what does concrete mean?

[basiligaw]

ok so I don't understand what is meant when a pt is called 'concrete'. I thought I did but recently when i was in on a family meeting with two psychiatrists one of the psychiatrists asked the schizophrenic(paranoid) what sideof the road do cars drive on in this country---the pt could not answer; the pt said 'well it depends which way you're facing...etc'. Then the doctor said see the pt is concrete. Basically Idon't understand how that question demonstrates that the pt is concrete. True most ppl would just say 'in the u.s we drive on the right side of the road'. but i feel like the pt just didn't understand the question
also it seemed wrong that the doctor point out to the pt that he could not answer the question, it seemed almost belittling to the patient. do psychiatrists often do this to pts, esp paranoid schizophrenics who have trouble accepting their illness?
please can someone explain to me what it means to be 'concrete'. i really thought i knew what it meant, thank you!

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[AF_PedsBoy]

If I remember right... concrete means kind of like it sounds, that the patient can't interpret things beyond the literal meaning. So if you asked them, for instance, what does, "Don't cry over spilt milk," or "A rolling stone gathers no oss" means, they would be unable to go beyond the literal surface meaning.

In the case you discussed the question posed to the question was a rather simple one - when you noted the patient didn't understand the question, you were likely right. Because the patient took it in its most literal meaning, if you were driving away from the patient you'd be on the right, towards the patient, you'd be on the left. Thus he was unable to answer correctly with one answer - he may not even have been able to think that far. (although that isn't the best question to have asked for concrete thinking)

So in short - concrete means unable to interpret past the most literal meaning - most of my patients think concretely - but then again most of them are like 2 years old

 

[Poety]

Hi Basil,

When a patient is "concrete" its referring to their ability to understand in the abstract. For instance, if you said to a patient, don't cry over spilled milk, and they responded, I didn't spill any milk, then you could infer that the patient is "concrete" in their thinking. i.e. they are unable to use analogies or understand abstract thinking. Anything you say to them is taken literally. So for this patient, since he cannot understand that what the question was asking is "which side of the road we drive on" it was inferred that he is concrete since he responded "it depends on which way you're facing".

Personally I think what the psychiatrist here asked wouldn't be that good in determining concrete thinking - (because of what you said, maybe the patient didn't understand the question) I always use the milk analogy.

Hope this helps!

 

[Poety]

If I remember right... concrete means kind of like it sounds, that the patient can't interpret things beyond the literal meaning. So if you asked them, for instance, what does, "Don't cry over spilt milk," or "A rolling stone gathers no oss" means, they would be unable to go beyond the literal surface meaning.

In the case you discussed the question posed to the question was a rather simple one - when you noted the patient didn't understand the question, you were likely right. Because the patient took it in its most literal meaning, if you were driving away from the patient you'd be on the right, towards the patient, you'd be on the left. Thus he was unable to answer correctly with one answer - he may not even have been able to think that far. (although that isn't the best question to have asked for concrete thinking)

So in short - concrete means unable to interpret past the most literal meaning - most of my patients think concretely - but then again most of them are like 2 years old

WHOA, this is twice today that I psoted at the same time as someone else saying the same thing SCARY 😱

 

[AF_PedsBoy]

I think you're psychic - either that or we were both abducted and brainwashed by the same alien. Say, did they use that big rectal probe thing on you too? Damn aliens...

 

[Poety]

I think you're psychic - either that or we were both abducted and brainwashed by the same alien. Say, did they use that big rectal probe thing on you too? Damn aliens...

Poety does NOT do rectal probes 😱 😴

 

[basiligaw]

Thanx guys; that's what i thought concrete meant. i think that was a bad question to ask the patient and it also embarassed the patient in front of his family and it didn't really serve it's purpose of showing the pt he has a thought disorder. Another thing is, I actually know this pt very well as he is a family member and I know for a fact that he is able to interpret things like 'don't cry over spilt milk' or 'a rolling stone gathers no moss' ; psychiatrists should be careful about using these little 5 second questions to analyze a pt and label them as to what they might not be
anyway thanx again!

Hi Basil,

When a patient is "concrete" its referring to their ability to understand in the abstract. For instance, if you said to a patient, don't cry over spilled milk, and they responded, I didn't spill any milk, then you could infer that the patient is "concrete" in their thinking. i.e. they are unable to use analogies or understand abstract thinking. Anything you say to them is taken literally. So for this patient, since he cannot understand that what the question was asking is "which side of the road we drive on" it was inferred that he is concrete since he responded "it depends on which way you're facing".

Personally I think what the psychiatrist here asked wouldn't be that good in determining concrete thinking - (because of what you said, maybe the patient didn't understand the question) I always use the milk analogy.

Hope this helps!

 

[Poety]

Thanx guys; that's what i thought concrete meant. i think that was a bad question to ask the patient and it also embarassed the patient in front of his family and it didn't really serve it's purpose of showing the pt he has a thought disorder. Another thing is, I actually know this pt very well as he is a family member and I know for a fact that he is able to interpret things like 'don't cry over spilt milk' or 'a rolling stone gathers no moss' ; psychiatrists should be careful about using these little 5 second questions to analyze a pt and label them as to what they might not be
anyway thanx again!

I agree, there are many ways to actually determine if they're concrete, not just by those questions. He should not have embarrassed the patient and he should not have said anything about the patients condition in front of the patient and his family to make him uncomfortable.

 

[MDgonnabe]

this patient is concrete.

i'd say axis 1 = schizophrenia. flat affect. catatonic with bizarre posturing. looks like there might be some religious delusions mixed in too.

 

[Poety]

this patient is concrete.

i'd say axis 1 = schizophrenia. flat affect. catatonic with bizarre posturing. looks like there might be some religious delusions mixed in too.

go do your ROL dammit 😛

 

[MDgonnabe]

go do your ROL dammit 😛

not doing mine til mid-feb. i'm a slacker supreme. 😀