Some observations on hallucination: clinical application of some developments of Melanie Klein's work

The analysis of a psychotic patient is used to illustrate the importance of certain developments of Melanie Klein's work. The case presentation focuses upon the formal qualities of the patient's communications, many of which were amalgamations of profoundly incompatible elements, particularly a subtle destructiveness which parasitized seemingly impartial reports about her state of mind. These communications embodied important object relationships. The patient used her communications to conjure up psychic disintegration. As a result of her involvement in 'chuntering' her preoccupations would become increasingly violent, cruel and sexualized. The patient's equivocal communications generate confusion. This is central to the patient's experience of self-destruction as persecution. A number of ideas are advanced concerning the origins of the patient's hallucinations. These include her relish at the introduction of sensory distortions. Questions are raised about the nature of certain types of hallucination, the origins and intractability of concrete thinking, about verbalization and about the typology of psychotic patients.