Comes from McKenna PJ & Oh TM (2005) "Schizophrenic Speech: Making Sense of Bathroots and Ponds That Fall in Doorways". Cambridge: Cambridge University Press; p 15-16.

The patient submitted the following document in support of his appeal against being detained in hospital:

Report re Hospital Managers Hearing
In address of: The Hospital Managers
From: Mr K.J.

Introduction: Mr J. is vehemently objecting of slanderous reports bearant of his name submitted to the Hospital Managers and to associative means of appeal against legally enforced detentionable psychiatric treatment of his person.

Background: Mr J. is a forty-five year old bachelor who is a life-dedicated yogi which entails a lifelong commitment to maintaining the religious ordination and stipulates whereof his life is surrendered.

Mr J. is a former undergraduate of – University – whereof he has an open invitation to return to study having left volitionally in order to pursue a career in musical performing entertainment – and of – University which discharged

Mr J. from a course of study in French and Italian in respect of a state of health determinantly unsuitable for the respective campus of the collegiate in 1979. Mr J. actively attempted to achieve a personal ambition of full employment in a musical performancal entertainment until April 1989 – whereof a professional contract with Virgin Records was proffered – when he ended all personal association of musicianship owing to irreconcilable personal détente in professional life; since this time Mr J. whose musical compositions are known of the Royal Northern College of Music and whose name is his registered copyright has maintained a personal protestable denouncement of illegal utilisation of his song and musical work associated with a previous repertoire.

Mr J. is now a registered writer – having written a book of aphoristic poetry – and an oratorial (i.e. public lecturial) academic.

Mr J. is considered by his father, Mr R.J., to be sufferant of the diagnosable disease of the human brain known in the medical term schizophrenic and has been recipient of this paternal party’s adamant stratagem of implementing continuous psychiatric medical treatment thereof since he committed himself into the state of insanity after leaving the initiated life of devout religious yoga in the Indian Divine Light Mission* established in the United Kingdom of Great Britain and Northern Ireland in 1972 – being an alternative act to personal suicide.

Social ‘History’: Since a long touring holiday in 1993 Mr J. has lived in commercial board and lodgings in N. and surrounding region. He has been denied repeatedly the means of establishing his own home and has been able to maintain basic existence only in respect of Department of Social Security – and personal – attitudes and policies towards himself.

Signed K.J.

* now known by the title ELAN VITAL, Reg’d Charity 24864


We have no other information about the patient than this letter. Putting a WKL diagnosis is thus impossible. However, this letter is a good illustration of the kind of thought and speech disorders that can be observed in cataphasia. It is proposed here only for this purpose.

There are derailments and speech disorders are especially prominent affecting both the lexical and syntactic parts. There are semantic paraphasias (word approximations), neologisms and paragrammatisms.

However, this conclusion should be especially cautious because of the stilled way of writing, which might have been voluntary chosen to impress the “Hospital Managers”. When the style is too formal to be afforded correctly, errors might occur. We fell that they are too numerous and not simply of the form of “self-important bureaucratic style”.

Alternatively, this kind of high-styled writing associated to such moderate ideas of grandeur is characteristic of people suffering from expansive paraphrenia, who typically use expressions which they consider to be cultured class, such as using foreign words (“détente”). Because of the use of such “self-important bureaucratic style” and their though disorder, they don’t use the right words, may do wrong words constructions, and commonly make grammatical errors. The concepts are not totally incorrect but imprecise and not entirely relevant. However, they are arguments against this diagnosis: the slight persecutory ideas, the playing with the words and clang associations (oratorial / lecturial) and such appeal against being detained is less likely to occur in expansive paraphrenia due to the fact that these patients typically have a great loss of initiative. Knowledge about the course and associated symptoms would have allowed to make the differential diagnosis.