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Beyond Psychosis, Toward Poiesis

By Brian J. Rose
University of North Carolina at Asheville
27 April 2011


Schizophrenia, as a psychiatric disorder, manifests in a plurality of symptoms and

resists rigid definition. The Oxford English Dictionary denotes the term (originating, via
German, from the Greek roots + , meaning "split mind") as "a mental
disorder occurring in various forms, all characterized by a breakdown in the relation
between thoughts, feelings, and actions, usu. with a withdrawal from social activity and
the occurrence of delusions and hallucinations." One of the most common symptoms of
the disorder is pathology of speech, and the seemingly bizarre linguistic constructions
that schizophrenics profess have attracted an immense array of study and analysis.
Schizophrenic speech was originally characterized as nonsensical by nature, and this
characterization has been preserved in present day studies of the pathological symptoms
of schizophrenic language. These studies typically approach schizophrenic language by
attempting to understand neurological/cognitive dysfunctions that contribute to the
perceived "nonsense" of schizophrenic speech. It is my intention, through an analysis of
schizophrenic speech/written samples and psycholinguistic literature, to demonstrate that
a new approach is necessary in order to prevent the social marginalization of
schizophrenic individuals. Through a more meticulous understanding of the
phenomenology of schizophrenia and its linguistic manifestations, it is possible to
empower schizophrenic individuals by conceptualizing their alleged "nonsense" as
poietic expression.
I will commence by adumbrating the basic anomalies of schizophrenic discourse
by linguistic features, beginning with features presumed to be relatively "normal," and
continuing with those that exhibit extensive pathology. In a review of psycholinguistic
literature entitled "Schizophrenia and the structure of language" Covington et al. assert


that schizophrenic speech typically displays normality in its use of phonology, syntax,
and morphology (though some exceptions subsist). Covington et al. suggest that
schizophrenia follows a regular phonological pattern similar to normal speech; they
maintain, "According to all reports, segmental phonology in schizophrenia is obstinately
normal. Even the most unintelligible utterances conform to the arrangements of speech
sounds permitted in the patients language" (Covington et al. 90). In her 1974 article "A
linguist looks at 'schizophrenic' language," Elaine Chaika notes that "because
[schizophrenics] are so consistent with the stress and phonemic rules of English, one
thinks the patient has actually made utterances of the language which one has failed to
catch" (Chaika 261). Schizophrenic speech also typically exhibits syntactic normality,
even if semantic obscurity renders their speech incomprehensible, as in this statement by
a schizophrenic patient: "If we need soap when you can jump into a pool of water, and
then when you go to buy your gasoline, my folks always thought they should get pop, but
the best thing is to get motor oil" (Andreasen). Such a statement is easily characterized as
nonsensical, but nevertheless obeys the conventions of English syntax. Covington et al.
claim that "[a]bnormal morphology in schizophrenia is quite rare," though some patients
employ extensive use of compound words and confusion of suffixes (Covington 90).
The "abnormality" that is quintessential to schizophrenic discourse is primarily
confined to semantics. For example, T.M. Oh et al. quote a schizophrenic patient who
remarks, "Oh, it [life in a hospital] was superb, you know, the trains broke, and the pond
fell in the front doorway" (Oh et al. 235). Should a statement such as this be disregarded
as utter nonsense, or does its obscurity possess some sort of semiotic substance? Most
theorists concur that such statements do indeed constitute an attempt to communicate


valid thoughts, but that semiotic association is confused by thought disorders inherent to
schizophrenia. Covington et al. maintain, "It has been suggested that schizophrenia is
fundamentally a semiotic disorder, a disorder of the recognition and use of sign
relations." They continue by citing the linguist J. Wrbel, "who points out that the first
symptom of schizophrenia is often a sense that everything in ones environment is filled
with special meaning. This proceeds to delusions of reference and a breakdown of
communication" (Covington 92).
Most contemporary theorists contend that the semantic obscurity of schizophrenia
may be attributed to "association chaining," or glossomania, in which "[t]he speaker is
distracted by the sound or meaning of his own words, and leads himself off the topic,
sentence by sentence. In essence, it is a form of derailment driven, apparently, by selfmonitoring" (Covington 94). This phenomenon has been demonstrated in a 1974 study by
Cohen, Nachmani, and Rosenberg entitled "Referent communication disturbances in
acute schizophrenia," in which participants were asked to identify the colors of discs with
subtle chromatic distinctions. Control participants typically offered answers such as
"Both are salmon colored. This one, however, has more pink." Schizophrenic patients,
however, exhibited extensive glossomania, as demonstrated by one response: "A fish
swims. You call it a salmon. You cook it. You put it in a can. You open the can. You
look at it in this color. Salmon fish." Cohen et al. attribute schizophrenic glossomania to
an insufficient ability to edit out irrelevant associations when considering a given subject
(Cohen et al.).
The anomaly of schizophrenic glossomania has prompted immense study in
regards to the lexical decision and semantic priming of schizophrenic patients, wherein


word associations are studied in order to determine how the semantic networks of
schizophrenics are constituted. Debra Titone et al. conducted research in this area in their
2000 study "Contextual Insensitivity in Schizophrenic Language Processing." They
presented test subjects with a modified semantic priming task in order to determine if
schizophrenic impairments in semantic priming were due to a global insensitivity to
context, or rather to an inability to filter out contextually irrelevant material. Subjects
were given sentences in which a single word whose meaning varied according to
surrounding context: such as, "Because it was extremely loud, we really enjoyed the
jam." Jam, herein, contains variable semantic meaning according to its context; the
meaning of "jelly" is its primary meaning (it is used more frequently), while the meaning
of "music" is its subordinate meaning (it is used less frequently). The contexts of
sentences provided to the subjects all favored the subordinate meanings of the variable
words. If the subjects failed to detect contextual information, it would imply that
schizophrenia entails a global deficiency in automatic semantic priming. However,
semantic priming for schizophrenics is often normal or larger than normal adults, and
semantic sensitivity is often broader in schizophrenics than controls (Titone 2000, 762).
Their research confirmed this hypothesis, with both controls and schizophrenics
demonstrating 98% accuracy in correct word identification; the schizophrenic subjects,
however, exhibited greater lexical decision latency than control subjects (763). This led
the researchers to conclude that In contrast to automatic processing, performance on tasks
of controlled or inhibitory processing is impaired in schizophrenia" (762); that is, they
have the ability to process contextual information, but are indeed so sensitive to parallel


levels of semantic meaning that they have difficulties in filtering out irrelevant
Titone then furthered this research in her 2002 study on idiom processing in
schizophrenia. In this study, subjects were provided a series of idioms, some of which
were categorized as "literally plausible" (e.g. to kick the bucket, which has both literal and
figurative meaning), while others were categorized as "literally implausible" (e.g. to be
on cloud nine, which has no explicit literal meaning). Subjects were asked to undergo a
semantic priming task based on these idioms; so, for example, the idiom to kick the
bucket would yield the option of die or pail. While control subjects showed idiom
priming for both literally plausible and implausible idioms, schizophrenic subjects
showed idiom priming only for literally implausible idioms. The researchers inferred that,
with regard to the literally plausible idioms, schizophrenics were unable to filter out the
literal meaning in order to access the idiomatic meaning; with regard to literally
implausible idioms, there was no literal meaning to filter out, and thus the subjects could
engage in idiom priming more easily. Titone et al. thus managed to discredit the global
idiom-processing insensitivity hypothesis, which "posits that difficulty detecting,
encoding, or representing contextually relevant information is the primary disturbance in
schizophrenia" (Titone 2002, 319). If this were so, one might have observed deficiencies
in idiom priming for both literally plausible and implausible idioms; this, however, was
not the case.
Such studies serve to demonstrate that schizophrenia is not so much an
insensitivity as a hypersensitivity; not so much an estrangement from reality as an
intimate engagement with another perspective of reality. Take, for example, the following


statement supplied by a schizophrenic patient when asked why he responded true to

"forks are used for fuel" in a semantic verification task:
Yes, they add up and kind of like a solution. It's say, it's an equine or equinox, like fungi.
Something in the brain tells you it's a high number. Bacteriology, a numerate number, it's
a particle, therefore it contains solution is to answer the right question. A fork is a
solution, an aqueous solution. Fork in a kettle, something bottle, do hairs bristle on a
comb or fungi? It could be naval or positive solution ratified like a kettle, if kettle is the
right answer. It could be 5th or 7th one, right? Brown aqueous solution inside the kettle.
(McKenna 44)

It is all too easy to become "lost" in such bizarre language, and thus to dismiss it as the
meaningless ramblings of insanity. But as the psychiatrist David Forrest states in a 1974
article: "The question is whether one will accept the possibility of random or meaningless
utterances by a human being" (Forrest 292).
Forrest, in his article entitled "Nonsense and sense in schizophrenic language,"
provides a brilliant critique of traditional conceptions of schizophrenia as nonsensical,
instead exploring how schizophrenic language is an attempt to communicate a unique
perspective of reality by the only means available to the schizophrenic. Forrest furthers
the notion of schizophrenic discourse as an act of poiesis. He writes: "Humans cannot
produce random signals, as far as is known. Interference with the process will tend to
provokenot nonsense as in the case of the computer and not mere imprecisionbut use
of parallel processes to produce circumlocution, the substitution of metaphors, the
substitution of metonyms and synecdoche, the part for the whole, and the association for
the main thought" (Forrest 293). He cites other theorists whose studies have demonstrated
this poietic quality to schizophrenia, such as Werner and Kaplan, who in their 1963 book
Symbol Formation argued that schizophrenic semantics were more dependent upon
connotative significance than denotative meaning; they also coined the notion of
"homophonic word meaning," wherein schizophrenics (much like children) attribute


phonetic aspects of a word as relevant to the word's meaningsuch as the word

"contentment" as relating to "men" because it contains the phoneme "men" (Werner and
Kaplan). He also cites Alfred Storch, who wrote that, in schizophrenic logic, "a single
emphasized feature possessed in common by objects is sufficient warrant for connecting
together the most heterogeneous things" (Storch 7). This leads Forrest to distinguish
between the artificial construction of Aristotelian logic and poietic paralogic: "The
Aristotelian logician requires all predicates or attributes to be identical, and the
paralogician, the schizophrenic, the dreamer, the poet, and all of us now and then tend to
be less discriminating lumpers of things together if they have one or only a few attributes
in common" (Forrest 292). He notes that the poet E.E. Cummings made use of nearly
every "aberration of language described by Bleuler (1950) in the language of
schizophrenics," and yet "wrote perhaps the most totally accessible poetry of our time" by
defining and redefining "his inventions for his readers to share by consistent use in
defining contexts; schizophrenic persons are often unable or unwilling to do this" (295).
Forrest demonstrates how schizophrenic language is not altogether disparate from
normal modes of human thinking, but rather just accelerated or totalistic. He posits, "The
fact that schizophrenics give passing mention to other forks in the linguistic path (or take
unexpected forks) is undeniable; so do most of us at times; we all have that ability, but
seem to do so only at certain times" (Forrest 297). He notes how the allegedly random
word associations of schizophrenics in fact conform to semantically or phonetically
related words, but this association occurs so prolifically within schizophrenic discourse
that it is difficult for others to keep pace. He writes, "Maher's (1968) idea of there being
vulnerable points in language where extra meanings arise in punning fashion suggests


that the extra meanings are extraneous, randomized, and nonsensical to some degree, but
he implicitly is pointing out there is recourse to the common lexicon or language, and
therefore ultimately to common sense, to the consensual definitions of words" (291-2).
Forrest maintains that experiences a schizophrenic regards as particularly painful,
troublesome, or important are likely to have been mentally recalled so often that he/she
often develops new terms and linguistic tools in order to more effectively address them.
He writes:
[The schizophrenic's] scorn is his having seen that none of the defenses by which all of
the rest of us maintain our sanity are watertight; they have failed the schizophrenic
person, and he knows this. In the face of the inevitability of death and loss the
schizophrenic person realizes that he has not fully lived in human society; realizing he
has missed being alive, and that he has lost all of humanity by not being a participating
partner, the schizophrenic flees his intolerable sadness into the magical, omnipotent
world of his psychosis. As he flees society, he flees the common lexicon, using words in
more private ways than most of us do and seemingly violating the laws of language. As a
restitution, he creates by the process I call poiesis a world of words, a universe of
language. (Forrest 295)

Forrest contends that we all participate in this poietic practice, but to different degrees, as
"when we wish to affirm our right of choice, to firm up the connection between ideas
we feel are related, to lend an impressive echo in another dimension of
communication, [or] to avoid the somewhat limited conclusions of our formal
scientific logic. The schizophrenic gets in trouble by trying to press on others
the private linguistic connections he or she has found as the order of things they should
accept" (297). Still, what is (in excess) considered a pathological expression of
schizophrenia is often practiced more subtly in common metonymical speech: "The
patient who calls the bird 'the song' is doing the same thing as anybody else speaking of
blue collar voting or Kremlin thinking." And the polysemia practiced by schizophrenics
who bend the usage of language is the same polysemia practiced by Shakespeare "as
when [he] first said 'cudgelling one's brain' and 'beggaring all description.'


Schizophrenics compound neologisms, and condense blends, but so did Lewis Carroll in
making slithy from slimy and lithe; so did Los Angeles in making smog from smoke and
fog; and speakers of German build compound words to order daily" (294).
Forrest eloquently defines schizophrenic poiesis as "as a kind of extension of the
poetic process used to reify words into a reality that could be believed in" (296). By
embracing this understanding of schizophrenic language, we allow ourselves to actively
listen to schizophrenic persons, rather than continuing to invalidate their words an
realities as nonsense; thus by recognizing their expressions as valid and recognizing
aspects of their own paralogical thought in ourselves, we preclude them from retreating
into the "magical and omnipotent world of [their] psychosis" and bring us closer toward
communicating with their unique perspectives.


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