A dialectical presentation, on the other hand, is disturbing, for it requires of its readers a searching and rigorous scrutiny of everything they believe and live by...if the experience of a rhetorical form is flattering, the experience of a Dialectical form is humiliating." 
"...rather than distinguishing, it resolves, and in the world [...] the lines of demarcation between places and things, fade in an all-embracing unity..." 
"...the dialectical presentation succeeds at its own expense...it becomes the vehicle of its own abandonment."
The dialectical relationship then is a left brained vehicle which ends in the shutting up of the left brain, so that a right brained understanding, a cloud of unknowing, may persist. Untruths which lead to truths, ladders that crumble under the weight of the climber, as Wittgenstein would have put it. The lines of demarcation fade, the opposites collapse into the reference, the past and future fuse in an expanding present.
Stanley Fish is writing here about the aesthetic of the good physician which is itself an anti-aesthetic which judges not, but merely repairs. It is in truth a necessary negation of being so that being may be revealed. In Christian terms this allows a soul to be "oned" or united with the creator, or in Blakean terms, the imagination, the creative principle as it maps onto human consciousness.
The anti-aesthetic is not against beauty, but rather against the privileging of one opposition over another, which is similar to what Derrida is accomplishing, but here there is a sense of meaning, where Derrida claims to a truth beyond meaning, Fish claims to meaning beyond Truth (with a big t). This is the lie that unveils the truth. The system of values that prevents us from being united with our creative principle is blank slated so that a new form of knowing can be understood, a knowing which sees all principles in a unified field.
The problem here is that once this dialectic has run its course, there's nowhere left to go. The creative principle seeks to resolve, unite, the analytical principle to distinguish and categorize.
If we must turn one off in order to access the other then the two are constantly engaged in a Zero Sum Game, sort of warring, and this amounts to a civil war of the soul, which is the nature of western religion.
Fear against desire, man against nature, man against man, reason against imagination, God against man, God against nature, God against reason, God against imagination.
The primordial apparatus of this dialectic then is negation; the property of negating negates all things until its only left with itself, and yes, it negates even that, and there we are, in a cloud of un-knowing, or knowing which is purely unconscious; floating as it is, in a stream of unconsciousness.
In Lacan, the symbolic order is patterned atop the unconscious, which is itself a roiling void of potentiality, the Zero principle in its Urizenic articulation, the wildcard, the variable, the infinite potential, the numberness of the the number.
The self-consuming artifact succedes because it fails, because it signifies not itself, but something beyond, meta, trans. It is a metaphysic of the fractured, a transpersonal identity that can be looked from, but not at. It is Tao for the Taoist, the Holy Spirit for the Christian.
It is then that Fish digresses into a Plato's Gorgias where he elucidates the human condition of the soul, which is to be constantly at war with itself. It is perhaps Plato's fault, for he is the one who made the primordial distinction between soul and body which forged the necessity of warring in the first place. The fallen live to delight in their own body, the philosopher mistrusts such indulgent behavior being at once the master of his own domain, and the slave of his own mastery.
There is a sense that we are born into this world with desires and expectations that are utterly foreign to beings which have evolved here. We spend our lives trying to recover a vision that was lost to us in the fall and this is literally true, (according to Plato) we are literally fallen.
If we are fallen in the Blakean way, then we tripped ourselves up, for Blake's is a vision that recovers the lost vision which allows us to see the infinite in all things.
Urizen himself is the left brained analytical impulse which has taken control of the entire game, ie: taken control over the other faculties of experiencing so as to prevent change.
On some basic level, many of us are comfortable with sameness and predictability. We don't necessarily want change to enter into our systems. We want them to work the same way they worked before. For this we sacrifice the Divine Vision which raises men's perception to the infinite.
In order to do this, we must sacrifice our false selves, the phony egoic image of who we are, as well as its self-bound desires. And it is Blake's argument that this sentence is again false. We don't have to sacrifice our natural desires, we have to sacrifice our self-conception, what in Lacan is referred to a imago and elsewhere in Freud and Jung persona.
We give unnatural precedence to the reputation, thereby conceiving ourselves in the sulfur of another's values, sacrificing ourselves without necessarily seeing it. We must as dialecticians sacrifice the desire to be seen as wise for the wisdom of dialectics is that a thousand falsehoods lead inevitably to the truth.
So then what can we rely on? Our senses? No. Our passions? No. Our reason? Nope.
The trick would be to bring the four intelligences into an order that allows us to integrate them all at once.