Some Thoughts About Language
Russell Meares
THE MAIN PRINCIPLE of the Conversational Model is that beneficial change occurs within and as a result of a relationship. This is a relationship of a particular kind. It is, of course, conducted by means of conversation. The conversation is the therapeutic instrument. The language of this conversation is touched upon in this chapter. Some repetition of points from the previous chapter is necessary. Further aspects of the therapist’s linguistic behavior are considered in later chapters.
LANGUAGE AND THE BASIC DEFECT OF BPD
In working with those with BPD, the conversation is directed toward a correction of the basic deficit in this condition. This deficit, as I propose it (Meares, 2012), is a failure of the maturation of that form of consciousness we call self. Its principal characteristic is cohesion. With this cohesion comes a reflective awareness of inner events, positive feeling, and enhancement of the bodily aspects of personal existing, such as the secure feeling of boundedness. In BPD, these and other aspects of selfhood are ill developed. The fundamental quality of personal existing—a state of coherence and continuity—is impaired. The therapy must have the purpose of fostering the experience of personal cohesion.
Self always involves a relationship. One resembles the other, not quite as mirrors of each other, but having corresponding forms. There is a reciprocal, ongoing interplay between these two main components of personal existing, each constituting, nourishing, and recreating the other. Facilitation of personal cohesion, a feeling of connectedness, arises in a conversation in which this feeling is engendered through being understood.
Ordinary personal existing is a unity comprising numerous states of mind that are linked to relationships specific to those states of mind. Each state involves a particular conversation. We speak in a slightly different way to a parent, a sibling, a child, a lover, the bus conductor, a doctor, and so forth. There is, however, communality among these ways of relating. Self can be conceived, then, as a unified but dynamic organization of a “community of selves.” In BPD, this community is relatively fragmented. Among the fluctuating forms of relatedness are those that cannot be integrated. These states have a traumatic basis.
A HIERARCHY OF LANGUAGE
Therapy begins when the therapist “enters” the conversation offered by a patient suffering from BPD. This conversation is a manifestation of a state of mind. The notion of “entry” implies that the therapist does not stay “outside” this state of mind, but allows it to become part of his or her own state. This fleeting and partial experience, felt as the words of the patient are uttered, is the necessary prelude to a suitable response.
A suitable response is one that engenders the feeling of connectedness. This is not easy in BPD since the sufferer’s state of mind is one of subtle incoherence, which is related to an equally subtle disconnectedness from others. This condition tends to make the other respond in a way that is also disconnected. We find, then, that the therapist working with a patient is in a momentary conflict at the point at which the response is about to be made. There is, first, the sense of the experience “entered,” and secondly, of the need to engage. The former opposes the latter. Having this contradictory awareness, the therapist necessarily experiences a kind of double consciousness. If this double awareness is not in play, the therapist is likely to make a response which, to an observer, might seem appropriate, but which is off-key in a slight but definite way. The most common fault is for the therapist to respond as if within his or her own form of consciousness, which is likely to be at a more mature level than the consciousness with which he or she aims to connect. (It is necessary to stress here that “more mature” refers to a specific and particular thread in the course of development, namely the emergence of selfhood.)
Language has a hierarchical form that resembles, and is part of, the hierarchy of consciousness, relatedness, and feeling (spoken of in Chapter 2). In simplest terms the layers of this hierarchy are comprised of phonology, lexicon, and syntax. Language develops in this order.
Phonology is the fundamental language of humankind. The sounds of the voice, its various inflections and intonations, create the language used between mother and child and between other caregivers who play the proto-conversation game with the child. At about 18 months, the lexicon, the use of single words, begins. Syntax develops over the next couple of years and is clearly established at 4 years of age.
The person suffering from BPD is conceived to be experiencing various and fluctuating forms of dissociation, from mild and barely detectable by ordinary means to frankly dissociative (i.e., disorganized; primary dissociation), or in a state of relative numbness (secondary dissociation). The therapist’s response to these states should be calibrated by the level of the hierarchy of consciousness. The lower down the hierarchy the patient is experiencing him- or herself, the greater the therapist’s reliance on the sound of the voice, combined with a limited lexicon that may be used in a barely syntactical way. The sound of the voice may be the principal source of meaning for a patient on this level of experience.
The kind of calibration needed is suggested by the mother’s responsiveness to her baby. In terms of level, the mother is always somewhat above the baby’s level. She uses words, for example. The fact that her expression is somewhat in advance of her baby’s ability leaves room for movement on the part of the infant to a higher state. For the mother to mimic the baby by staying only at the baby’s level would be to confine him or her to that limited state of mind.
CHRONICLES AND SCRIPTS
Different types of conversational style reflect particular states of mind. In the “brokenupness” of BPD psychic life, fairly distinct states of mind appear in different kinds of conversation. Among these various styles of conversation two are particularly characteristic of BPD: what I call chronicles and scripts (Meares, 1998).
The chronicle is typically a catalogue of symptoms and of problems with the family, with work, and so forth (Meares, 1998, 2000a, pp. 122–123). No part of this chronicling comes from an interior world. The individual is as if stimulus entrapped—experience is dominated by external events. The emotions that are part of this often-prolonged account are negative and reactive. There is no pleasure in the conversation, which instead conveys a sense of deadness, without any creative aliveness. The language is linear, and there is relatively little metaphorical usage.
The chronicle form of conversation can be seen as a manifestation of a depleted experience of self. A script-like conversation is understood in a somewhat different way. It is the form of language that comes with activation of the unconscious traumatic memory system. Intrusion of this system into an ongoing state of mind brings with it a language of a simpler kind, lower in the hierarchy. It is repetitive and dominated by the negative affect associated with the trauma. The voice may become shrill and harsh. The same body movements—for example, a chopping of the hand—recur with each acting out of the traumatic script. This script may be triggered by something that occurs in the session. The script is often a recital of a recent event; the account is one of the “facts” of this occasion. These so-called facts are not linked to the individual’s past but are told as if the trauma, say, devaluation, has been inflicted anew. This stunted story barely changes in its various repetitions.
RIGHT-HEMISPHERIC LANGUAGE
The therapeutic aim is to transform these traumatically based conversations into those more nearly having the structure of narrative. A properly told narrative involves a coordination between the two basic language forms that make up human conversation. The language sometimes called social speech is, in the ordinary sense, logical. It is linear, capable of proposition formation, and generally dependent upon left-hemispheric function.
The second kind of language, inner speech, is characteristically analogical and emotional. It is demonstrated both by the mother’s talk in the protoconversation and by the child’s chatter in conversational play. It is presumably dependent upon right-hemispheric function.
The language of succession, the left-hemispheric form, is essentially that of the chronicle. This style of conversation, when dominant, suggests that the individual is relatively deficient in right-hemispheric function. Indeed, we are proposing that this deficiency, or hypofunction, is the main basis of the reduced sense of personal cohesion in BPD.
The two axes of language, the logical-successive and the analogical-simultaneous, are equivalent to Saussure’s (1916) axes of the diachronic, which has the time of chronology, and the synchronic, which is the time of the moment. These axes are figuratively disposed as if at right angles to each other. People with BPD seem to be caught in the zone of the diachronic.
These remarks lead to the notion that a principal aim of therapy for BPD is stimulating right-hemispheric function. Using the models of the protoconversation and symbolic play, we infer that this activity necessarily takes place in an atmosphere of safety, one in which the fight–flight system, which is active in BPD, is relatively quiescent.
The right hemisphere may be stimulated when, as it were, it is spoken to in its own language. The conversation then has the form, figuratively speaking, of one right hemisphere conversing with the other.
Function of the right hemisphere is crucial to the development of self. Early in life, the right hemisphere is developing faster than the left. This development is “experience dependent” (Schore, 2003): That is, it develops as a consequence of those aspects of the mother–child relationship involving mutual emotional communications—what I call analogical relatedness. The mother’s manner of responding in these situations seems to be designed to stimulate and resonate with those capacities for which the right hemisphere is innately set up (see Meares, 2012, Chapter 15).
The nursery-school child has a language very like a person who is functioning mainly by means of the right brain. It is a language of immediate reality. Conversation with the child “is fitted into the world of objects, interpersonal acts, and events, all of which sustain the meaning of what is said” (Trevarthen, 2004, p. 878). The propositional structure of left-hemispheric language does not fit well with this state of mind. The left hemisphere, however, at this stage of development begins a maturational surge, soon becoming larger than the right hemisphere. At about the age of 5, the two halves of the brain become more truly coordinated and the conversation of the child is now also a coordination, comprising the two language forms. The syntactical language of the left hemisphere is the vehicle of another language that is more emotional and figurative, characteristic of right-hemispheric function. The latter aspect of BPD conversation is relatively lacking, consistent with the evidence that BPD is a particularly right hemispheric disorder.
Right-hemispheric language is characterized by the following features. It is:
• Relatively asyntactical: The language does not follow the order typical of more linear-type speech.
• Abbreviated: The language tends to omit the subject of a sentence, including pronouns. Only the predicates remain, as Vygotsky observed in studying the child engaged in symbolic play (e.g., “goes down there” or “down there” or even just “down”).
• Emotional: The interactions and inflections of the voice carry emotional expression, with the right hemisphere being particularly sensitive to the “meaning” of musical sound.
• Shaping: The language represents the “shape” of the overall feeling of a presented reality; it has a synthetic function.
• Figurative: In making “shaping” responses the therapist is providing analogies that can be developed into metaphor. The right hemisphere is involved in both an awareness of metaphor and its expression.
COHESION, REFLECTION, AND THE THERAPEUTIC SCREEN
Cohesion is fostered by the use of right-hemispheric responsiveness. An effect of cohesion is the enhancement of the reflective capacity. Reflection is further potentiated by a particular language form that is grammatically impersonal. The thoughts and words tend to be directed to a space between the conversational partners. It is as if they are gazing at an invisible and metaphorical screen, where a jointly created “movie” is being projected, its images only dimly perceived (Meares, 1983).
This kind of language emerges in a spatial reconfiguration of the therapeutic conversation that begins as a two-person arrangement. The shift to the reflective mode tends to set up a new arrangement in which the conversation is not directed at each other but is as if directed toward a third thing, the invisible “screen.” A dyadic situation becomes triadic. Examples of this kind of language include phrases such as “It looks like . . . ,” “It seems that . . . ,” “There is a sense of desolation . . . ,” and so forth. That is, the construction is impersonal. In this joint metaphorical gazing, the therapist is an auxiliary “I,” working with the subject as “I,” to enhance the “view” into his or her world. This joint gazing might be seen as a forerunner to the reflective process of the individual.
Integrating Pronouns
The therapeutic conversation takes a number of forms, each of which reflects a different kind of relatedness. The previous sections suggest that a language that is without pronouns is conducive to the generation of the consciousness of selfhood. But this is not to say that the therapist’s language is always of this kind. The language necessarily shifts to one in which pronouns are used, analogous to the protoconversation when there is a switching back and forth between face-to-face gazing and gazing away. The aim of the therapeutic conversation is not to have a conversation limited merely to right-hemispheric functions but to have one in which there is a coordination of left and right hemispheres. The generative process, however, necessarily begins with the right-hemispheric type of conversation.
The situations in which pronouns are used are several. One is a “reflection upon reflection.” That which emerges in reflection is spoken of in a different way, in this way enlarging the experience. Clearly, those conversations involving the more practical aspects of the therapeutic relationship are spoken in the ordinary way, using pronouns.
Pronoun usage implies a clear differentiation between self and not-self. A conversation conducted exclusively in this way is less than conducive to the “picturing” of interior life. Premature introduction of this kind of reflectiveness breaks up a flow of thought and is counterproductive. A typical conversation is conducted in alternating modes of what James likened to “flights” and “perchings,” making an analogy between the movement of thought and the flight of a bird. The state of flight is expressive; that of perching is reflective. It is the flight element of thought—its capricious, wandering course—which shows its cohesion. It is, therefore, the more fundamental of the two states when these metaphors are considered in the therapeutic setting.
QUESTIONS
As a general principle, questions are avoided because they set up the kind of relatedness that is the opposite of that toward which the therapist should be working. Questions tend to enhance a sense of disconnection. It is, of course, impossible completely to avoid questions, particularly as they concern the facts of the patient’s life. These questions are most suitably asked at a point that is relevant to the conversation.
For the most part, however, the therapeutic conversation is of a personal and emotional kind. Formulaic questions such as “How did that make your feel?” are felt as distant from the patient’s experience. They are often irritating. Not infrequently, in the case of those with BPD, they evoke anger.
It is the therapist’s job to try to understand the patient’s experience, using the capacity for empathic imagination. This is followed by attempts to represent this understanding. It is often speculatively expressed, giving the patient implicit encouragement to modify, elaborate, or correct the representation. The speculative style depends on phonology, or the sound of the voice, to a significant degree.
THE PRESENT MOMENT
Much of the work in therapy involves changing a traumatically based form of consciousness, which is split off from the ordinary sense of being, into another kind of mental life that can be integrated in the stream of self. A cardinal characteristic of self is the capability to create scenes in the “mind’s eye” that come from memory or imagination. The movement of the therapeutic conversation, then, is toward this scene-making propensity of mind.
In traumatic consciousness, there is limited evidence of visualization of interior life. Events are described in terms of their facts. The words used have little figurative power, are not evocative of “pictures” of these facts. There is a sense of these events being spoken about—and “aboutness” is to be avoided.
In order to change a conversation of aboutness, for example, the patient talking about the parents who were always putting him down, the experience needs to be sensed as if it were in the present rather than the past. The therapist tends to respond to such stories by speaking of them in the present tense. This has the effect of translating these events from those experienced in left-hemispheric mode into the “momentary” and more emotionally alive right-hemispheric zone of experience. (The terms of “right” and “left hemispheric” are used as shorthand, a way of talking about complex operations in which both hemispheres are involved.)
THE FUTURE
Selfhood involves the visualization of future events, which can only be imagined. When the patient begins to use words such as should, ought, or could, suggesting the possibility of actions different from the past, a milestone in the development of self is reached (Meares & Sullivan, 2004). The therapist does not introduce these terms, but when they appear spontaneously they can be a starting point for the creation of a scene that might contribute to changing the traumatic script.
NATURALNESS
The capacity for conversation is one of the abilities with which we have been naturally endowed. This aspect of our biological heritage is enormously complex. In this brief space only some of the most salient features of the therapeutic conversation with someone suffering from BPD have been addressed. Each conversation with each person with this condition is unique. Only a certain and limited selection from such a multiplicity of forms is possible here. There is one feature, however, that should remain in all these various conversations: the therapist’s naturalness. The therapist should hone and develop, in a disciplined way, his or her own style. A central aspect of conversation, as it is defined, is that it is “familiar” language. It is in the domain of the familiar that self is generated.