Malachi McCoy, en hommage à Charles Melman : « Somatic Prevenance : An Offering of the Body to Symptomatology » (Milltown Lacanian Association’s study day in Dublin on 10th September 2022)

Malachi McCoy


Title: Somatic Prevenance: An Offering of the Body to Symptomatology[1]


Abstract: My paper will ask what it means that something of the hysteric's body goes in front and offers itself up to embody symptoms to include those of protest?


What can we learn from Dr Charles Melman when he says that in hysteria there is a somatic prevenance, not compliance, where something of the body goes before, goes in front offering itself up to symptoms which include those of protest? In addressing and advancing these questions Melman returns to Freud’s writings, upon which we continue to found ourselves.      

Revisiting Hysteria today allows us to ask and question what this entity called hysteria is. What is this masked presentation of trauma repressed with all its fresh excitement? Now, with the complete translation into English of the first longitudinal study on the subject of hysteria we can appreciate what is at stake for those whose suffering continues today. From its first recording on medical papyruses of nearly four thousand years ago to its continuing presence, hysteria’s writing and embodiment as a major symptom cannot be wished away; no matter how masterful the baffled deaf continue their futile and harmful attempts to abolish the recognition of hysteria. Encouraging us to re-read Studies on Hysteria Melman’s work has a lesson for those of us who want to know how the incompatible continues to offer its mystifying presence up to us for deciphering. What is it that perpetuates this subject of frustration where there has been no reaction, where representations for the subject are pushed away and remain inhibited?    

With Freud’s discovery, the ethics of psychoanalysis calls for us to speak – that is, to restore the place of the word as the support for our desire. Here, by virtue of Studies on Hysteria Revisited, we can speak about this age-old disease which for some is a matter of life or death! The hysteric holds on to a dearly-felt subjective position, a defensive position which in-and-of-itself gives clear recognition of unconscious defenses; of repressed incompatible representations with real manifestations. Melman asks us to hold on to this question - whereas the suffering of obsessional neurosis appears in the mental processes, why are hysterical symptoms essentially placed in the body. 

Therefore, we return to Freud with Melman’s guidance. Freud understood that neurosis is linked to incompatible representations. Just as in logic, where there are things that can’t be admitted to the system and are expelled, these incompatible representations which are intolerable to the subject are repressed and pushed below. But how does this spatial arrangement account for the symptom of the repressed intolerable representation? Freud explains the process of the hysterical symptom as corporal fixation using the German Somatisches Entgegenkommen.

Melman writes that the term somatic conversion was fundamental to Freud. It was essential for him for the first implementation of his apparatus which obeyed a small group of elementary arrangements. These gave Freud the courage, permitting him take a new, psychoanalytic way. The tools which Freud has put into our hands allow for a certain number of putting things in place. Now in revisiting hysteria in the Twenty First Century we can say more. Melman has something new to tell us. 

Here, he brings our attention to this, noting that we should be careful of translation. The term which Freud used back then translates as somatic pre-venance. Therefore, it is not at all somatic compliance. This vital difference in translation is helpful in restoring, in advancing our understanding today. For the hysteric there is a somatic prevenance – where something of the body goes in front – pre; to come before - which offers itself up to symptomatology.

We learn that the body is the privileged place for hysterical symptomatology. To speak of the body is a challenge; a challenge because a successful presentation of the body leads to leaving the word with silence, with a mutism of the subject. There is an advantage however in speaking about the body because the subject who takes the risk to speak about it will be heard in a way in which he tries to unravel it; to attempt to find peace for himself with his body. Speaking about the body is a way of trying to make it leave us alone, in other words to bring about a state where there is no suffering, no desire, a kind of nirvana.

Freud talks about the body in a very interesting way where he illustrates in The Project his foundational schema. In Draft G of his letter to Fliess in 1895 he puts in place a picture of sexuality, a topology of a spatial arrangement with four sections – like the four discourses Melman confirms.

The Central Nervous System

Object Reality


Object: Put in a favourable position for sexual satisfaction



‎On the left of the picture we find:
the head at the top – the central nervous system;
and the body at the bottom – below, separated by a line, a bar. 



To the right:

                                                   on the top space is the object taken in reality;

                                                     and underneath, the object put in a favourable

                              position for sexual satisfaction.


Melman points out that Freud’s second topology is already present in this foundational schema – that is with the bipartition into the id, the ego and the superego. The advances which Lacan progressed with the Borromean Knot are also taken from this register.

This picture of sexuality is a fundamental schema for Freud because it demonstrates a frontier between the psyche and the soma where a bar is placed, a limit in the spatial arrangement between the psyche and the soma – a cut! Freud situates at this time with the division into four parts the function of space occupied by the psyche which is to lower tensions. The excitations which arise from within the body – below and left on the schema present a complicated tension from which we cannot take flight; from which we cannot get away. Freud describes the tensions coming from this space as needs: hunger; thirst; respiration and sexual desire.     

The problem for the frame on the schema occupied by the psyche is to get rid of the excitations, these tensions coming from within. There are only two ways to satisfy them:

  • The Pleasure Principle, where hallucination of the object is possible, and
  • The Reality Principle, with its postponing of jouissance.

Therefore, there’s no getting away from it, these excitations must be resolved and worked through! It is interesting that Dr Melman writes that well-being; being well is to be comforted by the body which effectively points in the direction of a nirvana, the death drive. He writes that the death drive is what we all aspire to but a detour through life is necessary. What stays with the living body is the question of the symptom. Here Dr Melman writes that it appears that a resolution of the tense excitations coming from the body can be brought by what he calls a phallic sanction – in other words, by its inscription under the primary of genitality; jouissance capable of resolving tension coming from the body.

Returning to the central question posed with this paper is the frontier which Freud illustrates in his schema between the psyche and the body and the definition of the body as a place which is characterized by its frontier. It is a line, a frontier which is capable of being crossed. This takes place because there are representations which are incompatible to the ego and are therefore repressed. Owing to the forces of repression these incompatible representations, which the subject finds intolerable, are pushed below the frontier into the lower frame and are converted into somatic manifestations. It is here we remember what has been called the mystery of somatic conversion; where the hysteric’s body offering itself up to embody her symptoms.     

In the report on the study days on hysteria at the Freudian School of Paris, 24th June 1973, which can be found in the Appendix to Studies on Hysteria Revisited, Melman writes that in Freud’s last article on hysteria in Some General Remarks on Hysterical Attacks he analyses attacks as grammatical sentences. What interested Freud with hysterics was, not to see them, but to hear them. As a result of traumatic origin there is an impossibility with the word. The hysteric speaks with her body. The speaking being’s appeal to the body giving evidence to the truth of her discourse; engaging in the capture of the grand Autre and gifting her body as a servant to be mastered. Her body’s enjoyment in keeping to the service of sacrifice and love.

But, what could this gift be? How can we understand it today? Melman outlines that hysterics have evolved with history and we do not have the same kind of ill people nowadays which Charcot and Freud saw. Why? It is probably because the hysteric has to give an account of the truth. The manifestation of this truth is manifestations is different according to the type of remarks which we will come to seal this and the type of ambient remarks which come along to mask this truth. This may explain that hysterical manifestations which Freud saw or Charcot saw are not the same for a whole lot of different reasons nowadays and that in the diagnostic manual the vocabulary hysteria has vanished. Melman asserts there is a feature[2] serving as a limit and function re-found in the symptom. Here we are reminded of that queen of social work – Anna O the pseudonym for Josef Breuer’s first patient.  

We read that Bertha Pappenheim, a militant feminist could be moody, contrary and unpleasant; with an energized obstinacy[3]. She was intellectually gifted but led an extremely monotonous existence in her puritanically-minded family. The element of sexuality was astonishingly undeveloped in her and she experienced ‘absences’ – day dreams. Among other symptoms which she suffered were paralysis of three limbs and a disturbance of her vison. She experienced a case of hydrophobia when she was unable to drink; and her powers of speech were affected too. Anna O developed a museum of symptoms in connection with her father’s fatal illness[4], and during her own illness she had to give up nursing her father to whom she was devoted.

It was at the time of the distressing nervous cough that Breuer was called in. In her psychotherapy under hypnosis with Breuer the young woman reproduced phantasies which she had muttered in her ‘absences’. They were profoundly melancholic phantasies; daydreams whose starting point was as a rule the position of a girl at her father’s sick bed. Recalling and speaking about her phantasies seemed to set her free to return to normal mental life. The recurring ‘absences’ were a result of the stimulus proceeding from the highly emotional phantasies. She cherished the process of her temporary recovery to a normal mental state as the ‘talking cure’ or jokingly referred to it as ‘Chimney Sweeping’.

The process of sweeping her mind with the talking cure brought more than temporary relief of her mental confusion. It also brought about the disappearance of the painful somatic symptoms of her illness if she was able to express the occasion and in what connection her bodily symptoms had first appeared.

During a period of extreme heat one Summer she had, despite suffering badly from thirst, she could not drink and could not account for the symptom which lasted for six weeks during which time she lived on fruit to lesson her thirst. In treatment one day she complained about her English lady-companion who she didn’t care for and described with disgust how she had seen in this lady’s room a dog – “horrid creature” – had drunk out of a glass there; but wanting to be polite had said nothing. However, after energetically expressing the anger, she had held back, she drank a large glass of water and the symptom permanently vanished. The first occasion, Freud writes, that a hysterical symptom had been removed along with the first insight into the deep causation.

Anna O’s disturbance of vision, we read, was brought about in the following way: Sitting by her father’s beside with tears in her eyes, he suddenly asked her what time it was. She could not see clearly and making a great effort brought the watch close to her eyes…with the face of the watch seeing very big – accounting for the development of her disturbance of vision – macropsia (a condition I which visual objects are perceived to be larger than they are objectively sized) and a convergent squint.

On one occasion she developed paralysis of her arm. One night she woke up in great anxiety about the patient who was in a high fever. Sitting at her father’s sick bedside with her right arm over the back of her chair she fell into a waking dream seeing a black snake coming towards the sick man to bite him. Freud outlines that the girl had probably been given a fright on a previous occasion which therefore provided the material for her hallucination. Anna O tried to keep the snake off her father but it was as though she was paralyzed. Her right arm over the chair had gone to sleep and when she looked at it, the fingers turned into little snakes with deaths heads. When the snake vanished, in terror she tried to pray but language failed her. She could find no tongue in which to speak until she thought of some children’s verses in English and then found herself able to think in that language. When the patient recollected this scene with the chimney sweeping of her talking cure the rigid paralysis - of her left arm! - which had persisted since the beginning of her illness disappeared. Her psychotherapy was brough to an end.

However, the evening of the day that Breuer finished with Anna O he was called back to find the patient he had finished with in a state of great excitement and apparently as ill as ever. Anna O who had been described as asexual and had never discussed or made any allusion to such matters during her therapy with Breuer was found in the throes of hysterical childbirth. Jones writes that after calming her down by hypnotizing her, Breuer then fled the following day with his wife for a second honeymoon.       

In his fourth chapter, Freud’s Studies on Hysteria Melman’s writings of these cases include reference to Anna O. He says that in every one of these cases there was a central mourning. He writes that there is a work of mourning which it represents; a mourning, that with enough intensity, duration, of devotion and sacrifice to put in place a father, a dead father for whom the subject could finally claim some filiation[5]. With regard to the therapeutic victory Melman says that it is though there is a cut, as if the repressed elements in the body’s symptomatology gives itself up to be recognized; to be decrypted. Contrary to that which Anna O’s Dr Breuer mocks, Melman affirms that Freud gives immediate importance to the constitution of the hysteric’s symptomatology, in other words respecting what is at stake for the subject.   

Melman continues that the famous Bertha Pappenheim, whose demands were seen in many activities, harbored a hatred of men, or more particularly he says, she held a hatred of what could be called the virile pretensions of men. As hysteric, she lived her love in a quarrelsome way; mother of orphans caught up in a passion for German, later Nazi culture. She engaged in considerable activity in social work in Jewish circles to which she belonged even though, in recent biographies, it is noted that she was strongly opposed to Zionism and that she maintained her attitude up to the very end even to the time of the Anschluss – the German annexation of Austria. She was very influential in her community. Melman includes Lacan’s remarks from those study days asserting that the hysteric is divided, caught in a conflict which supports her - with a seduction on the one hand and militant love on the other. This he asserts is what guided Bertha Pappenheim towards the end of her life!                                                                               

In 2022, thanks to Studies on Hysteria Revisited, we can learn how that old wounded memory continues to invigorate its contemporary representation. Rather than encysting and protecting itself like a new group of incompatible and traumatized separates, its infiltration is animated in protest. Can we say therefore that the so-called writing on the wall is a displaced mutism; a subverted discourse with the hysteric trying to change the course of the representation for the subject. Trying to make the agent from a position of mastery the hysteric will produce signs, produce elements with her demanding call in the dialogue; her love lived in an argumentative way. Compelled under the façade of her strongly felt principles for those around her, and hearing every word as a demand copper fastens her sacrificial commitment to her chosen activism. Can today’s hysteric be found pounding the streets united alongside her fellow protestors marching up and down the main streets of our cities under popular banners which demand new laws, which demand and call for new rights? 

Melman maintains, that those of his generation knew when they went into hospitals that there were totally authentic hysterics who were hospitalized for decades with a diagnosis of schizophrenia.”[6] What happens nowadays when the young, or not so young hysteric begins to speak out in protest disturbing what might be described as the modern-day family’s tolerance and respect for difference; where anything goes? Within this new and complex blended family structure are do we find a place of greater individual peace where the child knows his place, aware of his desire? Or will the hysteric offer herself up as the blacksheep, the scapegoat of the family? Because, as Melman says with regard to the subject of hysteria, the moment it has any intensity or is dramatized having consequences for family life, we say immediately that it is a psychosis![7]

 In these revised studies on hysteria we read how thousands of years ago Hippocrates, as Melman writes, understood that the subject is not master of his existence. In this sense today, the hysteric does us the great service of informing us what illness is, in the sense that illness is precisely when the subject is not up to accomplishing his phallic duty[8]. It is psychoanalysis which forces the analysand to speak from a subjective position. In other words, the analytic operation is in itself hystericising.[9] Here, Melman reminds us that Lacan emphasised that no matter what the structure of the patient, he will find himself being led, through the discourse of the hysteric, by the very fact of the protocol of the analytic cure.[10] This passage to the couch establishes a discourse which can be addressed to the grand Autre from the subject’s position of suffering, from the subject’s demands and the subject’s questioning.[11] Therefore it is a timely acknowledgement and appreciation of Freud that Melman reminds us that the aim of psychoanalytic treatment is to lift this hysterical repression which comes in second position to what has originally taken place in the subject’s childhood!                   







[1] This paper was presented at the Milltown Lacanian Association’s study day in Dublin on 10th September 2022

   at which Dr Charles Melman attended and gave his presentation to us via zoom from Paris.

[2] Melman. Studies on Hysteria Revisited. Translated by Helen Sheehan. Appendix p. 227

[3] Breuer & Freud. Studies on Hysteria. S.E. II. p. 30.

[4] Jones. The Life and Work of Sigmund Freud. Volume 1. p. 222.

[5] Melman, op. cit., p. 43.

[6] Ibid. p. 85.

[7] Ibid. p. 22.

[8] Ibid. p. 98.

[9] Ibid. p. 131.

[10] Ibid. p. 2.

[11] Ibid. p. 133.