英：symptom; 法：symptome
在医学上，症状是在其他方面可能仍旧尚未检测到的某种潜在疾病的可感知表现。因而，症状的概念便被建立在表面 (surface)与深层 (depth)之间的基本区分之上，即被建立在现象（可直接经验到的对象）与那些无法被经验到而必须被推断出的现象的隐匿原因之间的基本区分之上。在拉康的著作中，也有一个类似的区分，即症状总是被区分于“结构”(STRUCTURES)。此种区分具有超越表面与深层之间对立的优点，因为这些结构都被认为是像症状本身那样仅仅是“在表面上”的。正是病人的临床结构 (神经症、精神病或性倒错)而非他的症状，构成了精神分析的真正焦点，因而分析的结束 (END OF ANALSYSIS)便必须根据结构而非根据症状的治愈来构想
在拉康的著作中，“症状”这一术语通常都指涉的是那些神经症 (neurotic)的症状，也就是说，它指的是神经症的可感知表现，而非其他临床结构的表现 (但是也有一个例外，见：E, 281)。因此，精神病的那些表现，诸如幻觉与妄想等，就不是被称作症状，而是被称作现象 (phenomena),而性倒错则表现于那些性倒错的行动 (acts)。拉康派精神分析的目标并非消除神经症的症状，因为当一种神经症的症状消失的时候，它往往只是被另一种症状取代而已。正是这一点，将精神分析与任何形式的治疗区分了开来。
拉康遵循弗洛伊德的观点宣称，神经症的症状皆是无意识的构形，并且它们也总是在两种相互冲突的欲望之间妥协。拉康的原创性则在于他根据语言学对于神经症的症状的理解：“症状完全是在一种关于语言的分析中得到解决的，因为症状本身就是如同一种语言那样被结构的。”(E, 59)
在拉康的著述历程中，他将症状视同于语言的不同特征：
(1)在1953年，他指出症状是一个能指 (SIGNIFIER)(E, 59)。这便将精神分析的症状概念与医学的方法区分了开来，因为后者不是把症状视作一个能指，而是将其看作一个指示符 (NDEX)(E, 129; 见：S2,320)。就精神分析的理论所涉及的范围而言，此种区分的一个结果便是，对于一个神经症的症状而言，并不存在任何普遍的意义，因为每种症状都是一个特殊主体的独特历史的产物。所有神经症的症状皆是独特的，尽管它们具有表面上的相似性。另一个结果则是在神经症的症状与潜在的神经症的结构之间并不存在任何固定的一对一联系，没有任何神经症的症状，就其本身而言是癔症的或者是强迫症的。这就意味着一位医生会基于病人所呈现出来的症状而得出某种诊断，然而一位拉康派分析家则无法单纯基于病人的症状来确定一位神经症患者是癔症患者还是强迫症患者。例如，分析家并不会纯粹因为病人呈现出强迫症的典型症状 (仪式动作、强迫行为等)便把一位病人诊断为强迫症患者。相反，分析家可能把一个强迫症的结构归于一位没有呈现出强迫型神经症的任何典型症状的病人。拉康派分析家只能通过鉴别推动着神经症患者的言语的那个基本问题，而得出癔症或是强迫型神经症的诊断
(2)在1955年，拉康把症状视同于意指 (SIGNIFICATION):“症状就其本身而言，是彻头彻尾的意指，也就是说，是真理，是正在显形的真理。”(S2,320)
(3)在1957年，症状则被描述为一种隐喻 (METAPHOR),“症状是一种隐喻，肉身或机能在其中被当成了一个表意的元素”(E, 166)。拉康的意思是要在字面上来看待此种描述：“如果说症状是一种隐喻，那么此种说法本身却并非一种隐喻。”(E, 175)
(4)在最早出现于1957一1958年度研讨班上所讨论的欲望图解 (GRAPH OF DESIRE)中，症状被描述为一则信息。在1961年，拉康继续说症状是一则谜一般的信息，主体会认为它是来自实在界的一则晦涩难懂的信息，反而不会将其承认为是他自己的信息 (S8,149)
从1962年开始，在拉康的著作中便逐渐形成了一种脱离症状的语言学观念，而转向把症状看作无法得到解释的纯粹享乐 (jouissance)的倾向。此种概念上的转变，在1975年随着“圣状”(SINTHOME)这一术语的引入而达到了巅峰。
(symptome) In medicine, symptoms are the perceptible manifestations of an underlyingillness that might otherwise remain undetected. The concept of the symptom is thuspredicated on a basic distinction between surface and depth, between phenomena (objectswhich can be directly experienced) and the hidden causes of those phenomena whichcannot be experienced but must be inferred. A similar distinction operates in Lacan'swork, in which symptoms are always distinguished from STRUCTURES. This distinctionhas the advantage of transcending the opposition between surface and depth, sincestructures are held to be just as much 'on the surface'as the symptoms themselves. It isthe clinical structure of the patient (neurosis, psychosis or perversion) which constitutesthe real focus of psychoanalysis, and not his symptoms, and thus the END OFANALYSIS must be conceived of in structural terms rather than in terms of curingsymptoms.
In Lacan's work the term 'symptom'usually refers to neurotic symptoms, that is, tothe perceptible manifestations of neurosis, and not to manifestations of the other clinicalstructures (but see E, 281 for an exception). Hence the manifestations of psychosis, suchas hallucinations and delusions, are not usually referred to as symptoms but asphenomena, whereas perversion manifests itself in perverse acts. The aim of Lacanianpsychoanalysis is not the removal of neurotic symptoms, since when one neuroticsymptom disappears it is often simply replaced by another. This is what distinguishespsychoanalysis from any form of therapy.
Lacan follows Freud in affirming that neurotic symptoms are formations of theunconscious, and that they are always a compromise between two conflicting desires. Lacan's originality lies in his understanding of neurotic symptoms in linguistic terms: 'The symptom resolves itself entirely in an analysis of language, because the symptom isitself structured like a language' (E, 59).
Over the course of his work, Lacan identifies the symptom with different features oflanguage:
- In 1953 he argues that the symptom is a SIGNIFIER (E, 59). This distinguishes thepsychoanalytic concept of the symptom from the medical approach, in that the latterregards the symptom not as a signifier but as an INDEX (E, 129; see S2,320). Oneconsequence of this distinction is that, as far as psychoanalytic theory is concerned, thereis no universal meaning for a neurotic symptom, since each symptom is a product of aparticular subject's unique history. Despite their apparent similarities, all neuroticsymptoms are unique. Another consequence is that there is no fixed one-to-one linkbetween neurotic symptoms and the underlying neurotic structure; no neurotic symptomis in itself hysterical or obsessional. This means that whereas a doctor can arrive at adiagnosis on the basis of the symptoms presented by the patient, a Lacanian analystcannot determine whether a neurotic patient is a hysteric or an obsessional simply on thebasis of his symptoms. For example the analyst will not diagnose a patient as obsessionalsimply because the patient presents typical obsessional symptoms (ritual actions, compulsive behaviour, etc.). Conversely, the analyst may well attribute an obsessionalstructure to a patient who does not present any of the typical symptoms of obsessionalneurosis. The Lacanian analyst can only arrive at a diagnosis of hysteria or obsessionalneurosis by identifying the fundamental question that animates the neurotic's speech
- In 1955, Lacan identifies the symptom with SIGNIFICATION: 'The symptom is initself, through and through, signification, that is to say, truth, truth taking shape' (S2,320).
- In 1957, the symptom is described as a METAPHOR,'the symptom beingametaphor in which flesh or function is taken as a signifying element' (E, 166). Lacanmeans this description to be taken literally: 'if the symptom is a metaphor, it is not ametaphor to say so' (E, 175).
- In the GRAPH OF DESIRE, which first appears in the seminar of 1957-8, thesymptom is described as a message. In 1961, Lacan goes on to say that the symptom is anenigmatic message which the subject thinks is an opaque message from the real instead ofrecognising it as his own message (S8,149).
From 1962 on, there is a gradual tendency in Lacan's work away from the linguisticconception of the symptom, and towards a view of the symptom as pure jouissance whichcannot be interpreted. This conceptual shift culminates in 1975 with the introduction ofthe term SINTHOME.