Regression and Perception in Psychotic States*

THE APPLICATION OF PSYCHOTHERAPY commits each of its practitioners to a belief that the processes he is treating are psychogenic, functional, and reversible. Furthermore, it commits him to offer some explanation as to why he believes these processes to be reversible and by what mechanisms he believes they can change as a result of psychotherapy. However, psychotherapists tend to be shy when it comes to revealing what is really going on in the therapeutic situation. Most of the time they have to content themselves with presenting generalities and suggesting inferences, the usefulness of which, in their communication with their colleagues, is sometimes limited by differences in terminology. To understand a particular psychiatric writer requires extensive study. It also requires good will—a point which is not to be overlooked, for the psychiatrist is not likely to be free of prejudices; his training in accordance with one or another particular viewpoint may entail unresolved loyalties, and so, absurd as it may sound, he is perhaps less prepared for unbiased inquiry than are members of other professions.

This question of bias deserves consideration in its own right. I am reminded of the teaching of Descartes that philosophy must begin with universal doubt; hence he discarded the practice of the schoolmen of looking to authority as the ultimate source of truth. Yet universal doubt is a bias in itself. As Peirce (1923), the American philosopher, expresses it, “A person may, it is true, in the course of his studies, find reason to doubt what he began by believing, but in that case he doubts because he has a positive reason for it” (p. 146).

To return to my opening statement, I shall, in this paper, be chiefly concerned with the application of psychotherapy to psychotic states and with the ways in which psychotic states may change as a result of psychotherapy. I shall try to suggest some revisions in the formulation of