Linguistics, Pragmatics and Psychotherapy

This book provides a clear and practical guide to semantics, syntax and discourse analysis specifically for those working with psychotic patients. The opening chapter discusses the characteristics and diagnosis of schizophrenic speech and demonstrates how the traditional terms used to characterize disordered schizophrenic speech, such as "vague", "incoherent", "ambiguous", "containing confused references" etc., are too subjective and imprecise to describe accurately the exact nature of the speech and the ways in which it is disordered. The second chapter gives examples of actual speech samples from schizophrenics. These are examined structurally, and an exact analysis of how such speech differs from normal speech - even normal speech which is vague, incoherent etc. - is offered. Since this analysis includes not only phrases and sentences but also entire discourses, other characteristics of schizophrenic speech, such as flight of ideas and apparent rambling, are also discussed. From this exact analysis precise diagnostic criteria and rating scales can be constructed which enable the therapist to measure the severity of the speech disorder and to determine whether or not it is schizophrenic. In the third chapter the actual mechanisms of speech production involved in disordered speech are shown by reference to the analyses in chapter two, and explanations for the syndrome of speech errors in schizophrenia are offered. Chapter four addresses the question of whether or not schizophrenic speech is simply highly creative - so much so that people have difficulty understanding it. It discusses how words can normally be used in new ways to effect new meanings, how new words are formed and used, how metaphors and other figures of speech are created normally, and how these processes go awry in schizophrenic speech. Examples are given from many languages to illustrate the universality of these processes. The fifth chapter demonstrates how such diosrdered speech can often be interpreted if one understands what underlying mechanisms have gone wrong. Several long monologues by schizophrenics, never before published, are analyzed to show (1) that the speakers are often trying to convey messages and (2) how we can make reasonable interpretations of those messages. The final chapter discusses how group therapy based on what we know about normal conversation can help patients to communicate more effectively. The book should be of interest to speech and language therapists and pathologists - particularly those working in mental hospitals, and to psychiatrists, psychotherapists, psychologists and mental health workers.