THINKING AND SPEAKING

and so hold fast the direction of procedure necessary for fulfillment of the task. Normals are able to behave differently to the world and thus also toward the heap of colors in the test. We can, so to say, give ourselves over to the sense impressions passively; then we experience those color skeins that are equal, that cohere, and immediately stand out from the heap. If not many equal ones are there, those that are similar in one or another aspect come passively to the fore and we feel some unrest in the heap, while in choosing according to a definite category, those that belong together come definitely to the fore and we scarcely pay attention to the other ones as they are in the background. From the results with these tests and the observation that patients under everyday conditions also behave principally in a similar way as in the teststhat is, they are able to react normally only to any condition that does not demand abstraction-we came to the conclusion that we have to distinguish two attitudes in man’s orientation to the world, the abstract and the concrete one.‘ To clarify the difference further I may state that in the concrete attitude we are directed toward the actual thing in its particular uniqueness, while in the abstract one we are determined by a principle, a category, or a concept, in which the objects are only incidental examples and representatives. The Goldstein : Thinking and Speaking 41 patient’s behavior is similar to our concrete attitude. We say, therefore, that they are impaired in their abstract attitude and have become beings dominated to an abnormal degree by concrete promptings. We felt further justified to assume that the inability to name is an expression of the impairment of abtraction.^ This assumption of the structure of naming is confirmed by our experiences. When we name an object, let us say a table, we do not mean this particular table with all its properties but table in general, the concept table; the word is used as a representative of a category. This assumption is further confirmed by the fact that in concrete behavior language does not play the same role as in abstract behavior. In concrete behavior language does not occur a t all or only accompanies our activities; the word is not much more than another property of the object, such as size or color. In a situation where we have to act abstractly, words are very important as they induce us to take an abstract attitude; the approach to the world in a conceptual way is close to language. Our conclusion about the nature of naming became very relevant for the theory of language. Words are apparently not tools that may be handled like objects, but are means to help man to organize the world in a particular, conceptual, and symbolic way. Although stressing this character of language, we should not forget that it is not the whole of language. Words can also have another character. This fact was again revealed by observation of our patients when they used correct words in the task of naming an object in spite of their having a defect of the abstract attitude and in spite of the fact that analysis showed that their words had not the character of meaning and did not represent concepts, but were much more closely adapted to the individuality of the object. The essential difference of the words they used in naming became apparent when the patient did not utter the generic words such as the word red but used such words as rose-red, grass-green, strawberry-pink, or sky-blue. We call these words individual words because they fit only definite objects. They represent simple associations of sound complexes to a particular object. The patients will use more such words if they have them at their disposal from their premorbid life. It could be shown that even if, in answer to the object-naming task, the patient utters a word that at face value would appear to be a generic word, it does not have this character for the patient. Thus, for example, if a patient seems to be able to name a chair, he can utter this word in relation only to a special chair; he is not able to call other chairs by the same word, which we can do without difficulty. Apparently the word does not fit all chairs, does not represent a category, and is not a name. The situation becomes more complicated when we observe that the patient even after training may call the different shades of color in the test with words identifying the basic color quality, for example, all shades of red would be called simply red. It might be thought that the patient had regained the abstract attitude, but examination showed that this was not the case. The question arose as to whether he could have acquired the symbolic character of the word in spite of the defect in abstraction; that this concept was wrong may be illustrated by the behavior of one such patient. When we asked her why she now called so many different skeins red that she never did before and 42 Annals New York Academy of Sciences whether the word red really fitted all these different shades, she laughed and explained emphatically, “No, not one is red, but the doctors have told me that all these skeins are red, therefore I use this word to please you.” I t became evident that she had not regained the symbolic character of the words but had only, by her excellent memory, acquired a superficial association between one word and different objects. In the test of naming we call this use of words pseudonaming. In some patients we find a defect of these associations, that is, of the instrumentalities of language, for example, in those forms of aphasia that usually are called motor or sensory aphasia. Here an inability to use such associations can simulate a naming defect. The difference from the other kind of patients is that these latter understand very well what naming means. This difference shows, for instance, if, a t a request to write down the name of an object, they are able to do so without difficulty, while a patient with a defect in the function of naming is not at all able to accomplish this task. The patients with a defect in naming show characteristic modifications of their language in other respects. They have difficulty in starting to speak, in shifting from one context to another, their vocabulary is reduced in general, their language has changed from an active, spontaneous means for expressing ideas and feelings to a passive, more or less compulsive stereotyped reaction form to definite stimuli: in short, the effects of the impairment of abstraction. I cannot deal with this in detail here and it is not necessary to do so in connection with our problem of thinking and speaking. In all these respects the patients with difficulties in finding words in motor aphasia behave characteristically different. We can distinguish, on the basis of our experience with patients, two different forms of language: the language proper in which the words have the character of symbols; and the language consisting of learned motor and sensory performances that we call instrumentalities of language. In living speech we use symbolic language and instrumentalities intermingled. Now, it is very important to realize that the words uttered in one or the other form can, a t face value, seem very much the same. Thus, a correct interpretation of what the speaker wants to communicate will be possible only if we consider his speaking in connection with the total situation in which it occurs. Only then will we be able to make a decision as to whether we have to deal with the presentation of learned material or if the language represents thinking. Turning now to the discussion of the interrelationship between thinking and speaking I stress first that thinking is not the only factor besides language that determines man’s behavior. The influence of a number of other factors is usually spoken of in psychology, including images, interest, emotions, attention, memory, and automatisms. I have from the organismic approach criticized the assumption of such isolated capacities and tried to show that all of these apparent determining factors can be understood from the viewpoint that the influence of that that is best suited to guarantee self-realization comes to the fore: in pathology in spite of the defect and in normal life in abnormal difficulties. That can be exemplified, for example, by the significance of the “images” for performance. Previously abnormal behavior has mostly been interpreted-as have been aphasic symptoms-as a result of a damage of images of words. Goldstein : Thinking and Speaking 43 This interpretation has now nearly generally been abandoned as far as the abnormalities of “language proper” are concerned. It was found that the apparent inability of the patient to elicit images is not the effect of the damage of the image mechanism by pathology but of the impairment of the abstract attitude. That the images are not lost is shown by the observation that patients who are not able to elicit them on demand use the images passively in their performances without being aware of it. In cases where the abstract attitude is intact the patient may compensate a defect of the instrumentalities even by voluntary use of images. The same difference concerning the active and passive appearance of these “influences” are observed in memory, emotion^,^ and other mentioned conditions where one of these assumed factors appears to be defective. Concerning memory, patients with defect of abstraction are mostly very poor in rote learning in all fields. Even if they have gained some resultswhich takes place with unusually great effort-they usually forget what they have learned after a short time when it is not used continuously through adequate stimulation. Both incidents reveal the relationship of the acquired automatisms to the abstract attitude. I t could be asked how patients with impairment of abstraction, who are capable only of the concrete form of behavior,