This chapter describes the ways in which psychoanalytic theory has attempted to identify the nature of the delusional experience. It considers delusion to be the result of a withdrawal from reality that began in childhood. This dissociated reality provides the necessary nourishment for the psychotic part of the personality, destined to take the upper hand during the course of the full-blown illness. The chapter explains why it is so very tenacious and why it tends to re-present itself even after the true psychotic episode has been overcome. The various psychoanalytic conceptualisations about psychosis indicate an important distinction that calls for different therapeutic techniques. The persecutory delusional episode, which had begun before treatment, had appeared after a period of megalomania in which Giovanni had believed he could become powerful and famous, destined to dominate the world. In the fragment, the delusion was quickly re-formed on the basis of elementary associative connections.