Pazzagli Adolfo
University of Florence, Italy.
J Am Acad Psychoanal Dyn Psychiatry. 2006 Summer;34(2):367-76. doi: 10.1521/jaap.2006.34.2.367.
Delusions and narrations have very different communicative characteristics. Delusion, when reported, places itself outside of a shared communication, of an interactive field; it is presented as an absolute, non-modifiable, saturated truth, that can only be believed or refuted. A clinical vignette is an example on the possibility that psychoanalytic treatments might be sometime able to at least partly transform a delusion into an account narrated in an interactive situation. The possibility of treatment of a delusion by means of psychotherapy, which deals both with the delusion as a symptom and with the structures underlying it, by creating a relationship whose development can leave the person free to shed his or her delusion, should caution us against too hastily declaring that symptom inaccessible and thus considering it-as not infrequently happens -a sort of "marker" denoting a pathology which, from a psychological perspective, cannot be treated.
妄想与叙述具有截然不同的交流特征。当被报告时，妄想处于共享交流、互动领域之外；它被呈现为一种绝对的、不可修改的、饱和的真理，只能被相信或反驳。一个临床案例说明了精神分析治疗有时可能至少部分地将妄想转化为在互动情境中叙述的故事的可能性。通过心理治疗来治疗妄想的可能性，这种治疗既处理作为症状的妄想，也处理其潜在结构，通过建立一种关系，其发展可以让患者自由摆脱妄想，这应该提醒我们不要过于草率地宣称该症状无法触及，从而像经常发生的那样，将其视为一种表示某种病理学的“标志”，从心理学角度来看，这种病理学无法治疗。
