‘The Coronavirus Delirium Factory’

Dr. Jamieson Webster
 Dr. Marcus Coelen

As Coronavirus delirium gave way to mass protests against racist police brutality in America the vicissitudes of Freud’s beating fantasy assert its masochistic logic.


Scene I: A Patient Is Being Intubated – ‘I Can’t Breathe’ 
A psychoanalyst volunteers at a COVID-19 hospital. Something else than this work in palliative care concerns the psychoanalyst. The hospital feels like a psychiatric inpatient ward: patients were tied down to their beds, looked paranoid, were at times completely disoriented. Patients were said to be ‘agitated’ and ‘confused’ – something attributed to anxiety, lack of oxygen, the effects of the virus on the brain, and powerful sedative medications. Patients ripped off their oxygen masks; tried to get out of bed repeatedly; refused to eat for days, requiring feeding tubes; physically fought with nurses, requiring 1:1 monitoring. Doctors threatened patients with intubation, or, an increase in anti-psychotic medications. 

COVID-19 is considered a perfect storm for this syndrome which is not well understood and severely under-diagnosed. It is tied to the use of ventilators and the extreme stress of life or death moments, aided by hospital atmospheres all the more extreme in COVID-19 given that no visitors are allowed, patients know they have a virus with no cure, are visited by anonymous health providers in PPE who treat them as contaminated. 

The syndrome is itself caused by a deep confusion – on the side of patient and medical staff alike – around what is to be considered ‘physiological’ with what could be considered ‘psychological’. It is treated in the medical machinery like another aberration to be suppressed. Delirium flourishes in this factory; a reaction formation with the help of shields, screens, tubes, and masks, and our overreacting immune system. Instance, perhaps, of what Freud called a ‘cortical layer’.

Scene II: A Patient is Being Beaten – ‘No Lives Matter’ 
The patients who survived the virus reported terrifying psychic states filled with delusions of having their arms sawed off, being put into ovens, their skin pierced with needles in what they thought was a giant experiment on their body, reminiscent of the kind of experiences reported in paranoid psychosis. The situation is radically overdetermined; a beating fantasy arising as the patient feels reduced to a pure object. This indetermination is put into enigmatic shape – ‘a child is being beaten’ – as a psychical form. And when a subject becomes that – delirium is the only hope for survival.

Patients guard their delusions which are an interpretation which demands analysis, not in the sense of interpreting (since the delusion is already an interpretation), but as undoing and reorienting a subject. We must be attentive to the ways that the world can present overdetermined elements that drive out subjectivity, even when this is essentially a ‘medical’ crisis. The psychoanalyst knows that you cannot save a body while breaking a mind, mindful of the trajectory of violence and the extreme psychic states engendered by, and themselves engendering, violence. 

Scene III: A Black Man is Being Intubated – ‘I Can’t Breathe’
It was as if we were all in the midst of a regression to a core phantasmatic scene, even if we weren’t ill: ‘a world is being beaten’. Certainly the virus was the culprit, but as knowledge that aid from our governments was unequal, as a sense for how they failed to help, rose to the surface, it was not a large leap to a forceful question concerning the desire of the Other. ‘What does the pandemic want from us?’ Was this situation engineered to let an entire segment of the population die? 
There was a further condensation of elements, both real and phantasmatic: the displacement of significations, ‘I Can’t Breathe’ said by COVID patients to ‘I Can’t Breathe’ said by George Floyd; the condensation of COVID deaths skewed towards black and brown bodies, with the murder of black and indigenous peoples in the United States; the massive reversal of ‘Stay Inside to Save Lives’ to ‘Out On the Streets to Save Lives’; the diffusion of the signifier ‘life’ into its elements: who is taken care of, who is being beat, what counts as a life for the law. 

Scene IV: A Black Man is Being Killed – ‘I Can’t Breathe’ 
Is it any wonder how the video of George Floyd, in a setting characterized by the phantasm of beating and death, became a spectacle that incited mass global protests? The world watched as a black man cried ‘I can’t breathe’ and called for his dead mother, knee on neck, for an unbearable length of time. These are not only facts but arrive as images, sounds, clips, nourishing our imagination. They go viral. 

Like Freud facing the conundrum of the second ‘masochistic’ phase of the beating phantasy – ‘I am being beaten by my father’ – it has to be re-constructed. The interpretation of this ‘masochism’ reveals the love-hate relation to parents and how the superego usurps by reversal the pleasure principle, adding a sadistic enjoyment of a different stratum to it. Freud writes: ‘It is not only the punishment for the forbidden genital relation, but also the regressive substitute for that relation’.

Military and police are part of a culture of phallic genitality. The signifiers are pressing: Corona, Crown, Trump, Law, Police. The police concentrate the genital pleasure-and-pain zone into the spectacle of upholding law and order. The baton is too direct a metonymic symbol to be missed. Breathing is not only accompanied by slapping, and provoked screaming, the beginning and condition of extra-uterine life, it is also the first erogenization of the body by the outside. ‘I can’t breathe’ might be understood by those who continue suffocating others, not as a cry for help they ignore, but the indication of an enjoyment that defies the order of the stick. The maudlin complaint of ‘upright’ police unionists that they are the true victim of the situation is barely dissimulating the ‘father-is-beating-me’ phase that Freud had to hypothesize. 

Scene V: A World is Being Beaten – ‘Black Lives Matter’ 
Patients, protesters, have had to fight against passification, one given form and intensified by the lock-down. The corona virus brought mortality to the surface, and in a hysterical defense against death, protests erupted concerning the phallic violation of the law. ‘Black Lives Matter’ was a subjective assertion of Eros against the death drive, of mourning against perverse erasure. 

Freud writes of the beating fantasy that it is ‘not clearly sexual, not in itself sadistic, but yet the stuff from which both will later come.’ This societal regression reveals the confusion of the sexual and the sadistic, allowing us to begin to differentiate them, which is what racism always fails to do. We know that black bodies are suspected of enjoying more. We psychoanalysts know that to want the other to stop enjoying, is to wish them to die. 

Eros requires that life matters only in so far as there is just equivalence, the flash identification of all with one life, one name – George Floyd. This possibility arises from the bed of paranoiac coronavirus delirium; an interpretation, as Freud said, that speaks to a powerful kernel of reality that psychosis crystallizes, protects, and gives imagination to. ‘Black lives matter’ gives voice to the subject lost to delirium.

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