The Hamiltonian H specifies the energy levels and time evolution of a quantum theory. A standard axiom of quantum mechanics requires that H be Hermitian because Hermiticity guarantees that the energy spectrum is real and that time evolution is unitary (probability-preserving). This paper describes an alternative formulation of quantum mechanics in which the mathematical axiom of Hermiticity (transpose +complex conjugate) is replaced by the physically transparent condition of space–time reflection ( ) symmetry. If H has an unbroken symmetry, then the spectrum is real. Examples of -symmetric non-Hermitian quantum-mechanical Hamiltonians are and . Amazingly, the energy levels of these Hamiltonians are all real and positive!

Does a -symmetric Hamiltonian H specify a physical quantum theory in which the norms of states are positive and time evolution is unitary? The answer is that if H has an unbroken symmetry, then it has another symmetry represented by a linear operator . In terms of , one can construct a time-independent inner product with a positive-definite norm. Thus, -symmetric Hamiltonians describe a new class of complex quantum theories having positive probabilities and unitary time evolution.

The Lee model provides an excellent example of a -symmetric Hamiltonian. The renormalized Lee-model Hamiltonian has a negative-norm 'ghost' state because renormalization causes the Hamiltonian to become non-Hermitian. For the past 50 years there have been many attempts to find a physical interpretation for the ghost, but all such attempts failed. The correct interpretation of the ghost is simply that the non-Hermitian Lee-model Hamiltonian is -symmetric. The operator for the Lee model is calculated exactly and in closed form and the ghost is shown to be a physical state having a positive norm. The ideas of symmetry are illustrated by using many quantum-mechanical and quantum-field-theoretic models.