Coherence (psychology)

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The coherence ( latin cohaerere 'linked) is an important consideration in the clinical psychology and psychiatry , under which the formal thought processes are assessed by the patient (see thought disorder ). Coherence here means that the train of thought - apart from the objects and facts formulated in terms of content - is inherently logical , coherent and comprehensible.

Example of an incoherent train of thought

In the negative / disturbed training and assessment of the characteristic of coherence as a symptom of an illness, one speaks of incoherence or of disorientation or confusion of the train of thought. Thought contents that do not belong together are strung together and mixed up. There is a lack of content structure and an orderly flow of thoughts. An example of an incoherent train of thought reported by Emil Kraepelin (1856–1926) is: "On such occasions the girl is always unpleasantly acceptable tips". Uwe Henrik Peters writes that despite the shortcomings mentioned, an overall thematic context remains recognizable. The wording, which is sufficiently structured in terms of content, syntactically correct and more understandable in terms of logical sequences, would require a longer execution of the sentence. This example shows a compression work as described by Sigmund Freud (1856–1939) in the dream work, see Chap. Orthology .

Psychophysiological and psychopathological description

If one tries to describe disturbances in the formal train of thought, which the psychiatrist is obliged to do in his findings, for example, the patient's style of speech can be described as erratic to the point of being completely incomprehensible. In the case of severe forms, even the sentence structure is disturbed, resulting in a word or syllable salad . In some cases, the mental achievements of idle patients no longer stand up to critical scrutiny. The context of meaning is often no longer guaranteed. The patient may appear distracted from the outside . Thoughts either pursue a constantly changing goal or changing their direction of goal appears difficult, slowed down and laborious (monideism). It can also happen that the train of thought is determined by associations or sounds and rhymes. The judgment is often superficial . The patients sometimes seem inhibited or uninhibited in their train of thought . This sometimes appears impoverished, brooding, narrow, rambling or cumbersome . Awkwardness often arises from a feeling of insecurity. - It seems more difficult to describe physiological norm variants.

Orthology

The coherence of thinking can be changed or relaxed in the context of physiological processes, for example in the stage of fatigue and half-sleep . In sleep, criticism and censorship of thought are largely eliminated, as Freud already pointed out in his analysis of the dream work . Freud distinguished between compression , displacement, visualization, symbolism, agrammaticality and the role of oppositional words as mechanisms of dream work . Knowledge of these mechanisms makes it easier to decipher the latent dream content ( dream thoughts ).

pathology

The symptoms mentioned above are observed in different forms in almost all types of psychiatric illness. For example with schizophrenia (and some sub-forms of it), with mania , with psychoses , with delusional disorder or with some forms (and sub-forms) of depression as well as with some neuroses . Some people with intellectual disabilities also have difficulty with coherent thinking , that is, logical , coherent thinking. Strong degrees of incoherence are known as confusion .

On the reception and criticism of the term

Since it is a central term in the description of formal thought disorders, a strict standard of definition must be applied. However, there is no such uniform, strict standard. In everyday psychiatric practice, for example, incoherence and disorganization are by no means always used synonymously.

Classical (German) psychiatry

In classical German psychiatry , incoherence is a phenomenologically and psychopathologically informative parameter for formal thinking . For the definition difficulty, Manfred Bleuler's textbook points out the complexity of mental illness and poses the question of whether a healthy person could be affected by a thought disorder at all. In the negative case, however, this would lead to considerable problems in understanding pathological thought disorders.

While the term incoherence seems to be used in a general sense for mentally conditioned thought disorders, disorientation and erratic thinking is often almost automatically and exclusively associated with schizophrenia as a technical term, silly thinking with hebephrenia , flight of ideas and accelerated thinking with manic states, inhibited thinking with depression etc. The difficulty of a general definition of the term becomes clear. Incoherence is differentiated from disorganization, in that in the latter the usual meaning of the terms becomes blurred, while the individual representation appears clear in the case of incoherence. Confusion is thus the more far-reaching disorder, which relates not only to formal, but also to substantive thought disorders.

On the other hand, the term incoherence is limited by many authors to the context of exogenous psychoses. If one can also try to distinguish dynamic, logical, associative and affective moments as defining criteria in the coherence of thought, then a phenomenologically clear, i.e. H. psychopathologically adequate definition in the sense of describing individual disease states rather problematic.

Gestalt theory

On the part of gestalt theory , Georg Elias Müller (1850–1934) established so-called coherence factors. These factors are: spatial proximity, equality, similarity, symmetry and contour (differentiation of figure and background). From different parts of the stimulus area ( sensory projection center ) these factors are seen as belonging together and thus form a unit.

Psychoanalysis

On the part of psychoanalysis , it is considered relatively certain that in the case of psychoses incoherence (and thus the risk of disintegration and fragmentation of the self ) is in the foreground. Already Karl Jaspers (1883-1969), which is considered one of the founders of psychopathology and thus the classical psychiatry and facing reserved psychoanalysis, the unity and identity of the ego has retained the essential characteristics of the self-awareness. A factor influencing the unity and coherence of this consciousness is the so-called doubling of personality . Here, according to Jaspers, two series of mental processes arise at the same time next to each other and thus also two sides of “emotional connections that do not flow together with those of the other side, but rather are mutually foreign”. The term dissociation as the “disintegration and fragmentation of consciousness” comes from the French psychiatrist Pierre Janet (1859-1947), who was even described as an opponent of Freud in matters of hysteria .

Social psychology

The sense of coherence is a central aspect in the salutogenesis of Aaron Antonovsky (1923–1994). According to Antonovsky, coherence has three aspects:

  • The ability to understand the context of life. The feeling of being understandable.
  • The conviction that you can shape your own life. The feeling of manageability.
  • The belief that life has a purpose . The feeling of meaningfulness.

From a sociological point of view, reference should also be made in this context to the meaning of cohesion and, in particular, to the concept of group cohesion . The cohesion of society - as well as of family and friends - is an essential factor that leads to the avoidance of fear as a fundamental factor in the development of mental health or illness.

Psycholinguistics

The psycholinguistic approach, which has been pursued since around 1950, tries, partly on the basis of psychological-experimental methodology, but also on the basis of mentalistic-cognitive theories and grammatical and especially syntactic rules, to gain conclusions about deeper causes of mental disorders and thus to their understanding on the part of linguistics and communication research , information theory and cultural anthropology contribute. Psychoanalysis has also made use of the psycholinguistic method and examined the analytical conversation between doctor and patient in the sense of a language analysis. Alfred Lorenzer (1922–2002) tried to combine biological, psychoanalytical and socio-psychological aspects (metatheoretical investigation). He uses the methodology of scenic or analogous understanding . The elucidation of the specifically incomprehensible meaning of linguistic utterances (in the sense of a symptomatic scene or transference scene ) is carried out by contrasting and comparing with a corresponding or analogue early childhood original scene . If the child suffers an intolerable conflict in this original scene and fights it off, this simultaneously leads to a linguistic separation of the ideas associated with this situation (object representation) from formal public communication. This process is known as desymbolization. This results in private language deviations from the formal language. In the case of a non-deformed language game, there is congruence of the utterances on all three levels of communication: the “action level”, the “non-verbal bodily or body expressions” and the “linguistic utterances” themselves. Coherence is therefore in the broadest sense not just a correspondence between private and public language Meanings, but also to be understood as the congruence of different levels of communication.

See also

Individual evidence

  1. ↑ Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3rd edition 1984, page 273, Stw. Incoherence
  2. ↑ Sigmund Freud : The Interpretation of Dreams . [1900] Gesammelte Werke, Volume II / III, S. Fischer, Frankfurt / M., The following page numbers based on the paperback edition of the Fischer library, Aug. 1966; to head. "Compression": Chap. VII. On the psychology of dream processes, page 483 f., Like: Chap. VI. The dream work, page 235 ff.
  3. ↑ Klaus Dörner , Ursula Plog: To err is human or textbook of psychiatry / psychotherapy. Psychiatrie-Verlag, Rehburg-Loccum, 7th edition 1983, ISBN 3-88414-001-9 , page 238
  4. ↑ Sigmund Freud: The Interpretation of Dreams . [1900] Collected Works, Volume II / III, S. Fischer Verlag, Frankfurt / M, Notes: Paperback edition of the Fischer library, Aug. 1966, VI. The dream work, page 235 ff .; VII. On the psychology of dream processes, A. Forgetting dreams, page 432 f .; C. On Wish Fulfillment, page 459
  5. ^ Rudolf Degkwitz et al. (Ed.): Mentally ill; Introduction to Psychiatry for Clinical Study . Urban & Schwarzenberg, Munich 1982, ISBN 3-541-09911-9 , part III. Perspectives, nosological concepts and explanatory models of mental illnesses; Chapter 9.7 Thought Disorders, page 182
  6. ↑ Eugen Bleuler : Textbook of Psychiatry . [1916] Springer Verlag, Berlin 15th edition 1983, edited by Manfred Bleuler with the assistance of J. Angst et al., General Part, Chap. B. Description of the psychopathological symptoms, page 44 ff.
  7. ↑ Uwe Henrik Peters: Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3rd edition 1984, page 273
  8. ^ Wilhelm Karl Arnold et al. (Ed.): Lexicon of Psychology . Bechtermünz, Augsburg 1996, ISBN 3-86047-508-8 , column 1087
  9. ↑ Stavros Mentzos : Neurotic Conflict Processing, Introduction to the psychoanalytic theory of neuroses, taking into account more recent perspectives . © 1982 Kindler Verlag, Fischer Taschenbuch Verlag, Frankfurt 1992, ISBN 3-596-42239-6 , pp. 36, 124 u. 146
  10. ↑ Karl Jaspers : General Psychopathology . Springer Berlin 9th edition 1973, ISBN 3-540-03340-8 , 1st part: The individual facts of the soul life, Chapter 1: The subjective appearances of the sick soul life (phenomenology), § 7 ego consciousness, page 104 f.
  11. ↑ Pierre Janet : L'automatisme psychologique . Félix Alcan, Paris 1889. Reprint: Société Pierre Janet, Paris 1889/1973
  12. ↑ Uwe Henrik Peters: Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3rd edition 1984, page 285, Stw. Janet, Pierre
  13. ↑ Aaron Antonovsky , Alexa Franke: Salutogenese, to demystify health . Dgvt-Verlag, Tübingen 1997, ISBN 3-87159-136-X .
  14. ↑ Detlev Claussen : Conversations on the subject of fear . TV show Delta hosted by Gert Scobel in September 2005, 3sat
  15. ↑ Hans Wydler , Petra Kolip u. a. (Ed.): Salutogenesis and Sense of Coherence . 3. Edition. Juventa, Weinheim 2006, ISBN 978-3-7799-1414-3 , 206 pages. review
  16. ↑ Charles E. Osgood , Thomas A. Sebeok (Eds.): Psycholinguistics . Bloomington, 1965
  17. ↑ Psycholinguistics . In: Wilhelm Karl Arnold et al. (Ed.): Lexicon of Psychology . Bechtermünz, Augsburg 1996, ISBN 3-86047-508-8 , column 1735.
  18. ^ Alfred Lorenzer : Speech Destruction and Reconstruction. Preparatory work for a metatheory of psychoanalysis . [1970] Suhrkamp Frankfurt, 5th edition 2000, stw 31, 247 pages. ISBN 978-3-518-27631-0