ABSTRACT
The process of psychotherapy with delusional patients may, on occasion, be a short one, as the patient quickly grasps the symbolic meaning of his delusions or hallucinations and the feelings underlying such a delusional orientation pour out. The psychotherapy of delusional states has become a nearly lost art in this era of antipsychotic medications. Although medication can be very helpful, and at times essential, there are a number of reasons why antipsychotics alone may not help. Delusional orientation in a number of diagnostic categories diminished and sometimes stopped as patients responded favourably, over time, to an interpretive psychotherapeutic exploration of the meaning and function of their delusional thinking. As the process of intensive psychotherapy proceeds, various intrapsychic events happen. Little by little, the schizophrenic or delusional patient ingests, then introjects and eventually incorporates the therapist and a more rational observing attitude. This is where the art of psychotherapy with these most disturbed patients is so important.
