Delusion and reparation

This paper looks at the reparative quality of delusional systems. The Author explores and expands Freud's notion of delusion as an 'attempt at reparation'. Even if a delusion is mostly the consequence of hatred of reality and an omnipotent idealized construction to protect the ego from persecutory anxiety stemming from a destructive superego, its content and function show greater complexity. The function of a delusion is not just to protect the ego but also to protect the object (the analyst in the session) from the patient's violence. In order to show the coexistence in delusional systems of manic defensive aspects with proper depressive reparative ones, the Author presents detailed clinical material from the analysis of an adolescent patient who suffered from intense persecuting voices that negated her right to be alive. The paper proposes that understanding the fluctuation and manifestation of reparative unconscious phantasies, the recognition of their depressive aspects and of their specific function as they are lived out in the transference relationship is central to the development of psychic change in psychotic processes.