[The structure and psychodynamics of delusion]

Discussing classical psycho-analytic interpretations of delusion the authors show that neither the notion of "projection" nor the theory of regression to very early stages of ego-formation provide a satisfying explanation for the difficulty of those patients to discern inner world from external reality. An approach to this crucial question rather has to consider the underlying structural differences in order to differentiate between neurotic and psychotic symptom formation. The basis for psychotic symptoms is identified in a deficient mode of symbol-formation impeding certain structural patterns or spheres of conflict from being integrated into the whole of the subject's existence. If required under certain circumstances those "excluded" parts of the personality overwhelm the subjective experience arising as something radically strange and uncanny. A psychotic phenomenon like delusion bears witness of this break down, but at the same time is an attempt to cope with this threatening experience.