Thinking is a mental process of reflecting significant aspects of objects and phenomena of the objective world and their internal relationships.
Classification of thinking pathology
I. Quantitative disorders(disorders of the form of disturbance, formal, associative process).
b) Mobility
c) Focus
d) Grammatical and logical structure
II Qualitative disorders(disorders of idea content, structure, idea content)
a) obsessions
b) super valuable ideas
c) crazy ideas
Quantitative disorders.
Disturbances in the pace of thinking.
Acceleration of the pace of thinking (tachyphrenia) - accelerating the formation of the number of associations per unit of time. It manifests itself as accelerated speech (tachylalia); speech is mostly monologue. At the same time, however, the purposefulness of thinking remains, due to the predominance of simple, superficial associations. The most striking manifestation of the acceleration of the pace of thinking is leap of ideas (whirlwind of thoughts), manifested by a continuous change in the topic of thinking, depending on the phenomena and objects that come into view. Identified in manic syndromes.
Mentism (mantizm) - an involuntary influx of thoughts, memories, images that does not obey the will. It is a manifestation of associative automatism and is part of the structure of Kandinsky-Clerambault syndrome.
Slowing the pace of thinking (bradyphrenia) - slowing down the occurrence of the number of associations per unit of time. It manifests itself as a slow rate of speech (bradyllalia). The content of thoughts and ideas is monotonous and poor. Included in the structure of the depressive syndrome.
Sperrung (thought blockage) - state of blockade, breakage thought process. Subjectively, it feels like “emptiness in the head”, “a break in thoughts”.
Impaired thinking mobility.
Stiffness of thinking (torpidity, viscosity) - difficulty in sequential flow of thoughts, accompanied by a slowdown in the pace of thinking. It seems difficult to move from one thought to another or from one topic to another. Manifestations of stiffness according to the degree of severity of symptoms are detail, thoroughness, and viscosity. Occurs in epileptic dementia, psychoorganic syndromes, paranoid syndrome.
Violation of purposeful thinking.
Slipping - objectively unmotivated and not externally correctable transitions from one logically and grammatically correct thought to another. It is important to note that in this case there is no return to the previous thought even after indicating this from the outside (for example, by a doctor during a conversation).
Reasoning - ranting on lengthy topics on an unimportant matter. It is presented in the form of banal moral teachings, truths, and well-known sayings.
Violation of grammatical and logical structure.
Disjointed thinking - lack of connection between individual conclusions and judgments. There are two types of discontinuity - logical discontinuity - there is no logical connection between the individual components of a thought while its grammatical structure is preserved, and grammatical discontinuity (schizophasia, “verbal hash”) - loss of the grammatical structure of speech. It is necessary to answer that some authors (A.V. Zhmurov, 1994) put a slightly different meaning into the concept of schizophasia, primarily implying the monologue of broken speech.
Incoherence of thinking (incoherence) - violation of the logical and grammatical structure of speech at the same time. Outwardly, incoherence may resemble discontinuity, however, the latter is observed against the background of a formally clear consciousness, in contrast to the incoherence that manifests itself against the background of a darkened consciousness.
Speech stereotypies (interactions) - involuntary, often multiple, meaningless repetition of words and phrases uttered both by the patient himself and by those around him. These include: Verbigerations - repetition (“stringing”) of meaningless words and sounds.
Perseverations - getting stuck answering questions (for example, “What is your name?”, “Vasya”, “What is your last name?”, “Vasya”, “Where do you live?”, “Vasya”, etc.).
Echolalia - repetition in an unchanged form of individual words and phrases spoken by others.
Violations of grammatical and logical structure are detected in schizophrenic syndromes, organic dementia, etc.
Qualitative disorders.
Obsessions - represent a particular variant of obsessive phenomena (obsessions). They are involuntarily, against the will, persistent ideas, thoughts, judgments that arise, while they are correctly understood and critically assessed by the patient and cause him mental discomfort.
According to the mechanisms of occurrence of obsession, they are divided into situational- a consequence of psychogenia (obsessions contain a psycho-traumatic motive), autochthonous- arise for no apparent reason, divorced from reality.
Situational and autochthonous obsessions are primary obsessions. Following the primary ones, secondary ones are formed, which are protective in nature, relieving the mental discomfort that the primary ones cause, they are called ritual obsessions.
Most often they are various motor acts - obsessive actions. For example, primary obsessive fear infection (mysophobia) leads to the development of a secondary obsession - hand washing (ablutomania).
In combination with the pathology of mental processes, obsessions differ in ideational(obsessive doubts, abstract thoughts, contrasting thoughts, memories), phobias(nosophobia, fear of space, social phobia), obsessive volitional disorders (drives, actions).
Clinical example.
Patient, 42 years old.
One day, due to troubles at work, I felt unwell, shortness of breath and pain in the heart area. From that time on, the thought began to haunt him that he could fall and die at any moment. These thoughts intensified in the stuffy, closed room. Stopped going to public transport. For a long time I tried to hide my experiences from others, because I understood their groundlessness. Later, I became afraid that something would happen at work. One day, on his way to work, he was crossing the railroad tracks when a thought came to his mind: if he managed to pass under a slowly moving carriage, then everything would be fine at work. Subsequently, he did this several times with danger to his life, although he was aware that there was no connection between this action and the danger that something would happen at work.
Obsessions occur with obsessive and phobic syndromes, larval depression.
Super valuable ideas - judgments, conclusions that arose as a result of real circumstances, but subsequently took a predominant position in the mind and have a large emotional charge.
As a result, they occupy a dominant position in a person’s life, are not criticized, and determine his activities, which leads to social maladjustment.
The main differential feature when comparing obsessive and overvalued ideas is a critical attitude towards them - if the first are perceived as something alien, then the second are an integral part of the patient’s worldview.
In addition, if obsessive ideas are an incentive to fight them, then highly valuable ones encourage activities to put them into practice.
At the same time, the main hallmark super valuable ideas from systematized nonsense is the presence real fact, which underlies them. The following main types of overvalued ideas are distinguished: those associated with the overestimation of the biological properties of one’s personality (dysmorphophobic, hypochondriacal, sexual inferiority, self-improvement), associated with the overestimation psychological properties personality or its creativity (extremely valuable ideas of invention, reform, talent), associated with the revaluation of social social factors(ideas of guilt, erotic, litigiousness).
Clinical example.
Patient, 52 years old. Complains about discomfort(but not pain) in the back of the head, sometimes feels as if something is “overflowing” in the head.
I noticed the first signs of the disease two years ago. Since then, he has been examined by many doctors, who found no diseases in him or discovered minor disorders (cervical osteochondrosis).
I had consultations with professors several times and went to medical centers in Moscow. I am convinced that he has serious disease, possibly a brain tumor.
He counters all the doctor’s objections and references to the negative results of numerous examinations, citing excerpts from medical textbooks and monographs describing pictures of diseases “similar” to his illness. He recalls numerous cases when doctors did not recognize a serious illness in a timely manner. He talks excitedly about everything, interrupts the doctor, gives more and more details regarding his “illness.”
Overvalued ideas can occur in the form of independent disorders, in the initial stages of chronic delusional syndromes, etc.
Crazy ideas - Incorrect, false thoughts arising from painful grounds that cannot be corrected either by persuasion or in any other way. The set of delusional ideas is called delusion. Delirium is a formal sign of psychosis.
Signs of delirium:
fallacy of conclusions
the painful basis for their occurrence
full awareness of consciousness with appropriate behavior
impossibility of correction
continuous progression and expansion
modification of personality.
Delusional ideas are classified according to structure and content.
According to its structure, delirium is divided into systematized and unsystematized.
Systematized (interpretative, primary) delirium - characterized by the presence of a logical structure and a system of evidence. It usually develops slowly, in stages:
1. delusional mood,
2. delusional perception,
3. delusional interpretation,
4. crystallization of delirium,
5. systematization of delirium.
Unsystematized delirium (figurative, sensual, secondary) - develops along with other mental disorders (hallucinations, affective disorders etc.), there are no developed logical constructions, evidence system. Almost everything that comes into the ballroom’s field of vision is “woven” into the delirium; the plot of the delirium is unstable and polymorphic.
delirium with increased self-esteem - attributing to oneself non-existent outstanding qualities and properties (altruistic delirium, delirium of greatness, wealth, noble origin, invention, reform, etc.),
Persecutory delusion (delusion of persecution) - belief in threat or harm to mental or physical health, in that the patient is under observation, surveillance, etc.
archaic delirium - the influence of witchcraft, magic, evil spirits;
delusion of influence - exposure to hypnosis, radiation, any “rays”, lasers, etc.; b
red doubles - pathological confidence in the existence of one’s own copies;
delusion of metamorphosis - belief in the ability to transform into an animal, an alien, another person, etc.;
delusion of damage - a pathological belief that material damage is caused to the patient;
delusion of obsession - the idea of introducing animals or fantastic creatures into the body;
delusions of attitude (sensitive) - attributing neutral events, situations, information to one’s own account with a painful interpretation, etc.).
Mixed forms of delirium - characterized by a combination of ideas of persecution with ideas of increased or decreased self-esteem:
delusions of patronage - confidence in conducting experiments on a patient in order to prepare for any special mission;
nonsense of querulanism (litigiousness) - defending one’s false ideas, conclusions with many years of litigation, the means of litigation here are complaints, statements, etc.;
delusion of benevolent influence - conviction of influence from outside for the purpose of re-education, enrichment with experience, special qualities, etc.;
delusion of staging - a belief in a specialty, a setup of surrounding circumstances, events, while others play certain roles, hiding their true intentions.
Based on the involvement of other mental processes, the following are distinguished:
sensory delirium - combines and is closely related to various disorders sensory cognition, while delusional ideas derive their themes from the content of disorders of sensations, perception, representation, confabulatory delusion - combined with confabulations;
affective delirium- combined and associated with emotional disorders,
residual delirium - is residual phenomenon after emerging from a state of darkened consciousness and is characterized by uncriticality towards experiences acute period diseases.
Clinical example.
Patient, 52 years old. During last year abandoned work, writes something all day and even at night and carefully hides what he has written. He says that he invented the L-2 apparatus to capture thoughts at a distance. In his opinion, this invention should become the basis for a “technical revolution” and “has enormous defense significance.” Shows a lot of drawings, a thick manuscript in which, using equations from elementary mathematics, simple laws physicists are trying to substantiate their “hypothesis”. I took the first copy of the manuscript to Moscow, but on the way the suitcase was stolen. I am absolutely sure that the theft was committed by foreign intelligence agents. He is deeply and unshakably confident that he is right.
To characterize thinking, one should also keep in mind its verbal expression, namely, the construction of a phrase when oral speech and suggestions in writing. As you know, human speech is characterized by vocabulary and grammatical structure. It has been established that the number of words that a given person generally uses, and most importantly, their abstract level, largely reflect the level of his intelligence. In the same way, the grammatical structure of speech (as if reflecting the degree mental development humanity) is important characteristic thinking this person.
U mentally healthy people Two types of thinking are possible: logical-associative and mechanical-associative. At logical-associative type of thinking in the formation of his judgments and conclusions, a person goes to the goal “directly,” so to speak, the shortest path, that is, through semantic neuroassociations. Sentences and phrases (with this type of thinking) are constructed according to the laws of associations, revealing complex, most important (in particular, cause-and-effect) connections between objects and phenomena. This - highest type thinking, genetically, of course, connected with another, mechanical-associative type his. With a mechanical-associative type of thinking, emerging judgments and conclusions are expressed in sentences and phrases constructed primarily according to the laws of mechanical associations, that is, associations based on similarity (consonance, contrast) and contiguity in space and time.
It has been established that in a mentally healthy adult, the logical-associative type of thinking is the main, leading one, while the lower level, mechanical-associative type, predominates in children and the elderly. In cases mental disorders these relationships change radically.
A number of symptoms related to this stand out depending on the change in the pace and nature of the thought process.
Accelerated thinking is characterized by the facilitated emergence of associations and, as it were, an increase in the number of new associations that are formed in a given period of time. The latter is rarely revealed and more often the impression of rapid thinking is produced by verbosity, speech and psychomotor agitation manic patients.
Slow thinking- an undoubted clinical reality. It is manifested by a decrease in the number of associations formed in each this moment, difficulty in forming associations and connecting ideas. The latent period of speech reactions increases by 3-5 and even 10 times. The thinking of such (usually depressed) patients comes down to monoideism, and is sometimes experienced by the patient as a complete inability to think.
Stiffness (viscosity, torpidity) of thinking lies in the difficulty of continuity of judgments in the course of thinking, the transition from one idea to another. The speech and movements of patients become slow.
Thoroughness of thinking is manifested in a decrease, sometimes complete loss of the ability to separate the main from the secondary, the important from the unimportant, as a result of which, when expressing his thoughts, the patient gets stuck on meaningless little things, unnecessary details.
Blockage of the thought process (sperrung of German authors) consists of a sudden interruption of the associative process, a stop, a break in thought, the inability to restore an interrupted thought against the background of an unclouded consciousness.
Much more important in clinical practice is the group of symptoms that are formed when there is a violation of the harmony between the grammatical structure of speech and its content and are united by the concept of speech confusion.
At manic speech confusion in patients against the background of speech excitement, emotionally charged verbosity, figurative thinking clearly predominates with an obvious decrease in the general level of concepts due to a sharp weakening of logical-associative thinking. Due to the sharp weakening of active attention and the gross predominance of passive attention, patients easily move from one topic to another, from one subject to another, which is also reflected in the speech of patients. In the thinking and speech of patients, the number of logical semantic associations clearly decreases with a clear dominance of mechanical associations based on similarity (consonance, contrast) and contiguity in space and time. Patients rhyme easily and begin to write poetry, but due to a clear decrease in the genetic level of associations, their judgments become superficial and their actions rash.
“I don’t believe in God, there is no God, there is no need for a tsar, the chairman of a collective farm - why, my dear, did you bring me to Leningrad. I came when I got married for the first time, he left and left me.”
Amentive speech confusion is characteristic of disoriented, confused patients with the corresponding syndrome who do not comprehend their surroundings. The speech of such patients consists of stories about individual episodes of the past, which also include phrases related to the present, to the assessment of their condition. Although each of these phrases, reflecting mainly the memories of the past, is complete in itself, they are not all connected by any common goal idea, by any single logical connection. Amentive speech confusion is also called incoherent or dream-like. The last characteristic is due to the fact that episodes of the past and present (in the form of separate phrases) in the patient’s speech follow each other without any logical (or even mechanical) connection, just as individual scenes sequentially “float” in the consciousness of a sleeping person at the moment dreams.
“My homeland is not Leningrad, but the Pskov region. Why are you testing me? Then some car arrived and I have no idea how it ended up near the house. This ambulance brought me here. This is my home, I communicate and live here with everyone. Is it possible to walk along this corridor? I never think beyond that. I think it's gone."
For ataxic (schizophrenic according to V.P. Osipov, 1931) speech confusion is characterized by a combination in a phrase, a single sentence of ideas that are not coordinated with each other, abstract concepts and sensory-figurative ideas that are not normally combined with each other. It finds its expression in grammatical correct form, since by analyzing the written speech of patients with schizophrenia, one can always find the corresponding members of the sentence, and with auditory perception they are unmistakably determined by pronunciation and diction. And at the same time, this grammatically correct form contains nonsense. This kind of combination of incongruous things is called atactic closure. Such speech should not be called “broken,” since we are talking about an associative (albeit pathological) speech process. The fact that a patient, having once answered a question with an ataxic phrase, answers the same question in another conversation with a similar phrase, but without ataxia, shows that the basis of the ataxic speech of patients with schizophrenia is not so much organic as reversible functional disorders, and the term “discontinuity” does not apply to it.
“I was stolen from God as a small child in big body, small in a big body. Where do you release without pressing live? Why are you, such an incomprehensible bastard, holding your heart in your mouth? I am a child in a big body, what do I need men for? I worked in the sun, I work with prayer, I don’t know anything else, we work with prayer and that’s it. They made it look like her coffin is shown on TV mentally.”
With ataxic confusion, the disruption of communication “penetrates” the phrase itself and is found between words. With a more crude identification of this schizophrenic disintegration of thinking and speech, such a violation of connections and associations is found between syllables, i.e., it penetrates into the word, phoneme, leading to unusual word formation, neologisms, when the first two syllables belong to one word, and the next three to another . With schizophrenic reasoning, speech loses proper specificity and certainty. Instead of an adequate, clear answer to the question, the patient indulges in fruitless, lengthy reasoning, without communicating anything significant, that is, in fruitless philosophizing. When resonating, coordination is disrupted, ataxia is revealed not within a phrase, but between blocks of phrases, i.e., as if on a different, larger radius. Thus, in the concept of atactic thinking, specifically schizophrenic disorder several specific forms of speech pathology are combined: ataxic closures, ataxic speech confusion, neologisms and reasoning.
At choreatic speech confusion (observed in deep twilight states and severe delirium such as acute delirium); speech consists of interjections, separate short words and even syllables, meaninglessly piled on top of each other and repeated many times. Such speech, devoid of semantic content, essentially loses its signaling value.
The thinking of a healthy person corresponds to the laws of logic. Reflecting the essence of real life, it allows you to fully communicate and understand the world around you, the results of knowledge seem understandable. Psychology studies thinking as cognitive activity, differentiating it into types depending on the levels of generalization, the nature of the means used, their novelty for the subject, the degree of his activity, the adequacy of thinking to reality. In this regard, the following types of thinking are distinguished: verbal-logical, visual-figurative, visual-effective. Logical thinking to a certain extent the opposite of intuitive and, of course, autistic, associated with escaping reality in inner world affective experiences.
Mental pathology of the sphere of associations includes a number of factors that significantly affect the flow of thoughts and thinking. As a result, mentally ill people develop ideas, perceptions and conclusions that look dubious and often even completely unacceptable. In this case, not only qualitative, but also quantitative changes are important that characterize the associative process, thinking - its pace, speed, consistency.
Accelerating the associative process is an increase in the number of associations formed per unit of time in each given segment of time, facilitating their occurrence. Characterized by the continuity of the emergence of thoughts and judgments. Inferences in such cases become superficial; they may be due to random connections. In pronounced cases, the acceleration of thinking reaches the level of a leap of ideas (fuga idearum), a whirlwind of thoughts and ideas. What is most striking in such patients is the increasing distractibility, as E. Bleuler writes (1916), first internal and then external distractibility. Patients very often change their target ideas. In severe cases, with each new, only intended thought, there is a “jump” to completely different ones: the patient, for example, talks about a trip to a resort, then proceeds to describe extraneous details, jumps from subject to subject, often unable to complete the thought to the end. Increased distractibility from the outside may not be sharp, but more often it is quite clearly expressed. Every sensory impression that the patient experiences is immediately reflected in his speech: he notices the doctor’s chain and begins to talk about it, hears the clink of coins - he moves on to the topic of money. Such distractibility can also be interpreted as a disorder of attention (increased alertness). Thinking with a flow of associations and a leap of ideas cannot be called thinking without a goal; it is always there, but is constantly changing. One can observe the predominance of external and verbal associations over internal ones. Inconsistency is found in the judgments and conclusions of such patients. Both the choice of impressions and ideas and their order are equally unsatisfactory. Topics of thinking often change depending on the simple consonance of spoken words or an object that accidentally comes into view. In such cases, associative mentism is observed - a continuous and uncontrollable flow of thoughts, memories, an influx of images, ideas, which brings closer this state to mental automatism.
Inhibition of associations is characterized by manifestations opposite to excitation, primarily a decrease in the number of associations per unit of time and, in accordance with this, a slowdown in the thinking process itself.
Here, the totality of thought processes proceeds slowly and subjectively with difficulty; a change in the target idea does not occur immediately. In extreme cases, it becomes completely impossible. Preference is given to one particular view.
Inhibition of the thinking process reflects a slowdown in the emergence of associations, a decrease in their number formed per unit of time. Thoughts and ideas are formed with difficulty, there are few of them, the content is monotonous and poor. Patients complain of “lack of thoughts in the head,” loss of the ability to think quickly, “dulling of thoughts,” and intellectual impoverishment.
The incoherence (incoherence) of thinking is described by T. Meinert (1881). It is characterized by confusion, increased distractibility, loss of the ability to form associative connections, correct, logical connection of ideas and concepts, and a real reflection of reality in all its diversity. A loss of ability for elementary generalizations, analysis and synthesis is revealed, thinking becomes chaotic, associative connections lose their semantic content (nonsense, ). The speech of patients consists of a chaotic collection of words with a predominance of nouns, grammatical correctness is lost, and sometimes the speech takes on the character of rhymed, but completely meaningless chatter.
Thoroughness of thinking is the difficulty of forming new associations due to the dominance and retention of previous ones. Patients lose the ability to separate the important from the secondary, the essential from the unimportant, which reduces the productivity of thinking. When presenting any information, patients involve a large number of unnecessary details, diligently and in detail describe trifles that have no significance.
Stiffness (torpidity, viscosity) of thinking is a pronounced difficulty in the sequential flow of thoughts with obvious slowness and extreme viscosity. The speech of patients and their actions become torpid (sluggish, numb).
Perseveration of thinking is characterized, along with a general difficulty in the associative process, by the long-term predominance of one thought, one idea. The patient “treads water” on one thought, repeats it many times, the answer to the question is also persistently repeated even after a new question is asked, with a completely different content.
Delay, blockage of thinking (Sperrung) - stop, interruption of thoughts. At the same time, patients become silent, lose the thread of conversation, try to replace the “gone” thought with another, similar one, but again “lose” it due to a new blockage. This occurs with clear consciousness and is subjectively registered as a loss of thought. E. Bleuler (1920) specifically emphasizes that it is necessary to distinguish sperrung (delay of associations) from hemmung (inhibition), since the latter indicates depression, and sperrung is characteristic of.
Paralogical thinking is the emergence of incomparable associative connections and concepts, provisions, the unification of contradictory ideas and images with the arbitrary replacement of some concepts by others. In this case, there may be a “slipping” from the main idea to a completely different one in its direction, which is accompanied by a loss of logical connection and makes the speech unclear in content and meaning.
I. F. Sluchevsky (1975) cites a letter from one of the patients as an example of paralogical thinking.
“Dear comrades! Anything that can interest everyone is worthy of attention. To this I will try to add a few facts that are still happening before our eyes. Perhaps this will bring about some gentleness in your condescension, or rather, perhaps a gentle condescension will be at the center of your mood. So, the most human or humane profession so far is medicine. And everyone would admit this if they understood the clearly close dependence of the voice of the public, the face of society, with medicine. I don’t want to impose, although everyone’s attention to improving health is a modern, typical phenomenon. Of course, I’m not writing about the scale of life; probably, it’s still absolutely useful to expand, given the general purposefulness of attention to everything, to deny the little things in our horizons. My matter is simple... it is more difficult to formulate a question than to solve it, and constant daily familiarization with the same problems does not burden the working people at all.”
Reasonable thinking is characterized by the presence of empty and fruitless reasoning based on formal, superficial analogies. E. A. Evlakhova (1936) noted in patients with schizophrenia Various types reasoning. The version of “pretentious” reasoning is distinguished by the predominance of an autistic position and a peculiar personal proportion: subtlety, hyperaestheticism, observation in the presence of emotional flattening. “Manner-reasoning” thinking is characterized by a predominance of reasoning, an overestimation of the formal side of the subject of reasoning, little content and productivity of the subject of reasoning, banality, stereotypedness, and a tendency to stereotypes. “Pedantic reasoning” is distinguished by sufficient contact and greater liveliness of the intellect, a tendency to jokes and flat wit with a lack of understanding of humor, irony, a loss of the sense of tact, and excessive pathosity with which banal judgments are pronounced. The author does not correlate the identified types of reasoning with the characteristics of the course of the disease.
The psychological essence of reasoning is revealed in the works of T. I. Tepenitsyna (1965, 1979). She discovered that reasoning is not associated with any specific type of errors in the implementation of mental operations themselves, but is due to the characteristics of the personal-motivational sphere of patients. This version of the patient’s personal position is defined as an exaggerated pretentious-evaluative position, affective inadequacy of the choice of the subject of discussion, inconsistency with the methods of evidence and the subject, insufficient self-criticism, a peculiar manner of speech (floridity, a tendency to significant intonations, the use of excesses that are often completely inappropriate to the subject of discussion concepts, verbosity). Reasonable thinking is most often found in schizophrenia, but is also observed in, sometimes with oligophrenia, organic brain lesions.
Autistic thinking(E. Bleuler, 1911, 1912) is defined by the author as affective, in which the dominant motives for the formation of associations are desires, while real-rationalistic ideas are repressed. Autistic thinking occurs as a symptom of predominance inner life(autism), which is accompanied by an active withdrawal from real life. Autistic thinking, thus, can give expression to all sorts of tendencies and drives that are hidden in a person, at the same time the most opposite ones (ambivalence, ambitendent thinking). Since logic, which reproduces real relationships, is not a guiding principle for autistic thinking, the most diverse desires can coexist with each other, regardless of whether they are in conflict, whether they are rejected by consciousness or not. With realistic thinking in life and actions, a large number of drives and desires are ignored and suppressed in favor of what is subjectively important; many of these desires hardly reach our consciousness. In autism, with autistic thinking, all this can sometimes be expressed in the same autistic thoughts, opposite in content: to be a child again in order to innocently enjoy life, and at the same time to be a mature person, whose desires are aimed, for example, at achieving power, a high position in society; live indefinitely and at the same time replace this miserable existence with nirvana. At the same time, ideas can be expressed in the most risky symbols, and thinking at the same time becomes symbolic. Such features of thinking and autism as a special phenomenon are more common, according to E. Bleuler, in schizophrenia.
Psychologists are good at identifying the forms of thinking disorder and the degree of its deviation from the “norm.”
We can distinguish a group of short-term or minor disorders that occur in completely healthy people, and a group of thinking disorders that are pronounced and painful.
Speaking about the second, we are attracted by the classification created by B.V. Zeigarnik and used in Russian psychology:
- Violations of the operational side of thinking:
- reduction in the level of generalization;
- distortion of the level of generalization.
- Violation of the personal and motivational component of thinking:
- diversity of thinking;
- reasoning.
- Disturbances in the dynamics of mental activity:
- lability of thinking, or “jump of ideas”; inertia of thinking, or “viscosity” of thinking; inconsistency of judgment;
- responsiveness.
- Dysregulation of mental activity:
- impaired critical thinking;
- violation of the regulatory function of thinking;
- fragmented thinking.
Let us briefly explain the features of these disorders.
Violations of the operational side of thinking appear as reduction in the level of generalization when it is difficult to identify common features of objects.
In judgments, direct ideas about objects predominate, between which only specific connections are established. It becomes almost impossible to classify, find the leading property, and highlight the general; a person does not grasp the figurative meaning of proverbs, and cannot arrange pictures in a logical sequence. Mental retardation is characterized by similar manifestations; with dementia (advancing senile dementia) in a person who was previously mentally competent also manifests similar violations and the level of generalization decreases. But there is also a difference: mentally retarded people, albeit very slowly, are able to form new concepts and skills, so they are teachable. Dementia patients, although they have remnants of previous generalizations, are not able to assimilate new material, cannot use their previous experience, and cannot be taught.
Distortion of the generalization process manifests itself in the fact that in his judgments a person reflects only the random side of phenomena, and the essential relationships between objects are not taken into account. At the same time, such people can be guided by overly general signs and rely on inadequate relationships between objects. Thus, a patient who is characterized by such thinking disorders classifies a mushroom, a horse, and a pencil into one group according to the “principle of connection between the organic and the inorganic.” Or he combines “beetle” and “shovel,” explaining: “They dig the earth with a shovel, and the beetle also digs in the earth.” He can combine “a clock and a bicycle,” believing: “Both measure: a clock measures time, and a bicycle measures space when riding it.” Similar thinking disorders are found in patients with schizophrenia and psychopaths.
Violation of the dynamics of thinking manifests itself in different ways.
Lability of thinking, or “leap of ideas,” is characteristic of that person who, without having time to finish one thought, moves on to another. Each new impression changes the direction of his thoughts, he talks continuously, laughs without any connection, he is distinguished by the chaotic nature of associations, a violation of the logical flow of thinking.
Inertia, or "viscosity of thinking", is a disorder when people cannot change the way they work, judge, are not able to switch from one type of activity to another. Such disorders often occur in patients with epilepsy and as a long-term consequence of severe brain injuries. In extreme cases, a person cannot cope with even a basic task if it requires switching. Therefore, a violation of the dynamics of mental activity leads to a decrease in the level of generalization: a person is not able to classify even at a specific level, since each picture acts as a single copy for him, and he is not able to switch to another picture, compare them with each other, etc.
Inconsistency of judgment noted when the adequate nature of judgments is unstable, i.e. the right ways performance of mental actions alternates with erroneous ones. With fatigue and mood swings, this also occurs in completely healthy people. Such fluctuations in correct and incorrect ways of performing the same mental action occur in 80% of people with vascular diseases of the brain, in 68% of patients who have suffered a brain injury, in 66% of patients with manic psychosis. The fluctuations were not caused by the complexity of the material - they also appeared on the simplest tasks, i.e., they indicated instability of mental activity.
"Responsiveness"- this is the instability of the way of performing actions, manifested in an excessive form when correct actions alternate with the absurd, but the person does not notice it. Responsiveness manifests itself in an unexpected response to various random environmental stimuli that are not addressed to the person. As a result of this, the normal thought process becomes impossible: any stimulus changes the direction of thoughts and actions, the person either reacts correctly, or his behavior is frankly ridiculous, he does not understand where he is, how old he is, etc. The responsiveness of patients is a consequence of decreased cortical activity brain It destroys the purposefulness of mental activity. Such disorders occur in patients with severe vascular diseases brain, with hypertension.
"Slipping" consists in the fact that a person, reasoning about any object, suddenly gets lost in the correct train of thought after a false, inadequate association, and then is again able to reason correctly, without repeating the mistake made, but also without correcting it.
Thinking is associated with the needs, aspirations, goals, and feelings of people, therefore, violations of its motivational and personal components are noted.
Diversity of thinking- this is a disorder when judgments about any phenomenon are on different planes. Moreover, they are inconsistent, occurring on different levels generalizations, i.e. from time to time a person cannot reason correctly, his actions cease to be purposeful, he loses his original goal and cannot complete even a simple task. Such disorders occur in schizophrenia, when thinking “seems to flow along different channels at the same time,” bypassing the essence of the problem under consideration, without a goal and switching to an emotional, subjective attitude. It is precisely because of the diversity of thinking and emotional richness that ordinary objects begin to act as symbols. For example, a patient suffering from delusions of self-blame, having received a cookie, comes to the conclusion that today he will be burned in the oven (the cookie for him is a symbol of the oven where he will be burned). Such absurd reasoning is possible because, due to emotional preoccupation and diversity of thinking, a person views any objects in inadequate, distorted aspects.
Reasoning- verbose, fruitless reasoning that appears as a result of increased affectivity, inadequate attitude, the desire to bring any phenomenon under some concept, and intellect and cognitive processes in humans in this case are not impaired. Reasoning is often characterized as a tendency “to large generalization in relation to a small object of judgment and to the formation of value judgments” (B.V. Zeigarnik).
Violation of the regulatory function of thinking appears quite often even in completely healthy people. With strong emotions, affects, feelings, a person’s judgments become erroneous and inadequately reflect reality, or his thoughts may remain correct, but cease to regulate behavior, inappropriate actions, absurd actions arise, and sometimes he becomes “insane.” “For feelings to prevail over reason, the mind must be weak” (P. B. Gannushkin). Under the influence of strong affect, passion, despair, or in a particularly acute situation, healthy people may experience a state close to “confused.”
Impaired critical thinking. This is the inability to act thoughtfully, check and correct one’s actions in accordance with objective conditions, leaving without attention not only partial errors, but even the absurdity of one’s actions and judgments. Errors can disappear if someone forces this person to check his actions, although he more often reacts differently: “And so it will do.” Lack of self-control leads to these disorders, from which the person himself suffers, i.e. his actions are not regulated by thinking and are not subordinated to personal goals. Both actions and thinking lack purposefulness. Impaired criticality is usually associated with damage to the frontal lobes of the brain. I. P. Pavlov wrote:
“The strength of the mind is much more measured by a correct assessment of reality than by the mass of school knowledge, which you can collect as much as you like, but this is the mind of a lower order. A much more accurate measure of intelligence is the correct attitude to reality, the correct orientation, when a person understands his goals, anticipates the result of his activities, controlling himself.”
"Disconnected thinking" happens when a person can pronounce monologues for hours, although other people are present nearby. At the same time, there is no connection between the individual elements of statements, there is no meaningful thought, only an unintelligible stream of words. Speech in this case is not an instrument of thought or a means of communication, it does not regulate the behavior of the person himself, but acts as an automatic manifestation of the mechanisms of speech.
At euphoria, passion(for some people in the initial phase of intoxication), an extraordinary acceleration of the thought process occurs, one thought seems to “jump” onto another. Continuously arising judgments, becoming more and more superficial, fill our consciousness and pour out in whole streams onto those around us.
An involuntary, continuous and uncontrollable stream of thoughts is called mentalism. Opposite thought disorder - Sperrung, i.e. interruption of the thought process. Both of these types occur almost exclusively in schizophrenia.
Unjustified “thoroughness of thinking”- this is the case when it becomes, as it were, viscous, inactive, and the ability to highlight the main, essential is usually lost. When talking about something, people suffering from such a disorder diligently, endlessly describe all sorts of little things, details, details that have no meaning.
Emotional and excitable people sometimes try to unite the incomparable: completely different circumstances and phenomena, contradictory ideas and positions. They allow the substitution of some concepts for others. This kind of “subjective” thinking is called paralogical.
The habit of making stereotyped decisions and conclusions can lead to the inability to independently find a way out of unexpected situations and make original decisions, i.e. to what is called in psychology functional rigidity of thinking. This feature is associated with its excessive dependence on accumulated experience, whose limitations and repetition then lead to stereotypes.
A child or an adult dreams, imagining himself as a hero, an inventor, a great man, etc. An imaginary fantasy world, reflecting the deep processes of our psyche, becomes a determining factor in thinking for some people. In this case we can talk about autistic thinking. Autism means such a deep immersion in the world of one’s personal experiences that interest in reality disappears, contacts with it are lost and weakened, and the desire to communicate with others becomes irrelevant.
Extreme degree of thought disorder - rave, or "intellectual monomania". Thoughts, ideas, reasoning that do not correspond to reality and clearly contradict it are considered delusional. Thus, normally reasoning and thinking people suddenly begin to express ideas that are very strange from the point of view of others, and it is impossible to convince them. Some, without medical education, invent a “new” method of treating, for example, cancer, and devote all their strength to the struggle for the “implementation” of their brilliant discovery (“delirium of invention”). Others are developing projects to improve the social order and are ready to do anything to fight for the happiness of mankind (“nonsense of reformism”). Still others are absorbed in everyday problems: they either “establish” around the clock the fact of their spouse’s infidelity, of which, however, they are already obviously convinced (“delirium of jealousy”), or, confident that everyone is in love with them, they persistently pester others with loving explanations ( "erotic delirium"). The most common is “delusion of persecution”: a person is allegedly treated poorly in the service, they give him the most difficult job, they mock him, threaten him, and begin to persecute him.
The intellectual quality and degree of “persuasion” of delusional ideas depend on the thinking capabilities of the one who is “captured” by them. Finding them is far from easy, and not always possible. Therefore, delusional interpretations and positions can easily “infect” others, and in the hands of fanatical or paranoid individuals they turn out to be a formidable social weapon.
Torpidity of thinking(from the English torpidus - sluggish, inactive, numb, insensitive) is also designated by the terms viscosity of thinking, inertia of thinking, stickiness of thinking. It is characterized by a decrease in the mobility of thinking processes, a slow switching of thinking from one target idea to another. While developing one topic, patients seem to get stuck in it, mark time in one place, move forward very slowly and cannot transfer their attention to another topic, even if they have completely exhausted the previous one.
Often, when answering the next question, they repeatedly return to what has already been said, repeating themselves several times. Attempts by the interlocutor to speed up the pace of messages are often met with a reaction of dissatisfaction and resentment on the part of the patient because they do not want to listen to them or do not attach due importance to their statements. Torpidity of thinking is usually combined with excessive detail, cumbersome and ponderous construction of phrases. Typical manifestations of the disorder occur in patients with epilepsy, parkinsonism, and traumatic injuries to the temporal regions of the brain.
Oscillatory thinking. Oscillatory thinking (from the Latin oscillum - swing, oscillation) is a feature of mental activity, expressed in uneven tempo of thinking, in sharp fluctuations in the speed of thinking. The pace of thinking does not always remain unchanged and normal; it constantly changes depending on different circumstances. When these fluctuations take on a painful character, you can see how during a conversation patients speak quickly, loudly and a lot, as if they are in a hurry somewhere, then suddenly slow down their speech, limit themselves to individual statements, speak quietly, as if for themselves, they seem to disconnect from conversations and thinking about something of their own. Then follows a period of new recovery, which is replaced by another recession, and so on.
The duration of periods of revival and attenuation of thinking activity is limited to several minutes. Patients themselves usually do not notice this and do not explain in any way such noticeable fluctuations in their mental activity. This phenomenon sometimes concerns not only ordinary, but also delusional thinking. For example, oscillating delusions are described - unstable delusional ideas that appear and disappear. In manic patients, fluctuations of attention have been identified - instability of attention with its transitions from one object to another. K. Jaspers mentions fluctuations of consciousness - fluctuations in the clarity of consciousness, “which sometimes turn into complete absence" He reports a patient in whom such fluctuations occurred within one minute. The author emphasizes that in patients with epilepsy, “normal consciousness, as measured by responses to subtle stimuli, exhibits a significantly higher measure of fluctuation than in healthy individuals.”
