Is it possible to think without words? Give it a try now. Many researchers believe that, indeed, thinking takes place in the human brain independent of language. However, the German philosopher and linguist Wolfram Hinzen defends exactly the opposite. In his opinion, language and thought are intrinsically connected. Inseparable. Hinzen, director of the Grammar and Cognition Lab at the Pompeu Fabra University in Barcelona, Spain, carefully analyzes what people with brain disorders like schizophrenia, Alzheimer’s, autism and major depression say. In his opinion, language is a fundamental factor in all of them, which would prove his hypothesis: if thought is altered, it will necessarily be reflected in the words.
Hinzen is one of four lead scientists in a €10 million (around $11 million) European project that will try to detect changes in the language of people with psychotic symptoms. These patients — usually with schizophrenia, bipolar disorder or depression — can suffer from all types of delusions, like believing that they are aliens, that they are dating a celebrity, that someone wants to kill them or that they make prodigious inventions that will save humanity. For Hinzen, from the Catalan ICREA foundation, these delusions are also a language phenomenon, as well as an exceptional window into the human brain.
Question. What is language?
Answer. A common intuition is that language is just a way of communicating. So, we are thinking and there is a certain thing we want to say, a communicative intention, and then we kind of translate it into language, which is the way of getting it across to another person. Think of a computer: you attach a printer to it. Language is like the printer, which is what gets the content out of the computer and into the physical world. And so on this picture, thinking is separate from language, which is just a means of expression. If you take the printer away, the computer works in the same way. I reject that.
A. For me, language is not just a means of communication; it’s a means of structuring the thinking process itself. Humans need a particular linguistic frame that allows this thinking to be as creative as it is and as structured as it is. This frame is what language provides. Without this frame, thinking would fall apart. The reason we study mental disorders is that what happens in mental disorders is that thinking is falling apart. And if language is a way in which thinking is organized, and in mental disorders, we see that thinking is disorganized, it follows that we should see language to be disorganized in mental disorders as well.
Q. Do you believe that thought does not exist separately from language?
A. It depends. There are other forms of thought, for example, mathematical thought or musical thought, and all of this exists, potentially, independently of our language capacity. I think these are open questions. We don’t really know whether there could be mathematical thinking in the absence of language. It’s very controversial, but it’s entirely possible. All I’m saying is that the kind of thinking expressed in language intrinsically depends on language. It’s not merely expressed in it, but it depends on it for its existence.
Q. It is common to think that there is a place in the brain for thought, apart from language.
A. If there was, you would expect that we have found it, but we haven’t. There is no circuit or spot or network in the brain which is the thinking network. There’s no such thing.
Q. Is every corner of the cerebral cortex involved in thinking?
A. There was a time, in the late 19th century, when people took a very localizational view of the organization of language. A stroke can cause a focal injury in the brain, in Broca’s or Wernicke’s area, and disturb language functioning. This is aphasia. So people thought, okay, we have found language in the brain, and it’s this particular set of areas.” Nowadays, this has become very controversial, and people take the view that language is basically a whole brain phenomenon, although it’s not everywhere to the same extent. The moment you accept this, it becomes possible to look at it as something that is not a separable cognitive function, but a system which organizes our cognition as a whole.
Q. You have stated that the human brain would be the most complex object in the universe if not for the fact that its product, language, is even more complex, as it creates a community of minds. Do you really believe so?
A. We have very strange brains that have this huge capacity for producing language. They put a structure in place that goes beyond our brains, because the language is something that we share as something objective that is not just in your head or in my head. Like the internet. You know the internet is produced by computers, which are like the brains, but the internet is an enormous structure which cannot be reduced to any particular computer. It’s the network as such. Language would be maybe similar to that: it’s a network that comprises human knowledge. And it’s powered by brains, but it cannot be reduced to the brains.
Q. Your project, funded by the European Research Council, focuses on psychosis.
A. In psychosis, people go through fluctuations, so they go to the clinic for the first episode. They might be very delusional, they might hear voices or they might be very disorganized. We pick them up in this acute psychosis state and then usually they are medicated and they go eventually into remission, which is the state when your symptoms have gone away or are under control. We are interested in what changes in language. Is there a language phenotype in that acute state? Does language track your mental states? That’s the question. The idea of the project is to regularly monitor these people with a mobile device so that they collect their speech every week. We want to test whether that change predicts whether they will relapse or not.
Q. Can language be a kind of biomarker to diagnose psychosis?
A. Of psychosis and, in the best possible case, it’s a possible predictor of relapse. Just as a thunderstorm that is falling on the horizon, you don’t want to be surprised by it; you want to predict it before it happens. And we think that the language may change in subtle ways that announce this pending thunderstorm.
Q. Do you think it is possible to determine if a person has psychosis, Alzheimer’s, Parkinson’s or other diseases just by listening to their voice?
A. The evidence suggests that the answer could be yes in these cases, but we are not just doing voice-based analysis; we are transcribing what people say and then we do analysis based on the text and syntactic in the semantic structure. In this project, we are focused on psychosis. And the question you are raising is about differential diagnosis. One specific interest we have is, for example, major depression. I think it is very likely that in major depression language features change, but not as dramatically as in the case of schizophrenia, in which people have symptoms like delusions and hallucinations. For example, if I tell you I have a thousand children or I came to Earth in a cosmic bubble or the mafia is prosecuting me.
Q. In one of your studies, you wondered whether delusions could be understood linguistically. Is the answer yes?
A. We are proposing that. We have reasons to think that. The first reason is that, clinically, a delusion needs to be manifested linguistically. It’s not enough to feel that you might be Jesus Christ; you have to say it. It’s a linguistic phenomenon. You are uttering strange sentences which don’t have the same meaning that they would coming from your mouth or mine. If I tell you I’m Jesus Christ, I would be making a joke, or maybe it’s a metaphor to describe me as a saint or something. It wouldn’t be particularly worrisome. But if a patient says that, it’s not meant to be a joke and it’s not meant to be metaphorical. It’s an apodictic truth. They are absolutely convinced that that is the case. You can’t talk them out of that. So the meaning changes. It’s a linguistic phenomenon. We have a lot of evidence that in the way that psychotic patients speak, something is happening with the organization of meaning.
Q. What evidence?
A. When you’re producing speech, you’re producing one word after the other. Each of these words has a certain meaning, and you need to relate these meanings to each other. The way these words are related to each other, the way your sentences are organized, changes in psychosis. We think that this could be a basis for understanding how thinking changes, because thinking depends on building semantic structures.
Q. There are many types of delusions, such as believing you are famous, Jesus Christ or an alien. Do you include all kinds of delusions in your project?
A. Yes, it could be anything. It’s very difficult to associate a lot of clinical value to whether somebody believes he is Jesus Christ or Pedro Sánchez. The content of the delusion does not really matter. The essential thing is that you have a delusion and that you use language in a particular way, and that can tell us something about the brain mechanisms. The crucial feature of delusion is that it is maintained as true in the absence of supporting evidence; that, for me, is a change in the organization of the semantic space.
Q. Could language also be a biomarker in other diseases?
A. Autism, I think, is absolutely fundamental. The first warning signs of a child for autism, the first red flags, most of them are in the language domain. Around six months, babies start to babble, and in autism babbling is affected. It is either absent or it is anomalous. That continues later on: the child doesn’t react to language. Index finger pointing: around the first birthday, normal children start pointing to things. “This is a scarf, this is a table.” That is a nice bit of language development, because they point to things that they can also name. This kind of index finger pointing is affected in autism.
Q. Why do 30% of people with autism not speak?
A. This is the $100,000 question. This is the key question. If you have a theory of autism that says language is not important to autism, how would you explain that fact? That 30% of people with autism don’t even develop language. And up to 50% have very severe language difficulties. And it’s called low functioning autism. Some people say autism is not a language disease, it’s just a way of communicating. But if you say that, you have to separate communication on the one hand and language on the other hand. That’s a very strange distinction to make because in humans we communicate linguistically from day one of the human life. Even the baby – when the mother talks to the baby, the cooing and the first noises that the baby makes, that’s a kind of communication that is established. I’m moving my hands when I’m talking, but the movement of the hands is coordinated with the linguistic content I’m producing. It’s very difficult to see a communication problem that is not a language problem.
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