Psychoanalytic Notes on Psychosis, Disturbances in Perception, Delusional Narratives, and the Bayesian Predictive Processing Model of the Brain

Abstract

ABSTRACT This paper summarizes Freud’s contributions to the psychology of psychosis and shows how Freud’s conceptions provide a prelude to modern Bayesian predictive processing models of how the brain works, which in turn offer explanations a variety of psychotic phenomena, including ideas of reference, hallucinations, and delusions. The paper offers a psychological model of psychosis from a developmental point of view that draws upon psychoanalytic object-relations theory, and concludes with a detailed case history of the successful psychotherapeutic treatment of a man with a paranoid delusion of 8 years duration that was unresponsive to neuroleptic medication, but who achieved a robust recovery with 18 months of once-a-week psychotherapy. The case example is discussed from a Bayesian predictive processing and psychoanalytic point of view.