The language of schizophrenia and the world of delusion

The bizarre language of schizophrenics is nowadays generally believed to be the meaningless breakdown product of a neurobiological disorder. The psychological significance of hallucinations and delusions also remains mysterious. Verbatim vignettes are presented from an advanced stage of a psychoanalytically informed treatment to illustrate that schizophrenics speak a meaningful language that is syntactically and morphologically similar to ordinary language, but is qualitatively different in terms of semantics and pragmatics. From a semantic perspective the ordinary distinctions between words, things, body states and actions are absent, creating words and sentences that are not representational or symbolic. It is a language of equivalence, immediacy and action as contrasted with a language of self-awareness, thoughtfulness, reflection and communication. From a pragmatic standpoint, because the language of schizophrenia makes no distinction between mind and world, it enables and supports delusional thinking. In order for the psychoanalyst to comprehend what the patient means, and couch interpretations in such a way as to convey the meaning he/she intends, analyst and patient must become aware of their inability to comprehend one another's languages and find a way to bridge the communication barrier.