Schizophrenia videos
21 Sep 2008, 10:42 pm
Edited to add: When I say "you" here I don't mean Mike, I mean you-general.
Interestingly enough, many kinds of aphasia (there are more kinds than most people know about) involve the misuse of words. Some can even involve 'word salad' which is a term also used in psychiatry for describing a form of 'thought disordered' speech. However, aphasic people are not normally considered to have a 'thought disorder' just because they have a language problem.
Also, I have seen the different forms that so-called 'thought disorder' can take, which are many. Some (not all) of them are quite common in autistic people, and yet autistic people are known, also, to have language problems.
Here's the list of language thought to be indicative of "thought disorder" on Wikipedia, said to come from someone called Nancy Andreasen:
* Distractible speech - During mid speech, the subject is changed in response to a stimulus. e.g. "Then I left San Francisco and moved to... where did you get that tie?"
* Tangentiality - Replying to questions in an oblique, tangential or irrelevant manner. e.g:
Q: "What city are you from?"
A: "Well, that's a hard question. I'm from Iowa. I really don't know where my relatives came from, so I don't know if I'm Irish or French."
* Derailment/Loose Association (Knight's move thinking) - Ideas slip off the track on to another which is obliquely related or unrelated. e.g. "The next day when I'd be going out you know, I took control, like uh, I put bleach on my hair in California."
* Incoherence (word salad) - Speech that is unintelligible because, though the individual words are real words, the manner in which they are strung together results in incoherent gibberish, e.g. the question "Why do people believe in God?" elicits a response like "Because he makes a twirl in life, my box is broken help me blue elephant. Isn't lettuce brave? I like electrons. Hello, beautiful."
* Illogicality - Conclusions are reached that do not follow logically (non sequiturs or faulty inductive inferences). e.g. "Do you think this will fit in that box?" draws a reply like "Well duh; it's brown, isn’t it?"
* Clanging - Sounds, rather than meaningful relationships, appear to govern words. e.g. "I'm not trying to make noise. I'm trying to make sense. If you can't make sense out of nonsense, well, have fun."
* Neologisms - New word formations. e.g. "I got so angry I picked up a dish and threw it at the geshinker."
* Word approximations - Old words used in a new and unconventional way. e.g. "His boss was a seeover."
* Circumstantiality - Speech that is very delayed at reaching its goal. Excessive long windedness. e.g. "What is your name?" "Well, sometimes when people ask me that I have to think about whether or not I will answer because some people think it's an odd name even though I don’t really because my mom gave it to me and I think my dad helped but it's as good a name as any in my opinion but yeah it's Tom."
* Loss of goal - Failure to show a chain of thought to a natural conclusion. e.g. "Why does my computer keep crashing?", "Well, you live in a stucco house, so the pair of scissors needs to be in another drawer."
* Perseveration - Persistent repetition of words or ideas. e.g. "I'll think I'll put on my hat, my hat, my hat, my hat, my hat..."
* Echolalia - Echoing of one's or other people's speech that may only be committed once, or may be continuous in repetition e.g. "What would you like for dinner?", "That's a good question. That's a good question. That's a good question. That's a good question."
* Blocking - Interruption of train of speech before completion. e.g. "Am I early?", "No, you're just about on-"
* Stilted speech - Speech excessively stilted and formal. e.g. "The attorney comported himself indecorously."
* Self-reference - Patient repeatedly and inappropriately refers back to self. e.g. "What's the time?", "It's 7 o'clock. That's my problem."
* Phonemic paraphasia - Mispronunciation; syllables out of sequence. e.g. "I slipped on the lice broke my arm."
* Semantic paraphasia - Substitution of inappropriate word. e.g. "I slipped on the coat, on the ice I mean, and broke my book."
Now, the ones most obviously occurring in autistic people are echolalia, sometimes "blocking" (due to word-finding problems), perseveration, circumstantiality (it's especially commonly described in literature on AS), stilted speech, tangentiality (especially again in AS literature) and neologisms. (I've heard all of these phenomena frequently referred to in autism literature, sometimes by those names, sometimes by others.)
Semantic and phonemic paraphasia are also symptoms of some kinds of aphasia, and can occur in autistic people with language trouble (basically getting words or word-sounds mixed up). Word approximations I've seen a lot of autistic people do. I remember in a video of Tito they talked about him always moving the topic back to himself (self-reference). I think I've see "pressured speech" referred to somewhere, especially when it takes a huge amount of energy to get words out, some people build up a lot of momentum and have trouble stopping.
And basically... I've seen nearly all of these in autistic people, people with aphasia, people with language-related learning disabilities, and people with a whole lot of other things going on. In anyone who isn't considered psychotic, most of the above things are not considered anything but a language problem, and in fact some of them are named by the same name in discussion of language disorders of various kinds.
It doesn't seem to me a very good idea, that when someone is diagnosed with schizophrenia, you just automatically assume that their thoughts are disordered based on these speech patterns. Why assume it with them when you don't assume it with people with a huge variety of other conditions that cause the exact same things? Sure, it could be a 'thought disorder', but it could be a lot of other things, and I think professionals would do better to keep an open mind there instead of assuming.
Yes, many people diagnosed with schizophrenia have obvious non-language-related cognitive problems, but just because they have some cognitive problems doesn't mean the rest of them are necessarily anything but language problems. This kind of assumption led also to people assuming that people with Alzheimer's and other dementia lost their memory a lot earlier than they actually do in brain scan studies -- it turns out they have more cognitive functioning and memory than previously believed, it's just that language-based communication is often one of the things badly affected at that stage.
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"In my world it's a place of patterns and feel. In my world it's a haven for what is real. It's my world, nobody can steal it, but people like me, we live in the shadows." -Donna Williams
21 Sep 2008, 11:56 pm
I do / have done all those things in anbuend's post, but this in particular caught my eye:
Because when I've done this type of thing, in my case it hasn't been that I actually think that (in this example) the color of the object or box has anything to do with it fitting, but that I can't find the words to refer to size - and so, rather than pause or fumble, I go immediately to some other word.
The other word I go to can be another attribute of the situation (such as the color of the object or box), or it could be a random word, but it has to do with word finding difficulty combined with momentum. In my case, anyway.
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22 Sep 2008, 9:28 am
I think it's very important to actually ask people with schizophrenia what they were thinking when they were speaking in a "disordered" fashion. Some will say "I knew what I meant to say, but it came out wrong" or "I couldn't figure out how to start/stop talking"; others, something like "I wasn't able to stay on track" or "I thought I was making sense; but I actually wasn't". That's from the books I've read--no actual papers, yet; I'll probably get to some of that when my schoolwork here quiets down a bit and I can plunder the periodicals section again.
You do have to be sure that they're not repeating what the doctors told them about themselves when you interview them, though. Also, not everybody will have easy access to memories of disorganized episodes... and of course there's the fact that being on medication will cause confusion and "thought disorder" all by itself, in many cases. (It did for me. Haldol just about limited me to short little toddler-like sentences. Thankfully I only ever got that in the hospital, and only once. I'm very lucky my meltdowns look like crying spells and not psychosis.) Hopefully many people grow accustomed to medication and the side-effects clear up after a while... Still, it does complicate proper data-collection.
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23 Sep 2008, 1:05 am
On all my psych evals im either diagnosised with bipolarschizoaffective or schizotypal w/an affective disorder, as well as and asd and assortment of other things and i have schizo friends as well. The media portrays schizo disorders very inacturatly. The guy on the first video is a good example of someone who is severely psychotically active, but the doctors made him look worse than he is by saying he isnt making sence when you can make some sence of what he says even though his speach is disorganized and he is smart because he sayd things that most people just cant understand like how you can put your mind in a single molicule. sometimes i say random things meaning to say something else but i dont usually do that but i might say something like i cant reach the dishes instaed of im want some tacos. it is at times hard to think clearly and i have mood swings. i rarly hear voices but some people do and when i do i usualy cant make sence out of what its saying and it sounds like i cant understand it and i get thoughts that arent mine telling me to do things but i ignore them and i have weird preceptions that make me dissicotated and something everything looks like its made of a fake reality but i understand how it all works. i go to college and am in a professional band and am a music teacher and i am working on being a paranormal investagater. How do you know that the crazy ones are really crazy. theyve just opened to something others have not and the normies are the real crazys because theyre delusional that my delusions are actually delusions and not reality becuase everyone is in there own reality. The only thing i shouldnt do is drive unmedicated because i used to do that and lost my licence and was very impulsive and would drive on the shoulder 100mph on the highway in traffic jams holding down my horn and swerve towards other cars running over s**t and i would only do that stuff sometimes but not always. I am now going to school and plan to became a teacher at a school. I can take care of my self just fine.
23 Sep 2008, 12:50 pm
I didn't watch the videos, but the molecule part reminds me of Daniel Fisher. He is a psychiatrist diagnosed with schizophrenia. He had been a scientist, and eventually came to believe that he was the molecules he was looking at. He advocates for pretty much total reform of the psych system.
_________________
"In my world it's a place of patterns and feel. In my world it's a haven for what is real. It's my world, nobody can steal it, but people like me, we live in the shadows." -Donna Williams
