On the conceptual grounds of subjective rectification: Responsibility,choice,and freedom in Lacanian psychoanalysis

Abstract

This study aims to investigate the conceptual grounds on which subjective rectification and the interweaving of the therapeutic and epistemic demand rely, specifically the assumption that the subject is involved in their own suffering. This perspective presupposes a subject with a certain degree of freedom and choice. Drawing on Freud’s choice of neurosis, Lacan’s unsoundable decision of being and forced choice and Zupančič’s ideas on psychological freedom, we explore the kind of choice involved in psychoanalytic theory and how it can be understood in light of the psychic determination that is central to both Freud’s and Lacan’s work. We argue that the subject’s determination is self-chosen, albeit a forced choice. This allows the subject to take responsibility for what is experienced as a causal necessity. To illustrate this, we provide examples of childhood trauma and discuss how these children have taken responsibility for their position in what happened to them.

The patient is widely recognized as the principal contributor to therapeutic progress (Bohart & Tallman, 2010). In his theory of the patient as an active self-healer, Bohart (2000) argues that the patient’s active engagement with interventions, rather than the interventions themselves, leads to therapeutic change. Recent studies support this theory, indicating that patients are active participants in relationally based change processes rather than passive recipients of treatments implemented by expert-therapists (Dulsster et al., 2019; Williams & Levitt, 2007). In psychoanalytic therapy, the active role of the patient is also crucial (Benjamin, 2018; Cauwe & Vanheule, 2018; Demoulin, 2015; Zenoni, 2003). As Lacan (1975) states:

The point is to lead [my patients] through the gate, so that the analysis becomes a threshold, so that there is a real question for them. This question: what is it that they want to be rid of? A symptom. . . . I try to make sure that this question forces them to make an effort, an effort that will be made by them. (p. 32, first author’s translation)

In his writings, Zenoni (2003) argues that “the threshold” of analysis consists of interweaving two demands: (a) the therapeutic demand, which refers to the patient’s demand for an explanation or remedy from the analyst in order to be relieved of their suffering and (b) the epistemic demand, which refers to curiosity about themselves, without experiencing any hindering or suffering that instigates this curiosity. In the preliminary sessions of an analysis, both demands must be interwoven. The patient’s suffering has to initiate curiosity about themselves and prompt questions such as “what is happening to me?” and “why do I find myself time and again in these awful situations?” Patients, therefore, mostly need to shift from a position of complaining about their suffering and requiring others to alleviate their discomfort to a position where they actively explore and question the meaning of their symptoms. It is crucial in this context that the symptom is not approached as an obstacle that should be removed quickly using standardized recipes. Instead, it should be embraced as a riddle that needs to be solved, with patients engaging in free association directed at the analyst (Cauwe & Vanheule, 2018). The moment the therapeutic and epistemic demand are interwoven, the patient becomes an analysant and analytic work can start (Zenoni, 2003).

Clinically, we can think of the interweaving of the therapeutic and epistemic demand as whether patients position themselves in the victim role. In her book, The Choice: Embrace the Possible, Edith Eger (2017) argues there is an essential difference between “becoming a victim of” and “the victim role.” Sooner or later, everyone suffers due to circumstances over which they have little or no control. Freud (1929/1930) also states that people inevitably suffer from their bodies, the outside world, and relationships with others. Suffering, then, is universal. Yet victimization is optional; everyone has the choice whether or not to take up the victim role. Victimhood, according to Eger (2017), comes from within. When holding on to a victim role, individuals tend to fall into a way of thinking that is blaming, pessimistic, punitive, and without healthy limits or boundaries. In this way, Eger (2017) grants human beings a certain choice whether or not to position themselves in the victim role and thus whether they take responsibility for their suffering. She pushes her statement quite far, claiming that even in traumatic situations—as she herself experienced in the concentration camps during World War II—individuals have a choice about how they act and position themselves.

Likewise, Lacan (1958/2006c) highlights the responsibility of the patient when he, in The Direction of the Treatment and Principles of its Power, refers to the patients’ verbalization of their own involvement in symptomatic suffering as “subjective rectification.” He clarifies that subjective rectification does not concern a rectification of or adaptation to an external, presumed objective reality. Rather, it refers to how subjects positions themselves in their psychic reality (Meganck & Inslegers, 2020). While some conceptualize subjective rectification as a mode of intervention, referring to the famous example where Freud (1901/1905) points out to Dora that she plays a part in the mess she complains of, ¹ others approach it as the patient’s verbalization of their implication in the symptoms they suffer from. In each case, subjective rectification refers to taking up responsibility for suffering rather than being excused and/or pitied for scars and adversities (Cauwe, 2018). Miller (1997/2003) goes even further in stating that the analyst must cultivate the feeling of guilt in the patient. Yet, assuming responsibility for suffering requires the presumption that someone had some choice or impact on it. Subjective rectification therefore seems to resist the idea of (symbolic) determination, though the latter is inherent to the unconscious in both Freud’s and Lacan’s (early) theorization. In other words, we could argue that the psychoanalytic subject ² must be partly free; otherwise, patients would not be able to take responsibility for their own suffering.

Likewise, Zupančič (2000) uses the notion of (irrational) guilt as an argument for freedom. She departs from the paradoxical structure of guilt, pointing out that “we can feel guilty even for something which we knew to be ‘beyond our control’” (p. 26). She illustrates her point with the example of feelings of guilt after the death of a friend in a car accident. In this case, guilt can be explained at the level of desire: the event that gave rise to the feelings of guilt might be comprehended as revealing an unconscious desire for the friend’s death. Moreover, also on a structural level, Zupančič argues that human beings often feel guilty due to their very suffering. She interprets this as feeling guilty for the frame of their “psychological causality”: “it is as if they felt responsible for the very institution of the ‘psychological causality’ which, once in place, they cannot but submit to, to be ‘carried along’ by” (p. 26). This guilt is not related per se to what a person may have done (or desired to do) but rather to the experience of “the pressure of freedom”: when someone feels guilty for something that is out of control, they receive a glimpse of another possibility (of psychological causality). As Zupančič (2000) states it: “paradoxically, it is at the very moment when the subject is conscious of being carried along by the stream of natural necessity that [they] also become aware of [their] freedom” (p. 27).

Investigating how patients take responsibility for their suffering departs from an interpretation of psychoanalysis that does not excuse one’s wounds, but rather instigates questioning one’s involvement in their suffering (Cauwe, 2018). Such an interpretation inevitably has to situate a particular freedom and choice in the subject. However, it would be absurd to state that individuals always had a hand in what is happening to them. Quite the contrary, oftentimes certain disturbing events happen out of the blue. Despite having no control over such events, individuals have no choice but to take responsibility for their position in the aftermath. Consider the earlier example of the sudden death of a loved one in a car accident. Such an event can occur unexpectedly, yet the individual must take responsibility for their position with respect to the event and its consequences.

We are, thus, confronted with the (apparent) contradiction of taking responsibility for suffering that is experienced as beyond one’s control (see also Acke et al., 2022). How can someone explore and question the choice for a certain suffering within themselves while experiencing a lack of grip on what is happening to them? In this conceptual work, we investigate the conceptual grounds on which subjective rectification and the interweaving of the therapeutic and epistemic demand rely; namely the assumption that the subject is implicated in their suffering and has had a choice in relation to it. This perspective presupposes a subject that has a certain freedom, which at first glance seems to be contrary to the core of psychoanalytic theory. What kind of choice is at stake here, and how can we understand it in light of the psychic determination that is at the forefront of both Freud’s and Lacan’s work?

Our first research question is thus: How can we comprehend “choice” and “freedom” in Lacanian psychoanalysis? To answer this, we will discuss (a) Freud’s “choice of neurosis”; (b) Lacan’s “unsoundable decision of being” and “forced choice”; and (c) Zupančič’s analysis of “psychological freedom.” Following the discussion of these three conceptual approaches of choice and freedom, we will examine their implications for subjective rectification and the interweaving of the therapeutic and epistemic demand. Our second research question is therefore: How can someone take responsibility for suffering that is experienced as “happening to” oneself? Lastly, we will illustrate how people can take responsibility for their suffering in cases of childhood trauma.

Who chooses loses

The idea of choice is explicitly conceptualized for the first time in Freud’s (1913) choice of neurosis [Neurosenwahl]. This choice of neurosis refers to why someone chooses a particular psychopathology or type of neurosis (i.e., hysteria, obsessional neurosis, phobia, etc.). The Comprehensive Dictionary of Psychoanalysis emphasizes that “the process by which a particular neurotic symptomatology as opposed to another develops in an individual . . . is highly complex and not entirely fathomable” (Akhtar, 2009, p. 47). Although the term “choice of neurosis” gives the impression of a rational, intellectual choice, this is not how Freud approached the concept. The choice of neurosis is situated between blind faith and free choice and concerns a choice that can only be assumed retroactively, as it is impossible to pinpoint when this choice was made (Van Neygen, 1994).

The choice of neurosis is closely related to the concept of primary gain, ³ which lies at the basis of every neurosis as it is the easiest economic solution in the case of psychic conflict (Van Neygen, 1994). Freud believed that an individual’s psychic conflicts could lead to symptoms, which provide relief from the underlying conflict and the anxiety accompanying it. According to Van Neygen (1994), neurosis occurs when a person faces difficult choices. In such cases, the easiest economic solution is a compromise where the individual refuses to choose and thus refuses to lose. Neurosis is, then, a pathology that arises when a person chooses not to choose, a decision that typically has harmful consequences. In this sense, Freud states that one’s symptoms are never coincidental, but always a meaningful constructions that relate to how a subject positions themself and for which the subject can take up responsibility (Van Neygen, 1994).

More than 30 years after Freud’s choice of neurosis, Lacan developed the concept of the “unsoundable decision of being,” which refers to the subject’s choice to identify with certain images found in the outside world. Like Freud’s choice of neurosis, this decision is not an intentional process but rather concerns an unfathomable and unconscious one. In the following paragraphs, we will further explore the notion of choice in psychoanalysis examining the concepts of the “unsoundable decision of being” and the “forced choice” of alienation.

The unsoundable decision of being

In his early work on psychic causality, Lacan (1946/2006a) defines madness as the limit of one’s liberty and connects this to the “unsoundable decision of being” (p. 145). The latter refers back to an original, unconscious choice for certain identifications ⁴ the subject alienates themself to. By choosing particular identifications, the subject chooses a certain psychic determination. Lacan thus thinks about the subject as irreducible to a mechanistic causality, yet determined, and thus alienated, by its own unconscious(ly chosen) identifications (Leguil, 2012). Leguil (2012) argues that this choice depends solely on one’s freedom and is, therefore, always unfounded. As much as Freud’s choice of neurosis is not free, Lacan’s unsoundable decision of being is no free choice either. The subject is born into a world that has already been constructed and leaves no other choice than to choose themself in it, to position themself in it. Initially, the subject can only do so by alienating themself to identifications found in the outside world.

Lacan (1964/1981) will later conceptualize the subject’s first alienation as a “forced choice” where there are two alternatives, yet one option implies that neither of both alternatives are still available. According to Lacan (1964/1981), “the choice, then, is a matter of knowing whether they wish to preserve one of the parts, the other disappearing in any case” (p. 211). This choice is forced since the subject must choose if they don’t want to lose the possibility of choice itself (Zupančič, 2000). Lacan (1964/1981) illustrates the idea of a forced choice with the example of “your money or your life” or “your freedom or your life”. ⁵ Choosing the former (money/freedom) implies you would lose your life and you cease to exist, which also means losing your money/freedom. Therefore, if the subject wants to preserve the possibility of choice, one cannot do anything else but choose their life and thus lose their money/freedom. This forced choice is constitutive for the subject and implies that the subject always chooses their own unfreedom or determination. This choice inevitably implies that the subject loses something and will therefore always be dissatisfied.

The first alienation may then be interpreted as the human beings’ forced choice to lose something in order to subjectivize themselves. Applied on the being of the subject, Lacan (1964/1981) explains that

if we choose being, the subject disappears, it eludes us, it falls into-non-meaning. If we choose meaning, the meaning survives only deprived of that part of non-meaning that is, strictly speaking, that which constitutes in the realization of the subject, the unconscious. (p. 211)

Every living being is thus confronted with the forced choice to constitute itself as a subject in the field of the Other, ⁶ in the field of language (Lacan, 1964/1981; Van Neygen, 1994). This forced choice inevitably implies a loss: for a subject to emerge in the field of language, they inescapably have to alienate themselves to the Other (i.e., language), which is always foreign to them and always leaves them with a lack. Once the subject inscribes themself in the Symbolic order, they inevitably choose their own symbolic determination.

Beyond this (symbolic) determination lies a contingent choice that reveals the subject’s freedom to “pick” certain signifiers that determine the subject. This choice is contingent since it is rooted solely in their freedom, or the forced (cf. supra) refusal of it. It is thus impossible to determine what causes this choice (Leguil, 2012). Likewise, Zupančič (2000) asserts that change in psychoanalysis can only occur if we accept the postulate that a subject has somehow chosen their own unconscious. Referring to Freud’s choice of neurosis, Zupančič (2000) states:

The subject is at one and the same time “subject to” (or subservient to) [their] unconscious and the one who, in the last resort, as “subject of” the unconscious, has to be considered to have chosen it. (p. 35)

In what follows, we will draw on Zupančič’s (2000) discussion of “psychological freedom” to elaborate on the subject’s freedom and choice, which is located at the “border of determination” (Leguil, 2012).

Psychological freedom

Zupančič (2000) contends that our freedom is not only externally limited but also internally subjected to the laws of causality. This perspective contradicts views that perceive unfreedom primarily as the presence of restrictions in the outside world, and freedom as acting on one’s own impulses and desires. Zupančič (2000) departs from the concept of “psychological freedom,” which refers to the idea that any action of the subject can be explained by causal necessities. She argues that humans, when merely following their own inclinations, are internally unfree, even if they believe that their actions are self-chosen. This implies that merely following your “own rhythm” is anything but free, but is in fact self-determined by causality. In like manner, Žižek (2002) critiques the idea of spontaneity as being free, claiming that it masks our unfreedom while deluding us with the feeling of freedom (see also Pluth, 2016). Consequently, Zupančič (2000) argues that an act can only be considered free if it is completely foreign to the subject’s (internal) inclinations. The foundation of the subject’s freedom must therefore be situated in a “foreign body,” a term Freud used to refer to the symptom, and which Zupančič (2000) employs in her work to convey the idea that subjects can gain freedom to the extent that they experience themselves as strangers in their own house (Zupančič, 2000, p. 23).

Yet, while Zupančič (2000) argues that we are deeply unfree, she also stresses that we are responsible for all our actions. She therefore builds on the above-described paradoxical structure of guilt: the subject can feel guilty for its determination by which it is “carried along.” The freedom of the subject is then situated in the division expressed in the statement: “I couldn’t have done anything else, but still, I am guilty” (p. 25). Freedom can thus be situated at the point where a person feels guilty for things beyond their control, driven by inescapable necessities. How so? Zupančič (2000) introduces in this context the concept of the lack in the Other. The lack in the Other refers to the idea that there is no ultimate guarantee or foundation to be found in the Other. The Other lacks an external reference point or objective standard capable of providing an ultimate guarantee. Consequently, the Other is shaky and cannot rely on anything else. Because of this lack in the Other, the subject must assume responsibility for the missing guarantee, the lack of necessity (Bistoen, 2015). This implies that the subject alone can be held responsible for their actions.

It is in this respect important to emphasize that the Other is not an objective or fixed entity; rather, it is specific for each subject and emerges through intersubjective relations. As Neill (2011) states:

the Symbolic as Other figures only insofar as it figures in relation to the subject who would encounter it. The Symbolic order is a structural condition which, as it manifests for and in relation to the subject, can only be seen to exist insofar as it exists for that subject. (p. 224)

In other words: the Other is always shaped in relation to the subject. According to Zupančič (2000), the subject is only able to see the lack in the Other when becoming aware of how they depend upon and are determined by the Other. This is why she stipulates that the subject can only become aware of their freedom when having first traveled through the territory of determinism or unfreedom. The subject must first alienate themself to the Other (cf. supra: forced choice) and thus choose unfreedom and radical subordination to the Other to arrive at the point where they can see the lack in the Other and thus are able to gain freedom—or at least to see how they were themselves free to choose their own determination.

The lack in the Other is capital as it prevents the subject from being determined in an absolute manner. It provides breathing space for the subject to not evaporate completely in the process of alienation. Without the lack in the Other, “everyone would coincide perfectly with the narrative dictated by the Other” (Verhaeghe, 2002/2004). Therefore, the lack in the Other implies the possibility of freedom beyond determination. The only cause that lies beyond the deterministic causality in an individual’s life can be found in the subject themself. In psychoanalysis, the possibility of choice or freedom is thus located at the border of the individual’s unfounded determination. Becoming aware of the lack in the Other is a necessary precondition for clinical work as it allows the subject to retroactively take responsibility for their actions without being able to ascribe them to external necessities (Neill, 2005).

With this in mind, we can now explore the implications of the aforementioned concepts for the assumption of responsibility in psychoanalysis, as it is conceptualized in subjective rectification and the interweaving of the therapeutic and epistemic demand. Building upon the earlier conceptual elaboration of choice and freedom in psychoanalytic theory, we will aim to answer the question of how patients can take responsibility for something that is experienced as happening to themselves.

Responsibility for what?

Returning to our second research question, we can now state that the subject can assume responsibility for their own determination, although this brings along a “stream of necessity” they cannot escape (Zupančič, 2000). Indeed, as Soler (1996) states:

Symbolic determination does not contradict subjective responsibility, and when one speaks of responsibility, one implies a level of choice; for without choice it is impossible to conceive of responsibility. (p. 52)

On a structural level, the subject is responsible for the forced choice to inscribe themselves in the Symbolic order and alienate themselves to the Other. The subject has “chosen” to be determined by the Other (cf. supra) and can be held responsible for this choice, since this Other is lacking too. Taking responsibility for one’s subjectivity can therefore only take place in relation to the lack in the Other and must be considered an ethical act (Neill, 2005). It is in this respect important for a subject to explore how they installed their own mechanistic determination and how it affected them. This must be done retrospectively, as

it is in the moment of the assumption of subjectivity that the subject retroactively reads its responsibility into its actions. The subject, in assuming itself, assumes responsibility for the act of its own emergence. (Neill, 2005, p. 6)

Only in retrospect can someone take responsibility for how certain events and words determined them, which position they took in various situations, and how these positions are (partly) determined by the unconscious identification with images and signifiers coming from others. As Gentile and Macrone (2016) state: “The analysand must choose, must assert [their] agency, even if only to discover what is not free or consciously chosen” (p. 17).

In our conceptual work so far, we situated a certain degree of freedom in the lack in the Other, which refers to the point where the laws of causality that are installed by the Symbolic break off. In Lacanian theory, the lack in the Other is related to the order of the Real which is often comprehended as lying beyond the Symbolic and the Imaginary order and thus as inaccessible to language and representation. ⁷ In contrast to the Symbolic that is lawful, the Real is undetermined, contingent, and traumatic. We could argue that the Real is closely related to the concept of freedom, as it cannot be recuperated into lawfulness, and thus breaks the constraints of the Symbolic order. When experiencing something as Real, someone literally has no words or images for it. The Real thus does not refer to the fictions (i.e., signifiers) with which the subject dresses itself up but could be typified as the “foreign body” something that is experienced as “other” in oneself, yet that is most “truly oneself” at the same time (see supra; Zupančič, 2000, p. 23). Despite, or even due to the Real’s contingent and undetermined nature, it opens up possibilities for creation and freedom. The Real disrupts the stability that the Symbolic order provides and is therefore both terrifying and liberating. In this sense, assuming responsibility for one’s actions is only possible at the point “which refuses recuperation to an image or to a rule, that point where the Symbolic and the Imaginary break down or break open upon the Real” (Neill, 2005, p. 25). Building on this line of thought, we might posit that freedom, to the extent that it is attainable, can only be achieved through a rupture with the preestablished Symbolic structure, and therefore by introducing something contingent, something Real. Yet, the Real can only be liberating insofar as it allows the subject to reconstruct its symbolic co-ordinates. Otherwise, the Real would linger at the level of the traumatic, horrifying, and ineffable experience. Assuming responsibility is, in other words, only possible when the subject is on the one hand confronted with a rupture in the Symbolic and Imaginary realms and, on the other, insofar as the subject is subsequently reinscribed in the Symbolic realm that is distinct from the Symbolic that preceded the rupture (Bistoen, 2015; Neill, 2005).

Subjective rectification and trauma

In what follows, we will illustrate subjective rectification (i.e., taking up responsibility for one’s subjective implication in suffering) with three cases of trauma. Why trauma? Nowadays posttraumatic symptoms tend to be understood as caused by an event that is so horrific that one can do nothing but develop psychopathology (Bistoen et al., 2014). However, there is no unambiguous relation between the experience of trauma and the development of (PTSD) symptomatology. Empirical research indicates that the nature of the traumatic event cannot predict who will develop posttraumatic symptoms and who will not: some people do not develop any symptoms after a (severely) traumatic event; while others do develop PTSD symptomatology after events that did not qualify as traumatic according to DSM-IV’s criterion A, the “stressor criterium” (Rosen & Lilienfeld, 2008). ⁸ This indicates that the subjective interpretation of the traumatic event is of equal (if not greater) importance in the development of symptomatology (Bistoen et al., 2014). In other words, the case of trauma is exemplary for illustrating subjective rectification as being contrary to excusing people for their wounds (Cauwe, 2018). The same argument is made by Eger (2017), who narrates how she had to take responsibility for how she positioned herself towards the horrible events during World War II in order to work through the atrocities that happened to her in the concentration camps. In Dr. Eger’s case, her position was marked by feelings of guilt and doubt, questioning whether she was worthy of surviving.

Trauma is thus an excellent example of the paradox inherent in the concept of subjective rectification, as it requires taking responsibility for suffering brought about by events that are experienced as happening to the individual. This, nevertheless, has clinical implications that extend beyond therapeutic work with trauma. While therapists cannot go back and change the events that marked their patients, they can investigate how patients interpret these past (traumatic) events and how these have determined them, and guide them to a point where the determination breaks off and something new can appear.

Discussing trauma as a case to investigate taking responsibility for one’s suffering, we are navigating turbulent waters. Indeed, when studying cases of trauma, presupposing a choice of the subject in the formation of psychopathology tastes bitter. Common sense would suggest that, for instance, in the case of abuse, survivors did not have a choice in what happened to them, and that the perpetrator is to be held responsible. Holding the patient responsible for their suffering risks misrecognizing their helplessness and suffering on a personal level, but also structural problems on a societal level (e.g., the high, nearly epidemic, prevalence of childhood sexual abuse; see also Gentile & Feiner, 2021). Nonetheless, we believe that holding the perpetrator responsible on a juridical and societal level does not exclude paying attention to how a survivor of a traumatic event positions themself with respect to the event in the consulting room.

Furthermore, while we have argued that psychotherapists cannot change the traumatic events their patients have experienced; we do want to stress the importance of establishing safety in their lives and in the therapeutic relationship, particularly for minors and individuals still living in a traumatizing context (see also Herman, 1992). This safety is a necessary prerequisite to explore how patients have positioned themselves in relation to the traumatic events and how this fits within their subjective history, while recognizing the complexity of their situation. With this in mind, we will discuss Gentile and Feiner’s (2021) examination of the films Tale and Leaving Neverland, which recount disavowed memories of childhood sexual abuse, as well as the published case study of Nina (Chiriaco, 2015), who also experienced childhood sexual abuse and later recounted these events in analysis. By analyzing these cases, we aim to shift the focus from the victim to the subject and clarify how assuming responsibility can be understood in cases of trauma.

Clinical illustration

In a recent article concerning pedophilia and taboo desire, Gentile and Feiner (2021) refer to two films (i.e., Tale and Leaving Neverland) in which the protagonists recount the sexual abuse they suffered as a child. Strikingly, in both examples, the children initially experienced the transgressive behavior they endured as a fierce love story. Likewise the Dutch writer Marieke Lucas Rijneveld explains how he dislikes the word “abuse” and prefers to describe his book, My Heavenly Favorite: A Novel, as a story of forbidden love (Blom, 2020). The film Tale is based on a love story which Jennifer Fox had written when she was 13, but that in retrospect is to be understood as a testimonial of sexual abuse (Gentile & Feiner, 2021). She describes how this “love story” made her feel special and empowered, which incited her to safeguard it. Many years later, Fox started to reconceive, reinterpret and retell her “love story” as a violation of her nascent, erotic desire and exploitation of her infantile need for recognition, feeling special, and being loved. Similarly, Leaving Neverland depicts how James and Wade were originally loyal to Michael Jackson, with whom they had a “relationship” when they were children. During the sexual abuse and even after Jackson’s interest in them fades and other little boys took their place, they were devoted to him and hoped to restore their special relationship with him. In the documentary, Wade, for instance, tries to make sense of why he kept their sexual relationship secret and why he testified in Jackson’s favor in a legal trial prompted by allegations by another child. He describes having been “excited by the idea of being able to defend him and being able to save him” (Gentile & Feiner, 2021, p. 74). Moreover, James and Wade testify of their jealousy towards the other kids Jackson replaced them with. Those other boys, in their eyes, were the enemy.

Even though the questions raised in both Tale (e.g., Why did I cherish the abuse as if it was a sublime love tale?) and in Leaving Neverland (e.g., Why did I testify in favor of my abuser while I knew the allegations of sexual abuse to be true?) aren’t addressed in the therapeutic context, they seem to be illustrative for subjective rectification as they [Fox, James, and Wade] question their involvement in their suffering and take responsibility in the aftermath of the traumatic events. That is, they wonder why they reacted the way they did to the atrocities inflicted upon them. In these cases, the survivors of childhood abuse not only have to cope with the physical and psychological effects of the transgressive behavior but also with their own premature, erotic, taboo desire. These desires are initially perceived by the children as a cherished love but are pedophiliac and thus forbidden.

An example of subjective rectification that is situated in the context of an analysis is the case of Nina, who suffered incestual assaults when she was as a child (Chiriaco, 2015). Since she was 8 years old, her uncle, the beloved little brother of her mother who lived in their home, locked Nina in his room and touched her. The transgressive behavior continued until she, when aged 12, said “no” to him. Before this radical “no,” Nina kept silent, not only out of fear of her uncle, but also because there were no words for what was happening to her. Yet, she knew that what happened was forbidden, which left her feeling ugly, dirty, ashamed, disgusted, and terrified (Chiriaco, 2015). Although she had previously recounted the traumatic past to a therapist, posttraumatic symptoms seemed to revive when she became a mother herself. In his doctoral dissertation, Bistoen (2015) discusses Nina’s subjective response to the traumatic event, namely the unconscious construction of a reparative fantasy which covered up the disruptive experience, and which could be summarized in the statement: “I am the one who attracts men, I am their prey.” Bistoen (2015) explains how Nina, through recounting her love and professional life and working through the material produced in analysis, was able to formulate this fantasy. It would lead us too far to go into detail on Nina’s phantasmatic solution here. Yet, we do want to quote a passage where Chiriaco (2015) describes how Nina, already early on in therapy, takes responsibility for how she reacted to the traumatic event and questions why she did react in such a manner:

Early on, Nina had subjectively taken some of the responsibility for what had happened to her as a child. She suggested this when she wondered why she had endured it all for so long, even though it terrified her. “Why did I wait years to tell him no?” In doing so, she touched on that unspeakable pleasure that she did not understand but of which the shame, ugliness and filth were traces. Taking responsibility for her silence had allowed her, starting from what had become a mystery to her, to undertake an analysis beyond the mere recounting of the facts, something that had relieved her some years earlier. “I remained silent, I did not resist.” Just by saying such a thing, she distanced herself from a victim position. Nina was the one who had chosen to remain silent, who had not understood, had not dared. Now she was the one who regretted that. (p. 41, first author’s translation)

We can note several important clinical aspects in both the examples given by Gentile and Feiner (2021) as well as in the case of Nina (Chiriaco, 2015). First, subjective rectification does not concern the event itself: Nina is not to be held responsible for what happened to her during her childhood, which would imply victim blaming, but she does take responsibility for how she reacted upon the event, questioning why she kept quiet for such a long time, why she submitted for such a long time. These questions were raised during analysis, while recounting a dream where she is “tinged by a stain she could not get rid of” (Bistoen, 2015, p. 199). Nina associated this stain with her uncle’s transgressions and her reaction to it. As Bistoen (2015) discusses, both the dream and the questions it raises touch the dimension of the Real as they take Nina beyond her symbolico-imaginary solution that defended her against the traumatic events. The stain she can’t get rid of cannot be incorporated or concealed in words or images, but persists due to its irreconcilability with her reparative fantasy (for a detailed discussion, see Bistoen, 2015). Likewise, James and Wade, as well as Jennifer Fox are not responsible for the abuse that happened to them, yet they question how they positioned themselves towards these events; initially defending their abuser and cherishing it as an exceptional love story.

Second, we can notice how Nina’s subjective rectification opens up the possibility to start an analysis. This is in accordance with Zenoni’s (2003) argument that the therapeutic and epistemic demand must be interwoven in the preliminary work to allow an “entrance into analysis.” Nina’s suffering due to the traumatic event instigates curiosity concerning herself, as she becomes an enigma, a riddle to herself, which is only the beginning, the start of a working-through in the analytic context. Likewise, Wade’s attempts to figure out why he testified in favor of his abuser could be regarded as a pertinent question which could be further worked through in a therapeutic context.

Third, both in saying “no” to her uncle and in questioning why she endured the horrible events for such a long time, Nina enables herself to take up a subjective position, and as such refuses herself to be (approached as) a victimized object. Nina’s “no” to her uncle especially “procured a transition: the Other could no longer make use of her without her consent” (Bistoen, 2015, p. 198). It renders the interaction between her and her uncle a two-way interaction. We could therefore, aligning with Benjamin (2018), argue that taking up responsibility for one’s position and participation in a complex interaction is of major importance in the recovery of subjectivity. It allows the person to not merely perceive themselves as an effect of the deeds of others, but presupposes their own contribution—how small this might be. Yet, crucially, Benjamin (2018) emphasizes that taking responsibility must not be confused with self-blaming.

In cases of self-blame, a person either takes up the role of the perpetrator or victim, in Benjamin’s (2018) words one is either “doer” or “done to,” which leaves the person no choice but to be either reactive or impotent in face of the other, and as such “weakens one’s sense of being a responsible agent” (p. 25). Nina’s “no” is neither reactive nor impotent but rather testifies to taking responsibility, as her actions are not (absolutely) determined by the other but rather install a radical break with her preceding reactions (of impotence) and challenge these in a retrospective movement.

Lastly, we want to emphasize that the traumatic encounters described above are all circumstantial traumas, adding to the constitutive trauma every human being suffers from (Osserman, 2019). On the one hand, the constitutive trauma refers to the human condition which implies the “forced choice” of alienating oneself in the field of the Other (see above). This alienation in the field of the Other inevitably entails the choice for a particular determination and installation of a “causal necessity.” As such, the entrance in the field of the Other enables the subject to construct symbolico–imaginary co-ordinates that can, to a certain extent, cover up and thus protect them from the Real that is experienced as traumatic and terrifying, initially appearing in the newborn as their own drives (see also Verhaeghe, 2001).

Circumstantial trauma, on the other hand, refers to traumatic experiences that are contingent in nature, as they are not an inevitable part of the human condition. Circumstantial trauma introduces an additional layer of alienation for those who undergo it, thus adding to and reawakening the constitutive trauma. Circumstantial trauma always involves an encounter with the Real insofar that it disrupts one’s world, or more precisely, the symbolico–imaginary frame that has been constructed, thereby destabilizing the subject. ⁹ Paradoxically, the undetermined, circumstantial encounter has profound determining effects, which remain unpredictable as they are always subjectively colored. Similarly to the constitutional trauma of the forced choice, in the case of circumstantial trauma the subject is forced to choose how to react to the trauma and how the traumatic event will determine their subsequent life course. As much as one loses either way in the constitutive forced choice, one inescapably loses when forced to choose how to react to a traumatic event.

Conclusion

In the current article, we examined the conceptual grounds on which subjective rectification and the interweaving of the therapeutic and epistemic demand rely, namely, the concepts of choice and freedom in Lacanian psychoanalysis. We discussed Freud’s (1913) “choice of neurosis,” Lacan’s “unsoundable decision of being” (Lacan, 1946/2006a) and “forced choice” (Lacan, 1964/1981), and Zupančič’s (2000) ideas on “psychological freedom.” We concluded that the subject’s determination or lack of freedom is self-chosen, although this is a forced choice. This implies that the subject can take responsibility for their own determination and must somehow engage themself in the process of exploring the ways in which they have chosen their own determination. Now, what are the implications thereof for clinical work?

First, drawing on Zenoni’s (2003) emphasis on the interweaving of the therapeutic and epistemic demand to initiate an analysis, as well as Nina’s analytic work which commenced with her subjective rectification (Chiriaco, 2015), we believe subjective rectification or the interweaving of therapeutic and epistemic demand to be essential for embarking on the therapeutic work of exploring the terrain of psychic determination (Zupančič, 2000). While some patients may arrive at therapy already curious about themselves, others need guidance to get to a point where they approach themselves as an enigma to explore (Cauwe, 2018). In such cases, it is crucial for therapists to invite their patients to be puzzled about themselves and about what lies beyond their symptoms. As Benjamin (2018) emphasizes, the therapist has the responsibility to invite the patient into the domain beyond the dual doer/done to dynamics, where they can take up responsibility: “In taking such responsibility, the analyst is putting an end to the buck-passing the [patient] has always experienced—that is, to the game of ping-pong wherein each member of the dyad tries to put the bad into the other” (p. 42).

Second, fostering patients to take responsibility for their suffering, especially in cases with a traumatic background, requires a delicate balance for the therapist, who must acknowledge the devastating effects of certain (traumatic) events while also initiating curiosity about why patients reacted as they did. For patients to be able to question themselves and take responsibility for their reactions upon traumatic experiences, several essential preconditions must be met. These are discussed implicitly throughout the article and include providing a safe environment where traumatic situations no longer occur, installing a sustaining therapeutic relationship (Herman, 1992), creating a space where patients can speak with minimal restraint, and paying attention to how patients use language, encouraging them to listen to themselves differently (Dulsster et al., 2019; Gentile & Macrone, 2016).

In this context, it is important not to intervene too directly aiming at patients’ involvement in their suffering—as Freud did in the case of Dora. Rather, therapists can create the optimal conditions for their patients to assume responsibility and leave the choice of when and whether to start the therapeutic work up to them. For example, Van Nieuwenhove et al. (2020) observed that expressive interventions, aimed at exploring and working through core interpersonal patterns, initially led to deterioration in a patient with a traumatic background. After discussing the case in supervision, the therapist switched to implementing more supportive interventions aimed at installing a safe therapeutic relationship. The change of approach allowed the patient to follow her own pace, which had stabilizing effects. As a therapist, a majority of the work then consists of maintaining a balance between supportive interventions aimed at sustaining the patient and expressive interventions aimed at exploring what determined them, how, and why.

Third, to “travel the territory of determinism,” as Zupančič (2000) phrased it, patients should engage in free association, allowing them to unveil what is not free (Gentile & Macrone, 2016). By working through how they have been determined, patients can arrive at the conclusion that their determination is fundamentally unfounded, as no guarantee can be found in the Other. However, arriving at this conclusion on an intellectual level alone is insufficient. This conclusion, along with the speech leading to it, must be embodied, as it touches upon the most intimate part of one’s being—a “foreign body” that is experienced as unfamiliar but is the “most truly ours” (Zupančič, 2000, p. 23). In this sense, psychoanalytic work should touch upon what is Real within the subject’s experience (Voruz, 2022). This enables the breakdown of the previously established Symbolic frame—and thus also its determination—and allows the subject to reconstruct new symbolico–imaginary co-ordinates that leave more room to maneuver. However, the reconstruction of one’s symbolico–imaginary framework is never an intentional process. Moreover, as the Real is primarily terrifying and destabilizing, the therapist must—as we mentioned above—delicately balance between building a supportive relationship and encouraging patients to talk about what has been experienced as Real in their lives.

Lastly, as a traumatic experience can underlie varying psychopathological conditions beyond PTSD (e.g., substance abuse, eating disorders, dissociative, affective, somatoform, and sexual disorders, etc.; van der Kolk et al., 2005), the aforementioned clinical guidelines (i.e., being responsive to the patient, fostering free association and working through, aiming at embodied speech) may have broader applicability, especially in cases of neurosis. Yet, at the same time, we must be careful with making overly general claims. We want to stress that it might be counterproductive and destabilizing to insist that the subject must question themselves and assume responsibility for their choices when working with cases of psychosis—which also often co-occurs with trauma (Baudin et al., 2017; Read et al., 2005). In cases of melancholia (i.e., psychotic depression), for instance, the complaint itself may be an attempt to protect oneself against an absolute void and to inject some vividness into oneself (Hermans, 2023). In such cases, it is unrealistic and unhelpful to encourage the patient to be curious about their complaint.

In conclusion, we can state that when working with patients experiencing neuroses, it is essential for the patient to take responsibility for their suffering to initiate therapeutic work. By exploring the “territory of determinism,” patients can move towards the conclusion that what is experienced as a natural necessity is not absolutely determined and is fundamentally unfounded. This implies that the subject has had a choice, although this is a forced and unconscious one, for a certain determination. It is the therapist’s job to create optimal conditions for subjective rectification to occur. In doing so, the therapist must be mindful of the patient’s pace.