Friday 6 December 2013

The Pathology of Thought Insertion

Rachel Gunn

I’m a new PhD student at the University of Birmingham studying delusion. I work as a counsellor and psychotherapist in Birmingham, Coventry and Warwick and studied thought insertion for my Masters dissertation at the University of Warwick. (What follows is a very rough summary of some of the findings from my work on my Masters dissertation).

While trying to understand thought insertion I became aware of the lack of first person descriptions in the philosophical literature. I didn’t understand the phenomenon and didn’t feel that the philosophical literature helped me, as it was full of contradictions. I felt I couldn’t make progress without more information. In my work in this area I rely heavily on what patients and others say about their experience (using mental health web forums and other first person descriptions) and take their description of their experience seriously.

Alienonite from the Crazyboards web forum describes the experience:

“Often, in a quiet place, and all the time at night when I am alone, I experience thoughts that do not "feel" like my own. It's like they come out of a part of my brain that is not the part that controls my "normal" thoughts and into my awareness from there. It is hard to describe. These "false thoughts" are usually about random subject matter and usually make little sense, but are extremely distracting. Back when I first experienced them, I thought I was psychic and that I was picking up other people's thoughts (telepathy?). However, now I know that they are a part of psychosis because I experience them around the times I hallucinate… I'm lucky that the false thoughts don't tell me to do anything. They just annoy me and keep me from falling asleep. Sometimes I question if they are other people's thoughts, because I don't know where they're coming from.”

I can never have access to someone else’s mental activity and, because thought insertion is so bizarre, it is incredibly difficult for a person experiencing it to describe. They know that it differs from their ‘normal’ experience of thinking but when it comes to describing it in ordinary language it is difficult to capture. This was repeatedly highlighted in the first person descriptions used to inform the work. On examining the descriptions and the philosophical literature it seems that thought insertion may be multiply realised but I would not rule out the possibility that different aetiology represent different phenomena – again the difficulties in explanation and understanding make this problematic.

Whilst distressing for some, thought insertion alone, may not be indicative of illness and should not perhaps be a first-rank symptom for schizophrenia. Rather, it is the secondary phenomena such as content, level of influence and intrusion on other mental activities, functioning and wellbeing that determine whether psychiatric or other therapeutic help is required.

The transparent mental activity that means that my thoughts are owned and produced by me is ‘given’ in my normal though processes. When thought insertion occurs unity of experience is lost – this is what makes the phenomenon bizarre and this fact cannot be explained away. If we take the descriptions and definition seriously then thought insertion, as well as some forms of ‘inner’ voice experience, are a passive phenomenon where the subject experiences a lack of agency and a lack of ownership of thoughts whilst retaining subjective access to the content of those thoughts.

1 comment:

  1. This is interesting, as a pastor I deal with this all the time. From the perspective of Christian theism, thought control is the primary battlefield believers struggle with. Satan cannot read our minds but he can insert thoughts/lies and then observe our behavior to discover if we're swallowing that lie. This is why we are encouraged by the Apostle Paul to guard our thoughts. Some wrong thinking comes from our fallen nature and some wrong thinking comes from our enemy satan. Both sources need to be tested by biblical truth.


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