Table Of ContentCOHERENCE IN PSYCHOTIC DISCOURSE
Oxford Studies in Sociolinguistics
Edward Finegan, General Editor
Editorial Advisory Board
Douglas Biber Alessandro Duranti
John R. Rickford Suzanne Romaine Deborah Tannen
LOCATING DIALECT IN DISCOURSE
The Language, of Honest Men and Bonnie Lassies in Ayr
Ronald K. S. Macaulay
ENGLISH IN ITS SOCIAL CONTEXTS
Essays in Historical Sociolinguistics
Tim W. Machan and Charles T. Scott
COHERENCE IN PSYCHOTIC DISCOURSE
Branca Telles Ribeiro
GENDER AND CONVERSATIONAL INTERACTION
Edited by Deborah Tannen
THERAPEUTIC WAYS WITH WORDS
Kathleen Warden Ferrara
SOCIOLINGUISTIC PERSPECTIVES ON REGISTER
Edited by Douglas Biber and Edward Finegan
COHERENCE IN
PSYCHOTIC
DISCOURSE
Branca Telles Ribeiro
New York Oxford
OXFORD UNIVERSITY PRESS
1994
Oxford University Press
Oxford New York Toronto
Delhi Bombay Calcutta Madras Karachi
Kuala Lumpur Singapore Hong Kong Tokyo
Nairobi Dar cs Salaam Cape Town
Melbourne Auckland Madrid
and associated companies in
Berlin Ibadan
Copyright © 1994 by Branca Telles Ribeiro
Published by Oxford University Press, Inc.
200 Madison Avenue, New York, New York 10016
Oxford is a registered trademark of Oxford University Press, Inc.
All rights reserved. No part of this.publication
may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, without the prior
permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Ribeiro, Branca Telles.
Coherence in psychotic discourse / Branca Telles Ribeiro.
p. cm.—(Oxford studies in sociolinguistics)
Includes bibliographical references and index.
ISBN 0-19-506597-2—ISBN 0-19-506615-4 (pbk.)
1. Psychoses—Patients—Language—Case studies.
2. Discourse analysis—Case studies.
3. Cohesion (Linguistics)—Case studies
I. Title.
|DNLM: 1. Interview, Psychological—methods.
2. Physician-Patient Relations. WM 141 R484cJ
RC455.4.P78R53 1994
616.89—dc20
DNLM/DLC for Library of Congress 92-49156
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
To Zaida Costa
and Bianca Telles Ribeiro,
grandmothers.
To Jurema Cardozo,
whom I have never met.
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SERIES FOREWORD
Sociolinguistics is the study of language in use. Its special focus, to be
sure, is on the relationships between language and society, and its prin-
cipal concerns address the forms and functions of linguistic variation
across social groups and across the range of communicative situations in
which women and men deploy their verbal repertoires. In short, socio-
linguists examine discourse as it is constructed and co-constructed,
shaped and reshaped, in the language of everyday interaction and as it
reflects and creates the social realities of everyday life.
While some branches of linguistics examine the structure of sen-
tences independent of who is speaking (or writing) and to whom, inde-
pendent of what precedes and what follows in the discourse, and in-
dependent of the setting, topic, and purposes of the discourse, sociolin-
guistics aims to investigate language as it is embedded in its social and
institutional contexts. Not surprisingly, among observers who are not
professional linguists virtually all interest in linguistic matters likewise
focuses on language in use, for it is there that language mirrors the intri-
cacies of social structure and reflects the situational and strategic com-
plexities that shape discourse.
In offering a platform for studies of language use in communities
around the globe, Oxford Studies in Sociolinguistics invites significant
treatments of discourse and of social dialects and registers, whether oral,
written, or signed, whether treated synchronically or diachronically. The
series hosts studies that are theoretical or descriptive, analytical or in-
terpretive. While most volumes will report original research, a few will
synthesize or interpret existing knowledge. All volumes will aim for a
style accessible beyond linguists to other social scientists and to human-
ists examining human discourse.
Occationally, a volume may appeal to students and other educated
readers keenly interested in the everyday language of human affairs—for
example, in the discourse of doctors or lawyers trying to engage clients
with their specialist registers, or of women and men striving to grasp the
sometimes baffling character of their shared interactions.
By providing a forum for innovative and valuable studies of language
in use, Oxford Studies in Sociolinguistics aims to influence the agenda
for linguistic research in the twenty-first century and, in the meanwhile,
to provide an array of insightful and provocative analyses to help launch
that agenda.
viii Series Foreword
In the present volume, Branca Telles Ribeiro analyzes two extensive
samples of discourse, comparing and contrasting the structures of coher-
ence that characterize "deviant" talk between a patient and her psychia-
trist when the patient first enters a hospital for treatment of an acute
psychotic crisis and the "normal" talk used when she is discharged after
treatment. Using frame analysis and topic analysis as central tools, Dr.
Ribeiro untangles some of the confusion between assessment of language
and assessment of thought, and she explains how psychotic discourse
exhibits a coherence of its own. Focusing on the effect of frame and topic
on establishing discourse coherence, Dr. Ribeiro describes the different
forms that coherence takes in the admitting and discharge interviews.
Her fascinating study also takes up significant methodological questions
concerning the transcription of normal and deviant conversation and the
representation of conversation in translation. We are pleased to have this
valuable and pathbreaking study in Oxford Studies in Sociolinguistics.
Edward Finegan
ACKNOWLEDGMENTS
Many people have contributed to the development of this book. Most of
all, the book is the direct result of strong encouragement on the part of
Deborah Tannen, my professor and mentor while I was at Georgetown
University, and a dear friend from then on. From the book's earliest
stages up to its final form, Deborah has been a source of constant inspi-
ration, guidance, and support. She has my deep appreciation and sincere
thanks.
Also, I would like to thank my professors at Georgetown University,
especially Deborah Schiffrin and Cléa Rameh, for their interest and gen-
erous time. My gratitude also goes to Frederick Erickson, a friend and a
master, who has attuned my perception to the relevance of nonverbal
communication in face-to-face interaction. His constant support has been
most valuable.
My thanks to Drs. Eustáquio Portella and Jeremias Ferraz-Lima of
the Psychiatric Institute, Federal University of Rio de Janeiro, for pro-
viding the tapes and material used in this study. The interviews that
formed the subject matter of this study were conducted by a doctor who
will remain anonymous; her interest and availability for discussion were
most helpful to the study. And even though I have never met the patient,
I remain indebted to her.
My special acknowledgment to Dr. Eduardo Rodrigues da Silva for
having introduced me to the field of medicine, and specifically to psy-
chiatry. I owe Dr. Carlos J. Doin more than words could ever express.
At later stages, colleagues and friends have contributed valuable
time, suggestions, and references to this work. I thank, in particular, Lu-
cia Quental, Margarida Basílio, Malcom Coulthard, and Carmen-Rosa
Caldas-Coulthard. Douglas W. Maynard's careful review of and sugges-
tions on the initial manuscript oriented many of the changes made in the
book, for which I am thankful. I am particularly indebted to Susan M.
Hoyle for lengthy and stimulating discussions (over bitnet) and for her
encouraging responses. She was, and is, an excellent reader. I would like
to extend my appreciation to Susan Green for the fine drawings and her
keen editorial remarks. Cynthia Read, Peter Ohlin, and Melinda Wirkus
at Oxford University Press have provided me support and editorial assis-
tance, and I am grateful for their help.
A grant from the Conselho Nacional de Pesquisa (CNPq), with a
complementary grant from the Catholic University of Rio de Janeiro,
