Delusional construction: defence or pathological construction?

Delusional construction: defence or pathological construction? - The aim of this paper is to explore in depth the nature of the delusional construction so as to render it susceptible to a therapeutic approach. Particular attention is devoted to the nature and structure of delusion and its relation to the healthy part of the personality. In the author’s view, delusion is a psychopathological construction that makes it impossible for the patient to understand his own experience. The analytical task is to reduce its power over the patient’s mental functioning, in order to remove an obstacle to the reaccessing of intuitive thought and the re-establishment of contact with emotional reality. There is a place in the patient’s mind, virtually inaccessible to the analyst, where the patient constructs his psychosis. The dreams that psychotic patients bring to analysis are often very useful because they describe, often with great accuracy, psychotic functioning and the exciting and confusing power of the delusional nucleus. In this sense, as the author attempts to show in clinical vignettes, psychotic dreams are very helpful because they constitute true communications to the analyst. The communication of the dreams breaks down the secrecy of the delusional retreat. Considered in these terms, whereas delusion conceals, dreams communicate.

Keywords: Psychotic state, psychotic dreams, delusion, psychotic part, emotive reality

Franco De Masi, Il delirio: difesa o costruzione psicopatologica? in "RICERCA PSICOANALITICA" 2/2010, pp 73-92, DOI: 10.3280/RPR2010-002008