Language of depression?

“People with depression use language differently – here’s how to spot it” informed us an article from The Conversation. I don’t believe this for one second (like: that’s nonsense), so I decided to investigate. Here are the results of my investigations.

The article in The Conversation is based on a recent study and reports on another piece of research which I, a linguist, find very difficult to accept. Obviously, I am particularly interested in the language part of the study, but before I comment on it, let me just offer a couple of methodological points. First, the assumption that only people with/in depression write on fora devoted to depression, as the authors seem assume, is, I’m sorry to say, nonsense. There is absolutely no reason (I’m doing absolutist thinking here apparently) to assume that such fora cannot be frequented by families, friends of people in depression, let alone people simply interested in it (but the authors seem to be somewhat aware of problems here). The authors, further, seem not to care about the fact that ‘depression’ is used very loosely today and may have practically nothing to do with the depressive episode. Incidentally, they seem not to care (just as psychology in general) about the fact that people who write on such fora are likely to have relatively high literacy levels.

Finally, what really irritates me is the simplistic assumption that there is a simple relationship between word use and thinking. Given that half American communication studies (social psychology of language/communication) have over the years focused on various aspects deceptive communication, you would think  that psychology would be somewhat more cautious about saying that if you say something, it means you think something.  Wouldn’t you?! But even if it is possible to postulate that language does offer insight into what we think, such a relationship is much more than likely to be far more complicated that simply assuming that if you use a word or two, it means you think something.

Now, let’s focus on the heart of the study – the absolutists words. Here they are:

absolutely, all, always, complete, completely, constant, constantly, definitely, entire, ever, every, everyone, everything, full, must, never, nothing, totally, whole

There are a couple of problems with this list. The idea that this ‘absolutism’ can be achieved only through the use of certain words makes no sense at all. How about checking for:

  • at no time
  • don’t hold your breath
  • forget it
  • nevermore
  • no way
  • not at all
  • not ever
  • not in any way
  • not in the least
  • not on your life
  • not in a million years

and that’s just for ‘never’!! So, here’s the first problem. Without understanding that constructing the world in ‘absolutist’ terms can be achieved in a myriad of other ways, there is really hardly any point in studying ‘absolutist’ thinking. Yes, the research showed a difference in using certain words, but not much more.

There is more, I’m afraid. The authors seem to assume that ‘absolutist thinking’ can (only?) be expressed with the use of 19 words, which makes absolutely no sense (can you see my ‘absolutist thinking’ here as well?). The assumption that referring to something that will never happen can only be done with the use of the adverb ‘never’ should never (I’m doing it again) be made. Let’s put it differently, given that ‘absolutist thinking’ can admittedly be expressed by quite a number of means, what evidence is there for people in control groups not expressing it?

But then comes another problem. Let’s take ‘never’ again. Just as in studies of suicide notes where ‘never’ is assumed to be indicative of ‘all-or-nothing thinking’ (I have written about it in an article in Death Studies), also here ‘never’ is apparently indicative of absolutist thinking. But is it?

What never ceases to astonish me is that words in psychology (and psychiatry) tend to be assumed to have only one function: to represent some psychological reality of the speaker/writer. Thanks to that, the psychologist will come and like with a combine harvester, reap the words that will simply reveal what their author was thinking. Somehow normal communication rules somehow stop operating and, for example, people are not able to use emphasis, which is a common function of the use of extreme qualifiers such as ‘always’ or ‘never.’ And yet, experience tells us that people use emphasis or exaggeration in ‘emotional’ situations, when they argue, break up, scold others, or simply want to ‘score one’. And if we took every, say, marital ‘I’ll always hate you’ or ‘I’ll never speak to you again’ seriously, human relationships would be just about impossible!

Moreover, by focusing on words which have been taken out of their context, the authors have ignored the fact that what people say can be self-presentational, persuasive, rhetorical. Indeed, the authors offer no insight into what kind of texts the words come from. Surely, ‘never’ used in a statement is different from ‘never’ used in a request, and yet different in a question. I do wish psychology (and psychiatry) started looking at more than lexical material. Surprisingly, words are used in clauses and are used for a variety of goals.

In other words, next time, you use the phrase ‘language matters’, can you please mean something more than the dictionary? If you don’t believe me, try taking a dictionary of a language you do not speak and start communicating. I don’t think it will be particularly surprising to you to learn that you will not be able to. And yet, despite this, the psych-disciplines continue to talk about language referring only to the dictionary. It really (like, really) doesn’t make sense!

OK. With all this, it’s time to address one more thing. The authors did achieve a result. They did show a difference in use of a particular group of words between particular theme-focused internet fora. What did they show?

Well, it’s easier to say what they didn’t show. What they didn’t show is that lexical material can be used as a marker of depression. For the reasons I showed above, the likelihood that the use of the ‘absolutist words’ will show up depression is, to be honest, just about zero.  There is zero evidence of a causal relationship between depression and the use of certain words. Just as there is no evidence at all that there are other linguistic markers of depression (I’ve written about it before)

What they might (I stress ‘might’) have shown, I think, is that there are certain talking practices. It is unclear, however, whether these practices are of talking about distress in general or about certain kinds of experiences (such as depression). But there is significant difference between talking about depression and talking with/in depression as both, incidentally, are subject to all sorts of social pressures.

Before I finish, I would would like make one more point. The Conversation article says:

It will surprise no one to learn that those with symptoms of depression use an excessive amount of words conveying negative emotions, specifically negative adjectives and adverbs – such as “lonely”, “sad” or “miserable”.

Well, it will surprise me quite a lot. When I interviewed men with a diagnosis of depression, it turned out that none ever (I want to stress it: none ever) talked about being sad or miserable. I didn’t find anything that even vaguely referred to their mood. Why? Again, it’s hard to know. Maybe it’s because I didn’t expect them to talk about mood and I let those men simply tell me about their experiences. For I keep wondering to what extent we find ‘mood words’ because we look for them and we ask questions requiring them, while depression experience is way more complex.

Similarly, I simply cannot understand the insistence of psych-people (including the authors of the research) to talk about about positive and negative emotion words. Once again, it makes no sense at all (yes, yes, absolutist thinking, I’m sure). For example, I am yet to be convinced why the verb (or is it the noun?) ‘love’ is necessarily labelled a positive emotion. When I was reading my corpus of suicide notes, time and again I thought that love is spoken of as a curse. Something like: ‘You don’t love me anymore, I can’t live without you. So I must die.’ That is hardly positive, is it? Indeed, people can say/write things like ‘Unfortunately, I still love you.’ quite explicitly positioning their love as something unwanted and, in the context, negative. And yet, the word ‘love’ is consistently coded as ‘positive emotion’. Like hell it is.

Incidentally, I’m also quite sceptical of evaluating emotions. The apparently negative anger can actually be a goal of psychotherapy, making it, presumably, quite positive. Similarly, I fail to understand why emotions are consistently assumed to be expressed by ‘emotions words’, just like, say, anxiety only by ‘anxiety words’ (the term actually used in the literature).  I very much doubt that ‘anxiety words’ are used exclusively to express anxiety, much like ‘anger words’ are unlikely to be used only to express anger. The reverse is also doubtful. I don’t think anxiety or anger are expressed only by ‘anxiety words’ or ‘anger words’. In other words, let me press the point, the idea that emotions are miraculously linked to emotion labels is nonsense (I made this argument in some detail in the book on Men and the Language of Emotions).

Conclusions? Here you are. Language is not only words. Words are used in context. Communication is goal-oriented. There are no ‘absolutist words’. Language of depression? No!

Will you ever listen? Never!

 

3 Comments
  1. Prospero Radomsky

    Psychiatrists are not linguists, with perhaps a few exceptions, however language is an important tool of communication in psychiatry. I have listened to people in various states of distress and their use of language changes as they proceed from crisis to recovery. People who are depressed tend to reflect this frame of mind in their conversation and it could be said, that as they recover their health, their language becomes more optimistic. The internal dialogue of what depressed patients say to themselves can be brutal and often reflects catastrophic thinking. Language provides insight into mental states, which is an important clinical tool. A schizophrenic patient for example may use word salad and coin neologisms only understood by him, or use fewer pronouns, etc. We do our best and all of us use language in subjective and creative ways, some of keen interest and importance to psychologists, neuroscientists, and various professionals endeavoring to help the mentally ill.

    1. Dariusz Galasinski

      Thank you for your comment. At face value, it is difficult to disagree with it. Problems start when you begin to unpick what you say. For example, when you say “Language provides insight into mental states”, I don’t really know what it might mean. For example, does it mean you read of ‘mental states’ off language? Surely, that’s impossible to say. There is no evidence that, say, people in depression speak in a particular way and, even if there were, what the source of such patterns might be.

      But let us assume that, indeed, patients with the dx of scz do use fewer pronouns? Here are two questions:

      a. Fewer than who? Patients? Academics? General population? At what education level? What class?
      b. What is the source of such a pattern? Is it ‘schizophrenia’? or is it the expectations of the clinicians who pick on the pronouns?

      I don’t think there are answers to such questions, and not by a long way. Moreover, I tend to think that research into the language of people with dx of scz mostly achieves stigmatisation, showing their language mostly in terms of deficits which are imagined by those who assess it.

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