The discovery of the universal application of Natural Semantic Metalanguage in Narrative Medicine

It happens to me to participate to round tables, meetings, educational sessions, interdisciplinary study groups where traditional competencies in Health Humanities are present: doctors, nurses, anthropologists, psychologists, experts in communication science, patients’ associations, and much other aid or cultural professions. Still, the linguists, the experts in words, are missing. Linguistics is partially studied in Literature, Languages, Philosophy, Anthropology, Psychology disciplines: it is often a challenging exam, hardly connected to the rest of the study pathway. To make it short, there is a sort of stereotype that the linguist, that person who wants to decipher the secrets of our language’s structure, is sometimes “vague and ethereal”, with a slightly nerd attitude. None of this. We can find a profound tension towards the exploration of thought and human actions, just because we study words’ structure, their use over the centuries, how dictionaries have been constructed with their distortions, the importance of communication and understanding of meaning, both in our own language and in other ones.

At ISTUD Foundation, although we love literature, we have chosen the linguistic approach to collect narratives, and we built very plots with easy prompts that patients, even with disabilities, family members and care professionals write in. We ask to write possibly by hand, using less digital technology, because we know that this latter activates more primitive brain areas than those evoked by handwriting.

In Narrative Medicine, considering qualitative methods, the world is roughly divisible into two parts: on the one hand, “without track” people, writing on white paper,  as fresh and never beaten snow, and walking their “off-track” in an acrobatic and exhausting way. On the other hand, those writing “in the track”, in a path in which words are delimited by other words, leading to the finish line, in an apparently less creative way, and looking less eccentric, but more free and faster. The track unrolls itself with the draft’s evocative words, from how it was before the disease, to how the condition is lived, to the reflection on the future, using the terms of the Natural Semantic Metalanguage (NSM) [1]. The news we then deal with – thanks to the thousands of narratives collected through the draft’s original version with minimal changes depending on the context – is the emerging of every single person’s eccentricity. Precisely these universal words in meaning, composing the NSM and translated into English, Italian, Portuguese, French, Spanish, and now also Russian, reawake the narrator in patients, family members, professionals, and stimulate not only the chronicle but also the introspection on desires, feelings, and sources of pleasure.

The words used in the draft are simple and must be simple: I before the illness…, Then, something changed…, So to know I did…, Today…, I feel…, My body…, For tomorrow I would…, are just some of the universals employed, those atoms of meaning that make up more complex molecules, the structured words. We gave an interference to the story by choosing the Kronos-factor, and in fact, the draft follows diachronically the Yesterday, the Today and the Tomorrow. But Kairos is also present, the space of opportunity for change in the here and now: not the nostalgia for the past (of which one can freely write about, without remaining “ensnared”), but today. The time we know is given us is limited, and therefore the “change” (another universal word) and the move (idem) are provided by the rhythm of writing and of that I would like or Somebody wants.

The more we go on studying and exploring Narrative Medicine through drafts, the more we enjoy in changing words depending on the context: Food was…, Food is…, a near-universal inserted in Healthy, a European project aiming to promote healthier lifestyles. Through the same plot translated in Italian, Rumanian, Bulgarian, Turkish and Spanish, we collected the stories of people with obesity in those countries and, on the basis of their needs, difficulties and wishes,  we have structured a website of resources to promote a healthy life. Changing field of application, behind that condition we label “depression”,  we can move between the willingness to live and the one to die: I want to live, I do not want to live, I want to die… Here we have succeeded in making  “depressed” people taking a pen and giving it the pressure to get their thoughts out on the paper, those who generally do not have the energy to make this move, Very depressed people have left us what it means to live with this condition not only afterwards – and this is an easier task – but during the blue time.

A study on the NSM and Minimal Languages (composed by universals and near-universal) application in people with autism has been published, and I reported it as a case [2]: the simplicity of words and their unmistakability help those suffering from the autism spectrum, who take every word literally. Since we are speaking of a minimal and unequivocal language, it calms their psyche, in a world that is too confusing and indecipherable.

Moreover, these universals are related to the way of thinking, feeling emotions, knowing, making us human beings, with respect not only for the anthropological construct but also for the diversity of people. Children, kids, adults with mental disabilities, those who are called “mentally disable” and who need support at school: all of them wrote using our plot. Through the tracks, other forms of intelligence are revealed, beyond those generally computed by the Intellectual Quotient, the linguistic and the mathematical one. Then we can see a flourishing of multiple forms of intelligence [3]: the Visual, the Kinaesthetic, the Musical, the Interpersonal, the Introspective, the Natural and the Existential ones, emerging from the stories of these people with “other” qualities compared to able-bodied people. The monotony with which “normality” is considered is surprising: have you ever tried to do IQ tests? They are almost all based on the logical-mathematical world: the developers of the IQ test do not care for everything else.

As for the narratives collected with NSM, it is almost a paradox, but thanks to a simple outline, the schemes are broken down to bring out the originality of the individual in an essential way, beyond the veils of “autobiographical thought”, that if not “awakened” with the right words, continues to bring forth the image of the false self and therefore of its own fake desires.

The script includes The things I want to do… and this evokes a sense of movement, of revolution to the chaos that the disease has created. Considering migraine, we know that there are physical problems with “seeing” and “hearing”, two other universals: we will keep an eye on them and listen to understand, beyond the universality of actions, what and how each hears and sees during a migraine attack.

Bert Peeters, Associate Professor of Linguistics at the Australian National University, explains the importance not only of knowing how to use word atoms but of deconstructing complex words and reducing them to universal terms: heart, soul, mind, reduced to prime numbers, divisible only for themselves, in the various languages of the world. Impressive is the difference between what we would simply convey using the English lingua franca word “soul”,  “Psyche” in the King James Bible,  “Tamashi” in Japanese: in the former, the deconstructed meaning indicates something that cannot be seen, that is inside the body and moves away after dying… And then the final judgment will follow, depending on what the person has done in life. In the deconstruction of the latter, Tamashi is something that we cannot see, it is everywhere and moves, in people, in animals, in trees, in the things and in the pen with which I wrote the first version of this article by hand and in the keyboard with which I am writing the second draft. I wrote it by hand because, since we said that we should activate more advanced areas of the brain by handwriting, I decided to abandon the keyboard for the first action of reflection. The pen was animated, it had something inside that you could not see that made it alive: and this using the 65 universal words.

I suggest you to study the 65 beautiful words by heart [4], to try to play with them and to see how much they are present in all languages where we have to get straight to the essence. I have seen things that you human (near-universal)… Time to die…, are all universal terms, taken from Rutger Hauer‘s final epic monologue in Blade Runner, the replicant robot that saves, in the end, the human (?) hunter, Harrison Ford.

With these universal words, we also construct Epics and Poetry. This may surprise us perhaps because, before tackling linguistics, we thought it was just a set of operation of assembling terms in a mathematical and combinatorial way.

And here below, there are the specific words of Roy Batty’s, the “replicant cultural context”, mixed with the universals:

I’ve seen things you people wouldn’t believe.

Attack ships on fire off the shoulder of Orion.

I watched C-beams glitter in the dark near the Tannhäuser Gate.

All those moments will be lost in time, like tears in rain.

Time to die.

To us, the lightness of discovering what comes from Roy and his science fiction world and what instead is universal for everyone.
The beauty of monologue and scenes of Blade Runner leave us breathless, like the magnificence of these NSM 65 words and the infinite association possibilities are sublime: well-being and bad-feeling, whether you like it or not, are all universal.

[1] Goddard, Cliff; Wierzbicka, Anna (eds.), 2002. Meaning and Universal Grammar: Theory and Empirical Findings. John Benjamins.

[2] Marini Maria Giulia, 2019. Languages of care in Narrative Medicine.

[3] Gardner Howard, 1983. The frame of mind: multiple intelligences.

[4] https://en.wikipedia.org/wiki/Semantic_primes


Written by

Epidemiologist and counselor – 30 years of professional life in health care. Classic humanistic background, including the study of Latin and ancient Greek, followed by scientific academic studies, chemistry and pharmacology. First years of career, in private international environment. I worked in medical research, moved to health care organization, getting academic specialization in Epidemiology. Later, in consultancy and health care education. Counselor with transactional analysis orientation. Currently, director of Innovation in Health Care Area of Fondazione ISTUD, an independent not for profit Italian Business School with an humanistic approach acknowledged by the Italian Ministry of Researech.. Active member of the board of Italian Society of Narrative Medicine, tenured professor of Narrative Medicine at Hunimed, Milan, and in 2016, referee for World Health Organization for “Narrative Method in Public Health.” Writer of the book; “Narrative medicine: Bridging the gap between Evidence Based care and Medical Humanities,” edited with Springer and of international publications on narrative medicine in scientific journals. Last book “The Languages of care in narrative medicine: words, space and sounds in the healthcare ecosystem”. Lecturer in different international contexts from Academy to Public and Private Foundations.

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