Some Aspects of the Schizophrenic Formal Disturbance of Thought

by Erwin Levy

[first published in: Psychiatry, 6 (1943), pp 55-69;
German translation 1997 by Gerhard Stemberger in Gestalt Theory, 19 (1), S. 27-50:
"Einige Aspekte der schizophrenen formalen Denkstörung"]
Siehe auch: G. Stemberger (Hrsg.), Psychische Störungen im Ich-Welt-Verhältnis. Gestalttheorie und psychotherapeutische Krankheitslehre.

Note: The topics of this article were discussed in depth in the seminars of Gestalt psychology founder Max WERTHEIMER at the New School for Social Research in the presence of Erwin LEVY. See the chapters 32, Understanding Psychotics' Speech, and 33, More on Psychotics' Speech, in A. S. LUCHINS & E. H. LUCHINS, 1978, .Revisiting Wertheimer's Seminars, Vol. II: Problems in Social Psychology. Lewisburg: Bucknell University Press; pp. 255-262)
(5th part)

Immediately two new problems are presented. First, what does this recentering mean and imply? Second, there remain disturbances in the detail of the production which the mood factor alone does not sufficiently explain.

In this paper the answer to the first problem must be brief although it is concerned with important problems of personality dynarnics. Gestalt theory maintains that thinking is no isolated process but is concretely determined by the whole-relation of the person to his behavioral world. It will be recentered when the whole-relationship requires it.

In this connection the term 'recentering' means essentially the following simple and not infrequent human experience: in the course of the development of a human being and of his relationship to the world and to himself in it, critical episodes sometimes occur in which a sudden radical reorientation is vitally needed. The previous view of life, world, one's self, becomes untenable. Some facts, some experiences, some inner developments occur which do not fit in with the old orientation but demand a restructuring of one's view of the world and one's self in it, a widening, narrowing, or changing of the horizon, often a shift of emphasis as to what really matters in life. One has to find oneself anew. Puberty and adolescence frequently give rise to such crises, but adulthood is by no means free of them. These crises often bring with them moments of great intensitv, of strong new moods, amazing revelations and discoveries. Sometimes at first there is searching; the new view is only slowly organized and crystallized. Sometimes the new organization occurs precipitately, within a few days or weeks.

The direction of this recentering varies: the following examples will clarify what is meant. It may go in the direction of suddenly discovered personal freedom, of the throwing off of inner and outer shackles and prejudices, of newly acquired independence and fresh originality in confronting the world. It may lead to an ethical reorientation or to an intensified religiousness which becomes the firm center of one's relation to his world. In other cases it may lead to a sort of delicate and romantic Innerlichkeit in which one is gently but strongly and securely rooted. Still others may break through into a life of rich adventure, with excitement and joie de vivre and a penchant for great doings; they no longer want to bother with the pettiness of everyday life. There are many other possibilities.

The vital need for such recentering and restructuring of the perception of life and world presents one with a concrete job. Detailed processes must take place again and again if the recentering is to result in a liveable, concrete, and consistent view of life and world, compatible with the objective data and structures of the world, as well as with the psychological needs of the person. Every important part of life has to be worked in consistently with the intended new view of the whole: there has to be constant testing of the objective facts to see whether they will fit into the recentered view or whether they will resist it due to their own inner independent structure and organization. The job may sometimes require the originality of an artist, true productivity and creativeness. Therefore, such recentering crises often demand strength and time, persistence and vigor. This is especially true because in such moments the organism frequently undergoes a severe strain.

Clinically one frequently gains the impression that in the very beginning of an early schizophrenic process the patient has reached a stage in his development where he is inescapably confronted with some such far-reaching psychological job. Sometimes this is due to changes in the field; the subject is put under stress in the direction of having to meet new situational needs which demand an important change of outlook and attitude. [24] In other cases the patient's inner development itself may have reached a stage where a new phase, an energetic change of the personality is required: the development pushes forward, it wants to go ahead. This seems to have been the case with the 'introvert' patient who experienced the urgent and vital need to change in the direction of becoming a happy 'extrovert.' In the following the repercussion of such situations on thinking will be discussed.

Difficulty with respect to the working out of the detail, even if the new whole-trends are clear, may be encountered, The demand for psychic energy may be too great at a moment of frequently great strain. There may be a lack of strength to see it through; the subject may be too weak, too easily exhausted, too 'asthenic' to accomplish the job in its concrete detail. Again there may be a lack of necessary intelligence, talent, and versatility with which to discover the concrete possibilities of recentering and fitting in the facts and problems of life in the required direction. Or, the intended direction of development may be so extreme, so rigid, so extravagant as to clash with the objective requirements and structures of essential data of the world; this may then require a compromise, a modification of direction of the recentering until something liveable results. In such cases the demands for patience and tenacity, but also for elasticity and plasticity, may be especially great.

If the inescapable need for recentering clashes with one or some of the above-mentioned obstacles, or with any others, a tense situation may arise. There may be no other way out of the dilemma for the patient than to disregard, simply and brutally, those problems of concrete detail which create difficulty. He no longer can afford to bother with the tedious job of reaching consistence throughout. He distorts and forces resistive details into the centering against their inner structure in order to salvage at least the possibility of realizing the main trend of the new whole in its original purity and intensity and direction. If the structural details of the problem with which one is struggling do not lend themselves to easy recentering they are violated with complete disregard for the resulting inconsistencies - as long as the whole-trend remains clear and outspoken.

In this manner the person - no Ionger healthy, and overwhelmed by strong forces within himself - achieves a peculiar form of pseudo-freedom from the concrete structural requirements of the detail of the world, from the specific needs of logic, plausibility, consistency - but also from bis own inner personal limitations. The resulting contrast between the mighty, free sweep of the whole, and the poor, mixed-up shambles in the detail, makes for the grotesque and sorry impression which one so frequently experiences when observing schizophrenic behavior, and thinking.

BLEULERs patient does not make any consistent attempt to bother with the realities of the Epaminondas story. Whether the story will lend itself to being toId in his prevailing mood direction is not even examined. The effort to recenter it quickly but consistently so that a new flawless structure will result which will be consistent with both the facts and his new mood - this effort is not made, or it fails. An analysis of the correct answer to BLEULERs question will show the concrete requirements with which the patient was confronted, and will make clearer the nature of his difficulties.

Someone who thinks clearly could give the following correct answer: 'In the middle of the fourth century B. C. a series of wars occurred between the ancient Greek states. One of these was the war between the Thebans and the Spartans who had wrongfully attacked. The Thebans were led by Epaminondas who, by his masterful generalship, managed to achieve the two famous victories of Leuktrai and Mantineiai. He was faithfully assisted by his friend Pelopidas. Epaminondas lay dying on the battlefield when he was notified that the enemy was retreating. His last words were, "I leave two immortal daughters, Leuktrai and Mantineiai."'

On close examination one can see that this statement has a clear inner structure. First, all facts are given as parts of one large encompassing whole: they are facts of history. Second, history has large subdivisions: these facts belong to ancient history. Third, this again has subdivisions: the facts are part of ancient Greek history. Fourth, this again can be divided into a number of phases: these facts are concerned with the interstate wars. Fifth, the war of Thebes was an important orte of these. Sixth, Epaminondas is known in, and because of, his central functional role in this war. All facts concerning him are given in structurally clear succession and development.

This organization has a sort of modified figure-ground structure in which the fifth and sixth points of the answer constitute the figure which is placed in the immediate background of ancient Greek history, which in turn is itself embedded in vaster historical contexts. This is the organization of the mental picture which is clearly conveyed in a good answer.

The good clear organization of such thought figures implies features of consistent grouping. Structurally there must be clearcut boundaries between the various parts, between figure and ground. Figure and ground must respectively include those facts which belong, and exclude those which do not. These facts must be presented in their function in the structure of the context as a whole. The figure must be placed into its structurally required place in the background so that one can see clearly the larger context of which it is a part, and what essential functional relation it has to it.

To do such thinking means clear and consistent dealing with the dynamic structure of the whole in which each part must have its fitting place, its logical function, and its meaningful clear relation to the other parts. [25]

This figure-ground structure gives the skeleton of the good answer to the question. But the patient was faced with the task of presenting it in a version required by his own mood and world view. He had to produce his own variation of the theme, just as an obsessed musician might want to create a violent and distorted variation of a simple tranquil theme. Any theme, while being varied, must retain some essential structural whole-features. On the other hand, in the case of the patient, the theme had to be varied in such a way as to assume the new atmospheric whole-quality into which it had to fit. This was a much more difficult task than just an easy repetition of some paragraphs out of a textbook on ancient Greek history. The effort at production of the envisaged figure required vigorous thinking.

If a new, at first vaguely felt conception is to crystallize into a concrete thought-Gestalt the process of crystallization often demands a rather high level of organizing Gestalt forces if the whole picture is to have real consistency. This will insure the shaping and distribution of all parts in the direction of fitting in with the needs and the character of the whole. The inner figural pressure of the crystallizing thought tends to fit in the details with the new whole-atmosphere, and at the same time to exclude inconsistencies, inadequacies, inner breaks, and weak, short-of-the-mark formulations. When difficulties are encountered, when the crystallization process is blocked or becomes laborious, because, for instance, a required apt phrase does not readily emerge, the tension level required to overcome the obstacle may have to rise very high. [26]

The question arises as to whether schizophrenics are able to mobilize and sustain a sufficiently high level of such Gestalt tension to comply with their own vital need for the new original processes. lt is possible that the quality called asthenia [27] implies that a great difficulty exists in this respect. There may be an inability to provide the necessary strength and clarity of structural forces, and the recentering asthenic would be faced with a vitally important task beyond his power.

The schizophrenic thought figure would then be the result of a crystallization process occurring on too low a level of tension to yield a consistently organized whole. Instead one should expect to find thought figures with inner breaks and inconsistencies. However, these figures would somehow attempt to bring out the main whole-character of the intended thought, similar to what one often observes in the violent sketches of schizophrenic artists. The less the available Gestalt energy, the more of an effort would be needed, and the more forced would be the result. Often one does find just that-extreme, exaggerated whole-trends with the detail in a sketchy, hasty, often incoherent jumble. In other cases the Gestalt pressure seems to be still lower so that even the main direction of the whole becomes progressively insecure and unclear until it is either deflected or exhausted.

The purpose of this paper has been to take a few steps. New questions appear. The problems of the figural crystallization process in thinking, and its qualitative and quantitative aspects must be investigated. At present the additional hypothesis of the weakness of Gestalt tension in schizophrenic thinking, is offered as a working hypothesis only.

Still larger are the problems of the recentering of the subject-world relationship as a whole, and of the subsequent emergence of a new world, not within, but beside the common world. In this paper these crucial problems could only be briefly dealt with, but they had to be indicated, since thinking is not an isolated faculty but is part of the functioning personality in its relationship to the world.


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[24] Referencefootnote 5; item 4. [-> Back to text.]

[25] An analysis of the factors which determine the grouping in its detail is omitted. [-> Back to text.]

[26] This may show in ensuing fatigue and headache. [-> Back to text.]

[27] The present definitions of this term are still vague, largely external, and not dynamic. [-> Back to text.]

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