Thinking and problem solving

Prof. Dr. Saadoun D. Ahmed/ Consultant Psychiatrist

Thinking; it is a mental activity which doesn’t depend directly upon sensory or motor
contact with the present circumstances. Thinking is included in all our activities. It is the
language of the mind. Thinking (cognition) - mental activity that goes on in the brain
when a person is organizing and attempting to understand information and
communicating information to others. Mental images, mental representations that stand
for objects or events and have a picture-like quality.
The tools of thinking are concepts, are ideas which refer to objects, events, qualities,
etc...Your own concept of a certain thing may not agree in all respects with the standard
definition as your own concept consists of what you know or believe about this thing and
its interaction with your personality.
Anatomical sites concerned with thinking: Cerebral cortex, Limbic system, Reticular
activating system.
Definition: Thinking is the manipulation of mental representations of information.
Representations may be words, visual images, sound, data, or any sensory modality.
Thinking transforms a particular representation of information into new and different
forms in order to answer a question, solve a problem or reach a goal.
The building blocks of thought are mental images and concepts
Mental images: Mental images are representations in the mind of an object or event.
Every sensory modality may produce corresponding mental image. Some experts see the
production of mental images as a way to improve various skills and many athletes use
mental imaginary in their training; they visualize themselves playing, hearing the noise,
seeing the basket….
Concepts (categorizing the world): Concepts are categoriztion of objects, events or
people that share common properties. They enable us to organize complex phenomena
into simpler more easily used categories (Someone tapping a handheld screen is
described as using some kind of computers even if we have never encountered that screen
before).
Phases of concept formation
1. Generalization. Inability to differentiate between familiar and non-familiar objects.
2. Differentiation. Distinction between different items.
3. Abstraction. Ability to grasp the essentials of a whole, It is tested by proverbs.
Prototypes: They are typical highly representative examples of a concept that correspond
to our mental images e.g. a pigeon is a prototype of the concept bird. Cars and trucks are
prototypes of vehicles, but elevators are not. Concepts and prototypes helps physicians
make diagnoses by knowing concepts and prototypes of symptoms they learned in
medical schools.
Reasoning: It is the process by which information is used to draw conclusions and make
decisions
Types of thinking
1. Autistic thinking. 3. Creative thinking.
2. Purposive thinking. 4. Concrete and abstract thinking.
a) Problem solving.
b) Logical thinking.
1. Autistic thinking; it is not directed towards any purpose. It is a passive thinking which
does not need any attention and does not lead to any mental exhaustion. It is a sort of free

Behavioral Science/KMC 1 2023-2024

 Thinking and problem solving
Prof. Dr. Saadoun D. Ahmed/ Consultant Psychiatrist

imagination. It is more or less related to day dreams and dreams of the night when it is
moderate; it is beneficial leading to an escape or gratification of certain desires.
Indulgence in this sort of thinking may lead to withdrawal from reality and isolation from
the community and the whole thinking of the individual will be directed through this
autistic, unrealistic way as occurs in schizophrenia.
2. Purposive thinking; this is controlled and directed towards the goals of discovery and
invention. This type of thinking uses concepts and its combination of rules and principles.
We also use the language symbols for thinking. These symbols which are vocal and
written expressions are used in the first place for thinking. Examples of purposive
thinking;
a. Problem solving; the problem is solved when ways and means are found. The process
of solution then is the process of seeking and finding and often some of the work may be
done by thinking instead of motor exploration and manipulation. It is an active process, it
is a higher cognitive function. Thinking often takes place when we have a problem to
solve. Methods of learning specially the trial and error and insight learning type of
problem solving thinking. Insight means planning the solution on a mental level
beforehand. Insight is affected by past experience and full information about the problem
b. Logical thinking; when we reach a conclusion from our relevant data this is a logical
thinking. The opposite is illogical or loose thinking; using irrelevant data to reach
unaccepted conclusion e.g. Ahmed is Mohamed’s son and Hisham’s father. It follows
that Mohmoud is Hasham’s grandfather. The pattern of this particular data can be
diagramed with a vertical line with Ahmed in the middle, Mohamed at the top and
Hisham at the bottom.
3. Creative thinking
a. Controlled d. Has 4 phases
b. Goal directed 1) Preparation phase. Data collection and understanding all
c. Happens in arts and about the problem.
inventive 2) Incubation phase. It is a waiting period. Work is neglected
productions consciously but unconscious work is done.
3) Inspiration or illumination phase. The solution comes
suddenly out of the blue.
4) Verification phase. Testing the solution, experimental
work to verify scientific hypothesis
4. Abstract versus concrete
The difference between abstract and concrete thinking is an important one with medical
implications in certain forms of psychiatric and physical illnesses .We ask somebody
about the meaning of the proverb “people who live in glass houses should not throw
stones “a person who thinks concretely or just through the meaning of the words will say
that if he throws stones they will break the glass houses. It needs a real abstract thinking
and deeper understanding of the meaning of the words to explain it as that “those who
have faults should not criticize others”. When find that in various forms of brain injury or
mental retardation the patient’s capacity to think abstractly or to use words is impaired.
The same we implies in schizophrenia when there is disturbance of abstract thinking and
the patient will only think in a concrete way and so he start to fail in examinations and be
less productive in his studies because of this incapacity.

Behavioral Science/KMC 2 2023-2024

 Thinking and problem solving
Prof. Dr. Saadoun D. Ahmed/ Consultant Psychiatrist

Disorders of thinking
Disordered thinking: A failure to be able to "think straight." Thoughts may come and go
rapidly. The person may not be able to concentrate on one thought for very long and may
be easily distracted, unable to focus attention. The person may be unable to connect
thoughts into logical sequences, with thoughts becoming disorganized and fragmented.
This lack of logical continuity of thought, termed a "thought disorder," can make
conversation very difficult and may contribute to social isolation. If people cannot make
sense of what an individual is saying, they are likely to become uncomfortable and tend
to leave that person alone. Thought disorders are usually diagnosed when a person’s
behavior or speaking indicates problematic, illogical, or incoherent patterns of thinking.
Thinking normally involves three parts: thinking about something, stringing thoughts
together on what you are thinking about, and, finally, the delivery or flow of a thought
pattern. A thought disorder disrupts one or more aspects of the thought process. A
thought disorder is distinct from speech disorders, which occur as a result of difficulty
with speech patterns and production, rather than an underlying problem with thought
processes. Schizophrenia is disorder characterized by a type of thought disorder, and
delusions—false beliefs that a person persists in believing despite conflicting evidence—
can also be caused by thought disorders.
Symptoms of Thought Disorders. When people are diagnosed with a thought disorder,
they are often diagnosed with some other condition that causes or contributes to the
disordered thinking. Common symptoms of thought disorders include:
 Rapid, incoherent, or illogical  Delusions and false beliefs
speech  Extremely tangential speech patterns, during
 Frequent interruptions in a which a person rapidly discusses several
person’s train of thought apparently unrelated topics
 Belief that a person or entity  Inability to follow a logical train of thought or to
has removed the person’s clearly tell a story or convey an idea
thoughts
1. Disorder of the stream of thinking; we mean by this the general flow of thoughts,
ideas and talk. This may be a very slow and hard to elicit as occurs in anxiety and
depression. Thinking may be fast with flights of ideas and unconnected sentences and the
patient is talking very quickly unable to catch up with his stream of thinking as in mania
and hypomania. The stream of thinking may be blocked as in schizophrenia and in this
the patient while talking fluently may stop completely for a few seconds with vacant eyes
and restart again with a different pattern of thinking.
2. Disorder of the control of thinking; it usually occurs in schizophrenia and the patient
may complain of people being able to read his thoughts or withdraw (thought
withdrawal) them and broadcast them on the radio or produce them in the newspapers
and television (thought broadcasting). He may also complain that certain thoughts in his
mind in spite of his resistance (thought insertion).
3. Disorder of the content of thinking.
Thought is assessed from the history and specific enquiries. Thought content divided
into:
A. Preoccupations.
Hypochondriasis. Unjustified of suffering from a particular disease in spite of appropriate

Behavioral Science/KMC 3 2023-2024

 Thinking and problem solving
Prof. Dr. Saadoun D. Ahmed/ Consultant Psychiatrist

examination and reassurance.

Morbid thinking. Depressive ideas, e.g. themes of guilt, burden, unworthiness, failure,
blame, death, suicide.
Obsessional thinking. Repetitive, intrusive, senseless thoughts or preoccupations the
person cannot stop.
Phobia. A senseless avoidance of a situation, object or activity stemming from a belief
that has caused an irrational fear.
Ruminations. Repetitive, unproductive thoughts.
B. Abnormal beliefs. Abnormal beliefs fall into two categories:
(1) Those that are not diagnostic of mental illness, e.g. overvalued ideas, superstitious,
magical thinking
(2) Those that invariably signify mental illness, i.e. delusions. The main difference is that
delusions either lack a cultural basis for understanding the belief or have been derived
from abnormal processes.
Delusions. Delusions are false beliefs that are strongly held and unchangeable in the face
of refuting evidence and that are not consistent with the person’s educational, social and
cultural background. The psychiatrist and philosopher Jaspers (1913) define the three
main criteria for a belief to be considered delusional in his book General
Psychopathology. These criteria are:
i. Certainty (held with complete confidence)
ii. Incorrigibility (not changeable by proof to the contrary)
iii. Impossibility or falsity of content (implausible, bizarre or patently untrue).
Classification of delusions by content
Classification Content
Persecutory delusions False belief that one is being harmed, threatened, cheated, harassed
or is a victim of a conspiracy
Grandiose delusions False belief that one is exceptionally powerful(including having
mystical powers), talented or important
Delusions of False belief that certain object, people or events have intense
reference personal significance and refer specifically to oneself, e.g. believing
that a television newsreader is talking directly about one.
Religious delusion False belief pertaining to a religious theme, often grandiose in
nature, e.g. believing that one is a special messenger from God
Delusions of love False belief that another person is in love with one (commoner in
(erotomania) women). In one form, termed de Clerambault syndrome, a women
(usually) believes that a man, frequently older and of higher status,
is in love with her.
Delusion of infidelity False belief that one's lover has been unfaithful. Note that morbid
(morbid jealousy, jealousy may also take the form of an overvalued idea, that is, non-
Othello syndrome) psychotic jealousy.
Delusions of Capgras syndrome; belief that a familiar person has been replaced
misidentification by an exact double- an imposter.
Fregoli syndrome; belief that a complete stranger is actually a
familiar person already known to me
Nihilistic delusions False belief that oneself, others or the world is non-existent or about

Behavioral Science/KMC 4 2023-2024

 Thinking and problem solving
Prof. Dr. Saadoun D. Ahmed/ Consultant Psychiatrist

(Cotard's syndrome to end. In severe cases, negation is carried to the extreme with
patients claiming that nothing, including themselves, exists.
Somatic delusions False belief concerning one's body and its functioning, e.g. that one's
bowels are rotting. also called hypochondriacal delusion (to be
distinguished from overvalued ideas seen in hypochondriacal
disorder)
Delusions of False belief that one is infested with small but visible organisms.
infestation (Ekbom's May also occur secondary to tactile hallucinations, e.g. formication
syndrome)
Delusions of control False belief that one's thought, feelings, actions or impulses are
(passivity or 'made' controlled or 'made' by an external agency, e.g. believing that one
experiences) was made to break a window by demons. Delusions of thought
Note : these are all control include:
1st –rank symptoms Thought insertion; belief that thoughts or ideas are being implanted
of schizophrenia in one's head by an external agency.
Thought withdrawal: belief that one's thought or ideas are being
extracted from one's head by an external agency.
Thought broadcasting: belief that one's thought are being diffused or
broadcast to others such that know what one is thinking.
4. Disorders of the form of thinking; here the patient is unable to associate his thinking
in a logical way. He may fly from one topic to another. He is unable to give a definite
answer to any question and replies in an approximate way, always off the point. He is
usually vague and shifts his interest to philosophy, religion and Para psychological study
to satisfy his ambiguity and strange form of thinking. e. Concrete thinking, Illogical
thinking, loss of association. He may fly from one topic to another. Specific thought
disorders include derailment , Poverity of speech, Alogia (also poverty of speech) – A
poverty of speech, either in amount or content; it can occur as a negative symptom of
schizophrenia. tangentiality, illogicality. perseveration. Persistent repetition of words or
ideas even when another person attempts to change the topic., thought blocking.
Echolalia, Neologism, Flight of ideas, Words salads, …

Behavioral Science/KMC 5 2023-2024