Zeigarnik - 1987 - Loss of Spontaneity
Zeigarnik - 1987 - Loss of Spontaneity
B. V. Zeigarnik
To cite this article: B. V. Zeigarnik (1987) Loss of Spontaneity Due to Combat Injury to the
Frontal Lobes, Soviet Psychology, 26:1, 60-71
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B. V. ZEIGARNIK
255 patients were examined; 105 had wounds in the left hemisphere;
85, wounds in the right hemisphere; and 65, wounds along the midline
or a bilateral, symmetric wound of the frontal lobes.
I shall not attempt here to give a classification of the disorders in
mental activity observed in patients with frontal lobe lesions. However,
I should like to demonstrate the variegated picture of these disorders
that we were able to obtain in our study.
The patients we observed included some with scarcely noticeable
changes, some with gross disorders of affective life, and some disin-
hibited patients whose intellectual capacities were still intact. In addi-
tion, we also observed patients with an apathetic syndrome, who spent
whole days in inactivity, indifferent to their surroundings.
One special group was composed of patients in whom a distinct
psychopathoid syndrome began following the frontal lobe injury. Fi-
nally, we distinguished groups with various nuances of intellectual
disorders, beginning with slight changes and ending with a group of
“frontal” dementias with an amnestic symptom cluster.
Thus, the most varied mechanisms can be used as a basis for classify-
ing disorders secondary to ‘‘frontal lobe” injuries.
However, no matter how heterogeneous the groups obtained as a
result of such a classification, and no matter how broad the range of
their disorders, one single type of change accompanied all, namely, a
personality change that was expressed in disorders in the patient’s
activity.
From N. I. Grashchenko (Ed.), Nevrologiya voennogo vremeni [Neurology of the war
years]. Moscow, 1949.
60
LOSS OF SPONTANEITY DUE TO COMBAT INJURY 61
ness-for how long, he does not know. He suffered vomiting and nose-
bleed. On 21 July, the patient, in serious condition, was brought to a field
hospital, where surgery was performed. Many bone fragments were re-
moved, and a bone defect with extrusion of brain matter was discovered.
Fragments were also removed from the deeper areas of the brain. The
frontal sinus was found to be destroyed; there were bone fragments in
it. . . .
Neurological condition: narrow pupils, reaction to light and conver-
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gence lively. Visual field normal; fundus oculi normal. Eyeball move-
ment normal. Tendon reflexes normal. Sensibility intact.
Upon admission, considerable akinesia and fatigue, especially in intel-
lectual work, were observed. The patient displayed quite good skills in
the hospital, where he worked in a carpenter’s workshop as part of
occupational therapy.
The patient behaved normally in the ward; there were no signs of a
slowed response, and he answered the physician’s usual questions quite
promptly; but when he was faced with any uncomplicated task, his re-
sponses became delayed.
The patient was given a simple arithmetic problem to solve: “You have
bought 3 boxes of 25 apples each; you gave one-third of the apples to your
friend. How many apples remain?” This task should not have caused any
difficulties for a person who had finished the fifth grade. However, our
patient was very slow to tackle the problem; he sat silently for a long time,
directing his gaze past the experimenter; then, after much prompting by
the latter, he began to tackle the simple problem:
“How many did you say? Oh yes, 25 apples. How many were in each
box? 25 , . . (pause) 75. There are 50 apples left. The patient solved the
”
In this case, the patient’s incorrect answers were not the result of
intellectual insufficiency; they stemmed from an excessively rapid re-
action, a hyperresponsiveness.
This produces a paradoxical phenomenon: on the one hand, a slowed
reaction and, on the other, hyperresponsiveness. This unique combina-
tion of two phenomena seemingly contradicting one another is a char-
acteristic feature of a “frontal lobe” patient whom I have described in
another ~ o n t e x tIn
. ~reality, the two phenomena have a common origin:
lack of motivation for the activity, lack of direction.
If a person focuses on a task, that task does not seem to be an
amorphous whole for him; the different aspects of the task appear in a
differentiated way. In assuming the task, the subject discriminates one
aspect of it and transforms the diversity of meaning of the task into its
specific meaning. But if a patient addresses a task directly, without an
appropriate correlation with an internal purpose or aim, or solely on the
basis of an external requirement, the task becomes some sort of diffuse
requirement devoid of meaning; in this case, any random, even very
unessential, element of the task may acquire a determining role. . . .
Despite the fact that a patient may retain all the intellectual oper-
LOSS OF SPONTANEITY DUE TO COMBAT INJURY 67
to carry out the assignment, the practical situation gives him the possi-
bility of manipulating concrete aspects of the real situation. Even if a
patient departs from the real situation because of random factors, his
activity will still have some objective structure, and this is what gives
visibility to his action.
The situation is different with regard to intellectual activity. The
semantic “field” of intellectual activity does not have the level of stark
reality that is present in a practical situation; some “motivating”
aspects that catch the subject’s attention are in themselves extremely
dynamic; their meaning is nothing rigorously formulated, and the sub-
ject’s subordination to these aspects therefore does not, even externally,
assume the form of an action. The external and internal aspects of
intellectual activity are inseparable from one another; hence, the possi-
bility of a visible external act, such as manipulating things when there is
no internal orientation for doing so, cannot take place in intellectual
activity. Only one type of action is possible in intellectual activity, and
that corresponds precisely to this internal orientation.
In a “practical” situation, the external aspect of a goal has, as it
were, its own objective significance. This “external” significance
disappears in intellectual activity if it is not stably linked to an internal
significance.
In the case of a frontal lobe lesion, this instability of a task can reach
such a degree that we can classify it as feeblemindedness of a particular
structure.
I should like to distinguish two types of “frontal lobe” feeblemind-
edness.
The first type is when aspontaneity of intellectual activity reaches its
apogee: the absence of a goal is carried to such a degree that instead of
an intellectual act, we obtain only a response to a stimulus. For exam-
ple, the patient describes a picture portraying a traffic accident: “Here
is the car, and here is an X drawn . . . here are many people, here is a
70 ! ZEIGARNIK
B. I
gives the first explanation that comes into his head, and that is deter-
mined only by an external factor, i.e., a “gathering of children.”
It is clear that a gathering of children could also designate a “chil-
dren’s home,” a “nursery,” or something quite different. However, in
this particular case, the gathering was not the most conspicuous for us
because the content of the picture was not determined by the depiction
of a crowd of people, but by something quite different: the red cross on
the doors of the car, and the nurse carrying the child. But in the case of
our patient, most significant was the fact that the picture itself was in
the forefront of his thought: instead of interpreting it, he just described
it.
The second type of disorder is one in which aspontaneity of thought
assumes the character of nonsensical constructions.
Patient B. explains the proverb “Forge the iron while it is hot” as
follows: A group of people who lived in the same house at the sparsely
populated edge of the city once found out one morning that the gate had
been left open all night. So one could say: “One should do what has to
be done before it’s too late, and never put things off. , .” From this
illustration it is evident that the patient did not suffer from merely a
simple disorder in intellectual activity or an insufficient capacity to
interpret events: he invented nonsensical formulations. This propensity
to “think up” foolish statements and the facile production of judgments
similar to confabulation may be explained as follows.
The aspontaneity of a “frontal lobe” patient goes so far that even
stimuli themselves operate for an extremely brief time; the patients’
responses to stimuli are fluid and fleeting. But an experimental situa-
tion is such that it requires a definite response; the patient, devoid of
spontaneity, responds with any word and any judgment in a “short
circuit’’ manner.
Thus, we see that study of different types of disorders in the intellec-
tual activity of “frontal lobe” patients, from mild symptoms of
akinesia to cases of profound feeblemindedness, disclose one and the
LOSS OF SPONTANEITY DUE TO COMBAT INJURY 71
Notes
1. [Experimental psychological data on frontal lobe lesions]. In [Collection of
proceedings of a meeting of the Central Institute of Psychiat~y].Moscow, 1948.
2 . This phenomenon cannot be explained by brain injury in general since, in cases
of damage to other parts of the brain (temporal, parietal), return to an interrupted act
occurs in 66%.
3. On this point, see A. R. Luria, [Traumatic aphasia]. Moscow, 1948. Chapter
IV.
4. B. V. Zeigarnik, [Experimental psychological data on frontal lobe lesions]. [See
note 1.1