ABSTRACT
The psychodynamic orientation of the rehabilitation unit provided the setting necessary for the psychotherapy to be attempted, and Elmer was soon transferred to a treatment home that provided milieu therapy for six young psychotic men and women. After ten years of chronicity and disablement, Elmer was taken on at the age of 30 for twice-weekly psychotherapy by an experienced psychotherapist. Elmer made good contact with the therapist and soon acquired sufficient trust to disclose important aspects of his past life and details of his delusional inner world. Anti-psychotic medication treatment achieved a remission in Elmer's psychosis, and he was discharged after six months, extensive neurological investigations having failed to reveal any abnormality. As his self-understanding increased, he slowly abandoned such activities as the designing of spaceships, and his delusions and associated paranoid fears receded. A fetish may originate in early infancy as a defence against separation and subsequently as an attempt to repair a defective body image.
