Goldstein's Doctrine

GOLDSTEIN'S DOCTRINE (Kurt Goldstein). Goldstein, a professor at the University of Frankfurt (Germany), is one of the most prominent representatives of modern neurology and neuropathology. In his works, Goldstein, like a number of other researchers (Monakow, A. Pick, Head, and others), subjects the views of the classical school on brain activity to a fundamental revision—views that regard it as a simple sum of individual functions, the assignment of these functions, even the most complex ones, to separate, sharply delimited areas of the cortex, and primitive notions about the nature of the connection between brain centers and psychological experiences (for example, the idea of speech center cells as repositories of individual word images). He rejects these views as contradicting facts and as artificially simplifying the actual complexity of brain activity. Furthermore, Goldstein considers each pathological symptom not only as a direct manifestation of the insufficiency or absence of one or another part of the nervous system, but also as the final result of changes and reorganization of the entire brain activity as a result of the loss of one of its functions. At the heart of the symptom lies the holistic reaction of the entire organism, even if it is impaired in any of its parts. Such a view leads Goldstein to corresponding methodological conclusions. The attention of the researcher should be directed not only to the analysis of the most striking manifestations of the disease, but also to the search for hidden disorders in the sphere of the basic types of behavior of the organism. Goldstein demands the systematic application of the data of modern psychology, as the science of the holistic reactions of the organism, to the study of neuropathological phenomena.

Studying nervous function as a structural whole, Goldstein is one of the supporters and active proponents of the so-called "Gestaltpsychologie" (see Psychology). The regularities to which the relationships between the main (Vordergrund) and secondary parts (Hintergrund) of a complex reaction are subject were subjected to particularly thorough development by Goldstein. According to Goldstein, when the nervous system is diseased, there is a violation of the strict differentiation between the individual components of the reaction and a smoothing out of their specific differences. The pathological reaction becomes poor in content, indistinct in form, and loses its standard nature, insofar as from case to case its secondary parts unexpectedly come to the fore or fade away again, giving way to other partial acts. Goldstein managed to discover such disorders in their most characteristic form in lesions of the frontal lobe of the brain; however, their presence in any other localization of the pathological process allows Goldstein to consider the regularities underlying them as the most general for the holistic activity of the nervous system. Ontogenetic development of higher nervous activity, according to Goldstein, boils down to the increasing transformation of holistic, fused reactions into increasingly differentiated ones. Disease of the nervous system, however, leads to the degradation of this process. Such degradation creates the appearance of disinhibition of old phylogenetic mechanisms, but a more careful analysis shows that extreme caution is necessary when identifying the pathological reactions of humans with the normal reactions of their predecessors in the animal series.