Following an overview of theories on psychosis from Freud, Lacan, Bion and Winnicott, a hypothesis on the pathogenesis of schizophrenic delusion is proposed under consideration of the dilemma concept of Mentzos. An identity dilemma leads to dissolution of the ego organization with a disruption of subjective time. This makes it possible to insert a specific form of defence, which does not recognize the reality of a denial as being real but promotes the loss to the object of a search in the future. The technical consequences of this hypothesis for treatment are presented and discussed.
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