The Painful Analgesia of Cotard’s Syndrome

Yorgos Dimitriadis*
CRPMS, EA 3522 UFR “Psychoanalytic Studies”, Paris-Diderot University, 8 rue Albert Einstein, 75013 Paris.

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© 2014 Yorgos Dimitriadis.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the CRPMS, EA 3522 UFR “Psychoanalytic Studies”, Paris-Diderot University, 8 rue Albert Einstein, 75013 Paris; Tel: 0033611690528; Fax: 0033611690528; E-mail:


In the present paper, we look into what is painful psychical analgesia in relation to what 19th century clinicians have named “moral pain” in melancholia, and more particularly in the delusion of negation described by the French psychiatrist Jules Cotard in 1880, a form of delusion that can be seen mostly in cases of chronic anxious melancholia. This condition is characterized by a painful absence of emotions, which occurs when the subject, in the Lacanian sense of the word, ceases to be touched by the signifiers, and consequently ceases to exist as a subject. Hence, these patients often declare themselves to be already dead or incapable of dying. The psychoanalytical approach to this delusion allows an understanding of the ‘’lack of lack’’ concept, as these patients, having lost the lack, affirm that their body’s orifices are clogged, that they have lost their mental vision, that they miss various visceral organs etc. The completeness of their body – the absence of orifices – can sometimes attain universal dimensions and these patients can thus identify themselves to the universe, which contains everything. The delusion of negation teaches us something important concerning the essence of desire, in relation to what has been named by Lacan area-between-two-deaths. This Lacanian concept refers essentially to the tragic hero, but also, more generally, to the lonely condition where anyone’s desire should be able to exist beyond any narcissistic commitment, which means beyond the pleasure principle as well.

Keywords: Analgesia, Cotard, Czermak, Delusion, Lacan, Melancholia, Moral, Negation, Pain, Painful, Psychoanalysis.