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On the nature of intuitive and delusional thought: its implications in clinical work with psychotic patients.
Int J Psychoanal. 2003 Oct; 84(Pt 5):1149-69.IJ

Abstract

The author tries to differentiate intuitive imagination from delusional imagination and hypothesises that psychosis alters the system of intuitive thinking, which consequently cannot develop in a dynamic and selective way. Scholars of different disciplines, far removed from psychoanalysis, such as Einstein, Hadamard or Poincaré, believe that intuitive thinking works in the unconscious by means of hidden processes, which permit a creative meeting of ideas. Thanks to Bion's work, psychoanalysts have begun to understand that waking thinking is unconsciously intertwined with dream-work. The delusional construction is similar to a dreamlike sensorial production but, unlike a real dream, it remains in the waking memory and creates characters which live independently of the 'dreamer's' awareness. It is a dream that never ends. On the contrary, the real dream disappears when it has brought its communicative task to an end. In the analysis of psychotic patients it is very important to analyse the delusional imagination which dominates the personality and continuously transforms the mental state, twisting emotional truth. The delusional imagination is so deeply rooted in the patient's mental functioning that, even after systematic analysis, the delusional world, which had seemed to disappear, re-emerges under new configurations. The psychotic core remains encapsulated; it produces unsteadiness and may induce further psychotic states in the patient. The author reports some analytic material of a patient, who, after a delusional episode treated with drugs, shows a vivid psychotic functioning. Some considerations are added on the nature of the psychotic state and on the therapeutic approach used to transform the delusional structure. This paper particularly deals with the difficulty in working through the psychotic episode and in 'deconstructing'the delusional experience because of the terror connected with it. In the reported case, the analytic work changed the delusional construction into a more benign one characterised by phobic qualities. The analysis of the psychotic transference allowed the focus to be on the hidden work which had been continuously influencing the transferential picture of the analyst and the patient's psychic reality.

Authors+Show Affiliations

francodemasi@liberto.it

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14633423

Citation

De Masi, Franco. "On the Nature of Intuitive and Delusional Thought: Its Implications in Clinical Work With Psychotic Patients." The International Journal of Psycho-analysis, vol. 84, no. Pt 5, 2003, pp. 1149-69.
De Masi F. On the nature of intuitive and delusional thought: its implications in clinical work with psychotic patients. Int J Psychoanal. 2003;84(Pt 5):1149-69.
De Masi, F. (2003). On the nature of intuitive and delusional thought: its implications in clinical work with psychotic patients. The International Journal of Psycho-analysis, 84(Pt 5), 1149-69.
De Masi F. On the Nature of Intuitive and Delusional Thought: Its Implications in Clinical Work With Psychotic Patients. Int J Psychoanal. 2003;84(Pt 5):1149-69. PubMed PMID: 14633423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - On the nature of intuitive and delusional thought: its implications in clinical work with psychotic patients. A1 - De Masi,Franco, PY - 2003/11/25/pubmed PY - 2004/2/20/medline PY - 2003/11/25/entrez SP - 1149 EP - 69 JF - The International journal of psycho-analysis JO - Int J Psychoanal VL - 84 IS - Pt 5 N2 - The author tries to differentiate intuitive imagination from delusional imagination and hypothesises that psychosis alters the system of intuitive thinking, which consequently cannot develop in a dynamic and selective way. Scholars of different disciplines, far removed from psychoanalysis, such as Einstein, Hadamard or Poincaré, believe that intuitive thinking works in the unconscious by means of hidden processes, which permit a creative meeting of ideas. Thanks to Bion's work, psychoanalysts have begun to understand that waking thinking is unconsciously intertwined with dream-work. The delusional construction is similar to a dreamlike sensorial production but, unlike a real dream, it remains in the waking memory and creates characters which live independently of the 'dreamer's' awareness. It is a dream that never ends. On the contrary, the real dream disappears when it has brought its communicative task to an end. In the analysis of psychotic patients it is very important to analyse the delusional imagination which dominates the personality and continuously transforms the mental state, twisting emotional truth. The delusional imagination is so deeply rooted in the patient's mental functioning that, even after systematic analysis, the delusional world, which had seemed to disappear, re-emerges under new configurations. The psychotic core remains encapsulated; it produces unsteadiness and may induce further psychotic states in the patient. The author reports some analytic material of a patient, who, after a delusional episode treated with drugs, shows a vivid psychotic functioning. Some considerations are added on the nature of the psychotic state and on the therapeutic approach used to transform the delusional structure. This paper particularly deals with the difficulty in working through the psychotic episode and in 'deconstructing'the delusional experience because of the terror connected with it. In the reported case, the analytic work changed the delusional construction into a more benign one characterised by phobic qualities. The analysis of the psychotic transference allowed the focus to be on the hidden work which had been continuously influencing the transferential picture of the analyst and the patient's psychic reality. SN - 0020-7578 UR - https://www.unboundmedicine.com/medline/citation/14633423/On_the_nature_of_intuitive_and_delusional_thought:_its_implications_in_clinical_work_with_psychotic_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0020-7578&date=2003&volume=84&issue=Pt 5&spage=1149 DB - PRIME DP - Unbound Medicine ER -