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COGNITIVE NEUROPSYCHIATRY 2006, 11 (1), 84-93 Borne in our Minds? Argyris Stringaris Institute of Psychiatry at the Maudsley, King's College, London, UK Giora, Rachel (2003) On our mind. Salience, context, and figurative language. Oxford, UK: Oxford University Press. 259pp, ISBN 0195136160. £32.99/$55 (hbk). Metaphors, metonymies, the mental lexicon, contextuality, semantics, and pragmatics? How much of that isn't really just Greek to most of us and after all doesn't it all that have to do more with literature and philosophy? What could be the potential benefit to psychiatrists from getting a closer look at linguistics? Take the example of metaphors. Until some decades ago people thought that Aristotle was quite right to claim that metaphors are confined to literature. Obviously, this is not the case as evidenced by such common expressions as ``our lads are lions'' or ``fists of iron''. Moreover, figurative language is not just a feature of everyday communication, in fact scientists often resort to metaphors to describe their results; think about genetic blueprints, cell death, molecular chaperones, and radical scavengers. One needs a thorough account for something as pervasive as figurative language in general and linguists have been striving to find one over the last decades, with some success. Psychiatrists dealing with schizophrenic patients who, as some observers would have it, are prone to view the world either in too concrete terms (Goldstein, 1944) or suffer from blurring of category boundaries to become over-inclusive (Cameron, 1944), will be happy to learn what the actual similarities and differences are between literal and metaphoric or idiomatic statements. After all, is the patient's failure to interpret the proverb ``a rolling stone gathers no moss'' due to a selective inability to think figuratively or just the result of a more basic language problem at the lexical level? It is the search for answers to such questions that linguistics can be of decisive help in shaping psychopathological and cognitive theories. If you are looking for an authoritative and thoroughly enjoyable introduction to the various contemporary views on language processing, Giora's book is the right choice. It is concise yet not lacking in important information and despite being scholarly it is anything but dry. Each of the nine chapters contains valuable background information about the concept in question (e.g., metaphors, irony, jokes, etc.), based on a wealth of empirical data and theoretical considerations. Rather than resorting to overly abstract terms, Giora draws on a number of real-life examples to make a lucid and often 2006 Psychology Press Ltd http://www.psypress.com/cogneuropsychiatry DOI:10.1080/13546800444000119 humorous analysis. Throughout the book it is hard not to notice the author's strong views on political and gender-related issues, which certainly adds to the vividness of the text. The central aspect of this book is about the importance of salience. By salience Giora refers to those meanings of words and expressions that are foremost on our mind; as she puts it: ``Salience . . . relates to the entrenchment status of meanings at a given time in a given community. . .''. Giora's theory of graded salience, predicts that while a given context, depending on its strength, will have an impact on sentence interpretation, it will not inhibit retrieval of the coded, salient meanings. The latter will be immediately activated upon encounter of the stimulus. In other words, the graded salience theory holds that there are two pathways running in parallel, one that is determined by context and a sensu strictu linguistic one that is defined by degree of salience; thus initial access to salient meanings would not be blocked even if contextually incompatible. Take the example of a person dealing most of his/her day with monetary affairs; according to the author, even in a strongly biasing context (i.e., walking along a river), it is very likely that mentioning ``bank'' will evoke the financial rather than the riverbank meaning. Or try thinking of someone deeply involved with molecular genetics; which meaning of the homophones jeans/genes is likely to be activated even in the context of everybody wearing jeans? In a way, Giora's graded salience theory reconciles aspects of two apparently opposing theories, namely the modular view of exhaustive access to word meaning and the interactionist theory of thoroughly context dependent direct access to a particular meaning. The modular aspect of the graded salience theory stems from the assumption that linguistic information is encapsulated and that word meaning analysis is rapid and automatic, independent of external influences such as context. However, on Giora's account, exhaustive access to word meaning does not imply that all possible meanings spring to mind at once; retrieving meaning is ordered and dictated by salience. Conversely, the author recognises that in some cases contextual bias may be as strong as to allow faster guessing of the appropriate meaning compared to the salience-governed process and also that salient meanings would be revised if contextual misfit were detected. These claims are backed by reference to several very elegant linguistic experiments conducted by the author and her colleagues but also by taking a closer look at a substantial number of contemporary studies by other investigators in the field. Discussion of the results is fair and some interesting observations arise, for example that the effects of content and salience on deriving word meaning may depend on sentence position of the stimulus: an early sentence position is more context-independent. The theory put forward by Giora has several important implications far beyond the purely lexical level. Empirical data lend support to the hypothesis that salience of an expression would play a major role in the way metaphors are comprehended. Initial processing of familiar metaphors and familiar literal expressions passes along the same path, which is directed by relative salience. But what exactly is salience? An intuitive definition was provided already: The coded meaning foremost in one's mind. The author provides some factors that, she argues, critically shape salience: Frequency, that is, probability of occurrence in language; familiarity, relating to experiential acquaintance with a certain aspect of words or expressions; conventionality of the expression; and prototypicality, that is you are more likely to come up with ``robins'' than with ``chicken'' when asked to name bird types. Obviously, the next important question is how a meaning becomes salient in the first place; why and when does one meaning become entrenched over other competing meanings? Giora mentions in her book that salience is ``the product of learning and exposure'', however, she acknowledges the dynamic state of the mental lexicon and the difficulty in making predictions as to what will eventually become salient. Although the degree of exposure would obviously be a very important factor determining what becomes salient, other factors seem equally important candidates. Some of them may have to do with the relative emotional salience of words; empirical evidence clearly indicates that subjects remember verbal emotional items significantly better compared to neutral words matched for familiarity. Whether this would imply that the more emotional meaning of a word or phrase would also be processed faster compared to an equally salient competing meaning or biasing context is probably worth testing empirically. Then, there are notable interindividual differences as the ones mentioned above in the case of the biologist and his/her genes, but also variations caused by the very state of mind of an individual on a given moment: When angry the verbal items that spring to one's mind may differ embarrassingly from what would usually be salient. Clearly, making efforts at determining more clearly what after all becomes salient and when, may prove a particularly fruitful area of research. A clear achievement of the graded salience theory is that it focuses on what is on our mind, as the title of this book states. Thus it may be seen as a departure from the often heavily conceptual and suprasubjective point of view of linguistics towards a more psychological perspective. This is what makes it particularly interesting to psychopathologists. One is tempted to imagine that the graded salience theory could be of relevance to phenomena like the famous attentional bias of anxious patients. It is thought that negative contents are accessed through automatic processing, one of the reasons why anxious patients typically slow down when colour naming emotional compared to neutral words in a Stroop task. Clearly, the graded salience theory would be more in position to account for this observation than a strictly modular or interactionist view. Emotive words are more dominant than neutral words by virtue of their salience, that is by the extent to which they are entrenched in the individual's mental lexicon. In both attentional bias as well as in the example of mood-congruent memory in normals and depressed patients, the phenomenon is one of relative immunity to contextual information - perhaps using the graded salience hypothesis represents a hitherto missing bridge between linguistics and psychological explanatory models. For obvious reasons, interest in language mechanisms and thier anomalies is greatest when discussing schizophrenia. As referred to previously, efforts have been made in the past to link deficits in figurative language comprehension to schizophrenic thought disorder. A considerable number of studies suggest that the patient's relative insensitivity to context may lead to findings consistent with either concretism or overinclusiveness (Goldberg, Dodge, Aloia, Egan, & Weinberger, 2000; Kuperberg, McGuire, & David, 1998; Spitzer, Beuckers, Beyer, Meier, & Hermle, 1994; Spitzer, et al., 1994b). While this may apply in particular to patients with profound thought disorder, another mechanism that may underlie language distortion has been observed in patients with delusions. Schizophrenic patients appear to be biased towards their delusion content when interpreting sentences compared to healthy controls. Specifically, patients with schizophrenia compared to control subjects more readily accept as correct ambiguous or meaningless sentences provided the emotional content of these items is congruent to their delusions (Rossell, Shapleske, & David, 1998). For example, patients with persecutory delusions are more likely to label as meaningful a sentence such as: ``A cactus can bite'' and those with somatic delusions would be less likely to discard as meaningless the claim: ``Blackbirds eat Fingers'' (examples drawn from Rossell et al., 1998). This pattern was more consistent for patients experiencing delusions at the time of testing compared to schizophrenics who have had experienced delusions previously, implying a state rather than trait defect. For these defects to be accounted for by contextual insensitivity on part of the patients, one would expect that they make more mistakes in judging the meaningfulness of sentences overall. The fact that such mistakes occurred preferentially in the presence of themes congruent to their delusional content, rather suggests that preoccupation with a certain (usually emotionally tainted) material overrides contextual information. Put another way, contents of the delusional belief achieve unusually/unduly high salience, are foremost on the patient's mind and are thus preferentially retrieved even when the context is ambiguous and less supportive. An interpretation of that type could be taken to support a spectrum view of language deficits in schizophreniarather than a result of a breakdown of language processing mechanisms, ``linguistic incompetence'' on the part of the patients, the phenomenon of cognitive bias in deluded patients could be explained in terms of a shift in salience. Obviously, such a view is unlikely to radically change our concept of the disorder itself: The central question of how and why this shift occurred in the first place remains unanswered. However, adopting this perspective amounts to more than simply paraphrasing the same old problem. Accepting such a view about the language used by the patient increases the likelihood of treating what we hear on wards and in outpatient settings as not just the non-sense products of a disturbed mind. Furthermore, schizophrenic language understood in such terms may provide important clues regarding core beliefs and preoccupations and greatly facilitate empathic communication. Having said that, trying to determine the extent to which these preoccupations are explicable by the patient's past, frequently proves futile. Cognitive neuropsychiatry, which nurtures on interdisciplinarity, can greatly benefit from a closer relationship with linguistics. A considerable number of new and exciting concepts can be chosen from and be empirically evaluated in the context of mental illness. For researchers, Giora's book is bound to serve as an excellent source for very creative ideas from the field of linguistics. REFERENCES Cameron, N. (1944). Experimental analysis of schizophrenic thinking. In J. Kasanin (Ed.), Language and thought in schizophrenia. Berkeley, CA: University of California Press. Goldberg, T.E., Dodge, M., Aloia, M., Egan, M.F., & Weinberger, D.R. (2000). Effects of neuroleptic medications on speech disorganization in schizophrenia: biasing associative networks towards meaning. Psychological Medicine, 30, 1123-1130. Goldstein, K. (1944). Methodological approach to the study of schizophrenic thought disorder. In J. Kasanin (Ed.), Language and thought in schizophrenia. Berkeley, CA: University of California Press. Kuperberg, G.R., McGuire, P.K., & David, A.S. (1998). Reduced sensitivity to linguistic context in schizophrenic thought disorder: evidence from on-line monitoring for words in linguistically anomalous sentences. Journal of Abnormal Psychology, 107, 423-434. Rossell, S.L., Shapleske, J., & David, A.S. (1998). Sentence verification and delusions: a contentspecific deficit. Psychological Medicine, 28, 1189-1198. Spitzer, M., Beuckers, J., Beyer, S., Meier, S., & Hermle, L. (1994a). Contextual insensitivity in thought-disordered schizophrenic patients: evidence from pauses in spontaneous speech. Language and Speech, 37, 171-185. Spitzer, M., Weisker, I., Winter, M., Maier, S., Hermle, L., & Maher, B.A. (1994b). Semantic and phonological priming in schizophrenia. Journal of Abnormal Psychology, 103, 485-494.