Disorganized Speech


A common feature of schizophrenia is disorganized speech. The word “feature” makes me laugh. It’s not like automatic windows on a Subaru. Feature feels like the wrong word. Disorganized speech — illogical or unmeaningful speech, non-sequitur assertions (on a very basic level, eg, “I toasted the bagel so the laundry would rain.”) — is considered evidence of disordered thought. Surely if someone is making so little sense with their language, their cognition is significantly impaired.

I probably can’t explain why this isn’t true for me.

When I am suffering from disorganized speech — for me, a transient feature — it is as if my mental dictionary has been reduced to about 20 words. And they aren’t very helpful ones, either.

Say I am trying to make a sandwich because I am hungry. I walk into the kitchen and my husband asks what I’m up to. I attempt to reply with words from my temporarily limited repertoire. Here they are:

I, not, can’t, words, no, need, think, broke, dish, thing, that, my, the, are/aren’t, brain, have, to, I’m, working, yes.

The list and it’s length vary, but it’s short and always nearly useless.

So I answer him this way: “I need the… I have to… I’m… words not working… brain broke… can’t think… I’m… my…”

At this point, I’ve become more focused on my inability to communicate than the fact that I really freaking need that sandwich. I start hitting my forehead with the heal of my hand and grunting. At no point did I lose my knowledge of what I needed or what I was doing, and at no point did I think toasting a bagel would make it rain. My cognition is intact. My language is lost. I am a two-year-old with bigger thoughts than she has words for.

Also, sometimes I look at the toaster and all I can come up with to call it is “that thing!”

It is common for people to forget the name of something. If Annie forgets the word for a potato peeler, she simply calls upon her other words to help her out. She’ll say, “Please hand me… you know, that thing we use to take the skin off a potato.” Then, having said “potato,” her memory is probably jogged, and she’ll continue, “That’s right, the potato peeler.”

All I can come up with in a situation like that is gesturing wildly toward the utensil drawer while saying “that thing!” and ending up flapping my hands around because I’m aware that I’ve lost my words, and this is a devastating loss.

At times, I try to keep it together. This is almost always a mistake.

If instead, I try to communicate that I can’t communicate, I’ll say: “I can’t think. The words I need aren’t working,” or something similar. Then the person I’m talking to says, “You’re doing fine. Take your time. Calm down.” And then in an effort to help me, they will ask a question that I lack the language to answer. This makes it worse, because I haven’t lost the concept, I’ve lost the word.

So I’ve successfully said that I can’t communicate, and this is an apparent contradiction. I just need to try harder. But I can’t try harder. The only solution is to wait around for my words to come back. And I can’t say that, so I look like I’m being lazy or obnoxious. People think badly of me, and there is nothing I can do about that.
Across the board (and I’m guilty of this too), we should avoid assuming we know what another person is thinking or going through. Asking is always better.

I’m often embarrassed by my symptoms or what’s perceived as a general awkwardness by those who don’t know what’s going on. But when my words run away, and this has been happening daily lately, it’s incredibly frustrating. I can’t even explain my behavior. If you know me in real life, please be patient. I’m far more upset about it than you are, trust me.

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