The patient is an elderly lady with benign senescent forgetfulness. Although she has some difficulty with speech production we doubt this is aphasic. An interesting affect of her speech is her tendency to express herself frequently by using superlatives. We designate this symptom huperthetikosia (derived from the Greek “huperthetikos” for “superlative”). By superlative we do not mean expressions like “this is really good” or “that is highly doubtful.” Adverb phrases such as these are useful to compare and contrast features attributable to real-world phenomena. Rather we mean expressions like “this is the best I ever have seen” or “that is the worst in the world.” They are adjective phrases, which identify a thing or an experience and then extrapolate it to the most extreme case that is semantically possible. The patient deploys such expressions frequently, often referring to the same set of facts or state of affairs two or three times within a five-minute period.
Initially we thought this was counter-intuitive. With a richer background of practical knowledge, we hypothesized the patient would have more remembered or associated experiences to draw upon in making evaluative judgments. This would tend to lessen the likelihood that any of them would be designated as the superlative instance. We concluded however that the opposite is true. Given her slow cognitive decline, the patient’s world is subtly yet pervasively constricting. As it becomes more confined and circumscribed it becomes thinner and less experientially dense. Phenomenologically the patient experiences the world in states of progressively-increasing naivety. Thus it is more likely the patient will be delighted by simple situations that otherwise are unremarkable.