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Self Unhelped

Christian R. Gelder on psychoanalysis and therapeutic culture

Reviewing books by two of the world’s leading psychoanalytic writers, Christian R. Gelder explores the challenge that psychoanalysis poses not only to conventional understandings of self and sex, but also to the prevailing therapeutic culture. 

To seek out a therapeutic practice, we are sometimes told, is often the expression of a desire for change. But ‘therapy’ is hardly separate from the culture it intersects with, and may end up changing that very culture. If the poet W. H. Auden could describe Freud as ‘no more a person / now but a whole climate of opinion’, then surely that was because Freud’s language eventually became our own; phrases like ‘acting defensively’ or ‘feeling conflicted’, as John Forrester notes, have been absorbed into everyday speech. A particular therapeutic practice can thereby help to bring into being the self it seeks to describe (such as the epochal emergence of what Philip Rieff once called ‘psychological man’), as its models of successful treatment and its language for the mind, emotions, and behaviour become part of culture’s common-sense. Even the use of ‘therapy’ tells us something about its contemporary cultural status, indexing far more than any individual therapeutic act. ‘You should talk to a therapist’ is a refrain regularly printed on t-shirts, worn by internet celebrities of all stripes, and the remark trades off the sense that recommending therapy could be seen as an act of care just as it could also be a moral corrective for bad behaviour (‘go to therapy, you naughty boy!’). 

Our climate of opinion, though, is hardly Freudian, even if Freud’s own social and therapeutic insights remain as topical as ever. As Bruce Fink writes at the outset of his well-regarded introduction to Freudian practice, ‘[m]y impression, based on some three decades of psychoanalytic teaching, practice, and supervision, is that the most basic methods Freud developed for accessing the unconscious are no longer taught to the vast majority of students of psychology and psychoanalysis’. And it is sometimes remarkable to think that ‘analysis’ was ever considered a hegemonic therapeutic force: according to Robert P. Knight, there were only 485 members of the American Psychoanalytic Association in 1952, the overwhelming majority of which practised in New York – so hardly a mass force. Today, however, therapy is more cognitively- and behaviourally-minded than psychoanalytic, and the therapeutic encounter is usually limited to ten to fifteen sessions, sometimes with weeks or even months between them (a friend of mine jokes that she likes to tell people she has been in therapy for ‘years’, despite having only met her therapist just a handful of times).  

These more recent therapies have their origins in mid-century East Coast American psychology, popularised in large part by the ‘neo-Freudian’ Aaron Beck and the rational-emotive behavioural therapist Alfred Ellis. In the cognitive modalities, the clinical emphasis often lies more on developing goals and skills than in coming to terms with the unconscious (however theorised). Indeed, Ellis’s work straddled the line between scientific and self-help psychology: his best-selling co-authored book A Guide to Rational Living (1961) contained chapters that were titled ‘The Art of Never Being Desperately Unhappy’, ‘How to Stop Blaming and Start Living’, and ‘Controlling Your Own Destiny’, where the emphasis fell on individual responsibility and accountability, of ‘taking control’ in spite of one’s psycho-social environment. Ellis would also often invoke experiences from his own personal history that led him to reject psychoanalysis and embrace the behavioural model. In a famous anecdote, he challenged himself to approach 130 women over a period of a month at the Bronx Botanical Gardens in order to overcome his social and romantic anxiety. ‘Thirty walked away immediately’, Ellis recalled, ‘I talked with the other 100, for the first time in my life, no matter how anxious I was. Nobody vomited and ran away. Nobody called the cops’. 

A psychoanalytic approach might be a bit more discerning, noting that such behavioural signs – not vomiting and running away or calling the cops – are hardly inconsistent with deeper feelings of discomfort. The success of cognitive therapies has sometimes been attributed to the political climate into which they were born: in a culture of excessive economic rationalisation, one can see why the economy of the behavioural therapies is attractive to governments looking to fund the most cost-efficient therapies. Ellis himself once symptomatically drew a parallel between his own practice and the psychoanalytic model along exactly these lines: ‘Freud had a gene for inefficiency, and I think I have a gene for efficiency’, he noted, ‘Had I not been a therapist, I would have been an efficiency expert’. Indeed, cognitive therapies are often accompanied by a particular kind of politically-charged language, where old-fashioned notions of the ‘patient’ (or ‘analysand’, for that matter) have been replaced by the ‘client’ and analytic language shaped by emotional skill-management, as Lily Scherlis has recently explored in an excellent article on the cultural politics of Marsha Lineham’s Dialectical Behavioural Therapy.  

The cognitive therapies have also been sustained thanks to their status as ‘evidence-based’, though it can be difficult to assess their efficacy. As Nancy McWilliams wryly illustrates in her famous psychoanalytic riposte to the DSM, Psychoanalytic Diagnosis (2011), the desire for a fully efficient, completely scientific therapy can itself be an important marker in determining a person’s individual psychopathology. In the case of obsessional neurosis (or what she calls ‘Obsessional and Compulsive Personalities’), the emotion required for therapy is often kept at a safe distance by ‘oppressively cognitive’ rationalisations: ‘one man’, McWilliams writes, ‘with whom I did an intake interview responded to my question about the quality of his sexual relationship with his wife with the sombre assertion, “I get the job done”’. But a recent study based on a large-scale meta-analysis curiously suggested that the documented efficacy of cognitive-behavioural therapy for the treatment of depression wanes over time. The authors speculate that, among other things, new therapeutic modalities might operate a bit like placebos, offering an initial boost when first entering the cultural sphere before losing their potency, becoming just another opinion in our headily psychologised climate.   

As analysts and commentators have pointed out for many years now, analysis leaves open a space for inefficiency in a world defined largely by demands for the very opposite: ‘it may be precisely the emphasis on the specificity of psychotherapy that remains its trump card’, as Darian Leader nicely puts it in another forum devoted to the efficacy of psychotherapy, ‘the fact that it refuses the false gods of pseudo-scientific techniques and offers a space where each person can be listened to outside the framework of the service industry’. One of the most important and controversial psychoanalysts of the twentieth century, Jacques Lacan, once outlined the singularity of the psychoanalytic method, showing how it departs from the kind of ready-made model of therapy: ‘analysis as a science’, he remarked, ‘is always a science of the particular’. There is no formula for the direction of an analysis, no handbook for how a patient should be treated, no ‘standard model’: the ethics of an analysis often stresses the uniqueness of each case, how one must listen to a patient as if what they have to say could overturn the entire body of analytic theory. 

One reason that crossed my mind as to why psychoanalysis seems so untimely, so out of place in our therapy-positive culture, is that it can sometimes be just as much an account of why the therapeutic encounter is liable to fail than a robust theory of why it works. At first glance, its key concepts – the unconscious, transference, resistance, repetition compulsion, defence mechanisms, screen memories – are all explanatory mechanisms that aim to account for why people who undergo therapy find it so difficult to change, why the therapeutic encounter is at risk of faltering or stumbling at a particular moment, why the relation between therapist and patient can entrench certain behaviours rather than dislodge them. Psychoanalysis is a fundamentally incredulous activity and seeks to disrupt even the sturdiest narratives we tell ourselves about ourselves. As Lacan remarked, ‘[t]he basic thing about analysis is that people finally realise that they’ve been talking nonsense at full volume for years’. For these and other reasons, as I once heard an esteemed analyst say, there is no reason why it has to survive – and indeed, given our current culture’s obsession with measuring every aspect of every second of every day, the future institutional reproduction of psychoanalysis appears less assured than ever.  

Freud once said that the point of psychoanalysis was to turn ‘neurotic misery into ordinary unhappiness’. But what future does ordinary unhappiness have in the happiness industry? 


Bruce Fink and Darian Leader are both clinicians working in the Lacanian field who have contributed an astonishing amount to the life and practice of psychoanalysis over many years. There is a quietly radical tone to their work: suspicious, as analysts tend to be, of group formations and good intentions, but also aware of the singular power of psychoanalytic thinking, its untimely and often unwelcome ability to say what cannot yet be said. Both, however, have very distinct stylistic registers that shape the audiences they address and the issues they think through. ‘Style’ is in fact a topic pertinent to Lacanian analysis and psychoanalytic history more generally, calling to mind not only issues of transmission, but also one’s sense of self and relation to the other: think here of contemporary theories of ‘attachment styles’, which come out of the work of the American psychoanalytic psychiatrist John Bowlby. Lacan opens his monumental Ècrits (1966) by citing Buffon’s ‘style is the man himself’, and Leader is fond of invoking the Viennese-cum-American analyst Theodore Reik’s account of Freud’s ‘correction’ to this formulation: that style is the history of the man. In his new book Miss-ing (2024), Fink presents the testimony of the French analyst Claude Halmos, who was supervised by Lacan. As Halmos recalls, Lacan ‘tried to find out what made me tick and made me become an analyst through discovering my own “style”’. At another point in Miss-ing, Fink stresses exactly this point, outlining that his role as a psychoanalytic supervisor is to help his ‘supervisees develop their own styles’. 

Miss-ing is a book, in part, preoccupied with style, and Fink notes Lacan’s own correction to Buffon’s adage: that style is ‘the man one addresses’. Fink has had a long and legendary career dedicated to the transmission of Lacanian psychoanalysis, producing a set of now-classic texts that outline its clinical stakes. His early The Lacanian Subject: Between Language and Jouissance (1995), A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique (1997) and Fundamentals of Psychoanalytic Technique: A Lacanian Approach for Practitioners (2007), for example, sketched out a more pragmatic, grounded account of Lacan’s practice at precisely the time when Lacanian jargon was at its most opaque. Another paper printed in Miss-ing, a short talk given on the twenty-fifth anniversary of the publication of A Clinical Introduction to Lacanian Psychoanalysis, reflects on this:  

My Clinical Introduction to Lacanian Psychoanalysis was, naturally, criticised in some French circles for oversimplifying – which is undoubtedly true. But the criticism in some cases simply meant that it rendered accessible certain of Lacan’s ideas to non-specialists (against all odds, it has been translated into a dozen languages), many Lacanians being careful to never be too clear, to always leave some conceptual wiggle room, to always leave the listener or reader perplexed. That can be useful in a context in which the more listeners and readers are perplexed, the harder they work. I would argue that that context – assuming it was ever really widespread – is gone, that that moment in time has passed. 

Fink’s own style here is at issue: the clinical-didactic, open-ended yet deeply grounded in the concrete, suggestive but never hermetic. The addressed other is the clinician, not the theoretician: ‘[a]fter some thirty years in which Lacan’s work was isolated in a small corner of academia in the English-speaking world’, he reflects in another essay, ‘I decided to take seriously Lacan’s claim in The Four Fundamental Concepts of Psychoanalysis: “The goal of my teaching has always been, and remains, to train analysts”’. While the world of American psychoanalysis was once hostile to Lacan, that moment too may have passed. And there is optimism about the future of Lacanian psychoanalysis in Miss-ing, where Fink has noticed the desire to engage with Lacan’s work in many younger non-Lacanian circles.  

Also a noted translator, Fink produced the first complete English edition of the Écrits, as well as numerous of Lacan’s yearly Seminars, the most recent of which is the dense Seminar XVI: From an Other to the other (2024). The relationship between translation and transmission also receives a fair amount of attention in Miss-ing: how to translate a notoriously difficult thinker for ‘analysts who were not necessarily masochistic or in love with difficulty for difficulty’s sake, who were not very conversant in Continental philosophy, and who were certainly not familiar with all of French literature from François Rabelais to Raymond Queneau’. Readers can be justified in being fearful of Lacan’s writing, which moves, sometimes at light speed, between different theories, thinkers, and problems from the history of thought, ‘forever playing off’, as Elizabeth Rudinesco once memorably put it, ‘classicism against modernism’. But a substantial essay in Fink’s book shows that we ought to be just as fearful of sloppy English translations. One example, from an earlier partial translation of the Ècrits by Alan Sheridan, is illustrative here. In a famous essay on the direction of the psychoanalytic treatment – ‘a psychoanalyst directs the treatment [...] he must not direct the patient’ – Lacan produces a metaphor for analysis based on a game of bridge:  

[...] he tells us there that ‘the analyst strives to get the analysand to guess (lui faire deviner)’ the fourth player’s hand, the fourth player being the analysand, not as ego, but as subject of the unconscious. Alan Sheridan had Lacan recommend to the analytic world that the analyst ‘try to expose’ the fourth player’s hand. Yet there is a whole world between recommending that the analyst expose the analysand’s hand and that she, instead, get the analysand to guess his own hand, and that world is the world of mastery. [...] Should we be surprised if more mastery-oriented therapeutic work grows out of such sloppy renderings? 

Addressing a clinical audience, however, does not mean that Lacan’s prose gets worked to death, translated into its barest literal form. ‘I hope’, Fink remarks, ‘that I have managed to render a Lacan who still burns slightly whoever reads his writings’. 

Miss-ing has this kind of self-reflective quality. Written over the last decade, the suite of essays covers a vast variety of material, far more than can be easily glossed here, and it sees Fink occupy several different modes: auto-biographical but also technical, with papers concerning the psychopathological distinction between neurosis and psychosis and the nature of the imaginary, as well as a fascinating and lengthy case study about a possible male hysteric. The title is lifted from a remark of Lacan’s, given in his early seminar Desire and its Interpretation, which Fink has also translated. Critiquing a certain school in psychoanalysis who write about experiences of totality in the form of early maternal identifications, Lacan writes,  

It is as if they were so caught up in this aspect of things that they have forgotten what psychoanalytic experience shows us when it is pursued tenaciously to the outer edge of what we see in the phenomena – which is that it is impossible for human beings to accede to an experience of totality, because they are divided and ripped apart, no analysis being able to restore totality [...] human beings cannot help but consider themselves to be nothing more than beings who are, in the end, missing something. 

For Lacan, to feel as though something is always missing – and so to set in motion the mechanics of desire – is fundamental to the human condition. It is the price one pays for entry into a social and linguistic field largely determined by an other who is themselves lacking. Totality is thus fundamentally chimerical, whether longed for in an identification or in a therapeutic practice.  

But to miss can also mean to fail to accurately hit or understand. ‘Mis-’ is itself a widely used prefix indexing a negation: to ‘misidentify’, ‘misspeak’ and ‘misadvise’, for example, are all traps the clinician must navigate with great care if they attempt to understand too readily (Fink has also published two collections of essays entitled Against Understanding). These multiple senses of the word ‘missing’ structure the essays in Fink’s book, most of which concern questions of mastery, understanding, and lack. In contemporary culture, we might view a therapist as having a special kind of knowledge about the human psyche, as knowing something about us that we don’t know ourselves – this being the reason we seek out therapy in the first place. One virtue of Fink’s work, though, is to repeatedly problematise the claims to knowledge at work in the therapeutic field, emphasising instead the virtues of not-knowing, of not aiming to understand the words of an analysand too readily. As he notes in the first paper in Miss-ing, which continues his long-held critique of what is often called the ‘counter-transference’ in other schools of psychoanalytic thought, a Lacanian analyst should recognise that ‘he does not know the why and wherefore of the analysand’s actions, thoughts, feelings, fantasies, and symptoms. All he knows (like Socrates) is how to ask questions and hopefully how to decipher ciphered texts a bit better than the analysand does’. An analyst thus does not rush to give their patient ‘warmth, sympathy, recommendations, advice, or obvious interpretations’, even if a patient will sometimes look to a therapist to give them exactly this. ‘Instead’, Fink writes, the analyst ‘holds open a space characterised by a lack of knowledge, a lack of answers, and this spurs the patient on to find his own’.  

There are two cruces here, the first of which is, of course, separation: to help the patient separate from the ‘internalised figures that are associated with his symptoms’ and to clarify the moments at which they are working for themselves or working for someone else. Another is Lacan’s conception of love – which he defines as ‘giving what you don’t have’ (and which also characterises the analyst’s function) – a topic about which Fink has written a great deal. He has translated one of Lacan’s most famous seminars dedicated to the topic, Seminar VIII: The Transference and authored a full-length study entitled Lacan on Love (2015). Miss-ing contains an especially note-worthy essay on love in Lacan’s later work, which, to pick up just one of its threads, pushes back against the idea that the analyst must remain completely neutral, unaffected by what their analysand says or does. Of course, analysts have feelings for their patients: they might feel more interested in one topic over another, they might even find themselves reacting with love, hate, or desire that certain material brought into the analysis (an excellent episode of the podcast Three Associating, run in part by the Australian psychoanalyst Gillian Straker, deals with the complexities of the often taboo erotic countertransference). But whatever they are, Fink clarifies, those feelings ‘must merely smoulder and not get the upper hand, not burst into flames and lead to an outburst of some kind’. If the analyst has one true love, then it is the unconscious itself, which ‘must take precedence over [their] love for or hatred of the analysand’.  

This accounts for the analyst’s ongoing interest in dreams, fantasies, slips of the tongue and the other formations of the unconscious, which keeps their desire to analyse burning. Indeed, the process of an analysis might consist in converting the feelings of love and hatred that the analysand transfers onto the analyst into a love ‘for their own unconscious’. In this vision of analytic practice, love becomes not just ‘giving what you don’t have’, not just offering the other your lack. Love is, as Fink writes, ‘getting what hasn’t yet been’. An analyst does not give their analysand advice – they do not teach life-skills or attempt to make definitive interpretations. Instead, analysis consists in instilling a love for one’s own unknowing. 


Where Fink’s work delivers insight into his singular interpretation and practice of Lacanian psychoanalysis, Leader’s work hews more closely to the scientific spirit that marked psychoanalytic research in the first half of the twentieth century – a kind of empirical style often unexpectedly punctuated by a joke or punchline, with the mix of scientism and scandal that has made psychoanalysis so compelling. The clinic is Leader’s concern: he is a founding member of the Centre for Freudian Research and Analysis, the first Lacanian training school in the United Kingdom, and his writing is replete with examples drawn from his own practice. But like much of his other work, his latest book Is It Ever Just Sex? (2023) offers a sophisticated theoretical inquiry into a key psychoanalytic concern: how sexuality is formed, how our bodies become sexual (or indeed don’t become sexual), and where the various lines between sexuality and other emotions and affects can be drawn. The psychoanalyst, as Leader reminds, ‘was once famous for seeing sex in everything’: sex-obsessed, they were seen to attribute physical symptoms like the once much-discussed globus hystericus to a villainous sexuality unable to be mentalised in mannered bourgeois society. Leader’s book is a rigorous riposte to this cliche, holding out the possibility that sex itself can be a cover for things that are even more troubling or profound. Where Freud posited a lone unified pleasure-seeking force in the body called the ‘libido’, Leader investigates the way that sexuality, from its earliest appearance, both develops with and splits off from other psychical forces, calling into question where ‘sexuality’ begins, evolves, and ends. 

These issues have been with Leader for many years. His work has long offered forceful criticisms of contemporary biologicism, the ‘you and me, baby, ain’t nothing but mammals’ approach to sexuality. It also piercingly sees through contemporary trivialisations of the sexual act (‘we’re just fucking’). ‘When someone says, “It didn’t mean anything, it was just sex”’, Leader writes in his early book Freud’s Footnotes (2000), the negation of meaning actually implies an important set of meaning-making practices: separating sex and meaning could register ‘a desperate defensive measure brought into play precisely because sex really does mean an awful lot’. Indeed, as Leader notes, sexuality is complex, painful, pleasurable, disturbing, and comforting all at once, over- and underwritten with ideas both conscious and unconscious. It is also forged in childhood, not against but alongside the confusions, prohibitions and permissions that mark other developmental relations. ‘Aspects of parent-child interaction’, Leader writes in Is it Ever Just Sex?, ‘are less a sanctioning of sexuality than the actual creation of sexuality’. Freud himself noted the ways children regarded sexuality as indiscriminately ‘penetrating’, puncturing parts of the body, so much so that its advent appears less as a ‘promise’ than as a ‘threat’. If what we first learn of sex is quite violent, then ‘why on earth would we be so drawn to it later on’. ‘If we have a choice’, Leader rightly asks, ‘why do we do it? 

The sexuation of our bodies occurs in a complex and fraught manner: ‘as parents express their displeasure or revulsion or concern at these aspects of the body’, Leader writes, ‘they effectively colonise them’. Having been shaped by these words, judgements, and narratives, our bodies belong not just to ourselves, but also to someone else. The boundaries between discrete body parts can often themselves become blurred during this formation as well. As Leader comments, ‘children’s ubiquitous “tummy aches” are sometimes in reality states of sexual excitation that have gravitated away from their source and lack the possibility of vocalisation’ due to the other’s prohibitions. Reading this, I was reminded of a case from the American analyst Erik Erikson: a young child named Peter who suffers from constipation is found by Erikson to unconsciously believe he is pregnant, mistaking the stomach for the zones of sexual reproduction. Peter’s parents report to Erikson that their son’s condition seems to have been alleviated by a proper explanation of the facts of childbirth. Indeed, after Erikson leaves the session, Peter is able to perform a ‘superhuman bowel movement’. Viewing the other’s sanctions and prohibitions as a fundamental part of us goes some way to explaining why sexual desire often involves crossing a boundary into the forbidden: sexuality involves acting against or separating from the other.  

There is a compelling sense of frustration at the core of Leader’s book – frustration with simplified notions of sexuality, sexual practice, and the gendered relations that prop up ‘a misogynistic status quo’. But Leader’s more recent work has also been marked by an impatience with the insularity and monotheism of the Lacanian world. Lacan is mentioned just once in the book, and the major players are forgotten feminist thinkers, sexologists, and psychoanalysts such as Ruth Herschberger, Judith Kestenberg, Amber Hollibaugh, John Gagnon, and William Simon. Though certainly shaped by Lacanian thought, Is It Ever Just Sex? could be read in relation to Leader’s other recent work that has sought to map the parallels and open up new dialogues between Lacan’s clinical concerns and lesser-known currents in twentieth-century American psychoanalytic psychiatry (see, for instance, the 2021 article entitled ‘Lacan and the Americas’). In certain corners of the Lacanian world, American psychoanalysis is often dismissed as a mere symptom of American consumer culture, reduced to a set of clichés about ‘ego psychology’ (strengthening the ego and to help the patient better adjust to society). But Leader’s work conveys the astonishing diversity of the American tradition. ‘The real nightmare’, he wrote in a follow-up article, ‘for most Lacanians, is that Lacan’s name will become just another reference in a list of footnotes – a polytheistic catastrophe that must be averted at all costs, with the unfortunate result that we risk losing out on everything we have to learn from American colleagues and from the history of psychoanalytic thought in the States’.   

All this is to say, Leader is unafraid of being an iconoclast. Just prior to the publication of Is It Ever Just Sex?, he published another study on sexuality, Jouissance: Sexuality, Suffering and Satisfaction (2021), that mounted a critique of the obscurantism around one of the cornerstones of Lacanian thought. While ‘jouissance’ is often given as an example of Lacan’s extreme theoretical sophistication, its sense can be highly equivocal, describing at once: the painful enjoyment proper to the symptoms that bring people into analysis; sexual excitement (orgasm in particular – the sensation of the limits of bodily enjoyment); repetitive behaviours that ‘might promise enjoyment’ yet bring pain; ‘autoerotic activities’; and even the endless and sometimes frustrating enjoyment we get from making sense of the world, our lives, and the motivations of others (the ‘jouissance of meaning’). As Leader concludes his study, ‘To use one term to designate all of these things might be a useful shorthand, but it is more likely to inhibit than to facilitate research, and it risks substantialising the very ideas and feelings that in the practice of psychoanalysis we aim in fact to desubstantialise’. 

Similarly, Is It Ever Just Sex? is a thoroughly catholic study, polytheistic in the very best way, resisting any Lacanian cliches about sexuality (the notorious and hackneyed line, ‘there is no sexual relation’, does not appear once). In fact, Leader draws on Gagnon and Simon’s concept of sexual scripts, itself a challenge to psychoanalytic notions of fantasy. Leader summarises:

A script is like a code, directing what we think and feel and how we act, and it is composed of three basic dimensions: cultural, interpersonal and intrapsychic. If we have spent years fantasising about a particular person, and then, away on a trip, we return to our hotel room to find them there naked waiting for us, we are more likely to call the police than to become sexually aroused. This is because the right script is not being followed.  

The notion of a script, then, pushes back against the determinism sometimes implicit in notions of fantasy, showing how cultural forces interact with our fantasies, shaping and reshaping them in various ways. It thus helps to illuminate where and how we have sex in any given cultural milieu: though clapping, as Leader humorously notes, was in the seventeenth century a common part of the sexual script during moments of intense sexual pleasure, it would today be seen as a ‘weird turn-off’. One’s sexual life can be radically altered by interacting with someone else’s script, or indeed by a process of culturally-mediated ‘internal change’ (‘a woman might describe her choice of a relationship with another woman as the result of a series of disappointments from men, although we almost never find the opposite’).  

The concept of a script is incredibly generative, leading to many remarkable insights about sexual life. But the heart of the issue here is the creation of sexuality, which is where Leader’s book is at its most profound. Sexuality is expressed via a range of different cultural, social, and psychical scripts – but it is also forged in an atmosphere of ‘negativity and judgement’, shaped by the things we hear, interpret, glimpse, and overhear, by the atmospherics of secrecy and latency that are a part of childhood. In this, sexuality is always about something ‘more’ than the information we later generate about it, when multiple scripts collide in ways that are both functional and painful. Like Fink’s work, Is It Ever Just Sex? contains so many illuminating insights on sexuality, far more than I’ve touched on here, but its ending is particularly noteworthy. Given the ways in which sexuality is forged alongside anxiety, stress, pain, fear, and the negativity and absence wrought by the other, it is absolutely remarkable, Leader writes, ‘that people manage to have sex at all’. That is, given the duress of our own emotional lives and the difficulty of relationships, should ‘the actual ability to perform sex’ not itself be seen ‘as a disorder’?   

Leader’s book closes with a compelling answer to its opening question: why do we have sex? If sex is marked by different, asymmetrical relations, then these imbalances in our relationship with the other are the condition, not the accident, of sexual practice:

If in sex we are playing out, pursuing and avenging many aspects of the early relationship with our caregivers, there will always be an imbalance of power, because that’s how we started our lives. We were helpless, unable to express ourselves, and at the mercy of larger and more powerful bodies. Yet in sex there is almost always the sense of reversing helplessness, as we are momentarily the cause of feelings and sensations in the other person and in ourselves. That’s why people may feel such an erotic charge, in Amber Hollibaugh’s words, as they ‘see expressions of need sweep across their lovers’ faces’. We are finally able to cause things, to have brief agency in a world where we tend to have none. 


Someone I was casually chatting to about Leader’s new book said: ‘it broke me’. I later found myself thinking about this remark, partly because it seemed to index something important about how psychoanalysis works, how it thinks. In a therapeutic culture that prioritises skills for living, conformity and the adjustment to a norm, isn’t it completely symptomatic that both Fink and Leader’s books would appear challenging, even disturbing? It’s true that certain corners of analytic discourse sometimes inflates their own political importance – and as the psychoanalytic historiographer Marcelle Marini points out, although it is difficult to track down a source for Freud’s famous remark that he was bringing the ‘plague’ to the United States, the constant repetition of this remark says a lot about how certain analytic forms, ‘very well integrated in society’, need to see themselves ‘as a fundamental threat to all ideologies and institutions’. More than a century on from the founding of psychoanalysis, however, it’s still hard to talk about sexuality, and still no easier to talk to others about ourselves. And so Fink and Leader’s books embody what is so singular about the Lacanian spirit, taking what cannot be said and putting it into the symbolic, keeping lack in the picture in a culture where lack seems to be so profoundly lacking.