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Home > Altered Thinking (Thought Disorder)

Altered Thinking (Thought Disorder)

Thought disorders

a woman thinking.

There are two ways that our thoughts can be altered when having unusual experiences; either the way thoughts are formed and expressed or the content of the persons thoughts.

The experiences described below can be a part of everyday thought processes for anyone on occasion. They may become problematic if they are causing ongoing distress or difficulties with communication.

Altered thought form and expression (Disorganised Thinking)

  • Blocking: Speech that is broken by pauses as the trail of thought is lost.
  • Circumstantiality: Trouble getting to the point in speech. Talking around the point or adding unrelated points, sometimes excessively, before expressing the point of the message.
  • Clanging: Speech that is determined by the way the words sound rather than the meaning they express like rhyming or punning.
  • Derailment (loosening of associations): Trouble sticking to the topic at hand whilst speaking about loosely related or unrelated things.
  • Distractible speech: Trouble sticking to the topic at hand due to being distracted by other things going on.
  • Echolalia: Responses are simply a repetition of the words or phrases that the questioner is using.
  • Illogicality: Trouble reaching conclusions in a logical manner.
  • Incoherence (word salad, schizaphasia): Severe trouble making sentences, words are spoken but they don’t make sense together and the listener cannot comprehend the message.
  • Loss of goal: Trouble sticking to the topic at hand with speech that doesn’t reach a point or conclusion.
  • Neologism: The speaker uses words that are new or uses words in a new sense that only makes sense to them.
  • Paraphasic error (phonemic): Words are not pronounced correctly, or a slip of the tongue occurs.
  • Paraphasic error (semantic): Inappropriate words are substituted into speech to make a specific point to the listener.
  • Perseveration: Responses are simply a repetition of particular words, ideas, or topics.
  • Poverty of content of speech: Maintains conversation but is vague in responses and doesn’t convey much information though a lot may be said.
  • Poverty of speech: A lack of speech, brief and lacking detail in responses in conversation.
  • Pressure of speech: Speaks quickly and says a lot, typically loudly, and it is challenging to get a word in edgewise.
  • Self-reference: The responses and speech in conversation ends up referring to the person.
  • Stilted speech: Speech that is odd because it is overly formal, outdated, pompous or quaint.
  • Tangentiality: When questioned the responses are not relevant or don’t quite seem related to the question.
  • Word approximations: The use of words is not typical to their meaning as they are used inappropriately, or new words are made that make sense but aren’t actual words.

Altered content of thoughts (Delusional Thinking)

Control (passivity phenomenon):

This involves the person believing that they are being controlled by an external force. For example a person may believe that they are being controlled by the government and that their actions are not within their own control.

Persecution:

This involves the person believing that they are under threat from something or someone that wishes to do them harm. For example the person may think that there are aliens trying to hurt them.

Grandiose:

This involves the person believing that they are in someway special, important or powerful or that they are involved in something especially important. For example a person may think that they can control other people or events, that they have super powers, that they have special knowledge or that they are a very important person.

Religious:

This involves the person believing heavily in religious ideas that aren’t congruent with their upbringing, education and culture. It is more than simply believing in a religion. For example a person may be preoccupied with reading religious texts, interpreting it to have personal messages about their life.

Nihilistic:

This includes the person believing that they, or part of themselves, or the world isn’t real or is dead. For example a person may think that they are dead, that their body is decaying and that they don’t need to eat or drink as a result.

Jealousy:

This involves a person believing that someone close to them is cheating or lying. It is not backed up by evidence and the person is not reassured by this. For example a person may think their spouse is cheating on them and start searching for evidence, tracking their every move, looking through their belongings or looking at their emails or phone.

Guilt:

This involves the person believing that they are responsible for something terrible that has happened or feeling incredibly guilty without it being related to a specific circumstance. For example a person may think that they are responsible for an earthquake.

Love:

This involves the person believing that someone they don’t know, usually a famous person, is in love with them. For example a person may think that the prime minister is secretly in love with them.

Somatic:

This involves the person believing that they have something wrong with their physical health or a medical problem. For example a person may think that they have cancer despite medical investigations and tests being clear.

'For me it isn't always about "debunking" an unusual belief, or suddenly not believing it. It feels okay to keep the belief but let it go into the past so it becomes something that isn't affecting me in the present.'

Anonymous

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Is it okay if I totally trash your office? It’s a question Elyn Saks once asked her doctor, and it wasn’t a joke. A legal scholar, in 2007 Saks came forward with her own story of schizophrenia, controlled by drugs and therapy but ever-present.

(TED.com, CC BY-NC-ND 4.0)

How it may start (delusional mood)

People often find that altered thinking doesn’t just appear out of the blue. Typically the person experiences feeling unsettled by a sense that something isn’t quite right. They might feel anxious, guilty or low in mood. These feelings are often not attached to anything in particular. Then it may begin to feel as though things are being staged, or are unreal in some way, or that something is about to happen. How it feels varies depending on the person but this can be a helpful pattern to learn for oneself in order to understand where and how altered thinking starts.

If it’s a problem

Difficulties with altered thought form or expression or content of thoughts can be challenging. Below are some examples of things you could try if you’re struggling with your thoughts or beliefs or communication.

  1. It can help to check in with a friend, relative, carer or mental health professional if you need reassurance or a sounding board.
  2. Using any strategies that you have learnt to challenge the thoughts or beliefs, for example checking facts, considering others perspectives, doing an experiment.
  3. Setting aside some time each day to focus on your thoughts or beliefs but then focusing on other things outside of that time.
  4. Using tools or techniques if you are struggling to think clearly, for example checklists, reminders, keeping a diary, using voice notes, post it notes around the house.
  5. Using communication aids you can show people can be helpful, for example cards with how you are feeling on them, pictures that show what you need.
  6. Speak to close friends, family or an advocate who can help you to communicate your needs.

Consider more:

    1. Can you recognise any altered thinking in yourself?
    2. When evaluating your beliefs would any of them fit the types of altered content of thoughts above?
    3. How much control do you think we have over our thoughts and beliefs?