One of the most interesting things about Complex Primary Motor Stereotypy is that children find it difficult to explain, that is, to put into words, the experience. This is not necessarily a symptom. It is, rather, the crux of the problem. Behavioral psychology, which has been at the fore of treating (with some minimal relative success) Complex Primary Motor Stereotypy, remarks about the importance of creating an “awareness” of the excitation (“excitation” is my word for it). This is where Behavioral therapy falls short: it is not awareness at stake but rather signifiers, and the appearance of key signifiers which would inhibit some of the jouissance.
Soren was introduced to several signifiers: (1) the shakes, (2) flapping, and, moreover, (3) “Can I shake?,” and (4) “No Shaking now,” then the shaking subsided ever so slightly. When these signifiers are missing, his shaking emerged at an exponentially accelerated rate.
Behavioral psychology has only taken the surface level insight of psychoanalysis, ignoring the essential underlying insights. For example, recent research in the field of behavioral psychology (out of John’s Hopkin’s University) has found that variability in the “blocking” technique – which analysts know refers ultimately to the “blocking” of real jouissance, of the drives – increases the likelihood of treatment success. This is what a signifier does: it blocks jouissance.
The behavioral psychologists are making progress treating complex primary motor stereotypy only because they have taken some of the insights of psychoanalysis without realizing it. However, they have done so in ways that will not move as far as they could if only they would turn to psychoanalysis. For example: they are incorrect on the nature of “awareness,” (which is really about “signifiers”), “blocking” (which is really about inhibiting jouissance), and “variability” (which is really about the quest toward establishing a limit to freedom).