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Spontaneous social recovery in a hospitalized, mentally ill patient, following an acute psychotic episode, is by no means an uncommon occurrence. However, the means by which the return to social health are achieved, are all too often clothed in obscurity. Without the introduction of individual, intensive psychotherapy—and that is implicit in our use of the term spontaneous—the variety and nature of novel experiences to which the patient is exposed during the course of routine hospital procedure do not permit an accurate estimate of those influences promoting recovery. The comments of the patient solicited directly subsequent to the episode, reveal usually but little more than rationalizations concerning the true nature of the change: occupational therapy helped him, he enjoyed the recreational activities, the baths quieted him, or more often he just does not know how to account for his improvement. Significantly enough, there is, as a rule, little mention made of the human beings with whom he has had contact and established a relationship.
It is the common assumption that the spontaneous disappearance of delusions is associated with a healthy appreciation by the patient of their fantastic character; that somehow or other the pressure of external reality, exercised under the guise of institutional routine, forces upon him a realization of the distinction between what is real and what is unreal; that he thereupon becomes fully cognizant of the bizarre nature of his delusional beliefs, and renounces them because of his increased conviction of the reality aspects of his situation; that this renunciation inaugurates social recovery.
It was observed, however, during the course of a psychoanalysis