I also have cognitive problems; they are part of the difficulty that causes me great trouble. In my case I see them as a kind of dissociation: that is, the associations or connections between my thoughts get cut. This is a way that I think I developed as a child in order not to recognize what I was thinking, because if I accidentally expressed what I was actually thinking as a child I stood a good chance of getting severely punished. So it is connected to anxiety also.

It is very hard for me to work and try to get my thoughts connected, and when I succeed in doing that to some extent, it always gets destroyed again, and I fall back into a kind of frightened mindlessness. I can give "conventional" responses to people, but never anything "genuine," and people think everything is OK with me and cannot hear when I say it is not. It is something that the mental health professionals that I know do not "get" (or want to get) -- even though Freud wrote about mental censorship of this kind many years ago. People for the most part seem to prefer the "conventional" over the real.