oa South African Family Practice - The words are the illness : peripheralia

Volume 54, Issue 4
  • ISSN : 2078-6190
  • E-ISSN: 2078-6204



Recently, I had reason to suggest to a confused registrar that the words that a patient speaks may sometimes be the illness itself. I am not sure whether she entirely believed me. It's a concept that was first proposed by, among others, the Cambridge philosopher, Ludwig Wittgenstein. He suggested that we often assume that language works one way by literally translating our thoughts. He proposed that language also creates reality, as well as attempting to describe reality. This is especially relevant when a patient presents his or her felt symptoms and sensations, as well as life narratives in the consultation. Usually, in a routine day of continuous consultations and the immediate need for factual information, we take the words at their face value. In our trusting context, "face value" means that the genuineness or exactness of the words are not questioned.

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