Jacques Lacan's theory of the subject as real, symbolic and imaginary: how can Lacanian theory be of help to mental health nursing practice?



A. McSherry

Centre for Therapeutic Education

Roehampton University



E-mail: tony.mcsherry@cwp.nhs.uk


Accessible summary

  • Mental health nursing is in a process of redefining itself and being asked to promote mental health to a wider public, and it therefore needs to engage with ideas new to nursing.
  • Jacques Lacan's ideas appear of particular relevance to those interested in mental health. In particular, a symptom for Lacan is the way one may have to cope with one's particular way of being.
  • It is only when a symptom becomes a problem that we seek help. When a problem arises we need to look at it in a wider perspective rather than pathologize it, and this is where Lacan's concept of the three registers is of major importance.


This paper presents an outline of Lacan's theory of the human subject, in particular focusing on Lacan's concepts of the real, symbolic and imaginary registers, and how an understanding of these can inform change and practice in mental health nursing. Mental health nursing is under pressure to define itself as a practice distinct from other professions in the field, and to respond in new ways to promoting mental health to the individual and a wider public. Lacan's theory of the subject is of particular relevance to mental health nurses working with mental distress but has received little attention in mental health nursing literature. Six implications for practice are outlined in terms of: against normalization, the importance of the function of the symptom, what cannot be known, meaning as ever-changing, against empathy and against holistic ideas of the self.