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Invited commentary on … Word use in first-person accounts of schizophrenia

  • Edgar Jones (a1)
Summary

The use of pronouns and causal attributions in personal accounts has been analysed to distinguish between schizophrenia and mood disorders. The implications for both cognitive processing and the underlying pathology of symptoms are explored. Context is identified as a key variable in the analysis and interpretation of text.

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References
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1 Fineberg, SK, Deutsch-Link, S, Ichinose, M, McGuinness, T, Bessette, AJ, Chung, CK, et al. Word use in first-person accounts of schizophrenia. Br J Psychiatry 2015; 206: 32–8.
2 Woodman, T. First person account: a pessimist's progress. Schizophr Bull 1987; 13: 329–31.
3 Andreasen, NC. There may be a ‘schizophrenic language’. Behav Brain Sci 1982; 5: 588–9.
4 Andreasen, NC, Grove, WM. Thought, language and communication in schizophrenia: diagnosis and prognosis. Schizophr Bull 1986; 12: 348–59.
5 Gurney, I. ‘There is a Man’. In Collected Poems of Ivor Gurney (ed. Kavanagh, PJ): 153. Oxford University Press, 1984.
6 London Metropolitan Archives. Patient notes of Ivor Bertie Gurney, City of London Mental Hospital, Dartford, 21 December 1922 to 26 December 1937. London Metropolitan Archives, CLA/001.
7 Porter, R. A Social History of Madness, Stories of the Insane: 32. Weidenfeld and Nicolson, 1987.
8 Perceval, JT. A Narrative of the Treatment Experienced by a Gentleman during a State of Mental Derangement (2 vols). Effingham Wilson, 1838 and 1840.
9 Laing, RD. Wisdom, Madness and Folly: The Making of a Psychiatrist: 92–3. Macmillan, 1985.
10 Kapur, S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology and pharmacology in schizophrenia. Am J Psychiatry 2003; 160: 1323.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Invited commentary on … Word use in first-person accounts of schizophrenia

  • Edgar Jones (a1)
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eLetters

The Real Meaning of the experience... to the experienced

Anand Ganesan, Psychiatrist
02 February 2015

Thanks to the Author, on a fascinating and thought provoking commentary. This publication stimulates one to reflect on the way a patient's experience shared with a clinician, is being evidenced currently.

An experience shared is interpreted by the observer or clinician, whois often assumed to purely note down his observation accurately as an evidence. In reality, the observer only sincerely attempts to empathetically understand the one who shares the experience. In this process, how aware is the clinician that his understanding of the experience is coloured by his own experiences, attitudes and values? On the other hand, how unaware is the clinician that his interpretation of the experience may even be limited by his knowledge and current understanding of Psychopathology?

In other words, the skilful clinician beautifully paints a picture ofthe shared experience which finally turns out to be coloured by his own experiences and limited by his own knowledge and understanding. The one who evaluates such an evidence, is merely guided to the image of the experience recreated in the clinician's mind but not to the true experience of the patient.

Only first hand evidences such as verbatim recording of the disclosure of experience, free association art work such as paintings & music and self written accounts & poems could lead one to the mind of the patient. These recordings share the true, unadulterated image;the real meaning of the experience to the experienced. We should not underestimate the true value of these invaluable resources provided by ourpatients on every clinical encounter.

Time not only heals but also changes perceptions, attitudes and values. Ideas once widely accepted and practised as absolute truth a Century ago can now be obsolete. There is no doubt that history will keep repeating itself and it is the logical assumption, on which the whole scientific reality is based upon. We need to open up to this reality that what is held today as robust evidence may not hold its status a Century later. It is our responsibility, to protect the valuable experiences of patients and leave accurate evidences for future reference, as they may shed invaluable insights, a foundation to build new knowledge and better understanding.

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Conflict of interest: None declared

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