Academic journal article International Journal of Psychoanalysis

Delusion and Bi-Ocular Vision

Academic journal article International Journal of Psychoanalysis

Delusion and Bi-Ocular Vision

Article excerpt

As we all know, neither psychoanalysis nor delusion is a simple matter

(Nacht and Racamier, 1958, translated, p. 508)

This contribution seeks to define the specificity of psychotic delusion and to show that this creation of the mind differs in terms of violence and progression from any other pathological mental production. The delusional experience is the result of a grave disjunction in the psyche whose outcome is not readily predictable and the way to which is paved decades before it becomes clinically manifest. It constitutes a disconnection so fundamental that it is impossible to say whether the patient, having once entered into the delusional system, will be able to recover the unity of his2 mind. Delusion is not equivalent to a narration but is a purely perceptual construction which, as such, cannot be treated by the mind as a representation endowed with an implicit meaning. Examination of the specific mode of disjunction that accompanies and threatens to perpetuate the delusional experience may help us to understand the nature and radical character of delusion.

Phantasy, myth and delusion

To facilitate understanding of the nature of delusion, I shall adduce some contributions from the psychoanalytic literature which address the differences and similarities between delusion, phantasy, and myth.

In attempting to distinguish phantasy activity from the delusional experience, Lichtenberg and Pao (1974) pointed out that in phantasy the patient preserves a certain distance from the image created, whereas in delusion he clings to it desperately and irrevocably. Phantasy can easily be disrupted, whereas a lapse into delusion gives rise to disorientation and anxiety. With the waning of a phantasy, the subject will experience a diminution of pleasure if the phantasy is positive, or relief in the case of a negative phantasy. In the view of these authors, delusions are very stubborn because they are based on extremely archaic defensive configurations. They cite Freud's comment (1939, p. 76) on the persistence of archaic defences that are preserved unchanging within the psyche: "A State within a State: an inaccessible party".

Another important distinction drawn by the two authors is between phantasy and desire. Whereas in the former the derivative of the drive is fulfilled, in desire there is a clear sense of time and of waiting, and doubt remains as to accomplishment of the purpose. In desire, the future, present and past retain their representations; in phantasy, on the other hand, time and space can be manipulated by magic processes. For this reason, phantasy belongs more to the id, whereas desire falls within the realm of the ego, the preconscious and the conscious.

Igra (1997) postulates that the difference between myth and delusion depends on the mental state - whether open or closed - of the person generating them. Whereas myth preserves a creative potential open to symbolization, delusion is characterized by symbolic poverty and rigid structures. Myth can be regarded as a narration aimed at understanding reality. Because myth can create, expand, and transform symbols, it can generate new meanings, thus revealing what is not yet known. Delusion, on the other hand, is a closed reality that is incapable of creating symbols. Delusion is composed of signs already saturated by preformed convictions which entail a limited range of meanings. In the delusional experience, dominated as it is by omniscience, facts are deemed to be already obvious and thoughts are confused with actions. There is no such thing as a personal meaning, but only private realities isolated from the symbolic universe. In the open mental state to which myth belongs, uncertainty is linked to hope and expectation, whereas in its closed counterpart that is characteristic of delusion, uncertainty becomes persecution.

Pazzagli (2006) holds that narration and delusion have very different communicative characteristics. Delusions have no communicative intent and present themselves as absolute, saturated and unmodifiable truth, which can only be either believed or refuted. …

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