Greta Kaluževičiūtė
January 2026
This desire for discursive authority has a genealogy. As Foucault argues in Madness and Civilization (1961), the emergence of psychiatry depended on an epistemic regime in which the clinician assumed the power to classify, describe and narrate the truth of the mad. The psychiatric case transformed lived experience into a discursive object. The subject did not speak; the subject was spoken, written about, and organised. Psychoanalysis, even in its profound critique of this medicalising gaze, inherited the classificatory impulse: the hysteric, the obsessional, the neurotic, the pervert. These are categories Lacan would later treat with both fidelity and irony (Lacan, 1953/2006), faithful to the structural logic they reveal about the subject’s relation to desire, yet ironic about their historical baggage and any temptation to reify them as clinical diagnoses rather than theoretical positions.
But here a crucial distinction must be preserved. For Freud, these psychoanalytic categories were not pathologies to be corrected; they were theoretical structures, paradigmatic cases that go beyond the described individual (Flyvbjerg, 2006), through which psychic life as such could be understood. They reflect modes of relation to desire, to the Other and to the impossibility of symbolisation, not diagnostic boxes but conceptual prisms. In this sense, psychoanalysis, unlike psychiatry, uses its categories to think in cases rather than to normalise or correct so-called maladaptive behaviours or symptoms. The hysteric, for instance, is not a patient type per se but a social and discursive position: the one who interrogates the Other’s knowledge, who asks insistently, “What am I to you?” A hysteric society is one in which this position becomes widespread and emblematic, a society structured around demands such as “Tell us who we are”, “Tell us what we should desire”, “Tell us what you want from us”.
What emerges today is a transformation of this very demand. Instead of turning to the Other for answers, the contemporary subject turns to psychological discourse itself, seeking to occupy the place of the one who knows. The hysteric’s existential question “What am I to you?” is translated into the therapeutic idiom of self-diagnosis: “Define my suffering”. The demand persists, but its addressee has changed. No longer addressed to the big Other of tradition, authority or expertise, it is addressed to the floating lexicon of psychological signifiers that promise certainty where none can be given.
At this juncture, “mental health” itself becomes the clearest example of an empty signifier: a term that circulates with extraordinary authority and moral weight, yet whose meaning is diffuse, unstable and endlessly contested. On the surface it appears self-evident, an obviously desirable state, an unquestionable good. But the more the term is invoked, the less clear its referent becomes. What counts as mental health? Is it “resilience”, “stability”, “self-regulation”, “autonomy”, “balance”, “productivity”, “happiness”, “adaptation”? The concept expands to include almost anything, and in doing so it ceases to securely refer to anything at all.
And so the classic analyst–analysand, psychiatrist–patient or therapist–client asymmetry has been inverted. The subject, as opposed to the expert, now speaks for themselves, of themselves. They assume their own position in relation to pre-existing terms and theories, in whatever shape or form these have now taken: as hysteric, as traumatised, as avoidant, as resilient, as mentally healthy or unhealthy. And yet, our society has inherited these forms of classification without their content. We retain the vocabulary and authority of psychological categories while discarding the theoretical, clinical and conceptual frameworks that once made those categories meaningful. As a result, the psychological signifier begins to drift. Trauma becomes a universal solvent; narcissism a vernacular accusation; resilience a moral injunction. The signifier ceases to name a lived experience; it names instead the subject’s place within a discourse of expertise.
But this drift cannot be blamed solely on the subject. The expert, too, has participated in emptying psychological life of its density. In contemporary psychiatry and the evidence-based treatment regime, concepts increasingly function as operational categories rather than descriptions of lived experience. Diagnostic constructs become checklists; suffering becomes symptom clusters; therapy becomes a protocol delivered according to manualised stages. In such a system, the concept remains while the experience it was meant to illuminate is silently removed. The clinician, like the patient, comes to inhabit a discourse in which the names outlive the phenomena, where trauma, depression, anxiety or personality disorder designate administrative objects rather than existential realities. What remains is the carcass of a construct: a term that can be deployed, coded, billed and researched, but no longer speaks to the interior life it was once meant to describe. It is unsurprising, then, that the subject eventually took matters into their own hands and became, in effect, the master of therapised speech or, rather, discourse.
In Lacanian terms, the loss of lived experience attached to these concepts points to a fantasy of mastery through naming. “Trauma”, “narcissism”, “toxicity”: these become what Lacan calls master-signifiers, commanding yet hollow, authoritative yet unmoored from knowledge. Their referent is no longer the Real of suffering but the symbolic performance of legitimacy, the attempt to stabilise oneself through language that promises clarity without ever delivering it.
Here Kafka becomes prophetic. In The Trial (Kafka, 1925/1999), Josef K. - a 30-year-old bank clerk of unremarkable appearance and orderly habit, as we are told by Kafka - is condemned by a Law whose accusation is never explained. The charge is pure form. Throughout the entire novel, Josef K. desperately tries to learn what he is guilty of, but the court refuses to tell him. The accusation exists without explanation, yet it still has absolute authority over his life. He must attend hearings, plead his case, consult lawyers and justify himself, all without knowing what he is justifying himself for. Josef K. is not on trial for something he did; he is on trial because the Law has the power to accuse. The accusation is empty, but the system forces him to respond to it as if it were meaningful.
Likewise, modern psychological labels function juridically. The term “narcissist” binds with authority precisely through the vagueness of its meaning. Like Kafka’s Law, the pop-psychological signifier binds without understanding. It imposes structure without accuracy. It creates a world in which the subject is accountable to names that no longer name anything specific.
For Kafka, the catastrophe lies in the structure of the Law: its ability to bind without content. Yet this structural terror immediately opens an existential question: why does the subject submit to a hollow authority at all? Why does Josef K. exhaust himself trying to answer a charge that never explains itself? Why does he seek meaning where none is offered? In Kierkegaard’s terms, this behaviour reflects a self unable to bear its own inwardness, a self that anxiously seeks an external definition to escape the burden of becoming itself, a dynamic he names despair in The Sickness Unto Death (Kierkegaard, 1849/1983). Josef K.’s insistence that the Law must know something about him reveals precisely this existential weakness. Confronted with a meaningless accusation, he prefers the illusion of external meaning to the terror of inward freedom.
Kierkegaard helps us see that Josef K.’s tragedy is not simply that he is caught in a meaningless bureaucracy, but that he responds to it from what Either/Or (Kierkegaard, 1843/1992) calls the aesthetic mode of existence, the mode in which one allows external forces to determine who one is. Faced with an accusation that has no content, Josef K. still demands that the court tell him what he has done, what he means, what he is. He seeks an external definition to relieve him of the burden of defining himself. The same dynamic appears in the modern turn to psychological labels. Whether “traumatised”, “avoidant” or “dysregulated”, such terms function as aesthetic refuges: ways of letting a discourse name us (even if we were ‘masters’ of such a discourse, so to speak), as Josef K. let the Law name him, instead of undertaking the ethical task of becoming a self.
Kierkegaard and psychoanalysis remind us that the deepest forms of suffering resist capture in language. For Kierkegaard, the self is tasked with bearing the weight of its own inwardness, a weight that cannot be shifted onto any external category without falling into despair. Despair is the refusal to be a self, the attempt to substitute a ready-made description for the trembling work of inward becoming. Psychoanalysis echoes this insight when it insists that there is always a remainder, an unrepresentable kernel of experience, that escapes symbolisation. Life, death, love, desire, sexuality, anxiety, the body, the Other’s enigmatic wants: these are not simply difficult to articulate but structurally in excess of what language can hold. The unconscious and the Real both testify to the same fact, that our suffering exceeds the names we give it. To name suffering is necessary, but it is never complete. Something always slips away.
The contemporary demand, “Define my suffering”, is therefore a demand to be relieved of this slippage, to escape the uncertainty that both Kierkegaard and psychoanalysis take as constitutive of subjectivity. It repeats Josef K.’s error: seeking from an external order a final, stable meaning that no discourse can provide. The subject wants a label to stand in for inwardness, a diagnosis to stand in for the unassimilable textures of psychic life. But to indulge this demand is to collude in the very avoidance that Kierkegaard calls despair and psychoanalysis recognises as a flight from the truth of one’s desire.
Drawing from these philosophical and psychoanalytic accounts, the refusal of definition is not cruelty but necessity. No; suffer through the lack of definition. Not as punishment, nor as heroic rejection of comfort, but as acknowledgement of something fundamental: that suffering is shaped by what we cannot put into words; that no discourse can take over the work of facing our own inner life; that meaning arises not from forcing an experience into a category, but from dwelling in the places where categories fail us. Psychoanalysis does not try to close this gap in meaning. It takes the gap itself as the site of truth. And Kierkegaard does not promise a cure for despair. He asks the self to meet despair face to face, without disguises or borrowed explanations. In fact, Kierkegaard gracefully reminds us in Either/Or (1843/1992) that no choice will spare us from suffering:
“Marry, and you will regret it; don’t marry, you will also regret it; marry or don’t marry, you will regret it either way. Laugh at the world’s foolishness, you will regret it; weep over it, you will regret that too; laugh at the world’s foolishness or weep over it, you will regret both. Believe a woman, you will regret it; believe her not, you will also regret it… Hang yourself, you will regret it; do not hang yourself, and you will regret that too; hang yourself or don’t hang yourself, you’ll regret it either way; whether you hang yourself or do not hang yourself, you will regret both.”
The point is not that all choices are meaningless, but that no external arrangement of life can shield us from the fundamental burden of existence. Yet within this starkness lies a different kind of hope: not the hope of avoiding despair, but the hope of choosing oneself within it. The ethical choice does not eliminate suffering; it grants it meaning by making the self its author rather than its passive recipient.
Kafka’s Josef K. died without ever learning the charge against him, and the shame of that unanswered question seemed as if it would outlive him. Yet what Kafka leaves as tragedy psychoanalysis might take as an ethical necessity. The unanswered question is precisely where responsibility begins. To suffer through the lack of definition is not to die like a Kafkaesque dog, abandoned by meaning, but to remain alive to the part of ourselves that no system, no diagnosis, no vocabulary can absolve or fully explain.
REFERENCES
Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12(2), 219–245.
Foucault, M. (1961). Madness and civilization: A history of insanity in the Age of Reason. New York: Random House.
Kafka, F. (1925/1999). The trial (Breon Mitchell, Trans.). Schocken Books.
Kierkegaard, S. (1843/1992) Either or: A Fragment of Life. Penguin, London.
Kierkegaard, S. (1849/1983). The sickness unto death (H. V. Hong & E. H. Hong, Trans.). Princeton University Press.
Lacan, J. (1953/2006). Écrits (B. Fink, Trans.). WW Norton.