Sticks and Stones: On Linguistic Trauma
‘Sticks and stones may break my bones, but words will never hurt me.’
This adage was common in my childhood. After many years of psychological and linguistic research, I feel it could not be more wrong. We have long understood that language influences thought, and the ways in which people speak to others carry enormous potential for both good and harm.
In this piece, I want to speak briefly about the linguistic environment in which I was raised, where language often functioned as an instrument of control rather than care. After offering some examples, I want to suggest that people with schizophrenia and other neurodevelopmental conditions may be particularly vulnerable to unhealthy linguistic environments. I believe that more attention, in both research and clinical practice, should be paid to the relationship between communication and clinical outcomes. I touch on this to some extent in my latest—and final—Schizophrenia Bulletin first-person account, Language Under Pressure: Communication, Agency, and Recovery in Schizophrenia.
Both of my parents are people with a high need for control. This is not a moral judgement. They grew up in dysfunctional environments themselves and most likely inherited many of these behaviours. I do not view their actions as calculated acts of manipulation undertaken with full metapragmatic awareness. Rather, I think they learned, through reinforcement, that certain linguistic constructions and associated interactional behaviours induce compliance.
Take, for example, my mother’s use of the phrase: ‘Don’t you want the bookcase on the right?’
This followed an exchange in which she indicated that it was important to place a bookcase in my bedroom. I obliged, despite having no interest in a bookcase myself, to keep the peace. When I placed it where I felt it would look good, the question arose.
As a linguist, it stands out for a few reasons.
‘Don’t you want the bookcase on the right?’ appears, on the surface, to be a question about preferences, akin to ‘Where do you want the bookcase?’ But it functions very differently. ‘Don’t you’ or ‘do you not’ carries a loading, an expectation, and indicates that not wanting the bookcase on the right would somehow be incorrect.
There is also something else worth considering: her implied preference—for the bookcase to be on the right—is grammatically organised as though it should also be mine. The effect on the listener, at the psycholinguistic level, is essentially to trigger the question: ‘Why do I not want the bookcase on the right?’ From there, agency takes a back seat. Instead, a series of deliberations and justifications must arise to argue the case for the bookcase being on the left, alongside questions about whether it is reasonable or unreasonable to resist the expectation that it should be on the right.
You may, at this point, feel that I am reading too much into the linguistic structure of this phrase and the many ways it can be parsed and interpreted. This is partly what linguists are good at, and perhaps partly excessive.
But the point I am trying to make is that this question, while loaded in a bookcase-on-the-right direction, is not really a question at all. It is a compliance test. An instruction disguised as a question.
We can tell this from the consequences of expressing a genuine preference that resists the loading. When I replied, ‘No, the left is fine,’ the response involved nonverbal expressions of frustration and a series of punishments: the silent treatment, huffing and puffing, storming off, and slamming things.
Answering the question ‘incorrectly’ carried relational consequences.
This type of communication was persistent throughout my childhood. I was required to remain vigilant not only to what was said on its face, but to what was implied and what the consequences might be for ‘getting it wrong’. I learnt to process implied meaning more quickly than literal meaning. I learnt to keep myself safe, and in doing so I abandoned many of my own preferences and much of my agency.
I suspect that this linguistic environment may have contributed to the paranoid form my schizophrenia took. I do not mean that the linguistic pressures I grew up under caused schizophrenia itself. Rather, I wonder whether my longstanding vigilance towards implied meaning interacted with my core schizophrenia symptomatology, shaping how the condition manifested.
I became a student of language and linguistics partly to reclaim my agency: by telling stories, by writing, and by understanding the mechanisms through which meaning influences thought.
My father had a different linguistic style, but it was nevertheless equally preoccupied with control and compliance. He would speak over opinions he disliked by raising his voice and invoking my name. He would issue instructions openly rather than modifying them grammatically, as my mother did. He favoured tag questions appended to statements in ways that disguised their directive intent: ‘You will do X, won’t you?’ or ‘You won’t forget Y, will you?’
In many ways, his approach was easier on my cognition, but more directly controlling. My mother, on the other hand, was more discreet and required more mental effort to navigate.
One of my personal favourites, from an analyst’s point of view, is: ‘Don’t tell people you’re on benefits. They’ll laugh at you.’
I think back to this often, because I did not hear anything about people laughing at me in that phrase. I instead heard: ‘Don’t tell people you are on benefits. They will laugh at me.’
But instead of owning the fear, it was relocated in me. Much as my mother’s preferences about the position of a bookcase were located in me.
When I look back at these and many similar interactions throughout my life, I find myself wondering how many of my preferences, habits, and beliefs are actually mine. Given that I spent so long under a form of linguistic pressure that forced me to suppress my own desires and preferences in order to keep the relational peace, who am I?
Perhaps I am only now beginning to realise and explore that.
The effect of trying to find a way through the world while exposed to these equally suffocating, but ultimately quite different, forms of coercion made me incredibly sensitive to language and its power. It is why I am so careful with my words around my daughter.
When I interviewed fifteen people diagnosed with schizophrenia for my doctoral research, I noticed that most, if not all, were incredibly hesitant and careful in their use of language. In some cases, I could make out the sounds of relatives outright abusing them during the interview.
One man had to end our discussion because, if he did not cook his mother’s breakfast, she would become ‘a bit very angry’. The same man was interrupted mid-sentence when he began, ‘I’m—’
The other party offered: ‘Stupid?’
It is not a popular idea in mainstream psychiatry to suggest that people with schizophrenia may be made worse by the linguistic environments in which they are situated. Perhaps this is partly because of a legitimate fear that attention will turn once again towards parents and siblings, and that concepts such as the ‘schizophrenogenic mother’ or Bateson’s double bind will be resurrected.
These theories have a difficult and damaging history. But in rejecting crude and blame-laden accounts of family causation, I wonder whether psychiatry has sometimes become too reluctant to interrogate the communicative environments in which psychosis develops, persists, and recurs.
I am here to suggest that we should look at those environments, unapologetically.
Approaches such as Open Dialogue have renewed attention to relational and communicative contexts, while work on pragmatic rehabilitation—including Professor Valentina Bambini’s PRAGMACOM initiative—raises important questions about whether aspects of pragmatic functioning can be supported and rehabilitated.
If pragmatic abilities can change through intervention, then we should at least be willing to ask how the pragmatic difficulties observed in schizophrenia emerge. Which aspects are related to the illness process itself? Which reflect neurodevelopmental vulnerability? Which are shaped by repeated interaction across the life course? And how might these processes interact?
We should not be frightened of interrogating the communicative environments of patients with serious mental illness.
I think we owe patients a duty of care to do so.
