Psychogenic Disturbances in a Linguistically Strange Environment

Abstract

In the course of several years of work in several military hospitals I was able to observe three examples of an apparently psychogenic condition which seems to me worthy of report. As far as I can determine, nothing similar has been described in the literature as yet. Referred to is a syndrome which on the basis of its structure as well as its probable genesis appears to be closely related to the psychosis of persons with defective hearing which Kraepelin (1909–1915) describes. Just as a person who is deaf or hard-of-hearing is unable to understand the utterances of those about him, being forced to interpret their gestures and other behavior as best he can, anyone who is in the midst of persons speaking a language he fails to comprehend is in a similar position. He too is compelled to guess, forming his impressions on the basis of information of various sorts. One might well suppose that the person lacking knowledge of the language being spoken is better off than the one with a hearing defect; for although he fails to grasp the words, he may still succeed in drawing conclusions on the basis of what he hears. He can determine if his name is being mentioned and whether others are talking about him, whereas the person with hearing insuffiency could suspect this at any time. Also, he can judge on the basis of inflection what general mood is being expressed, e.g. whether this is of a threatening or a friendly nature. Undoubtedly these considerations do play a role. They may explain too why the disturbance we shall describe occurs so infrequently. I suspect, however, that the utilization of such cues requires a degree of intelligence which seemed to have been wanting in at least two of my cases. Furthermore, speech-melodic differences in the expression of various shades of emotion appears so great as to render the reliable ascertainment of the emotional content of an utterance extremely difficult. When listening to a foreign language one may well be able to determine whether the speaker is pronouncing sentences or simply words; for only in the former case is the sequence of words embedded in a melody, in a series of intervals which can be perceived as an organic whole. To be sure, one can recite meaningless words and sounds in such a manner that they give the impression of forming sentences. (A good example of this is the “poem” by Christian Morgenstern from his “Songs of the Gallows” bearing the title “The great lalu-la”) This is only the case, however, when such nonsense syllables are spoken in the linguistic melody with which we are familiar. In the polyglot armies of former Austria-Hungary I often had the occasion to hear a language being spoken from which I may have understood this word or that but never the context. I must admit that I usually was unable to detect whether a question or a statment had been intended and whether arousal — certainly perceivable as such — was of a pleasant or unpleasant nature. More than once I held a lively and friendly conversation to be a controversy. If such appraisals are so extremely difficult, even for someone whose training in foreign languages has lent him experience with diverse linguistic melodies, then it is quite comprehensible when a simple farmer, such as was involved in each of the three cases, fails completely at such a task. Therefore, I believe that, despite their hearing ability being intact, the situation of my patients can be considered analogous to that of persons with defective hearing.