Delusion and Hallucinations
Both delusion and hallucinations frequently coexist and one may bring either to the surface or judicious inquiry for the one or the other. Many patients in fact most neurotic complain of loss of memory. A little inquiry immediately reveals the emptiness of the complaint. Such patients suffer from want of attention (there are too self-centered): therefore they do not remember. Memory consists of attention (association), retention and spontaneous recollection. In true memory defect there is no retention, no power of association of ideas in order that they be retained and obviously no recollection. Each of these can be tested. The patient is asked to exact date and place of birth, age, address, name of wife and children or parents, names of day of the week or month of the year, the even of the previous days, the names of important persons, of capital cities, of outstanding occurrences, and so on. He may be show figures and asked to repeat them, or told a word and a few minutes later asked to recall it. He is given at first simple, then complicated, problem in arithmetic. In all these questions the educational status of the patient is to be considered. Generally memory for recent events is loss first and there for remote events preserved for a long time. Occasionally, a patient fills in gaps in memory with recital or false events. Disorientation as to time, place and person is generally the result of marked impairment of memory.
This is not the place to go in to discussion of the dynamics of the psychoses or the psychology of emotively or to describe the standard associations test or the free associations of psychoanalysis. It may be stated however, that acquaintance with the psychoanalysis technique greatly helps in obtaining a satisfactory mental history.