Dossia Avdelidi

 A forced excellence

Vassilia is 26 years old. I first met her three years ago when she appealed to me about the anxiety that overwhelmed her. Ever since she can remember herself, she has always wanted to become a doctor; not just any doctor, but the best of doctors. She has always been sure about it and she has never doubted it or deviated from her goal. The only association she makes, prompted by my questions, involves her paediatrician, a woman endowed with the benefits of the feminine masquerade as she was dressed beautifully, wearing make-up and jewellery and she was sweet talking. It is a specular identification.  

Even though she was the best student, she didn’t manage to get in the Medical School, but she did manage to get into another faculty. I met her while she was preparing to sit for the qualifying exams to enter the Medical School as a graduate. The prospect of these exams caused her a tremendous amount of anxiety because she was scared of failure.

All her existence depended on the result of these exams. Her anxiety was terrible. So terrible that led her to irrational thoughts which scared her. She explained to me that when she is under a great deal of anxiety, she has the thought that she acts on a theatre stage and that other people watch her. This has happened three times. During the first class of secondary school, then when she was 23 and more recently:

She describes an emergence of the real when she was 12. At the elementary school, she had a friend, Dimitris. When at the final year she was assigned to be the Flagbearer¹, Dimitris turned against her. At that moment, when her relationship with the specular other falters, something cracks inside her, as she says.  It is the moment of the detachment [débranchement] from the Other. At the first Class of Secondary School, Dimitris’ family moved and she has not seen him ever since. One day, while studying maths, she solved a very difficult exercise all by herself and she thought: It’s impossible to have done it by myself alone. Somebody else did it. And she thought that Dimitris solved the exercise for her. Is he watching me from where he is and controls my thoughts? And immediately she thought: Why am I making this thought? It’s impossible. Am I a schizophrenic?

When she was 23, the girl living over her flat plays the piano and so, she cannot concentrate and study. Vassilia starts calling her names, the piano stops and she thinks: Did she hear me and realise that I don’t like her playing the piano? Is she watching me? Has she placed cameras in my house? She immediately realises how irrational her thoughts are, she gets scared of getting crazy and she appeals to me.

Recently Vassilia told me the following: After some very difficult exams that had caused her anxiety, she received a phone call on her mobile by an unidentified number.  She answered it, nobody talked to her and then she thought: Has someone put some kind of virus into my mobile phone so that they can watch me? And immediately after that: Did they send radio waves to control my mind? After making sure that it’s impossible to control thoughts using radio waves, she tells me that the most valuable thing she has is her mind. She is afraid of losing it and this is how she explains her thoughts.

This is a case of Clérambault’s minor mental automatism. These elementary phenomena [phénomènes élémentaires], the idea that someone watches her or controls her thoughts are the only manifestations of the Real that Vassilia has experienced. The Imaginary passes into the Real, but this topical regression gets immediately mitigated when she criticises herself.

 Since she was in the kindergarten, she was told how much she stood out from her peers. I was Vassilia. My name was heard. She wants to be the first, to be the best; she wants other people to talk about her, to win the Nobel Prize. She wishes to stand out from the other people, just like a maternal uncle she admires who stood out in her grandparents’ and the rest of the family stories.

The only viable position for Vassilia is being in the place of exception. This excellence is forced. And this is her difference from a neurotic. The neurotic wants to be the phallus of the Other, whereas the psychotic must be the phallus of the Other².  There is no other position for her. Success or death. This is why she collapses at any thought of failure; her being comes out as waste [déchet].

She doesn’t have any memories as a child or at least she doesn’t have anything traumatic to tell. There is no evidence of childhood neurosis. Everything was perfect. She considers herself a mama’s girl. She cannot be away from her mother, as she says. When she was little, her mother would sometimes be away during the summer, leaving her daughter at the grandparents’ care. Vassilia would not sleep without having one of her mother’s tops to smell.

She says that since she was a child, she has had a strange character, she was serious, severe, she didn’t want to have her clothes wrinkled, and she would not make jokes with other kids. She was the good student and not the child that plays. She couldn’t have any other identity but the one of the excellent student.

Changes are hard for Vassilia. At the age of 23, when she was obliged to move to another city because of her studies, she cried for being away from her parents. My family is my support. We talk, they advise me, we go out together, I have fun with them.

Vassilia has never had a sexual relationship. Studying has always come first. A relationship would distract her from studying. She mentions an unfulfilled love for an older man, a doctor she had met. I saw him, his back turned to me, and I fell in love with him. I don’t know what I liked, perhaps his posture. She didn’t know him at all. In this love no symbolic element was involved just the Imaginary: the image of the doctor. It is an imaginary capture, a version of love when desire fails.

Medicine is more than just a profession for Vassilia. It is the way she has invented to give value to her being, a value that is not phallic, but a substitute. The point is not just to be a good scientist, but the top one, the best, unique. It is forced upon her. It does not concern the desire of the Other. Nobody compels her, as she says; she compels herself. It is an identification she has invented for herself. It is not a “you are this” which comes from the ideal of the Other, but rather a “I am this”. The unary trait [trait unaire], which organizes the void around her - like an endless line - is what she has chosen for herself: a Nobel Laureate Doctor.

Medicine has nothing to do with an idealisation placed on the Other, but it is an invention with soothing qualities. Medicine is the cloth she has put on the excellence, the only position in which she can be. Her invention is the fixation to this compensatory identity which she cannot give up, because her being would come out as waste.  Without Medicine she is nothing, the ideal ego has no consistency. It is an unmediated and intransigent identity, which however permits the bonding of the Real, the Symbolic and the Imaginary. Her being a doctor is her Name-of-the-Father, her Sinthome. And it is what allows her have a place in the social bond.

As far as my intervention is concerned, I’m trying to soothe and mitigate her requirement for perfection, not to demand anything of her, to support her ideal to become a doctor but at the same time to relativise her will to be the best so as not to trigger the ferocity of the super-ego. This has had as a result a change of her subjective position, which has also become her solution: Instead of being the best and get mad, I prefer to be mediocre and healthy, as she has told me recently.

¹ Honour awarded to the best student of the school

2 Miller J.-A., L’orientation lacanienne, De la nature des semblants, enseignement prononcé dans le cadre du département de psychanalyse de l’université Paris viii, 1991-1992, leçon du 15 avril 1992, inédit.