What Is Thought Blocking? Causes, Diagnosis, & Treatment

What Is Thought Blocking?

Thought blocking can happen from time to time. You start talking about something but then forget the content or lose your thought. In a clinical sense, thought blocking refers to the sudden halting of thought or speech. Research shows that it may derive from an excess (rather than a deficit) of associations.¹

Chronic thought blocking can be perceived as a disorder of thought. It’s often associated with underlying psychotic issues, a core feature of schizophrenia. The symptoms are rare, and experts don’t know exactly what causes this phenomenon.² Thought blocking is a specific symptom that is different from forgetfulness or distraction.

Types of Thought Blocking

Thought blocking can fall into different categories. People may experience one type of thought blocking or oscillating between different types. Stress or other intense emotions likely exacerbate the frequency and intensity of thought-blocking behavior. In the case of schizophrenia, thought blocking is known as a negative symptom.

• Positive thought blocking: Positive thought blocking refers to interrupting short thoughts or speech. After this brief pause, the person will continue with their original thinking or speaking.
• Irrelevant thought blocking: Irrelevant thought blocking happens when someone starts speaking in a completely random or non sequential way. They may be talking about one topic and then suddenly shift to another topic without warning.
• Perseverative thought blocking: Perseverative thought blocking occurs when someone’s thoughts continuously interrupt the conversation. It can also refer to excessive repetition of the same words or ideas even if they do not fit the conversation context.

What Causes Thought Blocking?

While experts can’t pinpoint the cause of thought blocking, it correlates with some mood and psychotic disorders. It can also be heightened during stress, emotional exhaustion, or neurological issues. Thought blocking may happen persistently and chronically, but it can also ebb and flow throughout the lifetime.

Thought blocking may be caused by:

Schizophrenia

The presence of both positive and negative symptoms generally characterizes schizophrenia. Negative symptoms refer to the reduction or absence of typical communication and social function behaviors.³ Thought blocking may be one of the first negative symptoms indicating schizophrenia, which can persist throughout life. In schizophrenia, thought blocking may coincide with disorganized speech and social withdrawal.

Bipolar Disorder

People with bipolar disorder experience depressive and manic episodes. Severe psychotic mania may result in communication issues, which can look like thought blocking, derailment, incoherent speech and talk, and loose associations.⁴ In these cases, the intensity of the mania leads to disorganized thought, affecting both logic and speech.

Psychosis

Psychotic disorders include schizophrenia, but they also include brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, and psychotic disorder due to another medical condition. Psychosis can also occur in severe depression. The thought blocking is a manifestation of losing touch with reality. Sometimes, a person may also become distracted by hallucinations or delusions.

Severe Anxiety

Although rare, thought blocking can occur in cases of extreme anxiety. When this happens, it may result in someone becoming so overwhelmed that they shut down and lose track of the conversation. In response to their overstimulation, they may dissociate, causing patterns of thought blocking or briefly feeling lost in discussion.

Other possible causes of thought blocking include:

• Extreme stress
• Exhaustion
• Lack of concentration
• Brain tumors
• Delirium
• Neurological issues

How is Thought Blocking Diagnosed?

Thought blocking is not a disorder. It’s a clinical symptom. A doctor or psychiatrist will evaluate the onset, intensity, and frequency of this symptom in relation to other symptoms. This can help establish an accurate clinical diagnosis. Having the right diagnosis can help people better understand their thought blocking patterns.

A doctor may use one or more of these methods to determine if you are experiencing thought blocking:

• Psychological evaluation: Psychological evaluations extensively measure and observe psychological behavior. These evaluations include comprehensive assessments and screenings to diagnose certain mental health conditions.
• Brain scans: Doctors may use brain scans to rule out neurological structural changes (i.e., brain tumors), but they are not reliably used to diagnose mental illness.

Thought Blocking Treatment

There are no specific treatments to treat thought blocking. Instead, treatment is focused on managing the disorders associated with thought blocking. Depending on the type of condition and its related symptoms, there are different methods of addressing thought blocking behavior. Some people will need to engage in a trial-and-error process to find the best treatment for their needs.

Medications

Psychiatric medication may benefit people experiencing thought blocking and related symptoms. Antipsychotic medication, in particular, is generally prescribed for individuals with manic or psychotic symptoms. Antidepressants may help alleviate severe depression and anxiety symptoms. Like with all medications, each drug has its own side effects, risks, and benefits, and it’s important to review these factors with your provider.

Psychotherapy Options

While talk therapy alone may not be sufficient for severe mental illness, research shows that therapy is beneficial when it teaches people how to better manage their difficulties.⁵ CBT may be beneficial because it is goal-oriented and helps people practice changing their negative thoughts into more realistic ones. Reducing stress can decrease intense mental health symptoms, and therapy can be a catalyst for this change.

Seeking Medical Attention

It’s important to seek medical attention if thought blocking begins to negatively impact your life. This symptom may indicate an underlying mental health condition or neurological issue. Getting proper medical care can help you establish treatment protocols that can help reduce or eliminate thought blocking from happening again in the future.

How to Help Someone Experiencing Thought Blocking

It’s important to remember that thought blocking isn’t intentional. Someone isn’t being absent-minded or forgetful on purpose. When thought blocking occurs, the person literally can’t remember what they were saying or why they were saying it. The most important thing you can do is remain calm and neutral. If it’s appropriate, steer the conversation back to what you were talking about.

Here are three ways to help someone with thought blocking:

1. Offer support: Aim to be open-minded and non-judgmental. Remind your loved one that you are there for them.
2. Encourage therapy: Support mental health treatment and ask your loved one if you can help them find the right provider.
3. Encourage medication compliance: Medication can reduce or eliminate psychotic symptoms. As much as possible, encourage your loved one to adhere to their medication or talk to their doctor if they have concerns about their prescription.

Getting Help for Thought Blocking

If thought blocking coincides with a mental health condition, it can be valuable to seek professional support. A therapist will often coordinate care with a treatment team, including a doctor, psychiatrist, and other specialized healthcare professionals. It’s important to choose a therapist specializing in the relevant condition (i.e. schizophrenia, bipolar disorder, or depression). You can get started using our online directory.

In My Experience

Thought blocking can be confusing to individuals and their loved ones. It’s important to take this behavior seriously and seek a professional evaluation if it’s happening to you. Occasional forgetfulness is one thing, but a chronic pattern may indicate the presence of a neurological or psychiatric issue. With that, getting treatment can help you feel much better.