Search

The aim of this work is to propose some thoughts on the construction of alternative realities in which some patients live. They can be designated in various ways as hysterical, borderline, psychotic or even people who manage to lead an apparently normal life. To appear real, alternative worlds must be constructed with special fantasies that do not correspond to the kind of fantasy capable of creating art or myth. The alternative sensorial world is an antagonist of the relational and emotional world and tend to monopolize the interest of the person who builds it. Even when it does not produce serious psychopathological situations, the construction of an alternative reality makes the identity of the person weak and uncertain. These patients prove unable to cope with the difficulties of life and often stop in their emotional growth. [ABSTRACT FROM AUTHOR]

In this contribution I will sustain that, given its origin, meaning and function, the superego is readily susceptible to the pathological distortions observed in clinical psychoanalytic work. After all, while we as psychoanalysts are unacquainted with the "normal" superego, we are accustomed to seeing patients with either an abnormal sense of guilt or a seeming absence of guilt. However, a distinction must first be drawn between the primitive superego and its pathological counterpart. Whereas some clinical situations involve a superego whose primitive aspects feature prominently in the foreground, in other cases one encounters psychopathological structures that do not stem from the primitive superego, even if they share the latter's seductive, dominant or intimidatory aspects. [ABSTRACT FROM AUTHOR]

Translations of summary The delusional experience is the result of a grave disjunction in the psyche whose outcome is not readily predictable. Examination of the specific mode of disjunction may help us understand the nature and radical character of delusion. I will present the therapy of a psychotic patient who after many years of analysis and progresses in his life continues to show delusional episodes although limited and contained. In his case, the two visions, one delusional and the other real, remain distinct and differentiated from each other because they both possess the same perceptual character, that of reality. He has a bi-ocular vision of reality and not a binocular one because his vision lacks integration, as would necessarily be the case if the two visions could be compared with each other. The principle of non-contradiction ceases to apply in delusion. A corollary of the failure of the principle of non-contradiction is that, if a statement and its negation are both true, then any statement is true. Logicians call this consequence the principle of explosion. For this reason, the distinction between truth, reality, improbability, probability, possibility and impossibility is lost in the delusional system, thus triggering an omnipotent, explosive mechanism with a potentially infinite progression. The paper presents some thoughts for a possible analytic transformation of the delusional experience. [ABSTRACT FROM AUTHOR]

In this contribution, which takes account of important findings in neuroscientific as well as psychoanalytic research, the authors explore the meaning of the deep-going distortions of psychic functioning occurring in hallucinatory phenomena. Neuroscientific studies have established that hallucinations distort the sense of reality owing to a complex alteration in the balance between top-down and bottom-up brain circuits. The present authors postulate that hallucinatory phenomena represent the outcome of a psychotic's distorted use of the mind over an extended period of time. In the hallucinatory state the psychotic part of the personality uses the mind to generate auto-induced sensations and to achieve a particular sort of regressive pleasure. In these cases, therefore, the mind is not used as an organ of knowledge or as an instrument for fostering relationships with others. The hallucinating psychotic decathects psychic (relational) reality and withdraws into a personal, bodily, and sensory space of his own. The opposing realities are not only external and internal but also psychic and sensory. Visual hallucinations could thus be said to originate from seeing with the 'eyes' of the mind, and auditory hallucinations from hearing with the mind's 'ears'. In these conditions, mental functioning is restricted, cutting out the more mature functions, which are thus no longer able to assign real meaning to the surrounding world and to the subject's psychic experience. The findings of the neurosciences facilitate understanding of how, in the psychotic hallucinatory process, the mind can modify the working of a somatic organ such as the brain. [ABSTRACT FROM AUTHOR]