Talking Past the Point (Vorbeireden)
Talking past the point is a pattern in which a person's answers make it clear that they have understood the question perfectly well, but they respond with something related yet wrong, as though deliberately or unconsciously missing the correct answer by just a little. A classic example is a person asked the colour of grass answering "white," and asked the colour of snow, answering "green."
This has traditionally been noted to occur in several quite different contexts — including certain dissociative or conversion presentations, and acute schizophrenia, particularly among adolescents, where it may be produced with an amused, facetious attitude rather than genuine confusion.
Also known as
- Approximate answers
- Responses that are clearly related to the correct answer but consistently, and just noticeably, wrong — a recognised feature of certain dissociative presentations.
Recognition features
- Answers show clear understanding of the question being asked
- Responses are approximately, but consistently and noticeably, incorrect, often swapping two related but opposite pieces of information
- May be accompanied by an amused or facetious attitude toward the errors, particularly in younger patients with acute psychosis
- In dissociative presentations, the pattern often arises in a context suggesting some unconscious psychological advantage to appearing impaired
Eliciting it at interview
- Ask a short series of simple, well-known factual questions and note whether the answers are related to, but consistently just wrong compared with, the correct response
- Observe the person's emotional attitude toward the incorrect answers, since amusement or a facetious quality points toward one particular clinical context
- Consider the wider circumstances carefully, since this pattern is described in both dissociative and psychotic presentations, which call for quite different approaches
Distinguishing features
- Differs from a genuine cognitive or memory impairment in that the errors are consistently close to correct rather than random or wildly implausible, and understanding of the question is clearly intact
- Differs from a formal thought disorder, since the responses themselves are coherent, grammatically intact, and clearly related to the question, rather than disorganised
- The overall clinical context — a dissociative presentation versus acute schizophrenia in a younger patient — shapes how this same surface pattern should be interpreted
Common misconceptions
- That talking past the point reflects a lack of intelligence or genuine confusion; the pattern specifically demonstrates that the question has been understood
- That this always indicates deliberate deception; in dissociative presentations the process is generally understood as unconscious rather than a conscious attempt to mislead
Related phenomena
Mutism · Catatonic Speech Disturbance · Ganser Syndrome
Practice this
Asked the colour of grass, a patient answers "white." Asked the colour of snow, he answers "green." His answers are coherent, grammatically intact, and clearly related to each question, showing he has understood perfectly well. What is this? · Asked simple factual questions, a patient's answers are frequently incoherent and difficult to follow, with sentences that trail off, blend unrelated ideas together, and never clearly answer what was asked at all. Before revealing the answer: is this talking past the point? · A patient's speech sounds unusual. Before revealing the answer, decide what distinguishes catatonic speech disturbance from talking past the point. · A patient consistently gives approximate, noticeably wrong answers to simple questions. Before revealing the answer, decide what distinguishes Ganser syndrome from talking past the point in general. · A patient's answers to direct questions are consistently incorrect in an unusual way. Before revealing the answer, decide what distinguishes talking past the point from a formal thought disorder. · You suspect a patient may be talking past the point. Before revealing the answer, decide how you would assess for this. · Explain why the clinical context in which talking past the point occurs matters so much to how it should be interpreted.
Illustration
Asked what year the Second World War ended, a young man with acute psychosis replies with the year of his own birth, and when then asked for his own year of birth, replies instead with the year the war ended, delivering both answers with a faint, knowing smile as though enjoying a private joke.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 4, 'Disorders of Thought and Speech'.