The symbolic and literal in schizophrenic language.

TOPIC. Differences between the symbolic, or poetic, and the literal in schizophrenic language PURPOSE. To enhance the nurse's therapeutic effectiveness with these clients SOURCE. Review of the literature CONCLUSION. What often is perceived as literal language in schizophrenic communication is, in many cases, full of symbolic meaning. Key words: Delusions, literal language, poetry, schizophrenic language, symbolism The oddities of schizophrenic language have been recognized since the classic works of Kraepelin and Bleuler, yet remain difficult to characterize and/or explain. As Manfred Bleuler (1982) remarks: "Schizophrenic language, like schizophrenic thinking and behavior, is not stable" (p. 591). To grasp the meaning of certain words or phrases, or follow the apparent aimlessness of the clients' speech, often is difficult. Their speech, with its unexpected swerves and cryptic references, often evoke an unnerving sense of having encountered someone inaccessible and strange. Schizophrenic Language Distortions Many schizophrenic clients use words in personalized or idiosyncratic ways, without providing the listener with an explanation of what they mean or even acknowledging that the words are being used in some metaphoric sense. Nevertheless, the intended meaning of a word may be somewhat transparent, as when a client speaks about "nonembriating," being tormented by "insinuendos," bothered by "elbow people," or threatened by a "deathilating machine." The language of schizophrenics often resembles that of poetry, especially in the rich use of metaphor. Poetry is any imaginative, structured language that employs imagery, simile, or metaphor with an artistic aim in mind. If a nurse heard the following lines spoken in a hospital corridor by a "mental patient" she might conclude that such speech represented "word salad" or "looseness of associations:" anyone live in a pretty how town with up so floating many bells down spring summer autumn winter he sang his didn't he danced his did women and men both little and small cared for anyone not at all.... Yet, these lines come from e. e. cummings' poem, "anyone lived in a pretty how town" (1970, p. 1043), and obviously had artistic aim. Clearly, a wellspring of emotion surges beneath the surface of life and the syntax of language. The French surrealist actor and producer, Antonin Artaud, writes: "My mind is open through the belly and from below it piles up dark, inexpressible knowledge full of subterranean tides, concave blocks, and frozen turbulence" (Corti, 1968, p. 38). In truth, Artaud suffered from episodes of psychosis. In one of his lucid moments he admonished readers: "Do not mistake this for imagery" (p. 39). If not imagery, what is the intent of such communication? When a schizophrenic man says, "My brain is an apartment house," is he using imagery or do his words represent a literal statement that is a direct presentation of his experience? A poem known to many people from childhood is Lewis Carroll's Jabberwocky. Lines such as, "twas brillig, and the slithy toves did gyre and gimble in the wabe," are renowned for their richly suggestive obscurity. Poet John Ciardi (1979) noted that Jabberwocky made a great deal of sense, beneath the apparent nonsense, at poking fun at Victorian hypocrisy. He wrote: "The very use of nonsense makes excellent sense.... The nonsensical surface-performance is one part of a very meaningful comment ..." (p. 87). Phraseology similar to that used in Jabberwocky often is seen in the "poetry" of schizophrenic clients: I think a little even a chittle if don't mittle on the little. . . (Arieti, 1974, p. 371) Clinical Illustrations A common nursing goal has been to interpret the feelings underlying a client's words and syntax. …