A patient is noted to be bending over backward in the group room. A peer asks what he is doing, and he replies, "People say they are bending over backwards to help me, so I am bending over backwards to help myself.". This is an example of:
a. abstract thinking.
b. concrete thinking.
c. impaired reality testing.
d. boundary impairment.
B
Abstract thinking is the ability to think in a nonliteral way and is essential for tasks such as understanding symbolism and abstract concepts such as love or time. Concrete thinking is the absence of abstract thinking, or literal thinking, and is seen here in the patient's interpreting the expression literally and actually bending over to help himself. Impaired reality testing is an inability to figure out whether a perception or thought is based in reality. Boundary impairment is difficulty telling where one's self begins or ends or how one is distinct from others or one's surroundings.
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