The thought must be conscious

This means that patients must be aware of their thoughts; awareness, which is so natural in normal minds, is only partial in cases of non-control. It must be remembered that psychasthenics suffer from mental confusion most of the time; thoughts are unconnected, and occur so rapidly that patients simply cannot be aware of everything that goes through their mind. Thoughts are rarely clear and precise, and are expressed only with great difficulty.

This state of cerebral unawareness varies considerably; it is sometimes so weak the patient doesn't know it's there; in other instances, it can be extremely intense and debilitating.

Obviously, we cannot ask patients to judge, rationalize or differ entiate between thoughts which they are unaware of. So the first step is to teach patients to be aware of what they are thinking, and to do this we have to determine the state of consciousness of their brain.

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