Clinical psychology. Violation of controllability and criticality of behavior (most important)

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Clinical psychology. Violation of controllability and criticality of behavior (most important)

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12. Violation of controllability and criticality of behavior

Failure to control behavior is one of the images of personality disorders. It is expressed in the patient's incorrect assessment of his actions, in the absence of criticality to his painful experiences. Investigating violations of criticism in mental patients, I. I. Kozhukhovskaya showed that uncriticality in any form indicates a violation of activity in general. Criticality, according to Kozhukhovskaya, is "the pinnacle of a person's personal qualities."

As an example of such a violation, consider extracts from the medical history given by B. V. Zeigarnik:

sick M.

Year of birth - 1890.

Diagnosis: progressive paralysis.

Disease history. In childhood, he developed normally. He graduated from the Faculty of Medicine, worked as a surgeon.

At the age of 47, the first signs of mental illness appeared. During the operation, he made a gross mistake, which led to the death of the patient.

Mental state: correctly oriented, verbose. Knows about his disease, but treats it with great ease. Remembering his surgical mistake, he says with a smile that "everyone has accidents." At the moment, he considers himself healthy, "like a bull." I am convinced that I can work as a surgeon and chief physician of the hospital.

When performing even simple tasks, the patient makes many gross mistakes.

Without listening to the instructions, he tries to approach the task of classifying objects, like a game of dominoes, and asks: "How do you know who won?" When the instruction is read to him a second time, he performs the task correctly.

Performing the task "establishing a sequence of events", trying to simply explain each picture. But when the experimenter interrupts his reasoning and suggests putting the pictures in the right order, the patient performs the task correctly.

When performing the task "correlation of phrases with proverbs", the patient correctly explains the sayings "Measure seven times - cut once" and "Not all that glitters is gold." But he incorrectly refers to them the phrase "Gold is heavier than iron."

Using the pictogram technique, the following results were obtained: the patient forms connections of a rather generalized order (to memorize the phrase "jolly holiday" draws a flag, "dark night" - shades a square). The patient is often distracted from the task.

When checking, it turns out that the patient remembered only 5 words out of 14. When the experimenter told him that this was very little, the patient replied with a smile that next time he would remember more.

Thus, we see that patients do not have a motive for the sake of which they perform this or that activity, perform this or that task.

Their actions are absolutely unmotivated, patients are not aware of their actions, their statements.

The loss of the opportunity to adequately evaluate one's own behavior and the behavior of others led to the destruction of the activity of these patients and a deep personality disorder.

Author: Vedekhina S.A.

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