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January 1965

Insight, Denial, And Prognosis

Arch Gen Psychiatry. 1965;12(1):96-98. doi:10.1001/archpsyc.1965.01720310098014

Underlying most current psychotherapies is the principle that bringing the facts of a person's existence into reflective consciousness will be beneficial to his mental health. While insight is generally a goal of treatment with office patients, expectations for hospitalized patients are often more limited, and discharge is commonly effected after symptomatic improvement. Hospitalized patients are frequently considered to have insight if they acknowledge that they have been mentally ill; insight into psychodynamics is not often achieved with hospitalized patients, and it is often viewed skeptically as pseudoinsight. A noted psychiatrist once commented: "They keep gaining insight and losing ground."

It may be useful to distinguish between the knack that certain patients have to learn the right kind of things to say and their ability to use dynamic concepts in a rational way. More important than the ability to learn neat phrases is the ability