ABSTRACT
Reality testing is the ability to perceive people and the world in roughly the same way most other people would, without major distortions. Since reality testing is mediated by perception, anything that impairs perceptual processing in the brain, or in the peripheral sensory organs, can result in impaired reality perception. Certain dementias, drug toxicity, febrile conditions, and even some nonverbal learning disabilities can impair one's reality testing. People with severe deficits in reality testing suffer from hallucinations, either visual or auditory. At this level of impairment in reality testing, medication is usually necessary to curb the perceptual distortions enough so that the patient can get a toehold in an alliance with the therapist. Mild glitches in reality testing seldom pose a significant threat to the alliance, so they seldom need to be designated as a primary treatment focus. Kleiger details how reasoning impairments show up in projective testing. Some reasoning styles are believed to have roots in family communication patterns.
