An application of Bion’s theory of thinking and transformations in hallucinosis. An experience of supervision with Dr Donald Meltzer

I hope in this paper to show how Bion’s theory of thinking and his later theory of transformations in hallucinosis, enabled psychotherapy in a special school setting many years ago to be undertaken with a psychotic child who was constantly hallucinating. The work was carried out under the expert supervision of Dr Donald Meltzer who managed creatively to employ these theories to help me make sense of what seemed like incomprehensible communications. Bion’s theories were indispensable in being able to make sense of non-sense. I hope to illustrate the nature of hallucination where according to Bion, the sense organs operate in reverse: showing how the function of hallucination is to provide an alternative to thought about absent objects or ‘no-things’. The distinction between thought based on the capacity to bear the frustration about the absence of the ‘no-thing’ long enough to discover its meaning, is contrasted with the immediacy of hallucination where the ‘meaning’ is already ‘known’. The nature and function of naming is explored along with its precursor: the binding of phenomena. I also discuss how rare it is nowadays for child psychotherapists to treat children like this as they tend to be medicated and not referred for psychotherapy.