Sunday, June 28, 2009

Normal Thinking: A Psychiatrist's Perspective





“We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world” Gautam Buddha.

It is hard not to think. During most of our waking hours and even when we are asleep and dreaming we are thinking. Thinking consists of cognitive rearrangement or manipulation of both information from the environment and the symbols stored in long term memory. It is the form of information processing that goes on during the period between a stimulus event and response to it.
Normal ThinkingThinking refers to the ideational components of mental activity, processes used to imagine, appraise, evaluate, forecast, plan, create, and will. Most thought involves complex rules that are probably best currently approximated (albeit inexactly) by fuzzy-logic decision-making algorithms that use neural net technology, increasingly applied by scientists and engineers in vague situations in which all-or-none, black-or-white thinking does not apply but in which multifaceted, contradictory, and competing possibilities and biases are the rule. Most of what is known about thinking derives from the study of language as the product (and reflection) of thought, yet a great deal of thinking takes place preverbally and nonverbally. Thinking occurs in images, music, and kinesthetic sensations and in symbols other than linguistic ones.

Ideas are the contents of the stream of thought. They may arise on the basis of a percept, may follow a memory, may arise out of a mood state or atmosphere, or may occur de novo. Those that are consistent with one's sense of self, compatible with the individual's self-image, are called ego-syntonic. Other thoughts that conflict with one's central values are called ego-alien or ego-dystonic.

Normal beliefs and valuesPhilosophers have for many years distinguished beliefs and values and debated the relationship between the two. A belief (or an inference) is something thought to be true because of observation or evidence. It can often be subjected to empirical testing or logic to derive facts, which tend to be objective and universally agreed. By contrast, a value is something thought to be good or important to an individual. Hence strongly held values are the principles on which one will not yield and are not subject to empirical testing. Normal values may be divided between those that are terminal (e.g. the importance of happiness) and those that are instrumental (e.g. the importance of being honest). Values (like beliefs) are on a continuum in terms of the degree of importance attached. Some values might be viewed as extreme (e.g. those values held by a racist organisation or an orthodox religious group) but they are not classified as a mental disorder. Evaluations (or attitudes) are associated with values. They are a rating of an event or person on a scale of good and bad. In comparison to beliefs, values or evaluations are not subject to empirical testing. They are more difficult to measure or challenge because they are subjective and personal. Sometimes beliefs are influenced by a value. For example, beliefs about the risk of HIV and sexual behaviours are influenced by values regarding excitement and stimulation. The reverse may also occur, in which values are influenced by beliefs. For example, a belief that there has been an increase in the incidence or severity of HIV infection may increase values about the importance of caution, restraint or self-discipline. The division between beliefs and values is often blurred. They are like two sides of a coin.

Belief systems are the scaffolding of thought, chains of impressions, and expectations around which plans and behaviours are organized. Belief systems may be attitudinal, setting general expectations and biases about the world that inform how incoming information is processed; examples are optimism, pessimism, and paranoia. Some beliefs are effervescent and fleeting, whereas others are pervasive, tenacious, enduring, and influential. The enduring belief systems are associated with behaviours consistent with the belief, at times dominating interpersonal relationships and lifestyles. Some beliefs are unique and private, whereas many are shared by others.

Abstract thinking is the ability to assume a mental set, to keep simultaneously in mind all of the aspects of a complex situation, to move from feature to feature as indicated by the situation, and to abstract common properties. Complex thinking also concerns the ability to simultaneously consider many different, vague, and subtle aspects of situations; to appreciate differing and contradictory points of view; and to integrate these multiple dimensions to form opinions that are marked by differentiatedness and nuance.

Concrete thinking is a disturbance in the ability to form abstract concepts, generally illustrated by literal mindedness and the inability to abstract the commonality of members of a group, for example, the fact that a flea and a tree are similar in that they are both living things. Concrete thinkers seem unable to free themselves from the literal or superficial meanings of words. Concrete thinkers may be more prone to prejudice and stereotypical thinking and more likely to manifest unidimensional or “all-or-none” reactions to complex situations. Concrete thinking can be seen in individuals with lower intelligence, organic mental disorders, and schizophrenia.

Freud considered division of thought into primary and secondary process-
Primary process thinking, the more primitive type, includes thinking that is dereistic, illogical, magical; normally found in dreams, abnormally in psychosis. This type of thinking disregards logic, permits contradictions to exist simultaneously, disregards the linear notion of time, and is dominated by wish and fantasy. It uses symbol, metaphor, imagery, condensation, displacement, and concretism in its organization, creating the jumbled and incoherent style of thinking characteristic of dreams and has been associated with visual images and creative thought.
Secondary process thinking is characterized by logic. In contrast to primary process thinking, the secondary process uses linear notions of time, clearly delineated abstract categories, and deductive rules of logic. The abilities to think abstractly and to think in detail about future plans are characteristic of secondary process thinking. Normal secondary process thinking is also characterized by predictability, coherence, and redundancy. Words, vocal inflections, and gestures provide important contextual cues and create a sense of overall coherence to the communication. Ideas follow one another in a sequence that is understandable to the listener.

Later Conceptualisations of Types of thinking
The process resulting in a thought can vary with regard to the degree to which external reality and goal-directness are taken into account. In this perspective three types of thinking can be distinguished which represent a continuum without sharp boundaries and are intertwined in everyday life: fantasy thinking, imaginative thinking, and rational thinking. Since each of these types can become dominant under some conditions, this distinction is useful to aid understanding of certain abnormal phenomena. The characteristics of the three types can best be illustrated by considering the differences between fantasy thinking and rational thinking.
Fantasy thinking (also called dereistic or autistic thinking) produces ideas which have no external reality. This process can be completely non-goal-directed, even if the subject is to some extent aware of the mood, affect, or drive which motivates it. In other cases fantasy thinking serves to exclude reality because it requires actions that the subject does not want to accomplish. This second kind of fantasy thinking is not undirected. Its goal is not to solve a problem but to avoid it via neglect, denial, or distortion of reality. Normal subjects use fantasy thinking deliberately and sporadically. However, if its content becomes subjectively accepted as a real fact, it becomes abnormal. This pathological exclusion of reality can remain limited in extent (e.g. in hysterical conversion and dissociation, pseudologia phantastica, and some delusions) or it may be manifested as complete autistic withdrawal from the real world. Bleuler believed that excessive ‘autistic’ thinking in schizophrenia was partly the result of formal thought disorder.
Rational (conceptual) thinking attempts to resolve a problem through the use of logic, excluding fantasy. The accuracy of this endeavour depends on the person's intelligence, which can be affected by various disturbances of the different components involved in understanding and reasoning.
Imaginative thinking can be located between the fantasy thinking and rational thinking. It is a process of forming a representation of an object or a situation using fantasy but without going beyond the rational and possible. This thinking is goal directed but frequently leads to more general plans than the solution of immediate problems. The essential difference between imaginative and rational thinking is that the former neglects the notion that each theoretical assumption should be accompanied by an attempt to falsify or refute it. Imaginative thinking becomes pathological if the person attaches more weight to his representation of events than to other objectively equally possible interpretations. In overvalued ideas, the imagined interpretation surpasses other interpretations in strength; in delusions, all other possibilities are excluded.


(References available on request)

14 comments:

  1. Interesting.seems to be well researched.

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  2. Is it that we are what we think? what about the feelings which so much dominate our life? It is not the intellectual insight that drives us, it is the emotional one. Perhaps it was feelings only (feeling the miseries of the people around) that lead buddha to an ascetic life!

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  3. Well said Zia, thanx for the stimulating n thoughtful comments on thinking.
    If I quote the (above)first para only 'Thinking consists of cognitive rearrangement or manipulation of both information from the environment and the symbols stored in long term memory'.
    So what we think will arise, also from our feelings which in turn are derived from within and without.
    I cant agree more, perhaps it was what lead Buddha!

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  4. Is it possible to think feelings? Feelings may manipulate the ways we think but can't be equated with thinking.

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  5. nice... I'll take time to understand it..


    AKB

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  6. Ur queries r getting tougher,but i will like to say this-
    Feelings can be considered as the 'subjective' experience of emotion, and, the emotion is designated by the content of consciousness which has evoked the physiological changes in a person; the conciousness is woven around the thoughts, which are in turn affected by the emotional tone... and so on...
    So rather than equating we can try to analyse it as a fluid and dynamic interplay of elements.

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  7. its surprising to see somebody talking about emotions(zia).i guess dr.aleem has shared his perspective about thinking(mainly) and it doesnot mean that he took emotions alltogether lightly.what we know buddha as for now is his perspective about mind where ofcourse his thinking(intelligence)must be triggered by feelings among other influences.i could see what must have triggered dr.zia to put such a question!!. mankind has come so far away that only thoughts are prevailing in everybody's mind thesedays and seldom emotion displays.we have been conditioned so badly to be preoccupied with prejudices,discriminations,condemnations,intellectualization,rationalization etc.and we fail to see(feel)the true essence of life as such.if only we learn to see what actually influences our thinking at first place, then perhaps we could realise what life is.i assume dr.aleem has quoted "ignorance is bliss'in that sense only.finally, to appreciate feelings, one should overcome his/her thoughts for which one have to be aware of his/her thought process.so the topic in this blog seems appropriate.keep going boss.

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  8. Thanks very much Selva for ur valuable inputs. I'm waiting for Zia to respond first.

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  9. OK finally i've been able to connect!

    Aleem - so nice to see you fulfilling even more - the meaning of your name

    Good work - with curious comments and academic responses

    Interesting perspective given by William James says that we first feel emotions in the body and then give them names

    Think about it

    This approach is very helpful in therapy - especially the ones like NLP and Body oriented psychotherapies

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  10. OK finally i've been able to connect!

    Aleem - so nice to see you fulfilling even more - the meaning of your name

    Good work - with curious comments and academic responses

    Thinking about Thinking is 'Meta-thinking'

    This thinking blog is turning into a meta-htinking blog?

    Interesting perspective given by William James says that we first feel emotions in the body and then give them names
    Probably thinking happens after Emotions / Experience - presumed and validated in CBT

    Think about it?

    This approach is very helpful in therapy - especially the ones like NLP and Body oriented psychotherapies

    Does it help in anyway Zia?

    Selva s statement is thought provoking -
    "if only we learn to see what actually influences our thinking at first place, then perhaps we could realise what life is"

    What do we think on this?

    And...
    The life transforming question- which thought disorder is this -
    "The Giraffe ate the Crocodile and the Jackal ran away"

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  11. Yes finally... its great to have u here Nitin.
    Im sure u will turn and churn so much that it becomes "meta-thinking' and further to "metastatic-thinking" one!!

    Jokes Apart...
    Consciously experiencing emotion requires having a mental representation of emotion: past feelings (memories), hypothetical feelings (imaginations), or feelings that are occurring at the moment (on-line experiences).
    There is also a tinge of intentionality in this experience.
    Overall a state of pleasure or displeasure is generated, with a certain amount of arousal.

    and "The Giraffe ate the Crocodile and the Jackal ran away" sounds just fine to me, no disorder, as at least the Jackal is saved, the Giraffe is satiated, and the bored Crocodile got a new pool...gastric juices to swim in. This because my approach for making a diagnosis is... I take every thing is normal/possible till proven otherwise.

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