Perseveration is a stable reproduction of any statement, activity, emotional reaction, sensation. From this, motor, sensory, intellectual and emotional perseverations are distinguished. The concept of perseveration, in other words, is a “sticking” in the human consciousness of a certain thought, a simple representation or their repeated and monotonous reproduction as an answer to the previous last interrogative statement (intellectual perseveration). There are spontaneous and repeated repetitions of the previously said, perfect, often referred to by the term iteration, and playback of the experienced, denoted by the term echomesis.
What is perseveration
Perseveration is considered a very unpleasant manifestation of obsessive behavior. A characteristic feature is the reproduction of a certain physical action, phoneme, presentation, phrase.
A typical example is a song that “gets stuck” for a long time in your head. Many subjects noticed that individual word forms or a melody are the hunt to be repeated out loud for a certain period. Such a phenomenon, naturally, is a weak analogy of the deviation in question, however, the meaning of perseverative manifestations is just that.
Individuals who are tormented by this violation do not control their own person at such moments. The annoying repetition appears absolutely spontaneously and also suddenly stops.
The deviation in question is found in the steady reproduction of the idea, manipulation, experience, phrase or presentation. Such repetition often develops into an obsessive unmanaged form, the individual himself may not even detect what is happening with him. Thus, the concept of perseveration is a phenomenon caused by a psychological disorder, mental disorder or neuropathological disorder of behavioral patterns and speech of an individual.
Such behavior is also possible with severe fatigue or distraction not only with mental ailments or neurological abnormalities. It is believed that the basis of perseveration is the process of repeated excitation of neural elements, due to the late signal about the end of the action.
The violation in question is often mistaken for stereotype, however, despite the general desire for obsessive repetition, perseveration is different in that it is the result of associative activity and a structural component of consciousness. Subjects suffering perseveration undergo therapy in healers, which first help to identify the root cause, and then carry out a set of activities aimed at eliminating reproducible thoughts, phrases, repetitive actions from the daily life of the subject.
In order to prevent the formation of the described syndrome in adults, parents should carefully observe the behavioral response of the baby to the presence of signs of perseveration. The following "attributes" of the violation in question can be distinguished: regular repetition of a single phrase that does not correspond to the topic of conversation, characteristic actions (for example, a child can constantly touch a certain area on the body in the absence of physiological prerequisites), constant drawing of identical objects.
In the childhood period, there are specific manifestations of perseverations due to the characteristics of the psychology of babies, their physiology, and the active change of life orientations and values of crumbs at different stages of maturation. This generates certain difficulties in differentiating the symptoms of perseveration from the conscious actions of the child. In addition, manifestations of perseveration can camouflage more serious mental abnormalities.
For the sake of an earlier identification of possible mental disorders in a child, it is necessary to carefully observe the manifestations of perseverative symptoms, namely:
- systematic reproduction of one statement regardless of the circumstances and the question asked;
- the presence of certain operations, repeating consistently: touching a certain area of the body, scratching, narrowly focused activities;
- multiple drawing of one object, writing a word;
- invariably repeated requests, the need for the execution of which is highly questionable within the boundaries of specific situational conditions.
Causes of Perseveration
This disorder is often born due to the physical effects on the brain. In addition, the individual has difficulty switching attention.
The main causes of the neurological focus of the described syndrome are:
- transferred localized brain lesions resembling affection in aphasia (an affliction in which an individual cannot pronounce verbal structures correctly);
- obtrusive reproduction of actions and phrases appears due to already arisen aphasia;
- cranial damage with lesions of the lateral segments of the cortex or the anterior zone, where the prefrontal bulge.
In addition to the causes of neurological orientation associated with brain damage, there are psychological factors that contribute to the development of perseveration.
The persistence of the reproduction of phrases, manipulations arises due to stressors, a long time affecting the subjects. This phenomenon is often accompanied by phobias, when the protective mechanism is activated by reproducing operations of the same type, which give the individual a sense of non-danger and comfort.
If autism is suspected, there is also an overly scrupulous selectivity in the performance of certain actions or interests.
The described phenomenon is often found with hyperactivity, if the baby believes that he does not receive due, in his opinion, a bit of attention. In this case, perseveration also acts as a component of protection that compensates for the lack of outside attention in the children's subconscious. With such behavior, the child seeks to attract attention to his own actions or himself.
Often the phenomenon under consideration manifests itself in scientific figures. The individual is constantly exploring something new, striving to learn something important, which is why he is obsessed with certain trivialities, statements or actions. Often, the described behavior describes such an individual as a stubborn and persistent person, but sometimes such actions are interpreted as a deviation.
Obsessive repetition can often be a symptom of obsessive-compulsive disorder, expressed in following a certain idea, which forces the individual to constantly perform specific actions (compulsions), or in the intimacy of some thought (obsession). Such a stable repetition can be seen, when the subject washes his hands often without need.
Perseveration must be distinguished from other ailments or stereotypes. Phrases or actions of a repetitive nature are often manifestations of established habits, sclerosis, subjective intrusive phenomena in which patients understand the strangeness, absurdity and meaninglessness of their own behavioral patterns. In turn, during perseveration, individuals do not realize the abnormality of their own actions.
If an individual develops signs of perseveration, however, no history of stress or trauma to the skull was noted in the history, this often indicates the occurrence of both psychological variations of the disorder and mental ones.
Types of perseveration
Based on the nature of the violation in question, as it was listed above, its variations are distinguished: perseveration of thinking, speech perseveration, and motor perseveration.
The first type of the described deviation differs by “cycling” of an individual on a certain thought or representation arising during the communicative verbal interaction. Perseverative phrase, can often be used by an individual to answer the above questions, while not having a bearing on the meaning of the interrogative utterance. Sticking on one representation is expressed in steady reproduction of a certain word or a word combination. More often it is the right response to the first interrogative sentence. Further questions the patient gives a primary answer. Characteristic manifestations of perseveration of thinking are considered to be steady efforts to return to the subject of conversation, about which we have not been talking for a long time.
A similar condition is inherent in atrophic processes occurring in the brain (Alzheimer's or Pick's). It can also be found in traumatic psychosis and vascular disorders.
Motor perseveration is manifested by repeated repetition of physical operations, both the simplest manipulations and the whole set of various body movements. At the same time, perseverative movements are always reproduced clearly and equally, as if according to the established algorithm. There are elementary, systemic and speech motor perseverations.
The elementary type of the described deviation is expressed in the repeated reproduction of individual parts of the movement and originates due to the defeat of the cerebral cortex and the underlying subcortical elements.
The systemic type of perseveration is found in the repeated reproduction of whole complexes of movements. It occurs due to damage to the prefrontal segments of the cerebral cortex.
The speech form of the pathology in question manifests itself by repeated reproduction of a word, phoneme, or phrase (in writing or in oral conversation). Occurs with aphasia due to the defeat of the lower segments of the premotor zone. At the same time, this deviation in left-handers occurs if the right side is affected, and in right-handed individuals, if the left brain segment is damaged, respectively. In other words, the considered type of perseveration originates due to damage to the dominant hemisphere.
Even in the presence of partial aphasic deviations, patients also do not notice differences in the reproduction, writing, or reading of similarly pronounced syllables or words (for example, “ba pa,” “sa - za”, “cathedral – fence”), they confuse the letters similar in sound .
Speech perseveration is characterized by stable repetition of words, statements, phrases in written speech or oral.
In the mind of a subject suffering from speech perseveration, it is as if a thought or a word “gets stuck”, which he repeats repeatedly and monotonously during communicative interaction with interlocutors. At the same time, the reproduced phrase or word has no relation to the subject of conversation. The speech of the patient is characterized by monotony.
The basis of the therapeutic strategy in the correction of perseverative anomalies is always a systematic psychological approach based on the alternation of stages. It is not recommended to use one technique as the only method of corrective action. You need to use new strategies, if previous results have not brought.
Often the treatment course is based on trial and error, rather than being a standardized therapy algorithm. When neurological brain pathologies are detected, the therapy is combined with the appropriate medical effect. From pharmacopoeial means weak sedative preparations of central action are used. Nootropics are necessarily assigned along with multivitaminization. Speech perseveration also implies a speech therapy impact.
Correctional impact begins with testing, the results of which are assigned, if necessary, examination. Testing consists of a list of basic questions and the solution of certain tasks, which often carry a trick.
Below are the main stages of the strategy of psychological assistance, which can be applied sequentially or alternate.
The expectation strategy is to anticipate changes in the course of perseverative abnormalities due to the appointment of certain therapeutic interventions. This strategy is explained by the resistance to the disappearance of symptoms of perseveration.
The preventive strategy implies the prevention of the emergence of motor perseveration against the background of the intellectual one. Because often perseverative thinking arouses the motor type of the deviation in question, as a result of which these two variations, the disturbances coexist together. This strategy allows you to prevent such a transformation in a timely manner. The essence of the technique is to protect the individual from those physical operations, which he often talks about.
The strategy of redirection consists in the emotional attempt or physical effort of a specialist to distract a sick subject from pesky thoughts or manipulations, by abruptly changing the subject of the conversation at the moment of the current perseverative manifestation or nature of actions.
A limiting strategy implies a gradual decrease in perseverative attachment by restricting the individual to perform actions. Limits allow for annoying activities, however, in a well-defined quantity. For example, access to computer entertainment for the allowed time.
The strategy of abrupt termination is based on the active removal of perseverative attachments by the shock of the patient. An example here are the sudden, loud phrases "This is not! Everything!" or visualization of damage caused by intrusive manipulations or thoughts.
The strategy of ignoring consists in an attempt to absolutely ignore the manifestations of perseveration. The technique is very effective if the etiological factor of the deviation in question is attention deficit. The individual, not receiving the expected result, simply does not see any sense in further reproducing the actions.
The strategy of understanding is an attempt to know the true course of the patient's thoughts during the course of perseverative manifestations, as well as in their absence. Often this behavior helps the subject to put his own actions and thoughts in order.