Prevention of Discourse: Virus of the Unconscious

Published online, May 2020.

After waiting so long for the moment to shape certain texts, written since 2002, in an attempt to contribute to the immense undertaking of the History of the HIV-AIDS pandemic, texts focusing in particular on prevention discourse and unconscious knowledge, it was another epidemic (that of COVID-19) that prompted their resumption, to question their relevance, to know whether they can support the elaboration currently underway. Not that the experience of HIV-AIDS shows us the way for that of COVID-19, but what the experience of HIV-AIDS has done to us for forty years, to us speaking beings, reveals and pertains to unconscious knowledge in relation—which is written and which is not written—with that mobilized by this new pandemic.

From there to linking what happens in a bed where a risk is lodged with the aisles of a supermarket where another is lodged, there is a whimsical step to take, to isolate, in particular, what of the sexual relationship—which is written more often in the real than our theories think at this hour—summons us to the task of analytic treatment, from which we might hope for some updates on the real of sex. To the task, and not to the act, for what can bring us together here, all invited in the position of analysands above all.

The qualities of psychic treatment, theoretical elaboration, and thought determine the contribution of an epidemic on a collective scale in the same way that the awakening force of illness can rise on an individual scale. From the HIV-AIDS epidemic, certain delicate questions, difficult to address head-on, have been set aside and continue to be denied. Yet they have nourished the deployment of morbid phenomena working to safeguard subjects of the unconscious left behind from a balance they cannot rid themselves of, phenomena that condition the possibilities of their subjective determinations in favor of extreme identity norms. For let us not forget that the existence of treatments, or even equality in law, has never resolved the real questions posed by an epidemic to a human society.

Enough to interest beyond minorities, communities and, through a pandemic, to target humanity confronting a new (unknown) one.

Enough to challenge psychoanalysts on the malaise—another epidemic, another human work—that risks uncivil escalation against a backdrop of psychic accidents and serious subjective collapses.

Enough perhaps to prevent psychoanalysis and some of its servants from falling into social works in the face of perils, where offers of services flourish as loaves are multiplied. Beware of wolves, beware of the criers of goodness that we are sometimes hastily determined to be for lack of having the knowledge. Where empathy, volunteerism, care, and resilience make the soft nourishment of bacilli capable of transforming malaise into balaise.

Minorities surrounded by illness have had in recent history to deal with it, to live with it (very common expressions from the 1990s): How to make love with someone who might be carrying the virus? work with this person? live under the same roof? Questions that bounce from one era to another. Will we have to restrain ourselves, give up our desires? Will this be livable, even humanly tolerable?

A large number of these questions, left hanging with HIV-AIDS, covered over as soon as it was possible to ignore them, to push them away a little (sometimes repressed, most often denied), will encounter bits of answers through the necessities posed by COVID-19. And, conversely, other unprecedented questions will emerge with this current situation.

For lack of being able to offer immediately the developments of a work that remains to be pursued, hoped for over many years, here are some elements of identification and questioning that could, in the future, constitute a work program capable of bringing together those who, from wherever they find themselves in their experience, will be willing to commit their time and attention to let themselves be thought by these unknowns that we aim to approach.

Let us accept, to do so, the temporal distortion to which we are becoming accustomed these days, applicable to the years 1980-1990-2000…-2020, which seem quite separate and yet equally joined, without possible confusion, here, in order to think about them and let ourselves be thought by what is happening to us. Let us also accept the confusion of objects between these eras and the incomparable current events that separate them, but of which we want to signal certain echoes.

This wandering leads us to the following points, to which other questions not formulated at this hour will be added:

 

1. Prevention discourse is a discourse of the State.
2. The fantasy of stolen jouissance.
3. Risk (revealer of alterity) and threat (support of desire): figures of the Other.
4. The price of prevention: the other.

 

Landmarks

At the turn of March 2020, I first thought that the experience acquired on the HIV-AIDS pandemic could inform us for that of COVID-19 still virgin. I said, a bit hastily: “COVID-19 is a bit like AIDS for everyone!” It didn’t make many people laugh; it was a bad pun, a failed witz. And above all, it’s false: one virus does not hide another, an epidemic even less so. Let’s look at this more closely.

Jacques Leibowitch would have gently chided me, responding 1– the viruses are different, useless to compare them to compensate in vain for our lack of knowledge about them; 2 – epidemics are not the work of viruses, but a creation of humans where their relationship to the real is illustrated. He would have added a well-felt jab toward psychoanalysis, particularly on Lacan’s side (even if Leibowitch may have broken with Lacanians in the last century, he nonetheless remained truly knowledgeable and signifying, the fellow); and drawing closer to mutter, he would have asked: “Tell me, to say your nonsense, did you ask the commander first?” The commander, thus he named the virus, not to elevate it to the rank of big Other, but to underline the function it occupies in the imaginary, beyond the “imaginary-Maginot lines,” as he qualified not without mischief what of the imaginary we hope for absorption of the real.

One of his credos? Not to batter the intruder-virus, on the one hand, nor to excessively inflate immune defenses suspected of working toward the general inflammation of the organism put in check, on the other hand; the speed and intensity of the immune and inflammatory response being the major problems to keep in sight, not the new cohabitant. Without an unconscious, the virus does not need history or language to operate, unlike us who panic immediately before it, or rather let’s say before the intruder that we are tempted to make object a bit too quickly.

We now know better that the AIDS pandemic began around 1921 in southern Cameroon, in the French and Belgian colonies (the official date of the epidemic is 1981-1983, depending on whether one retains the discovery of the syndrome or that of the infectious agent), when a virus, originally passive, present in bush animals, was able to colonize the human species where it became active, thanks to social inequalities (precarious workers), the sanitary measures of the time (care for the natives), the blindness of the global political imperialism of a few nations, to make it one of the most effective epidemics, still active in 2020, having caused more than forty million victims to date, as many people living with HIV currently, for only twenty-five million HIV-positive people treated around the world (only half, therefore), despite therapeutic progress and supposed political efforts.

As for the future, since this is what concerns us greatly today, Leibowitch said that a virus such as HIV, once passive, having become very active, could find its way back to a sleep conducive to its cohabitation with human beings. In three hundred or five hundred years, he liked to say, HIV could regain its calm, provided we do not want to reduce it to nothing, to “not excite it,” nor attempt beyond measure to be stronger than it: no napalm nor super immunity, especially not. Anything but war! It is indeed the immune and therapeutic ideology and policy of war that are targeted by his positions. In their place, a just enough that can make us think of Winnicott’s good enough.

It is thus that he outlined the first strategy of reducing therapeutic effort at the turn of the 2000s, where the virus is exposed only to the right dose of medication ensuring its rest (and, notably, an undetectable viral load, therefore non-contagious and less active). Responding to his detractors, because his discourse remained difficult to admit for many in the scientific community, he also often signed his messages with “We shall overcome because we were the weakest,” well summarizing his stance far from parties, far from the liberal ideology centered on performance, perpetual surpassing, guaranteed jouissance, which have long infiltrated medical, therapeutic, and sanitary ideologies on a global scale.

 

Just a Discourse

For lack of being sufficiently gifted in immunology to approach the infectious thing head-on, we nevertheless have access to a significant production of the relationship we maintain with it: the prevention discourse, where act and speech are engaged in a torsion unconsciously determined that may interest psychoanalysts—even if most of them have not at all looked into the AIDS epidemic except through pathologizing interest in homosexual particularisms, and to pour out old interpretations on death and ordeal sprinkled with jouissances (very far from what AIDS makes us know).

In forty years of the HIV-AIDS pandemic, psychic and unconscious stakes have never been taken into account by prevention discourse, by its actors (preventers), by public authorities. Many clinicians nevertheless devoted their work to it (around the world), without meeting the deserved audience: this is not the first time that unconscious knowledge available to know is refused.

Prevention, highly developed in France, which remains, undoubtedly, the country to have published the greatest variety of brochures and information leaflets in the world, has been considered only from the angle of information to be transmitted through adapted communication (simple, targeted), supported by informative materials and meetings with preventers, with the aim of modifying behavior. The unconscious has no real place there, a priori.

It is also the effect of the success of communication, advertising, and neoliberal management which, since Propaganda (written by Edward Bernays, Freud’s nephew), know how to use some of the psychic processes known thanks to the exploration of the unconscious, while rejecting what the ethical recognition of these processes requires—except if certain perverse polymorphous drive regressions conducive to purchase, destruction, aggression, possession, domination, all experienced in active and passive mode, are hoped for.

Let us not believe, however, that prevention discourse is of a private order because nourished by liberalism that gets along so well with individual claims. Several things must be distinguished 1 – prevention discourse is, always and above all, a discourse of the State; 2 – prevention is a speech structured by prevention discourse that makes it possible.

How do we know this? Prosaically, the State orders and subsidizes prevention messages, ensures their dissemination and controls their content, this is the first element. Let us remember that it has never been obvious to speak openly, for example, about condoms on television, or even about sexual acts which have remained and still remain taboos, that even the health crisis of the time did not dissolve. Why this reluctance? Is it in the name of morality? I do not believe so, at least not fundamentally, even if moralizing spreads at least as well as jam. Fundamentally, it is a structural question, linked to language as organization, modeling, determined articulation.

The prevention message articulates risk and threat as two figures of the Other. How would it emerge without balance from such adequacy to the necessities of language? Place of the Other, the source of prevention in extension is indisputable, but it should be said, then dispute the specificity of threat as precursor of excitation—thought of as product, risk being induced.

Have we not observed these masked heads, lowered, too silent, crossed on the sidewalk? Where some and others, some vis-à-vis others circulate, looking sheepish, nose in chin, as if from the prevention of which they have become the authors, they could not assume the part pertaining to the other who saw the other who saw the virus, and who burden themselves with having become themselves embodied risks. Being a risk is difficult.

In protecting oneself from something, one always ends up protecting oneself from someone, from the other: the price of prevention.

 

The One Who Says, Who Is

The taking of speech by prevention actors—whether authorities or professionals—is a taking of power with symbolic value, in the sense that their initiative to speak comes to break something of an intimately shared unsaid. To say, and more than reason since it is a matter of saying more than others and for their attention, constitutes a suspect act quickly judged—certainly unconsciously, but as always, the trace is found in what is said.

The initiative of the prevention agent comes to play right against the question of the Other. This is not without making those who are there to hear—the others—fear the worst.

According to one hypothesis, daring to rise to this position would constitute a crime for which one must answer. In this way, the public, to whom the prevention actor addresses himself, brings him to trial for jouissance, for stolen jouissance in this fantasy. For nothing is more suspicious than to allow oneself to say so much without this being suspected, closely or remotely, of being the result of shameful or guilty acts: unconscious theory, possibility of conspiracism.

That he authorizes himself to say so much when all the others observe only their submissive reserve and the expertise thus confessed does not delay in confounding the suspect. It is by wanting to make him fall from the place he thus aspires to that each strives to diminish the scope of his words and recommendations, and to attack even the authenticity of the individual, even private, approach of the one who works on behalf of prevention discourse. For in standing out in this way, fraternity is betrayed, jouissance is stolen. Let us not fear to grasp all the violence that is read in this movement: the relationship that prevention actors in health matters maintain with the public to whom they address themselves is perfectly untenable. Is this sufficiently taken into account to think about public action?

Thwarted, the success of these prevention practices is no longer a goal to be achieved, because the latter has fallen. Contradicting or transgressing the recommended behaviors even becomes a goal where the identitarian, as matter, becomes the cause of desire where it can be confused in the unconscious with the virus (HIV, and perhaps tomorrow COVID-19). It being understood that even those who speak—from the place of a supposed knowledge—are not exemplary—we know they do wrong and their project is doubtful—everyone can then be content with little.

Exemplarity no longer being appropriate, each person labors at their little jouissance and accommodates an approximation consented to in a low voice.

 

Stake

Over forty years, the prevention of HIV-AIDS transmissions has seen the discourse underpinning its structure accommodate various stakes, sometimes collective, sometimes individualistic. Where the notions of society, communities, love, desire, and jouissance have been reshuffled more than it has been possible to acknowledge and extract knowledge from them.

This occurred as the constraints linked to the prevention of contaminations became more or less unbearable to people who nevertheless had the necessity to protect themselves. Because effective measures against viruses are constraining, restrict freedoms, wound lives as much as they ensure, guarantee survival to these lives: treating infected people, treating those who are not yet, reducing treatments, measuring viral loads, attempting to influence community viral load, conceptualizing the viral precarity of some, etc., as many questions that will soon concern the entire world population, and no longer only minorities thought of in their supposed specificities.

In this recent past, there are undoubtedly two or three useful things for thinking about the present situation of the year 2020 and following ones. And to respond, a little, to immense ethical, moral, technical questions. To treat risks, threats, viral inequality, desire, care, jouissances, defiance against prevention, the a/Other, risk scales, fantasy, geolocation (tracking), public display of serological status, prevention discourse/State discourse, the subjective cost of protecting oneself, imaginaries, targeted communications for target populations, the impossible understanding between the preventer and his public, the imaginary status of seropositive people, the hierarchization of behaviors confused with risks on behalf of moral principles, without forgetting the discriminations and endangerments of minorities and the precarious, or again, of course, the major stake of access to screening and prevention material, etc.

 

The Masked Avenger

A mask for sessions with patients, analysands?

In recent days, the question has stirred, brought to the surface both some arguments and some pieces of fantasy, fears, moral principles, etc. Many things are said: “I will never wear a mask to speak to another, speech requires”; “A child will be afraid”; “Such specificity of such person does not allow observing this measure.” Or, conversely, which is never anything but the same content on the other side, or almost: “Without a mask the patient will not be able to enter the office, I am protecting myself.” The question is not to know whether one or the other of these quibbles is valid or justified. All serve only to conclude a deal whose negotiation is conducted elsewhere, on another level.

Without nuance, I attempt a question: was it disrespectful to the other to consent, or to insist, or to make possible for the other the material possibility of protecting oneself, of taking care of oneself, when it was (and/or still is) possible, even essential or desirable, to have sexual relations with a condom?

Or, another question, without nuance. Was it not already confronting a difficulty of a new kind? The temptation of the relationship that there is in a certain dimension authorizes discussing the conveniences of reality (another dimension), that it is sometimes more than urgent for the speaking subject to affirm, to support his discourse to tie symbolically justifications that have become white threads of too large a diameter.

The sexual relationship that there is at the threshold of possible contamination causes the trouble of meaning, a bit floating these days, that decisions would have to stabilize on behalf of small temporary certainties, weapons of a discourse, prevention discourse, which, on an individual scale, obscures the possibility of keeping open access to the unconscious: it prevents psychoanalytic discourse as law enforcement apprehends the future accused for Justice.

Stolen jouissance is first the jouissance that could be stolen, it is first a fantasy, even if jouissance is effectively not produced, not felt: missing by negativity, not by withdrawal. Founding, this fantasy contains the invisible arguments of a heist à la Casa de Papel, where resistance to public order figures the heroism of a desire presented as liberating, where the most extreme intimacy feeds on unconscious incestuous desires, for example. Piracy is not only romantic, or justified, it is truly heroic. Like the drive, it frees itself from obstacles.

That the Other, through the intermediary of a virus making itself cause, can so effectively relaunch the Phallus, is a condition that the epidemic fulfills. And here we are brought back to this time when others expressed the imperativeness of an extreme intimacy capable of organizing representations, logical articulations, the reality where love is dispensed (in all senses of the expression).

Prevention discourse, governmental or individual, when it is taken up on behalf of a subject, releases to the unconscious, like a Zorro, the remains of frustrations, privations caused by the right distance between generations protecting from incest, from incestuous desire. The prevention of discourse—effect of prevention discourse that settles and extends within oneself when it is absorbed—is a virus for the Freudian unconscious, a little Trojan horse that anguishes, drives mad, stirs up all available pre-Oedipal disputes, to constitute the center of hesitations, perpetual contradictions that we have no more to resolve today than yesterday, but much more to lead toward other discursive articulations: toward psychoanalytic discourse, again? The one from which one cannot prevent oneself, neither oneself, nor the A/other.

 

All that for that, you will tell me. Yes, to wait all this time, nearly twenty-five years, to see two tiny pieces of disparate thoughts come together, it is long in appearance. It is not even a distance to the unconscious, it is the effect of the absence of a principle of continuity. Instead of that, extension and its airs of separation. “It may be that spatiality is the projection of the extension of the psychic apparatus. Probably no other derivation. Instead of the conditions a priori of the psychic apparatus according to Kant. Psyche is extended, knows nothing of it.”

I am thought, therefore.

 

Resources

These various questions that I have encountered since 1994, barely introduced here, have been the subject of some publications since 2012, starting from gender questions posed by gay sexuality, going as far as identity consequences, to question prevention discourse and unconscious knowledge, and describe the processes of exclusion, election, radicalization, reification associated with them. Here are three presented, hereafter, with download links.

 

• 2012 – H.I.V. or Love Letters (journal Cahiers de psychologie clinique). The AIDS epidemic severely tests the laws of love and desire. Infected or not, those who love each other do not escape the effect of imaginary disturbance that the H.I.V. virus commits. Clinical experience teaches us that sexual risk testifies more to the psychic adaptation of the subject for the benefit of desire rather than to his capitulation before the forces of the death drive. With Lacan and Freud, we can extract some elements of the psychic processes of anxiety, capable of illuminating the march of fantasy and love in an ever-renewed effort to work on the fabric that supports them.
• 2014 – Gay Gender and Identity Suffering: The Slam Phenomenon (journal Nouvelle revue de psychosociologie). Slamming—intravenous drug consumption in a sexual context—appeared in the gay community. The manifest identity stakes associated with this new sexual and drug use practice invite thinking about clinical experience through a gender approach. The article proposes to observe and question identity suffering and its social, unconscious, political, and historical determinants through what the author defines as “gay gender.” At the limit of individual necessities of identity construction come to oppose the collective stakes of the community, sometimes making the individual bear the heavy tribute of an identity conquest.
• 2015 – Taking Care of Oneself, Against All Odds: Version of Care (journal Raison-Publique). On the deleterious and unexpected effects of prevention and medical discourses aimed at having a population take care of itself. In a community where attention to the risk of contamination has been brought to the highest—the gay community facing AIDS—contradictions appeared over the course of the epidemic’s history, both in discourses and in their consequences.

 

Vincent Bourseul

Publisher: Vincent Simon (simonvincent006@gmail.com)