When I was in elementary school, Sunday visits to Grandmother’s place made me nervous. Her apartment was a forty-minute drive from my home in Dallas, and I calmed myself by counting billboards along the interstate as my mother drove. I felt uncomfortable on visits. I didn’t always understand what my grandmother said or why my parting gifts were Mead-branded stenographer’s pads that had been cut in half. I was grateful that her personality wasn’t overly saccharine, like some of my friends’ grandparents; and, that when I did crave sweetness, I could pull out my jar of cherries to escape overwhelming feelings of awkwardness.
During my twenties, as I became more independent, I asked my mother about our family medical history. I had moved away from Dallas, was living in Kansas City, and searching for a new doctor. What Mom revealed, a decade after Grandma’s death, helped me understand my grandmother’s behavior—her need to put a semblance of normalcy on display.
Grandmother’s name was Evelyn Hollander. She was placed under psychiatric care several times during the 1950’s and 1960’s. Her treatments for schizophrenia included electroconvulsive therapy, which, at the time, was administered without muscle relaxants or anesthetics. After each release from a treatment facility, she lived with her mother, Molly, in the Oak Cliff community of Dallas, Texas.
Evelyn spoke to birds that did not exist and witnessed visages of the Virgin Mary. Because she feared additional medical treatment, Evelyn developed a persecutory fear of clinicians and distrusted her family. As a result, she relied upon puerile social relationships with delivery people for friendship, which led to compulsive spending. Preoccupied with lists and organization, my grandmother also hoarded steno pads and cut each in half, vertically up through the middle, by scissoring through the individual sheets of paper to form more narrow, perfect columns for list-making.
Molly helped raise Evelyn’s children and relied heavily upon faith in God during her daughter's episodes of hallucination and periods of inappropriate behavior or distress. In the margins of her bible, Molly wrote: “Tis the spirit that makes pure, that exalts thee, and will cure all they sorrow, sickness and sin.” This unaccredited quote sparked my desire to know more about schizophrenia.
Entitled Data Disorder, my graphic-design thesis focuses the narrative of schizophrenia through a visual display of language. Via research and data harvesting, I identified five different sets of language that exist within an individual’s diagnosis, treatment, maintenance, and recovery of a mental illness. These language sets helped shape my understanding of schizophrenia, giving me an emotional cognition of my grandmother.
The written note from Molly’s bible, an excerpt from Communion Hymn, a poem by Mary Baker Eddy, who founded the Christian Science movement, along with Evelyn’s particular symptoms of schizophrenia, I identified as “personal language.”1 Personal language acts like a filter and shapes an individual’s understanding of an illness by providing a context for the other four language sets. My grandmother’s personal language is rooted in religion because her primary caretaker, Molly, advocated religion as a spiritual solution to her mental health (or perhaps as considered by Molly, moral issues). So, I defined personal language as references to the behavioral, medical and familial history of an individual.
The second set of language identified helps clinicians to determine diagnoses based on an individual’s personal language. “Clinical language” references the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) that is published by the American Psychiatric Association. The DSM, now in its fourth edition, provides a shared vocabulary and criteria for medical professionals to classify mental disorders. As a collection of descriptions, the text is generally technical and codifies a patient’s diagnosis for hospitals and insurance companies. However, the diction forms strong and unexpected connections and divergent meanings when applied to the context of an individual’s personal language.
“Pharmaceutical language” is the third language set discussed in my thesis. It references the industry that develops products licensed for use as medication. Hundreds of psychiatric medications exist on the market today.2 And, with hopes of minimizing customer and clinician confusion along the circuit of any given prescription, both the U.S. Food and Drug Administration and European Agency for the Evaluation of Medicinal Products have stringent regulatory requirements for medicines to ensure diverse drug names. Roughly 35% of the names submitted to these agencies are rejected.3 Before the proliferation of drug treatment for mental disorders, trademark classes were much less crowded, and naming largely referenced science.4 This created predictable and sometimes confusing names that drew from chemical ingredients.5
As the market grew, invented pharmaceutical names and language became more common. Those beginning with the letter A rose in prominence first so as to appear at the top of drug listings.6 Followed by the contrarian strategy of using under-exploited letters X and Z to create visually compelling and more aurally dynamic brands, more palindromic names, like “Xanax, Lolzol, Merrem, Ketek and Lexxel,” also appear.7 Some modern naming applications also aim to be experiential and reference healing, like Abilify (ability) and Wellbutrin (wellness).8
Marketing messages are pieces of written communication presented to consumers on websites, commercials and printed ads. Commercials for some prescription drugs have aired since 1997; and many drugs, like Prozac and Xanax, are commonplace and highly recognizable brand names.9 So, building strong marketing tools like taglines and positioning statements helps bring in billions of dollars for pharmaceutical companies. “Commercial language,” the fourth set considered in my thesis project, references communication strategies used to market and sell psychiatric drugs.
Because profits are high, pharmaceutical companies rage against tougher regulation from the U.S. Food and Drug Administration. Some members of Congress consider pharmaceutical advertising misleading because drug warnings are not sufficient.10 In 2008, three of the largest drug companies agreed to a six-month halt to advertising new medicines at the request of the Congressional House Energy and Commerce Committee.11 Since then, pharmaceutical marketing messages have contained fewer doctors, or actors portraying doctors, and have relied more heavily upon positive language—notions of wellness, moving forward, success over time, and having to take medicine less often—juxtaposed against images of sadness.12
The last set of language in my project is “legal language,” and it references full prescribing and safety information pharmaceutical companies must release for each drug.13 Legal language is the hidden or discreet language set related to mental illness. Unlike commercial language, it rests just within reach of consumers, but pharmaceutical companies take measures to cloak its presence. Web links to these legal documents are often in small type or completely hidden beneath a drug’s homepage.14
Mental disorders span several types of language, and combined, they express a breadth of emotions. So, to conclude Data Disorder and the identification of the five language sets—personal, clinical, pharmaceutical, commercial, and legal—I started combining aspirational and negative messages into Risk Poems. By alternating the taglines of commercial language and phrases from drug safety documents, poems emerge and form a more stirring language hybrid.
1.
Pregnant tongue,
Take the
Fatal muscle,
Open a
Stopped mouth.
2.
Move forward
Well tolerated pain,
Focus on life
Consume treatment,
New release
Suicidal Heart.
3.
Keep it from
Steady worsening,
Effective treatment
Avoid contact control,
You’re part of a
Monitored movement.
4.
Hear my story
At first pain,
A long-lasting
History of feeling,
Experience a
Slow pressure.
5.
A day in
Permanent doses,
Coming back
Malignant machinery,
Start saving
for common fever.
By reinserting the idea of poetry, the language studies become cyclical and refer to the original religious excerpt found in Molly’s bible. As a graphic designer, I chose to direct my thesis toward research. Ultimately, Data Disorder resembles a combination of branding and market research that begins and ends with a very emotional connection to its subject, Evelyn Hollander, and content, schizophrenia.
Mary Baker Eddy, Communion Hymn, http://www.endtime.org/library/mbe/seven_hymns.html.
Monthly Prescribing Reference database, http://www.empr.com (2010).
U.S. Pharmacopeia (USP), A Report on the Relationship of Drug Name and Medication Errors in Response to the Institute of Medicine’s Call for Action, www.usp.org/pdf/EN/medmarx/2008MEDMARXReport.pdf (2008).
Rebecca Robins, Brand Matters (2006). First published in and excerpted from Pharmaceutical Branding Strategies, ed. Steven Seget (2006).
Linda Gundersen, The Complex Process of Naming Drugs, http://www.annals.org/content/129/8/677.full (1998).
Database of drug names, http://www.rxlist.com/script/main/hp.asp (2010).
Rebecca Robins, Brand Matters (2006). First published in and excerpted from Pharmaceutical Branding Strategies, ed. Steven Seget (2006).
Igor Naming Guide, Taxonomy of Biotech and Pharmaceutical Names, http://www.igorinternational.com/process/biotech-pharmaceutical-name-taxonomy.Iphp (2010).
Carrol Trosclair, Prescription Drug Advertising on Television, http://tv-advertising.suite101.com/article.cfm/prescription_drug_advertising_on_television (2009).
List of percentages related to misleading information in pharmaceutical ads, Stephen Allen Christensen, Selling Drugs to Patients, http://americanaffairs.suite101.com/article.cfm/selling_drugs_to_patients (2009).
Carrol Trosclair, New Drug Advertising Rules, http://tv-advertising.suite101.com/article.cfm/new_drug_advertising_rules (2008).
Example commercial with images of sadness and experiential recovery, http://pristiq.com/tv_ad.aspx (2010).
Example PDF of full prescribing information, http://pi.lilly.com/us/symbyax-pi.pdf (2010).
Example of drug homepage with warnings just below main splash page image, http://www.zyprexa.com (2010).