Symbol Formation and the Delusional Transference

THE TITLE of my paper, “Symbol Formation and the Delusional Transference”, brings together two phenomena: the crucial matter of symbol formation and the important clinical phenomenon of the delusional transference. The designation “delusional transference” may be unfamiliar to many readers, but I am sure that all will recognize in my subject features that are, in fact, familiar in their own clinical experience.

My interest in this subject arises partly from my conviction that in analytical psychology we do not have enough theory for the whole range of our clinical work. We are all familiar with Jung's wish to avoid having too much theory, and with his fear that theoretical preconceptions might be imposed on patients and interfere with the spontaneity of the synthetic processes that appear in the dialectic relationship of analysis. However valid this view may be, or may have been, it has its limitations. For there are certain patients, and certain mental areas in other patients, where we need new concepts, or the reformulation of existing ones, to help us to see what is going on and what, if anything, we should do about it, in terms of therapeutic intervention. I think that many analytical psychologists will agree with me about this, and that this need to extend and modify our theories is reflected in the development of a Section of child analysis in the London Group, and in original work such as that of Fordham.

The type of case I am concerned with here is the patient who develops delusional ideas about the analyst during the course of treatment. These may be present from the beginning, or may appear only for brief periods. I do not include florid psychotic cases, not because the phenomena are necessarily of a different order, but because in such cases they are only too obvious. In the cases I am dealing with they may be far from obvious, and may even go undetected. In fact I believe they are much more common than is generally realized. I think that this s