ABSTRACT

This chapter describes the clinical manifestations of concrete thinking, compares the various theories offered to account for such thinking, and outlines the technical modifications needed to make the psychoanalytic treatment of concrete patients more efficacious. A failure to engage in metacognition is an important and largely overlooked aspect of concrete thinking. Metacognition refers to a broad set of cognitive functions, chiefly metacognitive activities and the resulting metacognitive knowledge – thoughts about one's thoughts, thoughts about the process by which one goes about thinking, and the conclusions reached about the nature of one's own thinking having given due consideration to one's thought processes. The chapter offers a metacognitive perspective on concrete thinking – one that views concrete thinking as a developmental arrest – in contrast to the approach taken by writers who either focus on the concrete patient's difficulties in symbolizing and/or his failure to differentiate.