The Language of Schizophrenia – I

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Language and what we through it has been deeply contested by various scholars. A renowned psychiatrist, Prof. Ashoka, delves into the theory of language, its symbolisations and much more, as interpreted by Sullivan, Cassirer, Whorf, Sapir, Lidz, and Freud, in the first part of this three-part erudite research, in the weekly column. A Different Truths exclusive.

What are your views on language? Perhaps you have no views; you take language for granted. So do many of us in psychiatry despite the fact that we use words in the treatment of illness. Perhaps you think of words as useful and ornamental tags affixed to sensory images. Words, then, are labels upon a prior, independently formed, sensory experience. The meaning of a word lies ultimately in the image or images or relation between images to which it refers.

I think it must have been from a notion about language something like this that Sullivan was led in his 1939 “The Language of Schizophrenia,” to in a fantastical paragraph the idea that language and thought are intimately related. “I have for years,” he wrote, “contemplated the experiment of having a child taught one language for speech and another for writing. This would be quite feasible, although some persistent attitudes make us inept teachers. Such an individual would probably think as well as, if not better than, most of us do. He would not be misled about the intimate relation of language to thought.

“The fact that one or the other of his languages happened to decorate as grace notes what was going on in his mind would be to him clearly irrelevant.” Others, such as Cassirer, Whorf, and Sapir have disagreed, writing persuasively that language is not merely laid down upon experience, but is rather constitutive of experience. Stated briefly: language, to some extent at least, determines how and what we experience. Similarly, Lidz, in his work on schizophrenia, has held that the language we learn determines how we think.

Freud, as is true with so many lines of his thought, seems to have begun with the older, apparently simpler, naive realism. Without ever explicitly abandoning it, he nevertheless gradually permitted what was already also in him to emerge: a complex, and, what seems to me I must admit, a more sophisticated, truer view, and prefiguring developments in science he was not himself to know.

In his early monograph on impairments of speech, On Aphasia, as part of an effort to account for various types of aphasia, Freud differentiated thing-representations or thing concepts from word representations or word concepts. A thing-representation he defined as a complex of sensory qualities with various origins—visual, acoustic, kinesthetic, tactile, and so on. A word-representation he defined as a complex of images of the word as spoken, written, read, heard, and so on. The connection between thing-representation and word representation occurs, Freud supposed, through a linkage of the sound element of the word-representation and the visual element of the thin representation.

Freud then distinguished in terms of rather than localized anatomic lesion among verbal aphasias, asymbolic aphasias, and agnostic aphasias. In verbal aphasia, the symptoms are various kinds of a motor or expressive difficulties with language. Freud held that some functional relationship between the separate elements of the word representation—for example, between the images of the word as heard and the word as spoken—was disturbed in verbal aphasia. In asymbolic aphasia, the symptoms are various kinds of failure to receive or speech ( in the sense of relating a word to the thing to which the word refers). Freud held that some functional relation between word-representation and thing-representation for example, between the image of the spoken word and the visual image of the thing—was disturbed in asymbolic aphasia. In agnostic aphasia, there is a disturbance in the relation between the elements of the thing representation—for example, between a tactile image and a visual image of the thing—such that things are not recognized, and incitement to spontaneous speech arising from associations between the elements of the thing-representation does not occur.

I do not mean to distract us from our central concern in these lectures by a discussion of aphasia, which is still a mystery in medicine, largely, perhaps, because we do not understand language. However, important tendencies in Freud’s thought in this monograph were fateful for his later work; they are relevant to our understanding of a mental illness such as schizophrenia, and perhaps other mental illnesses as well.

Freud was dissatisfied with the notion that the type of aphasia depends upon the localization of discrete lesions. He conceived rather of a speech apparatus whose parts are interdependently related. This apparatus functions at different levels of an organisation. A higher level of organization or functioning requires more capacity than a lower one. Impairments of speech depend upon characteristics of the entire speech apparatus—for example, its general level of functioning as that is affected by any event depriving the speech apparatus of capacity and therefore acting to depress its level of functioning. In this conception, Freud was probably influenced by the neurologist Hughlings Jackson, who stressed the importance of the principle of hierarchy of organisation or level of function for understanding biological phenomena.

Freud, therefore, may be said to have thought as a system analyst or system theorist, long before this was fashionable, and to have conceived of impairment or disease as depending not upon localized lesions in, or the state of some part of, a system but rather upon the general level of function, or the state, of the entire system. In moving from a consideration of the neuro-physiological system to a consideration of the personality system, he retained these habits of thought, and some of his great theoretical contributions are related to them.

(To be continued)

©Prof. Ashoka Jahnavi Prasad

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Prof. Ashoka Jahnavi Prasad

Prof. Ashoka Jahnavi Prasad

Ashoka Jahnavi Prasad is a physician /psychiatrist holding doctorates in pharmacology, history and philosophy plus a higher doctorate. He is also a qualified barrister and geneticist. He is a regular columnist in several newspapers, has published over 100 books and has been described by the Cambridge News as the 'most educationally qualified in the world'.
Prof. Ashoka Jahnavi Prasad
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