Paradoxical Reactions

PARADOXICAL REACTIONS, a term denoting reactions whose form, content, and intensity do not correspond to, and sometimes directly contradict, the form, content, and intensity of the stimulus (situation) that caused them. In a broad sense, this definition includes all types of inadequate reactions, up to and including paralogical disorders. A narrower (practical) understanding interprets paradoxical reactions as specific manifestations of intrapsychic ataxia, mainly in the form of paramimia and parathymia of various origins. Paramimic manifestations of disorders in the field of expressive movements consist either of a discrepancy or opposition between facial movements and emotional and intellectual experience—the "inner life of the patient"—or in the preservation of one and the same facial expression accompanying experiences and statements that differ in their emotional quality. A weeping patient simultaneously demonstrates a smile, while another, with a cheerful face, talks about the torments, mockery, and persecution to which he is supposedly being subjected. A third, with a frozen facial expression, lifelessly recounts similar experiences. The latter type of paramimic manifestation bears the mark of stereotypy, and they are often combined with other stereotypical movements. The discrepancy and inconsistency between the content of consciousness and intellectual representations and emotional experiences constitute so-called parathymia. Its simplest manifestation is, for example, weeping when receiving joyful news, or reactions of cheerfulness and pleasure during stimuli of a negative emotional quality, or indifference and apathy toward both. More complex parathymic manifestations include the absence of an adequate emotional coloring in the delusional interpretations of patients, for example, delusions of grandeur against a background of apathy and lethargy, or delusions of persecution, nihilistic ideas, and ideas of self-accusation without melancholy or anxiety. The highest frequency of paradoxical reactions occurs in cases of schizophrenic psychoses, but they can also be observed in organic lesions of the brain (mainly focal, in the form of forced laughter and weeping), in cerebral arteriosclerosis, tumors, epidemic encephalitis, etc.; sometimes paradoxical reactions are observed in progressive paralysis and may also occur in psychogenic twilight states and epileptic equivalents. In addition to the peculiarities of the motor act itself, which in some cases distinguishes paramimic manifestations in organic patients from similar disorders in schizophrenics, the patient's own critical attitude toward the symptom is often striking in cases of organic lesions. Ya. Frumkin.