ABSTRACT
Some people become delusional when their ability to cope is overwhelmed by mood, intense feeling or drugs. Some patients are delusionally psychotic as the result of disordered thinking, and have tried repeated antipsychotic medication and inpatient hospitalisation, with little ameliorating effect. An intensive psychotherapy may unearth the origins of a delusional system, and play a much more primary role in treatment. Perhaps some schizophrenic and delusional patients are vulnerable neurologically and constitutionally; others may be so on a psychological basis, as a result of traumatic events. There is a high probability of the creation in childhood of imaginary companions who stayed, or receded for a few years and then returned with delusional force. Whether overwhelmed by external events or reacting to internal psychological issues, our task is to help the patient calm down sufficiently so that psychotherapy of the delusional state may proceed.
