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Word Salad

Too often psychotherapists try to deal with their patients by using their doctoral degree language, trying to explain the ego, superego, and the id, conscious and unconscious, and the patient doesn’t know whether you’re talking about corn, potatoes or hash. Therefore, you try to use the language of the patient. Now a patient had been at Worcester for nine years. The patient had been brought in by the police with no identification marks on his clothing, we could get no information from him at all, we didn’t know where he was from. There was no evidence he lived in Worcester. He might have been a transient. And for the nine years he was on the ward we’d be social and say “good morning”. He replied with word salad, “bucket of lard, didn’t pay up, sand on the beach” things like that . . . just irrelevant words all mixed up . . . didn’t make any sense at all. And when I came there I was intrigued with that patient, intrigued by him. I endeavored many times to elicit his name, and all I ever got was a continuous outpouring of word salad. So I sent my secretary out and told her, “Take down his word salad and transcribe it for me.” I went through that word salad and then I prepared a word salad similar to his but not precisely the same. And one morning at eight o’clock I said, “good morning” and he replied with a big paragraph of word salad to which I responded with a big paragraph of word salad. He responded and we “wordsaladed” each other for a couple of hours. Finally he said, “Why don’t you talk sense Dr. Erickson?” I said, “I’d be glad to, what is your name?” He told me. “Where are you from?” and I started taking a good history and all of a sudden he began his word salad again. So I responded in word salad. By the end of the day I had a complete history and medical examination—a very good account of him. And thereafter if I wanted to talk to him and he replied with word salad so did I. Well, he soon dropped his word salad. And within a year he was able to be released from the hospital and get a job. Now I certainly didn’t do any therapy. I just met him at his own level.

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