Aspects of Disintegration and Integration in Patient Speech*

The author describes his research on fluctuating patterns of language disintegration and integration in the speech of 14 psychoanalytic patients during 50 sessions. A lexical measure of narcissistically disintegrated language is developed and applied to the language of these patients to identify speech samples that are comparatively disintegrated versus those that are integrated. Samples of disintegrated speech were found to be associated with high levels of self-reference, negation, emotion, and reflective thought; an emphasis on immediate experience; the loss of function words that connect nouns; a loss of speech diversity; and an emphasis on equivocal expression where the self is represented as discontinuous. Samples of integrated speech were informationally rich narrative descriptions that were highly diverse, employed contexts of past/present and self/other as a means to unify experience, and represented the patient and others as continuous in time. The author concludes by suggesting that cycles of disintegration/integration occuring in patient speech reflect the mind's self-regulating method of adapting to changing internal and external conditions, proposing that psychopathology be conceived as disruptions in this self-regulatory process and that psychotherapeutic treatment be thought of as re-regulating this naturally occurring process.