26 - Elements of thought

Elements of thought:

© SPMM Course 6. Disorders of Thought:

Normal thinking: Normal thinking is of three types (or functions):

1. Fantasy/dereistic thinking or autistic thinking: There is no goal direction, unrealistic - daydreaming type. Predominant in cluster A personality, dissociation and pseudologia fantastica.
2. Imaginative thinking: Again fantasy elements but admixed with memory, involving abstract concepts but goal-directed and does not cross boundaries of possibility and realism. Determining the tendency of thoughts preserved e.g. lateral thinking.
3. Rational or conceptual thinking: based on factual reality and uses logic. Psychopathology of thought includes 1. Disorders of thought content (e.g. delusions) 2. Disorders of thought form (e.g. tangentiality) 3. Disorders of thought stream (e.g. pressure of speech) 4. Disorders of thought control (e.g. obsessions) Elements of thought: Normally every thought we have has the following four properties: 1. Form 2. Stream 3. Content 4. Control. As a student of psychopathology, one wonders why should the authors make a fuss about the stream, form and content of thought; what is the real difference among this three concepts? A simple way of understanding this is through an analogy of buying fruits in the supermarket. Element Supermarket Analogy Refers to Disturbances Content Apples, pears or oranges? ‘the material.' What is being thought about? Delusions of persecution, suicidal thoughts, etc. Form Bags, boxes, sold loose as single fruit? ‘the package.' In what manner is the thought present? Loosened associations, tangentiality Stream or flow Packed as a dozen, a score, just four only, half a dozen, etc. ‘the amount.' How is it being thought about? Fast, slow, etc. The poverty of thought, the pressure of speech and crowding of thoughts. Control of thought Mango is a produce of South Africa; tomatoes are from Spain, etc. ‘the origin.' Where is it from? To some extent obsessions can be considered here, passivity and first rank thought disturbances.

Thought content could be deciphered from ones’ behaviour, but thought form and stream, unless extremely deranged, cannot be studied without being expressed as speech. Formal thought disorder (FTD) refers to disturbances in form and not content; it is wrong to say ‘someone is deluded so he has a formal