If the nature of identity and self-image and Other - one-piece, continuous or unstable, discontinuous boundaries between I and Other clear or diffuse, as well as the quality affects allow you to distinguish between the neurotic structure from the edge of the structure, the ability to test reality, to distinguish borderline and psychotic structures.
the Ability to test reality can be described as the ability to split the I and not-I, to distinguish between internal and external reality and the quality of affects, in terms of social norms. In clinical practice, the determinant is 1 have crazy designs or hallucinations 2 strange bizarre affective state, cognitive disorders, strange behavior from the point of view of others 3 able or patient to explain and participate in the discussion of this behavior and whether capable of empathy. Empathy requires a realistic perception of the other.
it Is necessary to distinguish between cognitive distortions as a result of therapeutic regression or stress from pathological steady state.
so the ability to test reality is preserved if
1, the patient is able to critically perceive their actions and he had no delusions in the past, the present. Empathy to the therapist in the assessment of their actions and the assessment of the potential manifestations of empathy on the part of the therapist.
2 In the stage of confrontation with the dominance of the primitive defenses ability to test reality can dramatically propagat that will be negative when assessing the prognosis of treatment and the patient's condition.
in violation of the test of the reality of the person loses the ability to adequately building a causality, the information supplied in his mental world is highly distorted primitive patterns and primitive defense mechanisms. As such States are characterized by the loss of an observing Ego ability and critical evaluation of their actions from the outside, often paranoid attitude to criticism, while any attempt of confrontation can lead to severe affective outbursts.
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