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Delusions have often been considered incomprehensible, haloed with fear, dread, and awkwardness. Emotional encounters with delusions stimulate complex countertransferencial dynamics entailing the experience of the psychotic’s withdrawal from, and renunciation of, reality. We suggest that delusions represent unsymbolized emotional experiences that were so violent that the development of ordinary symbolization processes was prevented and, hence, their communicative potential is extremely high. It is manifested during sessions through delusional emergences and the consequent process of the therapist thoroughly working through such complex countertransferencial experiences may foster transformation and initiate symbolization processes. Drawing on in-depth clinical material from the treatment of a schizophrenic girl, we discuss our understandings and identify different steps in the transformation process of delusions showing the patient’s growing capacity to use the analytic relationship.
Paola Solano holds a M.D., and a Ph.D. from the Psychiatric Clinic, Dpt. of Neurosciences, Genetics and Maternal Care (DINOGMI), at the University of Genova, Italy. She is candidate at the Institute of the Italian Psychoanalytic Society (SPI) and psychodynamic psychotherapist. Her clinical activity and research focus on psychoanalytic treatment of psychosis and suicidal behaviors.
Luca Quagelli holds a Ph.D. from Paris Diderot University in Paris, France. Child psychoanalytic psychotherapist, his studies focus on the clinic of psychic figurability and the work of the negative both in children and adults. His clinical activity and research focus on the psychoanalytic treatment of autistic and psychotic children and adolescents.