Academic journal article American Journal of Psychotherapy

Book Reviews -- Coherence in Psychotic Discourse by Branca Telles Ribeiro

Academic journal article American Journal of Psychotherapy

Book Reviews -- Coherence in Psychotic Discourse by Branca Telles Ribeiro

Article excerpt

BRANCA TELLES RTBEIRO: Coherence in Psychotic Discourse Oxford University Press, New York, 1994. 320 pp., $49.95, paper $22.00.

Sociolinguistics, the study of language use, serves in this book to examine the baffling interactions between an acutely psychotic patient and her therapist. The patient was a middle-aged Brazilian woman who suffered from recurrent manic episodes with catatonic features. Ribeiro presents two detailed samples of discourse; comparing the deviant talk and interactions that characterized the patient's psychotic state and then the "normal" discourse after treatment. She demonstrates that psychotic verbalizations can only infer disordered thought processes. The reader has to deal with the fact that these sessions are translated from Portuguese and the encoding (transcription convention) markings are a language of their own.

The analysis of the interview when the patient was acutely psychotic shows in detail how and why the discourse coherence fails. I found the discussion and review of formal thought disorder to be very informative and clinically relevant. Psychiatrists classify thought disorder into "form of thought" as well as "content of thought." Sociolinguistics identifies some 18 subtypes of thought disorder and discourages the use of the term "thought disorder" as if it were a homogeneous entity. Schizophrenic speakers can be differentiated by the poverty and tangentiality of their speech, while manic patients present mainly derailment (looseness) and pressure of speech. Ribeiro notes that aphasic patients also manifest language disorders which should be noted when considering differential diagnoses. The author is relatively uninformed clinically and this weakness is most notable when she attempts to outline the diagnostic and psychodynamic features as well as the psychopharmacological management of such patients. …

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