Loose associations: straight and crooked thinking and the group of schizophrenias

In this paper I hope to provide the basis for a discussion on logic, logical thinking and creativity in medicine, particularly in psychiatry. By way of illustration we will examine schizophrenia with particular reference to biochemistry, but the discussion will focus on semantic issues and philosophical concepts. These issues are of fundamental importance in the development of psychiatry both as art and craft. Thus the paper deals both with the study of madness and madness itself. The title of the address illustrates some forms of communication which occur in the schizophrenias. It includes references to other ideas, to formal thought disorder and illogical thinking, private puns, vague links, and pointers to other sources and authors, namely, Bleuler (1950), Ernest Jones (1959) and Thouless (1974). These are all contained in a loose framework, wherein reference is made to a key anomaly always found in, but by no means unique to schizophrenia.