CIRCUMSTANTIALITY

Circuitous, “labyrinthine” speech; the inclusion of numerous trivial and often irrelevant details in relating an incident, explaining a point, or answering a question. The term overinclusion is sometimes applied to this tendency.The concept has particular relevance to psychiatric examinations. In a diagnostic interview the examiner must distinguish between three different types of circumstantiality. One is the normal variety in which a literal or small- minded person insists on giving every tiresome detail. The second involves a conscious or unconscious attempt to conceal facts by talking around the point or diverting attention to unimportant details. The third results from a definite disturbance in the flow of thought.Some individuals—usually the first type just mentioned—have never learned to focus their thoughts or to distinguish essentials from nonessentials. Others tell their story in exhaustive detail as a response to inner anxiety, or the need to evoke sympathy from the listener. Still others may be using a wealth of detail as a substitute for lapses in memory, or as a dodge to avoid ideas that are threatening to them. In examining for mental disorder, the psychiatrist must determine whether the circumstantiality is due to one of these factors, or to a disorganization of thought over which the patient has no control. The latter is frequently the case in schizophrenia, mental deficiency, some forms of epilepsy, and senile psychosis. The tendency may also be found in the manic phase of manic-depressive reaction.Illustrative Case: CIRCUMSTANTIALITY A schizophrenic patient who was asked whether prior to hospitalization he had been living alone or had shared his apartment took over forty minutes to answer the question. He detailed to an absurd degree the layout and furnishings of the apartment, the reasons why it might or might not have been desirable to have a roommate, the step-by-step changes from his initial preference for sharing the apartment to a later preference for solitude, and so forth. (Rosen and Gregory, 1965)