Monoideism in psychiatry: theoretical and clinical implications

The incessant repetition of disturbing monoideistic thoughts which cannot be eliminated from the patient's mind is a symptom of a variety of psychiatric conditions. The persistent monoideistic preoccupation tends to acquire the quality of a repetitive hypnotic suggestion or "inner commands" and creates an altered state of consciousness that transcends the limits of volitional control. The one-sided ideational context permeates interpersonal relations, intensifies family conflict and drains a considerable portion of available psychic energy. Disregard or an incorrect approach to this factor may result in painful therapeutic failure, since no exploratory psychotherapy or verbal intervention technique will be able to penetrate the monoideistic armour. THe continuous repetition of the dominant idea functions as a cumulative suggestion stimulus leading to disruption of spontaneous processes and self-defeating thinking, behavioral, motivational, and affective changes. The monoideistic preoccupation may be total and pervade the individual's entire life. Any comprehensive form of therapy should offer formulations and precise procedures--for the identified patient, nuclear family, and network of significant others--to block the feedback supplying system attached to the monoideistic pattern.