Violation of the operational side of thinking, Reducing...

Violation of the operational side of thinking

Thinking as a generalized and mediated reflection of reality appears almost as the assimilation and use of knowledge. This assimilation takes place not in the form of simple accumulation of facts, but in the form of a process of synthesis, generalization and abstraction, in the form of the application of new intellectual operations. Thinking is based on a well-known system of concepts that make it possible to reflect the action in generalized and abstract forms.

As correctly pointed out in his work, "On thinking and the ways of his research," SL Rubinshtein [159], generalization is a consequence of an analysis that reveals the essential links between phenomena and objects. It means a different attitude to the object, the possibility of establishing other connections between the objects. On the other hand, it represents the possibility of establishing a connection between the concepts themselves. Established and generalized in the previous experience, the system of connections is not annulled, the formation of generalization proceeds not only through the newly accomplished generalization of individual objects, but through the generalization of previous generalizations. This was pointed out by Vygotsky. The generalization is given in the system of language, which serves to transfer the universal experience and allows to go beyond the limits of individual impressions.

With some forms of pathology of mental activity, patients lose the opportunity to use the system of generalization and abstraction operations.

Thinking studies of patients suffering from various brain diseases have found that violations of the operational side of thinking take different forms. For all their diversity, they can be reduced to the two extreme options: a) reduction in the level of generalization; b) distortion of the process of generalization.

Reducing the level of generalization

The reduction in the level of generalization is that the judgments of patients are dominated by immediate ideas about objects and phenomena; the operation of common characteristics is replaced by the establishment of strictly specific connections between objects. When performing an experimental task, such patients are not able to select from among all possible signs the TC, which most fully reveal the concept. So, for example, in the experience of the classification method, one of such patients refuses to group the cat and dog into one group, "because they are envious"; the other patient does not unite the fox and the beetle, because "the fox lives in the forest and the beetle flies." Private signs lives in the forest & quot ;, flies more determine the patient's judgments than the common sign "animals."

With a pronounced reduction in the level of generalization, the problem of classification is generally inaccessible for patients: for subjects subjects turn out to be so specific that they can not be combined. Even the table and chair can not be attributed to one group, because "they sit on a chair, and eat and eat on the table." The patient refuses to unite the key and the scissors, as they are different: "This is the key, but it's scissors, what can there be in common between them?" In some cases, patients create a large number of small groups on the basis of an extremely specific subject relationship between them, for example, a key and a lock, a pen and a pen, a thread and a needle, a notebook and a pencil.

Sometimes subjects combine objects as elements of a plot (the patient tells something about these objects), but the classification is not made. For example, one group consists of an egg, a spoon, a knife; another - a notebook, a pen, a pencil; third - the lock, key, cabinet; the fourth - a tie, gloves, threads and needles, etc. The subject explains: "He came home from work, ate an egg from a spoon, cut off his bread, then took a little exercise, took a notebook, a pen and a pencil ..." We designate such erroneous solutions as concrete-situational combinations.

The ability to operate with generalized characteristics characterizes thinking as an analytic-synthetic activity. Therefore, violations of the type of specific situations were most often found in the performance of the main tasks (classification of objects, explanation of proverbs, etc.), in which this mental operation clearly appears.

Among all the patients examined, a group of those who fulfilled these tasks in the specific situational plan described above is singled out.

Table 2 shows the performance of patients assignments for the classification of objects by the type of concrete-situational combinations.

Basically, such decisions were in oligophrenics (in 95% of these patients), as well as in patients with early onset epileptic processes (86%). This type of solution was observed in a significant proportion of patients who underwent severe forms of encephalitis (70%).

In the mental state of these patients, as a rule, there were no psychotic symptoms (delirium, hallucinations, consciousness disorders); data on their general intellectual decline prevailed.

These patients can correctly perform some simple work if its conditions are limited and rigidly predetermined. Changing conditions causes difficulties and wrong actions of patients. In a hospital environment, they easily obey the regime, take part in occupational therapy, help staff; but often come into conflict with others, do not understand jokes, enter into disputes with other feeble-minded patients.

In some cases, with a more severe degree of disease, patients are at a loss even in combining words on a specific basis. So, for example, one of the patients with epilepsy makes the following group of words: cock, goat, dog, horse, cat. It would seem that he formed a group on the basis of the generalized sign "animals", but the patient immediately explains: "Here is a peasant's dog, a cock, a goat - all this on the farm; maybe he does not need a cat, although not if there is a dog, maybe a cat. " The group he composed is not a group of animals in general and not even a group of "pets", but specific animals from a particular host, who may not have a cat. Sometimes we encountered such a solution of the problem when patients offered to divide objects according to a certain type of production: paper, economic, tin-iron, etc.

Sometimes items are sorted in such a way that only the next two subjects are united. For example, a sofa joins the table ( the table should be seated ); a book is attached to the couch ( on the couch is well read), a notebook ( maybe you need to write something, ), a pencil ( pencil or pen, here it is not ). The task of classification is not accepted by patients.

From Table. 2 it can be seen that the classification operation, which is based on the selection of the leading property of the object, abstraction from many other specific properties, features of objects, causes difficulties, and patients resort to situational substantiation of groups.

Table 2

Completing a task to classify items according to the type of specific situation combinations

Diagnosis

General

number

Patients

Number of patients who completed the task by the type of concrete-situational decisions

Schizophrenia

155

14 (9.0) *

Epilepsy

50

43 (86.0)

Vascular diseases of the brain

125

5 (4.0)

Injuries

170

7 (4.1)

Oligophrenia

40

38 (95.0)

Encephalitis

30

21 (70.0)

Progressive

paralysis

30

11 (36.7)

Manic-depressive psychosis

15

2 (13.3)

Psychopathy

30

-

* The number of patients in brackets is indicated in %.

Similar results were found in this group of patients when performing the task using the exclusion method. In Table. 3 shows the distribution of solutions by the type of situational in this experiment.

Table 3

Executing a task to exclude an extra item but the type of specific situation combinations

Diagnosis

Number

Patients

Total number of proposed jobs

The number of concrete-situational decisions *

Schizophrenia

155

1550

230 (14.8) **

Epilepsy

45

450

355 (78.9)

Vascular

Disease

head

Brain

125

1250

350 (28.0)

Injuries

160

1G00

310 (19.8)

Oligophrenia

40

400

350 (87.5)

Encephalitis

20

200

84 (42.0)

Progressive paralysis

30

300

220 (73.3)

Manic-depressive psychosis

10

100

30 (30.0)

Psychopathy

30

300

50 (16.7)

* This number includes the refusal to complete the task.

** The number of concrete-situational decisions in% is indicated in parentheses.

Since the same patient does not always fulfill all 10 tasks assigned to him according to a certain type, the table shows the total number of proposed tasks and the total number of specific-situational decisions for each group of patients. The highest percentage of such solutions was found in oligophrenics (87.5%) and in patients with epilepsy (78.9%), i.e. in those patients who also assigned the task of classifying objects according to the type of concrete-situational combinations (respectively, 95 and 86% of the solutions). So, for example, when presenting a card on which three pairs of watches and coins are depicted, one of the patients of this group does not agree to exclude money: "No, money is not superfluous. Firstly, you can not live without money, then you can only buy a watch with money. " When, in the process of research, the experimenter explained that the coin was superfluous, the patient seriously protested and tried to prove the commonness of the hours and money by the fact that "both hours and money I can put in my pocket." Another patient from this group, when presenting items (thermometer, clock, scales, glasses) states that it is necessary to remove the thermometer, since it is "only needed for a sick person". The patient from the same group suggests combining the clock, the thermometer and the glasses, since, "if the person is short-sighted, he looks at the thermometer and at the clock through the glasses."

When four objects are presented, of which three belong to artificial light sources (kerosene lamp, candle, electric bulb) and one - natural (sun), the sick often give out a kerosene lamp as an extra object, explaining that now it is no longer It is necessary, "even in the most remote areas, electricity is carried." Other patients for the same reasons consider an extra candle.

In Table. 4 shows some typical responses of patients, indicating that patients operate with such properties of things and establish such relationships that are not essential for the performance of the task.

Table 4

Typical responses of patients with a decrease in the level of generalization in the experiment, but the method of elimination

Presented

Pictures

Sick patient

Responses of the patient

A kerosene lamp, a candle, an electric bulb, the sun

To. (oligophrenia)

You need to remove the candle. It is not needed if there is a light

D. (epilepsy)

Do not need candles, it quickly burns, it is unprofitable, and then you can fall asleep, can catch fire

With. (epilepsy)

The kerosene lamp is not needed, now there is electricity everywhere. Maybe I can also remove the candle? .. No, it must be left, electricity will suddenly deteriorate. We often do this, then we need a candle for stock.

K-n (epilepsy)

If the day, then you need to remove the sun, and without it it's light, well, and if in the evening (the patient thinks about it) ... In the evening there's still no sun ... No, it's wrong, in the daytime you need to remove the candle, leave the sun, and in the evening do not need the sun

Weighing, clock, thermometer, glasses

K-n (epilepsy)

You do not need a thermometer. There is no doctor here, there is no hospital here

We do not need scales. They are needed in the store when you need to hang it

C-in (oligophrenia)

You need to remove the thermometer, it only needs to be in the hospital

P-in (epilepsy)

I do not know, everything is needed. Clock for time, thermometer to measure temperature.

Points can be if a person sees well, but if he is short-sighted, then they need him. Scales are not always necessary, but also useful in the household

With a more pronounced degree of intellectual decline, patients can not understand the very meaning of the proposed task. They can not learn that to exclude the fourth superfluous object, it is necessary to unite the three objects on some principle, guided by which, the fourth must be countered. The very mental operation of unification and opposition is beyond their power.

Often immediately after reading the instructions, the patients protest: "There is nothing superfluous, all the items are needed". So, the patient D. (the results of the study is shown below) when presenting images of the shoe, shoes, boots and legs declares: "Sorry, there is nothing superfluous here. It's a human leg, you can put a shoe on it, and a boot, and a boot, and put on a stocking ... Yes, there's no stocking ... If a woman's leg, then a shoe ... Or maybe her leg is sick-then boots. .. For a man suitable boots, I judge so ". When the experimenter proposes to exclude the leg, since it is part of the body, and the other three items are shoes, the patient laughs: "What are you kidding, do not I understand? How can you remove a leg? If ns had a man's legs, then why does he need shoes?

Another patient (oligophrenia) also disagrees with the experimenter's suggestion to exclude the leg: "There is only one shoe, one shoe and one boot, there is no pair. So how do you dress them? They can be dropped sooner, but the leg must definitely be left. It is possible and with one foot, with a crutch to walk it is possible, though it is inconvenient & quot ;. Patients approach the depicted objects in terms of their life suitability and can not perform the theoretical action required of them by the task.

The inability to complete a task in a generalized plan, the inability to abstract from individual specific properties of objects is due to the fact that patients can not learn the conventions hidden in the assignment.

Such a lack of understanding of the conventionality in interpreting proverbs and metaphors is especially clear.

As is known, proverbs are such a genre of folklore, in which generalization, judgment is conveyed through the image of an individual fact or phenomenon of a particular situation. The true meaning of the proverb only becomes clear when a person is distracted from the specific facts mentioned in the proverb when specific individual phenomena acquire the character of generalization. Only under this condition, the content of the proverbial situation is transferred to similar situations. Such a transfer is similar in its mechanisms with the transfer of the method of solving one problem to another, which is particularly clear when assigning phrases to proverbs. Considering the problem of transfer, SL Rubinshtein notes that "transfer is based on a generalization, and generalization is a consequence of an analysis revealing essential links" [159, 67].

A number of works by both domestic and foreign authors are devoted to the study of understanding of portable meanings. Thus, the work of LS Vygotsky [50], J. Piaget [234] shows the relationship between the understanding of portable values ​​and the level of concept formation.

To. Schneider, E. Gadlich, K. Goldstein found that patients with diseases of the central nervous system often can not understand the figurative meaning of proverbs and metaphors. The experimental material collected by these scientists is of interest, however, they considered a violation of the understanding of the portable sense as an independent fact, attached it a self-sufficient significance, linking this violation directly with the altered meaning of the words. Meanwhile, the process of misunderstanding the figurative meaning of proverbs is ambiguous. Moreover, the facts of complete misunderstanding of the portable sense are seldom observed. As a rule, it is incomplete, only partially changed.

Difficulties in understanding the portable sense of sentences depend not only on the changed meaning of words, but also on other factors (inadequate attitude of the patient to the task assigned to him, the changed dynamics of thinking, etc.). Without dwelling on all these factors, we will talk about them in the following chapters, we want to point out here that patients who could not single out a generalized attribute in the experience of classifying objects often can not convey the figurative meaning of proverbs. "Cook the iron while it's hot". means, in the opinion of one of the patients, that "iron can not be forged when it is cold." Another patient states: "Iron hand does not happen. If we are talking about a prosthesis - it is made of wood, and nc of iron & quot ;. Another patient when presenting a proverb "Do not sit down in your sled". says: "Why should I sit down in other people's sledges?" How is it? It's not good to climb into other people's sleds! The experimenter tries to explain that this proverb can be applied and not with respect to the sleigh. The patient does not agree: "How did it happen to sit in someone else's sleigh?" Maybe, who thought about and absent-mindedly left his sled? " Experimenter: "Well, if a person does not take up his business, can you apply this proverb?" Sick: "No, you can not, it's a sledge, and there's some business there." It was only with great difficulty that in some cases the portable meaning was explained to the patient; However, when presenting the next saying, such a patient again tried to convey only her specific content. Due to the fact that the word appears for patients in its specific meaning, they can not comprehend the conventionality, which lies in the proverb.

In some cases, the lack of free coverage of the conditional value is expressed in the fact that although the patients are able to understand the figurative meaning, the proverb seems to them not sufficiently accurate, not reflecting all the possible life events. So, one patient does not agree with the proverb "Shila in a bag you do not hide," stating: "This is not always the case. It happens that the crooks hide, you can not catch them. I know this case & quot ;. Another patient states about the saying "Volkov to be afraid - not to go into the forest": "This is an incorrect proverb. Sometimes you do not need to risk: this adage preaches foul play. "

In this case, patients are able to understand the conditional sense of the proverb, but the fact that it can not be applied to all life events prevents them from recognizing its correctness. Patients can not be distracted from the fact that the meaning of the proverb can not coincide with private life situations. Consequently, in these cases excessive connection of the patients' judgments with real life facts, inability to abstract from them, which leads to a lack of understanding of the conventionality of the content of the proverb and the metaphor, appears.

Especially clear is the lack of understanding of the convention in the experience of mediated memorization (pictogram method). The complexity of this task is that the drawing can not (and should not) reflect that abundance of associations that can be actualized when perceiving words; It is necessary to select only one of them, which is able to become to the place of the word, and this is possible only with a sufficient level of generalization.

F. V. Birenbaum [34] with the help of this technique found the prevalence of specific situational connections in patients with gross organic lesions of the brain; she points out that the difficulty in correctly establishing conditional relationships was due to the violation of the formation of concepts.

Our studies have confirmed these data. In this group of patients, this experiment caused considerable difficulties. So, if necessary, find a picture to memorize the word development patient K. says: "What kind of development?" It is different: both the development of muscles, and mental development. What kind do you want? The same sick ns can come up with a drawing for memorizing the words "hard work": "What do you call hard work?" It was difficult for me to solve problems at school, and you probably are hard at physical labor, you are weak. I do not understand what to draw? Another patient finds it difficult to find a picture for remembering the phrase "sick woman". The patient tries to draw a bed, but immediately declares that this pattern does not fit, because the sick woman does not have to lie: "She may have the flu, and she carries it on her feet." Then the subject decides to draw a table with medicines, but this does not satisfy him: "It's not necessarily a sick woman who takes medicine. Maybe she is treated by physiotherapy, maybe she only has toothache, or maybe she has childbirth ... Although not, labor is not an illness and so on

Some patients try to photograph the life situation almost graphically in the drawing. So, if necessary, remember the expression merry holiday the patient says: "What to draw? It would be necessary to harmonize, dance, or you can still put the table, bottles would be, well, and food. How is this all portrayed? I'm not an artist, and the artist needs to draw for a long time. "

Investigating patients with gross brain lesions, GV Birenbaum noted in the above work that the difficulties in the performance of this task are so great that sometimes patients can not stop at any particular figure, since none transmit enough full and precise specific meaning of the word. Similar facts were observed in our patients. So, one of them wants to memorize the words "hungry man" to draw bread, but immediately rejects this drawing as wrong: "At a hungry person, there is just no bread." Immediately he decides to depict the figure of a bad person, but this picture does not satisfy him, because "a person can be thin not because of hunger, but because of illness."

Not being able to understand the conditionalities contained in the assignment, patients often try to clarify the literal meaning of the word. So, the patient whose data we just quoted reproaches the experimenter with irritation: "You did not tell me what kind of hungry person he was and why he was hungry: because whether the victim is a natural disaster or because he is unemployed in a capitalist country , or he just did not have time to eat. " Instead of the generalized concept of "hungry man" there are different ideas about a hungry person in different situations.

Here are typical examples of the implementation of pictograms by patients with epilepsy.

Sick A A fun holiday. How do I portray it? After all, you can have fun differently. One likes to go to a movie on a holiday - this is fun for him. Well, the other is a drink ... It's certainly not good ... Well, a little with friends, buddies so ... for another fun is that he will walk in the circle of his family, with the kids there, or in the circus with them coming down. How can this be portrayed? Well, you can come up differently, from the point of view of the public. There are national holidays, for all, well, for example, the First of May. Demonstration to depict, then you need many flags (the patient draws a flag, but is not satisfied). One flag is not enough, you need many flags, a crowd, but I can not draw ...

Dark night. How to depict, so that it was clear that, firstly, the night and that the dark, secondly. You can draw the moon, but then it's light ... Well, of course, when it's not a full moon, but only a crescent moon, then it's not light. But nevertheless this nc will show me that it is a dark night. I draw a cloud (strokes). But the clouds are not only at night, they gather in the daytime, or before a storm, black clouds gather, it becomes dark. Here Turgenev described a good storm, it seems, in the "Notes of the Hunter", but this does not mean nights. Better I picture a lamp, it lights up at night. True, it is often lit in the evening, at dusk ... Many are lit at dusk, although it is harmful to the eyes - I do not do this, I love to sulmure. What to depict to remember the "dark night"? .. I will draw a moon and a lamp. The moon is for the night, and the lamp is for remembering that it is dark. But it's not like that, I do not like what I'm drawing. After all, it's not what it says ...

Hard work. Well, it's absolutely impossible to portray, because macho is anything that can be hard work? Mathematics is difficult for one. I never loved her, she never gave me. And other literature is not given ... But it happens that a weak person physical work is difficult. Whether it is not enough that can be heavy ... I Will represent stones - stones to turn hard. Although now there are cranes, they can raise the heaviness ... No, I do not have to paint the stones, I'd better picture the hammer as in the smithy, but now they are not there, the hammers, it's also being done with the help of technical devices. I do not know, doctor, like ... Well, let there be a stone and a hammer.

Sick of a sick. Doubt . How to do, what can be doubted? After all, people can doubt, you can doubt that you do not know what decision to take. Weak people often doubt. One can also doubt things. Here you will buy a thing, for example material on a suit or dress. How to know if the coat is clean or not? You see how you can doubt about how many things, and you want me to picture it right away. To do this, one must have the talent, one must be able to represent all this, and it is impossible to do this by one drawing, I do not agree with it.

Thus, the comparison of data obtained with the help of various methods (classification of objects, the method of elimination, the explanation of proverbs and the method of pictograms) revealed a violation of the generalization process in patients with epilepsy, encephalitis, and oligophrenia: the specific situational nature of their judgments, , conventions. These patients were combined into a group of patients in whom a violation of thinking was qualified as a reduction in the level of generalization.

The decrease in the level of generalization was detected not only when the described experimental tests were performed, which required more or less complex analytical and synthetic activity, but also when associations were updated.

The associative experiment conducted with patients of this group (30 patients with epilepsy and 20 oligophrenic), reveals the non-aggregated nature of their associations. In 33.3% of cases (a total of 1,050 words were submitted), there was no response; the very requirement to answer with any word was for patients too conditional task: "The table is a table, what can I say?" 34.3% of patients' responses were the designation of the function or feature of the subject ("pencil-write"; "berry-red"), 11.4% of the answers were synonymous with the presented word and only 21% of responses were adequate.

Patient D. (doctor J. I. Chekhovich), born in 1921. At the age of 11 months he suffered meningoencephalitis. Developed with a delay. He studied at a secondary school, he did not receive a specialty. From the age of 16 began to work as an auxiliary worker. Physical labor loves, is fulfilling, diligent. It is easily irritated, it conflicts. There are outbreaks of psychomotor agitation with impulsive actions (tearing up their underwear, throwing things out of the window), and in connection with this, was repeatedly hospitalized.

The patient is correctly oriented in place and time, fussy, mundane, stereotypically repeats the same phrases, enters into conflicts with patients, does not submit to the separation regime, but participates in labor processes.

In order to illustrate all of the above, the patient's description of the group (reduction in the level of generalization) will include extracts from the medical history and data from experimental and psychological research of several patients.

In the experience object classification the patient does not immediately understand the instruction ("They are all different"), trying to count the cards. After further explanation of the experimenter in one group puts images of a cart and a horse, in the other - a doctor and a thermometer, saying: "Let him measure the temperature". The third group includes a cupboard, a saucepan, a beet: "This can all be boiled in a pan and put in a closet." He combines the flower with the beetle and bird, explaining: "We need to plant a beetle on a flower. Birds eat bugs, but this one is too big ... I saw birds feeding their chicks. " He combines the dress with the cleaner: "She will wear it". The fox, the bear and the tree unite in one group: "These live in the forest". The experimenter tries to help the patient to establish more general connections between objects, but without success. So, the proposal to unite the cat and the dog into one group the patient rejects: "They do not live peacefully". Similarly, the patient does not agree to group fish, fox, wolf and goat into one group: "No, it's not so good. The fish swims, the fox and the wolf live in the forest, and the goat runs around the yard. They can not be combined & quot ;. The patient is not able to combine the cards on a generalized basis, he is guided when performing the task with purely specific private features.

In the experience of decomposing pictures in sequential order, the patient describes the details of each individual picture, without linking them into one whole: "The cart broke here, and here (picture No. 4) is repaired; here the person walks (shows on the picture number 2, depicting the driver, going to the village for help). Here goes the cart (picture number 5) .

Experimenter: Where is the beginning of the story?

Sick. Here is the beginning (shows on picture # 1), the wheel broke.

Experimenter: Where is the continuation?

The patient. Here they are (No. 4).

Experimenter: And then?

Sick. Here comes with an ax ... Probably the wood chopping (No. 3).

Experimenter. Where is the driver driving?

Sick. Hack the trees.

Experimenter. And maybe to the village for help?

Sick. Yes, then this will be the second picture. Exactly.

The patient puts the second, then the fourth image after the first picture, then turns to the third picture, where the carter is shown, returning with the assistant. Only after leading questions of the experimenter the patient manages to arrange the pictures in the correct order.

The patient does not understand the instruction in the associative experiment for a long time: "The table is the table, what else can I say?" After further clarification and the examples given, the patient proceeds to the task. Response reactions of the patient (Table 5) are either definitions of the irritating word ("air" - "clean"), or its immediate function ("lamp" - "light", "bread" - "eat" ;). Of the 21 responses, 3 are a definition, 7 is the designation of the functions of objects; 10 responses indicate repetition of the stimulus word ("drop" - "fall", "brother" - "brother is brother"). Consequently, the patient's associations are non-aggregated, their range is narrow. The limitedness of the range of associations is particularly clear when the same stimulus words are repeated with an instruction to respond with a different word than at the first presentation. As can be seen from Table. 5, our patient reacts either with the same words as the first presentation, or one hundred replies are a repetition of the stimulus word. Only in five cases did he react with a different word (one of which is synonymous with the irritant word: "bell" - "bell").

Table 5

Associative experiment data (patient D.)

Word-stimulus

First presentation

Second presentation *

latent period

(c)

response

latent period (s)

response

Bread

1.5

eat

1.5

roll

Lamp

2.5

light

2

light

Singing

2

Good

2.5

Good

Wheel

2.5

turns

2.5

it turns, it's round

Beauty

3.5

Beautiful

2.5

Good

War

2.5

war

2

war, war

Red

1.5

color

2

dark red

Air

2.5

clean

2.5

air, I do not know

Blue

2.5

color

2.5

color

Call

3.5

rings

4.5

bell

Mountain

1.5

High

2.5

high, no, well, the cap

The moon

2.5

Month

2.5

month, well, crescent

Brother

2

brother is brother

3.5

brother, sibling

Treatment

1.5

cure

2.5

treat, yes, treatment is good

Ax

2.5

ax, cleaver

3.5

ax, ax handle

Falling

2.5

Fall

5

I do not know

Head

1.5

It hurts

3.5

head

Run

2.5

Fast

3.5

run, walk

Berry

2.5

Raspberry

3.5

Cranberry

Make noise

2

loud

2.5

shout

Depth

2.5

deep

3.5

I do not know

* Instruction: Respond with the wrong word that was answered before.

Understanding of metaphors and proverbs in a patient is difficult. At the suggestion to explain the metaphor "golden head" the patient says: "There is no golden head, it's only on the monument can be a gilded head." Say "Buy iron while hot". the patient explains as follows: "If the iron is cold, it is not soft, it can not be forged: you can not make a horseshoe for horses from it." On the question of the experimenter, whether it is possible to apply this saying to doctors, the patient responds: "It is impossible. The doctor heals, but does not, he is not a blacksmith. "

Thus, the data of this experimental test show that the patient is not able to distract from the concrete, habitual connections and relations between objects.

For illustration, we give one more extract from the medical history and the data of psychological research.

Patient S. (doctor A. S. Remezova), born in 1905. The diagnosis: an epilepsy. At the age of three she suffered a head injury. At school I learned hard and little. At the age of 15, convulsive seizures with loss of consciousness appeared, which gradually became frequent, memory, wittyness began to weaken dramatically. Since 1941, due to the deterioration of the state, it was periodically placed in a psychiatric hospital, received luminal treatment, most recently in 1952. In the department the patient was limp, silent. In movements and responses, it is slow. The stock of words is poor, the circle of interests is reduced. With staff obsequious, sometimes irritable, spiteful. There were frequent epileptic seizures (approximately once a week) with convulsions and loss of consciousness, which ended in sleep.

Pathophysiological study (conducted by SM Pavlenko) revealed the fragility of the differentiation reaction, the phenomenon of sequential inhibition, the weakness of the excitatory process and the weakening of internal inhibition.

When presenting an assignment for the classification of objects, the patient for a long time can not comprehend the instruction, he considers the cards for a long time. Pick up a picture of a goose and say: "There is no such thing here anymore, it's a gander, there are no more gander" (puts the card aside). He takes a card with a picture of carrots: "It's a carrot ... Look, you, what a beautiful caroton, there are no more such". The experimenter suggests putting carrots in one group with beetroot, the patient protests: "That carrot, and this is beet-borak; they are different & quot ;. After thinking, he continues: "You can cook borscht from them, cabbage there". She's looking for a cabbage card: "It's not there." The experimenter repeats the instruction once more, proposing to combine the suitable objects into one group. The patient lays a cow with a goat, saying: "They graze together". The experimenter suggests putting the bear in the same place, the patient frightenedly objects: "What are you, he will eat it." The offer of the experimenter to unite the blacksmith and the cleaning woman into one group: "Let them, this is the husband and wife, and where are the children?" Looks for among the cards, finds a skier: "This is their snap."

The task for establishing the sequence of events was as follows. The patient holds picture number 3, says: "They go, and this one (shows on picture No. 5) goes to the forest. To know, we wanted to go for firewood, we went, but this one remains, this home wants to go. " Takes the picture number 4: "Here the wheel" has broken. " Looks at the picture number 1: "A lot of bags were imposed". The experimenter repeats the instruction. The patient turns to picture number 4 and says: "Uncle went somewhere". Deploy the pictures in the following order: № 5, 3, 4, 2, 1; explains: "The uncle went somewhere, on the road saw something like something ... The wheel fell ... Then he ran ... The hammer, you know, it was needed ... And this (picture number 1) is guarded, so as not to sneak . Blue ran, and this one, in a red shirt, stayed. And where does he run? .. And the wheel is lying around like this ... The flour was loaded a lot, that's why the cart broke ... We did not look, not in a businesslike way. "

The data from the associative experiment (Table 6) reveal a limited, elementary character of associations in the patient.

Table 6

Association experiment data (patient C.)

Word -

irritant

First presentation

Second presentation *

latency period (C)

response

latent period (s)

response

Bread

2

breads

2

paper

Lamp

2.5

Light

2.5

Shine

Singing

2.5

Good

3.5

sing

Wheel

1.5

Round wheel

3

wheel ... I do not know

Beauty

3.5

I do not know

3

I do not know

War

3.5

Fight

5

is silent

Red

3

color

2

color blue

Air

5.5

in the room

5

The air is like this

Blue

1.5

blue

2.5

blue

Call

8

rings

3

cheerful

Mountain

3.5

mountain high

4

High

The moon

3.5

Round

3.5

The moon, the sun

Laughter

8

laughing

3.5

laughing

Brother

2

native

2.5

Sister

Treatment

3.5

treat patients

5

I do not know

Ax

5

firewood

4

A sharp ax

Head

3

The head hurts

4.5

head

Run

3.5

Run

3

is worth

* Instruction: Answer the wrong word that was answered before.

Basically, its responses are either a very elementary definition of the word-stimulus ("singing" - "good"; "wheel" - "round"), or echolaline ("run" - "run" ;; noise - noise ). When repeated presentation of the words-stimuli patient refuses to answer, often limited to repeating the word-stimulus or responds to the previous answer.

Patient K. (doctor I. I. Chekhovich), born in 1917. Diagnosis: parainfection encephalitis. Hallucinatory-paranoid syndrome.

The patient was born prematurely. In early childhood, often sick (suffered pneumonia, twice - diphtheria). To go and talk began with a delay. Since early childhood, mental retardation has become noticeable. He studied at a secondary school. Since childhood, he was mocked by children, he could not protect himself. He always moved slowly, thought slowly. In the future, all attempts to arrange a patient to work were unsuccessful because of the extremely slow pace of work, although the patient did everything very carefully. Since 1944 he worked in the bookbinder workshop of the day hospital of the psycho-neurological dispensary. At the end of April 1950, after the flu began to express delusional ideas of persecution, I heard voices that threatened to kill him were called somewhere. " I experienced great fear, especially at night, there was excitement.

Neurological status. Symptom of Gordon (left). Exophthalmus. Reaction to light is weak. When convergence, the left eye deviates to the outside. Asymmetry of nasolabial folds. On the right is a symptom of Marinesco. Hypotonia in the extremities. Knee and Achilles reflexes on the right are more alive. Swaying in a Romberg pose. Hyponymy. Tremor age, tongue, fingers. Salivation.

Mental state. Sluggish, intrusive. He treats with stereotyped requests ... He likes to talk about his experiences. I am convinced that he is pursued by a certain group of people with whom he lives in the same house. He does not hear voices in the hospital, but thinks that some patients "are related to his enemies or friends." The stock of knowledge acquired in the school for the mentally retarded is preserved. Interests are extremely narrow.

In the experience on the classification of objects, the patient asks: "Do you need to count, yes?" Experimenter: "No, you do not need to count, you need to decompose suitable to suitable". The patient looks, not understanding. Then the experimenter takes cards with an image of an elephant and a shovel and says: "For example, an elephant and a shovel can not be put in one group." The patient smiles, nods happily. I understand, we need an animal to an animal. " Begins to unfold. Forms the following groups: 1 - pig, horse ( it's animals ); 2 - blacksmith, cleaner ("people"); 5 - violet, bush ( flowers ); 6 - a cat and a dog (silent); 7 - a closet, a bookcase ( it's in the room ). Undivided into groups are pictures: a cart, an airplane, a beetle, a shovel, a goose. Then the experiment proceeds as follows.

Experimenter (points to the second group). What do you call this group?

Sick. These are animals.

Experimenter. What can I put there?

Sick. I do not know.

The experimenter. Put the goose there.

Sick. No, you can not, he's swimming.

The experimenter. Put the beetle there.

Sick. No, you can not, it's an insect.

Experimenter. Then put the goose and the sparrow together.

Sick. No, you can not - the goose swims, and the bird flies.

The experimenter. But is the goose a bird?

The patient. Yes.

Experimenter. Well, then put them together.

Sick. No, the goose is swimming, and the bird is flying, and she lives in the forest.

Experimenter. Well, can a bear and a fox be put together with a cat and a dog?

Sick. No, you can not. The cat and the dog live at home, and the bear and fox live in the forest or in the zoo, I saw them there.

The experimenter. But the fox and the bear are also animals?

The patient. Yes.

Experimenter. This will all be a group of animals. Let's put them together.

Sick. No, they are different ... Well, let's (hesitantly, immediately recides). It will not be right.

The experimenter. Well, can you put the table on the shelf and the cabinet?

The patient. You can.

Experimenter. Can I put the machine in the cart?

Sick. No, you can not, they are different.

Experimenter. After all, the cart goes and goes by car?

Sick. If you tie the cart to the car with a rope, it will pull it, I saw it.

Let's dwell on the results of the job "setting the sequence of events".

The patient begins to explain the picture number 3 (the driver with the master is following the instrument): "Here they come with an ax. Probably there will be wood chopping & quot ;. Takes the picture number 2: And here he goes for a walk. See, here it is. " The rest of the pictures do not pay attention. The experimenter repeatedly explains that the pictures must be decomposed in a sequential order. The patient takes the fourth picture in his hands, declaring: "The wheel broke here. They raised it, repair it ... And here (points to picture No. 3) they go for firewood. " The experimenter helps the patient, indicating that picture No. 2 also shows a broken wheel. The patient agrees ("Yes, broken"), but does not make any conclusion and continues to view the picture. Goes to the picture number 4: "Here he goes somewhere, and here stands a man". Then, examining, he returns to picture No. 3 and declares: "Here they repair the wheel." Looks at the picture No. 1: "We fixed it, it fell off again". The result is a sequence of pictures:

No. 5. "The chopped board. A man on a cart carries a basket. "

No. 1. "The cart has broken, the wheel has rolled away."

No. 4. "There is already a repair here."

No. 2. Again rolled back .

No. 3. "There are workers with axes, probably, chopping wood."

The above experimental data show that patients are not able to isolate the essential features of objects, can not disclose the basic relationships between them. When the patient D. sees the cards depicting the dress and the cleaner, he has an association: "A woman wears a dress." Associations the same "woman - living creature" or "dress-clothing", i.e. logical connections do not arise.

This impossibility of distraction from the whole aggregate of specific properties and details of objects leads to the fact that patients can not correctly solve the simplest problem if it requires the comparison of these properties, the retardation of some, the isolation of others. When you run the event sequencing (breakage and repair of the wheel), the patients were guided by individual details of the picture, ns tying them. So, patient D. starts to talk about the fallen wheel first, but seeing the master with an ax in the next picture, he suggests where the master is going with the ax: "Probably, wood is cut in the wood". Similarly, the patient S., when presenting a series of pictures depicting a boy walking through a forest, is attacked by wolves and how he climbs a tree, declares: "Apples tear, so he climbed the tree." When the experimenter draws the patient's attention to the snow and suggests that apples do not grow in the winter, the patient states: "Yes, really, how am I? .. Why did he climb a tree?", But does not correct the error. Any irritant causes habitual private associations: the boy climbed a tree, therefore, tears the apples; in the hands of a man's ax - goes to the wood to cut wood. The individual details are not linked, not synthesized, the situation as a whole is not comprehended. The associations that arise in patients are due only to isolated, isolated elements of the picture presented. The sense relationships between the elements of the perceived situation do not play any role in the emergence and progress of the association. The judgments of the patients about the subject matter of ns include all that is essential that really applies to it. Therefore, the knowledge of patients is incomplete, imperfect, meager. Because of this extremely narrow range of associations, a small circle of knowledge and skills, patients are extremely limited in capabilities and can only act under certain rigidly pre-determined conditions. So, for example, one of these patients T. (oligophrenia) worked as a courier, carefully performed the duties assigned to him. When once he was instructed to bypass all employees with a sheet on which they had to sign, he broke into a private meeting, explaining that the comrade who reported at that time should sign. The persuasion that this could be done later did not help, the meeting was interrupted, for T. ns left, cried, repeated: "I am instructed that everyone should sign." The changed conditions of the situation did not cause the patient to change the way he acts.

A sample of this behavior is given by A. A. Tokarsky in his article "About stupidity" [187]. It's about a fool from a folk tale who was beaten for laughing during a fire, inspiring him at the same time that the fire should be filled with water. When the fool saw the next day, as people were singing a pig at the fire, he grabbed a bucket of water, poured it on the fire, and was again beaten. The fool, therefore, only learned a private order that the fire should be poured with water, but did not understand that the burning of fire means here something else. AA Tokarsky correctly notes in this case that the fool has learned instruction, remembered it; However, the ns saw at the same time substantially changed conditions. The main characteristic of stupidity, according to AA Tokarsky, is "in the discrepancy of action with the requirements of reality," and this discrepancy occurs because the fool is unable to grasp all that is happening around him with his perception. "A fool," remarked AA Tokarsky, "sees and hears not what exists in reality, but only a small part of it." The inability to distinguish two similar cases and means narrowness, non-generality of the formed connections; this inability excludes the possibility of orientation in the new conditions of life. In order to apply this or that method of solution to this particular case, it is necessary to analyze (by Tokar, see ) all the signs and generalize them. This was not done by a fool from a fairy tale, as our patients who do not use the inadequate method of solution do not.

It is interesting to note that already E. Segen pointed out that the intellect of a mentally retarded child (in the terminology of E. Sogen - an idiot) is only excited by some single feature of a phenomenon that has a whole host of features. " Moreover, when interacting with such concrete phenomena, the mentally retarded, in the opinion of E. Segen, "not only limits the number of their possible minimum, but even in the sphere of this limited circle he does not have a complete permanent representation."

In the works devoted to the psychology of a mentally retarded child, experimental data are given, indicating that a mentally retarded child can not find common in a variety of single phenomena. Already in the 1930s. LS Vygotsky and Zh. I. Shif found that a mentally retarded child who assimilates visual communication systems is not in a position to systematize his experience on the basis of generalization and abstraction. The structure of the connections behind the words turns out to be changed in the mentally retarded child. I. M. Soloviev-Elpidinsky [176] notes that instead of generalizing in mentally retarded children, the old knowledge and elements of a new task are equated. Zankov points out that for such children the difficulty lies in the transition to thinking problems, the solution of which requires a change in the mode of activity in comparison with what was used earlier. Studies on mentally retarded children at the Institute of Defectology of the RSFSR APN R. Luria and his colleagues (ED Khomskaya, OK Tikhomirov, I. Lubovsky, AI Meshcheryakov) revealed a violation of cortical neurodynamics.

>

Using the motor speech technique, AI Meshcheryakov found that in a mentally retarded child, the developed connections, not being sufficiently mediated by speech, turn out to be fragile and unstable. OK Tikhomirov discovered that in mentally retarded children, the connections of the verbal system do not adequately regulate their behavior. If the verbal constraints "collide with the immediate, the latter turn out to be dominant, and the verbal connections, remaining in the speech system, cease to regulate the child's reactions. EM Marcinovskaya discovered in oligophrenics the absence of verbal analysis and generalization of direct systems of connections. These data are in accordance with the studies of NI Krasnogorsky, who revealed in oligophrenic weakness of the excitatory process and violation of the differentiation process.

Summarizing, we can say that the mental activity of such patients imperfectly reflects objects, phenomena and their interrelations, because a full-fledged process of reflecting the objective properties and regularities of things always implies the ability to abstract from specific details. Pointing out that human cognition is a transition from sensory contemplation to abstract thinking and from it to practice, Lenin emphasizes that the act of generalization is a departure from concreteness. The approach of the mind to the individual thing, the removal of the impression from it is not a simple, immediate, mirror-dead act, but a complex, forked, , including the possibility of flying away from life ... [5, 330].

In our patients, this departure from individual connections is extremely difficult. The word does not appear in them as a vehicle of generalization. It remains, by the definition of IM Sechenov, "the nickname". Stopping in his work Elements of Thought on the process of the concept formation in the child, Sechenov points out that not every knowledge of the word and its use mean mastering its meaning, that although a small child can correctly use words such as "plant", "animal", the word is for him only the nickname for similar items.

Only the use of common concepts brings a correct understanding, only it gives an opportunity to act adequately, only it brings a person, according to Pavlov, "extraordinary benefit". Clicks they are not a full-fledged instrument of thinking.

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