(1966).

Contemporary Psychoanalysis 3: 39-54

Language and the Schizophrenic Quandary1

Kenneth L. Artiss, M.D.

Statement of Dilemma
IN A REVIEW, "Sociocultural Factors in the Epidemiology of Schizophrenia," which appeared in the November 1963 issue
of Psychiatry, Mishler and Scotch [6] remind us that reliability in the diagnosis of schizophrenia is so poor that:
In one study, three psychiatrists agreed in only 20 percent of their cases and had a majority agreement in only 48 percent. Another
study revealed that the widest disagreement occurred among the most experienced clinicians.

These authors go on to note that the problem does not end there, for they seem to believe that the psychologist and social
anthropologist cannot agree on how they should study whatever subject it is, and find that most available studies range in value
from questionable to useless:
It is not difficult to criticize the state of the fieldfew studies are available, concepts and methods are unclear and unstandardized,
findings are inconsistent and speculation abounds in the absence of reliable empirical knowledge.

The authors, having reviewed a wealth of material, conclude with the disappointing note that nothing of really interesting
significance has yet appeared.

1 Expanded from a paper read at a meeting of the Harry Stack Sullivan Society, New York City, March 10, 1964.
- 39 -

In this sense, then, the conclusion is of a piece with those of all other reviews of etiology which we have been reading all
throughout our professional lives. Whether the author be reviewing biochemical studies, serological studies, anatomical studies,
or whatever, the conclusion is the samethere is no conclusion.
Many will remember the passionate and sarcastic manner in which both Eugen Bleuler and Harry Stack Sullivan2 dealt with
this problem.
Bleuler wrote over 50 years ago:
Our literature is replete with complaints about the chaotic state of the systematics of psychoses and every psychiatrist knows that it is
impossible to come to any common understanding on the basis of the old diagnostic labels.

We might note parenthetically here that Bleuler's annoyance with his predecessors did not save him from the same pitfall of
the label trap.
Bleuler's passion shows through clearly as he goes on:
In a certain hospital there would be a big pot, labelled 'dementia.' Now along comes a new physician who labels a second pot,
'paranoia' then carefully proceeds to seize the old inmates of the institution by some vestige of a delusion and puts them, one by
one, in his new potand in doing this believes that he is correcting the errors of his predecessors.

Harry Stack Sullivan, a generation later, and only a half-dozen years in psychiatry at the time, echoes these sentiments [8]
with:
The characteristics by which (schizophrenia) is distinguished have not been worked out with precision. Bleuler's formulation, for
example, is unsatisfactory alike in its basis in the old ideaassociation psychologyand in its contradictory if not actually
incoherent, propositions.

Instead of the ritual accusation of our antecedents of either wrongdoing or stupidity, I propose that they were probably
victimized by the language of their day which caused virtually insurmountable problems in thinking about and dealing with
schizophrenic persons.
Some of us like to think that Sullivan at least glimpsed a way out of the dilemma, but we all must admit that even today,
when experts gather to discuss schizophrenia, disagreement is the only characteristic finding.

2 It is my misfortune to have missed knowing Sullivan, but David McK. Rioch, Dexter Bullard and Janet MacK. Rioch have all kindly discussed him with me at
some length.
- 40 -

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 I shall try to address myself to this issue of disagreement within the profession. I will try to show(1) with data from our
studies in the use of Milieu Therapy [1] for the treatment of schizophrenic soldiers at Walter Reed General Hospital, (2) together
with certain linguistic phenomena attested to by Sapir and Whorf, (3) added to and related to some provocative speculations
which originated with George Herbert Mead in his lectures on social psychology at the University of Chicago early in this
centurythat there may be both necessary and sufficient reason for our profession-wide difficulty. I shall further attempt to
specify the location of this difficulty as being in our language and to narrow down the problem insofar as I am capable, to the
connotations attached to certain significant verbal symbols which I will identify in a moment.
Let me explain in some detail first a few of the implications, the connotations, of the language in which we so often discuss
schizophrenia, so that we can later approach the data with advance notice as to where to focus our attention.
The vast majority of our psychiatric residency training programs continue to teach the Bleuler view of schizophrenia. You
will recall that Bleuler [2] stated in 1911:
The fundamental symptoms consist of disturbances of association and affectivity, the predilection for fantasy as against reality and the
inclination to divorce oneself from reality, (autism).

If we had no more material than this to give us direction and deliberately ignored Zinkin's translation problem, we could still
explore right here to considerable depth. For illustrative purposes only, let us briefly note that the denotation of Bleuler's
statement includes the idea of a positive preference for fantasy as against reality, and its connotations, familiar to us all, would
include the idea that when given a choice, with no specific consequences tied to either, and without past history, a given
schizophrenic person would prefer to entertain a fantastic explanation rather than to know what really happened. The denotative
meaning of "divorce oneself from reality" includes the idea that, once having been related to reality, the schizophrenic person
inclines to separate himself therefrom in an orderly, planned and intended-to-be-final fashion. Common connotations would
include the ideas of willfulness, self-interest, loss of interest in the otherand at a second or third order of magnitude in terms of
inferencethe hint of skullduggery, deliberate evasion of contract
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or responsibility, and the almost completely hidden notion of the absence of some factor which might have made for a happy, or
at least a continuing, marriage with reality.
Here I have detailed but a small sampling of the very rich connotative connection matrix which our culture attaches to the
meaning of that fragment of the classical Bleuler definition. Our paradoxical position comes into sharper focus when we note that
we are compelled by our medical model to think of the person as sick or disabled ("mentally ill," we say) whereas the
connotations of the descriptive language which is used definitely carry us immediately into an ideational field which includes
organized deceptive planned evasion of responsibilities as thematically prominent.
Now, for the first time in this long preamble, we come to data from our study. All our patient-subjects were diagnosed as
schizophrenic, including a cross-section of paranoid, catatonic, undifferentiated, schizo-affective and simple subtypes. Early, and
occurring frequently in our study, we found a remarkably predictable and ubiquitous transaction between patient and staff which I
will detail in a moment. We altered our response to the transaction and the phenomenon changed, but once we had become
alerted to it, all of us discovered how easily it could be recognized elsewhere. The transaction is one which occurs soon after the
new patient's admission to a hospital ward, when he accosts one or many of the staff to inquire "Why am I here?"
Conventionally, the response is: "Because you are sick." Whereupon the patient, angered usually, puzzled sometimes, asks
"What do you mean, sick?" Adding the defiant addendum, "There's nothing wrong with me."
The debate begins here, and may go on endlesslyeven for years, as some of you well know.
At the risk of being over-obvious may I call your attention to the fact that this continued argument or debate is centered upon
the meaning of words and more specifically about the connotative or if you will allow me, the social implications of these words.
Rephrased, it appears safe to assume that the patient quickly recognizes the staff member's verbally unstable situation or stance,
strikes out against him by demanding an explanation which cannot be provided in any clarifying fashion and thereby forces the
staff member to retire in verbal confusion to an authoritarian position in which
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the logic of the operation becomes eventually, "You are sick because we have the social authority to name you as such, so don't
argue."
Most of you have experienced what comes next. The patient tests out the actuality (or reality if you will, for here he is not
divorced from reality) of the authority in whatever terms it appears: locked doors, enforced medication, unrequested treatment,
and other constraints. Once he has become thoroughly well acquainted with the constraints, he is regrettably all too frequently on
the way to a new problem, chronicity.

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 Leaving that painfully familiar scene, let us return to our theme for a closed inspection. Are we not forced, by the
paradoxical and uncertain position in which the connotations of our own professional language place us, to energetically renew
our efforts again and again to find some biological, serological, chemical, or similarly medical-model-oriented proof of the
presence of an illness or defect, so as to once and for all be rid of our nagging dilemma of the medical model on the one hand and
the theme of evasion of responsibilities on the other?

Basis for the Language Approach to the Dilemma

How we may be driven to this sort of action by our language is suggested by Benjamin Lee Whorf [11] in his remarks in
"The Name of the Situation as Affecting Behavior."
I came in touch with an aspect of this problem before I had studied under Dr. Sapir in the course of my professional work
analyzing fires and explosions. In due course it became evident that not only the physical situation qua physics, but the meaning of
that situation to people was sometimes a factor, through the behavior of the people, in the start of a fire. And this factor of meaning
was clearest when it was a linguistic meaning, residing in the name or the linguistic description commonly applied to the situation.
Thus, around a storage of what are called "gasoline drums," behavior will tend to a certain type, that is, great care will be exercised;
while around a storage of what are called "empty gasoline drums," it will tend to be differentcareless, with little repression of
smoking or of tossing cigarette stubs about. Yet the "empty" drums are perhaps the more dangerous, since they contain explosive
vapor.

If indeed we are similarly driven to action by language symbols whose only clear "raison d'tre" is an authoritarian one,
rather than by the simply observable facts of the case, then more than ever
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we can respect the puzzlement with which our patient responds upon being told that he is "schizophrenic."
What do I mean, "simply observable facts of the case"? Only these: attention to the patient rather than to the language
reveals that he displays a marked indifference to, and uninvolvement with, the social environment. When you inspect this
phenomenon further from the operational point of view, it soon becomes apparent that your patient is primarily deficient in social
skills. By and large, he is unable to sustain a friendly conversation for three minutes, to fit himself smoothly into even simple and
uncomplicated social groups outside of his family circle. In fact and simply, he is comparatively deficient in social skills.
Furthermore, he is aware of this problem and can discuss it with you at great length, usually beginning with his concern about
being different from others which he often introduces with some note about estrangement.
Now may I tell you something about the manner in which the basic data for this discussion were accumulated. Some years
ago, I had the good fortune to be provided with a ward and a staff to run it; with a supply of schizophrenic patients, freedom of
inquiry, freedom of choice in the patients I accepted, and in how long I wished to keep them, had companion investigators and
knowledgeable consultants to aid me in the task of devising a therapeutic milieu for these patients. To some degree, the staff and
I succeeded in these goals and much of this material is available elswhere. It was a group experiment from beginning to end and
each staff member was required to record his observances concerning the transactions in which he participated. These
observations served as multi-observer cumulative behavioral record, a staff information-communication system, a method of
alerting the staff to problems and furnished material for use in postulating behavioral messages (the potential symbolic content of
non-language behavior).
Early, we attempted to locate some single factor about the schizophrenic person which would set him off as unique. We
failed in this objective, of course, but the experience sharpened our abilities to observe at the same time that it reduced our excess
baggage of presuppositions to a more manageable size.
By the end of the second year, we were able to specify operationally some aspects of patient behavior which have held up
reliably in repeated tests, such as:
A. The behavior of the schizophrenic person will differ from the
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"norms" of society in terms of "too much" or "too little." The idiosyncratic behavior will at no time have a unique content,
but will be unique only at certain times and then only in the stylistic aspect of over- or under-emphasis.
B. When we use acceptable social behavior as a reference measure, he will be found to consistently violate these boundary
conditions in a manner which strongly suggests a lack in social regulatory function or, as we came to describe it later,
deficiencies in social skills. (This is not to say that a given schizophrenic person may not be able to demonstrate
magnificently skillful evasive behavior or even highly skilled social manipulative ability in a family-limited social field.)
C. He demonstrates something odd about his use of language which is not adequately described in the classical literature.
He insists upon certain self-defining prerogatives concerning the meaning and use of words. He does not accept the

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 culture's right to establish, teach, and define the meaning of its language forms, insists upon abrogating this authority and
clashes again and again with the social structure at this precise juncture. (I have discussed these phenomena elsewhere
under the title of "The Naming Prerogative"). [1], p. 140
Apropos of the theme of lack of social regulatory function is that of "bidding for deviance." Quite early in our study,
Marlowe [4] had described the soldier, still on duty, not yet a patient, as demonstrating deviant behavior, apparently in an effort
not only to call attention to himself, but also in so doing to obtain a specific label from his associates. These bids for the
"deviant" label, according to Marlowe, consist of
continuous throwing out of cues to the group a continuous flow of themes centering around his inabilities, incapabilities and
despondency. It is to others and to official agencies that he presents these behavioral forms as the instruments through which the
"difference," his singularity, will be ratified.

This "bidding for deviance" apparently continues steadily or accelerates in pace until the end is achievedexpulsion from
the groupvia hospital admission. Briefly summed up: He will engage in a predictable series of transactions with the group
which will end in his expulsion from it.
At the point of expulsion the form for verbal statement is "Yes, now you can see it. I am different." He has self-defined the
situation and the explanation. The first lead we had for the points I wish to
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emphasize tonight was the discovery that we could agree with him in part by concurring that his behavior was indeed different.
Gradually developing our sensitivity to what the patient was saying after he had been "expelled" and was on a psychiartic
ward, we were enabled to pick up two distinct themes which were constantly repeated. First was, "I don't belong" and second, "I
am different." I want to emphasize belong and am. In group therapy sessions for example, these themes came forward. "I don't
belong any place. I don't feel human. I don't belong to the human race. I've never belonged in the group of people that are
successful in this world, that hold jobs, things like that. I am different. I feel separated off, maybe I'm a queer or a homosexual."
These concerns then refer to membership and being or identity. Later he would be found disputing with staff members over
definitions or names. For example, "Your name is not what you say it is, I know. I don't believe that name tag you're wearing. It
is a part of the plot. Furthermore, all these other people here have false names. They're putting on a play for my benefit." Not
infrequently, a patient might be even more specific, "My name is not Private So-and-So, my name is Jesus Christ."
The struggle then would be over his attempt to self-define two things, his role and his identity. In the hope that I have not
obscured the issue by too much condensation of the data, let me now state the hypothesis of this paper, which by this time would
be roughly as follows:
The schizophrenic's quandary results from a relative deficit in the connotative aspect of language.

The Language Hypothesis about the Schizophrenic Quandary

It seems reasonable to entertain such an hypothesis on several grounds. It fits with the language data. The behavior which I
have described (and that described by others with different emphases) could be explained by it. The overwhelming sense of
difference and estrangement which the schizophrenic person describes could be the resultant of a loss or absence of fine shades of
meaning, the implicit social consequences, of language, so as to make him relatively insensitive to others' intentions and insulate
him, as it were, from clarity of perception, from the poetic aspect of metaphor, from the softness,
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the tenderness, and the gentleness which can only be expressed in connotative subtlety.
It fits with the behavioral data. The awkward and clumsy social behavior of the schizophrenic person could again result
from a relative connotative deficit. We know from his history, in our sample, that he has been ostracized from acculturating play
with neighborhood children and has spent most of his non-school time in relative isolation, often long hours in his room with
nothing but a phonograph for company, for example.
During this isolated time, one assumes that the other neighborhood children are playing and in other ways acquiring the many
thousands of nuances which make for their acculturation. One can easily imagine that each hour of isolation enlarges the gap in
social skills between our subjects and their peers who are spending the same time in acquiring a few additional social nuances.
As time passes, the situation should deteriorate in that the to-be-schizophrenic child would appear increasingly deficient to his
playmates and by that token increasingly undesirable as a companion.
The necessary requirements for an escalation theory of schizophrenia are met, without the necessity of further assumptions.
It is an attractive hypothesis also because ways should soon be available for us to test it.
Let's take a look at the over-all size of the problem. The boundary conditions are to some extent understood already. For

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example: Acculturated persons have denotative vocabularies ranging from 5,000 to 50,000 words out of a lexicon size ranging
from 100,000 to 650,000 words as a maximum.
The numbers of connotations in an efficient language have been estimated by Van Der Berg [9] to be in the neighborhood of
one million. No scientist to my knowledge has yet estimated the number of connotative interconnections but a goodly number of
mathematicians are approaching language studies with a multivalued logic model. I gather that the problem looks no more
overwhelming than many other hyperspace problems which may require computer solutions.
Terminology such as multivalued logic and hyperspace are infrequently heard in psychiatric groups, so a digression in order
to explain is in order. First, we could begin by translating multivalued logic to multidimensional logic. We are familiar with the
three-dimensional logic of space and human vision in which we classify in terms of height, width and depth or use X. Y. and Z
coordinates. However, a
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four-valued or four-dimensional logic has a more unfamiliar quality until we recognize that it is easily achievable in our
experience by the addition of a time dimension to the space dimension already so familiar to us.
However, at this point it becomes more difficult to think of even more dimensions varying at once. The mathematician or the
general systems researcher has learned to use the concept of a hyperspace to deal with four or more values and it is part of his
professional language.
Permit me, at this point, to elaborate further on how the thinking borrowed from the mathematician with his assistant, the
computer, is helpful to us in dealing with the complexity of connotations. The mathematician, when he is interacting with his
machine assistant, the computer, is required to present it with a series of logicsdegrees, distances or amounts over which a
value may vary in this instanceeach of which must be completely specified. If he were conceptually inhibited by a sort of
geometrical space notion, then he would experience difficulty in thinking about a language or communicational "field" with, let
us say, ten dimensions, all varying to a specifiable extent and yet all interacting to some degree. He can free himself from such
habitual conceptual constraints by inventing or creating a "space" or field in which many interacting variables are possible. To
adequately respond to the size of the language analysis problem, apparently he must engage in some creative act of this type in
order to avoid being overwhelmed by the "apparent" complexity of the problem.
To illustrate: There are, despite our reluctance to know it, only a finite number of definitions for, and implications which
may be drawn from, the pronoun, "I." There are a finite number of relationships (symbolized by verbs) in which "I" may engage.
There are a finite number of definitions and implications which may be attached to the pronoun, "you." No great conceptual
problem here. When our reluctance is overcome, we can accept that all possible relationships between you and I can be specified.
However, we immediately note that each such possibility is modified, made possible, rendered impossible or deemed
necessary by the presence of absence of a host of "he's," "she's" "it's," and so on, in the field. Each contingency, moreover, can
itself be as readily defined as our earlier examples.
At this point, and we have only just begun, most of us would begin
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to find that our ability to follow the argument was diminishing. Complication is piling upon complication and our geometrical
space image together with our linear language habits are beginning to interfere to such an extent that we withdraw, often with a
parting disparagement about people who pursue such matters.
But the computer is simply a machine, it has no habits to unlearn and is just as ready to tackle a problem with ten interacting
logics as one with two. All it needs is a programmer and mathematician who can mentally allow for a space with no limit on the
number of dimensions it may contain or the number of values which may obtain from the intersections among these.
There are a certain number of true or correct values (a truth table is an example) which are allowable in a logic system.
There are a certain number when several logical systems are all operative at once. Much of the logic of denotative language
usage (the language logic of classes) has already been worked out by Russell and Whitehead in Principia Mathematica before the
computer could help, by hand as it were, with an almost incredible expenditure of scholarly energy. The solution to specifying
the connotative logic in a language would seem to demand application beyond what could be expected from man and call for
machine solution from the outset.
Charles E. Osgood reported at our 1963 APA convention in St. Louis on his attempts to use such a system in the analysis of
cultural values. His book, Measurement of Meanings[7] takes up the issue at some length under the general heading of the
"semantic differential."
I do not consider myself presently qualified to discuss such an approach at any great depth. Generally, up to this point, we
have tended to analyze language with the use of four gross dimensions as follows:

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 I. Morphologythe linguistic or structural analysis of words.
II. Syntaxthe ordering and placement of words.
III. Denotative Meaningthe formal, explicit, dictionary meaning of words, universals in a sense.
IV. Connotative Meaningthe informal, implicit, often contextual and colloquial meaning of words, to include
communication of style, poetry and subtlety.
These last two dimensions of meaning rely heavily upon George Herbert Mead's concepts [5], p. 125 that meaning includes
the response of the other in a social field and a relationship of present response to later responses which are in some sense already
initiated.
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Finally, and of signal importance, this hypothesis, that the schizophrenic's quandary results from a deficit in the connotative
aspect of language, cannot only be tested eventually, but is stated in such a fashion as to allow for the possibility of its being
proven wrong. This specific factor, and it alone, allows for the application of scientific method to the analysis of human
behavior.
In passing, I might take this opportunity to emphasize that an hypothesis which cannot be put to some test containing the
possibility of disproof, is no hypothesis at all in the scientific sense. The normal progress of science is from observation to
hypothesis, through tests to theory, through exhaustive tests to behavioral law. More definitely stated: Hypothesis implies
insufficiency of presently obtainable evidence and, therefore, a tentative explanation; theory implies a much greater range of
evidence and greater likelihood of truth; law implies a statement of order and relation in nature that has been found to be
invariable under the same conditions.
Those of us interested in research have lived through a long period of heated dispute about the scientific validity of
dynamic-psychiatric theories; critics reminding us that most of them appeared full grown without having been preceded by
hypothesis-testing. For myselfall too frequently in these discussions I found that I "came out the same door wherein I went."
The probable reason for this lack of closure now appears to lie in the realm of this paper's theme, for example, symbolic logic and
linguistics.3 In all probability, we are going to discover that our psychodynamic theories were formulated only for the purpose of
achieving a method (a language) that would serve us in talking about our patients to each otherand that alone. Therefore, logic
in our theories is required only to the degree that it promotes cohesiveness and a degree of tautology necessary for a useful
technical language. Such languages then, serve to symbolize or represent reality and have no other important purpose. It must
follow then, that any attempt to "validate" a psychodynamic theory (designed for communication purposes only) against the
reality of behavior must inevitably fail of its avowed purpose and to a large extent expose our innocence about the necessity for
tautological relationships in language

3 Symbolic logic is a series of statements about the intrinsic allowable, necessarily tautological sets of relationships between the elements of any symbolic
system. A language is a system of symbols, words being symbols for things and events, and therefore, symbolic logic is language logica spelling out of
exactly what may and may not take place.
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which have been so carefully delineated by the symbolic-logician.

In contrast, this hypothesis proposes that a certain type of behavior, (1) that labelled schizophrenic, and (2) a relative
connotative deficit in language, will be found upon investigation to be positively correlated. If such an hypothesis be verified, it
should take us one more step toward what might some day become a theory of behavior, but in this instance a "theory" which has
scientific rather than communicative function. I dwell at some length on this point because it is both germane to this paper in
particular and our profession in general.
Now, to reestablish the theme, let us examine how we go about analyzing the situation when we observe that a given person
appears not to possess the shadings and nuances of meaning which we would expect, for example, he doesn't come to the same
conclusions that we do on the basis of similar evidence. Actually, our mental operations are likely to be of the highest
mathematical precision, consistent with the latest concepts of set theory or Boolean algebra4 (and in perfect accord with the
"new" mathematics our children are being taught.
We will be likely to assume a representational field in which we will ask about roles. In all probability, we will be interested
in trying to determine what role this person is playing in order to explain his arrival at conclusions which differ from ours.
Below, using a series of questions about roles, and their prominent connotative aspects, translating these into symbols, for
example, C, F, W-,

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 Figure 1

and eventually superimposing these upon a Venna diagram [10]5 we can proceed to examine all logical possibilities. The
Venn diagram simplifies this task because the areas of overlap in the superimposed circles are used to indicate the simultaneous
existence of more than one of the factors being symbolized.
For example, the shaded overlap area designated (1) is contained within the factor "child" and the factor "foreign" and thus is
the only possible place for symbolizing the role designation "foreign

4 George Boole (1815-1864), first Professor of Mathematics at Queen's College, Cork, son of a school teacher but largely self-educated, is considered the
founder of the theory of mathematical logic from which both symbolic logic and the modern-day computer have been derived. His "law of thought" states that
there is an intrinsic pattern in the way that men think which classifies ideas as belonging to classes and categories.
5 An excellent discussion of the practical aspects of the Venn diagram appears in the September 1966 Scientific American in an article entitled, "Computer
Logic and Memory" by David C. Evans.
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child." Similarly, the shaded overlap area (2), being contained within the factor "child" and the factor "wrongdoer," is the only
possible location for the role designation "juvenile delinquent." Location (3) is the only possible place for the co-existence of
"foreign" and "wrongdoer" which combine to form "spy." All three factors come together only in (4) combining to form the
logical symbol, "Foreign juvenile delinquent." All logically possible roles can be located in the diagram.
Figure 2

We note that certain combinations of sets are possible and that there is a place in the field where no set applies. This is
referred to as the null set and is diagrammed
Figure 3

with the bar above the symbols to indicate "not," for example, not C, not F and not W-. We note with great interest that this
is the area which satisfies the operational requirements for psychosis (craziness) in a formula as follows: Crazy=outside the
allowable sets of social roles.
Set theory quite obviously does not allow us to consider psychosis as nonexistent or mythological, since it is clearly in the
field, however absent in roles. Of course, this fits in with our experience, for we cannot dismiss the fact that schizophrenic
persons are problems
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and that their presentation as "problems" is operationally one of not fitting neatly into the roles which their society has available.

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 Before we return from this brief detour into mathematics, may I add that it is not considered foolish these days to think about
using the computer to aid in specifying whatever logical system may be present in a language any more than it is to use it as a
help to specify the factors which would be required to produce a comprehensive artificial language. Many simplified artificial
languages are already in use, both encoding and decoding.
Surely we will not have to wait too long before the interaction between the linguist and the mathematician begins to open up
new approaches for us. Who knows, maybe the psychologist with these interests can show us a useful method of approach.
So, I save what is to me the most attractive and I hope most provocative aspect to the last. What I choose to call George
Herbert Mead's "manifesto" was made in his lectures on social psychology at the University of Chicagoto which I referred
earliersome 50 years ago. This manifesto is condensed by Charles W. Morris as follows: [5, p. XIV]
Mind and the self are without residue social emergents: and language, in the form of the vocal gesture, provides the mechanism for
their emergence.

Today, a modern scientist like Kalmus [3], in talking about analogies of language to life, can state quite simply:
Language may be considered as consisting of symbols (words) arranged according to certain syntactic rules and can become
nonsensical if words are either misspelled, missing or wrongly combined.

What a shaking thought that our children might some day come to know what we today call schizophrenia as something like,
"the behavioral syndrome resulting from words wrongly combined and misconstrued." If so, much of what our patient tells us
today could be thought of as personalized metaphorical allusion to what it feels like to be socially deprived to the degree that one
cannot locate a way to remain related to one's fellows and is thereby constantly threatened with becoming "disconnected" from
them as a result of one's own linguistic clumsiness.
Is it possible that we have been led by our models and their associated language into a meaning non sequitur so that by
classifying delusions and hallucinations, for example, as symptoms, we have
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been required to postulate a disease entity, by the language logic itself rather than by the phenomenology? Has this emphasis
caused us to attend so vigorously to the fantasy world, as it were, that has perhaps only flowed in to fill up the social-experiential
vacuum in the lives of these people, that we have failed to consider it as a possible artifact only? And if so, have we failed to
locate a more adequate model to include the deficiency concept becauseand here I use a colloquial representation only for
emphasisbecause we have been led by our language to the hole rather than to the doughnut?
And in closing, should this rather disturbing possibility become the case, then Harry Stack Sullivan will indeed be seen as a
prophetic figure. Was it not he, more than any other, who pointed out the need for tutoring in the treatment of the psychotic
person?

REFERENCES
[1] Artiss, K. L. Milieu Therapy in Schizophrenia (New York: Grune & Stratton, 1961
[2] Bleuler, E. Dementia Praecox or the Group of the Schizophrenias transl. J. Zinkin (New York: Int. Univ. Press, 1949).
[3] Kalmus, H. The Scientists Speculates ed. I. J. Gooddr (New York: Basic Books, 1962), p. 276
[4] Marlowe, D. H. The Symptom as Communication to Schizophrenia ed. K.L. Artiss (New York: Grune & Stratton, 1959), p.
99
[5] Mead, G. H. Mind, Self, Society ed. C. W. Morris,(Chicago, Ill.: Univ. of Chicago Press, 1934-1963), pp. 125 XIV
[6] Mishler, E. G. and Scotch, N. A. Sociocultural Factors in the Epidemiology of Schizophrenia, Psychiatry 26 1963 315-351
[7] Osgood, C. E., Suci, G. J., and Tennenbaum, P. H. The Measurement of Meaning (Urbana, Ill.: Univ. of Illinois Press, 1957).
[8] Sullivan, H. S. Schizophrenia: Its Conservative and Malignant Features, Am. J. Psychiat. 81 1924 77-91
[9] Van Der Berg, A. R. The Scientist Speculates ed. I. J. Good (New York: Basic Books, 1962), p. 58
[10] Venn, J. Symbolic Logic, 2nd. ed. (London: Macmillan & Co., 1894).
[11] Whorf, B. L. Language, Thought and Reality ed. J. B. Carroll (New York: John Wiley, 1956), p. 135
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Article Citation [Who Cited This?]

Artiss, K. L. (1966). Language and the Schizophrenic Quandary. Contemporary Psychoanalysis 3: 39-54

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which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever.