thus: "It is in an
accident in this register and in what takes place in it, namely, the foreclosure
of the Name-of-the-Father in the place of the Other, and in the failure of the
paternal metaphor, that I designate the defect that gives psychosis its essential
condition, and the structure that separates it from neurosis" (215). Because
"foreclosure" (forclusion), which is Lacan's translation of the Freudian term
Verwerfung (also translatable as "rejection," "repudiation," or "exclusion"), is
distinct from repression, a structural-as opposed to phenomenal-distinction
exists between neurosis and psychosis. This distinction invalidates the diagnostic
category of the "borderline" patient (and thus points to one of many important
differences between Lacan and Kristeva, for whom the "borderline" category is
central). In contrast to the neurotic subject, who experiences a return of the
repressed in the symbolic (the discourse of the Other), the psychotic subject
experiences a return in the real of what has been foreclosed of the symbolic.
How is American society psychotic about AIDS? Recall that the S in the
acronym AIDS stands not for "signifier" but for "syndrome," and that therefore
AIDS is to be understood not as a specific disease (it is not in itself contagious
or communicable) but rather as a condition of the body, an index of the body's
vulnerability to disease, to its surround, and to itself. The analogy of socia
psychosis enables us to understand AIDS as a condition of the body politic, an

6. To this distinction between reality as norm-to which Lacan says our only access is
imaginary-and the traumatic real (to which we have neither imaginary nor symbolic access an
which is governed by the death drive) should be added the differential of Freud's "psychic reality"
(which is governed by the pleasure principle and therefore immune to the claims of external
empirical reality): Lacan's real is quite different from both.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 87

index of the socialized body of the Amer

signifiers that renders it vulnerable to AID
signifier for AIDS, it faces the prospect th
will return in the real. By persistently rep
population" that remains largely immun
pushes AIDS-and the social groups seen as
of its psychic and social economies, treating
City, for example, 13,000 PWAs have been
less by a sociopolitical system that refuses
cost-effective than treatment," said George B
Following such a lead, emphasis has been
shit?), but on identifying the "outside" (calls
it may be excluded all the more thorough
persons who test positive for HIV). Howev
ecrit, "It is not his rags, but the very being
among the waste matter in which his first

7. See Michael Fumento, The Myth of Heterosexual

concludes (pp. 326-31) that to the extent that an insu
dying from AIDS, too much federal money is being
As Simon Watney, among others, has argued, the noti
obtains as its corollary the notion of a "disposable p
p. 135). This argument is developed with respect to W
"Missionary Positions: AIDS, 'Africa,' and Race," Differ
respect to cultural representations of "the family" in
(Winter 1987), pp. 71-86. In more recent essays Watn
of inverting its categories: the general population's sel
threatens it with extinction. See Watney, "Psychoanalys
Gay Politics and Culture, ed. Simon Shepherd and M
pp. 22-38: "For centuries homophobia has hurt and
that it is turning back on heterosexuals themselves, in
the reality of HIV disease. At this moment in time
epidemic among heterosexuals, unless they can ident
homophobia. That is the underlying tragedy of AIDS
seem totally unable to comprehend" (37).
8. This figure, like other statistics in this essay, wa
of Plague: 110,530 Deaths ... and Counting," The Advo
piece was the primary inspiration for writing this essa
approximate. ACT UP's PWA Housing Committee est
City in Spring 1989; the projected estimate for 1991
Graphics, ed. Douglas Crimp and Adam Rolston (Seat
note that these statistics reflect not so much the expo
indulge in unsafe sex and drug practices as the system
identified as HIV-positive in terms of housing, employ
9. Crimp and Rolston, eds., AIDS Demo Graphics, p
10. Lacan leaves the reader in no doubt that he is ta
poking fun at analysts for whom "the anal phase" is m
good to see the analyst's face if the patient suddenly
(225). To complete the quotation about the subject's bein
an early adumbration of the concept of object a: "It is

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 88 OCTOBER

here is not o
but concerns
sulating Laca
more than a
where it thin
excludes. AID
AIDS current
To fully arg
nuities of La
periodization
quoting, "On
supposedly r
Les Psychose
first publica
differ signif
the Name-of-the-Father remains unformulated in the Third Seminar, and is
hardly even implied in the earlier parts of the seminar from which Lacan's
headnote claims the 6crit derives. Conversely, the familiar maxim that "what is
foreclosed in the symbolic returns in the real," which is repeated in the seminar,

takes up its position among the waste matter in which his first frolics occur, much as the law of
symbolization in which his desire must operate catches him in its net by the position of the part-
object in which he offers himself on arrival in the world, in a world in which the desire of the
Other lays down the law." The relation between the analyst and the turd as object a is prefigured
early in the Third Seminar, in which Lacan proposes another 'justifiable" analogy, this time between
the analyst and a dipotoir-a container for night soil, a kind of cesspit (Le Seminaire livre III: Les
Psychoses (1955-1956), ed. Jacques-Alain Miller [Paris: Seuil, 1981], p. 39). As object a in the
transference, it is this impossible place that the analyst must occupy.
11. The etymological link between "symptom" and "syndrome" reinforces the implications of
the notion of a social "symptom": in a profound way, AIDS names the condition of contemporary
American society. I should perhaps add that my use of the term "symptom" at this point accords
with Lacan's later, more radical conceptualization of the symptom as sinthome, the "fourth order,"
which grounds the ternary orders of imaginary, symbolic, and real in their Borromean structure,
thereby giving consistency to the subject's being through jouissance (see Jacques Lacan, "Les paroles
imposees" [Legon du seminaire Le sinthome], ed. Jacques-Alain Miller, in Johann Listing, Introduction
d la topologie, trans. Claude Leger and Michael Turnheim [Paris: Navarin, 1989], pp. 83-91). Slavoj
2izek summarizes Lacan's development of the concept of the symptom in The Sublime Object of
Ideology (London: Verso, 1989), pp. 55-84.
12. Lacan himself contributes to such a periodization by referring, in "On a Question," to his
1932 psychiatric thesis, De la psychose paranoiaque dans ses rapports avec la personalitM, and commenting:
"An early study of paranoia led me thirty years ago to the threshold of psychoanalysis" (184). At
this juncture Lacan thus characterizes his own early work as "pre-Freud." I discuss the epistemology
of periodizing Lacan in "Historicizing Lacan?" Newsletter of the Freudian Field vol. 6, no. 1/2 (1992),
forthcoming.
13. It is the complete failure to consider this crucial discrepancy that mars the otherwise useful
account provided in Michael Walsh, "Reading the Real in the Seminar on the Psychoses," in Criticism
and Lacan: Essays and Dialogue on Language, Structure, and the Unconscious, ed. Patrick Colm Hogan
and Lalita Pandit (Athens: University of Georgia Press, 1990), pp. 64-83.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 89

is itself foreclosed from the forty-five-p

clusion and of the difference between th
the seminar and the icrit may be gras
tendency for psychotic hallucinations
exemplary psychotic patient, who hal
"Sow!"-poses a theoretical problem wit
cause the real is supposedly defined by i
lacks nothing precisely because it is wholl
phenomenon of verbal hallucination sugg
the discourse of the Other, which rathe
chosis and neurosis. To try to resolve thi
that the foreclosed returns in the symbo
real is, after all, partially symbolizable.
completely unnoticed, at least by Dimitr
indicates that this paradox concerns the
it is soluble by reference to "the evolu
Lacan."'5 The only addition I can make
the topic is to say that the paradoxes of
by reference to the evolution of the c
mental thesis that will end up revealing n
of a subject of the real.
The appeal to the real in the Third Sem
the hallucinatory phenomena encountere
more than an attempt to stress the radi
are experienced: a way of saying that ha
from outside. However, although not ex
exteriority is as much a property of the
the real, for alienation names the subject
a register of alterity that precedes, succe
in the Other therefore houses the "ou
distinction between the real and symbol
depends upon the difference between ex
of the seminar maxim ("what is foreclose
from the eicrit represents Lacan's acknow
distinction, thereby revealing the real n
subject of psychoanalysis, but also as a pr
Vergetis formulates the progress from
focusing on the subject's relation to the
question," 193]), rather than on the conc

14. Lacan, Les Psychoses, pp. 21-22.

15. Dimitris Vergetis, "Deux axiomatiques des p
64. Subsequent references provide pagination in m

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 90 OCTOBER

why the sem

of the Other
and the Nam
for forging t
that the late
because the o
of the subjec
(particularly
-this being th
than as subje
which "the s
definition th
"the Other s
implies the r
subject into
(which form
(hence the pr
and schema
precisely a c
subject: fro
characterizat
subject S (ne
Other O. Wh
which Verget
of speech in

16. The definiti

subject" is invok
and Psychoanaly
kins University
17. Vergetis, "D
Lacan himself a
analysis to elabo
"I am much mor
distinction betw
Eleventh Semina
the phraseology
seminar to desc
Concepts of Psyc
1979], pp. 44 an
The conceptual
noting the alter
dialectic based o
in Le transfert (
Other subject")
Le Siminaire liv
18. Lacan, "On a Question," p. 193.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 91

signifying chain thereby takes theoretic

of speech.
Crucial though these distinctions are,
acterization of schema L continues in th
of the schema over whose four corners
in "his ineffable, stupid existence" (194)
as descriptive rather than evaluative, sin
the subject as outside the symbolic (ho
interpret this primordial subject as presy
its inscription is formal and its mapp
Neither subject of speech nor of discours
is real (S rather than $). As Vergetis con
of the exclusion of the Other, for what
the subject himself" (63).
This concept of a primordially real sub
notion of an unconscious real (to whic
section), becomes more comprehensibl
tion of the real in "On a Question." My
Lacan's crucial and extensive reformulati
rather than reality has allowed his equ
the real to be obscured. Concluding h
"Sow!" reported by his psychotic patient
example here only to show in living, con
ization is not everything in the symbol.
real should be beyond question, it has on
in the form of a broken chain" (183). Th
course, the signifying chain, which is d
The locus of the signifying chain is the
the subject's being is real, for which reas
istent in, the Other. The subject as an
subject, a response to the trauma of bein
real is also the space of the subject: an
registers the strictly negative identity pr
lack of identity that renders identification
identify itself with a master signifier i
closed from the symbolic order.19 Beside
paradoxical subject of psychoanalysis can
porally, or even semiologically, and m
(Lacan's schemas are far from extraneou

19. See Slavoj Zizek, Looking Awry: An Introductio

bridge: MIT Press, 1991), p. 163.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 92 OCTOBER

reached the p
may be consid

The L

It is entirel
linguistic sys
view profoun
chosis. Yet in
theorize AIDS
"theory," cert
(tenaciously h
case for several reasons.
First, although psychoanalytic theory emphasizes the determining effects
of the signifier upon the human subject, it is also, as I will argue, the only
contemporary theory equipped with a rigorous concept of extradiscursivity.
However, the concept of object a, which represents a cause outside of-but not
preceding-language, has been almost universally lost in the Anglo-American
tendency to assimilate Lacan as merely one among many versions of French
structuralism or poststructuralism.
Second, the AIDS epidemic has been from its very beginning a source of
linguistic crisis: the rapid transformations of nomination, the proliferation of
acronyms, euphemisms, and metaphors, plus the birth of whole new social and
scientific discourses, together with the development of strategies of discursive
censorship, attest to a characteristically postmodern linguistic formation in
which language itself, let alone sex, seems "unsafe." The very term "AIDS"-
whose connotative ironies have become so naturalized that many of us find its
enunciation routine, while for others it remains so alarmingly new and volatile
that they find it impossible to let the term pass their lips-is mutating once
more: "HIV disease" seems to be establishing itself as the preferred, more
accurate term.21

20. See the widely disseminated cover article by Daniel Harris, "AIDS and Theory," Lingua
Franca 1 (June 1991), pp. 1, 16-19, which takes a thoroughly anti-intellectual, reactionary stance
in order to argue that any theorizing about AIDS is worse than useless. Harris's crude logic,
mobilized principally against what he conceives as the influence of deconstruction on ACT UP,
opposes thought to action, and argues for the latter at the expense of the former: a counsel to
thoughtless action.
21. On the case for renaming the syndrome "HIV disease," see Simon Watney, "Taking Liberties:
An Introduction," Taking Liberties: AIDS and Cultural Politics, ed. Erica Carter and Simon Watney
(London: Serpent's Tail, 1989), pp. 14-17. The independent, nonprofit AIDS service, HERO
(Health Education Resource Organization), for which I work in Baltimore, is one example of a
group that has recently substituted "HIV disease" for "AIDS" in all its printed material.
Media language usage with respect to AIDS is analyzed in Watney, Policing Desire; and the
October special issue devoted to AIDS is also heavily weighted toward linguistic and visual

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 93

If the steady proliferation of neologis

cogency of the social, scientific, and pol
problem, we perhaps should note also
characteristic of psychosis too. The intim
revealed by any examination of AIDS
itself is diseased, or is a form of disease.
discussed the tropology of biomedical di
of "an epidemic of signification," sugg
essentially unnatural but that it is so be
very nature of AIDS is constructed thro
the discourses of medicine and science.""
ler's Foucauldean argument reaches beyo
which one can speak of "an epidemic of
consequence of the rapid spread of ne
ones) to such a degree that language and
The epidemic of signification that sur
nor under control. AIDS exists at a
narratives intersect, each with its ow
which AIDS acquires meaning. It is ext
lure, familiarity, and ubiquitousness
virus [sic] enters the cell and integrat
lishing a disinformation campaign at
that replication and dissemination will
of discursive dichotomies; the discourse of AIDS attaches itself to
these other systems of difference and plays itself out there. (63)

At this homological level, one of whose rhetorical costs consists precisely in the
failure to resist the disinformation ("AIDS virus") of which it speaks, it appears
undecidable whether illness is a metaphor or metaphor a kind of illness, a
disabling condition of the subject of discourse.
The notion of illness as metaphor is, of course, an allusion to the work of
Susan Sontag, whose book AIDS and Its Metaphors has been wholeheartedly
denounced, in terms self-consciously drawn from the medical discourse on
AIDS, as "opportunistic" because of its heterosexist, homophobic "silence about

representations--or "discursive constructions"-of the syndrome: see Crimp, ed., AIDS: Cultural
Analysis/Cultural Activism, especially Jan Zita Grover, "AIDS: Keywords," pp. 17-30.
22. Paula A. Treichler, "AIDS, Homophobia, and Biomedical Discourse: An Epidemic of Sig-
nification," in AIDS: Cultural Analysis/Cultural Activism, p. 31. Subsequent references give pagination
in main text.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 94 OCTOBER

people with A
metaphors."23
Sontag's book
homophobia th
women and ga
phor such that
end up inscrib
now, however,
discourses on AIDS and metacritical discourses about those discourses seem
unable to avoid terms of disease. These discourses are themselves diseased,
contaminated, in the sense that their distanced metacritical purity is impossible
to maintain, and the language of AIDS thus appears as part of its discursive
object.24
I would like to propose an alternative emphasis to that implied by the
deconstructive tendency of this part of my argument by suggesting that it is the
subject of discourse who is "diseased," rather than language. The radical
dis-ease to which the subject is introduced via the signifier is in fact part of
Lacan's account of psychosis, for one of the things thrown into relief by the
dilemma of the psychotic patient is our common malaise as linguistic subjects:
"How do we not sense that the words we depend upon are imposed on us, that
speech is an overlay, a parasite, the form of cancer with which human beings
are afflicted?"25 Lacan's question is rhetorical because it is precisely our failure
fully to "sense" speech as imposed that prevents us from succumbing to psy-
chosis. If Lacan had survived to witness the ravages of the AIDS epidemic,
would his question formulate AIDS, rather than cancer, as figure for the afflic-
tion particular to subjectivity? And would such a formulation, in its supposed
generalization of AIDS at the price of gay specificity, count merely as one more
"opportunistic" relation to AIDS?
The struggle to speak or remain silent about AIDS is certainly in larg
measure a struggle, as another commentator has put it, "to say or not to say
the word 'gay."'26 But to argue that AIDS has unleashed an epidemic of signi
fication is not tantamount to claiming that American society's symbolization
of the deaths, of the personal and political struggles of gay men-has been in
any way adequate. Since symbolization is defined in a Lacanian perspective by

23. Susan Sontag, AIDS and Its Metaphors (New York: Farrar, Straus & Giroux, 1989). The critiqu
comes from D. A. Miller, "Sontag's Urbanity," October 49 (Summer 1989), pp. 91-101.
24. Lee Edelman makes a related argument in "The Plague of Discourse: Politics, Litera
Theory, and AIDS," South Atlantic Quarterly: Displacing Homophobia 88 (Winter 1989), pp. 301-17
25. Cited by Jacques-Alain Miller, "Teachings of the Case Presentation," Returning to Freu
Clinical Psychoanalysis in the School of Lacan, ed. and trans. Stuart Schneiderman (New Haven: Y
University Press, 1980), p. 49.
26. Helena Michie, "A Few Words About AIDS," American Literary History 2 (Summer 1990
p. 328.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 95

its failures, such inadequacy is in one sen

zation of AIDS hinges upon a specific po
failures. That is, those in power have mad
lishment of any identificatory signifier b
hundreds of thousands of gay men, nonw
groups could achieve positive significa
signification without any officially affirm
closure of any such signifying possibil
American response to AIDS as psychotic
terattempts by AIDS activists to produ
Lacanian theory of discourse in which t
signifier is elaborated.
In the recently published seminar L'env
rates four discursive structures-that of th
and the analyst-using combinations of
These units have the following denotat
signifier of primary identification; S2 re
movement Si - S2 represents unconsciou
signifying chain; $ is the subject in its div
effect of the signifier; a represents jouissa
cause of the subject nonetheless. It sho
these units in specific discursive structur
theory of discourse from other theories.
seen as constitutive, but the Lacanian co
discursive cause-a-within its structure,
scription as the effect of desire beyond t
particular discourse structure with which
of the master, which Lacan writes thus:27

SI S2 master signifier knowledge

a subject jouissance
Later, in Encore, Lacan will inscribe the arrow (-) under the
thereby indicating that the movement of unconscious inte
by the discourse of the master.28 This particular structure
it is the characteristic political discourse (L'envers, 99). Th
L'envers de la psychanalyse is explained in the text: "l'enve
c'est cela meme que j'avance cette ann&e sous le titre du

27. Jacques Lacan, Le Seminaire livre XVII: L'envers de la psychoanalys

Alain Miller (Paris: Seuil, 1991), p. 105. Subsequent references give pag
28. Jacques Lacan, Le Seminaire livre XX: Encore (1972-1973), ed. Ja
Seuil, 1975), p. 21.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 96 OCTOBER

[The contrary
under the tit
is written by

S2- Si

And Lacan introduces this analytic discourse under the session title "The Cas-
trated Master" by declaring that "the psychoanalytic discourse finds itself ver
precisely at the opposite pole of the discourse of the master" (100). L'envers
la psychanalyse is the seminar for the 1969-70 year; its reference to the maste
discourse as the discursive structure of politics is made in the aftermath of Ma
1968 and should be understood therefore as implying that what is contrary t
psychoanalysis is precisely the hegemonic ideological formation against which
struggles were being waged. Psychoanalysis is political precisely to the exten
that the discursive position of the analyst diametrically opposes that of the
master discourse, for the latter of which all division is repressed by the unici
of certainty:

S1
$--

Indeed, all discourse is political from a Lacanian viewpoint, "discourse being

that which determines a form of social tie."29
The master discourse functions politically in two ways: first, in relation to
subjective identification; and second, in relation to occulted jouissance. Because
the subject, $, is subject of a lack, Si offers a symbolic consistency to fill that
lack. Lack is a consequence of the subject's division, for which a fantasy of
oneness provides the illusion of identity as well as reassurance that the traumatic
real of sex can be rehabilitated to a sexual relation (a fantasy image of sexual
completion, the copulatory couple). The price of such identification with SI in
the master discourse is precisely the repression of division ($ below the "bar"),
the mechanism by which political discourse itself functions repressively and by
which it displaces division to its outside in the form of embodied agents of
division. Thus, for example, the concept of the nuclear family functions in
contemporary Anglo-American political discourse as an Si, operating as the
fundamental social unit to which political discourse addresses itself.30 Like the

29. Jacques Lacan, "A Love Letter" (1973), in Feminine Sexuality: Jacques Lacan and the Ecole
Freudienne, ed. Juliet Mitchell and Jacqueline Rose, trans. Jacqueline Rose (New York: Norton,
1982), pp. 152-53.
30. Although it would be correct to argue that the Enlightenment philosophy from which the
American political tradition derives enshrines the individual in his autonomy (rather than the
family) as the fundamental unit of social address, my suggestion is that the master discourse on
sexuality addresses the family insofar as the individual accedes to his sociopolitical "rights" only in
a familial context: persons achieve "individual" status only by fulfilling certain ideological prereq-

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 97

Holy Family (and the doctrine of the Trinity)

family is sacred; as a unit denoting unity, one
repressing divisions of gender, sexuality,
giving rise to the routine domestic violences
symptomatic returns of the repressed. As a
tutive repression entailed by any S1 in the
understood as obtaining only an external sou
ceived as threatened from without by forces
and "coloration" (these last two being combine
on immigration and travel restrictions for t
elevated an S1 status does the mythical famil
acknowledgment of its illusory, purely symb
most extreme proponents of the master disc
damentalists) as the ruinous destruction of so
From this it should be apparent that discou
tie" not directly with other members of soc
"neighbor," but with a collective identificato
ginary) identification alone is insufficient to
subject and the social cohere, such as they do
the Lacanian theory of discourse makes prov
erence to object a. An understanding of jouis
"a form of social tie" with the noxious neigh
But before examining the crucial role played
ican society, let us consider the contemporar
of American politics.
In June 1991, when the first draft of this
catory signifier "Vietnam" had finally been e
the American subject by the signifier "victor
what represents a subject for another signifi
impelled, governmentally orchestrated bec
national signifiers-the Stars and Stripes of t
democracy, freedom, the West-is what cause

uisites that are historically variable. Thus although "the

operates as a powerful Si in political discourse, when th
family" is S1.
31. If I may be permitted a Zi'ekian moment here, I would adduce as the best embodiment of
Lacan's "noxious neighbor" in popular culture to be Dennis Hopper's character in David Lynch's
1986 movie, Blue Velvet.: psychotic Frank. During a joy ride that we must interpret as a jouissance
ride in the sense of a "death drive," Frank consistently addresses the horrified Kyle McLachlan
character, inganu Jeffrey, as "neighbor." Lacan's discussion of the "noxious neighbor" may be found
in Le Seminaire livre VII: L'ethique de la psychanalyse (1959-1960), ed. Jacques-Alain Miller (Paris:
Seuil, 1986). My thinking on this and related topics has been greatly aided by Joan Copjec, "The
Sartorial Superego," October 50 (Fall 1989), pp. 57-95.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
98 OCTOBER

The past de
imagery-his
matic-about
zation of nat
most recent
supply if mo
made to sym
Ronald Reaga
until late 198
the epidemic
The work of
private doma
various kind
into the publ
signifies. One
private, dom
public spect
Lacan's term
"quilting"-of
may press t
functioning
six years of
tradition of
semiosis with
it is displaye
Although cu
mourning, in
tion of the f
as inadequate
of mourning

32. Ernesto Lacl

cratic Politics,
point de capiton
33. There is, ne
function in rela
subgenre of wh
testimonial litera
to AIDS (New Y
Straus & Giroux
Jones and Edmu
and a series of b
St. Martin's Pre
1988); Afterlife
Despite the imp
medium of cont

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 99

native American tradition (elegy is a genre

death by assassination), whereas quilting a
ically American histories.
As textile, the Memorial Quilt is also te
with the name of somebody who has d
famous-Rock Hudson, Michel Foucault,
Mapplethorpe-to those "ordinary peop
them. As a multimedia elegy and a public
as a contemporary genre of testimony, tes
remain anonymous (this text bears no sig
will not. When it was last displayed in W
view of the White House and the Capito
fourteen acres of the Ellipse and compr
metonymic pile of dead bodies arranged
president (the White House), and symboliz
mental lack, in comparison with which th
ally funded and endorsed, testifies acco
signifying structure of the quilt is thus o
logic of substitution: panel for grave (a su
resemblance), grave for body, house for b
contained), and the linked metaphors of
Vietnam Memorial), quilt for page. It is b
substitutions that the bodies of the dea
minimal symbolic identity-and by this
testimonially.
This testimonial structure operates also at the microlevel of the individual
quilted panel, for each section combines disparate media, heterogeneous sig-
nifying systems (images, names, words), and different perspectives in a single
grave-sized plane. Pieces of the dead person's clothing, locks of hair, photo-
graphs, other objects invested with memory and desire, and metonymic shreds
of various kinds are quilted via the S1 of the proper name. Perhaps we could
say that these material shreds represent objects a, since anything that "falls"
from the body, bearing thereby a purely metonymic relation to it, is capable of
becoming such an object.34 The object a as cause of desire thus enters the
signifying chain in the form of an interruption, which prompts a signifier of

in Jeff Nunokowa, "'All the Sad Young Men': AIDS and the Work of Mourning," in Inside/Out:
Lesbian Theories, Gay Theories, ed. Diana Fuss (New York: Routledge, 1991), pp. 311-23, and the
essays by Gregg Bordowitz, Crimp, and Martha Gever in Crimp, ed., AIDS: Cultural Analysis/Cultural
Activism.
34. Jacques Lacan, "Introduction to the Names-of-the-Father Seminar," Television: A Challenge to
the Psychoanalytic Establishment, ed. Joan Copjec, trans. Denis Hollier, Rosalind Krauss, Annette
Michelson, and Jeffrey Mehlman (New York: Norton, 1990), p. 85.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 100 OCTOBER

demand as the
is articulated by
name of the deceased.
That the quilt functions as a potent identificatory signifier in American
society is left in no doubt by the testimonies of those quilters who have produc
panels for people they never met or whom they knew only slightly. Inspired b
a photographic "quilt" published by Newsweek in 1987 ("The Face of AID
profiled 302 people dead from AIDS in the year ending July 1987), many
readers were symbolically impelled to symbolize their identification with th
chronic loss occasioned by AIDS. As one such woman, 'just a housewife," p
it: "I felt bad about all the people who die of AIDS that nobody knows."35 Th
quilt's testimonial power-the power of a homemade Si-has been officially
recognized by the collective decision to show it in the nation's capital one mor
time, despite the acknowledgment at its last full showing in Washington, D.C.
in 1989, that it had grown too large ever again to be displayed there in o
piece. Over 14,000 panels are scheduled for simultaneous display in Washingt
on Columbus Day weekend, 1992.36
In March 1987, three months before the first quilt panel was sewn and
with presidential silence on the topic of AIDS still unbroken, another America
tradition was revived for symbolic purposes: civil rights activism. Founded b
Larry Kramer, the "direct-action group" ACT UP (AIDS Coalition to Unlea
Power) takes as its rallying slogan "Silence=Death." This austerely brief text,
"Silence=Death," is typically set beneath the figure of a pink triangle for whic
it thereby functions as legend (a pink triangle being the symbol appended to
gay men in Nazi death camps), and the whole thus intensifies its rhetoric
urgency via allusion to the Holocaust as the contemporary signifier of absolut
horror. Unsurprisingly, the slogan has itself generated much discourse an
many competing interpretations of its significance and effectiveness, not leas
because its structure dramatically conflates a causal relation with an ident
relation.37 First, the equation points to the perpetuation of AIDS deaths as a
direct consequence of governmental silence and inaction. Silence as a refusal
symbolization also functions as a disavowal of death, a refusal to allow AI
deaths to signify; silence thus performs a kind of second death on top of th
first, physical death by forestalling the mourning that allows the dead to achie
their proper relation to the living. The double logic of the slogan therefore

35. Cindy Ruskin, Matt Herron, and Deborah Zemke, The Quilt: Stories From The NAMES Projec
(New York: Simon and Schuster, 1988), p. 61.
36. I am grateful to Michele Cinq Mars of The NAMES Project, San Francisco, for providing
me with this information before its official announcement, and for confirming factual details about
the quilt.
37. Besides Harris's article (note 20) and Edelman's (note 24), see Patton, Inventing AIDS,
pp. 126-30, Crimp's introduction to AIDS: Cultural Analysis/Cultural Activism, pp. 3-16, and his
response to Edelman's argument in Douglas Crimp, "Mourning and Militancy," October 51 (Winter
1989), pp. 3-18.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 101

points in two directions at once: on the on

then speech (or discourse or symbolizat
saved by a discourse of AIDS education
research; while on the other hand, it imp
in the sense of conferring proper digni
the implications of the ACT UP slogan
symbolization and mourning, but for n
slogan that places such emphasis on the li
for a group whose manifest commitment
What rhetorical or semantic function
phrase "direct action" serve? Is it not t
tantamount to symbolic action, and that t
rather dilutes the urgency of symbolizati
is necessary to acknowledge that ACT UP'
the incalculability of those actions' effect
the attempt to circumvent symbolic stru
real. Let me make clear that the only pos
of symbolization is psychotic access. Furt
of the effects of symbolic action is a co
unmasterable. The paradox of the signifie
tive effect obtained by the breaking of s
such that the subject's every effort at re
indeed, it is this very failure that constitu
This psychoanalytic premise will no
members, not because it represents a sligh
because it diametrically opposes activist th
revisions of activist practice. The second ed
(1989)-which includes a remarkably s
"AIDS" (denotatively qualifying the "alw
offers its primary definition of "activism
to a twentieth-century "philosophical theo
and active existence of everything." Thus
theory before practice. The OED's secon
policy advocating energetic action, and
seems not to merit a separate entry of its
advocate of activism in either the primar
added is that logically one cannot be an
of energetic action) without also being

38. See Zifek, The Sublime Object of Ideology: "The

process of his symbolic representation" (p. 173). O
Kramer, "Afterword to the Paperback Edition," Repo
Activist (New York: St. Martin's Press, 1989), pp. 2

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 102 OCTOBER

course there are at least some members of ACT UP who are activists while
explicitly subscribing to philosophical theories incompatible with the dictionar
definition. Douglas Crimp, for example, takes a standard Foucauldean line in
introducing the best collection of AIDS work to date when he writes, "I asser
to begin with, that 'disease' does not exist.... AIDS does not exist apart fro
the practices that conceptualize it, represent it, and respond to it."39 No "prac-
tice" conceptualizes, represents, or responds to anything without the interven-
tion of the signifier and the consequent installation of "practice" within the fie
of discourse. Yet the tendency remains to consider the signifier's interventio
as an avoidable barrier to effective political intervention, and to consider the
"talking cure" no real cure at all.
This paradoxical tendency, which is one of the greatest stumbling blocks
for any political program centered on "direct action," is caught in the title of
collection of ACT UP documents and archival material coedited by Crimp
AIDS Demo Graphics. AIDS demography, the study of population statistics wit
respect to AIDS, is achieved in this book by presenting graphic images-ph
tographs and posters-that function demonstratively, as examples (the boo
presents itself in the classic American genre of the handbook) and as actual,
active interventions. The prefix demo- is inflected according to its "proper,"
etymological (Greek) meaning, people, but also according to its colloquial mean
ing, as an abbreviation of demonstration (whose Latin root has nothing to do wit
the Greek word for people). The titular demo thus signifies people acting
intervening symbolically via organized public demonstrations in the political
spheres that affect their lives: "This book . . . is meant as direct action, puttin
the power of representation in the hands of as many people as possible."40 Ye
this book is precisely demo-graphy, people writing, people caught in a signifie
whose defining characteristic is displacement of the subject elsewhere than the
place of his conscious intention, for which reason representative power is dis
placed and deferred at the moment of its dissemination-a qualification th
nevertheless should not discourage the effort. Recognition of language's non-
transparency does not eliminate that opacity; however, eliminating a naiv
conception of representational power may indeed help us wield more accurately
the very significant power representation and rhetoric hold over our lives.
But what about ACT UP's implicit recognition in its slogan of the power
of the signifier in relation to life, the power of silence to cause death? In on
sense, the implication of the slogan-namely, that if silence=death, then
speech=life-runs directly against the Lacanian thesis that speech mortifies th
subject, that the signifier itself entails a certain death. However, in another
sense, the assumption behind both activism and the quilt that symbolization

39. Crimp, AIDS: Cultural Analysis/Cultural Activism, p. 3.

40. Crimp and Rolston, AIDS Demo Graphics, p. 13.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 103

AIDS deaths has been institutionally insuff

tion, one that is consonant, moreover, wit
response to AIDS as psychotic. For in an
Lacan defines mourning in his seminar on H
"What are these rites, really, by which we
the memory of the dead-if not the total m
of heaven to the depths of hell, of the enti
is possible to read this formulation as an a
spearean influence on Lacan (and on psyc
which the debt owed is partially tendered
diction in the Lacanian text (this would
Lacan). My primary concern here, howe
Freudian paradigm of mourning (which is
of a model of mourning based on a signify
redefine psychosis as a question of the subj
in terms of its relation to reality, so too L
mourning as a symbolic economy leads to
regresses to an earlier theoretical moment
Where is the gap, the hole that results
forth mourning on the part of the subje
means of which the subject enters in
inverse of what I have set forth in earlier seminars under the name
of Verwerfung [repudiation, foreclosure].
Just as what is rejected from the symbolic register reappears in
the real, in the same way the hole in the real that results from loss
sets the signifier in motion. This hole provides the place for the
projection of the missing signifier, which is essential to the structure
of the Other. This is the signifier whose absence leaves the Other
incapable of responding to your question, the signifier that can be
purchased only with your own flesh and blood, the signifier that is
essentially the veiled phallus.42

That this seminar, dated April 29, 1959, should revert in its formula for psy-
chosis to a moment preceding the insights of the psychosis icrit, composed early
in 1958, confirms that any periodization of Lacan's teaching cannot proceed
adequately by chronology. Nevertheless, the notion that psychosis and mourning
are linked in a relation of structural inversion supports our thesis that the social
relation to AIDS is properly psychotic as a consequence of its refusal of a
signifier for AIDS that would provide for mourning: silence = death.

41. Lacan, "Desire and the Interpretation of Desire in Hamlet," p. 38.

42. Ibid., pp. 37-38.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 104 OCTOBER

It is worth re
of mourning,
When Freud d
terms: melanch
society continu
of thousands o
taken by acti
mourning revi
as the definin
psychosis beca
as pathological
the lost object)
in the Freudian
identified and chastises it with the viciousness of a hatred that is the underside
of any love relationship having the status of "ambivalence." From this under-
standing Freud develops his concept of the superego, which Lacan will refor-
mulate in the seminar on L'ethique de la psychanalyse through the concepts of the
noxious neighbor and jouissance.
What about those of us so torn by grief at the losses occasioned by AIDS
that the act of mourning the objects of love is transformed into identification
with the cause of loss? I am thinking here of a comment by Larry Kramer, who,
recounting the conditions under which he founded ACT UP and responding
with justifiable ire to President Bush's denunciations of AIDS activism, declared:
"ACT UP is impolite, abrasive, rude-like the virus that is killing us."45 Iden-
tification with the cause of loss only unleashes an aggressivity whose ultimate
aim, no matter against whom or what it is directed, is death.46 Ambivalence
toward the object of love may indeed be endemic to any love relation, yet Freud
emphasizes ambivalence as one of the prerequisites for the transformation of
mourning into melancholia. How much more ambivalent must homosexual love
be in a homophobic culture, and therefore how much more prone to melan-
cholic identification -and the subsequent unleashing of murderous
aggression-must gay men be in the age of AIDS?
In an essay remarkable, among other things, for its willingness to engage
with psychoanalysis and for the emphasis it places on the unconscious, Crimp

43. However, society remains perfectly willing to render meaningful the deaths of those perceived
through a disavowed tautology as "innocent victims" -for example, children-on condition that
the latter maintain a nonsexual status.
44. Sigmund Freud, "Mourning and Melancholia" (1917 [1915]), The Standard Edition of the
Complete Psychological Works of Sigmund Freud, trans. James Strachey (London: Hogarth, 1957), vol.
14, p. 249.
45. Kramer, "Ten Years of Plague," p. 62.
46. Freud stresses that the melancholic's desire for suicide is simply a displacement onto his ego
of his unconscious murderous wishes toward the loved object.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 105

expresses the psychic ambivalence of gay p

with AIDS: "We must recognize that our m
the more painful feelings of survivor's gui
wishes, during our lovers' and friends' prot
die and let us get on with our lives."'47 The
"Mourning and Militancy," none of which s
truth value just because it de-idealizes the p
utopianly purified out of existence in explic
icism. What seems to me particularly usefu
allows for consideration of the death drive
outside by a homophobic culture, but as
social conflict" (16). The death drive is a
neither Crimp nor Jacqueline Rose (from w
argument is derived)48 gets very far with
death drive in terms ofjouissance Lacan ma
jouissance suggests that there is a certain ki
itself is actually something one might, at s
Crimp's terms in the quotation above-"
-resonate with the kind of popular psyc
choanalysis so firmly sets itself. Indeed, the
the one that most clearly distinguishes psyc
death drive is reducible neither to the level
nor to the popular notion of self-destructi
men with such renewed homophobic vigor
ization of pure negativity, the death drive i
psychology, which, as Joel Fineman put it,
that which motivates an action, as an impu
However, I would like to consider briefly
"survivor's guilt," by a consciously gay-iden
dramatizing the death drive as it is conce
story "Aliens" (1984) is not about AIDS; n
identified as gay. As the title suggests, thou
and abnormality through each of its fam
abnormality, deformity, and crisis are not
typical, suburban, middle-class, American
essential condition.50

47. Crimp, "Mourning and Militancy," p. 10. Subsequent references give pagination in main text.
48. Jacqueline Rose, "Where Does the Misery Come From? Psychoanalysis, Feminism, and the
Event," in Feminism and Psychoanalysis, ed. Richard Feldstein and Judith Roof (Ithaca: Cornell
University Press, 1989), pp. 25-39.
49. Joel Fineman, "The Sound of O in Othello: The Real of the Tragedy of Desire," October 45
(Summer 1988), pp. 82-83.
50. David Leavitt, Family Dancing (New York: Knopf, 1984), pp. 79-94.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 106 OCTOBER

Like other sto

first-person po
the automobil
half his vision
thematized in
bolizable, word
"Earlier, durin
good, and I h
reason I'm around to talk about it." The other characters are the narrator's two
children, Charles and Nina, and the narrator's mother, the grandmother, who
assumes the form of a superegoic voice by communicating only via the tech-
nological Other-"her new cordless electric telephone" and mimeographed
Christmas "family report" letters she begins preparing (gestating) in March,
nine months early. From this technological Other comes the truth of the family's
condition: their status as survivors and their jouissance in monstrosity.
It is not possible to delineate here the complex interweave of fantasized
identifications with the alien and the monstrous in this story. Suffice it to indicate
the condensed effect of survival as the defining element in the characters'
familial identifications. This is a consequence of the metonymic relation between
loss and survival that enables survival to function as object a in the family's
collective fantasy of itself. It is, finally, not "survivor's guilt" of which the narrator
is accused by her mother's allegory of the Holocaust so much as survivor's
jouissance. Speaking of a "study" reminiscent of that conducted by the satirized
Dr. Tree in Cynthia Ozick's story "Rosa" (1983),51 the narrator's mother reads
over the phone:
"There is a man who is studying the Holocaust," she says. "He makes
a graph. One axis is fulfillment/despair, and the other is success/
failure. That means that there are four groups of people-those who
are fulfilled by success, whom we can understand, and those who are
despairing even though they're successful, like so many people we
know, and those who are despairing because they're failures. Then
there's the fourth group-the people who are fulfilled by failure,
who don't need hope to live. Do you know who those people are?"
"Who?" I ask.
"Those people," my mother says, "are the ones who survived."
It is this fiction's thematization of the notion of fulfillment in failure-the idea
that there might be something at the heart of the subject that wishes it harm

51. Cynthia Ozick, The Shawl (New York: Vintage, 1990). Dr. Tree Pursues Rosa, "a madwoma
and a scavenger," in order to subject her to his study of Holocaust survivors, based on a theor
entitled-in a perfectly American amalgam of Freud and Disney-"Repressed Animation."

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 107

yet to which it clings as the very groun

satisfaction-that seems to me radically ins
To begin with, such an insight dispense
notion, prevalent in so many studies of h
people has a purely external source, to t
internalized homophobia, is conceived ac
a homophobic society being internalized b
identifies as a social subject.52 Considerati
conceptualization of a nonexternal force t
against the subject's well-being), yet which
of internalization. When one tries to c
negativity-in terms of inside/outside (an
theorization inevitably fails; furthermore
that the death drive is not merely an effec
outside dichotomy, and that "the ambigui
itself."53 It was to circumvent such imp
developed a theory of the subject mappe
notion of an individual with a psychic int
outside world the notion of a subject in th
status is thinkable only by the noncomm
M6bius strip, and whose description req
vocabulary, including such terms as extimit
The impatience of many critics, particul
sustained theorization makes it necessar
understanding about AIDS and homopho
inside/outside spatial model require new te
in order to make certain phenomena ac
biomedical nomenclature for AIDS has bee
ogy to describe the subject of AIDS and of
of philosophy, linguistics, and sociology m

52. See Nunokowa, "'All the Sad Young Men,"' wh

death as something that comes from outside-in th
the homosexual in terms of his youthful fatality: "T
time by a double burden: the variegated regime of
acknowledging the loss of a gay man, it also exact
casting his death as his definition" (p. 319).
53. Rose, "Where Does the Misery Come From?"
54. See Jacques-Alain Miller, "Extimite," Prose Stu
argues the necessity of the term and its conceptual r
about a psychism supposedly located in a bipartiti
follows, therefore, that "extimacy is not the contrar
that the intimate is Other" (p. 123). Among other
jouissance to adumbrate a psychoanalytic theory
psychoanalytic theory of homophobia.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 108 OCTOBER

choanalytic ac
matics, princ
mappings bas
which all the
and meaningle
map the subje
an object as by
the effects o
terms-jouissa
nifier of sexu
drive," accord
represents in

The J

It is alwa
siderable
as there a
the manif

-Sigmun
Disco

Perhaps the
segregates and
life-and with
its combinatio
resistance of
theoretical dis
by the Ameri
of Lacan, mea
Freudian deat
If for Barthes in 1973 the relevant distinction is between the text of
pleasure and the text of bliss (jouissance), this is because Lacan has already

55. Lacan, "Desire and the Interpretation of Desire in Hamlet," p. 11. The best account of Lacan's
use of topology is Jeanne Granon-Lafont, La topologie ordinaire de Jacques Lacan (Paris: Point Hor
Ligne, 1985). What are we to make of the fact that the development of topological science i
historically coincident with the emergence both of "the homosexual" as a discrete ontological identity
and of psychoanalysis (all late-nineteenth-century, quintessentially modern phenomena)?
56. Lacan, Four Fundamental Concepts, p. 205. In an 6crit from the same period, Lacan concludes
that "every drive is virtually the death drive" ("Position de l'inconscient," Ecrits [Paris: Seuil, 1966
p. 848).

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 109

formulated jouissance as the beyond of Fr

terms the relevant distinction with regard
unconscious wish for somebody else's death
or pulsion toward one's own death (Todestr
approximately into Lacanian terms as the
and jouissance. Let me elaborate.
In the second part of his 1915 essay "Th
Death"-an essay that, contra Sontag, is
psychic consequences and implications of
can be read profitably as analogous to soci
of AIDS-Freud discusses the disturbance in our relation to death that war
brings. War and AIDS occasion a confrontation not only with death b
its place in the unconscious, and hence its relation to desire. Thus, rehea
the theme he would develop fifteen years later in Civilization and Its Disc
-namely, that an instinctual repression is demanded as the price of c
and that there is therefore an incurable malaise intrinsic to culture itself-
Freud argues that a historically cumulative series of repressions exact
culture has modified our attitude to death, so that in the unconscious we not
only wish for the deaths of our enemies, but often desire the speedy elimination
of our nearest and dearest, too, as a consequence of the ambivalence that infects
all love.58 From this counterintuitive proposition--that (unconsciously) we
would like to see those we love dead-it seems but a small step to suggesting
that we desire our own deaths, that there is something at the heart of the human
subject that wishes it ill. Yet since one of the properties of the unconscious is
that, existing atemporally, it knows neither contradiction nor negation (and is
therefore immune to logic), there is no provision for the subject's own death,
no signifier for self-annihilation, registered in the unconscious: "It is indeed
impossible to imagine our own death; and whenever we attempt to do so we
can perceive that we are in fact still present as spectators.""59 The death drive
therefore cannot be conceptualized at the level of unconscious desire; it is not
part of the Other's discourse (the unconscious is the discourse of the Other),
but is an effect of the Other's jouissance.
Jouissance is real, hence extradiscursive. However, as Lacan comments in
L'envers, "nothing is more burning [br2lant] than what, in discourse, makes
reference to jouissance" (80). The "straight" way to read this statement would
be to understand that any discursive reference tojouissance makes the discourse

57. Roland Barthes, The Pleasure of the Text, trans. Richard Miller (New York: Hill and Wang,
1975).
58. Sigmund Freud, "Zeitgemisses Uber Krieg und Tod," Gesammelte Werke (1913-1917), bd. 10
(London: Imago, 1946), p. 351.
59. Sigmund Freud, "Thoughts for the Times on War and Death" [1915], Standard Edition, vol.
14, p. 289.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 110 OCTOBER

itself torrid (o
could also read
of fire (burnin
second reading
cause remains
"jouissance is f
version of the t
is achieved at
"a pound of fle
ance is therefo
only substanti
Jouissance and
scious) are stri
pleasure princ
text, for insta
Apropos of Sad
as "the law of
jouissance is ch
acceptance of
death is compl
impossible for t
Sade's value f
object of the O
a "right to jou
ative. As Lacan
recognized, wo
evermore outd
to slip, by an
than the egoi
jouissance, is e
jouir de] your
any limit stop
the taste to sa
ethical-law in

60. Jane Gallop, T

61. The possibility
Up," p. 246.
62. Jacques Lacan, "The Subversion of the Subject and the Dialectic of Desire in the Freudian
Unconscious," Ecrits, p. 319.
63. Jacques Lacan, "Kant with Sade," trans. James B. Swenson, Jr., October 51 (Winter 1989),
p. 56; and Lacan, L'ethique, p. 222, respectively. Subsequent references to "Kant with Sade" give
pagination in main text.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 111

vidual good or subjective interest; it is ther

rocal.
Since there is no danger that this "right" tojouissance will make you happy,
we could add that it is also a particularly un-American right-were it not for
the anomaly of one of America's most visible and popular cultural icons, Ma-
donna, taking for the text and spectacle of a recent commercial exploit rather
precise Sadian imagery and the approximate Sadian motto, "Poor is the man
whose pleasures depend upon the permission of another" (a nice perversion of
the Christian Beatitudes). It is clear, by the fact that it was banned, that Jean-
Baptiste Mondino's 1990 video for Madonna's "Justify My Love" was perceived
as exhibiting the obscene, excessive, worse-than-useless jouissance of the Other.
Staging its scene in a sort of hotel de Sade, the video is replete with stylized
gestures representing the whole catalogue of perverse activity: lesbianism, fe-
tishism, voyeurism, transvestism, troilism, and the ritual accoutrements of sado-
masochism. Yet it is incorrect to suggest, as many have done, that the video was
banned because of its depiction of lesbianism, for Madonna had already rep-
resented lesbian voyeurism explicitly in the video for "Open Your Heart."
However, there is something about the Other's homosexual jouissance that makes
it particularly intolerable today, in the age of AIDS.
Its genital nonreciprocity with the opposite sex, together with its overt
anti-utilitarian-that is, nonreproductive-pleasure, plus its association with
fatality and self-destruction (for which AIDS is the current, most intensified
figure), makes homosexuality appear as an especially noxious form of the Oth-
er's jouissance. Only in the context of this understanding of homosexuality can
the statement about HIV transmission made by Dr. Opendra Narayan of The
Johns Hopkins Medical School make any sense: "These people have sex twenty
to thirty times a night .... A man comes along and goes from anus to anus and
in a single night will act as a mosquito transferring infected cells on his penis.
When this is practised for a year, with a man having three thousand sexual
intercourses, one can readily understand this massive epidemic that is currently
upon us."64 This fantasy is clearly Sadian, inhuman, delineative of an impossible,
Other jouissance. Gay sex in Narayan's scenario is beyond bestial, it is entomial,
sex in the service of nothing but the absolute worst, namely death. From this
image of obscenity, it should not be difficult to grasp how the jouissance of the
Other operates as a mechanism of social exclusion, fueling homophobic recoil
from gay people in the society of AIDS. In this context, we can supplement the
Lacanian aphorism about transference and the sujet suppos6 savoir-"he whom

64. Cited by Leo Bersani, "Is the Rectum a Grave?" in Crimp, AIDS: Cultural Analysis/Cultural
Activism, p. 197. Subsequent references give pagination in main text. Although I disagree with her
interpretation of it, I am grateful to Frances Ferguson for discussing Bersani's essay with me.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
112 OCTOBER

I suppose to k
to know how to
In the course
Seminar, Lacan
neighbor is in
our desire is p
Other. Homop
be appreciated
are capable of
in their uncon
pendent upon
onism not onl
but is internal
dependence u
sexual enjoym
forms of hom
self-antagonis
they argue th
around a centr
that neither
identity is sel
through the r
In this respe
homosexual jo
pressed by R
Dugas, whose
origin of Nor
from effects
ance of the Ot
politically exp
two opposite y
and Leo Bersa
issue on AIDS.
by him to wh

65. Jacques Lacan

this formulation o
and Psychology,
66. Sigmund Freu
67. Randy Shilts,
Martin's Press, 19
of irony, as the
before you fuck
is And The Band P

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
The Psychoanalysis of AIDS 113

"Having learned to support and grieve for

the fight against fear, hatred, repression,
lives so as to protect ourselves and one a
subjectivities, our communities, our cultu
sex."68 In direct contrast to that apparen
remarkable essay "Is the Rectum a Grave?
which any psychoanalytic account of AID
"There is a big secret about sex: most p
promiscuity and aversion, loving sex and dis
ance and the concept of the death drive, fo
"tinting" the drive with both erotophilia a
Crimp's argument in "How to Have Pro
tophilic and dismisses erotophobia (and, alo
the death drive) as a form of homophobia; i
others, for all of whom "sex has been the r
Cindy Patton's analysis of erotophobia,69 C
invented safe sex," the recoil from gay sex
jouissance is "perversely distorted," which
insist that our promiscuity will destroy us w
will save us" (253). Shilts's tacit slogan, sex=
(safe) sex=life-thereby providing his erot
of, not merely apology for, promiscuity: "
instead as a positive model of how sexual
granted to everyone if those pleasures we
limits of institutionalized sexuality" (253).
This erotophilic model of sexuality is
critique of "the general enterprise . . . which
of sex" (215), an enterprise so broadly enco
ents, besides Crimp, such various and oppos
Catherine MacKinnon (feminist antiporn
Rubin (proponents of lesbian sadomasoc
Weeks (propornography, gay Foucauldean

68. Douglas Crimp, "How to Have Promiscuity in an Ep

Activism, p. 270. Subsequent references give paginatio
69. Cindy Patton, Sex and Germs: The Politics of AI
70. Consideration of the full implications of Bersan
his two most recent books (The Freudian Body: Psychoan
Press, 1986], and The Culture of Redemption [Cambrid
at least an article in itself. However, it should be no
redemptive impulses they so vigorously critique. For
Grave?" concludes: "If sexuality is socially dysfunction
plunge them into a self-shattering and solipsistic joui
thought of as our primary hygienic practice of nonvi

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 114 OCTOBER

Like Lacan in
version of sex in favor of "the inestimable value of sex as-at least in some of
its ineradicable aspects-anticommunal, antiegalitarian, antinurturing, antilov
ing" (215). Thus in a completely opposite way to Crimp, Bersani embrace
certain image of the Other's noxious jouissance as it is associated with gay se
Such a position is dependent, however, upon a certain heterosexist conflatio
in Bersani's argument of sex with fucking-in this case, homosexual anal pen
etration (buttfucking). Anal penetration is indeed the archetypal sexual
associated with the Other's jouissance, as is suggested by Lacan's enigmatic r
erence in "Kant with Sade" to "spintrian jouissance" (jouissance of the sphincte
defined by the OED as "pertaining to [male prostitutes and] those who seek ou
or invent new and monstrous forms of lust"), and as is illustrated by the fate
Sade's Justine, who, during her interminable submission to every whim of sex
caprice (following the "right to jouissance"), is buttfucked countless times, b
only once, symbolically, is she vaginally raped."
Bersani pictures the rectum as a grave "in which the masculine ideal of
proud subjectivity is buried," an ideal that he unmistakably identifies with th
ego. It is thus the ego-shattering jouissance of receptive rectal sex that leads h
to characterize sexuality as "a tautology for masochism" (217).72 The problem
with this fascinating psychoanalytic argument is its ultimate appeal to the ga
ego as an agent of mastery, for in the face of AIDS Bersani recommends "an
arduous representational discipline," which involves "the pain of embracing,
least provisionally, a homophobic representation of homosexuality" (209
order to make the gay man's rectum a metaphorical grave for "the sacrosan
value of selfhood, a value that accounts for human beings' extraordinary wi
ingness to kill in order to protect the seriousness of their statements" (222
Recent U.S. foreign and domestic policies, including the political responses t
AIDS, must compel increasingly vigorous assent to Bersani's characterization
the fatal dangers of upholding "the sacrosanct value of selfhood." Howev
any appeal to the ego, even an appeal for it to solicit its own shattering, mu
count as a nonpsychoanalytic solution, for in seeking to eliminate the significa
of the unconscious, Bersani's recommendation implicitly advocates a redemp
tion of subjectivity-if not of selfhood-as such. The crucial distinction we w
able to make earlier (with the help of Vergetis) between a subject founded i

71. Lacan, "Kant with Sade," p. 67 (and Swenson, "Annotations," p. 95). For Justine's spint
fate, see "Justine, or Good Conduct Well Chastised" (1791), The Marquis de Sade,Justine, Philoso
in the Bedroom, and Other Writings, trans. Richard Seaver and Austryn Wainhouse (New York: Gro
1966), pp. 447-743.
72. This idea is developed in Bersani, "Sexuality and Aesthetics," October 28 (Spring 19
pp. 27-42 (reprinted as Chapter 2 of The Freudian Body), in order to argue that masoch
nevertheless "serves life" rather than death because "it is only because sexuality is ontologic
grounded in masochism that the human organism survives the gap between the period of shatte
stimuli and the development of resistant or defensive ego structures" (p. 34).

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 The Psychoanalysis of AIDS 115

the ego (the subject of speech, presented in

founded in-and therefore split by-the un
presented in the psychosis ecrit) is a distinc
tendency to deploy "ego," "subject," and "se
where Lacan sees jouissance as threatening t
disruptive of the ego. Because Bersani's is
(and jouissance is not a Freudian term), an
ofjouissance from Bataille rather than from
between subject and ego gets lost altogethe
purity will eliminate this problem, for, as I
with the effort to cure subjectivity itself.

A Cure?

The problem of bypassing the difficulties of the unconscious by appealing

to the ego devolves upon the question of the possibility of political change:
Bersani's appeal is motivated by the political desire to substitute psychic violence
(sexual self-shattering) for social violence. Although there is not yet any cure
for AIDS, we write in an effort to contribute toward a cure for sociosymbolic
ills. My essay bears a complex political intention, and is addressed to a hetero-
geneous audience. In response to various impasses of conceptualization (occa-
sioned by the dominance of a Foucauldean, implicitly antipsychoanalytic,
paradigm in gay studies), I have tried to develop a psychoanalytic perspective
on AIDS and its effects. In response to a relative neglect of gay questions and
an avoidance of the overwhelming cultural import of AIDS by psychoanalytically
oriented thinkers,"4 including Lacanian political critics, I have tried to analyze
AIDS while at the same time reassessing the place of psychoanalysis in contem-
porary cultural theory and contributing to a necessary periodization of Lacanian
thought. What this essay has not done is provide a post-AIDS psychoanalytic
account of gay desire.75 However, Lacan's ethic of psychoanalysis-"don't give

73. Georges Bataille, who is mentioned only once in "Is the Rectum a Grave?" and not at all in
The Freudian Body (but see Chapter 4, "Literature and History: Malraux and Bataille," The Culture
of Redemption, pp. 102-23), was of course a significant contemporary influence on Lacan; yet a
reliable account of the mutual rivalry and influence obtaining between Bataille and Lacan remains
to be written.

74. But see Francois Leguil and Danible Silvestre, "Psychanalystes confrontes au SIDA," Ornicar?
45 (Spring 1988), pp. 5-13, and Tim Dean and Graham Hammill, eds., Psychoanalysis and AIDS, a
special issue of South Atlantic Quarterly, forthcoming.
75. Such an account might begin by considering the contributions of members of the Freudian
Field to the discussion of perversion, a term used descriptively, indicative of a structure, rather
than evaluatively, redolent of moral censure. See particularly Marie-Hdlne Brousse et al., "L'homo-
sexualite masculin dans les structures cliniques," Traits de perversion dans les structures cliniques (VIkme
Rencontre internationale du Champ freudien, Paris, Juillet 1990) (Paris: Navarin, 1990), pp. 162-
71.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms
 116 OCTOBER

up on your des
and the pernic
I have taken t
American socia
for AIDS has
psychic structu
the compensat
makers of the
symbolizing A
tions" of AIDS
account of the
object a as cau
American rece
overemphasis
concept of the
theorize the death drive.
My argument is that in a psychotic society we are all PWAs. The question
remains: Is there a cure for this, if not yet a cure for AIDS? One of Lacan's
many revisions of the orthodox theory of psychosis was his demonstration that
psychosis is not untreatable via the talking cure ("On a Question," 214). However,
Lacanian psychoanalysis offers nobody a cure for subjectivity. Rather, it insists
upon a confrontation with the very condition of subjectivity: that the death
drive inhabits our being, that death is at the heart of life, and that there is
therefore something fundamentally incurable in being human. Because AIDS
has become a figure for death in life, we may say that although the acronymic
S stands for syndrome, a condition of the body, it stands also for the subject of
the signifier, $. Living with language, we are also now, as a consequence of the
political specificities of contemporary U.S. society, living with AIDS. If ACT UP
sometimes makes its point by writing AID$, my final point must be the reminder
that we are subjects of AID$.

This content downloaded from

156.110.45.99 on Thu, 20 Jul 2023 13:38:20 +00:00
All use subject to https://about.jstor.org/terms