ABSTRACT
It is not possible to begin to categorise a problem without the insight that a problem exists. To solve a problem a person has to ultimately acknowledge that they have a problem, and sometimes the problem is more apparent to those close to the person, even if they don’t know how to quite label it. People with acquired mild cognitive impairments may not see themselves as any different from before their trauma or stroke, but those close may see a difference. Similarly those with a severe mental illness may not, at least at certain times, see their delusion or hallucination as in any way misguided. Sometimes those with obsessive-compulsive disorder see, for example, their repeated checking/cleaning/ritual as absolutely necessary. The absence of insight makes it particularly challenging for relatives, friends and clinicians to make the therapeutic alliance necessary for problem solving.
