ABSTRACT
In this chapter we focus on psychoanalysis as part of psychiatry, showing how Freud's work was grounded in German diagnostic categories and forms of treatment but also how psychoanalysis today begins to break from such assumptions about the relationship between analyst and patient. The limits of that break and the reproduction of psychiatric approaches in present-day psychoanalytic practice are explored. The chapter reviews the conceptual transformations in psychiatry and then psychoanalysis as a renewed emphasis on the talking cure took place, this to appreciate the repercussions of Lacan's training in French psychiatry. This is one way of approaching the historical context through which it is now possible to rede®ne and challenge diagnosis, adaptation and direction of patients in psychoanalysis, and to ®nd new ways to articulate the enmeshment of the dimensions of the imaginary, symbolic and real with alienation in clinical practice.
