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COMMUNICATION

The Social Matrix of Psychiatry

COMMUNICATION

THE SOCIAL MATRIX OF PSYCHIATRY

Jurgen Ruesch, M.D.

AND

Gregory Bateson

W • W • NORTON if COMPANY • INC • New York

Copyright, 1951, by W. W. Norton & Company, Inc.

First Edition

PRINTED IN THE UNITED STATES OF AMERICA FOR THE PUBLISHERS BY THE VAIL-BALLOU PRESS

CONTENTS

1. VALUES, COMMUNICATION, AND CULTURE:

An Introduction 3

by Jurgen Ruesch

2. COMMUNICATION AND HUMAN

RELATIONS:

An Interdisciplinary Approach 21

by Jurgen Ruesch

3. COMMUNICATION AND MENTAL ILLNESS:

A Psychiatric Approach 50

by Jurgen Ruesch

4. COMMUNICATION AND AMERICAN VALUES:

A Psychological Approach g4

by Jurgen Ruesch

5. AMERICAN PERSPECTIVES:

An Integrative Approach 135

by Jurgen Ruesch

vi CONTENTS

6. COMMUNICATION AND THE SYSTEM OF

CHECKS AND BALANCES:

An Anthropological Approach 150

by Jurgen Ruesch and Gregory Bateson

7. INFORMATION AND CODIFICATION:

A Philosophical Approach 168

by Gregory Bateson

8. CONVENTIONS OF COMMUNICATION:

Where Validity Depends upon Belief 212

by Gregory Bateson

9. PSYCHIATRIC THINKING:

An Epistemological Approach 228

by Gregory Bateson

10. THE CONVERGENCE OF SCIENCE AND

PSYCHIATRY 257

by Gregory Bateson

11. INDIVIDUAL, GROUP, AND CULTURE:

A Review of the Theory of Human Communica- tion 273

by Jurgen Ruesch and Gregory Bateson

REFERENCES 290

INDEX 303

COMMUNICATION

The Social Matrix of Psychiatry

1- VALUES, COMMUNICATION, AND CULTURE: An Introduction

By Jurgen Ruesch

Today, in the middle of the twentieth century, scientists and clinicians alike strive for mutual understanding. To renounce dogmatic views and to abandon scientific isolation is the fashion of our time. Psychiatrists have moved out of the enclosing walls of mental institutions and have found a new field of activity in the general hospitals of the community and in private practice. The transformation of the former alienist into a modern therapist and the change from static to dynamic principles necessitated a revision of psychiatric theories. While, in the past, theories of personality were concerned with one single individual, modern psychiatrists have come to the realization that such theories are of little use, because it is necessary to see the individual in the context of a social situation. Our technical civilization has re- duced the intellectual isolation of people to a minimum, and modern means of communication and transportation accelerate the dissemination of information to such an extent that in the not too distant future we can expect that no individual or group will be able to escape such influences for long.

The authors have attempted in this book, which is dedicated to a presentation of the broader aspects of communication, to conceptualize interpersonal and psychotherapeutic events by con- sidering the individual within the framework of a social situa- tion. Focusing upon the larger societal systems, of which both

psychiatrist and patient are an integral part, necessitated the de-

3

4 COMMUNICATION

velopment of concepts which would encompass large-scale events as well as happenings of an individual nature. We have sketched this relationship in a unified theory of communication, which would encompass events which link individual to individual, events which link the individual to the group, and ultimately, events of world-wide concern.

In the course of our investigation we had to examine the posi- tion of psychiatry within the framework of social science. Special attention was paid to the management of scientific information about the behavior of people and the interrelation of data ob- tained at the individual, group, and societal levels. We refer par- ticularly to the dialectical difficulties which develop when the scientist operates at different levels of abstraction. To facilitate the consideration of an event, first within the narrower context of an individual organism, and then within the framework of a larger societal system, the concept of the social matrix was used. The term "social matrix," then, refers to a larger scientific system, of which both the psychiatrist and the patient are integral parts. This larger system, however, is of no immediate concern to the psychiatrist or to the patient at the time of interaction. Devoting attention to a particular subject matter, and delineating a cir- cumscribed set of events, the limited concerns of the doctor- patient teams may not immediately affect the larger universe. Nonetheless, the smaller system is a part of the larger system; and conclusions drawn within this smaller system may become inaccurate or even invalid when seen in the framework of the wider over-all system.

This phenomenon we have related to the more general prob- lem of "part and whole" (151). The physician and the psychiatrist, in their work, repeatedly deal with relationships between one cell and the surrounding tissue; one organ within an organism; an individual within the family group; a family within the com- munity; and ultimately, perhaps, the community within the framework of the nation, and the nation within the United Na- tions, These varied foci of interest are usually watched and studied by different disciplines, all using their own concepts and their separate technical languages. Such divisions, though useful at one stage, can become merely obstructions at a later stage.

VALUES, COMMUNICATION, AND CULTURE 5

Therefore, in order to facilitate progress, we propose to use one single system for the understanding of the multiple aspects of human behavior. As of today, we believe that communication is the only scientific model which enables us to explain physical, intrapersonal, interpersonal, and cultural aspects of events within one system. By the use of one single system we eliminate the multiplicity of single universes, the multifarious vocabularies, and the controversies which arise because we, the scientists and clinicians, cannot understand each other. To introduce the reader to such a system of explanation in its application to the field of psychiatry the present volume has been written.

At this time the reader may ask what, if any, relationship exists between communication and the variety of topics which are pre- sented in this volume. In reply we ask him to bear with us for a little while until such time as we have been able to demonstrate how value theory, psychiatric thinking, and observations about the American culture are intimately connected. We hope to show that these multifarious features which are included under the heading of social matrix are the silent determinants of our means of communication, and that communication is the link which connects psychiatry with all other sciences. It is well to remember that almost all phenomena included under the traditional head- ing of psychopathology are disturbances of communication and that such disturbances are in part defined by the culture in which they occur. Contemporary psychiatric theories were imported from Europe by Europeans, and inasmuch as psychiatric theories are implicitly theories of communication, they must undergo modification and progressive change when transplanted from one country to another. Therefore, considerable time and space have here been devoted to an understanding of the American system of communication and its implicit influence upon psychiatric practices and thinking.

At first sight, problems of communication seem to be of only secondary interest to the student of individual behavior. People act on their own, they do things alone, and at times they manage, exploit, coerce, or kill others without announcing their intention of doing so. But communication does not refer to verbal, explicit, and intentional transmission of messages alone; as used in our

6 COMMUNICATION

sense, the concept of communication would include all those processes by which people influence one another. The reader will recognize that this definition is based upon the premise that all actions and events have communicative aspects, as soon as they are perceived by a human being; it implies, furthermore, that such perception changes the information which an individual possesses and therefore influences him. In a social situation, where several people interact, things are even more complicated.

When persons convene, things happen. People have their feel- ings and thoughts, and both while they are together and after- wards, they act and react to one another. They themselves per- ceive their own actions, and other people who are present can likewise observe what takes place. Sensory impressions received and actions undertaken are registered; they leave some traces within the organism, and as a result of such experiences people's views of themselves and of each other may be confirmed, altered, or radically modified. The sum total of such traces, accumulated through the years by thousands of experiences, forms a person's character and determines in part the manner in which future events will be managed. The impressions received from the sur- roundings, from others, and from the self, as well as the retention of these impressions for future reference, can all be considered as being integral parts of a person's communication system. Inas- much as a person's way of responding to perceived events neces- sitates the forwarding of messages to the peripheral effector organs, the intra-organismic network is conveniently considered as a part of the larger interpersonal, or even superpersonal (cul- tural) network.

What, then, the reader may ask, is not communication? In order to answer this problem, we must investigate the questions which a scientist wishes to answer. Where the relatedness of entities is considered, we deal with problems of communication; when entities are considered in isolation from one another, problems of communication are not relevant. To be interested in communication therefore becomes synonymous with assuming a definite scientific position with a viewpoint and interests focusing upon human relations. However, the scientific investigation of communication is made difficult by the fact that we have to com-

VALUES, COMMUNICATION, AND CULTURE 7

municate in order to investigate communication. Inasmuch as it is impossible to fix at any one moment our position as observers, we are never quite sure of that which we purport to observe. We can never abstain from communicating, and as human beings and members of a society, we are biologically compelled to com- municate. Our sense organs are constantly on the alert and are registering the signals received, and inasmuch as our effector or- gans are never at rest, we are, at the same time, continually transmitting messages to the outside world. Therefore, our bio- logical need to receive and transmit messages is in some ways a handicap to the investigation of the scientific processes of com- munication. In order to overcome this difficulty, it is necessary for us to make a structural assumption regarding the state of signs and signals within our own organism. This end result of percep- tion and transmission we refer to as information.

The acquisition and retention of information is paramount in any system of communication. In order to retain some traces of messages received and sent, and in order to evaluate these, the human organism is equipped to detect common features in apparently diverse events. The elements or patterns which are common to a variety of happenings are of necessity abstract, and it is these abstract relationships which are retained by the or- ganism. However, in order to proceed with abstraction, the organism must be exposed to a sufficient number of events which contain the same factors. Only then is a person equipped to cope with the most frequent happenings that he may encounter. If a person is able to predict events, and if he possesses the ability to cope with certain happenings, he is said to have relevant information. As far as we know, that which is referred to as in- formation consists of an arrangement of nervous impulses and connections. This arrangement must consist of relationships which are systematically derived from those among the original events outside the organism.

In the social sphere, the acquisition of information about relatedness to people occurs through continuity and consistency of exposure to similar social events; it begins with the child's experiences with his mother, then with members of his family, and later with contemporaries at school and on the playground.

8 COMMUNICATION

The youngster learns from adults and from his age mates to follow rules and to master the obstacles which he encounters. The repetitive character of social events teaches people to react in stereotyped ways; and stereotyped behavior creates, of course, stereotyped surroundings. Therefore, when we speak of a so- cial matrix, in which interpersonal events take place, we refer to the repetitive and consistent bombardments with stimuli to which human beings are exposed. These originate, on the one hand, in the social behavior of other people and, on the other hand, in the objects, plants, and animals with which people surround themselves. Gradually the stimuli perceived and the responses chosen become stylized; the stimulus shapes the re- sponse, and once the response has been learned, the individual is conditioned to seek those stimuli which will elicit his learned responses. This whole process can be compared to the bed which a river cuts into the surface of the earth. The channel is formed by the water, but the river banks also control the direction of flow, so that a system of interaction is established in which cause and effect can no longer be isolated. Stimulus and response are thus welded into a unit; this unit we shall refer to as "value."

Values are therefore, so to speak, simply preferred channels of communication or relatedness. Information about the values which people hold enables us to interpret their messages and to influence their behavior. Values are not only characteristic of an individual but are also held by groups of people and by whole cultures. The reader will recognize that as soon as in- terpretation of messages is considered, no clear distinction can be made between communication theory, value theory, and anthropological statements about culture. This combination of features is the medium in which we all operate; therefore we refer to it as the social matrix.

As individuals we are usually not fully aware of the existence of this social matrix. Unable fully to encompass the effects of our own actions upon others, and because of our limited human perspective, we are unlikely to grasp the magnitude and nature of what happens. When we quarrel with a family member, or when we attempt to explain the reasons for a rise in the price of butter, we tend to treat such incidents as unique; thus,

VALUES, COMMUNICATION, AND CULTURE 9

unaware that thousands of other people might have similar ex- periences, we blame our relatives or we curse the grocer. As a matter of fact our behavior in such situations is already both a response to other people's reactions and a stimulus for their behavior. Our personal and interpersonal concerns, the im- mediate foci of our daily life, make it difficult for us to appre- ciate fully the wider aspects of social events. Therefore, in this book, we have made it our task to illustrate some of the relations which exist between individual, group, and culture. While for the average person it is quite sufficient to possess some practical working knowledge of these matters, the psychiatrist, in addition, must possess explicit and systematic knowledge of these relation- ships if he wishes to help his patients. The relationship between superpersonal systems on the one hand, and interpersonal and individual systems on the other, is not merely a dialectic fancy of the scientist, but is embedded in the daily needs of the in- dividual, whose life and sanity require that he be able to com- municate successfully with other human beings. To the achieve- ment of this end the psychiatrist has dedicated his life.

After introducing our subject matter to the reader it might be worth while to say a word about the methods we used to study the social matrix. It is well to remember that regardless of whether the scientist studies psychiatric, social, or cultural phe- nomena, sooner or later he has to consider the individual. The only thing that differs is the data obtained from individuals. Therefore in carrying out this study we have found it convenient and necessary to keep clear in our thinking the differences be- tween the various sorts of data with which we have had to deal. Especially is this true of the differences between participant ex- perience and experimental operation, and between observation of behavioral acts and introspective reports. The fact must be faced that when a culture or subculture is studied as an integrated communication system, it is necessary to consider in the scheme of scientific operations the following circumstances:

(a) That the members of the population studied make gen- eralizations about their own culture.

(b) That the investigator observes interaction and communi-

10 COMMUNICATION

cation between the members of the population as a neutral spectator.

(c) That each member of the population has his own view of his own roles and can in some measure report these to the ob- server.

(d) Lastly, that the investigator obtains important insight from his own personal interaction with members of the population.

Each of these circumstances determines a particular way of collecting data, and it is necessary to insist that the data collected in any one of these ways are not the same, either in their order of abstraction or in the distortions which they introduce, as the data collected in one of the other ways. In general, it may be said that these four types of data are mutually corrective and that an undue specialization in any one of the four leads to a distorted picture. The sorts of distortion which result from over-special- ization in each type of data collecting may here be mentioned:

If the investigator overspecializes in his attention to what people say about their own culture, he will arrive at an idealized or stereotyped picture of that culture; he will collect a system of social generalizations which ignore the actual behavior of actual people. His picture will be a function of the culture which he is studying, because he will collect stereotypes which are themselves culturally determined; but it will be a distorted function. Further, if the investigator is sociologically minded, he may be guilty of the sort of oversimplification which occurs in organizational charts, forgetting the human individuals and see- ing only their defined functions.

Similarly, if the investigator specializes in being a neutral ob- server of interaction between members of a population, he may build up a picture of customs and character types from which human individuality and the idiosyncrasies of motivation will be lacking. He might, for example, arrive at the position com- mon in anthropology of paying attention to individual behavior, only to use his observations of people's reactions to point up their culturally stylized attitudes.

If, on the other hand, the investigator specializes in collecting personal introspective reports, he will arrive at the distortions

VALUES, COMMUNICATION, AND CULTURE 11

characteristic of the overspecialized therapist; he may see the individuals as isolated entities, not related to each other or to himself. He will be limited to a discussion of their internal structure and dynamics, not seeing the structure and dynamisms of the larger social whole.

Finally, the scientist who overspecializes in participant ex- perience will perceive individual trends and interaction but will tend to ignore the more static phenomena of convention, social organization, and other social determinants. His picture will resemble one which might be drawn by an overspecialized psychiatrist who sees the unique dynamics and flux of an in- dividual's responses to himself without seeing that individual's life as socially determined.

Also, it is of interest to note that the systematic differences and distortions which follow when the investigator takes a particular view of the system which he is studying, or when he specializes in a particular method of collecting data, are them- selves clues to his value system. The nature or slant of his knowl- edge is determined by his methods of obtaining that knowledge and by his notions of what knowledge is. If we describe his selective awareness — his structuring of perception — we shall, in fact, be describing his system of values.

As authors, we are fully aware that whatever we may say about value systems of psychiatrists, patients, or the American culture will be colored by our own personal values. On the other hand, we are also fully aware that no scientific observer can escape being bound to his subjective way of perceiving, inasmuch as any investigator is an integral part of the com- munication system in which he and the observed — be it human, animal, or object — participate. In the present study this danger of distortion has been acknowledged by including various types of data and by having more than one author, each with a dif- ferent background and viewpoint, participate in the evaluation of the data. This combination of contrasting types of data and differently trained observers tends to minimize the distortions mentioned above.

The facts, combinations, and concepts presented in this volume are based upon the following experiences of the authors:

12 COMMUNICATION

(a) We have studied psychiatrists 1 in non-controlled inter- views in their homes, their offices, our offices, or wherever the opportunity presented itself. In this type of interview the focus of the investigation centered in the interaction with the psychia- trists, in order to gain a better picture of the informant's inter- personal approaches.

(b) In addition to these innumerable interviews in informal settings, about thirty sessions of one or two hours' duration with more than thirty different psychiatrists were recorded on wire with the knowledge of all participants. These interviews were not shaped according to questionnaires, nor were the psychia- trists subjected to detailed questioning such as must be resorted to in linguistic or genealogical studies. The approach was some- times that in which an anthropologist gives freedom to his in- formant to follow the lines of his own thought guided only by occasional questions and suggestions of topic, and sometimes that in which die interviewer expresses his own honest opinions, leading to argument and discussion. The open-ended suggestion of a topic tended to focus the conversation upon the psychia- trist's therapeutic interest, and eventually led to his individual- istic formulations, which tended to reveal more clearly the value system which governed his therapeutic operations.

(c) We have attended psychiatric meetings in which either theoretical issues were discussed or cases were presented, and we have studied the way psychiatrists relate themselves to each other and the way they talk about theory and about pa- tients.

(d) We have as patients participated in individual therapy and experienced the psychiatrist in his function as therapist.

(e) We have examined the literature of American psychiatry and the assumptions contained therein. The printed sources which we studied were confined to the contemporary publica- tions of leading psychiatrists, psychoanalysts, and psychothera- pists of every school of thought. European sources were not par-

i This work was part of a research study on nonverbal communication in psycho- therapy, which is in part supported by a research grant from the Division of Mental Hygiene, U. S. Public Health Service. In particular, this grant enabled us to do the work mentioned in paragraphs (a), (b), and (g) above.

VALUES, COMMUNICATION, AND CULTURE 13

ticularly emphasized because they do not reflect American think- ing on the subject.

(£) We have studied the popular stereotypes of the psychiatrist as they appear in cartoons and anecdotes as well as the formal and informal reactions of the public to psychiatry.

(g) We have recorded many hundreds of hours of therapeutic sessions. Several therapist-patient teams were followed longitu- dinally and many more teams were studied cross-sectionally. These recorded interviews were then analyzed by the authors for material pertinent to the value systems of both therapist and patient, and especially for the study of the modification of values in and during therapy (135), (136), (142), (146), (148), (150).

(h) We have made a study of the American cultural milieu in which the psychiatrist operates (139), (140), (143). The value premises of the American culture were derived from sources listed in the bibliography, from years of interaction of the au- thors with Americans, and from the study of the systems and methods of communication in press, movies, radio, advertising, courts, hospitals, and other institutions. In brief, our impres- sions, derived from living in America, have been drawn on and checked by discussions between the authors and by current ob- servations during the progress of the study.

Psychiatry and anthropology are still at the stage of being descriptive sciences; and because, in such sciences, the theoretical premises are left implicit, these sciences have difficulty in ac- cumulating a coherent body of clearly formulated hypotheses. The present book has been dedicated to the task of stating and illustrating at length the premises which underlie the various approaches to social science. We have chosen psychiatry as the focus of our attention because the psychiatrist in his daily prac- tice is concerned with disturbances of communication; he and the communication engineer, of all scientists, seem to be most aware of the laws of communication. The essence of our message to the reader is that communication is the matrix in which all human activities are embedded. In practice, communication links object to person and person to person; and scientifically speaking, this interrelatedness is understood best in terms of systems of communication.

14 COMMUNICATION

In gathering information relevant to communication we had to combine the most diversified approaches. In this book the reader will encounter a number of chapters which have been labeled in succession as interdisciplinary, psychiatric, psycho- logical, integrative, anthropological, philosophical, and episte- mological approaches. In so naming the chapters we have at- tempted on the one hand to define the position and viewpoints of the observer, and on the other hand, to show that in spite of different viewpoints, such observers use a system of communi- cation common to all. Furthermore, the chapters have been arranged in such a way as to present a progression from the more common observations of a concrete nature to the more abstract and theoretical formulations. The use of a variety of topics, of differences in approach, and of multiple levels of ab- straction was thought to encompass the field of human com- munication more thoroughly than would have been possible by any single approach. Hence psychiatric, psychological, and an- thropological concepts have been synthesized with theories de- rived from cybernetics and communication engineering.

The present volume is concerned with theoretical matters. The notions of information, communication, preference, and value are notoriously obscure, and the phenomena associated with these notions are exceedingly difficult to dissect. This book is concerned with such dissection. It is a descriptive, not an experimental, study, and this fact has curious implications:

In an ideal experimental presentation, a hypothesis is stated, the outcome of a crucial experiment is described, and at the end, it is clear what contribution has been made to theoretical knowl- edge; the hypothesis is fortified, modified, or discarded. In a descriptive study things are not so simple because the theoretical premises of the scientist determine his techniques of description and have themselves been determined in part by his experience of the phenomena which he is describing. At the end of such a presentation, it may be clear that certain new facts have been added to knowledge, but it is usually very unclear what con- tribution has been made at a more theoretical level.

Although each of the two authors is individually responsible for the chapters he has written, in thought and context the book

VALUES, COMMUNICATION, AND CULTURE 15

is the result of interdisciplinary teamwork between a psychia- trist and an anthropologist. Data related to the uniqueness of the individual are therefore combined with data related to the more abstract similarities which men have in common. We invite the reader to participate in judging whether or not com- munication is the common denominator which bridges the gap between the various fields of social science. If the answer is in the affirmative, the first step has been made towards the estab- lishment of a more unified theory of human behavior.

BASIC PREMISES

To help the reader to understand our viewpoint and to fixate the point of departure of our sometimes rather theoretical con- siderations, we have verbalized our basic premises in a few sentences. These may serve as milestones for that which we shall illustrate, amplify, and pursue further in the later chapters of our book.

Delineation of Universe: The unit of consideration is the social situation.

Social Situation: A social situation is established when people enter into interpersonal communication.

Interpersonal Communication: An interpersonal event is characterized by:

(a) The presence of expressive acts on the part of one or more persons.

(b) The conscious or unconscious perception of such ex- pressive actions by other persons.

(c) The return observation that such expressive actions were perceived by others. The perception of having been perceived is a fact which deeply influences and changes human behavior.

Intrapersonal Communication: The consideration of intra- personal events becomes a special case of interpersonal communi- cation. An imaginary entity made up of condensed traces of past experiences represents within an individual the missing outside person. However, a crucial difference exists between interpersonal and intrapersonal communication with regard to

16 COMMUNICATION

the registration of mistakes. In the interpersonal situation the effects of purposive or expressive actions can be evaluated and if necessary corrected. In intrapersonal or fantasy communica- tion, to perceive that one misinterprets one's own messages is ex- tremely difficult, if not impossible, and correction rarely, if ever, occurs.

Mass Communication: A social event may be characterized by mass communication — e.g., through the media of radio, televi- sion, movies, and the press. When exposed to such mass com- munications, an individual is likely to feel on the one hand, that he is a participant in a larger superpersonal system, and on the other hand, that he is unable to delineate the system. This contradiction is brought about by the fact that in mass com- munications the originators and recipients of messages are so numerous that they usually remain anonymous. Therefore, un- der such conditions, the individual is not able to observe the effect of his own messages upon others, nor can he communicate his personal reactions to a message originating from committees, organizations, or institutions. Cause and effect become blurred, correction and self-correction of messages become delayed in time and removed in space; if correction finally occurs, it often is no longer appropriate.

Communication Apparatus: The communication apparatus of man has to be viewed as a functional entity without anatomical localization. The reader should be reminded that several parallel sets of expressions exist to denote the phenomena of communica- tion. While the engineer's "communication center" corresponds to the mentalist's "psyche," the organicist refers to it as "central nervous system." We believe that one of the most important changes which must follow from interchange of theories between engineers and psychiatrists is an increasing precision in the use of mentalist phrasings. Engineers and physiologists are still very far from giving us an organic base on which mentalist theories can be built, but they have already given us certain general notions about the characteristics of networks of relays, and these general notions must guide and restrict our loose use of men- talist abstractions. In our view, the communication apparatus of man is composed of:

VALUES, COMMUNICATION, AND CULTURE 17

(a) his sense organs, the receivers

(b) his effector organs, the senders

(c) his communication center, the place of origin and desti- nation of all messages

(d) the remaining parts of the body, the shelter of the communication machinery.

Limitations of Communication: The limitations of man's com- munications are determined by the capacity of his intrapersonal network, the selectivity of his receivers, and the skill of his effector organs. The number of incoming and outgoing signals, as well as the signals that can be transmitted within the organ- ism, is limited. Beyond a certain maximum any increase in number of messages in transit leads to a jamming of the net- work, and so to a decrease in the number of messages which reach their appropriate destinations. This type of disruption of the communication system the psychiatrist calls anxiety. It is subject to conjecture whether reduction of the number of in- coming messages, and messages in transit below a certain mini- mum, may lead to a "starvation phenomenon." From information gathered in the study of infants it seems that mental retardation is the result of insufficient interaction with others. There is also a more obscure limitation of communication which results from the difficulty of discussing the basic premises and codification of a system of signals in those same signals. This difficulty is shown to be of special relevance in the psychiatric situation, where the patient and therapist have to achieve communication about their own understanding of their own utterances. The same difficulty is also present in all attempts to communicate between persons of different cultural backgrounds.

Function of Communication: Man uses his communication system:

(a) to receive and transmit messages and to retain informa- tion;

(b) to perform operations with the existing information for the purpose of deriving new conclusions which were not directly perceived and for reconstructing past and anticipating future events;

18 COMMUNICATION

(c) to initiate and modify physiological processes within his body;

(d) to influence and direct other people and external events.

Effect of Communication: Communication facilitates speciali- zation, differentiation, and maturation of the individual. In the process of maturation reliance upon protective and corrective actions of others is gradually replaced by interdependence upon contemporaries in terms of communication. Instead of looking to elders for guidance, the adult person seeks information from contemporaries on how best to solve a problem. Exchange is substituted for receiving, and action of self replaces actions of others.

Interference and Communication: Interference with goal- directed behavior of an individual gives rise to the alarm reac- tion. If the interference can be successfully disposed of or avoided altogether, the alarm reaction will recede. However, frequently the source of interference cannot be avoided or eliminated. Under such circumstances, the sharing of anxiety with non- anxious or non-threatening individuals by means of communi- cation becomes an efficient device for tolerating the impact of interference.

Adjustment: Successful communication with self and with others implies correction by others as well as self-correction. In such a continuing process, up-to-date information about the self, the world, and the relationship of the self to the world leads to the acquisition of appropriate techniques, and eventually in- creases the individual's chances of mastery of life. Successful communication therefore becomes synonymous with adaptation and life.

Disturbances of Communication: Abnormalities of behavior are described in terms of disturbances of communication. In the past, these disturbances have been summarized under the heading of psychopathology. It is well to remember that the term "organic" refers to disruption of the internal communica- tion machinery, that "intrapersonal" refers to a network limited to one individual, and that "interpersonal" refers to a network composed of several individuals. Complete descriptions of dis- turbances of communication therefore include:

VALUES, COMMUNICATION, AND CULTURE 19

(a) on a technical level, statements about the communica- tion apparatus, the dimensions of the network, and the functional implications as well as physical aspects of transmission and reception.

(b) on a semantic level, statements about the accuracy with which a series of symbols transmit the desired meaning of a message, including semantic distortions.

(c) on an interaction level, statements about the effective- ness of the transmission of information upon the be- havior of people in an attempt to achieve a desired effect.

Psychiatric Therapy: Psychiatric therapy aims at improving the communication system of the patient. The neurophysiologist, neurologist, and neurosurgeon endeavor to improve the internal communication apparatus of the patient on a technical level, while the psychotherapist aims at restoring a broken-down system of interpersonal communication on a semantic or interaction level. This is achieved either by reducing the number of incom- ing messages and preventing jamming, or by increasing the number of messages in transit and preventing isolation and star- vation. Once communication of the patient with the self and with others has improved, correction and self-correction of in- formation provide the foundations for a change in the conduct of the patient.

Nature of Psychotherapy: Regardless of the school of thought adhered to, or the technical terms used, the therapist's opera- tions always occur in a social context. Implicitly, therefore, all therapists use communication as a method of influencing the patient. The differences that exist between the therapist and the patient are differences in their systems of value, which can be traced to differences in the codification or evaluation of per- ceived events.

The Psychiatrist's Value System: In order to understand the differences which exist between the communication system of the patient and that of his fellow-man, the psychiatrist must possess information about both. If the psychiatrist's communica- tion system were similar to that of the patient, he would be unable to help him; if the psychiatrist's communication system

20 COMMUNICATION

is identical with that of the people surrounding the patient, he will notice that the patient is different, but still will be unable to help him. Therefore, it becomes necessary for the psychiatrist to possess values which are somewhat different from those of the patient and somewhat different from those of the core group.

The Psychiatrist and Culture Change: The differences in the psychiatrist's value system from those of the core group arise from specific life experiences. Essentially they are related to ex- periences of culture contact and repeated exposure to differing systems of value during the formative years. Such conditions sharpen the social perception of the future psychiatrist and make him aware of the fact that values differ from group to group. Being forced to reinterpret his own position whenever he meets a new group, he develops the necessary means which enable him to perceive and evaluate the various communication systems of other people. Such basic life experiences are necessary if a man wishes to become a successful therapist. Training merely supplies a system for an orderly arrangement of these basic life experi- ences.

Distorted Communication and Marginal Status of Patients: The values which distinguish patients from other people and from the therapist are a result of the particular social situations in which the patients were reared. Unable to assimilate divergent trends within the home, or between home and surroundings, these patients have never developed satisfactory means of com- munication. This results in marginal status as compared to the people who make up the core of the group in which the patient lives.

Mental Hygiene: The psychiatrist's work is aimed at helping the patient to acquire a communication system which is similar to that of the core group; and as an interpreter, he familiarizes the core group with the peculiarities of marginal man. The nature of the mental hygiene movement and other endeavors is to prevent the development of disturbances of communication which, in turn, are directly or indirectly responsible for disturb- ances of behavior.

2 • COMMUNICATION AND HUMAN

RELATIONS : An Interdisciplinary Approach

By Jurgen Ruesch

The field of communication is concerned with human related- ness. Every person, plant, animal, and object emits signals which, when perceived, convey a message to the receiver. This message changes the information of the receiver and hence may alter his behavior. Change in behavior of the receiver, in turn, may or may not perceptibly influence the sender. Sometimes the effect of a message is immediate; at other times the message and its effect are so far apart in time and space that the observer fails to connect the two events. For purposes of our presentation however, we shall be concerned more with the immediate effects of messages and their influence upon the behavior of people.

CHANNELS OF COMMUNICATION IN EVERYDAY LIFE

In order to familiarize the reader with the varieties of human communication, let us view the experiences of Mr. A as he pro- ceeds with his daily activities. In the morning when Mr. A enters his office he reads his incoming mail (written communica- tion). In sorting his mail he encounters a number of pamphlets which are designed to describe the merits of various business machines (pictorial communication). Through the open window the faint noise of a radio is heard, as the voice of an announcer clearly praises the quality of a brand of toothpaste (spoken com-

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munication). When his secretary enters the room she gives him a cheerful "good morning," which he acknowledges with a friendly nod of his head (gestural communication) while he continues with his conversation on the telephone (spoken com- munication) with a business associate. Later in the morning he dictates a number of letters to his secretary, then he holds a committee meeting (group communication), where he gathers the advice of his associates. In this meeting a number of new governmental regulations (mass communication) and their effect upon the policies of the firm are discussed. Later in the meeting a resolution to the employees of the firm concerning the annual bonus (mass and group communication) is considered. After the committee has adjourned, Mr. A, engaged in thoughts concern- ing unfinished business (communication with self), slowly crosses the street to his restaurant for lunch. On the way he sees his friend Mr. B, who in a great hurry enters the same luncheon place (communication through action), and Mr. A decides to sit by himself rather than to join his friend, who will probably gulp down his coffee and hurry on (communication with self). While waiting, Mr. A studies the menu (communication through printed word) but the odor of a juicy steak deflects his gaze (chemical communication); it is so appetizing that he orders one himself. After lunch he decides to buy a pair of gloves. He enters a men's store and with the tips of his fingers carefully examines the various qualities of leather (communication through touch). After leisurely concluding the purchase, he decides to take the afternoon off and to escort his son on a promised trip to the zoo. On the way there, John, watching his father drive through the streets, asks him why he always stops at a red light and why he does not stop at a green light (communication by visual sym- bol). As they approach the zoo, an ambulance screams down the street, and Mr. A pulls over to the side of the road and stops (communication by sound). As they sit there he explains to his son that the church across the street is the oldest in the state, built many years ago, and still standing as a landmark in the community (communication through material culture). After paying admission to the zoo (communication through action), they leisurely stroll over to visit the elephants. Here John laughs

COMMUNICATION AND HUMAN RELATIONS 23

at the antics of an elephant who sprays water through his trunk at one of the spectators (communication through action), sending him into