The term Verwerfung is used in ‘The Neuro-Psychoses of Defence’ (1894), although Freud does not exploit the idea in 1894. He won’t have an interesting case of psychosis until 1896. This case will also be explained entirely by the concept of repression. We shall see that Freud does not find it easy to give up his notion of repression. It is the cornerstone of his system.
In ‘The Neuro-Psychoses of Defence’ Freud formulates a relation between the ego and an intolerable idea.  It’s a relation of defence in which if the ego rejects (verwirft) the idea, the result is a psychosis. It looks like a quick road to madness rather than a defence. Having an intolerable idea is not necessarily the road to madness. Having an intolerable idea imposed on one from without in a constant fashion is more like something becoming of a psychotic phenomenon. The intolerable idea is a signifier + enjoyment: S + J, J for jouissance, the French term. With the intolerable idea Freud is introducing the economic point of view without saying so because he hasn’t formulated his metapsychology yet. There is always an economy of enjoyment. To say, however, that a certain economy of enjoyment took the subject beyond the limits into the field of psychosis doesn’t tell us much about the aetiology. It’s up to the subject to decide on the economy of enjoyment that led him to foreclosure, not up to the ego since the latter is able to decide only on the image. The signifier is foreclosed by the subject.
The opposite decision would have led the subject to accept this relation, to accept the unacceptable. Presumably, then, no psychosis would have triggered. Lacan uses Freud’s original term to name this situation of consent: Bejahung. When the subject consents to the S + J, the signifier is not foreclosed. But if he forecloses it, he behaves as if the idea or signifier never occurred to it at all, and from that moment the subject is in a psychosis, according to Freud.  If it’s aetiology we are looking for, one would want to understand why one subject decides on foreclosure and another subject consents to the signifier under similar conditions. In fact Lacan passes the responsibility to being: the unfathomable decision of being. I understand this as aetiology being an obscure decision of the subject.
The subject behaves as if the foreclosed signifier never occurred to him/her at all, says Freud.  He does not remark on the subject’s relation to the unconscious following the foreclosure. The signifier in question is not rejected into the unconscious. As a result of foreclosure, there are no representations of it in the unconscious. Under conditions of repression representations are inscribed in the unconscious. The analyst who wants to work with Freud’s thesis supposes that the inscription of these representations indicates that the concept of repression is in play and not that of Verwerfung. The effect of Verwerfung is a hole in the subject’s unconscious. Indeed, history has a hole in it as well since the unconscious is a repressed part of the subject’s history. A foreclosure means that the cluster of psychical representations involving the questionable signifier is wiped out of the individual’s subjective world and not reinscribed elsewhere. The subject no longer has a relation to the foreclosed signifier, but it cannot avoid its effects.
The ego, says Freud, breaks away from the intolerable idea which is an idea in reality, where reality is taken as ‘outside’. There is something intolerable in the subject’s reality from which the ego must free itself. The conclusion is that the ego by breaking away from the idea is breaking away from the reality to which it is attached.  Everyone’s definition of the madman that he is detached from reality re-emerges here. The reader’s attention is deflected from the notion of Verwerfung to the conclusion: the madman is not in touch with reality.
The foreclosed signifier is outside in the sense of being outside the individual’s subjective world, not outside in reality. This outside is a psychotic phenomenon Lacan calls the real. The incompatible idea with its charge of unbearable enjoyment has traumatic effects which are real and not reality. Enjoyment is in the real. A subject enjoying a trauma enjoys it in the real. However, a trauma is not always unassimilable to the subjective world.  The foreclosed signifier does not disappear. It continues to have a presence no longer in the symbolic but in the real. Foreclosure does not, in fact, get rid of the idea. An idea having suffered Verwerfung has changed its status from symbolic to real. The subject has to bear the persecutory effects of this real, as though it were outside.
‘The Neuro-Psychoses of Defence’ (1894) is a commentary on hysteria and obsessional neurosis. There is hardly anything on psychosis. Verwerfung is presented as a hypothesis. It is, says Freud, the most energetic and successful kind of defence.  Is it a defence? From the moment of foreclosure the subject is facing the real with no defence. Having foreclosed the signifier, no discourse can be placed between the subject and the real. His report on a case of chronic paranoia in ‘Further Remarks on the Neuro-Psychoses of Defence’ (1896) is explained by his burgeoning notion of repression and not by Verwerfung. Freud thinks that to reject an intolerable idea is a mode of defence. It would be a mode of defence but one which doesn’t really get rid of the incompatible idea. It could be said that in using foreclosure the subject aims at defence and gets worse: the idea returns in the real. The subject is in a psychosis.  In paranoia, says Freud, no defence can avail against the returning symptoms to which belief is attached.  On the one hand, according to Freud, Verwerfung is a defence, on the other hand, there is no defence in paranoia.
In ‘Further Remarks on the Neuro-Psychoses of Defence’ Freud upholds the thesis of ‘psychosis of defence’. He is not using his new invention of Verwerfung as the principle of psychosis. The three forms of repression in the above writing are repression by conversion into somatic innervations in hysteria and repression by substitution and displacement in obsessional neurosis.  For paranoia one finds repression by the return of the repressed and repression by projection.  It won’t be till he meditates on the Schreber autobiography and writes up the fruits of that meditation in 1911 that he realises the concept of projection fails to explain the structure of paranoia.
He focuses on the use of repression in psychosis and reports on a case of chronic paranoia that would demonstrate the thesis. He does this to a point that one thinks that, really, Frau P., his patient, is a hysteric. Freud himself says that in the analysis she behaved like a hysterical patient.  He also remarks that her intelligence was undiminished, that is, she was not deteriorating socially and intellectually as she might, were it a case of dementia praecox. However, he had written the case up before the worst came. A short time after the treatment had ended his patient entered an acute hallucinatory state which had, he said, all the signs of dementia praecox. She nevertheless made a recovery which lasted twelve to fifteen years during which she had another child which was quite healthy and was able to carry on with all her duties in a satisfactory manner. Then, as a result of her husband’s unemployment, his relatives were obliged to support Frau P’s family. She relapsed again and had to be admitted to an institution where she died. Freud added this news in a footnote in 1924 that his patient suffered from dementia praecox after all. He waited for what Kraepelin called course and outcome to make the diagnosis. But we don’t know if she would have declined into dementia. The course and outcome was pneumonia. She died of it. 
Frau P. is a 32 year old woman whose psychosis first broke six months after the birth of her child. Until then she was well.  She was swimming in a sea of unbearable ideas called delusions of reference. Her relatives and neighbours were behaving differently towards her, says Freud, from how they did before. She felt insulted by them. Her friends and relatives ceased to respect her and, in fact, slandered her. She was certain that meaning pervaded the atmosphere but had to rack her brains to find the reason for it, says Freud, to extract the meaning. Meaning remained enigmatic. What Freud called a lack of definiteness in these phenomena indicates this enigmatic void.  Freud was considering her ideas as the return of the repressed or as repression by projection.  The self-reproach becomes reproaches by others in the case of projection. That people were reading her thoughts was certainly delusional, since she was also able to conclude that they knew everything going on in her house. She was using her delusion logically. People were watching her undress in the evening which forced her to take precautionary measures and to undress under the bedclothes. 
These phenomena of reference are the effects of an absent signifier, not repression, an absence created by its foreclosure. Jacques-Alain Miller provides us with a structural definition of foreclosure: a linguistic element suffering foreclosure no longer enters the speech-circuit because it has been subtracted from language. It produces an increasing mobilisation of meaning around the foreclosed signifier without this meaning being able to meet up with the signifier question. Freud observes the same thing, stated in his way: the phenomena of reference only increase in intensity (on-going mobilisation of meaning) with no increase in definiteness (no joining up between the signifier and signified). The enjoyment associated with the signifier is not resorbable in the speech-circuit. 
She was admitted to a hydropathic establishment in 1895 where somatic and visual hallucinations occurred. She also had a sudden onset of sensations in her lower abdomen whilst alone with her housemaid. The latter must have had an improper thought, according to Frau P. However, the sensations in her abdomen do not have the character of sexual enjoyment. The abdominal sensations became more frequent. She blamed the housemaid for having provoked the enjoyment. Freud says that she felt her genitals as one feels a heavy hand. To feel one’s genitals as one feels a heavy hand sounds strange. Whatever is going on in the lower part of her body doesn’t remind one of sexual enjoyment.  Frau P. was experiencing a return of enjoyment to her body. In Lacan’s School this return of enjoyment to the field of the Other or to the subject’s body will become one distinction between paranoia and schizophrenia respectively. And even then, it would be a good idea to exclude hysterical somatisation as cause.
She was having visual hallucinations of naked women involving the lower abdomen including pubic hair. The images presented themselves at the same time as the physical sensations in her own abdomen occurred. She was seeing the woman in an indecent state of nakedness at the same time as the woman was having the same picture of her.  The images occurred in the hydropathic establishment a few hours after she had in fact seen a number of naked women at the baths. They turned out to be simple reproductions of a real impression, according to Freud. 
This mutual relation between two well-formed, imaginary objects is a topographical regression to the mirror stage. The images are not at all degraded as in Schreber’s topographical regression to ‘one leper corpse leading another leper corpse’.  The images nevertheless horrified her. One supposes that the somatization of Frau P’s lower abdomen represented interference from the real of enjoyment in the imaginary. The return of enjoyment to her body is what horrified her, marring the images. She felt ashamed for these women as she herself had been ashamed to be seen naked in front of her mother, her sister and the doctor for as long as she could remember. There must have been identification with these images. Otherwise, she would not have experienced the horror and shame.
Freud suspected that she had an experience about which she had not felt shame.  She remembered a scene from her sixth year in which she had no shame undressing in front of her brother. It emerged that she and her brother had a relation of mutual exhibitionism before going to bed without feeling any shame. It had been going on from her sixth to her tenth year. The memory of these scenes with her brother returned, according to Freud, in the delusion of being watched undressing for bed. Freud remarks that his patient is making up for the shame she had omitted to feel as a child. In his Project for a Scientific Psychology written at the same time Frau P. was in treatment with him Freud would have said that her sexual activity became a trauma by deferred action. That is to say, she experienced shame retroactively. 
A second episode of topographical regression to the mirror stage occurred during a visit from her sister-in-law when the latter said: ‘if anything of that sort happens to me, I treat it in a light vein.’  Frau P. took it as a reproach, since she was in the habit of taking serious things lightly. Freud asked her why she applied the words to herself. Frau P. replied that it was her sister-in-law’s tone of voice, a detail characteristic of paranoia.  She applied the sister-in-law’s words to herself because of the imaginary regression and interference from the real by the object voice. Making the tone of voice a detail characteristic of paranoia must record its ability to penetrate a thin skin, or, more generally, there is no defence against returning symptoms in paranoia. The tone of voice is a pure enjoyment from which there is no escape for the neurotic as well as for the psychotic. It is imposed from without a in both these clinical structures. The voice has an imposing object value, probably experienced as something quite deadly by Frau P. Lacan called it an object little (a) which can also acquire an agalmatic value. In all instances it must be quite a common value assigned to the analyst.
The sister-in-law had suddenly become her specular image, and Frau P. made an imaginary identification with her with transitivistic effects. A self-reproach had become a reproach of the little other. In this case it’s an imaginary projection. It did nothing to attenuate interference from the real into the imaginary. From that moment she was certain that she was the victim of a general slander. This goes back to the foreclosure that spewed the delusions of reference. What did the sister-in-law treat in a light manner? She had related to Frau P. how in her parents’ home there had been all sorts of difficulties with her brothers, and added what Freud called a wise comment: ‘In every family all sorts of things happen that one would like to draw a veil over. But if anything of the kind happens to me, I take it lightly.’  Frau P. lands again in the field of the sexual adventure with her brother. Freud reminds us that this sort of affair between children is often found in the aetiology of hysteria.
She manifestly encountered the gaze during this early sexual activity which generated no shame. How did it suddenly acquire delusional status of being watched undressing? Between the two children some enjoyment was localised in the field of the Other before the gaze split from the function of the eye. It must have acquired the status of the evil eye on splitting from the eye in its visual function. Before the splitting (Spaltung being Lacan’s term), psychical representations would have been inscribed. There would have been mnemic residues. After the splitting, inscriptions would have ceased. Do we count this as a type of foreclosure?
She reproduced the various scenes in which her sexual relationship with her brother had culminated. During this work of reproduction the physical sensations in her abdomen ‘joined in the conversation’, as happens with hysterical mnemic residues, according to Freud. Having worked through these scenes the somatic hallucinations and images disappeared and have not returned.  We learn in the footnote on pp. 180-1 that they did return. The treatment may have been too short, or it may never have worked.
But that isn’t what Freud is saying. He says that the presence of significant unconscious ideas in a case of paranoia allows the hope of discovering repression. ‘The hope of discovering repression’ is a very interesting expression. If unconscious thoughts could be realised by way of the conscious like in neurosis, there would be hope of curing paranoia by psychoanalytical treatment- which is the conclusion not drawn but hinted at by Freud. Following hard on this hope is one peculiarity, noted by Freud, that these unconscious thoughts were heard inwardly or hallucinated by the patient in the same way as her voices. If he means thoughts spoken aloud, that ranks pretty high with Schneider as a psychotic phenomenon. There is also an idea of the co-existence of foreclosure and repression in the same structure.
Mnemic residues of psycho-sexual events indicate the inscription of psychical representatives under the sway of repression and not of foreclosure. In Freud’s analysis of the case he obviously thought that some hysterical mnemic residues had been inscribed. Jacques-Alain Miller opened up an area of research into the border category in his analysis of the Wolf Man. The paternal function is preserved in the Wolf Man case whilst castration is foreclosed. He is being held in neurosis by the paternal function, and the foreclosure of castration produces some psychotic phenomena. We have been accustomed to consider the presence of an elementary phenomenon in what otherwise may appear to be a case of neurosis, but the structure is psychotic. There is now this idea that it could be borderline. If this works and it is repression holding Frau P. in neurosis, co-existing with foreclosure, it would be the first borderline case in psychoanalysis.  Can repression co-exist with foreclosure in the same structure? In my opinion this deserves out attention.
Richard Klein, Finsbury Park, London
About the author:
Richard Klein is a practising analyst living and working in London. The following papers issue from clinical experience, textual labour and his characteristic commitment to the transmission of psychoanalysis in the Lacanian orientation.
-  Freud, ‘The Neuro-Psychoses of Defence’ (1894), SE 3, p. 58.
-  Ibid., p. 58.
-  Ibid., p. 58.
-  Feud (1894), op. cit. p. 59.
-  Trauma has a spectrum longer than the autistic one.
-  Ibid., p. 58.
-  Ibid., p. 58.
-  ‘Further Remarks on the Neuro-Psychoses of Defence (1896), SE 3, p. 185.
-  Ibid., p. 175.
-  Ibid., p. 184.
-  Ibid., p. 177.
-  Ibid., p. 180-1, note 2.
-  Ibid., p. 175.
-  Ibid., p. 176.
-  Ibid., p. 184.
-  Ibid., p. 176.
-  Miller, J.-A., ‘L’Homme aux loups’ (part of a postgraduate seminar, Paris VIII, 1987-88), published much later in La Cause freudienne, nouvelle revue de psychanalyse, issue 72, November 2009, p86.
-  Ibid., p. 176.
-  Ibid., p. 176.
-  Ibid., p. 178.
-  Lacan, ‘On a question prior to any possible treatment of psychosis’ (1957-8), Ecrits, W. W. Norton & Co., 2006, p. 473.
-  Freud (1896), op. cit., p. 178.
-  Freud, Project for a Scientific Psychology (1895/published in 1950), SE I, p. 356.
-  Freud (1896), op. cit., p. 179.
-  Ibid., p. 179.
-  Ibid., p. 179.
-  Ibid., p. 180.