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Must Out of Sight Mean Out of Mind?

Levinas, Language and the Schizophrenic Other

Ada Fetters

Seattle University

“We build a foundation but where do we stand

When all air is water and all water is land?”

Trey Anastasio, Twenty Years Later


“Language as an exchange of ideas about the world… presupposes the originality

of the face without which… it could not commence” (Levinas, 1979, p. 202). Emmanuel

Levinas spoke out passionately against reductionist language. In therapeutic terms,

reductionism translates into letting the diagnosis speak instead of the patient. Even now,

mainstream psychology holds Karl Jaspers’ view that diagnoses and terms are a necessary

template; that we must label schizophrenia and its symptoms in terms of form rather than

content because such individual characteristics of the content mean there is no truth in

such experiences for a therapist to understand. I contend that Levinas offers an ethical

alternative to this rather dehumanizing point of view by reminding therapists that only the

Other human being knows the truth of his own individual experience, and this holds true

for schizophrenics just as much as for therapists, or anyone else for that matter.

Further, Levinas’s view is not merely theoretical. It is practical in that he absolves

therapists from comprehending the patient fully by seeking one universal truth or

template to contain them. However, it is the job of the therapist to understand the nature

of patient’s struggle. Levinas can help therapists here as well. He reminds us that

language (the primary tool of a psychotherapist) can be both a bridge and a barrier for

communication between unique individuals, especially therapist and patient.

Psychological language is liberating when it gives words to those who do not yet have

their own vocabulary, but terminology can still their voices if it reduces their experience

to generalizations.

Levinas and the Schizophrenic Other

Levinas writes of the limitless distance between all individuals in his Totality and

Infinity. Behind the face of the Other person, the physical features and affect, is the vast

reach of interiority. He writes that “The face is present in its refusal to be contained. In

this sense it cannot be comprehended, that is, encompassed” (1979, p. 194). This is

because for Levinas, the human face was much more than a membrane stretched over a

bony casing. For Levinas, the face was the manifestation of transcendence. The infinite

uniqueness and Otherness of the person not only shows in their face, but always

overflows their mere appearance. The face is not just flesh. It is the way the Other

presents himself while always exceeding not only his own form and image, but also any

idea I have about him and his character. It is “the infinite in the finite, the more in the

less” (p. 50). The infinity of the interior is constantly being produced so that it is in a

perpetual state of beyond. It is beyond comprehension, beyond summary, beyond any

boundary or template imposed upon it no matter how much of it might be discovered.

Before we go any further, it is important to note that I do not intend to reduce the

full complexity of Levinas’s Other – I relationship to that of patient – therapist.

According to Levinas, the Other comes from a transcendent height, and I am forever

below. The dimension of height is noteworthy and its application or lack thereof to the

therapeutic relationship has been long debated among philosophers and psychotherapists.

However, this paper will focus on Levinas’s dimension of distance as applied to the

therapist and patient, as well as the benefits and deficits of language to bridge that

distance. The various angles of therapeutic height will not be discussed here.

Levinas’s insights into the dynamic of relation versus totalization are particularly

useful when a therapist is faced with a schizophrenic patient, for two reasons. Firstly, the

interiority of a schizophrenic Other is unique, as are those of all Others with whom we

come in contact. Secondly, schizophrenic patients have marked difficulties relating

across the distance that separates each person from everyone else. However, Levinas’s

insight is even more important in that it helps therapists to remember that the second does

not negate the first. No matter what his words or lack thereof, the schizophrenic patient

is an Other with an infinite internal landscape and his face, in Levinas’s sense, is beyond

our totalization or comprehension.

By “comprehension,” I mean that we can never know a schizophrenic patient

fully, not that we can never understand them at all, the way Karl Jaspers maintained. He

was so impressed with the idiosyncratic nature of the schizophrenic person that he

proposed that hallucinations be classified according to form rather than content, for the

content itself was so unique from case to case as to lack pathognomic finality. He wrote

that hallucinations were basically empty and meant nothing, and thus could never be

understood by a reasonable person.

Nothing could be further from the insight Levinas offers: that the schizophrenic is

an Other coming from his own viewpoint with his own meanings - not that his meanings,

however bizarre, do not exist simply because we cannot comprehend them. “Madness is,

after all, defined by its very difference from reason,” writes Brendan Stone (2004),

“…generally speaking it is characterized variously by fragmentation, amorphousness,

entropy, chaos, silence and senselessness” (p. 18). In the last century we reasonable ones

have grown skittish of the chaos of madness, especially that of schizophrenia. Although

it is the second-oldest defined mental disorder, schizophrenia defies categorization. It is

both amorphic and polymorphic in that no one is sure whether it has no form at all or

whether it is actually several different things. Either way, its vague outline does not sit

easily with the Age of Reason. We tend to turn away from the possibility of meaning in

schizophrenia. “Hence an abyss yawns in the middle of confinement; a void which

isolates madness, denounces it for being irreducible, unbearable to reason” (Foucault,

1961/1988, p. 228). Levinas, with his ethics of relation between two infinitely distant,

irreducible, Other beings, absolves the therapist from knowing the final, static truth about

a schizophrenic patient. A therapist does not have to set the patient to a template in order

to sit with him. Antonin Artaud declared, “I am not of your world / mine is on the other

side of all that is, knows itself, is / consciousness, desires and acts. / It’s entirely another

thing” (1965, p. 201). Levinas’s ethics allows room for both the therapist’s world of

reason and the world of the schizophrenic patient in all its amorphous, alien,

unreasonable Otherness.

Relation versus Totalization

“How can the same… enter into a relationship with an other without immediately

divesting it of its alterity?” (Levinas, 1979, p. 38). In other words, if Levinas demands

that an ethical therapist not totalize the schizophrenic patient, then what is the therapist to

do? Levinas can help here as well. Instead of attempting to comprehend, he advises the

therapist to relate. “The relation between the same and the other-- upon which we seem

to impose such extraordinary conditions-- is language” (p. 39). Dialogue is not only the

primary tool of a therapist, but it is also a form of relation that does not totalize. Levinas

writes that language is the universal: it takes the individual into the general. It allows

people to relate, draws them together into a common world, while also allowing them to

remain separate. All therapeutic conversation is the patient informing the therapist of

their meaning. “For in the patient’s insane words there is a voice that speaks; it obeys its

own grammar, it articulates a meaning” (Foucault, 1961/1988, p. 188). Patients

thematize the world as they speak about it, and their way of thematizing what they notice

about the world of phenomena, is different from anyone else‘s. This is especially so with

schizophrenic patients, whose perception of the world is often radically different from

those around them.

Communications Breakdown

The objection to such a statement regarding a schizophrenic patient is

immediately apparent in the Diagnostic and Statistical Manual of Mental Disorders-IV-

TR (American Psychiatric Association, 2000). Classed as a negative symptom, alogia “is

manifested by brief, laconic, empty replies. The individual with alogia appears to have a

dimunition of thoughts that is reflected in decreased fluency and productivity of speech”

(p. 301). Certainly, most of what we can observe of a schizophrenic patient is their lack

of facial expression and dearth of speech. The DSM-IV-TR attempts to be objective and

impartial. After all, it is describing phenomena that exist and are extremely problematic.

Yet its definitions for such symptoms as “alogia” and “flat affect” spill over from

describing an outward appearance to making assumptions about the person’s internal

state. Alogia originally comes from the Greek α-, “without,” and λόγος, “speech.” The

original meaning of the word was not specifically directed toward capacity for thought. If

we cannot see expressions and do not hear words, Western (behavioral) medicine tends to

assume that emotions and thoughts do not exist. Antonin Artaud, a diagnosed

schizophrenic who suffered greatly from his lack of words, wrote that “a man possesses

himself in flashes, and even when he does possess himself he does not quite overtake

himself… Is he to be condemned to nothingness on the pretext that he can give only

fragments of himself?” (1965, p. 20). Out of sight is out of mind, especially when those

we observe are apparently out of theirs.

In this case, the “idealist” Levinas is actually the voice of moderation and reason:

he points out again and again that people are infinitely more than their physical forms and

observable behaviors. He reminds therapists that the affect we can see is only part of the

human face. The vast majority of what goes on lies behind the plastic form. Indeed, the

narratives of schizophrenic patients document hyper-reason, excesses of thought and

hypersensitivity. The excellent Sass writes, “Far from indicating a lowering or shutting-

down of conscious awareness, many negative-symptom experiences in schizophrenia

actually involve forms of “hyperrflexivity” and alienation” (2004, p. 304). This

alienation may be due, at least in part, to the schizophrenic individual’s compromised

ability to communicate with others.

Mark Vonnegut writes about his first schizophrenic breakdown, “Holy shit, my

mind is running. The coffee isn’t even cold yet. I’m thinking about a million miles an

hour, spinning fantastic webs. It’s a gas. Cramming whole lifetimes of thinking in

between sips of coffee” (1975/2002, p. 139). Yet Vonnegut also demonstrated alogia

such that “my voice came out all funny. I t was too fast or I had said it backward or

something. I couldn’t make my voice sound right…” (p. 134). At times such as these

Vonnegut could barely speak at all, let alone let anyone else know what was happening to

him. However, a diagnostician who used the term “alogia,” with its “dimunition of

thoughts,” would miss the greater part of this patient. Levinas, who was not a therapist or

psychologist, would likely have seen more of Vonnegut than a behavioral psychologist.

Levinas held the view that ethics is a matter of optics. So, in many ways, is

psychotherapy. The way a therapist looks at a patient determines to a great extent how

the patient is treated. Instead of looking at alogia as reflecting a dimunition of thought,

which reflects an interior state that we cannot observe and thus can never know for

certain, a therapist is better served by looking at “the thing itself,” αλόγος, that is, a

patient’s loss of language. In other words, alogia might be more ethically (and

accurately!) seen as a failure of vocabulary to describe the schizophrenic experience of

cognitive chaos than a dehumanizing lack of thought.

Form and Transcendent Meaning

Again and again we see accounts of schizophrenics who are distressed by their

loss of words. Levinas’s distinction between the form and transcendent meaning can help

therapists understand at least part of what is happening when a schizophrenic person uses

isomorphic language. For example, Renee, a young schizophrenic girl, notes that during

one of her earliest hallucinations, she cries, “Stop, Alice, you look like a lion, you

frighten me!” (Sechehaye, 1979, p. 23). Her schoolmates tell her that she does not know

what she is talking about. Renee appears to be distressed by the fact that she could not

communicate almost as much as by the experience itself. “But actually, I didn’t see a lion

at all: it was only an attempt to describe the enlarging image of my friend and the fact that

I did not recognize her” (p. 23).

Renee‘s words take form: “Alice, you are a lion!” Yet she is also trying to express

her terror at her perceived transformation of her little friend. In fact, her transcendent

meaning is more even than this. All words and expression overflow their form just as the

presence of the face does. They transcend beyond anything a patient could ever tell a

therapist or anyone else. It is extremely important that the therapist understand this

distinction, for a schizophrenic patient’s hyper-reflective meaning will transcend faster

and more strangely than most Others’. A schizophrenic patient is not trying to deceive

when this happens. Renee was trying as best she knew how to communicate. The trouble

came because her friends’ understanding of a word differed so greatly from the meaning

she was trying to give it. Therapists run into the same difficulty with all patients, but

schizophrenic patients in particular tend to seek apparent synonyms, which turn into

isomorphs like Renee’s “lion.”

Levinas (1979) offers the valuable insight that “The primordial essence of

expression and discourse does not reside in the information they would supply concerning

an interior and hidden world” (p. 200). Levinas meant that over and above the

information that is or is not conveyed by a patient‘s words, discourse is about the call to

responsibility manifested by the patient who expresses himself. The task of the therapist

is not to comprehend the patient‘s interiority, but to offer support for the individual

struggling with this problem and guidance toward the patient’s own responsibility.

Note that this section was not titled “Form versus the Transcendent.” Both are

needed. There is no such thing as communicating the transcendent meaning directly,

without the benefit of forms, that is, words. If there were, there would be no dialogue.

We would exist en masse, in comprehensive unity. There would be no need for language,

no infinite distances, and no individuals. Madness and misunderstanding would be non-

issues. There would, literally, be no word for them.

Thus by its very nature language is a bridge for the therapist and patient, but it is

also a barrier. For most philosophers and psychotherapists, this means that a patient’s

language is a series of symbols to be translated. Levinas is unique in that he looks at both

the words that are said and the transcendence of the face as an expression of meaning.

For Levinas, language can be a barrier because it reveals and conceals, not because it is

merely symbols that require our translation. For example, Renee’s schoolmates did not

understand her. Their widely agreed-upon meaning for “a lion” was completely different

than Renee‘s isomorphic one. If a therapist looks at language this way, as meanings

expressed instead of a sort of concretized “code” that we must decipher, then speaking

with a schizophrenic Other is less nerve-wracking. Therapists are absolved from having

to interpret a chain of loosely-related thoughts. They do not have to translate unreason

into reason or struggle to make the patient’s fragmented statements fit into theories.

If Renee had said, “I am having a very frightening visual hallucination,” her

playmates would probably have known what she meant. There is no guarantee that they

would have believed her, and they might not have been very understanding even if they

did believe, but they would have known what she was trying to communicate. The

general public has agreed upon what the word “hallucination” entails. However, the

trouble with such terminology is that it is general, and the particular trouble with

terminology and schizophrenia is that the expressed meanings of schizophrenia are


In order to form a relation across infinite distance, it is critical for the therapist to

have at least some understanding of what the schizophrenic patient is “saying” in the

words he has “said.” It is difficult for even the most ethical therapist to help a patient if

she cannot understand his experience at all. While language provides a way to relate,

therpists are absolved from having to comprehend totally via language. Levinas reminds

us that speech does not arise where there is already knowledge and agreement, but that

“speech proceeds from absolute difference” (1979, p. 194). This is the case with any

Other, even two brothers who grew up in the same household at the same time with the

same parents. They speak when they need a better understanding of the way the other

brother views the world. This is especially so for a schizophrenic patient. This also

means that avoiding reductionist language is extremely important.

Terminology: A Barrier

All language reveals and conceals. The more general a word is, the more it tends

to conceal about the specificity of the patient’s meaning. Antonin Artaud (1965) wrote

with great irritation that all terms were “for me really TERMS in the proper sense of the

word-- veritable terminations… I’m completely paralyzed by my terms, by a chain of


terminations” (p. 36). Artaud’s thoughts overflowed his words so quickly that his letters

are dizzying, rife with his own frustration at the way words for his ever-transcendent

meanings do not capture them alive, but instead deaden them. Artaud actually wrote and

spoke aloud with flair exceeding that of many reasonable people, but he was very angry

when his transcendence appeared to stop in the terminal of form. Hence, “I no longer

have the gift of the tongue” (p. 39). He felt that he could not make his meanings

understood. It might have helped his psychologist to adopt Levinas’s attitude. “Better

than comprehension, discourse relates what remains essentially transcendent” (1979, p.

195). There is always more to the patient and more to their words than what they have

said. If a therapist tried to get a sense of the meaning Artaud expressed, instead of

attempting to translate him into reason by picking at his words, both therapist and patient

might have been a great deal less frustrated. As it is, Artaud (1965) accuses his therapists

of being “dogs, I mean you go around barking, I mean you rabidly persist in not

understanding” (p. 37). They let his diagnosis speak for him, which this rather brilliant

patient did not appreciate at all. He felt that he was being totalized.

At the other end of the terminological spectrum I shall examine an Anonymous

account that deals much with “anxiety in the early catatonic stages of disorganization”

(1964, p. 110). Anonymous uses the very ideological language Artaud despises. She

gives great respect to the science of psychology by using its terms and by writing an ode

in the form of a poem called “A Vision of Science.” Anonymous’s narrative is “as clear a

picture of schizophrenia as one can find anywhere” (p. 89) because she uses terms that

anyone who has taken Psychology 101 can recognize. At the level of the words that are

said, she communicates what happened to her much more easily than Artaud does. Yet

Van Kaam (1966) offers a disconcerting insight to Anonymous’s penchant for

psychoanalytic language. “Instead of exploring the intimate structure or meaning of

experience itself, he simply accepts the scientific interpretation which I hand to him and

continues his alienation from his true self in a more sophisticated way than before” (p.

155). Anonymous’s neat terminology and explanations very likely stem from exactly the

same loss of words as Artaud, Renee, Vonnegut and many others experienced. She not

only borrows from the language of psychoanalysts, she also borrows words from poets:

Swinburne, Shakespeare, Emerson and others. “Poetry could be counted on not to lead

me astray,” Anonymous writes. When she was “unable to think coherently or plan [her]

next action” (1964, pp. 96-97), she sought refuge in the words of others. The pre-set

meaning of words such as “guilt feelings” and “anxiety” kept her own meanings from

coming unmoored from any words she herself chose.

An ethical psychotherapist can see that although Anonymous has many problems,

she does not suffer from lack of thought or lack of sensitivity. She has, as she writes, a

“sense of discovery, creative excitement, and intense, at times mystical, inspiration”

(1964, p. 98). It is true that not much of this creative inspiration comes through in her

narrative, which is quite dry. She uses reductionist language to the point of obscuring her

own meaning. A therapist can easily get a general idea of what is going on, but it is very

difficult to know Anonymous herself from this account. Thus it is important to remember

that Anonymous’s personal experience has just as much meaning as Artaud’s or any

other. She is no less a unique Other because she is using psychoanalytic terminology to

communicate instead of original description.

Terminology: A Bridge

It is tempting for a therapist who sees through the optics of Levinas’s ethics to

denounce all terms and terminology as psychagogy, conformist and useless, nothing but a

Procrustean bed which chops off bits and pieces of highly individual schizophrenic

patients to make them fit into a very general psychopathology. Did not R.D. Laing (1965)

correctly point out that “it is just possible to have a thorough knowledge of… just about

everything that can be known about the psychopathology of schizophrenia without being

able to understand one single schizophrenic” (p. 30)? Yet let us remember again the high

level of cognitive chaos endured by these particular patients. Not all of them have words

for what they are going through, let alone words that a therapist will understand. Levinas

would never wish for the excision of terminology at the cost of further isolation of the

patient. In some cases, terminology can build a two-way bridge from patient to therapist

that allows them both to form an idea of what is going on.

Anonymous found a way to communicate in the language of psychoanalysis. This

is a good step, but she would be best served by gently exploring her own “intimate

structure,” for it does exist. Out of sight is not out of mind for the ethical therapist. Just

because someone cannot speak (or write, or put up appropriate expressions on their face

like a signpost), that does not mean that personal experience is not there. It does not

mean they do not feel or think. It does not mean that they have no meaning that they are

trying to express. A therapist must always remember this transcendence. Anonymous

was more than a collection of psychologisms. She loved poetry, after all. She could

recall verses during severe mental anguish. Poetry was her link to the world. It was her

way of deciding a course of action and of expressing herself; Anonymous also wrote

poetry. Perhaps it is not great poetry in an artistic sense, but it is a great step in

expressing her own sentiment in her own words - something neither Levinas nor a

therapist nor a schizophrenic person would take for granted.


Levinas reminds therapists that the loss of words is not mere silence. It is also

isolation. If a patient lives in a world for which there are no words, let alone words that

others will understand, then it is extremely difficult to relate across the infinite distance

that separates all human beings. Sometimes the best a schizophrenic patient can do is

present amorphous fragments to a therapist. Instead of concentrating solely on the forms

of the words themselves, a therapist should also explore expressed meaning. All words

reveal and conceal this meaning, but some words conceal more than others, especially if

they are very general. Thus while psychiatric terms can give words to someone who has

no vocabulary for what is happening to him, terminology can be just that, a termination

which totalizes and obscures by speaking for the patient. Whether the language is unique

or general, a therapist must “be constantly aware that language can never be the

experience itself of my counselee but only a limited inadequate expression of this

experience” (Van Kaam, 1966, p. 158). Although some schizophrenic patients may have

limited capacity for language, their interiority is beyond mere comprehension. Just

because we cannot grasp the extent of their experience and meaning does not mean these

things do not exist. For Levinas, out of sight is definitely not out of mind.


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental

disorders (4th ed., text revision). Washington, DC: Author.

Anastasio, T. (2009). Twenty Years Later [Phish]. On Joy [CD]. Burlington: JEMP


Anonymous. (1964). An autobiography of a schizophrenic experience. In B. Kaplan

(Ed.), The inner world of mental illness (pp. 89-115). New York: Harper & Roe.

Artaud, Antonin. (1965). Antonin artaud anthology (2nd. Ed.). San Francisco: City Lights


Foucault, M. (1988). Madness and civilization: A history of insanity in the age of reason.

New York: Random House. (Original work published 1961).

Laing, R.D. (1965). The divided self: An existential study in sanity and madness. New

York: Penguin Books.

Levinas, E. (1979). Totality and infinity. (A. Lingis, Trans.). Boston: Martinus


Sechehaye, M. (1979). Autobiography of a schizophrenic girl. New York: Grune &


Stone, B. (2004). Toward a writing without power: notes on the narration of madness.

Auto/Biography, 12, 16-33.

Van Kaam, A. (1966). The art of existential counseling: A new perspective in

psychotherapy. Wilkes-Barre, PA: Dimension Books, Inc.


Vonnegut, M. (2002). The eden express: A memoir of insanity. New York: Seven Stories

Press. (Original work published 1975).

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