December 1963

Perceptual Organization and the Development of Insight

Author Affiliations

From the Department of Clinical Research, Eastern Pennsylvania Psychiatric Institute (Drs. Rashkis and Diggory), and the Department of Psychiatry, Woman's Medical College of Pennsylvania (Dr. Rashkis).

Arch Gen Psychiatry. 1963;9(6):552-558. doi:10.1001/archpsyc.1963.01720180024004

Clinical evaluation of mental patients is largely based on their verbalizations. Although some patients, while very sick, may develop a pseudoinsight or speak pseudorationally, we do not ordinarily see the converse of this: patients who are clinically well but cannot express themselves reasonably. Accordingly, if we were to set up a scheme for evaluating patients' statements with regard to increasing connectedness or relevance of ideas, we would expect a good, though not a perfect, correlation between improvement on our scale and actual clinical improvement.

When we try to make prognostic statements based on such a scale, however, we may run into difficulties, for we may find that patients who enter a hospital making no verbal sense at all go on to a speedy remission, while thoroughly rational-sounding patients may never budge from their admission-level plateau, or may actually seem to get worse. This is

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