A Language for Psychosis: Psychoanalysis of Psychotic States edited by Paul Williams. Published by  Whurr, London, 2001;  207 pp. Parental Psychiatric Disorder: Distressed Parents and their Families edited by Michael Göpfert, Jeni Webster and Mary V. Seeman. Published by  Cambridge University Press, Cambridge, 1996;  358 pp; £95.00 hardback, £34.95 paperback.

Is a language needed for communication between people with psychosis and their carers, both professional and non-professional? If so, does there need to be one language or several? The answer to this question is determined partly by the unusual experiences of people with psychotic illnesses. Many of them are not shared with the general public and therefore language has not developed to encompass them. There is of course a professional vocabulary to describe these experiences, for instance ‘delusions’ and ‘hallucinations’, but these terms are not in common usage so are only taken up by patients who learn them from the professionals. Some patients develop their own words to stand for their unvoiced experiences, creative extensions of language known technically as neologisms. For example, a patient of mine referred to his auditory hallucinations as ‘acousticals’. Others employ words in everyday usage but juxtapose them in apparently illogical nonsensical sequences. A patient produced the following speech: ‘I didn't do this properly and I got thrown out of jail by super-bails, cricketer's bails, sir, Normans. Do you know Normans? Roses and R.C.s and E.C.s. Inch prisms and Canterbury bells’.

This seeming random association of words becomes meaningful when we know his recent history. He was arrested and put in prison in Canterbury, from whence he was bailed out by a friend of his named Norman. Without the illumination of the factual story the patient was attempting to convey, his utterances could easily be dismissed as nonsense. The same is true of delusions and hallucinations, which are often treated by professional and non-professional carers alike as the nonsensical products of a diseased mind. But they do not originate in the chaos of psychosis even if they are transformed by it. They have their roots in real experiences, of events and emotional states, sometimes dating back to the patient's early years. A particular kind of listening is required to decipher the langua