PERPETUAL PAST: PSYCHOANALYTIC EFFECTS ON THE TEMPORAL LOGIC IN A CASE OF PSYCHOSIS

: In this paper, our aim is to study a specific clinical case taking the temporal dimension as the main angle of analysis. We explore the effects of psychoanalysis on time’s representation of a patient showing psychotic symptoms. We analyze the different moments of the therapy that made possible an original integration of the temporal dimension by working on the local coordinates of the therapeutic setting. The “subjective effects” that guided the cure are stipulated and articulated to the different interventions to show the logical foundation of the psychoanalytic clinical practice in this case.


INTRODUCTION
The presence of psychoanalysis in mental health institutions nowadays and the effects that psychoanalysis yields are two questions that cannot be considered apart from each other. How does psychoanalysis operate in mental health institutions? What are the effects that can be expected from its practice? Or else, as Laufer puts it : "How, in a hospital setting that is often depersonalizing, de-subjectivizing or alienating, can a patient be concerned for his or her own singularity and rediscover the place of his or her own speech?" (LAUFER, 2007, p. 22).
Analysts and researchers have studied these issues and they have proposed different answers to these questions, based on Freud's founding works and Lacan's Seminars and writings on structural psychoanalysis, which are the main references of our paper.
Usually, the different answers emphasize that psychoanalysis' effects are not limited to a symptomatic relief produced by suggestion or reeducation. The subject, as introduced by Lacan, always implies a logical move that cannot be assimilated to the individual or to the person (LACAN, 1960. It is worth remembering that Lacan criticizes not only psychotherapy in general but also a psychoanalysis oriented according to the egoic coordinates (LACAN, 1977). In fact, the analysis of the "ego" in Freudian theory is one of the central subjects of his first seminaries (cf. his first Seminar [LACAN, 1953[LACAN, /1975 and his text Le temps logique et l'assertion de certitude anticipée [LACAN, 1954[LACAN, /1978), even if Lacan keeps insisting on this all through his teaching (for example, when he criticizes the concepts of projection and introjection [LACAN, 1968[LACAN, /2006).
The introduction of the categories of Symbolic, Imaginary and Real provides a way to order and formalize the position of the subject, specifically by breaking off with the academic psychology's opposition between the real and the imaginary (LACAN, 1960 in the same way as one opposes reality to chimerical, fantastic or illusory worlds. According to Lacan, relying on this usual distinction is not the right way to approach them in psychoanalysis, since reality and fiction are both constructions that must surely be distinguished from each other, but neither in terms of a supposed "external objective consistency" nor independently of any reference to the subject. He says: "Every reality is suspect, not of being imaginary […] but of being fantasmatic" (LACAN, 1971(LACAN, /2011.
Before addressing the next issue, we would like to highlight a fundamental aspect of the notion of Subject in our framework: the Subject is a logical effect. The foundation of this assertion lies in Lacan's continuous recourse to theories of logic not with the intention of "reducing" the Subject, but of giving it an effective status (cf. LACAN, 1961, Lesson 16-11-1966. What really matters here are the aporias, the difficulties, the paradoxes raised by logic. The Subject is necessarily related to formalization, but is not reduced to it. In this sense, we find several affirmations by Lacan about the defining relationship between the Subject and the signifier, the split Subject on the graph of desire, the Subject of the unconscious as a divided Subject etc. Previously, we have introduced the expression "temporal logic" when talking about the Subject. It is somehow astonishing to talk about "temporal logic" because, like mathematics, logic is in general "outside time". Not only in the sense of a Platonian universe of pure entities detached from reality, but meaning that formal procedures, equations, laws, deductions, should timelessly hold. Even if nowadays there exist "temporal logics" in the field of modal logic (GARSON, 2021), this is not what we mean by the logical time related to the Subject. In physical science, the main problem is to leave the observer aside, but this is also true for formal sciences. In fact, the subjective perception of time while solving a problem, should play no role in theoretical developments. On the contrary, in the logical approach set forth by Lacan, time is conceived as being undetachable from the emergence of the Subject at the moment of confronting the unavoidable paradoxical points of reality, including the others. Consequently, linear chronological time and personal history have to be reassembled to deal with disruptive events that threaten the illusion of continuity. At these moments, the logical functions that guarantee the stability for each one, are required to make the "knotting of reality" and they will respond in a specific way depending on the clinical structure of the patient.
Let us now return to the question of therapeutic effects in psychoanalysis. According to Adriana Rubistein, psychoanalytic effects must be analyzed following the logic of their production (RUBISTEIN, 2009). In this way, any reference to an external verification, in the sense of observational confirmation, will be excluded ("data" from social workers, school etc.). Obviously, changes will take place but they will only have a precise meaning in the co-text of the patient's discourse developed in the psychoanalytical session.
The therapeutic effects may include some kind of relief of the subjective suffering as presented by the first expression of the patient's demand such as symptomatic relief, reduced anxiety or attenuation of somatic pain, for example.
However, the therapeutic effects that can be identified as properly psychoanalytical ones always involve a subjective movement that can be formalized in terms of the specificity of the Subject in our field like, for example, the onset of transference or a change in the libidinal economy. As Dana says, a pathway in the institution, […] can eventually become an event and produce a decisive subjective mutation or even give rise to a new enunciation. (DANA, 2005, p. 28). We argue that the subjective movement pointed out by the previously mentioned authors, has the symbolic coordinates as fundamental reference. This means that the effects of the treatment for each case admit a precise relation to the symbolic dimension in terms of its own logic and of the structural and functional characteristics of the model. Obviously, this way of proceeding is not a universal key to find the truth of each case because holding this statement would mean to subscribe to a reductionist scientific principle implying the concomitant exclusion of the Subject. However, the way in which truth is touched for a patient and the kind of subjective effect it produces can be accurately determined.
Our former question on the way in which psychoanalysis operates in public health institutions cannot be answered without an effort to formalize what happens in a particular situation. In the clinical case that we will analyze in the next pages, we will find that this subversive praxis can affect the way in which someone experiences time as a subjective symbolic experience. We will argue that this kind of reorganization is not only a therapeutic effect but a consequence among others of a Subject effect.

THE CASE 1
The interviews with Marc began about five years ago. Interviews took place weekly at a Psychological Medical Center in the city of L**, on a fixed day and time and lasted half an hour each.
Marc suffers from various psychotic symptoms, and he has a long history in the institution that began more than 10 years ago. When I saw him for the first time, I asked him to introduce himself and to tell me, in his own words, what the reason for his consultation was.
He answered: "I was born in 19**. I'm 47 years old." "I don't feel well; the problem is my lack of references. My life is a torture." "I'm not a psychotic." "I'm wandering and I do not know which way to take." "I had a difficult childhood and a dark adolescence." "Life is a very serious thing; it's no joke. I don't know how other people live. I wonder [...] but I really don't know. I don't have the instruction manual." During this interview, he told me that he had already seen a psychologist for some months, but he stopped because, according to the psychologist, he was not able to change and for the moment it seemed impossible to go on with the therapy.
The psychiatrist that Marc sees regularly, told him that in our institution there is the possibility of doing a psychoanalytic therapy and, upon hearing this, he decided to make an appointment, because, in his own words, he needs "a global and long-term work" to organize his own life and to go forward.
During the interviews, Marc outlined the fundamental elements of his personal history. We will point out here three central moments that will take the form of fixed points and whose main characteristic is the amalgamation between utterance and meaning; every time that Marc talks about these events he does it not only in the same way, but using the same words in the exact same order and the same intonation. When they appear, one has the strange impression of a recording that starts with the first syllable. For him, there is no questioning whatsoever, his words are what we might call "personal aphorisms". In fact, this is an example of holophrasic functioning of the signifier. As Lacan says, the holophrase consists in a monolithic expression -like injunctions in current speech -where "the subject himself is the monolith, the receptor of the message is absolutely excluded" (LACAN, 1958, Lesson 3 dec. 1958).
These events are, according to Marc's expression, "the three mistakes of a life". 1. When he was 13 years-old he breaks up with his best friend: "My separation from T** was my first big mistake. We were like brothers. It was the beginning of the end. Since November 19** I have been alone. I do not know why I did it. It was a mistake." 2. After finishing high school, he decided to study at the university: "I asked one of my teachers for advice and he told me that I had to find many, many, many friends. Friends [...] they don't exist [...] that crazy woman! I looked for friends but I only found enemies. Then [...] I asked another student, who lived in S** and who had come to study as I did, if we could work together and he said: 'We are young men, young men don't work [...] they have fun!'". Upon this, Marc told me: "Hey, you see, I always attract morons!".
"Now I want to find just ONE person, only ONE, to talk about books or movies, and this until the end of my life. Then I shut my mouth and I take a vow of silence." 1. When arriving in the city of L**, he enrolled in the Medical School. At the end of the year, he took the exams but he failed: "I failed, I didn't feel well, I didn't feel well [...] I was crazy, I was living in a basement".
According to Marc, the consequences of these events are: 1. The fact of being alone since the separation from T**, when his "descent into hell" began. 2. The impossibility to make friends. It is not only people, potential friends, that bother him, it is the word "friend" itself that terrifies him; talking about this, he told me that if someone comes to say it, for example a radio announcer, he is forced to change the station at once. 3. The impossibility to turn away from his father and from his brother who have made him suffer: "If I had passed the exam, I would never have spoken to them in my entire life. But now, since I failed, it is not possible." Another important event for Marc, shortly after the exam, was his meeting with a woman while selling clothes in the marketplace. She asked him the price of an item and he answered her impatiently: "Just look, it is just written on the item!". Marc told me, "I offended her. But it was not on purpose, I didn't mean it! At that moment, I was not feeling well. I have recently failed the exam".
Each date is precisely acknowledged by Marc. He can remember events that took place decades ago with an astonishing accuracy and, when talking about his activities during the current week, he looks for the exact time and day. When he is not sure, he takes some time to remember it correctly before saying anything.
During his first years of therapy, Marc lived in a small room in a community house. He had reduced all contact with neighbors to a minimum, "only a 'good morning' and that is all". He lived only on the public assistance program, a small amount of money to pay the rent, to eat and to buy some clothes.
One of his most important ambitions was to pay off his debts. He has calculated, with a personal rule, how much he owes the others and, since there are people he will never see again (like the market woman), he has decided to give that money to some beggars in the street. It is a very precise amount that keeps coming back in his discourse all through these years -how much he has already given and how much he still owes. In order to do it, he puts a sum of money aside whenever he can.
He says: "In this way, I will have no more debts. No more blame on me. And, once I have given all the money back, I will pay close attention not to owe a single penny to anyone. In this way, I will be blameless until the end of my life."

ABOUT THE EVER PRESENT PAST
In one of our last sessions, Marc told me about his trip to a museum in our region: "I got up late and so, instead of taking the morning train I took the midday train. The train made a stop in the city of S**, the city of that bastard, of the damned one! The one who told me "who cares about studying, we are young men!".
"It was 14:40 and I had to wait 17 minutes for the next. I turned my back to the station, I sat on a bench on the far side and didn't look inside or outside the station, I just kept looking down in the direction of the rails without moving my head." "Then something strange happened to me. I was alone, I did not see anyone, and at that very moment I thought of Tolstoy who died on a bench in a train station." "When I realized, it was 3 o'clock and my train was leaving. I tried to catch it and the doors closed, I saw a controller at one of the train's doors who beckoned me. I couldn't do it. It was all over in a second. I told myself that I'd take the next train. But then I saw that the next one wouldn't arrive before two hours. So, I waited two hours sitting on the bench in the cold not looking anywhere. Almost 30 years have passed and that bastard keeps on hurting me. Finally, I missed the guided tour of the museum, I only paid a quick visit because I only had 15 minutes before the closing hour." TIME Our aim is to study this case taking the temporal dimension as the main angle of analysis. For Freud, time in its chronological character conceived as an orderly homogenous sequence cannot be applied to the unconscious: Not only do memories resist the erosion of time emerging with astonishing accuracy at very late moments of life, but the order of events itself has no necessary relation to the sequential form of life episodes. (FREUD, 1915, p. 187).
In Lacanian conceptualizations, there are two key references in the characterization of temporality. The first one concerns the importance given by Lacan to Freud's notion of nachträglich as an actual inversion of temporality in the cause of symptomatic productions of neuroses.
The second one concerns the logical status of time -as stated in the text Logical Time and the Assertion of Anticipated Certainty (LACAN, 1945. This text introduces in a rigorous way the particular bond that links logic and time from a psychoanalytic point of view and, most important, he sets forth the notions of anticipation and retro-action as two key moments of the emergence of the Subject and his relation to the act. Let us not forget that the time we are talking about, the time of the Subject of the unconscious, is the future perfect in French. This is necessarily related to the sequential character of the signifier chain as Lacan says explicitly in his Seminar The desire and its interpretation where he insists on the double temporal reference of this verbal tense in relation to the statement and its enunciation (LACAN, 1958, Lesson 3-12-1958. This characteristic is underlined by Fink when he affirms, while talking about separation, that "Lacan never pinpoints the subject's chronological appearance on the scene: he or she is always about to arrive -is on the verge of arriving -or will have already arrived by some later moment in time. Lacan uses the equivocal French imperfect tense to illustrate the subject's temporal status" (FINK, 1997, p. 63).
The resolution of the logical dilemma included in Lacan's text -in which the prisoners' lives are at stake -needs an act. However, we can say that this act does not occur in time, rather, individual historical time appears simultaneously with the act, showing its discontinuous character.
It should also be remembered that the assertion of anticipated certitude is the fundamental form of a collective logic. Then, the act cannot be thought of as purely individual but as determined by the other's behavior not only as a similar being; the act is necessarily linked to the calculation of the other's hesitation. It is in this sense, speaking of his own text, that Lacan says in the seminar Encore: "There is something there whose value I only underlined, the fact that something like an inter-subjectivity may succeed, but we would have to consider this matter more carefully" (LACAN, 1972(LACAN, /1999). Time has a direct relation to the possibility of symbolization and therefore, to the creation of a legalized link to the others.
We will see that for Marc, temporality has a particular "structure" and this nuance will become a possibility for subjective positioning in the treatment. We argue that, in general, there are at least three different possibilities that open up from the clinical consideration of time and its presence in the cure: 1. the time of the setting (day, hour and duration of sessions, interruptions); 2. time as the movement throughout imaginary identifications. The integration of one's personal past history (LACAN, 1953(LACAN, /1971); 3. time as an effect of the cutoff produced by an event -the time of the event -that marks the possible place of the Subject of the unconscious.
Let us consider how we can analyze our case considering these different aspects of time one by one.
1 -Regarding the setting, Marc is very respectful of the established frequency and he is always on time. While sitting down, he always looks at his watch without saying a word. Sometimes he also takes a look when I announce the end of the session. He always begins by saying: "It's been a week" and sometimes he makes a remark on how quickly time passes. On holidays, he returns to his family's home and each time he informs me of his absence exactly a month before leaving.
It's very important for Marc to be sure that he can go on with the therapy when coming back and he needs to be sure about it. The dual character of rigidity and flexibility of the setting seems crucial for him: on the one hand, he must organize his activities taking into account the day and time of the session that have been previously fixed; on the other hand, he can be sure that he can leave and resume his therapy when coming back, if he has announced it at least one month before. We agreed on it together at the beginning of the treatment and it constitutes a preliminary condition to order his own time in multiple ways and to keep a connection with the surrounding world. At this point, we find the inscription of the possibility of anticipation trough the apprehension of the setting by Marc: "I will be able to go on speaking about myself in the forthcoming sessions if I am sure that they are ordered so as to take into account the interruptions and the resuming." 2 -The sense in which his personal history and the history of his identifications can produce a link to the past is different here from the retroactive (après-coup) movement which, for the temporal logic of the neurosis, allows the psychoanalyst to operate on the cause of the symptom. Obviously, when Marc talks about his own history we have a narration of past situations. But, what it is not guaranteed for each of his memories is the possibility of opening the question of his subjective implication. The only thing he can say, when he does not understand why he behaved in a certain way -for example what happened with T** or with the woman in the market and also when he failed the exam -is: "I was not feeling well; I was crazy". If we tried to exchange on some specific usual facts, he will stay perplexed. This was the case once, when he said, with an air of embarrassment, that he would accompany his mother to the doctor as he had done for years. Seeing that this situation seemed to bother him, I asked him why he should do it; he looked at me and said: "I do not understand your question. My mother asked me to do it". I went on saying that maybe he could refuse to do it this time. His response was immediate: "You cannot refuse what a mother asks you to do", and, on this, the discussion was over.
We can see here a cyclical character of time, but of a particular type, as C. Soler asserts: "We see that paranoia remains more similar to the divided subject than the 'schizophrenic' subject, because the structure of the temporal retro-action is still present, even if it appears in a cyclic form that does not correspond to the neurotic one [...]" (SOLER, 2012, p. 120). This cyclical time points out the character of the signifier repetition in a special way. In the case of Marc, the impossibility of repeating -that always includes a failure -, that would make possible to fix the past by a subjective act, does not operate and we have observed instead a superposition of instants. The scene at the train station is a good example. His "enemy" continues to hurt him even after 30 years; Marc is forever blocked at the same point. One has the impression that nothing has changed. It is worthless to tell Marc that this person has probably forgotten him, that he may have moved from that city, that now he is older and that he has surely changed, or just that for him the sentence he uttered at that particular moment had no importance at all. This same rigidity is flagrant concerning his early years. His souvenirs are completely disconnected to the present. Marc doesn't talk about his childhood or, when he does, he merely states an isolated fact without any affective content. As Aulagnier puts it: " The memory and what is 'recordable' of childhood depend on the success or the failure of the labor of the repression […] The failure of repression may also appear by its excess or by its weakness, in both cases, the effect is a drastic reduction of the field of possible relationships […] The effort of historization cannot be successful, childhood remains a chapter that is impossible to write with a beginning and end" (AULAGNIER, 2015, p. 717-718).
In this case, we can say that the operation at stake from the psychoanalyst's point of view would be to introduce a localized past reduced to the last few years, from which one could interrogate in a limited way certain events of his life.
For Marc, a very important episode in his recent life was his moving into an apartment. It marked a standpoint from which he could tell at the present time that his former housing conditions were unbearable. He always repeats: "I wonder how I lived like that for so many years." Now, he has achieved an important thing. By consulting the social workers, dealing with the administrative procedures, meeting the employees, he rented a studio in which he lives alone. Along with this, he has decided to do ALL the exercises in the manuals that are published once a year to prepare the final examination of the baccalaureate 2 -even if he already finished high school. This is what his discourse turns around through the sessions. His greatest pleasures are to drink coffee, read novels and go to the movies. In this way, another personal dimension, work, has been fixed in a limited way: to complete exercise books, to read scientific update magazines; he has even enrolled in French, mathematics and computer courses for adults. He usually evaluates his own evolution and he often regrets not making much progress due to his lack of concentration, but he adds that it is time for him to resume working.
This regularity enables him to distinguish between work and recreation, representing in a certain way social commitment and a link to others through public associations, libraries or simulated examinations, as much as a modest place only for himself. At the same time, it has been important to give to this movement the character of a personal accomplishment in an explicit way. This led him to affirm that he is better than he was, not because of his new accommodation conditions -which are in fact better -but because he has been able to recognize the bad conditions in which he had been living in until then and do something to change them.
3 -With respect to the third axis we mentioned before, both the anticipated possibility of the Subject related to the act in the framework of a stable meaning and the production of a Subject effect in the unforeseen confrontation to the limits of the signifier, seem not enabled, at least as possible predesigned interventions in the case of Marc. Commonly, logical time, as opposed to chronology, allows the complex temporality of the divided Subject to emerge as a surprise. With Marc, some kind of "uncommon strategy" had to be invented to inscribe both a logical and a meaningful time different from an empty chronology or a frozen present. Our aim was to arrange a place for the subjectivity, actually a narrow one, in the restricted relational field of our institution that may have a temperate effect in his everyday life.
Concerning the therapeutic effects, we can state that Marc has been able to move away from the invasive effects of the anguish provoked by his "madness", as he calls it himself, to find a way to improve his living conditions and to find a stable condition open to the future.
As for the elements that allow us to account for these effects from a logical point of view, we consider that the question of temporality previously evoked is fundamental. The limited historical localization reduced the possibility of the emergence of puzzling situations to a certain immediacy, excluding the most paradoxical points for Marc from all interrogation. The intervention was oriented by operating on the pair retroaction/anticipation articulated to the temporal setting of the treatment. This kind of intervention makes it possible to rethink a history that is mainly restricted to the recent years -with its achievements and its failures -and to envisage a possible future.
In our case, the temporal dimension, which is inseparable from the subjective effect, allows us to articulate the logic of a treatment admitting the operability of the boundary, the edge, the barrier that prevents the sliding of certain points from the past to the present and their overlapping in a perfect cycle.
However, we should not forget that this solution is partial and always fragile. Even if Marc has managed to become, to some extent, autonomous, even if he has taken a few but important decisions, there are still events like the train station one that can puzzle him considerably and make him suffer. The environmental social condition -like the terrorist attacks in the last months -can be the source of a great stress. Links to other people are almost non-existent due to his basic distrust in human beings. However, Marc keeps coming back to sessions each week and, in his own words, this helps him "to face his inner demons and to carry on his projects".
This space-time of speech, the time of displaying a narration of his own life addressed to the psychoanalyst, works as a discretization of a continuous time flux during the weeks or months of treatment. For us, it has not only been a question of exploring or assembling the past and the future in a symbolic way but mainly to operate one step earlier, spinning the knotted string of time.

CONCLUSION
We propose that mental health institutions can benefit of what we can call, following Lacan, the analyst function. Psychoanalysis is not an issue of setting, but of production of the Subject effect and its libidinal consequences in the subjective economy. The study of particular cases treated by psychoanalysts in mental health institution is a way of asymptotically rejoining the subjectivity of our time (LACAN, 1953(LACAN, /1975, considering that each patient can teach us something new about his singular ways of suffering and the solutions he managed to treat them. Certainly, many things remain to be said about the offer of psychoanalysis in the field of psychosis. In the case we have analyzed here, the singular experience of time can be captured and proposed as the base of the solution by the careful reading the analyst offers to Marc every week. Dana invites us to consider the effects of psychoanalysis in the institutional treatment as a personal legend written by the patient by saying that "the institutional legend, which is necessarily written over a long period of time, supplements the history of the Subject and, at best, may awaken it" (DANA, 2005, p. 28). Introducing a temporal logic in Marc therapy, required to move aside from any institutional pre-existing "programs", it meant taking a risk, the risk to break down the frail ersatz of stability that paralyzed him. We did it in three different ways. First, by bringing our appointments close together and thoroughly respecting their regularity both in time and in space, and also by holding to their continuation after holidays or after announced interruptions. This is not only a technical issue but an ethical one in health institutions nowadays, where, as Bruckman says, "the time to understand is no longer relevant. The new fashion is urgency" (BRUCKMANN, 2004, p. 107). Second, by inscribing, through a recurrent dialogue, the few signifiers particularly meaningful for Marc when he talked about his history or his future ambitions. Finally, the third and most important way to introduce a temporal logic was to accept the absolute exclusion of a precise signifier, the one that, in his own words, destroyed his life: "friend" and, in this way, to stop the attraction of an unrepresentable distant past. This is the legend that Marc has been able to write in different places and at different moments at the institution. While working with Marc, we attempted to keep in mind a fundamental principle about therapy and psychosis outlined by Laurent: "There are many possible practices, do what you can but actively and bearing in mind what the structure allows" (LAURENT, 2003, p. 24). Based on our own clinical experiences, psychotic patients may find in psychoanalysis, namely in a mental health institution, a place to be heard and to make use of the exiguous freedom we have as human beings.