Talk about talk: metacommentary and context in the analysis of psychotic discourse

This paper presents an analysis of an interview with a manic patient at a time when her discourse seemed incoherent. It addresses itself to the interface between discourse and context, and argues that adequate contextualization of discourse can render incoherent speech more understandable. Appraisal of context and analysis of metacommentary--speakers' references to the ongoing talk--makes apparently incoherent discourse intelligible, and gives access to the patient's experience of her illness. The implications of discourse analysis for psychiatric research are explored. General goals for discourse analysis in psychiatric settings are suggested, and strengths and weaknesses of the approach discussed.