Mapping the Psychotic Mind: a Review on the Subjective Structure of Thought Insertion

Delusions of thought insertion involve subjects claiming that external agents of different nature had placed thoughts into their minds/heads. However, despite being regarded as one of the most severe and complex symptoms of psychotic disorders, a number of disagreements surround the description of its most fundamental phenomenology. This work has reviewed classic and current research on thought insertion in order to examine and clarify its main experiential features as reported by patients from a first-person perspective. The review shows that such features can be grouped into two categories: (i) experiential changes characterizing the period preceding the adoption of the delusion and, (ii) subjective features of full-blown delusional cases. While the discussion of the latter set of experiential features has received some attention within literature, the examination of the former set has been largely neglected. After this, the review offers a discussion of the most important conceptual disagreements surrounding the phenomenological descriptions of the symptom. Overcoming disagreements regarding the experiential structure of thought insertion is fundamental to elaborate phenomenologically and empirically coherent explanatory theories of the symptom and advance its clinical treatment.