Month: August 2019

Pathology of Judgments

It’s Intrusive, overvalued and delusions, if we consider them according to the degree of aggravation. How to distinguish them?

Obsessions arise involuntarily, against the will, and disorganize the logical course of thinking. Important: they are perceived by the patient as painful, and they remain critical, they do NOT determine the direction of the activities of this person, that is, do not subordinate it to themselves, although they disorganize mental activity as a whole.

  • Obsessive thoughts arise in the mind of a person involuntarily and even against his will. While consciousness remains nepomucenum, clear.
  • Obsessive thoughts are not in a visible connection with the content of thinking, they are in the nature of something alien, extraneous to the thinking of the patient.
  • Obsessive thoughts can not be eliminated by the will of the patient. The patient is unable to get rid of them.
  • Obsessive thoughts arise in close connection with the emotional sphere, accompanied by depressive emotions, a sense of anxiety.
  • Remaining alien to thinking in General, they do not affect the intellectual level of the patient, do not lead to violations of the logical course of thinking, but their presence affects the productivity of thinking, mental disability of the patient.
  • The morbid nature of obsessive thoughts is recognized by patients, there is a critical attitude towards them.

Supervaluable idea. The concept of overvalued ideas was put forward by K. Wernicke (1892). They affectively rich take a large (disproportionate) in the mind of the patient, disrupt his mental activities and dominate in large measure his behavior. Occupying an intermediate position between obsessive and delusional ideas, they, unlike the latter, are always based on their real (not fantastic, not fictional) background, although criticism of them is already formal or not at all.

Delusional ideas are painful, absurd, unshakable judgments and conclusions that do not correspond to objective reality, disorganize mental activity and subordinate the behavior of the patient, not amenable to criticism and correction.

Figuratively speaking, the husband, suffering from obsessions of jealousy, tormented by the question — and does not change his wife, but because he can not find real evidence of that, suffers to himself. Husband with overvalued ideas of jealousy, convinced that his wife is wrong, can cause some very real, albeit indirect, of facts and a considerable part of free time devoted to the Amateur detective, aware that, even having found them, to kill no one. A husband with delusional ideas of jealousy doubts nothing. He KNOWS she has the mayor’s lover. Or downstairs neighbor. Or specially called her a witch, the Incubus. The evidence, therefore you don’t even have to look, but if someone still doubts — here: the color of the clothes in which she went to work, the spirits, who certainly likes not only her cigarette butt with her lipstick, thrown on the lower balcony, as well as traces of astral presence. And essential, volatile, ejaculate. And in case of paraphrenic delirium of the spouse and at all the organizer, the ideological inspirer and the only volunteer of an all-galactic brothel.

Now more

Obsessive phenomena can be divided into ideatory, phobic and motor. Ideational, or obsessions, is abstract obsessive thoughts, obsessive doubts (turned off or not turned off the stove-water-light) and memories, haunting score (and there are nine steps, and for me at the bus stop consisted of five people, and the next eight) and thought, often blasphemous or sacrilegious (and dead-it is better all settled, it is not hot; and there is the girl in black — well, so I would…), obsessive sophistication (at least the goal is to guess whether the mood of watching something dead or alive Schrodinger’s cat).

Motor (volitional) disorders are divided into the following categories:

Obsessive drives — the desire to make unnecessary, antisocial, sometimes dangerous actions, which is accompanied by internal discomfort, if not implemented. Most often they are not implemented, especially those that are dangerous:

Homicidalmaniac — obsessive attraction to murder, often of a close person; suicidaire — obsessive desire for suicide; coprolalia — the desire to flip off as it should. By the way, the obsessive desire to step out of the window or from the balcony belongs to the same group, it is almost never realized.

Obsessive actions — implemented obsessive drives, often ritual (made — obsession has passed). Among them, automania — obsessive hand washing when mysophobia, bacillophobia. There are other self-obsessive actions: autoreplace — pulling out own hair (not to be confused with makeup and autoreplace sacral-ischial region, since the objectives are totally different); onychophagia — nibble nails, burrs, obsessive ticks.

Overvalued ideas — allocate the content dismorphophobia (“my nose is a honker, not the chest, and the two blemishes, the legs are as hereditary cavalry, and authorship over the form of the ears are fighting elves Cheburashka”); hypochondria (“Oh, somewhere, something popped, gurgled, tumbled and capricornus — not otherwise kirdyk on approach”); inventions (“not bosonic engine for flying saucers, something more earthy, like a special feature head rivets, but the patent office zadolbali»); reformism (amendments to the law on pensions, the proposals of various parties about the change of the Charter, leadership and the main line); litigation (querulant, prosecutors in their work calculated volumes and tones); erotic (starting from the desire to bring happiness to a marriage Miss My Hometown and ending with a pathological belief in their own irresistibility and sexual omnipotence); sexual inadequacy (“I do not like human beings and, in General, such as me, is that a good wholesale”).

It is necessary to distinguish super-valuable ideas from dominant, dominant — which occur in mentally healthy people and represent devotion to any scientific, cultural or religious ideal, the idea for the sake of the celebration of which a person is ready to neglect everything else (remember the ardent fighters in the name of anything).

If you are paranoid — it does not mean,

that THEY’re not after you.

Every fighter against punitive psychiatry sincerely wish at least once in his life to be woven into the delusional system of one of our patients. An unforgettable experience is guaranteed, level up (raising the level) in the worldview and impatient “when will these wonderful people come in white coats?”as a free bonus.

Pathology of the Associative Process

Depending on what part of the associative process of thinking has suffered, we can conditiaonally divide these violations as follows.

On rates:

Accelerating the pace of thinking, when a person processes information, makes a decision and generates ideas much faster than others. Characteristic of manic States, where this acceleration can be expressed up to the “jump of ideas”. Slowing down the pace of thinking. Reflection and decision-making is delayed, sometimes so much that the attempt to talk turns into mutual torture for its participants, and if the second interlocutor is also still in a manic state (see the previous paragraph), not far from self-harm.

Mentalism is an involuntary influx of thoughts, when these thoughts invade in addition to the will of a person in his measured thought process, thoroughly interfere with his activities, often completely disorganizing it. How would you like, say, if the influx of thoughts about the fate of the Fatherland caught you watching a porn film?

Stop (blockage, sperrung) thinking — involuntary breakage, stopping the flow, the absence of thought. Thought-thought — and all. Deadlock. Cliff. No thoughts. And no dialogue to continue, no thing to do there is no way. Frozen, waiting for everything to move again.

By mobility, liveliness of the process:

Detail — secondary nonessential details are constantly involved in the thinking process. It is as if you are in a casual conversation about the weather made happy by the classification of clouds and the average annual norms of temperature and precipitation.

Thoroughness — a pronounced detailing with a systematic stuck on the details and side associations. The wind rose, the discussion of the spoiled ecology and the coordinates of the most trustworthy forecast Bureau would surely have been added to the previous details.

Viscosity — a pronounced thoroughness in which thinking becomes unproductive, to track the original thought is not possible, as well as the direction in which the conversation was originally – in General, by the fourth hour of the discussion, you are likely to be painfully decide who to beat the face: Greenpeace, meteorologists or interlocutor.

On the grammatical structure of speech:

Speech stereotypes — stamped turns or use of a question to build an answer; this is when the speech uses cliched, formulaic turns (“so, what I said…”, “well, as they say, let’s go back to our rams”, “as one of my friends said — however, you do not know…”), as well as the use of the question to build an answer: “How is my name? And my name is too well known for me to tell you!”Verbigeration is a meaningless repetition of the same words, phrases, endings of words or individual sounds. Incoherent — “verbal hash”, a set of individual words or phrases, devoid of logical and grammatical structure (not to be confused with the poem “Mom, dad, spoon, cat”).

By focus:

Flowery — in this case, to Express even a simple thought, the patient resorts to a mass of comparisons, excerpts from various sources, metaphors and sayings, formulas and scientific terms. All you have to do is say, “go fuck yourself.” Now imagine how such a person would sound an explanation of love.

Slippage — this disorder can be represented as follows. The patient talks, for example, about cats. Thinks quite coherently and sensibly. Suddenly, clinging to the fact that some of them are gray, recalls the Maxim “in the dark all cats sulfur” and then gives a lengthy discussion on the relationship of cats, darkness, demonic beginning in the cat’s soul… and then as if nothing had happened returns to the discussion of what they are, in fact, cute and fluffy creatures. Why the slippage? Because such a course of thought looks like a patient, walking along the path of reasoning, slipped, leaning on a minor Association, and for a while rode on it, and then returned to the previous, well-trodden path.

Logic-chopping — long-winded philosophizing, the transfusion of a sieve, lengthy torrent minor subject — without a goal, without any direction. Who met with a flood (chatter off topic) in the comments replicas that way for twenty or thirty, I understand.

Formalism of thinking — when all the attention and all the power of the intellect is not thrown to the comprehension of the essence of the issue, but to a clear execution of the Protocol and the letter of the Charter.

Diversity — in this case, the patient can consider the subject or phenomenon from several points of view, based on several evaluation criteria, constantly changing the levels of generalization, but is not able to come to a decision what in this particular situation should be preferred. So, asking him to exclude from the pictures with the image of the castle, castle and hut one thing, you will not get an answer from him. He says that in one way or another all the pictures are interconnected, nothing extra on them, and in General, specifically, whether such an unsolvable puzzle planted?.. Amorphous — fuzzy, contradictory use of concepts. In this case, it is built syntactically and grammatically correct, but it is not possible to understand WHAT it says. There is no main idea, no conclusions — only a set of phrases that seem logical to the patient himself. If you ask him “how is life”, the answer may well be: “Well, how to say? That is to say must. Because you know the difference between that and that. You can’t just go one way. Justice will prevail though, but it’s when we second such a leader will find objective conditions are not impossible to satiate. When the top can’t, the bottom doesn’t want to. And when it’s full, it’s too late to talk. That’s it.”

Paralogical thinking is a violation of the logic of thinking, the so-called “logic curve”, when either the prerequisites or the evidence suffer, or the process of establishing a connection between cause and effect (this distinction is conditional). Example? The patient basically does not drink juices. Why? “Juice is health. Health is sport. Sport is a lot of money. A lot of money — a lot of women. A lot of women is AIDS. AIDS is death. Am I so fucking happy?”Symbolic thinking — thinking based on pseudo-concepts, symbols, the meaning of which is clear and accessible only to the patient. So, he can talk about the special meaning of what colors are dressed today his employees, and that it can mean. Or to say that for him all the numbers have, in addition to the main, more and additional, secret meaning, thanks to which each new date is an encrypted message with a guide to action.

Pathological polysemantism — when a patient discovers a new meaning in words, based on how many vowels or consonants they have, for example, whether they rhyme with a particular word — say, with such as “death”, “love”, “treason»…

Autistic thinking — is thinking, little in contact with the surrounding reality of the patient, clear and accessible only to him, reflecting his world, in which outsiders are not allowed. Thinking fantastic and bizarre, but not devoid of its own pretentious logic, “feast behind closed curtains” E. Bleiler. Here is an example given by Blejleru [18]: “the Patient B. S. in the work of Jung’s early dementia is Switzerland, she is also Ivikov the crane; she is the owner of all of the world and a seven-story factory of Bank bills; it is also double the Polytechnic University and the assistant of Socrates. All this seems, at first glance, complete nonsense, and indeed is nonsense from the point of view of logic. But if we look more closely, we will find clear connections: thoughts are essentially subject to affective needs, i.e. desires, and sometimes fears; the patient is a Willow crane because she wants to be free from guilt and depravity; she is Switzerland because she must be free.”

Archaic thinking — in this case, for the Foundation of the building are the judgments “the times of Ochakov and the conquest of the Crimea”, attitudes and stereotypes, for example, the same dissenters-old believers. Or the Neanderthals — there could be as lucky…

Perseveration (from lat. perseveratio — perseverance, perseverance; from persevere — persevere, continue) — most clearly this disorder is characterized by an anecdote: “Doctor, I do everything four times, four times, four times, I am very tired, very tired, very tired, but the wife is happy, the wife is happy, the wife is happy…” This is a steady repetition or continuation of once started activities, phrases, and this repetition continues even when the context appropriate for him is exhausted. For example: “what’s your name? — Lesha. — How old are you? — Lesha. Are you retarded or something? — Lesha. — Where do you go? — Lesha. — Who are your parents? I’m not retarded.…»

Fragmentation — the lack of logical connection between individual conclusions, judgments, concepts with the formal preservation of the grammatical structure of speech. If the rupture of thinking acquires an extreme degree of severity — begins to suffer and speech. Example: “I believe it is necessary to use extreme geographical, constitutional and obscene terms, that every kind and species, sex, and religion you have understood who could not stop performing our great, horrible, but extremely pleasant mission membership in the Federation Council”.

If the above were described violations of the associative process of thinking concerning how a person thinks, now we will talk about WHAT he thinks.

Memory Disorders

If all the angry questioning your half repeats the mantra “I debianchangelog”, do not rush to take up kitchen utensils, posing a diagnostic and educational objectives. Perhaps the man really does not remember anything.

Memory disorders can be divided into quantitative and qualitative.

Quantitative memory disorders are hypermnesia, hypomnesia and amnesia.

Hypermnesia (from Greek. hyper — over and mnesis — memory). This does not mean that the subject suddenly acquires a phenomenal memory that allows him to become a superspy or a successful card player. The ability to remember it often does not change. But dramatically increases the playback of memories, against the will of man, begin to invade the consciousness and does not contribute to clarity of thought and clarity of objectives, rather the opposite — desorientiert, muddle.

Hypomnesia (from Greek. hypo — under and mnesis — memory). In this case, the memorization of current information or the reproduction of past events is weakened.

Amnesia (from Greek. a— as a denial and mnesis — memory) is characterized by the lack of the ability to save, reproduce and (in some cases) record the patient experienced events — at a particular time. I would like to emphasize that this is not a weakening of memory, as in hypomnesia, but its complete disappearance for some period. And depending on what it is for the period, there are the following types.

Congrega amnesia (from lat. prefixes con— together and gradior — go) — loss of memories for the period of the darkened consciousness (in most cases — if it was switched off by itself or due to insurmountable external circumstances). Retrograde amnesia — loss of memory of everything that was BEFORE the painful condition (injury, attack, etc.).

Anterograde amnesia is the loss of memories for the period AFTER an injury, attack or acute stage of the disease that caused a violation of consciousness, that is, the recovery period is forgotten. Interestingly, in this period the patient, as a rule, adequately behaves, talks and answers questions, but in the future all this will be erased from his memory.

Anteretrograde, or total amnesia — there’s you know…

Depending on which of the memory functions suffers more, you can also highlight the following types of amnesia.

Fixation amnesia — a strong weakening or complete lack of ability to capture and hold in memory new information, current events (in such cases say, that “memory as sieve”).

Anaktoria (from the Greek. an— + ekphorio — make) — the failure timely to recall a known fact, the inability of the memories without prompting (not to be confused with the state of the student during the delivery of the session!).

According to the dynamics of amnesia is divided into the following:

Progressive— when there is a disintegration of memory in accordance with the law of RIBO, from the current to an increasingly long past; while a person may not remember where he lives, but perfectly list all the neighbors from the village where he lived in his youth. Especially if one of them once owed.

Stationary — when the existing memory impairment is not aggravated, but does not pass. Regressing — when eventually after a pronounced deterioration in memory is gradually improving and memorizing the teachings, and playback of the past. Retarded — when events fall out of memory not immediately, but after a while after an illness or injury.

By object can be selected:

Affectogenimap, or catalkoy, amnesia — when memory fall only special, meaningful human events, resulted in very strong feelings (usually unpleasant, those which this man can not continue to live in peace).

Hysterical amnesia, which is somewhat similar to the previous one, when selectively erased from memory (Freud would say — replaced) only unacceptable for the individual events (with the experience about them, unlike those in catatymic amnesia, may be weak or not at all — whether to worry about what was not!).

Sodomization, which is similar to the previous form of amnesia, her memories fall out partially, the plots but the personality is not the hysteroid.

Epochal — it usually occurs after shock and covers long periods of life (months, years).

Separately it would be possible to allocate an alcoholic palimpsest (from Greek. рalimpsestos — text, manuscript, written on top of that scraped from the parchment — that nothing material to translate, but some of the previous labels you can guess). This is a condition where some of the details and events that took place during the libations are erased from memory, leaving behind only vague hints and a feeling of vague anxiety in half with a painful awareness of his own wrong, but still would remember what exactly… Alcoholic palimpsest — the first bell warning that not far off alcoholic amnesia and other delights of alcoholic brain damage.

Qualitative memory disorder is to many cases of paramnesia. It’s a distortion, a perversion of memories. To paramnesias include pseudoresistance, confabulation and cryptomnesia.

Pseudoresistance (from the Greek. pseudos- — false-, lat. reminiscentia — memory) — usually occur in a patient suffering from fixation amnesia. He tries to fill the gaps in his memory as best he can, eventually filling them with events that REALLY took place in his life, but not at the time he is trying to remember. So, as “patches” may well fit student or even school years, or those of the more recent events that were able to stay in memory.

Confabulation (from lat. confabulari — to talk, to tell) — in this case, the patient fills in holes in the memory of what never existed, and often does could not exist. So, asking to talk about violent youth, you can get the answer a story about the guerrilla actions in the forests of Belarus with the exact personally killed the Nazis, as well as modest mention of the fact that the flight to Mars has been, just for the purposes of secrecy not publicized, and who do you think flew there? Yes, and the defeat of the third intergalactic occupation case don’t forget. With these two hands sword in zero gravity Mahal. There are substitute confabulations — when the holes are filled with something close to reality, everyday-mundane (went to the bath, drank beer, immediately after fishing — this was a bite!). By the way, General Ivolgin in F. M. Dostoevsky’s novel “the Idiot” demonstrates the replacement confabulations. There are fantastic confabulations — it’s just about Mars, checkers and weightlessness.

Cryptomnesia (from Greek. kryptos — hidden, secret and mneme, memory, remembrance) — when it is better not to give up fantasy. And put the TV away. Otherwise you will be told about the adventures in the spirit of the main character of Sapkowski’s novels, with the beheading of all monsters in the vicinity of the promenade and circuses. And strictly to ask, what makes the kitchen the old hag and just what happened to Maria. The patient, being unable to remember or dream up, draws events from those sources of information that are at hand: books, Newspapers, television – without making a distinction between his own life and all other events. What he saw in the dream, by the way, can also be regarded as taking place to be in fact, so that “return back to the Bahamas and the mulatto with lush Breasts.”

Amnesia — when the patient there is a sense that the event is repeated. Most frequently occurs when substance-induced psychosis.

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