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The author presents in the best psychoanalytic tradition his understanding of
the hallucinations and delusions of a deeply regressed schizophrenic. Such restitution processes of the ego as delusions were traced historically to the patient's background. Her traumatic childhood and her fantasies were finally uncovered; they correspond in minute detail to many of her symptoms. It was possible to corroborate Freud's idea that a delusion contains a factual statement about the patient's life. The ideas of reference and persecutory delusions, for instance, were understood in terms of a sadistic primal scene (the patient's mother was killed by her father when she was nine months old). The parent's coitus could only lead to her destruction. Hence the persons who 'talked about' her and those who later 'persecuted' her were always plural, because 'the persecutors are formed by the parents' being together, and against her, in a [sadistic] primal scene'. The primal scene led to her actually losing both parents at once: mother died because father shot her, and father went to prison. These feelings about the parents were later elaborated into 'a beast' of dual character, having 'a good penis' which gave pleasurable masturbatory sensations, and 'a bad penis' which terrorized the patient at night. The hallucination also represented her father's incestuous approaches. The father, after completing his sentence in prison for the 'crime of passion', forced the patient to live with him. When she was eleven she deserted him because he had twice approached her sexually while drunk. The delusional system based on these traumas was worked out in the 'narcissistic transference' of the patient. The article shows a healthy understanding of the countertransference.
This patient had been psychotic for the eight years preceding treatment. At first the therapy resembled Rosen's 'direct analysis', but with more attention than Rosen accords to the primary thought processes and the app