Temas e Controvérsias


(Versão em português neste mesmo BLOG- JBP.vol58.n1.2009)

What would you think if you came across the expression “hypertimic impulse” or “hypobulic affect” being used to denominate some mental phenomenon related to the WILL or the AFFECTIONS of someone? It would be very strange, would it not?! This misusing of terms could be classified as some sort of absurd and unacceptable hybridism. Well! We have been doing something very similar, since the fifties, through the use of the expression DELIRIOUS PERCEPTION. As we all know, the first term refers to the ability to JUDGE (related to one’s capacity of thinking), and the second one is related to our capacity of reacting to external stimuli (SENSE-PERCEPTION) in order to produce mental representations of the environment.

In addition to that, when trying to define the phenomenon, we are forced to provide lots of initial excuses: “In spite of such name, there is no problem with the patient’s sense-perception since his capacity to perceive objects is not disturbed. The problem is related to the associations and conclusions he makes (in the majority of cases self-directed and persecutory cause/effects relations) without any logical connections with the object or the situation perceived”. This kind of “explanation” indicates that such denomination is very poor, therefore the phenomenon must be redenominated.

It was W.Wundt (1832-1920) who, for the first time in psychology (after W.G. Leibniz), gave importance to the necessity to separate in three phases the process by which our mind makes contact and integrates with the environment: 1-SENSATION: series of physical-chemical reactions to various stimuli (producing mainly the sensation of colors and intensity to our eyes); 2- PERCEPTION: immediately after the stimulus arriving into the cortical areas responsible for its integration (formation of images); 3- APPERCEPTION: comprehension (mainly in frontal areas) of the situations or scene. Some anecdotes say that K. Jaspers did not give much importance to Wundt’s work. Maybe for that reason he did not take advantage of a concept that would solve a very important conceptual problem.

For many years we could have had some doubts regarding the real existence of an APPERCEPTION as an independent phase of the process that reproduces the environment internally. However, after describing the concept of APPERCEPTIVE and ASSOCIATIVE AGNOSIAS, it is unacceptable for one not to apply it to redenominate the phenomenon-title as DELIRIOUS APPERCEPTION. The existence of some patients who are able to draw many objects, machines, etc., but cannot make the connection between them, is a proof that the APPERCEPTION must be treated independently.

From the Semiology’s point of view, in order to characterize the “DELIRIOUS APPERCEPTION”, the majority of writers give much value to the absence of any logical connection between the perception and the conclusion, but the limits for this “non-connection” are not very clear. To us, the occurrence of a kind of SELF-DIRECTED IMMEDIATE REVELATION, without intermediations by any kind of “enchainment” of thoughts is also a mandatory criterion.

Vice- Diretor do Instituto de Psiquiatria da UFRJ