This post is a commentary by Maria Giulia Marini on Heart- and Soul-Like Constructs across Languages, Cultures, and Epochs (New York and London: Routledge, 2019) edited by Bert Peeters.
Narrative medicine, a discipline of the medical humanities, aims to improve healthcare service by listening out for the rational and emotional aspects in patient narratives, thereby eventually turning the relationship between carers and the cared-for into a real affiliation. If a primary focus of the medical humanities has been on literature-based patient stories, narrative medicine foregrounds true stories based on daily clinical practice (Greenhalgh 1999). In line with prevailing bio-psycho-social and spiritual models, such stories generally unfold in three phases: the past (falling ill), the present (being ill), and the future (two possible endings: getting better or getting worse). Narrative medicine posits that interpretation of illness narratives of this kind requires a rigorous method. When patients write about themselves and their disease, they rely on their minds, their souls, their courage, their concept of life, using towering and eminently culture-specific words such as mind, soul, courage, life, and many more, which psychologists and philosophers all too often take for granted. What exactly do they mean, and how can we state this in a way that makes sense to carers and the cared-for alike? This is where we need to embrace linguistics, which can help us explain and increase our awareness of the anthropological peculiarities of words we think we understand, although we often do not understand them nearly as well as we should. One area of linguistics that is particularly relevant in this context is the so-called “Natural Semantic Metalanguage approach”.
Bert Peeters, the editor of the book under review, is a well-known linguist and advocate of the Natural Semantic Metalanguage (henceforth NSM), a descriptive tool elaborated by Anna Wierzbicka, Cliff Goddard and colleagues to reduce and ultimately remove cultural complexity by re-paraphrasing words into semantically simple terms. The core of NSM vocabulary is limited to 65 so-called semantic primes (Goddard 2018). The primes are building blocks that are found in all (or nearly all) of the world’s languages and that NSM practitioners believe to be semantically irreducible. NSM syntax is as universal as the primes; it sets the rules for the combination of primes into the semantic components that make up an explication. Each of the primes has its own set of combinatorial properties. Among the primes are I, you, people, body, (some)thing, think, want, don’t want, know, feel, see, hear, touch, true (not truth), live (not life), die, can. The challenge that the contributors to Peeters’ excellent book Heart- and Soul-Like Constructs across Languages, Cultures, and Epochs have successfully met is to analyse ethnopsychological personhood constructs such as mind, heart, soul, life across different cultures, using NSM for maximum clarity.
Let’s compare the NSM explications for psykhe, the word used in New Testament Greek to refer to the Christian soul, and tamashii, a Japanese word often translated in English as ‘soul’. The former is taken from Peeters’ introductory chapter; its original author is Anna Wierzbicka. The latter is taken from the chapter written by Yuko Asano-Cavanagh.
A) [WHAT IT IS]
something inside this someone
this something is part of this someone
people cannot see this something
people cannot touch this something
this something is not part of this someone’s body
this something is something very good
B) [HOW THIS SOMEONE CAN THINK ABOUT THIS SOMETHING]
this someone can think about this something like this:
“this something is like someone
this something can want something very much
this something can feel something very bad,
sometimes this something can feel something very good
I can say something to this something”
at the same time this someone can think about this something like this:
“this something is me”
C) [WHAT THIS PART OF SOMEONE IS LIKE]
this part of someone is not like anything else
people have this part, (other) living things do not have a part like this
because of this, people are not like (other) living things
D) [WHAT PEOPLE CAN KNOW ABOUT THIS PART OF SOMEONE]
people can know that it is like this:
after someone dies, this part of this someone does not die
because of this, after this someone dies, this someone can live in another way
when this someone lives in this other way, this someone can live forever
at the same time, people can know that it is like this:
something very bad can happen to this part of someone
if this happens, it is very bad for this someone
it can happen if this someone does something bad
other people cannot do anything bad to this part of someone
Wierzbicka’s explication relies on what is known in NSM circles as a “semantic template”, a mould intended, among other things, to provide the reader with some navigational help, especially in the case of lengthy explications where, because of the amount of detail that is being conveyed, one is at risk of not seeing the forest for the trees. The template structure helps foreground the idea that psykhe is very much related to a human being, with his/her hope of life after death.
Asano-Cavanagh’s explication of the Japanese word tamashii does not use a template (one of the striking features of the book is that its various chapters reflect an evolving framework, “one where each author, to the best of their ability, contributes to the field, being bound only by the requirement to use NSM, not by any guidelines as to how to use it”, p. 20).
something inside someone’s body
this something is a part of this someone
this something is not a part of this someone’s body
people cannot see this part
many, not all, people think like this:
people have this part
at the same time, many, not all, people think like this:
animals have this part, a big tree can have this part
this something can feel many things
because of this, people can feel these things
they can feel these things inside this something
when someone dies, this something cannot be inside this person’s body anymore
after this someone dies, this something can go to any place at any time
this something can be inside another baby’s body after this
this can happen many times
because of this, this something can be a part of someone many times
because of this, this something can know many things
this something cannot die
Here, we have moved away from an “anthropocentric approach”, typical of Western culture and Christian religion, to the Shinto belief that there is a “soul” in every natural being, including trees and animals, and that someone’s “soul”, after death, can move into another body. Expressing culturally complex concepts into semantically simple (minimal) terms allows us to better understand the soul of our Western people and patients, even though there are limits due to unavoidable generalizations, and to see how it differs from the nature-centred approach adopted by the Japanese.
In this book, other words are deconstructed, including dusha in Russian (Carsten Levisen quoted by Peeters), inochi in Japanese (Yuko Asano-Cavanagh), anoa in Longgu (Deborah Hill), chai in Thai (Chavalin Svetanant), hugr in Old Norse/Icelandic (Colin Mackenzie), and a few more. Peeters’ own chapter includes, apart from a general introduction to NSM methodology and its philosophical underpinnings, a meticulous reconstruction of the various adjustments made over time to the NSM explication of the English word mind, starting with Wierzbicka’s first attempt in 1989.
It is amazing how many lessons we, in medical humanities, can learn from deconstructing single words, and particularly these existential words, into minimal terms. The differences are huge. In our healthcare ecosystem, where the calls for inclusion grow louder each day, I would argue that all professional caregivers should be aware of the existence of NSM and the different meanings of important words for humankind. Carers have the very difficult task of finding an alignment, of building a constructive dialogue with their patients. The major advantages of NSM are that it unveils the hidden meaning of words in different cultures and limits the dominance of English as the international lingua franca. Respecting the diversity of languages means to also respect different beliefs, and this is the first step to becoming a good carer (Marini 2018).
Maria Giulia Marini is an epidemiologist, counsellor and lecturer in different international contexts from the academy to public and private foundations. She is currently director of Innovation in Health Care Area of Fondazione ISTUD, an independent not for profit Italian Business School with a humanistic approach acknowledged by the Italian Ministry of Research. An active member of the board of the Italian Society of Narrative Medicine, and referee for the World Health Organization for “Narrative Method in Public Health”, she is the author of Narrative Medicine: Bridging the Gap Between Evidence Based Care and Medical Humanities and Languages of Care in Narrative Medicine: Words, Space and Time in the Healthcare Ecosystem.
Trish Greenhalgh (1999) Narrative based medicine in an evidence-based world, British Medical Journal 318(7179): 323–325.
Cliff Goddard, Ten Lectures on Natural Semantic Metalanguage: Exploring Language, Thought and Culture using Simple, Translatable Words (Leiden: Brill, 2018).
Maria Giulia Marini, Languages of Care in Narrative Medicine: Words, Space and Time in the Healthcare Ecosystem (New York: Springer International, 2018).