Birth of the Other

The way in which she is fed is suspected to be the reaction on months of staying in institutions where she was only one child in a row, with her reaction as “la véritable expression du non désir de l’Autre marqué par l’absence de mots, de signes affectifs d’attachement et d’attitudes indiquant à l’enfant qu’il est traité dans une série complètement anonyme”[1]. Lefort refers to this as the dimension of being an object of satisfaction of the need for sustenance”[2], the bottle that only serves as an object of need[3]. After all, Il n’y pas de figure de l’Autre désirant pour parler à l’enfant comme à un sujet afin de l’amener vers l’émergence subjective”. There is no mother or father who, through absence and presence, through words, love, attachment and specific care, can give the infans the message that he or she is being treated in a unique way. In that context, the gift of nourishment becomes an extreme intrusion, because no love is given that connects with it. Or - from Aulagnier's point of view - the nourishment does not become a lustful experience, the desire of the Other[4] , which evokes the excitation in a sensory zone, is lacking[5]. As a result, the child could not be included in the field of the demand and of the desire to turn the adult into another[6]. 

We get a very detailed description from Nadia and her appeal on Lefort as Other, and because of this appeal there is the possibility to install a relationship, in which food can be allowed, and objects of exchange are created within that relationship. There are the "metaphorical" objects that very succinctly evoke a scene that Lefort calls invidia, a kind of total experience, attractive and terrifying at the same time. These metaphorical objects have to do with the bottle, the doll, the activity of sucking, because everything Nadia sucks on becomes a metaphorical object. In addition, there are the metonymic objects, in which the aspect of "being just a particle" predominates, what makes these object less overwhelming. 

There are two elements that will contribute to distancing this original scene from the invidia: the signifier of her name, Nadia, but also language in general, and secondly the metonymic objects.

Language breaks the fascination, and Nadia allows it, when Lefort calls her by her name, during that key scene of 10 December that is described very briefly in the book, but is central throughout the analysis. Lefort describes moreover how she constantly is verbalising everything that Nadia goes through, being at the same time the one who prohibits that total experience. It's clear that Nadia understands what she's saying, because she stages what Lefort mentions.

Nadia gradually begins to use sounds as language herself, but it only becomes real language when she succeeds in separating the metonymic object, in this case the spoon, from being woven into that original experience, which is increasingly being repressed. It is that emptying that also allows Nadia to become detached from the person of Lefort herself, and installs that kind of relationship that she can later transfer to other persons.

That is why the Other here, I think, can stand for the language but also for that significant Other in a transferance relationship.

The following text is a description of the most important moments in that case study, always including Lefort's interpretation of it, with the following main elements :

- Lefort draws attention to the transition from “invidia” to the scopic and the oral drift, when Nadia breaks away from a scene of fascination that Lefort calls invidia, and from the mutual inclusion, which makes it possible for the situation of being fed to become lustful.

- She describes the interaction between the oral and the scopic, and how this is linked together. We see that, for example, when Lefort's glasses, the scopic element, are coupled with sucking.

- We read how this experience of sucking is transferred to objects in order to turn them into metaphorical objects.

- Once the fascination is broken, there is a very strong ambivalence towards the image of a child absorbed in being fed. It is an ambivalence that partly finds its origin in Nadia's earlier experiences, in those institutions where she was effectively reduced to the mere object of the Other. It is this ambivalence that leads her to move away from it. The ambivalence shows itself in that combination of tenderness and aggression towards Lefort and towards metaphorical objects, indeed less so towards metonymic objects.

- She gives us a very rich description of the mirror phase, in which various components are discussed. First the image as a metonymic object for Nadia herself and for Lefort, which allows a separation between Lefort and Nadia, much more effective than in the first movement, where Lefort as a real other had to be separated from an image of the Other, stuck on Nadia's eyes. There is also a separation between the mirror image and the real experience. We see how all these situations require a real working through and cannot simply go back to a mythical moment in development.

- And finally that transition, from the relationship to Lefort as a specific Other, to a relationship to Others, while Nadia can also use signifiers, released from being imbued with that original total experience.

But let’s go discover this in the story itself.

1. Invidia – A+a (Other + a) -> A//a (separation of A and a)

On 13 October, Lefort sees Nadia for the third time, and Nadia laughs as she approaches. This changes when Lefort pays attention to another child in the room: Nadia first makes shrieking noises, then she starts crying. She stops, she turns her back to Lefort, puts a thumb in her mouth, without sucking it, and puts her other hand over it. She makes a rocking movement with her hands, as if she is cradling herself. A little later she parted her hands, she looks at Lefort, she smiles, and she plays with Lefort's hands, almost daring to accept a toy that Lefort is holding out to her. Shortly afterwards she falls seriously ill, she withdraws, refuses everything that is offered to her, and she continues to rock continuously, with a disconsolate look - the look that makes Lefort take her into analysis.

The day before, Lefort had already noticed how Nadia reacted when other children got attention. Lefort held out her toy, she grabbed it, she kissed it, she licked it, she threw it down, picked it up again, gave it to Lefort and so on. But then a nurse started feeding the other children. Each time Nadia saw the nurse doing something for another child, she hit the rubber sailor, and she threw it down. A similar scenario as the day after, so.

The desire appears, according to Lefort, when Nadia sees how a nurse or Lefort herself pays attention to another child: "It was only her sensitivity to another little counterpart being fed and cared for by the Other that triggered invidia in her. This bore witness to her own desire, which inscribed itself in the gap between her and this counterpart” [7].

Lefort observes that Nadia reacts to other children only at those moments; outside those moments they do not seem to exist. She does not see it as jealousy; after all, Nadia does not like to get food, or to sit on an adult's lap. For Lefort, this is above all about "seeing" what is involved: an adult paying attention to another child, and it reminds her of a passage from Lacan, who talks about invidia[8]: "Telle est la véritable envie, celle qui fait pâlir l’envieux - devant quoi ? - devant l’image d’une complétude qui se referme et de ceci que le (a), le (a) par rapport à quoi il se suspend comme séparé, peut être pour un autre la possession Zont il se satisfait, la Befriedigung. (…) C’est à ce registre de l’œil comme désespéré par le regard, qu’il nous faut aller pour saisir le ressort apaisant et charmeur, la fonction du tableau, le côté civilisateur de ce qui, chez le peintre, est produit par une action spécifique. Et ce rapport foncier du (a) au désir me servira comme exemplaire dans ce à quoi nous nous introduirons maintenant concer­nant le transfert. »[9]   

Lefort describes it as Nadia being confronted with “what appeared to her a picture of completeness on the part of the other, and his satisfaction, rather than just a food-object as such.” (…) Her desire was in the specific relation to an object that aroused her covetousness only if it belonged to another child (….) Surely this object in relation to another, and which she had to keep at distance, was non other than Lacan’s object a, the object cause of desire"[10].  So there is an image of a child that seems to be completely absorbed in that scenario of being fed, and although Nadia's desire is evoked by it, she does not allow herself to end up in that situation. 

O'Loughlin states: "Nadia was  functioning in  what  Lacan refers to as invidia. That is to say she could only ovet the emotional expression of others whom she observed, but she showed no capacity to desire the breast for herself”. He refers to a failure to inscribe the Real in the Other, through processes such as the pictogram described by Aulagnier, and he states that Nadia had no other ability to maintain her desire except " in the gap of the object she had not let go of, or invidia” [11].  Lefort indeed writes that " What was missing was the active part of the drive ; but she was impelled to establish it on the morning of 12 november, by demanding to take her breakfast from the bottle."[12].

How might we understand this ? 

Primarily everything seems to have to do with the gaze of Lefort. Lefort describes a number of situations where the same thing happens over and over again :

12/10 : Nadia plays with a rubber sailor. The nurse starts feeding the other children. Nadia sees that, she hits the toy sailor and throws it down.

13/10 : Lefort leaves Nadia with the rubber sailor. She goes to another child, Nadia sees it and throws the sailor away. Lefort returns, Nadia tries to attract her attention.

15/10 : Lefort approaches, Nadia smiles. Lefort goes to another child, Nadia starts crying.

16/10 : Lefort has put a building block beside Nadia, a child wants to take that block. Nadia cries, throws herself backwards, she turns to Lefort and offers her an arm.

23/10 : Nadia is ill, Lefort is sitting with her, Nadia explores her mouth. Another child comes and touches Lefort; Nadia throws herself back and shows disgust. As soon as the child is gone, she continues the exploration of Lefort's mouth.

27/10 : Nadia and Lefort sit in the dormitory, and Lefort puts her hand on the empty cot next to Nadia's. She sees how the girl tenses up, she pulls her hand away, and Nadia laughs.

Could we assume that the whole interaction between Nadia and Lefort is centred around Lefort's attention for Nadia ? That Nadia, as soon as she feels that Lefort's attention goes to another child, throws herself - or an object - away ?  Much further on in the book, Lefort mentions that this only happens when Lefort is there ; when another child appears and Lefort isn't there, it doesn't happen.

Possibly the dynamic of the situation has to do with something, explained by Claudine Crommar[13], as the mother's gaze that prevents the child from disintegrating. This need seems less urgent when we see Nadia reacting on the child who is not present, but who can remain present through its representation, through that empty crib. Lefort assumes that Nadia reacted to the trace of the other child, " a trace I erased when I withdrew my hand ". The movement of withdrawing her hand counts as a separation from the trace of that other child, but also as an interpretation, she says: "...put me in the foreground as an Other who could separate from an object, that is to say, who was marked by a lack". As a result of that movement, Lefort becomes an Other with a lack. And "It was the last time that Nadia felt herself destroyed and annihilated faced with another child. She would no longer lose contact with me in the presence of another (with the exception of the session of 10 december)” [14].  There seems to be some kind of continuity, Nadia can use the crib as a symbol of the child's presence, but at the same time she herself does not fall apart when another child reaches out for Lefort. 

Secondly, Nadia explores Lefort's body, and then she literally searches for a hole in her body, especially her mouth. But in fact it has to do with transitivism, says Lefort, which can be read as a kind of converging without any possibility of difference.

23/10 : Nadia sits on Lefort's lap, looks at her and explores Lefort's mouth with her fingers. Even later at dinner, she can’t stop looking at Lefort, who is approaching.

27/10 : Lefort sets herself up next to Nadia, Nadia smiles and puts her finger in Lefort's mouth.

28/10 : The same scenario, she puts her finger in Lefort's mouth, she sucks it, she puts it back in her mouth (of Lefort). And she takes one of Lefort’s fingers, shakes it, she seems disappointed for not being able to separate it from Lefort.

1/11 : Nadia is sick, tense, anxious, yet she starts to explore Lefort's mouth again. She pulls her teeth, like before her finger. After a tense reaction she hits Lefort on the mouth, she relaxes again, putting her finger and then her whole hand into Lefort's mouth. This is too much for her, she is petrified.

3/11: Lefort gives her a rag doll, Nadia takes it and presses it against Lefort's mouth, and then against hers; she repeats this. Lefort kisses the doll, Nadia is surprised and then she puts the doll to her mouth and she licks the doll, she tries to force the doll in the mouth of Lefort. And then she puts an animal to her own mouth.

Lefort describes it this way: " she hit me on the mouth, that mouth she always returned to and that was, as we have seen, as much mine as hers "[15].

In this description two things strike me as important : on the one hand the exploration of the hole in the body of the other, essential basis for the installation of the deficit and the desire, on the other hand the Other as a mirror for the subject.

The hole. Lefort describes how Nadia plays with her mouth, " she circled around my mouth as a place, a gap” [16]. She emphasizes how Nadia tries to separate a part of her body in that period, her finger, her tooth. Rodulfo formulates it like this : to be, one has to make holes, like the baby has to make its way through the birth canal. The most important activity in the first year of life, he says, is producing holes, preferably in the mother's body[17]. He explicitly refers to Nadia, who indeed does and can do this because of the transferial relationship, with the analyst that makes itself available for this purpose. Only later on there will be a metaphorical doubling of that movement, the theoretical model built around the lack in the symbolic system. He refers to Aulagnier, when he talks about a mother's discourse in which no lack is allowed, when the mother does not allow herself to be 'pierced', where there is no distance between that private mother and the cultural register of 'the mother'. We will come back to that later.

The mirror.  There is Winnicott's famous quote, in which he talks about the child being mirrored in the mother's face[18], but he seems to be talking mainly about the baby's state of mind being mirrored by the mother. Sami Ali[19] goes further when he works out a theory about the face. The face, he says, can be touched, but not seen, only in front of the mirror. So the face is something of the outer world, on the level of the body image it is an emptiness, there is first of all a baby who has no face. Then the only face the baby has, is the face of the mother that,  in that initial period, coincides with the visual field. There is no possibility yet to create a distance between subject and object; the Other is both subject and object at the same time, the subject can construct itself as an other in relation to himself. In the third period there comes the perception of the face of the other as being different from that of the mother. The difference introduces the distance, but also the fear, of the distance to the other and to oneself[20].

Lefort himself speaks of transitivism: “… on the evening of 7 November, I bit off the corner of the cracker she had put into my mouth, it was she – in the transitivism at play, between us – who vomited"[21]. 

Thirdly : the possibility of the toys being placed between her and Lefort - "proved to be the intermediary she needed to accept having contact with me and enjoy it [22]" - can allow Nadia to enjoy the contact.

7/11: The same game with the chicken ; Nadia first presses it against her mouth and then against the mouth of Lefort, but in the meantime, she was able to touch Lefort's hands without anxiety.

9/11: At first Nadia puts the car to her mouth, then the chicken to her mouth and then to Lefort's, and in the meantime she also pushes her hand against Lefort's mouth. Then she sits on Lefort's lap, she sticks her fingers in her mouth, she scratches slightly the base of her neck, Lefort makes her jump up in her lap. But she is very watchful, she doesn't want Lefort's hands to touch her. During that session, Nadia takes a doll and holds it to Lefort; Lefort cradles the doll and Nadia takes it back, throws it in her crib. Then she wants to sit on that lap, looking a little anxious. A little later she picks up the doll again, she holds it out to Lefort, she takes it back after she makes Lefort kiss the doll, she wants to get on Lefort's lap, with the doll, and she licks the doll, she makes Lefort cradle the doll and then throws it away.

10/11: Nadia sits on Lefort's lap again, another girl comes closer and she touches that girl, looking at Lefort. She makes a kissing sound with her mouth, Lefort kisses her but Nadia pushes her away. The other child, until now the scopic object that was involved in that scene of invidia on the other person's lap, is now linked with oral arousal, says Lefort, and with muscular activity. Nadia shows herself how happy she is on the Other's lap, and in the meantime she can look at that child.

Lefort says about this: before there was only a pure gaze, without the possibility of being looked at, and now there is the transition from invidia to the scopic drift; "Nadia passed from a situation where she was alone and passive when confronted with her sight to an activity that involved not only the object but also the Other that I was. It was as if she was saying to the other child: Look at me (…) on the lap of the Other (seeing oneself), so I can look at you (seeing)" [23]. So we have the position of someone who is looking, someone who is being seen and the Other. Meanwhile the object is connected to the oral arousal, the doll is being kissed, Nadia makes kissing sounds, but she can't bear that Lefort would kiss her, and touching her wasn't allowed either. That's why Lefort says that the circuit of the oral drive does not yet include all three moments.

Lefort says about those three sessions: " Nadia was driven, in the sense of the drive, to approach my body more directly, by a structural necessity that makes the object participate in both the signifier and in the body of the Other"[24] - where the signifier refers to the objects that are being exchanged, since the mediation confers them a signifying dimension in the context of Nadia's question.

On 13 November, Lefort decided to introduce a bottle in the session because Nadia had demanded a bottle in the institution the day before. "“… the bottle was the object of Nadia’s demand”. Nadia drinks the bottle greedily, but with her body stiff, tense, without looking at Lefort. Initially the feeding, during the sessions, brings a lot of tension to the girl, but eventually Nadia can relax and enjoy begin fed – with more and more sounds of sucking, thumb sucking and the like. But it takes a long time before she can relax while drinking from that bottle on Lefort's lap. Lefort refers to the fear of a psychological lack of separation between subject and Other - Nadia did not want " to be in the place of this small other that fulfilled the Other” (…) The Other did not speak, did not have a separate existence, she drank it in with the milk [25]".

On the 5th of December she looks at Lefort and says "mama-mama", for the first time, joyfully, "putting the seal on the difference between her and me"[26].   By calling her mama, Lefort became someone other than the nurse, and the bottle could be an object of a demand in the relationship to Lefort, as a symbolic object. Lefort notes: when Nadia has emptied the bottle, when she has shown how it satisfied her, she turns on Lefort, aggressively, as if to she means to say that bottle was not what she was looking for. It was not "that". For Lefort this is the mutation of the real object to the Other in this signifier "mama"; the "mama" allowed Nadia to move into the field of speech, allowing her to renounce the object, allowing the signifier to take its place, and thus to win the love of the Other, the love of a metaphorical, signifying structure.

On 10 December, Lefort discovers Nadia, sitting, fascinated by a nurse bouncing another child up and down on her lap. As she watches, she makes sucking sounds. Lefort calls her, repeatedly, by her name, until Nadia smiles. But she gets immediately very frightened when Lefort extends her arms to take her for the session. She allows Lefort to play with her feet, but she seems frightened to get close to Lefort. She fingers her ring, while she is babbling "ma-ma-ma", sometimes with gestures of sucking. 

Lefort describes this very intense scene as "the logical and hallucinatory realization of Nadia's desire". She speaks of a irruption of that primordial image, which fascinates Nadia, and where the Other no longer exists except on her eye, " the eye as priveleged point of the envelope on which the Other was glued. The subject, that is to say, the whole surface of her skin, was concentrated on this privileged point.”[27] Could this be an echo of Aulagnier, when it describes the pictogram[28]?

Lefort calls the child several times by her name, Nadia clearly cannot immediately give up the fascination. Nevertheless, she is sensitive enough to hear her name and to smile ; she is not completely enclosed in this fascination, which makes Lefort conclude she is not psychotic. If she had continued to look at that image, the existence of the Other would have been excluded, the Other would have remained on the level of an unattached signifier.

When she turns around and smiles, this indicates a breach in the fascination, by the signifier of her name. Nadia is no longer "the one who looks" but "the one who was looked at by Lefort", where she was signified on the level of the signifier. By naming her, Lefort also pronounces a prohibition, a loss about the certainty of the image, being that the Other was not where Nadia wants to see it. Until now, says Lefort, Nadia only knew the image of the totality "A(Other) + (object)a", where child = breast, part of the body of the Other. By calling her by her name, that image is taken from her eye. For Lefort this was the castration. The image A + a, which she wore on her eye, is repressed. 

Where Lefort calls her by her name (which gets the weight of a demand, but from Lefort) this means a leap, from the hallucinatory satisfaction of her desire, to the presence of Lefort as the Other. A leap from the Other attached to her, to the intrusion of a real, separated Other. Nadia here separates the image from herself, forever. The inclusion through the eye is lost; from now on the Other is the bearer of the object of the drive. But immediately she receives a signifier for her name, Lefort turns to Nadia as subject. Because the real now becomes a signifier on the level of the image, it will be a foundation for the metaphor and metonymy.

The sucking movements during that scene indicate that the hallucination of the primordial desire is successful ; they belong more to the drive than to the fascination, although at that moment no separate object can be assumed.

Nadia liked to mirror herself in the totality of this image, but she refused to be for the Other only what she had always been in the institution, an object that could be manipulated. It was that fear that moved her to assume that signifier.

Lefort outlines this evolution as follows :

• Initially there is a relationship of inclusion[29]. “That was what she always saw, it was what was looking at her when, at feeding time, she had to wait for her bottle. It was an image that could not be separated into its two elements ; and this was what she came back to in the scene of fascination, which throws light on what was involved : a purely scopic report, an image in which she found herself included”.[30]
• At the beginning of the treatment there is the immediate effect of a dissociation of that totality; Lefort disengages herself from that image, and so the little a is created, which robs Nadia the Other of the object that was part of her own body (invidia).
• Nadia knew the Other when she witnessed the invidia, when she saw a child being fed and cared for by the Other, she was very sensitive to it. “In this case, the Other was merely the agent of the completeness of the small other ; and inversely, in Nadia’s eyes, the small other was the image of the object of the completeness of the Other.”[31]
• In the scene of October 27, the demand of the Other and the questioning of the desire of the Other for the other appears. But there remains a relationship of transitivism.
• On November 10th, there comes a real separation between A and a, when Nadia takes an interest in another child, while assuring her own link with Lefort's body by jumping up and down on her lap.
• From that moment on, she can search for an object for herself, and ask for the bottle.
• Then comes the debate for the position of the object in relation to the Other. Nadia was sometimes able to indicate that the Other was the bearer of the object of desire, for example when she says "mama" on 5 December, but above all she remains attached to the primordial image, that primitive form of the Other, to which she is connected through a relationship of transitivism.
• In that period there is an exclusion of Lefort itself, as being real, therefore Lefort should not be seen at the moment of drinking. Where milk was the metaphorical object representing Lefort, Lefort as Other was not allowed to exist for Nadia, she refused to be the (metaphorical) object that would be fulfilment for Lefort. Nadia was stuck in this trap : to defend herself she had to inscribe the Other in the milk she drank, of which she had made herself the container. But the presence of Lefort betrayed the metaphorical character of the milk.
• These two movements go together, because of the transitivism, so that the fulfilment of the Other goes hand in hand with the fulfilment of Nadia herself. There is no difference between Nadia and the Other when she drinks the milk; hence the dismay when Nadia is confronted with an empty bottle.
• On 10 December there is the irrupton of that primordial fantasy, with Nadia being reduced to a fascinated look. There is no need for a real Other, the Other is contained on the surface of the subject herself. The child on the woman's knees was part of the woman's body, it was her breast. In this primordial fantasy, Nadia is the envelope of the Other and all the objects attached to it, without any separation. This regression could only be achieved through the transferal relationship.
• Further evolution was needed to get of this trap. Gradually Nadia would turn more and more to the body of Lefort, to the objects she was carrying, which allowed her to install the Other as a separate entity – using these objects to introduce a separation between subject and Other, as Lacan elaborated in seminar IV .

We will see how there will be a transition from the bottle to other objects connected to Lefort, and because Nadia was able to connect the bottle to the presence of Lefort, it can become a relationship of exclusion to a relationship of inclusion. Later came the transition in which Lefort is recognised as someone who is separated from Nadia, but who is also the bearer of the object. Where the bottle initially excluded Lefort, Lefort could become external to Nadia, and became the bearer of the object. We will come back to that later. That's why Lefort can state: where she used to be part of the bottle, but was then excluded as a real person, (that for which) the bottle (stood) was now part of Lefort as an object, separated from Nadia. ???

Throughout this evolution, there is a constantly referring to that invidia-scene, and eventually this will culminate in this session of that particular 10th December. In one way or another, the whole sequence of events appears  to be all related to this, in the sense that it is a kind of disconnection from that scene but also an adaptation of it. First it had to do with the gaze, from which Nadia can detach herself without losing her continuity of being. Secondly Nadia dared to touch and make contact with Lefort's body, in a transitivism between her body and Lefort's, discovering and allowing the oral cavity.  Thirdly she had to allow the desire to exist alongside being fed, which in that first period only was possible at a distance. The feeding-scene is no longer confined to the context of physical needs, now it can take part in the circulating of the desire. And so, finally, this phantasmatic scene can appear with a structure as described by Aulagnier. The fantasy that, as she said, could only appear when there is a separation possible between subject and Other[32] . We do indeed find the three positions mentioned[33] :

- There is the nurse/Lefort, who pays attention to a child or feeds the child.

- There is the child that sits on the lap, that is bouncing up and down on the lap, that is being fed.

And there is the third position:

- The gaze, seeing itself represented and where the excitation should be situated; the fascination and the sucking sounds bear witness to this.

The scene of 10 December is a turning point. "Lefort describes it as the loss of “the inclusion through the eye"[34] and the discovery of Lefort's real body. “From that time on, the Real of my presence took on the role of a command ; she could no longer include me in herself by attaching me to her ; I was irremediably external to her.”[35]. Nadia could no longer include Lefort in herself, she had inevitably become external. In the following period, the loss of this primordial image is symbolised when Nadia pulls Lefort's glasses off her head, which she continues doing for days. Although there is still a transitivism between Nadia and Lefort as the Other, Lefort sees her glasses as a representation of the image that is unstuck from her eye. By taking those glasses off, it is as if Nadia can unstick this image. Playing with the taking off the glasses is also playing with the non-sticking of that image.

From now on the body of Lefort as Other will be at the center, when Nadia is constantly searching for love and for the object of the drive. There is an ambivalence that will continue dominating the sessions for the time coming. On 11 and 12 December, Nadia expresses her aggression when she hits the bottle or the toys, but at the same time she manages to drink from the bottle in a completely relaxed way, lying in Lefort's arms.

Nadia could take the place of the metaphorical object in that real body, which meant the horror of being stuck to Lefort, of being part of her body, of being her breast. On 12 December, Nadia reaches the metaphorical realisation of the image of 10 December, when she drinks from the bottle, lying in the arms of Lefort, and looking at Lefort, and she enjoys it. It was as if she had to establisch her debate, to let it take root, in the Real, something she had probably never done before“[36], says Lefort; can we assume that this is the inscription of the Real in the Other that O'Loughlin was talking about, the rooting in the primal processes as defined by Aulagnier ?

2. The pre-specular phase

In the following period two tendencies are coinciding : on the one hand Nadia does not want to accept the separation with Lefort, on the other hand she is looking for it.  We see this in the way Nadia is positioning herself against the real body of Lefort, we see this again in the way she handles objects, in the exchange with Lefort.

1. The search for inclusion of the Other

The image of 10 December could, through the eye, ensure a totality A(Other) +(object) a. This constellation has been broken because Nadia can no longer deny the real presence of Lefort.

In the following sessions, Lefort describes a number of ways of how Nadia is searching for a relation of inclusion, notwithstanding a simultaneous tendency towards separation. Even later on, during the mirror phase, the desire to stick to the Other also returns regularly.  ??

- Nadia tries to obtain this inclusion through the skin, with a continuity between the inside and the outside of her body, in a transitivism with the body of Lefort. When the relationship of inclusion turns out to be impossible, an aggressive reaction occurs.

 24/12: Nadia touches by chance the skin of Lefort, under her white coat. She flees immediately, what is followed by a violent scene, she pulls on Lefort's lips, scratches her, pushes her head violently backwards, pinching her skin with her fingers.

After the session, Nadia smears her excrement all over herself, up to her neck, her ears, all over her face and her legs, even into her mouth.

Lefort understands it as a reaction to touching her skin : Nadia was overwhelmed by passion when she encountered Lefort's skin, as the Real of the absence of a hole. And here we see why it is so important for children to be able to drill a hole in the mother's body: “my body had to be a surface with holes, because of the objects she wanted to get from it, so that the holes in the surface of her own body could by filled by them”[37].  By smearing herself with excrement, including her mouth, she also turned her skin into a surface without holes, without interior or exterior.

Lefort interprets it as a refusal of her mouth, that her mouth did not exist as long as it could not be filled up by sticking to the Other or the object that the Other wore. Nadia would smear herself with excrement a few times more, always outside the sessions, always in the absence of Lefort.

25/12: Nadia wants Lefort to hold her, and for a minute she hides her head on Lefort's shoulder, she hugs her tightly, she gives her a tender look. So again this transitivistic movement, where it is difficult to decide who is whom ; Nadia can't bear to be physically separated from Lefort that day, because when Lefort puts her on the floor, she becomes aggressive.

16/1 : Nadia lays down on the floor, at Lefort’s feet, as if she were really a (metaphorical) object of Lefort, after having symbolically robbed her of her gaze by pulling off her glasses.  She remains attached to that image of 10 December, she continues to search for the possession and the sucking of the object. She refuses to acknowledge her own loss and that of Lefort.

- Nadia searches for the object on Lefort itself, under her coat.

30/12: The session takes place on Lefort's lap; there is the game with the cracker in and out of Lefort's mouth; then there is a moment when she happens to touch Lefort's skin. She opens the white coat, she sticks her head in it to take a closer look, then she gets furious. She hits Lefort with both hands on the breast, she hits the bottle, she spills the milk, she relaxes and she comes back into Lefort's arms. After the session, she urinates in her diaper.

Lefort interprets it as a search for the real object, which she doesn't get to see, because the only thing Nadia sees is the blouse under the coat; the object remains veiled, forbidden. The result is a reversal, in which Nadia makes herself Lefort's object by stretching out into her arms. But through her urination, she introduces another, missing object, the real of her body.

Nadia would try this three more times, each time with the experience that her gaze was incapable of taking the veiled object, the breast, from the body of Lefort, on which she makes herself the object of Lefort, in her arms.

- The orality

16/1 : Nadia sits on Lefort's lap, her mouth stuck to Lefort's face, and she tries to absob her. It is no longer a matter of losing oneself in the "seeing" of the object, but of having and sucking on the object. 

1. Separation - two types of objects

Lefort distinguishes between a metaphorical object and a metonymical object. A metaphorical object “did not efface the object, even if it substituted another”[38], and retains its links with the Real, with all  the intensity, whereas a metonymical object is a piece that can be separated, and is therefore just that bit safer, “the only objects that guaranteed she would not dissolve in my body and in the other”[39]. 

For indeed, the metaphor, although a psychic representative of the object, is too close to the real of the body, says Lefort, which implies a return to a dual relationship between Nadia and Lefort. A metonymic object is an object that also can be destroyed, but which can above all be separated, such as a piece of paper, the buttons of Lefort's coat, the speech. We will see how Nadia will therefore either destroy the metaphorical objects - the bottle, the big doll - or replace them with a metonymic object.

Lefort refers to the difficult term "Vorstellungsrepräsentanz"[40], by Freud. According to her, this "Vorstellung" does not stand for the definition of a unique phenomenon as far as an object is concerned, but for a field of representation that is the signifier. In that field, the Repräsentanz of the object can inscribe itself as a signifier and thus enter in connection with other signifiers in the chain. In this way the energy, the quantum of affect, is bound, and the possibility of the imaginary or even the real return of the bodies is excluded. That is where the energy, the quantum of affect, is bound. We will see how this happened with Nadia through the liberating and triumphant characteristic of the spoon, which became a metonymic object. But there was a continual drifting towards the return of the metaphor, and in the orality the subject returned to the impasse of consumption of the body.

Let’s go on, step by step, and see how Nadia, in her handling the objects, acknowledges the difference between Nadia and Lefort.

14/12: Nadia relaxes for a few moments in the arms of Lefort, to take the bottle (metaphorical object); but after a few sips she throws it away, far away, under the radiator, using both hands and feet.

She goes to Lefort, bringing her attention to the buttons of her white coat. There is a happy moment when she bounces on Lefort's lap. She takes a piece of paper (metonymic object) out of the breast pocket of Lefort's white coat, she shakes it, she tears it, she gets excited, she puts it in her mouth, she looks at the bottle under the radiator, even with the gesture of giving it a kick. Then she takes that piece of paper out of her mouth and puts it in Lefort's mouth, to pull it even more violently out of Lefort's mouth and tear it to shreds, without any fear.

15/12 : Nadia tries to put a large doll (metaphorical object) on a chair when Lefort arrives and calls her. She turns around, she smiles, she tries to put the doll there again, before giving it to Lefort. She then immediately replaces it with the metonymic objects stuck to Lefort's body : the buttons of her apron, the piece of paper - then she returns to the body of Lefort : she contemplates her face, her nose, her eyes, her hair, her mouth. She has diarrhoea, she is uncomfortable, she sucks her thumb. Lefort asks a nurse to change her.

Then she comes back into Lefort's arms, on her lap, and another child yelled. Nadia gets frightened, she presses her head against Lefort, she plugs one of her ears so as not to hear those cries. Here we see how, as Aulagnier describes it, the cries she hears become an intrusion on a lustful experience. Lefort describes a similar violation during the feeding: when sound came from outside the consultation, Nadia became uncomfortable and frightened, but she managed to reverse this, by making her own sound, hitting the chair with a car while looking at Lefort. In this way she was able to rule out the fear. The "heard" had to do with Lefort's presence or absence, waiting for her footsteps, for her voice in the hallway.

17/12 : Nadia first plays with a cracker (metaphorical object), she shakes it, she uses it to make a noise, she puts it in Lefort's mouth, then in her own mouth. She strucks violently the table with the cracker, and she throws it up in the air.

Then she turns to Lefort to inspect the buttons of her white coat at length, and she babbles "mama" and not "ma-ma-ma". Then she hits her breast, with her hand.

Now it's the turn of the bottle (metaphorical object): she hits it so hard on the floor that it cracks and the milk splashes out. The bottle ends under the radiator.

30/12 : Nadia experiences much joy when she can give her feet, as a metonymical physical object, without revealing the fundamental fantasy of the desire of being stuck to the Other; she alternately looks at her shoes and at Lefort. Something could be assimilated without a loss, in a passing from a hole (which has to be stopped up) to an envelope (which conceals something).

31/12: Nadia sits on Lefort's lap, she throws the biscuits and the bottle, she grabs her glasses, she puts them on her own eyes, and then on Lefort's, and then she throws the glasses out of reach and she comes to Lefort's knee.

She pulls the lips of Lefort, while poking out her own tongue. With her finger she searches for the tongue of Lefort, and when she finds it she pushes it back inside with a look of disgust, and she closes her mouth. She pokes out her tongue again and she tries to find Lefort's tongue, she scratches it with her fingernail and makes a lot of movements with her mouth and tongue.

At the moment this has no longer to do with looking for the hole of the mouth, says Lefort, but with a game between her tongue and that of Nadia. Nadia pushes Lefort's tongue into her mouth, and at the same time she closes her own mouth. When she looks at Lefort's, she pokes out her own tongue. According to Lefort, the disgust is aroused by the metaphorical discovery of the tongue that represents an oral fantasy. 

3/1: Nadia puts a cracker in Lefort's mouth. Lefort bites a corner from it, and then Nadia throws the cracker away, and with her fingers she scrapes off the pieces of the cracker that were stuck on Lefort's tongue, but without the disgust she showed the previous days.

4/1: Nadia grabs the doll, which she sprinkles with milk from the bottle. She pulls the doll's hat off, she hits its head very hard on the floor, she makes big circles with it, and then throws it away from her. She hits Lefort once with the doll, after hitting her own head with a toy car.

Lefort sees the doll as a metaphorical object, an element of the scopic fantasy she had given up on 9 November, the small other sitting on the knees of the big Other, a return to the repressed image of 10 December. Now, however, Nadia allows herself to be very active and aggressive towards the doll, even to the point where the fantasy of destruction, behind the violence, frightens her. The violence against the doll turns against herself, she hits herself on the head and she hits Lefort on the head. At the same time, she wants to be hugged and kissed, but that too makes her uncomfortable.

5/1: Nadia is indeed afraid when Lefort arrives, and she calms down when she puts on her shoes and socks - the metonymic object that guarantees that she would not dissolve in Lefort's body and in the other. In the session, there is again the aggression against the bottle, but at the same time she licks Lefort's sleeve, as if she wants to eat her, Lefort tells her that. Nadia hits with her hand and she becomes anxious. She is a bit reluctant in her motor activity and in her babbling.

6/1 : A special relationship emerges toward Lefort, with regard to her mouth. Until recently, she could not attain the oral behaviour, drinking the bottle or eating the crackers ; she confined herself to a licking game. From now on she will go so far as to put her open mouth to that of Lefort, for a moment, drooling and with sucking movements.

And so it goes on for a while; the aggression against the doll, the tenderness towards Lefort, and the impossibility to endure it.

16/1 : Nadia comes into the arms of Lefort, she clings onto her, she makes sucking sounds, but there is no "mama", no sound. The ambivalence is too great. She goes looking for a lead soldier and she sucks his rifle while looking at the bottle (bottle -> rifle). She doesn't dare to touch the bottle itself. Lefort tells her that she sucks on that rifle instead of the bottle, and Nadia drops the soldier, she makes sucking noises, she grabs the boat and she sucks (soldier -> boat), and she throws it away. Then she starts sucking on the toy sailor (boat -> sailor). (We see how she passes from one object to another: the gun, the boat, the sailor - but the bottle itself has to stay at a distance). She drops the sailor, she stands up against Lefort, and she looks at her after biting her chin, very close to her mouth, without aggressiveness, with weak sucking movements. She refuses to acknowledge her own loss and that of Lefort, she continues to search for having and sucking on the object.

The sailor may initially have been a metonymic object, says Lefort, but through the sailor Nadia now initiates her entry into the metaphor, when she drops it to go immediately stick herself to Lefort, sucking and biting her. The only way out of the metaphor will be the image of the totality of her body in the mirror, the metonymic object par excellence. But the ambivalence will remain, for a long time, as we can see in the session of 27 January.

27/1: Nadia goes to get the spoon, she picks up the doll, she looks intensely at it, she puts a spoon in her mouth, but immediately she smacks the doll violently against the floor. She asks Lefort to put the doll on her lap, and then she takes the doll away and hits her. Then she wants to get up Lefort’s lap, with the doll, and finally in the crib with the doll in one hand and the spoon in the other. She throws down the doll and she becomes aggressive against the spoon, she steps on it, she throws it away, she picks it up and so on and so forth. Then she puts it in Lefort's mouth. Lefort tells her she wants to feed herself, the doll, or Lefort, but that she doesn't tolerate Lefort feeding her during the sessions because this becomes unbearable for her. She hits Lefort in the face with the spoon and she hits her on the mouth with her hand, and she bites Lefort's shoulder.

3. The mirror

The importance of the mirror is particularly known Lacan's theory of the mirror stage, which speaks of a "jubilant assumption"[41] of the mirror image, allowing the child to anticipate the possibilities of his body. Other psychoanalytic authors also write about the importance of the mirror, highlighting different aspects. 

For Sami Ali[42] the identification with the mirror image is not the beginning of an evolution, it follows the identification with the face of the other - as we have seen before. The mirror image is also the moment of accomplishing the primordial cut-off between inside and outside, he says, and of being able to bypass the primitive disquieting strangeness associated with the perception of the double in order to arrive at the primacy of that perception.

Dolto[43] describes how the scopic pulse will suddenly come to dominate over all other pulses: the image of a baby in the mirror will superimpose itself on the experience. Dolto speaks of individuation, through the experience of the mirror : no more confusion between the child and the other, nor with phantasmatic images of oneself, a bus, an aeroplane, a bird... From now on, this appears only in the conditional mode: "if I were an aeroplane"...

In addition, Dolto, like Lacan, stresses the importance of the presence of a mother or a known person; it is this person, being with the child, who, through recognition, gives the scopic image the meaning of a living experience. Moreover, the child sees that person doubled, next to himself in the mirror, and can therefore swallow that scopic image as something that belongs to him.

Aulagnier too points at the separation and at the enjoyment of the gaze of the other : the child is looking at something identical to himself, and at the same time there is an encounter with a gaze. She describes how the child can invest libidinously in the image of the body, and also experience a kind of mastery over it (cf. the jubilation that Lacan speaks of). But at the moment when an image appears that is I - in which that desire can be situated - the image also shows what it is not: the body as separated from the mother, different from the breast, bounded by the skin. One is only this body, only this gender.

She describes the two movements, in front of the mirror: the subject turns his gaze away from the reflection and looks at the gaze of the mother, which reflects her pleasure of seeing. Then the subject looks back into the mirror and sees his own image as the object of that pleasure for the one who is looking. Thus, through that gaze of the spectator, something is added to the mirror image. Indeed, "the mirror privileges a moment of pleasure for the adult who is quite happy to share it with the child, gazing on the latter's image with a more tender eye than on the real child being cared for"[44],  confirms Lefort. The pleasure of the adult has, at that moment, more to do with the image i the mirror, than with the real child. 

We will see how the different aspects described above are reflected in Nadia and Lefort's experiences with the mirror.

Nadia knew the mirror from way back; it was just above a table that was used to change the babies, and the nurse had the habit of holding the babies in front of the mirror and making them look at themselves, together with the nurse.

Moreover, there was that other mirror when Nadia looked at her reflection in the fascinating image of 10 December. That image is repressed, says Lefort, what follows is the return of the repressed.

16/1 : Lefort brings Nadia back to her room, while Nadia holds her toy sailor. Every day they pass by a large mirror above a fireplace with that table in front of it. Nadia sees her reflection in the mirror as she is carried by Lefort, and today she wants to stand up on the table in front of the mirror. Her facial expression is almost frightened, and eventually she turns her head away violently. A few moments later Lefort hears her crying, and she sits by a crib, without the sailor.

Nadia sees only herself in the mirror, without the image of Lefort - making her mirror image her own metonymic object for the first time. (1) It becomes a real loss for Nadia, because she cannot stick to a virtual image. (2) It means immediately the end of the Other's function, transitively as a real image, as a real mirror; she loses Lefort where she could still belong to the image of 10 December, as if it were sticking to her eye. (3) But Nadia also cries because she has lost the sailor ; it had only recently become a metaphorical object for Lefort, connected by the gaze and by the mouth (when she sucked on it while Lefort looked at her). For Lefort it symbolises the real loss of the object, which cannot be mirrored. "“The scales fell from her eyes : the (sailor – other) and (me – real Other [unbarred]).”[45]

The first encounter with the mirror has different effects. Nadia's face has changed, says Lefort, she finally has the face of a child her age. There was a possibility of separation, Nadia no longer needed the mechanical movement to separate herself from an object. And when she now turns to Lefort, the signifier is for the first time enriched with the dimension of meaning.

Nadia then makes herself an object of Lefort again, by lying at her feet, but this time it's more of a game, and she immediately stands up again. But there is also a lot of aggression, aggression because Nadia had discovered her own image, but not that of the Other. Lefort assumes that Nadia wants Lefort herself to be put in the same position, marked by a loss. There is still a desire to absorb Lefort, when she tries to eat her cheak at 20/1, and when she doesn’t succeed, aggression comes. Nadia tries to put her finger in Lefort's eye, as if she assumes that Lefort has kept that image of 10 December, as if she is trying to find or destroy it.

22/1 : The nurse puts Nadia's shoes on the small table in front of the mirror. Nadia first assures herself that Lefort is nearby, and then she shows a lot of interest in her reflection, and in Lefort's reflection, when Lefort moves so that she is visible. Her gaze goes from her image to that of Lefort and from the image of Lefort to her real face.

Lefort calls this the return of the repressed, Nadia and Lefort both appeared in the mirror, without a loss. 

The discovery of the image of Lefort is not enough to prevent a massive return of the Real of the body, the inclusion of the Other, by means of the orality, when Nadia bites the arm or the chin of Lefort. The drive would appear through her attempts to devour Lefort or to take an object from her, her glasses, Nadia sucks on the arms of those glasses, which breaks off several times. For Lefort, the glasses make a link between the oral and the scopic, as the scopic for Nadia supplemented the oral. Where the oral comes back to the foreground, Nadia returns to the search for the inclusion of the Other.

Lefort tries to solve this by returning on 25 January and giving Nadia her meal outside the session and outside the analytical space, trying to broaden this oral relationship with the ritual of meals with which Nadia is familiar. When she arrives, Nadia sits crying in her cradle, sucking her thumb, facing the image of a nurse feeding another child with a spoon. It's not the same scene as before, says Lefort; the object used to stick to her eye, and at that time it was her tongue that gave her pleasure ; now it's external, she's sucking her thumb. There is the reality that there is an Other giving an object, food, for a little other counterpart.

Nadia accepts the feeding by Lefort, within the framework of satisfying her needs, she also shows that she likes it. Lefort uses a spoon to feed Nadia, and when she puts that spoon on the plate, Nadia immediately conquers it. Whereas the spoon initially takes on the dimension of a bodily object, as an extension of Lefort's body, it will eventually take on the position of a purely signifying object, the metaphor of sticking the bodies together can make way for the spoon. But at the moment it is still in that substitute dimension of a bodily object; this is apparent when Nadia has to try to take it three times, followed by her mechanical movement.

When she gets hold of him, the spoon is no longer an metaphorical object, the trace of that connection with the body of Lefort has disappeared. Now she can use the object as an extension of her own body. Nadia swings the spoon, starts to touch all objects with that spoon, as if to baptize the world - but at the same time the world, in that process, loses the excess of the Real. The spoon became the signifier of the lack.

27/1 : Lefort is still looking for a way out of this massive return of the orality. That's why she brings a plate of cereal and a spoon into the material of the session, so that a dimension other than pure nourishment could appear. Lefort expected Nadia to spread the grain over herself and over Lefort. When Nadia notices the plate, she puts her hand in the plate, and she licks her hand. She does that a couple of times, she also needs a couple of attempts to pick up the spoon, she plays with that spoon.

29/1 : Nadia uses the spoon to approach the food, but also to baptize everything in the outside world. Unintentionally, she knocks over the bottle, without violence. She licks the spoon, she licks the grain on her hand, and then comes a flood of aggression against everything that has to do with food : she jabbered furiously, she hits the crackers, the floor, the wall, the crib with the spoon, she takes a cup out of the (Noah’s)ark and she sucks it aggressively.

Lefort tells her what she sees : that Nadia would like to be fed by Lefort, but this desire always brings aggression, because feeding used to be a disappointment, because the nurse was not the person she wanted to be fed by. That's why Nadia didn't want to eat, but she had to. Meanwhile, Nadia enacts the whole scenario, while Lefort speaks.

30/1 : Nadia sits on Lefort's lap, with the spoon. She gives Lefort the spoon, she shows her dish of cereal and she waits. Lefort fills the spoon and she holds her hand with the spoon beside her over the crib. She tells Nadia that she can do with it what she wants. Nadia radiates: she takes the spoon, she licks it and she likes it. She holds the spoon to Lefort, so that Lefort could lick it too. Lefort tells her it is good to fill you with good and beautiful things, close to someone whose presence makes you feel good about it. That Nadia didn't have this, that she was forced to eat food which made her feel disgusted to everyone. Nadia listens attentively, she asks three times to pick up the spoon and fill it. The first two times she pushes the spoon out of Lefort's hand, the third time she takes it and she licks it. She sits on Lefort's knees, she presses her cheek against Lefort's, and then she tries to bring the spoon between the opening of the white coat, and she licks Lefort’s chin. Lefort says she is looking for food that comes from her so she can incorporate it, and vice versa. Nadia tried to go back to the search of the prespecular phase, the quest for the object on her body. But this time she doesn't do it anymore by pushing her head inside the white coat, she does it through the spoon, and it will also be the last time she tries to look for the breast.

From then on the spoon will be used to cover what in the prespecular phase had to do with topology of the surface of the bodies. She uses the spoon to spread the grain, over the floor, over Lefort, when she spreads a spoonful of grain over her cheeks and her hair.

31/1 : Nadia took two spoons from the table. She sucks at the end of Lefort's nose, she nibbles at it a little and she is drooling, as if to absorb them. Lefort tells her that and she says Nadia realises that she can’t do that, because they each have their own body. She says that Nadia is perhaps not satisfied with the cup and the dish, because that food is not Lefort, but that she can still discover every day together with Lefort that the cereal is there and that it is good to fill herself with it. While Lefort does that, Nadia goes to the ark, she puts the little dish back in and she stands in front of the dish of cereal. She dips a spoon in the cereal, she licks it, she does it again and she decides it's very good, she looks at Lefort, babbling, licking her lips. And she uses the spoon to eat more than half of the cereal. So she gives the cereal the role of metaphor of Lefort's body, in contradiction to the real body.

Then she wants to splatter the cereal on the floor, and she spreads the drops out with her hand. She comes into the arms of Lefort, full of joy, she rubs her cheek against that of Lefort, and Lefort is as besmeared as Nadia herself. The spreading is different from the last time, because she no longer represents Lefort as an object on her skin through an object of her body. Now the spoon plays the role of mediator, representative of both their bodies, which is why she doubled it at the beginning of the session. These metonymic objects make it possible to cover each other with grain.

After that session they go back to her room, she walks to the table in front of the mirror, she wants to get up on that table. She looks at the image of Lefort in the mirror, without seeing herself, and her smile disappears. Is it because the mirror reveals to her the loss of Lefort, the loss in seeing the reflection, without seeing herself? The metaphor - active in sticking together their cheeks - then gives way to the metonymic image of the body. Just like the experience of the first mirror, the experience would also be decisive here.

1/2 : The session starts on Lefort's lap, Nadia looks intensely at her face, she babbles ma-ma-ma - the scopic is linked to the signifier. She takes Lefort's glasses, she returns them to her, takes them back, throws them away, and a little later she hesitantly touches one of Lefort's eyes – the return to the scopic object of which Lefort would be the bearer. Nadia cuddles Lefort, she brings her mouth to Lefort's shoulder as she’s drooling - a synthesis of nibbling and smearing. Lefort tells her that there are two of them. Nadia dips her spoon into the dish of cereal, smears cereal over her face, makes a trace of cereal over the edge of the dish. Then she goes back to Lefort, touches her eyes, looks for her glasses.

Lefort interprets this as a showing of the persistent relationship between the image on Lefort's eyes, and the cereal she smears herself with, as a substitute equivalent. The oral object is then only a surface object.

Then she cuddles Lefort, brings her smeared cheek against Lefort's, and her mouth by Lefort's shoulder, as she dawns - this is more than a relationship on the surface, the hole of her mouth participated actively, in a synthesis of nibbling and smearing. But this structure is projected onto the space, as Nadia explores the wall and looks outside, through the window - bringing a third dimension not only into the space, but also into her body[46]. This introduced for the first time a beyond of the pure surface, a third dimension that founded an exterior and an interior, of the room and of her body.

Then she asks again to stand in front of the mirror. She looks at herself, she looks at Lefort's reflection, and then she turns around and looks at Lefort herself. Again she turns to her image, she peddles and she touches it. She shakes the mirror, she touches the reflection of Lefort, and then she turns around to be in her arms. The touching here is about the mirror image that is a surface, where that surface used to have to do with Lefort's eyes. It is as if she wants to ensure the presence of Lefort, and she casts a quick glance in the mirror to see that other image.

Lefort notes that Nadia has meanwhile discovered the hole in the window in the room where they are together. However, in the mirror's place, the hole corresponds to the surface of the mirror, the hole loses its real character. That's why she shakes it, Lefort thinks, as if to test the disappearance of the hole and the appearance of her image, with its metonymical function. Then she touches Lefort's reflection, very cautiously, fearing that she would be robbed of the real person.

Then she explores the whole building, curiously touching all the objects, which Lefort interprets as a search for finding the consistency of objects. Maybe that's why she asks again to stand in front of the mirror, when she returns, to do the same before - as if the image can only exist against the consistency of the outside world. She can do this quite relaxed, this time she seems to be very much aware of the fact that there are two people.

2/2 : Nadia puts on Lefort's glasses, she lingeringly touches her eyes. She hugs her neck, she hit her and sucks her chin. Then she sits down in front of the dish of tapioca pudding, she licks her spoon, she asks Lefort to lick the spoon, and then she smears herself with tapioca, and a little later she rubs her smeared face against Lefort's face. Again a transition between the surface of the eyes that are touched hesitantly and the surface of the skin, brought together during the smearing. For the first time, she addresses Lefort with a "mama-mama" and not with a ma-ma-ma. In a similar way she explores the wall, the hole of the window and she looks outwards as if enchanted.

3/2 : Nadia cries because Lefort unexpectedly has to leave the room twice briefly when she goes to pick her up. She calms down when Lefort comes back, but when they pass the mirror, she turns away from it. Nadia lost too much when Lefort was absent; she couldn't lose it again in front of the mirror. She eats the pudding with both hands, there was no relief of the metaphorical object by the spoon; then she smears her face, and so she lands on Lefort's lap. Her desperation became violent against the object that represented Lefort, against the bottle.

Later she explores the wall of the room, the floor and the things standing there again to feel the consistency of all the objects. But every time she touches an object, she looks at Lefort.

They return to the mirror, Nadia stays in the arms of Lefort and she looks at both of them, she squeezes her neck, she puts her cheek against Lefort's, and she follows the whole scene in the mirror. Now she can fully accept that reflection, with the experience of the cheeks against each other.

During the next five sessions, the return to the spoon and its metonymic function dominate, although it could easily be transferred to a metaphorical representation - for example, when Nadia tries to replace the spoon in the ark with the doll. Then she goes to the bottle, which she briefly brings to her lips before throwing them down. In these sessions, she also regularly looks through the window, at the outside world.

4/2 : Nadia tears off Lefort’s glasses, for the last time, and touches her eyes, for the last time. The glasses have become a signifier representing Lefort. This is apparent when Nadia places the glasses next to the spoon in the ark. In this way Nadia creates a closed, three-dimensional space for herself, with a bottom she can also feel, the same spatial dimension as the room, which she explores with delight.

9/2 : Nadia is angry; she has heard Lefort speaking to another child she was treating. The violence of the session was directed against Lefort herself this time, Lefort has caused her to be born, and now she had to experience emotions and suffering again.

The jealousy cannot be equated with the situation in the period of the invidia, says Lefort. The invidia only manifested itself within the relationship with Lefort, in her presence, not outside; this was confirmed by the nurses. So in this first image there was a unique Other, not interchangeable, in the real, and another, whoever, was interchangeable. If that other came too close to the Other, or attracted the attention of the Other, there was that typical initial situation where Nadia let herself fall.

In the case of jealousy, the Other is no longer unique, Lefort should no longer be present in reality. That does not mean that Lefort was one of many in a row, because that would have meant a return to the original situation. A relationship was possible, because the Other had acquired a signifying dimension, and was able to connect with other signifiers - such as the glasses and her spoon. The Other had lost its exclusively real dimension, but had gained the opportunity to be represented by other adults.

The other, on the other hand, remained an object that was too much part of the real, and therefore attrackted Nadia’s aggression and destructive violence. This was already the case on 19/1, when she was hitting two children, or later, when she hit the doll. This scenario would not acquire a specular image, she would not look in the mirror when she did it; so it remained a non-reflectable feature placed on the statute of object a. After all, from the beginning the little other had been given the role of object a for the Other.

Jealousy is the question that the subject asks the other, about what the subject himself is to the Other. In the invidia the question was about the object of the Other.

On the way back after the session, Nadia asks to stop in front of the mirror. She put her cheek to Lefort's mouth, looking clearly at the mirror while Lefort kisses her. Then she turns her head and puts her mouth against Lefort's jaw, and imitates the kiss, with great emotion. After expressing the jealousy, at the beginning of the session, Nadia here seems to question whether she is truly the (oral) object of Lefort.

10/2 : At Lefort's suggestion, Nadia held out the ark to her, to put some tapioca in it, but immediately afterwards she empties the contents of the ark onto the floor.

She finds a transparent ball filled with water and three duck, and in vain she tries to take one of them. But just like her reflection in the mirror, her ducks were out of reach.

Then she goes to feel the wall, and the windowpane, being separates her from the outside world. The consultation room became the ball, she placed herself both outside the ball and inside a container, together with Lefort, just as she had just placed them both metonymically in the ark.

On the way back, in front of the mirror, Nadia starts the game of kissing the day before, and she taps excitedly, but not aggressively, on the mirror. It seems to feel more like a kind of feeling, on a surface that also had to do with space.

When looking in the mirror, she notices a nurse she knows. She turns with great interest to see the nurse in reality. She laughs with her discovery, puts her arms around Lefort's neck, and brings her cheek close to Lefort's cheek.

It was here, says Lefort, that the world of images really founded itself, specifically the image of the Other (of Lefort), which lost its unique character by mirroring, by blotting out the real. Until now she could compensate the loss, but when she met that third term in the mirror, by the resort to the real of the body, in this case she could not stick to the body of the Other.

12/2 : On the way back, Nadia plays hide-and-seek with a trainee: she reaches out to her, but when the trainee wants to pick her up, she seeks refuge at Lefort. In the mirror, she is confronted with the image of the three of them, and the game stops immediately, she glues herself to Lefort.

13/2 : On the way back, Nadia looks for the mirror, she leads Lefort to the mirror. There is again the kissing and looking in the mirror while being kissed, Nadia also shakes the mirror, and then she sees the trainee, and she clings to Lefort's neck when the trainee holds out her arms for her. Lefort leaves and after a few minutes she comes back, and she sees Nadia radiant, holding the trainee’s hand. Nadia clings to Lefort, hugs, licks, kisses her, buries her head in her shoulder. Lefort tells her to go back to the trainee, she leans towards her but she looks sad when Lefort leaves.

Nadia accepts to go to the intern, Lefort says, when she is told that she could accept the Other who was the intern. She will actively search to accept her, walking through the room while holding the intern.

15/2: When Nadia stands in front of the mirror, she sees Lefort, herself and the trainee. She laughs with this new image, and she quickly turns around to laugh at the real person. The trainee holds out her arms towards her, but Nadia smiles and clings to Lefort. For a long time she looks at the image of Lefort and the intern in the mirror, and then she comes to give Lefort a kiss, without sucking. In the meantime she can accept the image of the trainee a little better, and just like in the beginning she compares it with the real body. But where Lefort's real body was a refuge, the intern's real body provokes a refusal, one could say that here she chooses the image. It was as if, as far as the dimension of the real of the Other is concerned, only one could be present; the presence of another Other had to be passed through the image. This was solved by the last dimension of the signifier.

Lefort goes back that same evening, because she had heard Nadia crying and she suspected that Nadia had heard her speaking. Nadia sees her and stretches out her arms, Lefort grabs her and the crying stops immediately. In front of the mirror Nadia asks to be kissed, and she kisses Lefort herself, and she looks at their reflection, as if to comfort herself.

Once away from the mirror, Nadia bends down to pick up a spoon, and she puts it in Lefort's mouth - the spoon is no longer just hers, but Lefort's as well. What's more, she takes a second spoon, one for her and one for Lefort. But before she does, she uses her hand to take some of the food that was left on the dish. In this way it became clear that there was a separation between food and spoon. She comes with both spoons in Lefort's arms, and says "cuillère", and she looks proudly at Lefort. From now on, the spoon fell  from the role of signifier, referring to the primordial signifier of the Other; it had simply become an object with use-value. She will actually use it to eat.

16/2: Nadia wants to stand in front of the mirror. She looks at their reflection, she leans her head against Lefort's cheek, and against her mouth. Lefort kisses her, she smiles at her image in the mirror, she turns around to kiss Lefort, after putting her arms around her neck. The third term is no longer a problem; she agrees to go into the nurses' arms when Lefort leaves.

Lefort describes how Nadia's relationship with the objects in the outside world, her curiosity for them, changes over the next two weeks. There is better contact with other adults, and there is clearly jealousy towards the other children.

4. The body, with a hole

The potty, the passage to that other hole

In the period when Nadia is still fully in the ambivalence around orality and the relationship with her mouth and with Lefort, she also discovers another object linked to the surface of the body, when the potty became a new object of interest. In any case, the potty was several times a day a collective ceremony in the institution, so Nadia knew it well.

9/1: Nadia goes to the potty, but she comes back to pick something up and she sits some way away from the potty, and on all fours she goes to look in the potty. Then she goes to pick up the pencil to poke around in the potty and she plunges in it for a long time, several times in a row.

Lefort sees the interest in the potty as a redemption of the interest in the oral hole in the surface of her body and in function of the stopping of an anal opening. Initually there had been a scene where Nadia brought her open mouth close to Lefort's mouth, drooling profusely and making sucking movements. It seemed as if she could stop the oral hole that way, so that there would be no more desire to devour each other in the relationship between Lefort and herself. Lefort had also verbalised this when Nadia was licking, Nadia reacted by slapping her hand and looking frightened.

Nadia treats the potty as something sticking to herself, as a part of her skin. Lefort emphasises the sequence of events : the potty is first the object of the gaze, then she will feel the potty with the pencil, and only then will she plunge in it, as if she needed the pencil, an object taken from the body of Lefort, to stop up that hole in the potty that was also an orifice in her body. Lefort suspects an analogy with the thermometer, as the children's fever was measured twice a day.

13/1: Nadia is very aggressive, especially after hitting the potty with the car. After that, she doesn't dare go near the potty any more. She also shows considerable violence towards Lefort's mouth, she also hits it with the car, and finally she also hits herself before throwing the car away.

14/1: Nadia still throws the biscuits, but far less aggressively. She passes the bottle and tries to go around it, without touching it. There is the usual game with Lefort's glasses, then she picks up a biscuit on the floor and goes to the potty. After going around the potty a few times, she hits it on the edge with a cracker, and then inside it. Then she goes back to Lefort and she wants her to eat a corner of the biscuit, and she takes it out of Lefort's mouth. Then she throws the biscuit down.

Lefort again considers an analogy between the potty and the mouth, since what Nadia repeats with the cracker and potty what she has been doing with the cracker and Lefort's mouth. Lefort tells her what she is doing.

Then Nadia is tense and aggressive; she wants to go on the potty, but she keeps turning around, and then she goes away from it. She goes to the doll (metaphorical object), she treats it badly, and then she takes a piece of paper from Lefort (metonymical subject) and she throws it over her head. At the end of the session, she doesn't know what she wants to do anymore, to get into Lefort's arms, or to get away from Lefort.

Content/container

In the same period, Nadia discovers a Noah’s ark in the consultation room, where she can take things out and put them back in.

17/1: Nadia discovers a litte cup from the doll's tea set, she throws it down, picks it up and examines it. Lefort tells her she can drink from it; Nadia puts the cup to her mouth and sucks it, but she looks at the bottle and throws the cup down. She tries to push over the bottle, but she still doesn’t dare to touch it herself ; she has to do it with other toys. And then there's again the throwing down the cup and picking it up, until she throws it on the floor, picks up the bottle for the first time, she hits it with the cup and she babbles "a-pa, a-pa".

18/1: Nadia goes looking for toys, in the ark she finds a small dish of that tea set. Lefort tells her it's a dish. She has to do some efforts to get it out of the ark (because it got stuck), she sucks on it, she throws it down, and then it goes back and forth to Lefort, as with the cup. This was accompanied by varied and articulate babbling : "a-pa, a-pon, a-té, a-ca".

30/1: Nadia is delighted when she comes to the session. She takes the toys out of the ark, and she can take the dish and the cup. She shows violence only towards things that had to do with food and toward the doll; in the previous sessions she had not systematically thrown around all of the ark's contents, and had been able to put back the objects she took out of it. Even Lefort's glasses were put into it.

So far, Nadia's main focus has to do with the objects she finds in the ark, making them metaphorical or metonymical objects, as seen earlier. Only after the fourth mirror, when Nadia is exploring the room, she discovers that third dimension for the first time, with an inside and an outside, of the room, of her body, that she seems to be interested in the ark itself.

6/2: When the ark is empty, Nadia lifts it with one hand, and she makes sure with the other hand that it is really empty. She looks for Lefort's glasses, she looks for the spoon she put in the ark, she takes it out, she feels the empty bottom, and then she puts the two objects back in. Thus she creates a space in which she constitutes herself, a closed three-dimensional space, with a bottom that she secures for herself by feeling it. This spatial dimension was also the dimension of the space in which they were both located, and Nadia explored it with delight.

9/2: Nadia had an experience of space in the session, when she found a transparent ball, half filled with water and ducks, in the ark. She explored the surface of the ball, and she tried to get hold of one of the ducks. Again, the experience of space prompted her to explore the room, she goes to feel the wall and the windowpane. The consultation room becomes the ball, and in her playing she places herself both outside, with respect to the ball, but also inside, with me, with respect to the room, in the same way she had placed them metonymically inside the ark.

15/2: Nadia discovers a little Russian box in the ark; she sticks her index finger into it and says "ca-ca-ca", then she puts her tongue in it and puts the small box in Lefort's mouth. Thus, for the first time, she indicates the structure of the body, as a container with a hole from mouth to anus.

The first of the containers was the ark, with metonymic objects. She now wants to make another one of the Russian box, she tries to put Lefort's glasses in it, but it doesn't work. So she goes back to the ark.

The potty (bis)

1/3 : Lefort takes Nadia to a new consultation room, Nadia had learned to know this room some days ago. Nadia walks toward the door and she babbles "ca-ca-ca" and "po-po-po". Lefort, knowing that she is now put on the potty twice a day, without any difficulty, tells Nadia that she might want them to go and find a potty. They find a potty and put it near the cradle.

Nadia is delighted, she fingers the potty, she picks it up and puts it back, and Lefort tells her that she is happy because she has a potty to herself and she can do what she wants, without Lefort asking anything of her. Nadia puts her hand inside the potty, she fingers the edges, she takes off Lefort's glasses and she puts them into the potty, and she walks triumphantly with potty and glasses in the corridor, from room to room, just like she did with her spoon. Then she comes into Lefort's arms, and she wants to be stood up in front of the mirror, with the potty in both her hands.

Lefort remarks that it seemed to Nadia to have been a real discovery, that this container that the potty was, had a rim and an interior, as if it had not had a real existence until now, it had only formed part of her body, on the analogy of the breast, the cork for the orifice of her mouth. The potty had corked her anal opening and was part of her skin. Through the mirror she could give this object a licence to exist, giving Nadia another opening for her body. As it had done for her body, the mirror created for the potty an interior, an exterior, a rim, and a bottom, and a lack, which was symbolised by the key of a cupboard that she later on would put in the potty.

Lefort notes that Nadia, in the period from the beginning of March to the end of April, was, as it were, waiting, waiting for the transition from her demand of Lefort, toward a demand of Lefort to Nadia. A transition, also, from orality to anality.

That connection can only come about when the small subject has a sense of his body as a body with an inside and an outside, where that inferior orifice in the body is inscribed in the field of the Other - a hole that goes from mouth to anus. The subject must also experience his body as autonomous concerning the motor activity[47].  Meanwhile, the food was lightened, so that it could gain a dimension of play, with the food as a metonymic object between Lefort and Nadia. Still, it happens that Nadia searches for an metaphoric object adressed to the body of Lefort. Lefort limits this through her interpretations, for instance when she says that Nadia feels abandoned by Lefort (since there had been no session for several days), that she therefore doesn’t want to ask her to eat. Nadia understands this, because immediately afterwards she asks to be fed, or tries to feed Lefort. There is another regression when she asks Lefort for the bottle again, several times. But the bottle no longer has the value of a physical object, because other objects have taken over: her fingers, one of Lefort's fingers. The bottle still gives her the pleasure of sucking, but lacks the metaphorical effect. In that sense, it has become only a container of milk. Nadia also wants to suck Lefort's finger, to which Lefort interprets that it is only a finger, not her mother. Nadia doesn’t accept this limit, interpretation, but Lefort keeps repeating it. Lefort sees it as a kind of denial of the castration, which was short-circuited by Lefort's interpretation of her own lack and her refusal to return to the metaphor.

Early April, the failure to fill her lack by means of a metaphorical body-object led Nadia to approach the anal pole of her body. In March, the potty was present in the session, but there was a kind of inhibition in questioning the metaphorical objects that traditionally are being  connected with the anal pole: the potty, the sand, the boxes.

17/3: Nadia sucks on a small train, and she looks at the dish. Lefort interprets her inhibition : Nadia believes that Lefort has withdrawn her food because she has not taken her to the session the last two times. Then Nadia opens her mouth, first eating from Lefort's spoon, then with her hand, and then again with the spoon.

At first she ignores the potty, then she stops in front of it and fart audibly a few times, and she leaves again. Then she squats at some distance from the potty, but not on it. Lefort tells her that she longs to give her a present, but that she is not happy with Lefort that day. And that it is only possible to give what one is sure what it is properly one's own, that playing with the potty assured her that Lefort recognised her property and her independence. Nadia is feeling much better when she goes back to her room.

Similar scenarios occur over the next few days. On 29/3, there is a clear connection between the bottle (she knocks over the bottle) and the potty (immediately after that she is aggressive towards the potty). Nadia discovers the same problems she had with the food when she is confronted with the potty. Everything that was debated, resolved in the analysis, with respect to the bottle, was reactivated in connection with the potty. Lefort supposes that every time Nadia encounters an object that is important in relation to the world, she is confronted with the same ambivalence, also in relation to the Other.

In April, Nadia was very interested in boxes, not only because of their three dimensions (inside, outside, bottom or side), but also because of the decanting of objects they made possible, making container with a contents, transferring this content from one box to another.

6/4: Nadia discovers a cracker box, she turns it over, she fingered the bottom with great interest. She puts a rubber bird in it, she tries to pull out the paper lining the box and plays with it, she shakes it, she puts an object in the paper and she takes it out again.

8/4: Nadia notices that Lefort puts her biscuit and her sugar in a box, and she goes to put a small bowl in her cradle. She tries to get two small wooden animals out of the bowl, puts them back, and repeats this. She plays with the contents of two nested boxes for a long time.

9/4: Nadia discovers the crackers in the box on the floor, she takes them out of the box and puts them back in. Lefort notices that her diaper is dirty and tells her that she will get another one and come back. This had happened the day before, for the first time, and Nadia was very happy.

It is not the first time that Nadia has a dirty diaper during the session, but it was previously excluded that Lefort would concern herself with this from her place as Other, because this defecation was just about excluding something from the real. Now it was about a different context; it was not about a part of her body, but a question of a container and a content that could be exchanged. It was about the inside of the body as a container, which cannot be destroyed by the loss of its content. Lefort was now the Other of the anal object. In het beginning, Nadia wanted Lefort to change her dirty diaper, later on a wet diaper, and finally, on 19 April, she would even ask for a clean diaper, "for nothing",  for the pleasure of it.

During that session of 9 April, Nadia articulates this changing on the anal and on the oral level, when she tries to unwrap a piece of candy, and she says "caca". Before, she sucked on it, and had also asked Lefort to suck on it. Finally, she puts a piece of candy in the potty. The oral object had become the anal object, without losing its former nature. In this way, a connection was made between the two openings of her body, the mouth and the anus. Unwrapping the sugar stands for the unveiling of the hole, while changing stands for unveiling and blocking of that hole by the diaper.

23/4: Nadia eats two spoonfuls of pudding, then she says "no" and Lefort puts the spoon down. After an interlude with the thumb, Nadia goes to take some candy. She gets on Lefort's lap, and she sucks herself on the sugar or she asks Lefort to suck on it. For Lefort, there is no question anymore of a metaphorical substitute for the object of the body, of sucking a finger, or even her own thumb (because just before Nadia had made the movement to her own thumb but dropped it again), but rather a metonymical object between Nadia and Lefort, and Nadia for the first time questioning Lefort's oral desire, analogous to her own. She thus marks the Other as having a deficit. The same game of the lacking object will be repeated with the beads, accompanied by an energetic "caca". She discovers a mug of beads, she takes the beads out of the mug, she puts them back, she scatters some of them on the floor, she is delighted when Lefort puts those beads back. At the end she holds some beads between her fingers, she makes Lefort hold out her hand, she pretends to give those beads and then she puts them back in the mug, laughing. Before she played the same game with the cracker, but then it was about a lack on the body, looking for the object on Lefort's body. Now it was the laughter that brought them together, Lefort says, after the latter had lost her real body in the mirror. We see it again shows when Nadia, in the same session, takes a picture book and lingers on the image of the cat, an animal she really knows, and caresses the image with a smile. It indicates that the real of the cat has become an image, that there has been a loss somewhere, just as there was a loss for Lefort. Nadia was not interested in the image of the dog, because she had never seen a real dog.

The lower orifice of her body could only be constituted in one way, by the inscription of the orifice into the field of the Other ; she had only the previous reference of the upper orifice to guide her. The first orifice had to go through all the vicissitudes of transitivism to establish itself, until it found its status in the mirror. The lower hole of the bodily cavity could establish itself on bases already acquired through the confrontation of images in the mirror. The Ream had already been sent away from the hole. There remained a metaphorical object and the attempt to block it, Lefort's finger as an imaginary phallus, but Lefort stopped this through her interpretation. Nadia would eventually reintroduce the dialectic of inscribing the opening into the field of the Other through a metonymic object, the piece of candy, which could form a connection between the upper oral hole and the lower anal hole.

25/4: Nadia plays the game with the beads again, and incessantly she babbles "ca-ca". Then she picks up the little train, which she puts in the potty, and then she turns the potty over and the train falls out. Lefort then realises that she has soiled her diaper, and tells her so. Nadia is very violent, she scatters the beads around, and then she puts the train in the crib, she takes the doll, she picks it up by its diaper, and then she gets on Lefort's lap. After an exchange of crackers, she picks up a clean diaper and holds it in front of her, so that Lefort can change her.

The anal object is alternately represented by the beads and by the small train, but it is noticeable that she puts the beads in a mug, so in an oral container. The game is still very much connected to her body, because Nadia defecates herself at the same time as she is becoming violent and scatters the beads around herself. At that moment there was a momentary failure of exchange, which showed itself when she became anxious when she put the train into the cradle and she took the baby doll out, by the diaper, and she was clearly hooked into a succession of metaphorical equivalents: excrement, train, doll. It was probably the return of the repressed that frightened her: the excrement in her diaper was returned to the dimension of smearing her body, at the moment the body was only a surface.

In the following sessions, Nadia finds her way back to Lefort, through the game with the candy, through the exchange with the train. However, she refuses to give the beads to Lefort, to make them an object of exchange. The beads are mainly used to express her anger, when she throws them around and urinates in her nappy while standing up. She does not cooperate when Lefort changes her diaper. Lefort interprets it as anger because she is not always there, and Nadia therefore does not want to give anything anymore. But even when Nadia allows Lefort to take off her nappy, she doesn't cooperate changing it.

7/5: Nadia eats a few spoons, and then she wants Lefort to take off her nappy. But she makes it very clear that she does not want to have a clean nappy put on. Lefort does it anyway, and Nadia urinates a few times, out of resentment, she scatters beads around and she walks on them.

8/5: The session starts the same way, but now Lefort does not put a clean diaper on her; she has finally understood, she says. Without a nappy, the excrement can take on the value of a gift, a gift that can be freely given or being refused to give, as Lefort does not have to take it off. So Lefort shows her that she has a diaper on her lap, and that Nadia can choose what to do with it. Nadia spins around in the room, delighted with her bare bottom. She looks at the diaper on Lefort's knees, and discontentedly,  she goes off to scatter the beads, and urinates on the floor. She starts playing with the beads, saying "potty-caca", and then she stands in front of Lefort, looking at the potty, looking at Lefort. She wants Lefort to put her on the potty, and as soon as Lefort has done so, she gives a radiant smile. She moves so that she can play with the beads, and the moment she defecates she gives Lefort one of the beads. She moves closer to Lefort so that she can help her off the potty, and then, sitting at Lefort's feet, she begins to play the game with the train. When she gets back up to bring the book, Lefort puts a clean diaper on her, trying to make clear to Nadia that she has understood that Nadia has given her something, and that Lefort's changing of the diaper is now no longer a refusal of the gift. In this way, Nadia was also able to link the Real and the signifier.

5. Language

On 5 December, Nadia looks at Lefort and for the first time she says "ma-ma-ma", joyfully. But, says Lefort, it could just as well have been "pa-pa"; so this hasn’t yet to do with the meaning of the words, it is more a word that indicates a kind of expectation[48], beyond that significant Other. 

This does not mean, however, that it was Nadia's first encounter with the language. Indeed, Lefort describes how she, from the first meeting, on 8 October, spoke to Nadia - to which Nadia immediately responded, she laughed. In contrast to being fed, being spoken to was clearly a pleasant experience - what, according to Aulagnier, is a good basis for acquiring the language. From 24 October onwards, Nadia started babbling herself.

There was already playing with sound. In November, Lefort notes that Nadia uses the car mainly to hit it, to make noise and to be heard, unlike the chicken she used to approach the bottle. From 30 November onwards, there is a development of the combination between looking and being heard, when, for example, Nadia bangs the car against Lefort's chair and looks at her when she’s doing it. The sound is clearly directed at Lefort, and being heard, via the toy car, is also meant to express Nadia's aggression towards Lefort.

More and more, the babbling becomes meaningful babbling; at least, that's how it's interpreted by Lefort.

12/12: Nadia throws away the cracker she is holding, she makes a gesture as if she wants to hit Lefort, and she babbles in a guttural fashion while making movements of denial with her head.

14/12: Lefort goes to pick up Nadia and take her in her arms, Nadia sighs contentedly, and babbles joyfully. Later in the session, Lefort lets her bounce on her lap again, while Nadia babbles happily "mama-ma and "da-da-da".

15/12: Nadia sits on Lefort's lap, there is a lot of motor activity but also a strongly articulated babbling, especially "ma-ma-ma", while looking at her or while touching the buttons of her white coat. A little later, she pushes her away twice with her arms, shaking her head and almost saying "no-no".

17/12: A similar scenario: first, the cracker is used to make noise, then Nadia goes to inspect the buttons of Lefort's coat and she babbles "mama", not "mama-ma".

22/12: Nadia explores the space, and halfway through she stops to look at Lefort and she babbles with a certain amount of articulation and modulation, she seems to be explaining something.

29/12: Nadia is relaxed, Lefort hums softly. Nadia looks at her intensely, and when Lefort stops she answers, Lefort says, very articulate, slow, modulated, pregnant, like language.

2/1: Nadia does not go to Lefort, she goes in the opposite direction, she smiles and she says "no, no" once; she babbles continuously and in such an articulate way that Lefort thinks she will soon start talking.

9/1: Nadia comes to Lefort, she hugs her, she smiles tenderly, and she babbles almost in a kind of song.

13/1: Nadia walks from one crib to another, babbling as if she is hurling insults.

16/1: The emotional tone of the session is dominated by an overwhelming desire to be cuddled and by a negativism that forces Nadia to push Lefort away as soon as she has let herself go a little. She doesn't babble at all.

18/1: Nadia comes into Lefort's arms, she brings a toy dish, she throws it, goes to pick it up again, accompanied by varied and articulate babbling: "a-pa, a-pou, a-té, a-da, a-ca". At that moment, says Lefort, the signifier is for the first time enriched by the dimension of the signified: when the syllables are doubled, there comes "papa, tété, caca" and the "pou" is related to "poum", which for her meant "falling".

19/1: Nadia turns her attention to a piece of cloth she's trying to tear up, she stops and she babbles "a-ga, a-poum", like when something falls.

29/1: Nadia has a spoon in her hand, she hits the dish with the spoon, she babbles furiously, and then plaintively when she fails to put the dish back in the right place.

Lefort speaks to her, about her desire to get food from Lefort, and about the aggression because that desire makes her angry, because in the past she was always disappointed by getting food. That Nadia knew that Lefort would not force her to eat, that she would like to be forced, but that it would hurt her. And as she says that, Nadia enacts what Lefort is saying, in the same order. She takes a cup and she holds it out to Lefort, anxiously waiting for a reaction. Lefort puts some food in it, Nadia climbs onto her lap, looking tense. Lefort offers her the cup, Nadia dips her fingers into the cup, she licks her fingers and she becomes even more anxious. Her face lits up when Lefort tells her that Nadia knows why she is not being fed by Lefort; because Nadia cannot accept it, because she still wants to express her violence towards that food, which she used to be forced to take without having anyone to love. Nadia beams and she licks her chin. And Lefort responds that Nadia in fact wants to eat Lefort.

5/2: Meanwhile, the whole evolution around the mirror takes place. Lefort describes here how Nadia wants to come into her arms, she presses herself against Lefort while saying "mama-mama", and then she goes to the crib, plays with a spatula, she holds that spatula out in front of Lefort, and she says "Here!" Then she leaves to explore the wall and window, babbling.

12/2: In the session, Nadia takes a piece of cloth out of the toy ark and she babbles "pa-pa-pa", for the first time. So far, all her sounds started with an "a" - "a-pa, a-ga, a-pul, a-ca, a-da" - with exception of ma-ma-ma. "Between 12 and 16 February Nadia performed a veritable working-through in order to situate the Other as a third term. Her first means, says Lefort, was a signifier she uttered for the first time and that designates the third term for any child: "pa-pa-pa".   

15/2: Nadia finds a small Russian box, she walks around with it, and she babbles a lot, articulating different syllables, especially "a-poum-ca-da", joined together as if they were a word. On Lefort's lap, she plays with the little box, puts her finger in, stirs and says "ca-ca-ca" (in anticipation of the potty), she also puts her tongue in.

After the meal, she is in Lefort's arms, they sit in front of the mirror. Nadia takes a spoon and puts it into Lefort's mouth, a little later she brings two spoons. Lefort pronounces the words and Nadia repeats "cuillère" for the first time, looking proudly at Lefort. With this, the spoon was no longer a signifier that Nadia referred to the primordial signifier of the Other; it had become an ordinary object.

16/2: Nadia plays with throwing the spoon, and she picks it up again. She babbles joyfully, laughing, and with a teasing expression, "ca-da, a-poum ca-da!"

When she has finished eating, she throws the dish on the floor, and stands with both feet on the upside-down dish. She stamps on the dish each foot in turn, with the attitude, expression and babbling of someone who has taken possession of something she very much wants.

1/3: Nadia walks to the door and she babbles "ca-ca-ca" and "po-po-po". Lefort tells Nadia that she might want them to go find for the potty together. This is a turning point, Lefort says, on that day Nadia was almost speaking.

 17/3 : Nadia goes back and forth between the landing and the room, and she says "caca... potty... potty... mama... mama!"

6. The farewell

14/5: Nadia asks for a spoonful of stewed fruit, then a second, and then she turns her head away. Lefort smiles because Nadia manages to put her in the position of a mother to whom one asks something in order to be able to refuse it. The same thing happened with the potty: the first time, Nadia had asked Lefort's help, but since then she sat on it of her own, she remained on it throughout the session, but nothing came, nor did she ask for her diaper to be changed.

On 16 May, for the first time in her life, Nadia sits alone outside, in the garden. Two days later, Lefort sees her playing with her shadow through the window, joyful because she sees how the shadow changes shape, when she changes position. Nadia seems happy in the garden, looking for the company of the older children. She now is going to a nursery and she seems very involved there. On 27 May she is so absorbed in her play that she is reluctant to come to the session, and during the session she shows much more engagement with the outside world and with the street.

In this period she goes to the nursery, where she has to adapt to a different rhythm of life, and to other children who are all older, but who also attract her. This adaptation requires a lot of energy, she is exhausted during the sessions.

It is not until 20 June that Nadia can be joyful again during the sessions, when she laughingly does the things she used to do, taking out the pieces of candy, putting beads in a mug, giving the mug to Lefort and then tipping the mug over and laughing very hard. The unconscious, the death drive, was there, Lefort says, but only in that wink Lefort got, which made them both laugh, without having to say much about it.

3/7: Nadia sees the baby doll in the crib, she looks at Lefort and she knocks it over. She climbs onto Lefort's lap, and she asks for the bottle. Nadia opens her mouth, Lefort gives her the bottle, at first there is a happy expression, but then Lefort sees how Nadia is tense and how she pushes the bottle away. However, that is because someone forgot to make a hole in the nipple. Nadia angrily throws the bottle on the floor, Lefort interprets everything for her but she no longer wants to drink from the bottle, but from a mug. And then she can enjoy drinking.

Then Nadia discovers the baby doll on the floor, she picks it up, she holds it by the diaper, and she throws it away. She lies down in the crib by herself so that Lefort can pick her up. It seems as if she wants to take the place of the doll. But she smiles and feels comfortable with it, apparently no longer affected by the image of the little other that had fascinated her. Lefort interprets that the libido that had attached to the other and caused her despair had been siphoned off by the ego, which no longer holds the drive and therefore also desexualises the external reality.

Here the transference became exhausted.

The unconscious is necessary for the subject no longer to be prey to the Real. The relationship to the Other was at first too massive for Nadia, but eventually Lefort became for her the place of lack, of castration, the symbolic dimension. Her ego, a mirror construction, could not include Lefort, and so she could detach herself from Lefort, or let Lefort fall.

On 15 July, Lefort tells Nadia that she will not be present for three weeks. In August it appears that Nadia was doing well, was active, could walk and dance and climb on chairs, and never got angry. She no longer had diarrhoea or an ear infection. After holiday, there were a few more sessions. Nadia had grown and changed considerably, was also more stable in posture.

On 5 September, there is no sound or movement except for sucking on the sugar. At first, Nadia would not look at her, and then her eyes would not let go of Lefort's face, a deep look, but it seemed as if she did not recognise Lefort. There was no interest in the objects in the consultation room, but she remains relaxed in Lefort's arms, and that shows the confidence she has. At the same time, there is that look that says that Lefort had abandoned her, and therefore there was no joy when she saw her again. A few days later the smile did come. Lefort speaks to her at length about her resentment of that absence, and Nadia is wonderful in response. The great emotions are finally expressed by a terrible attack of diarrhoea. There is another attack a few days later, but that will be the last time.

The next time Nadia gives Lefort a bead, without the diarrhoea, she looks outside and says "dada". In this way, she puts an end to the treatment, and Lefort agrees. Nadia becomes attached to one of the nurses of the nursery, and is able to invest in life there. Every now and then Lefort sees her in the institution, Nadia comes to ask for a kiss, and then she goes back.

Conclusion

It has been quite a task to go through this work, as the wealth of details stands in the way of an overview. Therefore, the overview can only be incomplete. Furthermore it  was difficult because many aspects of this work seem to refer to other authors, with always the question of comparison with their views.

I am thinking of Winnicott, with the transitional object. Lefort explicitly states, at one point, that she is not talking about a transitional object, but still one could ask whether specifically the metonymic object, as she describes it, could not be compared to the definition of the transitional object.

The situation of mutual inclusion is described by Sami Ali, as well as the emergence of depth when the latter author refers to the famous Ford-da scene and the play of Freud's grandson.

Sami Ali studied how the imaginary space is created by analogy with the body image, of which we had examples here.

The mirror stage and its different dimensions are discussed by several authors; I referred to Lacan, Aulagnier, Dolto and Nasio.

The transition from the first situation of invidia, with a structure of the fantasy as described by Aulagnier, but with a clear indication of the importance of a rooting in the pictographic.

The transition from the fantasy to language, with Aulagnier - the transition from the primary to the secondary, from the lust principle to the reality principle.

All these aspects seem to be touched upon here, yet introduce nuances that require further processing and discussion. Could it be otherwise? This is a story about experiences that can hardly be captured in language, and each author contributes with their own emphasis. But just as language creates meaning by relating signifiers to each other, the juxtaposition of these different readings of archaic experience can only enrich our clinical work. 

[1] Berger, F. Naissance du sujet et structure de la psychose. In  Cahiers de psychologie clinique 2007/2 (n° 29), p. 51-70

[2] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 35

[3] Taccoen contrasts the three concepts, continuing on from Lacan's teaching. Need has to do with a biological need, needed to survive. Those who want to live are hungry and in need of food. A demand adds the intersubjective dimension: a question is asked to someone. This demand may be related to a concrete need, but the dimension of desire is added, with pleasure as the imaginary end point. Imaginary, because it is only by forsaking total pleasure that a desire can arise.

Taccoen, L. Gehoorzaamheid en perversie. Antwerpen/Apeldoorn, Garant, 2005, p. 106-107.

[4] The meaning of the Other can, I think, be discussed. At this stage I would rather think of the following description (in translation), where this Other is placed in a similar context: "In the satisfaction of needs, man is dependent on the other, a linguistic relationship arises. In order to achieve satisfaction, one must use words that are intelligible to the others. Regardless of whether or not the object can be obtained, the other person's answer becomes especially important. Here the question exceeds the satisfaction of needs and becomes a question for the Other. The Other is then written with a capital letter because he is elevated to the status of someone who gains power over the subject who asks him a question. This is where the transition to the register of desire takes place. A question that is linked to words from a question of need satisfaction takes on a different meaning: need satisfaction becomes less important and gives way to a question of love, of recognition".

Dolto, F. Kinderen aan het woord. Nijmegen, Sun, 1998, p. 54.

[5] Miller refers to Aulagnier : “… an “expectation” of the object that possesses an ability to excite and a “need” of information that explains that the activation of the various sense zones has the property of bein accompanied by what I call erogenous pleasure”. Hij voegt eraan toe : “The quality of the primary object’s response to that expectation – the object that possesses the ability to excite – is decisive for the awakening for the potentialities for mental development that require the satisfaction of that need for sensory information and the pleasure to which it gives rise.”

Miller, P. Driving soma. London, Karnac, 2014, p. 140.

[6] Berger, F. Naissance du sujet et structure de la psychose. In Cahiers de psychologie clinique 2007/2 (n° 29), p. 62.

[7] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 36

[8] Het Latijnse “invidia” komt terug in het Franse “envie”, wat het verlangen oproept, maar ook in het Latijnse “invidere” wat de nadruk legt op het vijandig kijken.
Baïetto, M.C. L’envie et l’accès à l’objet. In : Analyse freudienne presse, 12/2006, p.74-82.

[9] http://staferla.free.fr/S11/S11%20FONDEMENTS.pdf, p. 62

[10] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 9

[11] O’Loughlin, M. The emergence of the speaking subject : child therapy and the subject of desire. In : Essays from cradle to crouch, p. 371.

[12] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 24

[13] Crommar describes how a baby, just after birth, has an experience of falling apart. "After all, the narrow uterine wall is no longer pressing on him. He has the feeling of disintegrating, his body falls "open". (...) In the first few months, he will often relive this feeling and it will always be accompanied by fear and therefore crying. (…)" (translated) And further: "If the baby is placed on the mother's belly, in no time he will very intensely look at her. With this, he prints the blueprint of her face into his brain. For him, her face is the most important beacon to cling on during the first few months". Is that why Nadia was so conspicuously looking for someone to meet her gaze?

Crommar, Claudine. Nieuw boek voor vaders. Antwerpen/Apeldoorn, Garant, 2018, p. 61 - 62.

[14] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 16

[15] Ibidem, p. 14

[16] Ibidem, p. 17

[17] “Ich würde gern mit allem Nachdruck die buchstäbliche Seite der psychoanalytischen Entdeckung festhalten, dass die Herstellung eines Lochs Seinsbedingung ist. (…) Um zu sein, muss man Löcher machen, denn es gibt keinen Geburstkanal, solange es kein Baby mit der Fähigkeit gibt, sich seinen Weg dadurch zullen bahnen. (…) …stellen wir fest, dass die nachhaligsten und regelmässigsten Aktivitäten des ersten Lebensjahrs mit der Herstellung von Löchern zu tun haben, und zwar nicht irgendwo, sondern mit Vorliebe am Körper des am Ursprung – also in der mütterlichen Postition – stehender Anderen”.
Rodulfo, R. Die lange Geburt des Subjects. Giessen, Psychosozial Verlag, 2004, p. 118.

[18] “What does the baby see when he or she is looking at the mother’s face ? I am suggesting that, ordinarily, what the baby sees is himself or herself”.
Winnicott, D.W. Playing and Reality. London/New York, Routledge, 2005, p. 151.

[19] Sami Ali based his theory on his analytical experience with psychosis and with children with psychomotor retardation, and more generally with the therapy with children and adults.

[20] Sami-Ali. Corps réel. Corps imaginaire. Paris, Dunod, 1984 , p. 121

[21] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p.17

[22] Ibidem, p. 15

[23] Ibidem, p. 23

[24] Ibidem, p. 22

[25] Ibidem, p. 36

[26] Ibidem, p. 38

[27] Ibidem, p. 44

[28] “Un “bruit” et non pas un enoncé porteur de signification, une odeur non définissable, une proprioception concernant l’interieur du corps propre, ont fait brusquement irruption dans l’espace psychique, l’ont totalement envahi : le sujet n’est plus, ne peut plus être, n’a plus été, que cette fonction percevante (audition, olfactive, proprioceptive) indissociablement liée au perçu : le sujet est ce bruit, cette odeur, cette sensation et il est conjointement ce fragment et ce seul fragment du corps sensoriel mobilisé, stimulé, par le perçu. (…)  Tout se concentre sur une zone, mieux, sur un point sensoriel qui devient le représentant métonymique de tutes les zones et de toutes leurs fonctions, de même que le “perçu” auto-engendré par la psyché (halluciné) devient le répresentant métonymique des objets du monde. Nous assistons à une mise hors circuit de la représentation ideique et de la représentation fantasmatique, au profit de la représentation pictographique d’un objet-zone complémentaire”.

Aulagnier, P. Un interprète en quête de sens. Paris, Payot, 1991, p. 395

[29] Sami Ali makes use of a similar concept, mutual inclusion, in a slightly different way. He distinguishes :

- the specular space of three dimensions, a system of three-dimensional coordination in which the relations are symmetrical but not reversible, where a here and there can be defined, and a left and a right.

- A more archaic structure of a flat surface, regulated by reciprocal relations of inclusion. The third dimension is missing, everything is simultaneously inside and outside, content and container.

The author will situate these two different spatial forms in the evolution of the relationship between mother and child, just as Lefort does in this case study.

Sami Ali …. (aanvullen)

[30] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 43.

[31] Ibidem, p. 36.

[32] In this case it appears to be a very rudimentary separation, as Lefort herself says, without a third dimension, but mediated by the object.

[33] “… l’exigence, pour le phantasmant, de poser dans la scénario qu’il contemple deux objets et, à l’extérieur de la scène, un troisième représenté par le regard qui la contemple. (…) La nécessité de poser à l’extérieur de la scène un regard, supposé éprouver du plaisir, ou du déplaisir, est la conséquence du postulat selon lequel fonctionne le primaire”
Aulagnier, P. La violence de l’interpretation. Paris, PUF, 2017 , p. 87  

[34] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 66

[35] Ibidem, p. 68

[36] Ibidem, p. 67

[37] Ibidem, p. 71

[38] Ibidem, p. 112.

[39] Ibidem, p. 87.

[40] In English translated as “ideational representative” : “We have reason to assume that there is a primal repression, a first phase of repression, which consists in the psychical (ideational) representative of the instinct being denied entrance into the conscious. With this fixation is established; the representative in question persists unaltered from then onwards and the instinct remains attached to it. This is due to the properties of unconscious processes of which we shall speak later”.
Strachey, J. Standard Edition of the Complete Psychological Works of Sigmund Freud by Sigmund Freud, p. 2979

[41] “L’assomption jubilatoire de son image spéculaire par l’être encore plongé dans l’impuissance motrice et la dépendance du nourrissage qu’est le petit homme à ce stade infans, nous paraîtra dès lors manifester en une situation exemplaire la matrice symbolique où le je se précipite en une forme primordiale, avant qu’il ne s’objective dans la dialectique de l’identification à l’autre et que le langage ne lui restitue dans l’universel sa fonction de sujet”.
Lacan, J. Le stade du miroir comme formateur de la fonction du Je. In : Ecrits I. Paris, Seuil, 1999, p. 93.

[42] “L’assomption jubilatoire” acquiert alors une triple signification : elle est achèvement de la coupure primordiale du dedans et du dehors ; elle est dépassement de l’inquiétante étrangeté primitivement liée à la perception du double ; elle est confirmation du primat absolu de cette même perception”.
Sami-Ali. Corps réel. Corps imaginaire. Pour une épistémologie psychanalytique. Paris, Dunod, 1984, p. 150.

[43] “Mais la notion d’individuation propre à ce narcissime premoïque, réferée pour chacun aux limites de la peau, dans sa réalité cohésive, tactile et visible, découle d’une autre expérience, celle du miroir. Cette expérience de l’image qu’il voit dans le miroir, quand il l’intuitionne comme sienne, met brusquement le sujet aux prises avec une plus-value des pulsions scopiques qui ne va pas de soi et qui s’affronte aux valeurs d’echange comme aux valeurs narcissiques des autres pulsions : olfactives, auditives, tactiles”. (…) La vue de son image dans le miroir impose à l’enfant la révélation que son corps est une petite masse à côté de tant d’autre masses de différentes dimensions et surtout de la grande masse des adultes. (…) Il y a ceci encore de nouveau : la découverte d’un visage et d’un corps inséparables dorénavant l’un de l’autre. L’enfant ne peut donc plus, dans la réalité, à partir de l’expérience scopique partagée avec autrui, se confondre (…) aec le père, ni avec la mère, ni avec un ainé, (…) avec les fantasmes narcissiques qui le portaient à s’imaginer tel qu’il désirait être : car l’enfant imagine facilement étant un autobus, un avion, un train, un cheval, un oiseau …. (…) Dans ces jeux imaginaires où il aime à fantasmer une autre identité, apprait dans son parler le “conditionnel” : “Je serais …
Dolto, F. L’image inconscient du corps. Paris, Seuil, 1984, p. 150-154.

[44] Lefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 109-110.

[45] Ibidem, p. 117.

[46] I think this is an example of the projection of one's own body image into space, which is described at length by Sami Ali ; the mirror, he says, puts an end to this disquieting strangeness when the double - in this case the space as the double of the mouth - is perceived.
Sami Ali , …

[47] In this respect, Nadia had undergone quite an evolution since 12 December. In that initial period, it was especially important that she could move without inhibition, translating emotions into action - as opposed to the clumsy and automatic movements of the beginning of the treatment. In the period of December and January there was an evolution to standing up and walking, where Nadia could intensely enjoy the activity of her legs - but always keeping contact with Lefort's gaze. From 31/12 onwards she has been wearing shoes. This immediately became an object of exchange between her and Lefort, when Lefort put on her shoes and socks in the morning before she went to the session. 

[48] “…she showed that it was not me who was at stake, in the form of some mother substitute, but a beyond. In other words, beyond the signification of “mama” there was an irreducible signifying function.”

ILefort, R. Birth of the other. Urbana/Chicago, University of Illinois Press, 1994, p. 48.