Obsessional subjectivity in societies of discipline and control

Pre-history of obsession: Scrupulosity and self-negation

Preoccupied thinking predates both monomania and our contemporary notion of obsession. The embodied, pre-modern, Christian soul that is tempted by pleasures of flesh or of blasphemy is not possessed but obsessed. As Davis (2008) notes, obsessio and possessio were two different ways of besieging a city. Possession meant breach of city walls, being overrun; obsession meant surrounding a city. So, in the earliest sense, a person obsessed was aware of being tempted by a demon but not overtaken by one. Later, pre-modern and early modern preoccupations with one’s eternal fate would travel most frequently under the name of scrupulosity wherein blasphemous thoughts insidiously torment the faithful, whose efforts to dispel them cause them to magnify in number and intensity. In the 15th-century, Antoninus, the Archbishop of Florence, in Summa Theologica Moralis likens blasphemous thoughts to barking dogs who needed to be ignored to be silenced (Collins, 1961). Scrupulosity, thus, has a long history within Catholic theology, including Ignatius of Loyola (1991) and Alphonsus de Liguori (1999), among others.

Likewise, in Reformed theology, scrupulosity attains a significant role in the soul’s journey towards redemption. In Grace Abounding to the Chief of Sinners, the 17th century English Puritan writer John Bunyan (1907) writes of a recurrent fear of steeple bells that followed his public conversion: “Now you must know, that before this, I had taken much delight in ringing; but my Conscience beginning to be tender … I began to think, How if one of the Bells should fall?” (p. 15). Bunyan ultimately exhausts himself in his desire to demonstrate his righteousness to himself and, realizing that “God could justify a sinner at any time” (p. 79), finds redemption in God’s grace and mercy rather than his own intentionality in following scripture or attaining purity of thought. Still, not surprisingly, contemporary authorities on obsessive–compulsive disorder (OCD) and scrupulosity find little difficulty interpreting historically antecedent experiences by the light of current nomenclature, as Bunyan “showed the insight of a true obsessional” (Osborn, 1999, p. 55).

Retrospective applications of 20th-century diagnostic rubrics codified in the DSM or ICD on obsessionality are quite tempting (Ciarrocchi, 1995; cf. Rapoport, 1989); however, scientifically Whiggish preambles to clinical tracts addressing scrupulosity mostly ignore the authentically spiritual dimension of these practices. Differentiating Catholic and Protestant trajectories toward salvation (the former oriented around a different conception of upholding moral law through works over faith), Cefalu (2010) writes of the role of scrupulosity in Bunyan’s conversion narrative:

It is reductive to argue that Bunyan has been liberated from both pathological obsessive sinning and scrupulosity … In order to find salvation, he needs to relinquish subjective agency, and in order to relinquish subjective [worldly] agency, he needs to realize the ineffectiveness of scrupulosity to attain his election. Scrupulosity is the positive condition of its own negation and eventual supercession. (p. 119)

Consequently, as concretized in this instance of Protestant salvation, scrupulosity is both problematic for the sinner, and in this sense a kind of threshold or limit that is passed in the intensity and suffering of doubt, yet also a necessary stage of struggle in the shedding of pride. Though well beyond the scope of this essay, Cefalu’s (2010) argument illuminates the possibility that such ruminative thought—though undoubtedly having specific, if potentially variable, neurobiological correlates—exists within historical constellations of practice, which may not be easily shorn of their particular meaningful ascriptions or function within regimes of power/knowledge or ethical self-relation (Foucault, 1983b).

Monomania: Dangerous fixations and their discipline

For the historical context for monomania, it helps to sketch the changing notions of what constitutes madness. In contrast to the early Foucault’s (1965/1988) binary opposition of reason and madness, an uncontaminated rationality would insinuate itself into discourses on the mundane effects of mental illness. Before the 18th-century, humorism continued to inform conceptions of madness—including repetitious thought and action (Diethelm & Heffernan, 1965)—that were often considered inescapably pervasive disorders in a subject’s being, as exemplified in lunacy, melancholia, and idiocy. In The Anatomy of Melancholy, Robert Burton (1621/1883), hence, writes of the intractability of melancholy and its considerable hold on the soul: “This melancholy of which we are to treat, is a habit … a chronic or continuate disease, a settled humour … It will hardly be removed” (p. 95).

This ordering of madness in the 18th-century would be dismantled through an emergence of proto-psychological thought, first through philosophical discourse. Already, Descartes’ other of reason—error, illusion, dreaming—is installed into the very structure of knowing itself, at its margins. In principle, anyone could “firmly assert they are kings, when really they are miserably poor” (1954, p. 62). This would be crystallized differently in Locke’s (1690/1959) notion that some—formerly irretrievably mad—had merely “lost the faculty of reasoning … They err, as men do, that argue right from wrong principles” (p. 209). Later, Condillac (2001), radicalizing Lockean empiricism, would articulate an increasingly persuasive “sensationist” perspective, which would have profound influence on 19th-century French psychiatry. In parallel, the predominant propensity of a newly minted “physiological” or “positive” psychology—represented in the work of Cabanis, Gall, and Broussais—would fold mental life into the material organization of the body. Condillac, who was drawn on by the French alienist Pinel, and through him Esquirol as well, holds that mind as a tabula rasa depends entirely upon sensation as the mind’s embodied “animality” (Goldstein, 2001). Pinel (1798/1806), thus, conceives of madness as disruption of self-control, a disturbance of the will, where rationality itself as an ideal space of reflection is preserved. Consequently, despite the conceptual differences among these outlooks, what increasingly manifests in the médecine mentale of post-Revolutionary French thought is madness as a gradient of psychological disruption which leaves the human subject as a civically defined being—possessed of natural rational, political, economic capacities—intact.

Madness that had existed in the margins of God’s indelibly created order, or in the Other of Enlightenment Reason, increasingly becomes curable through “moral” treatment calling for a conversation with the patient, while also being consigned to a different constitutional substrate altogether, that of “nerves.” As such, Pinel’s (1798/1806) exemplary text, A Treatise on Insanity—mandating patients’ shared living arrangements, observation, confrontation, and work requirements—heralds a sea change for the mechanism of the French asylum. These institutional spaces, the asylums populating 19th-century France for instance, become less warehouses for the segregation of the insane, and more so laboratories for social change. As Gauchet and Swain argue, these new asylums

strive to restore insane people to reason, in any case, following a new line of moral treatment that operates by … creating a social mechanism that can condense and make masterable the power to forge individualities and to take charge of their most intimate mainsprings. (1999, p. 70)

Consequently, the asylum reforms, being enacted consistently with the Declaration of Human Rights, partake in an ever-democratization of madness, extending the limit of what is normal and pathological, not only in the asylum but also into civil and respectable bourgeois society. Now, anyone can be both mad and sane at the same time.

Into this scene of partial insanity in the early 19th-century bursts the entirely new diagnosis of monomania, in which sufferers are aware of the impropriety of their actions but are not totally deprived of reason. In other words, they continue to function as good Cartesian subjects who are able to rationally reflect on their actions and mental contents. Monomania has its immediate origins in Pinel’s view of insanity as a lesion of the will rather than deprivation of reason, a manie sans délire, epitomizing

[his] practice and his experiences in the Revolution: a pure disorder of the will and an undisturbed mind, i.e., a bodily tension with no external causes, manifesting itself merely in a spontaneous, blind drive, in an (abnormal, affectively perverse, criminal, forbidden) action but nevertheless a disease. (Doerner, 1981, p. 132)

Pinel’s formulation—as part of the aforementioned expansion of madness into everyday life—would have particularly confusing effects on the legal treatment of insanity. As Goldstein (2001) argues, an opportunistic forensic psychiatry rushed to support defense lawyers who pled that their client’s atrocities were attributed to manie sans délire; however, this created a somewhat contentious relationship between medical and legal institutions, the latter’s discourses on intentionality and agency often inconsistent with the medical subtleties of the alienists’ diagnostics.

Pinel’s student Esquirol is first to explicitly outline the contours of this new category, where mental faculties like the ability to abstract, compare, or remember are damaged by a lesion confined to one specific object, which embodies the fixation, the idée fixe. For Esquirol (1845) monomania stands apart from both lypemania and mania as a partial form of insanity that is outer-directed, characterized by rashness and audacity, but not a perversion of reason on every subject matter. Moreover, as Doerner (1981) remarks, Esquirol generally categorizes monomania according to three further types: (a) monomanie intellectuelle (where one false idea, such as a delusion, organizes the patient’s struggle), (b) monomanie instinctive (repetitious acts against reason), and (c) monomanie affective or monomanie raissonnante (where affections and dispositions are perverted but reasoning remains untouched). Hence, Esquirol (1845) speaks of sufferers whose “reasonings are logical … But the actions of these patients are contrary to their natural affections, to their interests and social usages” (p. 343). This formulation parallels Prichard’s (1835) notion of “moral insanity,” where the moral dimension signifies both a transgression of a social norm of conduct or behavior and the affective disposition that would unhinge a person from the usual conduits of action. Relatedly, for monomanie ambitieuse (Descuret, 1841) patients of high professional status, typically, are tormented with socio-economic aspirations against the grain of circumstance.

Throughout this diagnostic constellation of monomania, patients neglect their familiar social roles for love affairs, are driven to succeed in their commercial enterprises, manifest a reversal of opinion or attitude, change completely what we now call “lifestyle,” or commit themselves unwaveringly to artistic or scientific endeavors. As Esquirol (1845) writes, these sufferers

commit ridiculous and blameworthy acts, contrary to their former affections and true interest … They abandon the objects of their affections; leave their families and business [for other pursuits], and compromise their true interests; always actuated by motives, more or less plausible … The signs of reasoning monomania, consist in the change and perversion of the habits, disposition and affections … Understanding is not essentially disordered. (p. 351)

Accordingly, the bonds that locate individuals in their hereditary or assumed roles within communities are dissolved in the face of particular callings that must appear to those near and dear to them to be fixations of self-possession and will and, quite simply, insane.

Esquirol’s (1845) clinical work at the Charenton asylum provides ample evidence for a newly found vision of self-interest deepening as an almost contemporary existential seizure of selfhood. One patient, a corn-merchant and baker, was known for having an agreeable and mild disposition, and expressing great fondness and obligation toward his wife and children. However, after experiencing an economic setback and subsequent triumph and expansion of his business, he “assumed an imperious tone, and expressed sentiments which he had never before entertained. … He no longer remains with his wife and children; eulogizes whatever he sees elsewhere, and finds fault with whatever transpires in his own house” (Esquirol, 1845, p. 346). Another patient, a merchant of considerable fortune, becomes so avaricious as to neglect his own physical well-being, leaving his wife and marrying another: “After a few months … his new wife was unable to endure the caprices of her husband, who, it was perceived, was affected with mental alienation” (Esquirol, 1845, p. 347). Along somewhat different lines, a woman who loses a child undergoes a radical change of disposition, her warmth and conjugal duty overtaken by self-directed excitation: “Soon after, she becomes more active, thinks she possesses a superior understanding, and is a victim to the ignorance of her husband … She neglects her affairs, her children and household” (Esquirol, 1845, p. 344). Subsequently—though capable of thoroughly rational relations with others—this patient is committed to Charenton on three separate occasions over the course of almost 15 years, attempting to secure her own liberty through letters to the prefect of police, magistrates, and lawyers; however, on the third occasion she resumes her old habits of decorum and regularity of conduct.

Under Foucault’s three axes of historical ontology (knowledge, power, and ethics) (Hacking, 2004), monomania—as constellation of both discourse and clinical practice—tracks most closely with Foucault’s analysis of modern power, which focuses on the subject as externally acted upon, as disciplined. As Foucault (1980) writes, “What makes power hold good, what makes it accepted, is simply the fact that it doesn’t only weigh on us as a force that says no, but that it traverses and produces things” (p. 119). As is well known, the disciplinary power that comes to the fore in the 19th-century is architecturally embodied in Bentham’s panopticon, where permanent visibility, central supervision, and permanent isolation of subjects facilitates embodiment and internalization of the techniques pressed upon them (Foucault, 1975). As an instance of panoptic power, the asylum is an apparatus (dispositif) of specific treatment and cure. Within these ordered pathways of movement and surveillance, patients confined in 19th-century French asylums such as Charenton are submitted to the aforementioned moral treatment, which constituted a kind of flashpoint between technology and cure. Of moral treatments, Foucault (2006) writes that

there is no application of technical medical formula to something seen as a pathological process of behavior. What is involved is the confrontation of two wills, that of the doctor and those who represent him on the one hand, and then that of the patient. What is established, therefore, is a battle, a relationship of force. (p. 10)

Questions, however, arise concerning the target of moral treatment for monomania: What deviance is being disciplined? What are the ends of this instantiation of disciplinary power?

As suggested supra, monomania—among other mental disturbances—arises within institutional corridors and discourses that explicitly offer a socio-cultural understanding of both its cause and cure. For instance, Esquirol (1845) himself writes that “without a doubt civilization occasions diseases, and augments the number of the sick, because, by multiplying the means of enjoyment, it causes some to live too well, and too fast” (p. 42). Being a political supporter of an older, established hierarchical social order—with its relatively fixed stratified class system and roots in a post-feudal agrarian economy—Esquirol positions monomania as a form of suffering specific to a period of history where such social relations and their attendant understandings of duty, obligation, and community are rapidly changing. Monomaniacs, hence, are struggling with a consolidation or translation of a multitude of valued modes of being and relation—involving family, conjugal love, religious piety, and the habitus of class position under monarchy—into the language of capital, self-interest, and specialization. What is disordered is a particular subject’s willing engagement within the confines of these older patterns of conduct, action, feeling, and thinking. The deviance targeted pertains to that subject who comes to act willfully according to his or her values, preferences, and ambitions. Such singular movement appears repetitive as an idée fixe to others, its own idiosyncratic logic unseen by disciplinary machinations that would orthopedically correct its nomadic departures of self-possession. The focus of such discipline, in the French context, relates specifically to a return to sedimented forms of selfhood preservative of a pre-Revolutionary organically social order, with antipathy toward “the political form of the republic … [which] gives free rein to the passion corresponding to artificial rather than natural instincts (ambition, greed, egoism, indolence, speculation, lust for power)” (Doerner, 1981, p. 145).

Fittingly, Davis (2008) persuasively links the sudden appearance of monomania to the rise of specialization and professionalization. That is, a discretely Lockean, forensic personhood is severed from its relations to immediate others in love and work, and given over to its particular projects, gifts, and trajectories, which the emerging industrial world will make use of—to its artistic, scientific, and commercial ends. In this vein, Davis (2008) argues that the focus and hyper-attention required for engagement in, and flourishing within, one’s chosen work would become an increasingly emergent quality of 19th-century, early industrial consciousness and—significantly—that monomania relates to a “humanizing of the insane and an insanizing of the human” (p. 100). That is, the culture itself becomes more and more pervaded with a monomaniacal sensibility, both as a kind of fixation of thought and also a libidinous attachment to one’s chosen path, against prevailing social logic and winds of expectation. Consequently, it is perhaps more apt to say it is the disappearance of monomania that occasions the full emergence of self-directed and self-possessed pursuits in work and elsewhere, when such endeavors become normative, as supportive of nascent industrial capitalism and political arrangements privileging liberty over obligation. Thus, not surprisingly, monomania as psychiatric diagnosis was quickly swept away as we are all now admonished to become Ahabs of our own fabrication. In short, monomania has become so naturalized in our world, its techne—as a panoply of clinical practices for the marginalization of individual self-actualization—has become problematic. Its triumph in escaping the pathologizing gaze of psychiatric power is expressed in its pervasively invisible hold on our being.

Obsessional subjectivity in societies of control

As Berrios (1996) notes, in French psychiatry of the early 19th-century, what would be first termed “obsession” in the medical sense by Falret in 1866 still traveled under variously familiar terms—monomanie intellectuel, manie sans délire, and folie lucide. In the latter half of the century, the notion that emotions and volition play the primary role in obsession would be developed by Morel (1866), reflected in the term, délire emotif. Alternatively, la folie du doute (doubting mania; du Saulle, 1875) was connected to Cartesian doubt, skepticism leading to “metaphysical insanity” (James, 1890/1950; Knap, 1890). This French conceptual lineage culminates with Janet’s (1903) placement of obsession within the somewhat amorphous category of psychasthenia (which comprised the “neuroses” along with neurasthenia and hysteria) including also phobia, panic, and hypochondria.

Freud, in some parallel with Janet, separates obsession from neurasthenia. ² For Freud, and for his cognitive-behavioral heirs, obsession also becomes organized around the incompletion of knowledge, and a fixation on certainty. The confusion surrounding the singular clinical existence of obsession is initially settled by Freud’s (1894/1962) opposition of hysterical and obsessional neurosis, writing that the obsessional neurotic “lacks the aptitude for conversion … In order to fend off an incompatible idea, he sets about separating it from its affect” (pp. 51–52). In the well-known case of the Rat Man, Freud’s patient struggles with an intensely loving bond with his father, whom he also unconsciously hates for disapproving of his love for a woman, this having a putative origin in both an anal fixation of early years, and an oedipal rivalry that left the young man with a certain moral rigidity in relation to his instinctual life. Consequently, he suffers from a repetition compulsion in which he imagines a ghastly scene of rat torture befalling both his girlfriend and his father should he not repay a trivial monetary debt, involving many circuitous actions, constant self-monitoring, and self-doubt. Such compromise formation manages the irrational vis-à-vis its symbolic replacements—ruminations around one’s being as a potential murderer or sexually transgressive individual, vows and mental procedures that can never be accomplished but merely thought through, attempted, etc. Concerning the fundamental dynamic in play, Freud (1909/1955) writes that

where the epistemophilic instinct is a preponderant feature in the constitution of an obsessional patient … The thought-process itself becomes sexualized, for the sexual pleasure which is normally attached to the content of thought becomes shifted on to the act of thinking itself. (p. 245)

Hence, associative displacement of thinking away from unpleasant sexual and aggressive impulses, wishes, and affect becomes the central mechanism at work in obsessional neurosis. Esquirol’s fixation of will is, thus, libidinally shifted—from the self-possession of various alternative lives lived against the grain of social hierarchy—onto operations of reason, specifically that of epistemology. How does the subject know what he/she thinks he/she knows? This becomes a question of the utmost significance concerning the subject’s very being.

Another generation of psychoanalysts would render these displacements of thinking into a more experience-near idiom: the obsessive–compulsive dynamism prevents any feeling or thought that may produce distress to the ego, whether feelings are hostile, sexual, or otherwise (McWilliams, 1994; Salzman, 1982; Shapiro, 1965). The obsessive subject is, therefore, primarily driven to attempt control, and its principle instrument is that of achieving a totalitarian perspective on her own interiority:

The obsessional can be comfortable only when he feels he knows everything. He is convinced not only that this is absolutely necessary but also that often it is possible, even in the face of this intellectual grasp of the impossibility of achieving the goal. (Salzman, 1982, p. 25)

This ultimately impossible stance requires a reflexive status toward the subject’s own deeply ambivalent being and imperfections, and a submission of experience to the ultimate arbiter of Cartesian doubt. As obsessionals we cannot know if we will impulsively do violence to others or sexually act out in public unless we continually test ourselves, to imagine both horrific possibilities and the experience of restraint. Nonetheless, doubt—as a measure of certainty—is a cruel taskmaster, and if we do not summon God as did Descartes, we are condemned to the unfinished project of being absolutely certain of our nature, our character, in short of who we are.

Psychoanalytic theory has largely addressed obsession as a pervasive dimension in the neurotic personality; however, the more contemporary category of OCD more acutely figures a heightened technological monitoring of thought and impulse. Though obsessive–compulsive personality disorder (OCPD) is most often treated as an entirely separate clinical entity, there appears to be correlation between OCD and OCPD (Gorden, Salkovskis, Oldfield, & Carter, 2013). ³ According to recent cognitive theory, the obsessive component is occasioned by great difficulty in dispensing with various intrusive, unwanted, and repugnant thoughts and impulses that most of us take to be extraneous flotsam in our experience—those classically involving aggression, sexuality, or blasphemy, but also those involving contamination. Cartesian doubt and uncertainty implicate an incompletion of knowledge inflected differently, more comprehensively and horizontally than psychoanalytic preoccupations with depth.

In many cases of OCD, sufferers report a kind of “mental pollution” (Rachman, 1994). In most cases, such thinking is accompanied with dysphoria, distress, shame, guilt, a sense of uncontrollability, as well as avoidance, attempts to neutralize such thoughts/impulses, and compulsive defenses against imagined dangers. Imagine a 30-year-old accountant with intrusive and seemingly irrational thoughts and images of harming his neighbors’ young children. When he looks at them, playing in their backyard—from his bathroom window in his solitude—he is crippled with uncertainty, the notion that he is a potential murderer, as if these thoughts and images themselves were evidence of some underlying disposition for such malicious acts. People suffering with such unwanted thoughts appear to desire to exert an extreme degree of control on the contents that flitter through their consciousness, exhibiting a hyper-developed responsibility for the hygiene of their mental life (Purdon, 2007). Increasingly what is doubted is not a sin of the flesh or a thought-crime against God, but anxiety concerning ever-present danger. Consequently, any thought that might reference a potentially dangerous inner condition or external one is appraised from an overbearingly catastrophic perspective, sacrificing realistic probability for the unacceptability of a false negative (Type 2) error. Rachman (2003) writes that these sufferers have

interpreted these thoughts, impulses, or images as revealing important but usually hidden elements in their character … I am dangerous; I am unreliable; I may become totally uncontrollable … one day I will break down and cause serious physical harm to others. (p. 15)

Recently, it has been proposed that obsessions do not result from simple intrusions of cognitively exaptational “junk,” but rather metacognitive operations where sufferers fear an imaginary “self-as-could-be” (a potential murderer, blasphemer, person who is ineradicably contaminated, etc.) discordant with a “self-as-is”—in short, “a fear of whom they might become” (Aardema & O’Connor, 2007, p. 191; cf. Doron, Szepsenwol, Elad-Strenger, Hargil, & Bogoslavsky, 2013). It is as if people with such distressing thoughts feel an obligation to maintain hyper vigilance toward their own status as psychologized subjects.

Davis (2008) argues that the rise of obsessionality parallels Foucault’s description of disciplinary power, as described in relation to monomania, supra. Recall, however, that monomania existed within the institutional matrix of the asylum, with its physical confinement, imminent moral confrontation, and omnipresent supervisory relays. Neither obsessive personality (in the psychoanalytic sense) nor OCD appear within this particular socio-historical clearing, having been loosened from ubiquitous surveillance. Consequently, the more contemporary clinical apparatus of obsession appears to more precisely fit another, different arrangement of power. As such, Foucault (2009) speaks of the newer constellation of bio-power as “the set of mechanisms through which the basic biological features of the human species became the object of a political strategy, of a general strategy of power” (p. 16). Here, power shifts from the mode of localized individualization toward positioning the subject within globalizing formations of certain “populations” ensuring “health, well-being (that is sufficient wealth, standard of living), security, protection against accidents” (Foucault, 1983a, p. 215). Later commentators have also taken the theme of security and risk as defining features of late modernity—the ability to contemplate, anticipate, and prevent dangerous conditions (Beck, 1992), and of the position of the social sciences such as psychology in appraising and mediating risk (Giddens, 1990).

For the existence of obsessional subjectivity within late industrial societies, bio-power appears in parallel to what Deleuze (1992) calls “societies of control,” where hyper-rapid free-floating control replaces the closed enclosures of the barracks, schools, hospitals, and asylums. Against these analogical spaces, where the referential point is always the metaphorical power of the prison to form the subject into predetermined molds of action and thought—to return the monomaniac’s desire to the usual objects of the social field—this newer form of power operates to track metastatic risk. As Deleuze (1992) writes,

Enclosures are molds, distinct castings, but controls are a modulation, like a self-deforming cast that will continuously change from one moment to the other, or like a sieve whose mesh will transmute from point to point … Individuals have become “dividuals,” and masses, samples, data, markets … For the hospital system: the new medicine “without doctor or patient” that singles out potential sick people and subjects at risk, which in no way attests to individuation—as they say—but substitutes for the individual body or numerical body the code of the “dividual” material to be controlled. (pp. 4–7)

Accordingly, obsessional subjectivity comes to shadow and be shadowed by such modulating technologies.

In alignment with bio-power and existing within societies of control, contemporary evidence-based treatments for OCD under dominant cognitive-behavioral models incorporate two elements in tension—epidemiological dividualizing of risk, and standardized, perpetual training modulating the fit of the technique to the particular subject. As for the former, any potential risk must be located according to symptom profiles hanging together en masse as a disease-like entity (Foa et al., 1995). As for the latter, Exposure and Response Prevention (ERP) and cognitive therapy both serve to monitor the OCD sufferer’s behavior and thinking to tailor treatment to the specific dysfunction. For instance, ERP protocol most often advocates for a finely graded hierarchical in vivo or imaginal exposure to a feared situation (i.e., to handle knives in the face of fear of hurting others) (Rowa, Antony, & Swinson, 2007). Cognitive therapy traditionally consists in the practice of addressing several micro-forms of appraisal that have gone horribly awry—overestimation of threat, intolerance of uncertainty, responsibility, over-importance of thoughts, etc. (Taylor, Kyrios, Thordarson, Steketee, & Frost, 2002).

States of psychologized subjectivity occasioning OCD (i.e., the fear of being a murderer, contaminated, etc.) become co-constituted by the very technologies that seek to discern the traits and constituents of certain populations (the sociopath, contaminated individual, etc.). In other words, discourses of psychology and psychiatry themselves, in part, make possible these fears (self-as-could-be). Moreover, for risk management in public health—by means of an ever-proximate checking of thought and behavior—the practices of remediating dysfunction install a higher-order obsessionality seeking to discern a modicum of risk. In this meta-obsessional tracking, the epidemiological assessment surpasses the individual subject’s first order monitoring (“Am I a sociopath who would push a person from an open window?”) to ask another, second-order question (“Am I the kind of person who cannot limit the scope of his/her inner monitoring?”). Hence, the security monitored shifts from the aim of the subject examining its own psychological states for signs of danger—occasioning the contemporary bent towards preemptive identification of those who may transgress the social register—to the plane of risk associated with identifying subjects whose obsessionality impairs their day-to-day functioning as intermediaries in social exchange. Consequently, as Castel (1991) suggests, such technologies

Promote a new mode of surveillance: that of systematic predetection. This is a form of surveillance … [which] dispenses with actual presence, contract, the reciprocal relationship between watcher and watched, guardian and ward, carer and cared … [These policies] deconstruct the concrete subject of interventions, and reconstruct a combination of actors liable to produce risk. Their primary aim is not to confront a concrete dangerous situation, but to anticipate all the possible forms of irruptions of danger. (p. 288)

The apparatus of OCD, and therapeutic technologies such as cognitive therapy and ERP, align themselves as newly plastic forms of surveillance. Therapists, under this regime, do not—as in the case of monomania—stand in constant presence to the subject in efforts to press upon any particular individuality. Nor do they seek to discern the truth of the subject’s desire, as in psychoanalytic practice, which sacrifices efficiency and practicality in relatively time-consuming and monetarily expensive analysis. Rather, therapists stand in relation to their patients as trainers who—in their questioning of the actual risk at stake—inculcate in the subject a highly flexible self-accounting. Such practices, thus, anticipate multiform “irruptions of danger” to life and limb and contamination, and also the subject’s overactive, cognitive breakdown. The social body—through the subject’s own efforts—aspires toward a self-repairing machine, or a computer running anti-virus software at regular intervals, constantly updating itself, responsive to new and heretofore unseen risks.

Obsessionality in Lacanian psychoanalysis

Contemporary cognitive-behavioral approaches to obsessionality, while following the Freudian lead of addressing the pernicious presence of hypertrophied, Cartesian doubt, orient themselves solely to what may be consciously understood within a psychologically epidemiological frame. In contradistinction to these approaches and those of experience-near psychoanalysis, Lacanian psychoanalysis orients itself to the unconscious subject in respect to the symbolic order and the play of desire. As such, what is addressed is ontological doubt (“What am I beyond thought”) rather than epistemological doubt (“What am I that may be thought?”). Hence, the subject’s conscious life is not tracked as psychobiography but as a fantasy of identity emanating from the subject—as a divided and desiring being—and implicated in a symptomatic thought process infused with desire and enjoyment. Consequently, the rabbit hole goes deeper, revelatory of the institutional regulation of desire forming, in part, conditions of possibility for modern subjectivity. Importantly, to avoid a view of subjectivity merely replicating the effects of bio-power, the structure of the subject in societies of control must be accounted for.

Though monomania has become—diagnostically speaking—extinct, its concern with the desire and the obsessional’s concern with doubt and knowledge persist structurally for the modern subject in Lacanian diagnosis. For Lacan (1966/2006), subjectivity is not precipitated from consciousness but from a being’s submission to the castrating, alienating effects of the symbolic order, and separation from its imagined return to a position of plenitude vis-à-vis the Other. The modern subject is at bottom a lack in being (manqué a être). As such, desire does not, properly speaking, have an object, but rather an object cause—that which sparks its own continuation in the name of the Other’s desire, toward an impossible fulfillment. That is, the Lacanian subject is propelled to align its desire with that of the Other, which involves a fundamental fantasy that will never be attained. As a result of differing strategies in maintaining desire in the face of the unattainable, hysterics and obsessionals have differing relations to petit object a (the object cause of desire)—what falls out of the Real in the relation to the Other—and differing relations to knowledge. As Lacan (1966/2006) writes, “In the case of the obsessive … he negates the Other’s desire, forming his fantasy in such a way as to accentuate the impossibility of the subject vanishing” (p. 698), as in Descartes’ subject whose being is ironically founded on the disjuncture between thinking and being (“Even if I am being deceived as to what I am, I am at least thinking”). As Fink (1997) observes, “The obsessive is convinced that he is, that he exists, only when he is consciously thinking” (p. 122). Furthermore, whereas the hysteric famously identifies his/her coming to knowledge with what the other wants from him/her, the obsessional subject fantasizes that she/he may come to knowledge outside of this relation, as a non-divided subject fantasizing about an unmediated relation with the object cause of his/her desire. Consequently, the obsessional subject’s link with the Other is dissimulated, and his/her jouissance (which desire aims for) is only found within the confines of his/her own mind. Along these lines, Soler (1996) observes that the return of the repressed—as eroticized thought—sutures the structural gap in the obsessive’s castrated, divided being. The desire seen in monomania, of blind ambition, is shifted onto certitude of knowledge. Because the obsessive is wedded to the transparent reflexivity of the Cartesian theatre, unwanted sexual urges, fears of contamination, aggressive impulses appear not as manifestations of the unconscious but as fantasized knowledge of one’s psychologized selfhood, an impossible desire.

Obsessionality is incriminated not only for its more acute effects, its fear of being unable to finally ascertain its own being, but also for the work it undertakes on behalf of a technocratic society, and the mode of its production of knowledge. As Fink (1995) notes for Lacan’s four discourses, unlike the discourse of the hysteric, there is no discourse of the obsessive; however, the obsessive subject’s desire most consistently aligns with the ends of the university discourse due to his/her attempt to exhaustively represent the world (and his own selfhood) to him or herself. ⁴ According to Lacan (2007), the structure of university discourse is schematized as S₂/S₁–>a/$. Here, the signifier as knowledge (S₂) substitutes for the master signifier (S₁) in the position of agent that addresses the Other as object a, or the surplus value over what may be said, represented, or known; the divided subject is so produced, but also barred, and the master signifier becomes the truth that underwrites said relation.

Not only for, but as obsession, psychological knowledge (S₂) amounts to the impossible, final accumulation of theoretical knowledge (systems of signifiers) regarding its own etiology and functioning. For Parker (2001), the psychological Other (positioned as object a in university discourse)—as the addressee of this power/knowledge in the Foucauldian sense—is what escapes the frame of reference, what constantly recedes from institutional territorialization. What is produced or falls out of this relation is the subject ($) beyond that of psychology, whose divided being may not finally be circumscribed in knowledge. It turns out that the impossibility of achieving such epistemic mastery reveals the fundamental difference between representation/thinking and what is represented/being, which is precisely the condition of possibility for effacing the “self as could be” (Aardema & O’Connor, 2007) as a dangerous individual, as being ineradicably contaminated, etc. This effacement requires an openness in the subject’s being—required for the discourse of obsession itself to found new technologies, to come to new knowledge. Something must be left out for innovation to occur.

Besides the existential freedom necessary for a client/therapist who would act/understand otherwise than the psychologized tendencies, traits, and qualities that the human sciences attempt to technically discern, the master signifier (S₁)—such as God, Freedom, Nation, Reason—operates as to legitimate the supposedly neutral/objective nature of scientific knowledge (S₂). Advanced post-industrial, bureaucratic societies, however, increasingly—in a nostalgic return to the dream of the aperspectival representation of the 18th-century—imagine reality as a closed geometrical, symbolic system (S₂–>S₂) without fissure or recourse to a master signifier that would signal its dependence on authority or ideology (Pavón Cuéllar, 2010). For the psy-disciplines, in such a dream, master signifiers are often veiled by claims to technical and professional expertise relying at the point of contact with another embodied subject. As an example originating in an OCD diagnosis, consider the statement that “studies of ERP outcomes suggest that improvement in social, family, and work functioning do occur … the therapist not only provides expert education and consultation, but also is someone to whom the patient feels accountable” (Tolin & Steketee, 2007, pp. 48–49). Here, psychological knowledge addressed to a suffering Other is therapeutically buttressed not through a primal signifier having transcendental status but through credentialed expert knowledge pragmatically “knowing better,” and speaking as the proxy of devalued counterparts to older historical master signifiers—in this case, in the names of those typical end games of bio-power: improvement, functionality, accountability. In these strategies, the positions of the technocratic agent of the psy-disciplines and the sufferer of obsession—in orientation to university discourse—are interchangeable, as “the patient is recruited as a cotherapist with increasing responsibilities as the treatment progresses” (Tolin & Steketee, 2007, p. 49).

Such is the pervasive reach of university discourse, which includes not only the paralyzing dysfunctionality of OCD and the suffering of persons who love and work in more or less functional ways (OCPD, nowadays), but also the technology of psychology itself. Each of these forms obeys the structurally libidinalized knowing of selfhood as a matter of pure knowledge, pursuant to the form of power particular to our age, that of bio-power, with its strategies of attaining jouissance:

In the University discourse, is not the upper level (S₂–a) that of biopolitics (in the sense deployed by Foucault to Agamben)? … The usual notion of the relationship between excess-enjoyment and symbolic identification is that symbolic identity is what we can get in exchange for being deprived of enjoyment; what happens in today’s society, with its decline of the Master-Signifier and the rise of consumption, is the exact obverse: the basic fact is the loss of symbolic identity. (Žižek, 2004, p. 399)

Because the obsessive subject partakes in our culture’s fantasy of completeness, biographical continuity, and the power of technical reason to ascertain the nature of things, its symbolic castration is concealed. This subject interrogates—and is thereby interrogated by—the mystery of Being, or the surplus value of science or commercial pursuits, from the perspective of theory, data, and what can be known and communicated. More to the point, the desire that would be addressed to the Other, in relation, is annulled in favor of jouissance that would be attempted without such entanglement: “The return of the repressed in the signifying chain dissimulates the gap in the obsessive, that is, sutures it” (Soler, 1996, p. 263). As such, from a Lacanian perspective, a society of bio-politics would not only work on our bodies and consciousness to form its habits of action and thought, but also to—inter alia—obsessively structure our unconscious relation to knowledge, to infuse into us a desire to enjoy our own epistemological self-regulation, to attain scientific knowledge to the ends of its own security.

Critically, obsession in the age of bio-power requires a double movement of Oedipal subjectivity to achieve its ends. The doubt instantiated in epistemological questioning of psychologized being—that is, to ask the questions that implicate one’s fixed nature as a person bearing dangerousness or dysfunctionality—requires a certain fantasy of desire, or coming to knowledge that is obtainable and unobtainable at the same time. Under the Lacanian perspective on neurotic structure sketched out above, the obsessional subject’s lack or division is plugged through an impossible desire of coming to psycho-biographical knowledge of selfhood, but one that constantly escapes. Contemporary psychological discourses on obsession actively collude with this fantasy of producing knowledge that will increasingly facilitate this subject’s own self-monitoring. On the one hand, for societies of control, such knowledge as university discourse (S₂-> a, the upper half of the formula) must address the fantasy as possibly completed or realized. On the other hand, reflexive doubt requires an openness (or lack) in the subject’s being ($) that would escape any particular form of experience that would render the subject non-functional or paralyzed for his/her work, family life, etc. The various master signifiers at work in bio-power (the S₁’s)—for example, “The clients’ desire to protect others from harm is entirely appropriate and rational” (Purdon, 2007, p. 126)—must simultaneously afford the benefit of closing down the subject’s being for purposes of tracking, while opening the aperture for its limited and circumscribed escape for ongoing work and consumption without losing grip—in the terminology of Deleuze and Guattari (1972/1983)—on a fully nomadic subject or, for Lacan, a being becoming the cause of its own desire. In other words, societies of control need to effectively manage epistemological doubt, maintaining the subject’s openness in being and time without triggering ontological doubt, which would revolutionize subjectivity itself. ⁵

Conclusion

For contexts within human sciences and the psy-disciplines where bio-power predominates, neo-liberal governmentality connects political legitimacy with the positioning of the subject’s relation to knowledge of itself, as well as desire. As Foucault (2008) contends, liberalism and neo-liberalism require a foundation for politico-economic legitimacy outstripping both traditional post-feudal, agrarian arrangements as well as successor Enlightenment formations in social contract. In this regard, governmentality necessitates installation of self-governing structures within subjectivity that link the production of knowledge to the immanence of functionality. The modern subject’s agency is addressed as a matter of epistemic management of the horizon of possibilities constrained by the dangers of accidents, disease; in short, the contingencies that shorten the quantity and lessen the quality of the collective exercise of desire as preference or the expression of interest. Therefore, agency is constituted, in part, by the reduction of risk to populations and also the fostering of “security” as a calculative principle. Additionally, Foucault (2008) argues that mechanisms of control that protect liberal and neo-liberal subjects against a risk (i.e., disease, poverty, criminality, etc.) are not counter-forces to freedom but the source of a certain freedom itself. Put differently, contingencies—deleterious to economic activity—potentially yield under the technologies of prediction, control, and aggregation of human populations in ways that maintain the subject’s future becoming and various cathexes. As Patton (2016) writes, security mechanisms “deal with probable rather than actual events … in terms of cost and in terms of a norm of acceptable outcomes rather than a binary division between the permitted and prohibited” (pp. 106–107). Hence, the clinical apparatuses of the psy-disciplines participate in such attempts to prevent the loss of health and well-being, as a predictive “archiving of the future” (Anthanasiou, 2003, p. 144). As argued supra, obsessionality—as the discourses OCD and OCPD and their related practices—intersects both the metrics of populations and the specific techniques of intervention of the individual, engaging future risk involving contaminants to the biographies of populations. At the same time, an ontology of subjectivity may be held as a horizon of open, yet malleable possibility and socio-economically circumscribed expression of desire.

The discontinuous movements of obsessional subjectivity—from scrupulosity to monomania to obsessional neurosis and OCD—indicate not only a history of shifting pathologies and the norms and privileged subjectivities they imply. Importantly, the subject’s desire is channeled differently amongst these various forms. The monomaniac’s desire, disciplined to remain in certain traditional conduits is set free to narcissistically fashion a selfhood of one’s own work and experience of the world. Accordingly, bio-political strategies make their own demands on the subject’s libidinal economy. Recently, Lacanians have been talking about the “new symptom,” organized around a direct relation to jouissance via the commodities that the post-industrial world produces for consumption (Svolos, 2011). According to some, this new relation gives rise to ever newer addictions such as internet pornography, cutting, bulimia, and anorexia nervosa, which bypass the knowledge encoded in the symbolic Order. This is an issue for another essay, yet suggestive of a different subjective structure circulating with greater intensity around a different social need, that of consumption. Pointedly, however, what this emergence manifests for the continued viability of obsession is the very different oscillating subjectivities upon which we are called to exist in our time, where we are called on to addict ourselves, to lose control and abandon ourselves to what is produced for us. This illustrates Deleuze and Guattari’s highly ambivalent stance towards a post-industrial capitalist world, where desire is simultaneously set free from the symbolic order, and its distant and tenuous connection with sovereign power, but—to borrow a phrase from Latour (2005)—is always drawn towards its attachment to the next “plug in.” Yet, even as these forms of life draw us to them, often circumventing our safety and well-being, we are persistently enjoined—as psychologists, therapists, bureaucrats, and sufferers—to love our status as inner watchmen along the towers of safety, to love our enlistment as sleepless agents of bio-power in a risk society.