The Difference Between Pretend and Simulation
When a person pretends to be ill, they just lie in bed; but when they simulate illness, they produce actual symptoms, thus blurring the lines of reality.
To dissimulate is to pretend not to have what one has. To simulate is to feign to have what one doesn't have. One implies a presence, the other an absence. But it is more complicated than that because simulating is not pretending: "Whoever fakes an illness can simply stay in bed and make everyone believe he is ill. Whoever simulates an illness produces in himself some of the symptoms" (Littré). Therefore, pretending, or dissimulating, leaves the principle of reality intact: the difference is always clear, it is simply masked, whereas simulation threatens the difference between the "true" and the "false," the "real" and the "imaginary." Is the simulator sick or not, given that he produces "true" symptoms? Objectively one cannot treat him as being either ill or not ill. Psychology and medicine stop at this point, forestalled by the illness's henceforth undiscoverable truth. For if any symptom can be "produced," and can no longer be taken as a fact of nature, then every illness can be considered as simulatable and simulated, and medicine loses its meaning since it only knows how to treat "real" illnesses according to their objective causes. Psychosomatics evolves in a dubious manner at the borders of the principle of illness. As to psychoanalysis, it transfers the symptom of the organic order to the unconscious order: the latter is new and taken for "real" more real than the other - but why would simulation be at the gates of the unconscious? Why couldn't the "work" of the unconscious be "produced" in the same way as any old symptom of classical medicine? Dreams already are.