Skip to main content
SpringerLink
Log in

A linguist's insight into insight

  • Original Article
  • Published:
Social Theory & Health Aims and scope Submit manuscript

Abstract

In this article I am interested in exploring the notion of insight. Specifically, after offering a critique of the dominant debates, I shall take the debate forward by proposing a new perspective on insight, based on linguistic analyses of patients’ narratives. My article, anchored in a constructionist view of discourse, is based on six unstructured interviews with patients diagnosed with schizophrenia (F.20). All my informants were in their twenties and were undergoing voluntary treatment in a day-care clinic of a university hospital in Poland. They were described as ‘having insight’. My primary argument will be that insight is not an attribute of the person, but rather of what they say. I shall also argue that (a) insight is dynamic and provisional, not only within the context of a particular communicative event, but also, potentially, within a particular story line; and (b) it is the discursive form of what is being said that is crucial in understanding and exploring insight. In conclusion, I shall point out that while the approach I am proposing undermines the possibility of ‘measuring insight’, it places the suffering person at the centre of psychiatric focus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Owing to space limitations, I have decided to cite only the English versions of the extracts I quote. All translations are mine, and I have done my best to render what my informants said and how they said it. This has occasionally resulted in disjointed or ‘bad’ English.

  2. As it is the grammatical form of verbs that is crucial here, I decided to gloss the verbs in question in the translated fragment. I also realise that the English in the translation is not grammatical; the Polish original is in ‘good’ and grammatical Polish.

References

  • Amador, X.F. and Kronengold, H. (2004) The description and meaning of insight in psychosis. In: X.F. Amador and A. David (eds.) Insight and Psychosis, 2nd edn. Oxford: Oxford University Press, pp. 15–32.

    Chapter  Google Scholar 

  • Amador, X.F. and Strauss, D.H. (1990) The Scale to Assess Unawareness of Mental Disorder (SUMD). Columbia University and New York State Psychiatric Institute.

    Google Scholar 

  • Baier, M., Murray, R.L.E. and McSweeney, M. (1998) Conceptualization and measurement of insight. Archives of Psychiatric Nursing 12: 32–40.

    Article  Google Scholar 

  • Barker, C. and Galasiński, D. (2001) Cultural Studies and Discourse Analysis. London: Sage.

    Google Scholar 

  • Bauman, R. (1986) Story, Performance, and Event. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Beck, A.T., Baruch, E., Balter, J.M., Steer, R.A. and Warman, D.M. (2004) A new instrument for measuring insight: The beck cognitive insight scale. Schizophrenia Research 68: 319–329.

    Article  Google Scholar 

  • Beck-Sander, A. (1998) Is insight into psychosis meaningful? Journal of Mental Health 1: 25–34.

    Article  Google Scholar 

  • Brody, H. (2002) Stories of Sickness. New York: Oxford University Press.

    Google Scholar 

  • Carroll, A., Fattah, S., Clyde, Z., Coffey, I., Owens, D.G. and Johnstone, E.C. (1999) Correlates of insight and insight change in schizophrenia. Schizophrenia Research 35: 247–253.

    Article  Google Scholar 

  • Corrigan, P.W. (2002) Adherence to anti-psychotic medications and health behavior theories. Journal of Mental Health 11: 243–254.

    Article  Google Scholar 

  • David, A.S. (1990) Insight and psychosis. British Journal of Psychiatry 156: 798–808.

    Article  Google Scholar 

  • David, A.S. (2004) The clinical importance of insight. In: X.F. and A. David (eds.) Insight and Psychosis, 2nd edn. Oxford: Oxford University Press, pp. 359–392.

    Chapter  Google Scholar 

  • David, A.S. and Kemp, R. (1997) Five perspectives on the phenomenon of insight in psychosis. Psychiatric Annals 27: 791–797.

    Article  Google Scholar 

  • David, A.S., van Os, J., Harvey, I., Foerster, A. and Fahey, T. (1995) Insight and psychotic illness. British Journal of Psychiatry 176: 621–628.

    Article  Google Scholar 

  • Debowska, G., Grzywa, A. and Pietura, K. (1998) Insight in paranoid schizophrenia – its relationship to psychopathology and premorbid adjustment. Comprehensive. Psychiatry 39: 255–260.

    Article  Google Scholar 

  • Dell’Osso, L. et al (2002) Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Bipolar Disorders 4: 315–322.

    Article  Google Scholar 

  • Fairclough, N. (1992) Discourse and Social Change, Oxford: Polity Press.

  • Fludernik, M. (1996) Towards a ‘Natural’ Narratology. London: Routledge.

    Book  Google Scholar 

  • Galasiński, D. (2004) Men and the Language of Emotions. Basingstoke, UK: Palgrave Macmillan.

    Book  Google Scholar 

  • Galasinski, D. (2008) Men's Discourses of Depression. Basingstoke, UK: Palgrave Macmillan.

    Book  Google Scholar 

  • Ghaemi, S.N., Sachs, G.S, Baldassano, C.F. and Truman, C.J. (1997) Insight in seasonal affective disorder. Comprehensive Psychiatry 38: 345–348.

    Article  Google Scholar 

  • Halliday, M.A.K. (1994) An Introduction to Functional Grammar, 2nd edn. London: Edward Arnold.

    Google Scholar 

  • Hamilton, B. and Roper, C. (2006) Troubling ‘insight’: Power and possibilities in mental health care. Journal of Psychiatric and Mental Health Nursing 13: 416–422.

    Article  Google Scholar 

  • Hodge, R. and Kress, G. (1993) Language as Ideology. London: Routledge.

    Google Scholar 

  • Keshavan, M.S., Rabinowitz, J., DeSmedt, G., Harvey, P.D. and Schooler, N. (2004) Correlates of insight in first episode psychosis. Schizophrenia Research 70: 187–194.

    Article  Google Scholar 

  • Kinderman, P., Setzu, E., Lobban, F. and Salmon, P. (2006) Illness beliefs in schizophrenia. Social Science & Medicine 63: 1900–1911.

    Article  Google Scholar 

  • Kirmayer, L.J., Corin, E. and Jarvis, G.E. (2004) Inside knowledge: Cultural constructions of insight in psychosis. In: X.F. Amador and A. David (eds.) Insight and Psychosis, 2nd edn. Oxford: Oxford University Press, pp. 197–229.

    Google Scholar 

  • Lally, S.J. (1989) Does being in here mean that there is something wrong with me? Schizophrenia Bulletin 15: 253–265.

    Article  Google Scholar 

  • Macpherson, R., Jerrom, B. and Hughes, A. (1997) Drug refusal among schizophrenic patients treated in the community. Journal of Mental Health 6: 141–147.

    Article  Google Scholar 

  • Markova, I.S. and Berrios, G.E. (1992) The meaning of insight in clinical psychiatry. British Journal of Psychiatry 160: 850–860.

    Article  Google Scholar 

  • Markova, I.S. and Berrios, G.E. (2001) The ‘object’ of insight assessment. Psychopathology 34: 45–252.

    Google Scholar 

  • Markova, I.S., Roberts, K.H., Gallagher, C., Boos, H., McKennab, P.J. and Berrios, G.E. (2003) Assessment of insight in psychosis. Psychiatry Research 119: 81–88.

    Article  Google Scholar 

  • McCabe, R., Quayle, E., Beirne, A. and Duane, M. (2000) Is there a role for compliance in the assessment of insight in chronic schizophrenia? Psychology Health and Medicine 5: 173–178.

    Article  Google Scholar 

  • Mintz, A.R., Dobson, K.S. and Romney, D. (2003) Insight in schizophrenia. Schizophrenia Research 61: 75–88.

    Article  Google Scholar 

  • Ochs, E. and Capps, L. (2001) Living Narrative. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Osatuke, K., Ciesla, J., Kasckow, J.W., Zisook, S. and Mohamed, S. (2008) Insight in schizophrenia: A review of etiological models and supporting research. Comprehensive Psychiatry 49 (1): 70–77.

    Article  Google Scholar 

  • Peralta, V. and Cuesta, M.J. (1998) Lack of insight in mood disorders. Journal of Affective Disorders 49: 55–58.

    Article  Google Scholar 

  • Perkins, R. and Moodley, P. (1993) The arrogance of insight? Psychiatric Bulletin 17: 233–234.

    Article  Google Scholar 

  • Polanyi, L. (1989) Telling the American Story. Norwood, NJ: Ablex.

    Google Scholar 

  • Pollock, K. (2007) Maintaining face in the presentation of depression. Health 11: 163–180.

    Google Scholar 

  • Rathod, S., Kingdon, D., Smith, P. and Turkington, D. (2005) Insight into schizophrenia. Schizophrenia Research 74: 211–219.

    Article  Google Scholar 

  • Saravanan, B., Jacob, K.S., Prince, M., Bhugra, D. and David, A.S. (2004) Culture and insight revisited. British Journal of Psychiatry 184: 107–109.

    Article  Google Scholar 

  • Speed, E. (2006) Patients, consumers and survivors. Social Science & Medicine 62: 28–38.

    Article  Google Scholar 

  • Startup, M. (1998) Insight and interpersonal problems in long-term schizophrenia. Journal of Mental Health 7: 299–308.

    Article  Google Scholar 

  • Sturman, E.D. and Sproule, B.A. (2003) Toward the development of a mood disorders insight scale. Journal of Affective Disorders 77: 21–30.

    Article  Google Scholar 

  • Titscher, S., Meyer, M., Wodak, R. and Vetter, E (2000) Methods of Text and Discourse Analysis. London: Sage.

    Google Scholar 

  • Van Dijk, T.A. (1993) Principles of critical discourse analysis. Discourse & Society 4: 249–283.

    Article  Google Scholar 

  • Weiler, M.A., Fleisher, M.H. and McArthur-Campbell, D. (2000) Insight and symptom change in schizophrenia and other disorders. Schizophrenia. Research 45: 29–36.

    Article  Google Scholar 

Download references

Acknowledgements

The author thanks Charles Antaki and Justyna Ziolkowska for their comments on ths article.

Author information

Authors and Affiliations

  1. Humanities, Languages and Social Sciences, University of Wolverhampton, Wolverhampton, WV1 1SB, UK

    Dariusz Galasiński

Authors
  1. Dariusz Galasiński
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galasiński, D. A linguist's insight into insight. Soc Theory Health 8, 66–82 (2010). https://doi.org/10.1057/sth.2009.20

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/sth.2009.20

Keywords

Search

Navigation