In 'Analysis terminable and interminable', the old Freud concludes rather pessimistically that governing, educating and psychoanalyzing - or, more broadly, professions that involve some degree of curing - constitute impossible professions. According to him, in none of these professions can one predict one's ultimate success owing to the large number of uncontrollable factors involved. At any rate, one can be sure beforehand of achieving unsatisfying results. Freud's focus here is of course on psychoanalysis, and his essay accentuates the unresolved and troubling factors that persist in the person of the analyst, in the analysant, in the relation between them, and in the psychoanalytic technique.

Over the years a number of authors have returned to Freud's pronouncement on the impossible professions and discussed the question of impossibility within psychoanalysis. Some reject Freud's cynical conclusion, arguing that it no longer reflects the actual status of psychoanalysis; others consider it still to be all too appropriate. While only a few authors have thoroughly considered the concept of impossibility and its clinical roots, fewer still have discussed the consequences of Freud's pronouncement for the care-giving professions. Those who do, stress the difficulty inherent in this type of work.

In this paper we will discuss the problem of impossibility in care-giving positions and focus on the nature of the difficulties care-givers experience. Our interpretation starts from Lacanian psychoanalytic theory and from our own research in the special education profession.

Lacan is prudent in his pronouncements on the professions that Freud qualifies as impossible, defining them as hazardous undertakings and challenges ("gageurs"). The least one can do, he says, is to produce evidence of the impossibility involved in these professions. Indeed, there has been very little empirical investigation into these three professions. Few authors have yet engaged in a systematic empirical research into impossibility. An interesting line of thought, however, has been opened up by Arnold Cooper who links impossibility with professional burnout.

In 1974, Herbert Freudenberger - a New York psychoanalyst of German-Jewish origin, analyzed by Freud's pupil Theodor Reik - first used burnout as a psychological construct. Although an analyst first gave burnout its psychological meaning, the concept was hardly studied from a psychoanalytic point of view. Maslach and Jackson, the two psychologists who introduced the concept of burnout into the academic world, define it as "a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that can occur among individuals who do 'people work' of some kind". This definition has become widely accepted. According to this definition, burnout has three underlying dimensions. Emotional exhaustion is a dysphoric feeling of being used up and tired of working. Depersonalization is understood to mean the attitude whereby one tends to withdraw from contact with clients and to address others in an impersonal manner. Reduced personal accomplishment indicates that one feels less competent than before and perceives oneself as having failed.

Classical burnout-research indicates that burnout coincides with difficult interpersonal relations (among other factors, such as personality, organizational characteristics, etc.). We took this idea into consideration and questioned if burnout can specifically and significantly be explained in terms of the different ways workers perceive and experience their relations with others at work. We also wondered if the different types of interpersonal relations involved in this work have a differentiated effect on burnout, such that the impact of the relation to a superior, for example, can be differentiated from the impact of the relation to a client. Based on a large-scale, cross-sectional survey study and statistical data-analysis (regression analysis), we indeed found that 4 levels of interpersonal relations have a significant impact on people's burnout, i.e. the relation to clients, colleagues, direct superiors and management. This finding clearly indicates that interpersonal relations need to be considered in a differentiated way, and also indicates the important domains for intervention.

In the remainder of the paper we will specifically focus on care-givers' relation to their clients. Researchers have found a significant link between professional burnout and clients' aggressiveness, challenging behavior and the severity of their disabilities. For instance, professionals working with chronic schizophrenics or demented elderly have more severe burnout complaints. The degree of burnout seems to increase proportionally to the client's difficulties, although this relationship could not always be confirmed. Most interesting, from our point of view, is the discovery that the professional's subjective perception seems to be an important intermediate variable. Psychodynamic investigations on the subject of stress and burnout, in particular, emphasize that these subjective perceptions of interactions at work (and peculiar patterns within these perceptions) are closely connected to burnout.

What the so-called impossible professions clearly have in common with one another is the pivotal nature of intersubjective relations - learning takes place through pupils' relations with educators, healing takes place through patients' relations with therapists, and the disadvantaged are helped through relations with social workers. In each of these relations, the professional acts as an agent who addresses another in order to effect change. Hereby, intentionality can be located on the side of the professional, and the relation is the medium that is used to realize one's aim. On the one hand, a problem these professionals are confronted with is that there seem to exist no univocal answers or laws that determine the process in which they are engaged. Engineers who design airplanes can take into account the laws of gravity in producing their products, but such scientific universal rules and clearly defined laws are not available for the management of human interrelations (e.g., which laws determine a successful education?). A far greater degree of uncertainty is at stake in human service professions. On the other hand, it is clear that the medium (human interrelation) through which an effect is realized, is itself an influential factor in determining possible results. Ideally, the professional is invested in creating a meaningful and workable relation; however, if impossibility is experienced by a burnt-out professional, the relation will most likely be involved too.

What remains unclear from these past studies is whether there are any common factors in the way burnt-out professionals typically regard their work relations. For example, we questioned what is the nature of the relational position that care-givers experience as difficult or impossible. We also wondered how this relational position affected their subjective perception and interpretation of the difficulties they experienced with clients. Therefore we went back to the narratives of professionals working in special education and counseling, and studied their processes of attributing meaning to events.

In what follows we present some results from our qualitative research into the experience of impossibility and burnout in care-giving professions. Through a comparison of contrasting groups of employees - one group had a clinically significant high score on a burnout questionnaire (and consequently experienced a considerable degree of impossibility in the job) and the other group had a low score - we will typify burnt out employees by the way they relate to others in their job, and especially how they relate to clients.

In our interpretation we start from Lacan's theoretical model of the three registers of mental experience: the real, the symbolic and the imaginary. Throughout his teaching and work, Lacan attempted to conceptualize psychoanalysis along this three-part structure.

The dimension of the real refers to the dimension of the drive. Because of the drive's incongruous nature, this dimension is characterized by the inevitable failure of all representations. It is the dimension we mentally try to deal with, but in relation to which all representational efforts fall short. Anxiety is considered to be its clinical manifestation.

The concept of the imaginary refers to the activity of identity-building and the formation of subjective images which are primarily acquired through the so-called mirror stage. In the mirror stage, the subject-to-be identifies with an image presented by another in an effort to cope with certain impossibilities associated with the drive. While, on the one hand, this suggests recognition (self-recognition in a recognised other), it also implies a fundamental misrecognition (of one's own disarray and the other's other-ness). Lacan not only locates affects such as love and hate in the imaginary domain, but also, more generally, people's impressions, intuitions and prejudices. Imaginary formations are coupled with misjudgement and (self-)deception since they are fundamentally biased. They fix people's attention, fail to take into account the relativity of assumptions and simplify complex reality.

The symbolic refers to the structure at the foundation of every reality; it is the organising context of experiential phenomena. The essence of the symbolic structure is the signifier. The 'signifier,' a term borrowed from structural linguistics, points to the indeterminacy of words which, having no definite or fixed signification, can only obtain meaning embedded within a context of other signifiers. The symbolic introduces a third element that mediates between the subject and the other; it enables the subject to extricate itself from direct experience and thereby permits the subject to entertain a mediated and detached attitude toward its imaginary representations. Unlike the imaginary, which aims at reconciling and concealing the fundamental lack that for Lacan is the determining feature of subjectivity, the symbolic implies and makes this lack apparent. The symbolic enables the subject to obtain distance from the imaginary identifications and introduces the possibility of making other choices and of occupying different positions. By this change, the originally dual and fixed meanings are replaced by signifiers.

We will now discuss some aspects based on which we differentiate between high and low scoring responds on a burnout-questionnaire.

A first characteristic typical of high-scoring respondents lies in their general orientation towards others. They have a specific style of interaction, which we could typify as imaginary. This first and foremost means that they strongly identify themselves with their professional role. In fact, they tend to merge with it completely. This role with which they so strongly identify tends to be strictly complementary with the role assumed by the other. The educator who works with pupils that are perceived as helpless, for example, tends to identify with a complementary role of the caretaker. Conversely, he who sees his pupils as unruly will feel confronted with the responsibility of mastering them. Precisely as a result of this complementarity, an escalating cycle is created by which both roles are reinforced. Both persons can react to this situation by submitting themselves to the role they occupy, or by rebelling against it. The fact is that both are strongly determined by it.

In line with this first observation these high scoring respondents tend to occupy a peculiar position towards the clients they work with. They really long to affect clients and fantasize about achieving clear results in working with them. Beginning with a definite image of their clients in general, and of their own specific work, they want to direct the other. This image is clearly a cultivated personal construction. It is as if they have a stereotype or a template in mind with which their clients should comply.

This observation tallies with Lacan's observation that, in attempting to do good, people in general tend to interpret and give content to what they think the other wants. Lacan observes how, in wanting the good for my neighbour, "I imagine their difficulties and their sufferings in the mirror of my own … what I want is the good of others in the image of my own". People tend to interpret what the other wants by assuming a similarity between themselves and the other; 'what the other wants is what I would want if I were in his/her shoes'. This assumption is a typical imaginary supposition. We suppose we know what the other wants before this other could ever have indicated what he/she desires. Lacan says "we are … at one with everything that depends on the image of the other as our fellow man, based on the similarity we have to our ego and to everything that situates us in the imaginary register". He illustrates this through the story involving the fourth-century Christian, Saint Martin, who, as an officer in the army, once ripped up his cape to share it with a beggar. Lacan draws attention to the way Saint Martin shared his cape with the ragged beggar by imagining what this distressed other wanted. Lacan stresses how the need that Saint Martin believed himself to be observing is an interpretation that could just as easily be wrong. Consequently, "perhaps over and above that need to be clothed, he was begging for something else, namely, that Saint Martin either kill or fuck him". People's interpretations of what the other wants typically neglect the subjective voice of he/she who is in a perceived state of need. The example of Saint Martin shows that the latter's compassion and self-projection into the beggar's situation actually silences the beggar. A universal concept of the good is imposed at the level of the subjective voice of the one in penury ('the object I consider as good is indeed good for the other'). What Lacan makes clear is that the other's subjective voice, in its essence, could radically concern something totally different from the good offered. So, what Saint Martin really covers with his cloak is the kernel of the beggar's subjectivity. By interpreting the other's lack as a need, the latter's lack gets arrogantly materialized and his desire becomes obscured.

The high-scoring respondents from our research can especially be typified by this kind of imaginary care-giving. The problem they experience is that many of their day-to-day interactions with clients don't fit with their image of how these interactions ought to be. This evokes a feeling of unease. One of the respondents puts it as follows:

"I work with moderately retarded adult women who have a personality disorder … I direct a workshop and they come to work there every day, for 6 hours. What I want, is that all of them have a significant daily occupation and that they can experience the workshop as a place where they can be themselves… I do much more than just supervise their work. What I want is to offer them the full scope to develop and express themselves… But at the end of the day I always think 'it's enough'. It really is a burden, you continuously have to be attentive, you're always busy with their lives and you haven't a second to take a break…Elisa is someone who is quickly agitated if she doesn't understand things, then she starts yelling and abusing. So, one has to be attentive. At the same time Anna starts complaining that she doesn't find her underwear anymore and K. starts crying for something else. Sometimes it's too much for me, but one has to consider their complaints…Take for example Anna and her remarks on the lost underwear. One can't just say that she should search for it. For her, it's a problem of vital importance, so if we can't solve it, she doesn't feel well and then I would be wrong… In fact, she really is a pathological case and she makes me feel a bit like I'm going to explode. I'm not exaggerating, she can ask me the same question 60 or 70 times a day, and each day she has another question… I hope that at least she will feel understood, it's a kind of therapy for her … at the end of the day I just want to yell at her and shout that she should shut her stupid mouth, but that would not be fair".

From a Lacanian point of view, each (work-related) interaction between an acting agent and another always results in a product. The problem high-scoring respondents experience as unbearable is that the product they obtain doesn't correspond with the images they cherish prior to any interaction. We observed that our respondents are disturbed by the fact that they fail to realize the outcomes they have in mind for the other. One of the respondents puts it as follows:

"The problems we are confronted with are all very complex. One can't just say do this or do that. Then it stays on my mind and I keep on brooding. The emotional things, you take them home. You try to find a solution but you can't find one… I have the impression they do want an answer from me, for they keep on asking, they continuously return to it. In fact, they ask more than we can give… They undoubtedly see and feel that I can't give an answer. Now it's too much, I reached the limit, I can no longer stand it. I always take things very personally".

A major consequence of this inability to realize cherished goals is that the outcome of the interaction obtains a negative connotation for them. This inevitably evokes an aggressive attitude. The aggression that is normally sublimated in people's professional striving gets released in this feeling of being deceived, but it can't easily be acted upon since it is incompatible with the whole project of taking care of the other.

Indeed, experiences of difficulty in care-giving often begin when the other doesn't go along with the caregiver's best intentions, when the other doesn't follow the script of the caregiver's mental scenario in their actual social relation (imagine the beggar refusing the offered half of Saint Martin's cloak). In this case, the other appears as recalcitrant and strange in relation to the goodwill-hunting caregiver. The imaginary altruistic relation implies a relation of power. By giving the deprived the good I dispose of, I confirm my own wealth. So, if I give others my wise advice I narcissistically confirm the superiority of my own wisdom. Within the same line, the other's refusal of my good wounds my narcissism and disturbs the relation of power I aimed to install via my good advice. It is predictable that the insulted and unappreciated benefactor will feel inclined to restore the disturbed balance of power.

Depersonalization - dealing with clients in an impersonal way or pre-occupation with non- client related activities (e.g. being concerned with doing the bookkeeping more than with clients) can be understood as an effect of a professional's retreat from his/her own evil tendencies towards clients. Lacan argues that resistance to the idea of taking care of the other can be understood as a resistance against one's own evil. People will retreat from doing good for another if there is something on the horizon that expresses this evil. If the activity of caring is contaminated with cruelty, caring as such will most probably be inhibited. Inhibition of an activity is to be expected if the ego can't stand the ambiguity this activity implies.
Dealing with clients in a cynical or harsh manner are other measures we observed designed to keep the disturbing other at distance. In interviewees' accounts of inappropriate client behavior, we often observed that punishment was not primarily considered as a therapeutic or pedagogical measure, but often as a kind of compensation for the injustice suffered by the interviewee. The story of a respondent illustrates this:

"I work at a ward for youngsters with a severe character disorder. We now have a guy who really gets under my skin … he really hunts me. One day there was a quarrel during diner. I said something to him; that he should calm down, and then he charged at me. He wanted to beat me, but then I took him by his throat and I pushed him to the wall. He said that he would bring his older brothers and they would wait for me when I go home in the evening… Later that week I was at his school and I saw him with a couple of friends. They were laughing at me. It was really too much for me. I immediately went to the director and I said that they should suspend him temporarily from the institution and that the guy should apologize personally. I told the director that he was lucky that I didn't react. I am like that, I hit back when they hit me… I respect them, what I want, is that they respect me in return".

In classical burnout research, this kind of behavior would perhaps be seen as a way of restoring reciprocity in a process of social exchange. What we, based on our observations, can add to this line of reasoning is that this kind of rectification is a measure designed to defend against the disturbing strangeness of the other. The other behaves in a way that is peculiar to that professional, and that makes the latter suspicious, wondering whether he or she is a victim of the other.

Previous research has observed that socially inappropriate or unexpected behavior (e.g. aggression, assaults) in the workplace has a traumatic effect on the worker and that it can eventually result in burnout. Our interviewees revealed that they are frequently confronted with client behavior that, compared to their own usual standards of behavior, is shocking. High scoring respondents are especially troubled by this experience and talked about it only diffidently. They seemed to be very personally touched by it or, on the contrary, rationalized it quite strongly. They have difficulties in maintaining subjective distance. When they feel challenged they are liable to respond. In this way, they lose their grip on the situation and merge themselves with their problems with clients.

These high scoring care-givers act like those care-givers the psychoanalytic pioneer August Aichhorn referred to as "unskilled workers", those who don't recognize the importance of transference and who don't understand the metaphorical value of clients' acting out. We observed that this is not so much connected to skills in the academic sense, to years of experience or to specific scripts pertaining to the other, but rather to the absence of a general tendency to start one's reflections from the perspective of the other. High scoring respondents judge situations according to their own standards and tend to take everything that goes on very literally. The comment of a respondent illustrates this:

"One day, one of the kids said that my mother is a whore and that she has a fat ass. I said that she shouldn't say things like that. She didn't know my mother and had never even seen her… I come from a decent family, imagine if my mother heard that".

We observed that problems high scoring respondents experience with clients tend to expand to problems with colleagues, executives or clients' relatives. This can be interpreted as a result of psychic defense. Unease experienced at the level of the client-professional relation in this case is projected onto others.

By contrast, people who have a low score on the burnout questionnaire maintain a subjective distance in their interactions with the other and in relation to events in the context of work. They, too, occupy a role in relation to the other, but they don't tend to merge with it. They, too, often find their expectations regarding their profession do not match their experience, but they deal with this difficulty in a different way. Indeed, a degree of difficulty seems to be inherent in all relations where the relation itself is used as the medium for influencing another. Yet compared to high scorers, the experience of this contradiction is less problematic for members of the low-scoring group. The contradiction was not perceived as a source of conflict and it didn't result in the idea that their job is impossible (as it did for high scoring respondents). We suggest that this is because low scorers have less crystallized imaginary fantasies of the product they aim for (i.e. fewer pre-established fantasies regarding the result, fewer expectations concerning reward, fewer pre-established ideas on their role). They tend to have more moderate and flexible expectations of what one can realize. In their relations with clients, they begin not so much from the perspective of their own point of view, but from that of the other. They too want to transform their clients so that things will be better, but they have less of a fixed image of what that improvement should look like.

We will now conclude. In this paper we discussed the difference between high- and low-scoring respondents on a burnout questionnaire. We found that both groups experience a dimension of inability and unpredictability in their professional activity. The job in each case seems to contain a 'real' (see Lacan) kernel that can't be grasped. The difference between high and low scoring respondents lies in the way they deal with this structural inability. Low-scoring respondents primarily deal with it in a symbolic way, whereby they take into account the structural context of the events with which they are confronted. This helps them to detach themselves from the surrounding events and prevents narcissistic absorption. They consider the inability with which they are confronted as a challenge and on the whole maintain a symbolic distance towards their clients. High-scoring respondents deal with this structural inability in a different, imaginary way. They cherish a defined and optimistic fantasy of what they want to reach, feel uneasy about the results they achieve and dwell on the reason and meaning of why things don't run the way they imagined. They clash with their job, feel overwhelmed by impossibility and merge with the role they occupy vis-à-vis the other. They are easily absorbed by negative events.

This differentiation between high and low scoring respondents requires additional refinement. The strict dichotomy between the imaginary and the symbolic is an artifact of the contrast analysis we made. In Lacanian theory, both registers are fundamentally intertwined and all subjects' functioning can be typified via both of these registers. The nuance we consequently should add is that in the functioning of high-scoring respondents, imaginary characteristics attract attention and dominate the symbolic aspects of functioning, whereas in low-scoring respondents the opposite is true.

We believe our findings have relevance for clinical practice. Freud once said that everyone in such fields as the special educators we interviewed, "should receive a psycho-analytic training, since without it children, the object of their endeavors, must remain an inaccessible problem to them". We don't propose to go that far, but we do think our results indicate the importance of individual and collective psychoanalytic supervision and of psychoanalytic workplace-counseling. An external consultant who stimulates people to talk about their work-experiences could help workers attain a symbolic distance from their imaginary roles and conflicts. High-scoring respondents indeed experienced their clients as inaccessible and strange, giving them a feeling of unease which low-scoring respondents didn't appear to have. We think this is partly because low-scoring respondents are able to maintain a symbolic distance in their interactions and thus demonstrate a less narcissistic approach to their work. Psychoanalytic intervention is useful because it stimulates the process we observed low scoring respondents to engage in spontaneously - their ability to speak freely about their difficulties helped them to maintain symbolic distance. Since people's position in the imaginary and the symbolic reflects a particular position taken toward the real, psychoanalytic intervention has to involve more than merely stimulating people into making a mental or cognitive shift.

Intervention needs to focus primarily on people's attachment to their style of interaction and, consequently, this must be designed on the basis of the concept of working through. These interventions could be organized permanently or in relation to specific conflict situations.