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Lingua 294 (2023) 103596
www.elsevier.com/locate/lingua

What is in a word? An exploration of the metaphorical use

of schizophrenia in general American English
Emilia Castaño Castaño
Department of Modern Languages and Literatures and English Studies, University of Barcelona, Gran Via de les Corts Catalanes,
585, 0800 Barcelona, Spain

Received 17 March 2023; revised 22 August 2023; accepted in revised form 22 August 2023;

Abstract

Research on the representation of schizophrenia in the media has revealed that it might have become the new illness
as metaphor and that its pejorative metaphorical use is a determining factor in its negative public perception. Drawing on
Conceptual Metaphor Theory, this study presents the first systematic analysis of the use of “schizophrenia” as a meta-
phor beyond the media by examining the use, distribution, framing and evaluative/argumentative functions of the terms
“schizophrenia”, “schizophrenic” and “schizophrenics” in the largest freely available corpus of contemporary American
English, the COCA corpus. The results show that the metaphorization of “schizophrenia” is particularly frequent in
internet-based genres and that it is employed to describe a wide range of phenomena ranging from people and political
ideologies to religion, law, and social attitudes toward topics such as sex, drugs, or immigration. It usually conveys neg-
ative connotations (94% of cases identified in the corpus) and is instrumentalized for different argumentative purposes
including its use as a derogatory or dismissive remark or as a word of caution.
Ó 2023 The Author. Published by Elsevier B.V. This is an open access article under the CC BY license (http://
creativecommons.org/licenses/by/4.0/).
Keywords: Conceptual metaphor; Framing; Schizophrenia; American English; Stigma

1. INTRODUCTION

The publication of Sontag’s Illness as metaphor in 1979 brought to the fore the stigmatizing consequences of using
“illness” as a metaphor for “what is felt to be socially or morally wrong” (Sontag, 1979:61). Taking tuberculosis and can-
cer as epitomes of this phenomenon in the 19th and 20th centuries, respectively, Sontag argued that feared, multi-
determined, and mysterious conditions have the widest possibilities for use as metaphors for all types of negative or
problematic aspects of society, conjuring up negative associations imbued with myths, fear, and stigma, which have
harmful effects for those who have the real disease (Sontag, 1979). In the four decades that have passed since,
research has shown that not only does cancer continue to be persistently used as a metaphor in contemporary English
(Potts and Semino, 2019), where expressions such as Reagan’s popularized “cancer of drugs” or Obama’s “cancer of

E-mail address: e.castano@ub.edu

https://doi.org/10.1016/j.lingua.2023.103596
0016-7037/Ó 2023 The Author. Published by Elsevier B.V.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
2 E. Castaño Castaño / Lingua 294 (2023) 103596

corruption” are still in vogue, but also that other conditions such as schizophrenia are also instrumentalized as meta-
phors (Duckworth et al., 2003; Chopra and Doody, 2007).
Although mental disorders in general are subject to negative judgements, there is evidence that stigmatization varies
by mental disorder (Rössler, 2016). Schizophrenia is considered one of the most, if not the most, stigmatized medical
conditions (Girgis et al., 2021) with public attitudes toward people with this condition having deteriorated over the past
few decades (Schomerus et al., 2012). Among the most common negative beliefs about the condition that have been
identified in the literature is the perception that adults with schizophrenia are more likely to pose a danger to the public
than people with other mental disorders (Link et al., 1999; Anglin et al., 2006; Martin et al., 2007) or that they are unpre-
dictable and unreliable (Rössler 2016), which translates into greater social distancing (Schomerus et al., 2012).
These widespread misconceptions about the disorder in the lay community are said to be partly grounded in (a) the
fact that, more than one century after the disease was first described by Kraepelin (1896), it is not yet well understood
(Keshavan et al., 2011) and also (b) the fact that the most important sources of information about mental illness for the
general public, media and entertainment industry, often draw on overly negative notions such as unpredictability, dan-
ger, violence, criminality, insanity, and behavioral bizarreness in their coverage of the condition (Coverdale et al., 2002;
Owen, 2012). These factors actively contribute to shaping the public view of this and other mental conditions (Thornton
and Wahl, 1996; Dietrich et al., 2006) spreading and amplifying misperceptions, social rejection, and fear. However,
adverse news reporting and unrealistic cinematic portrayals of the disease are not the only reasons why schizophrenia
is stigmatized. The pejorative metaphorical use of the disease has also been argued to play a key role in its negative
perception (Duckworth et al., 2003; Chopra and Doody, 2007; Vahabzadeh et al., 2011) as it links the disease itself with
negative connotations (Rössler, 2016). In fact, previous research has suggested that schizophrenia might be the new
illness as metaphor (Duckworth et al., 2003).
Cognitive linguistics embraces a view of words as points of access to networks of encyclopedic knowledge stored in
our minds (i.e., a vast repository of structured knowledge grounded in our physical and cultural experience, which also
includes imaginative aspects of cognition such as metaphors, folk theories and stereotypes (Lakoff, 1987, Evans,
2019)). Hence, an analysis of the metaphorical use of “schizophrenia” is crucial for gaining an insight into our concep-
tualization of this disease, the beliefs, and expectations that its metaphorization reinforces, and the reasons why its use
persists despite its contentious status.
In this context, and given that no study to date has conducted a systematic analysis of the use of “schizophrenia” as
a metaphor beyond newspaper articles, by drawing on Conceptual Metaphor Theory and assuming that metaphor is one
of the “principal vehicles for understanding our physical, social and inner world” (Lakoff and Johnson, 1980:159), this
paper analyzes the metaphorical use of “schizophrenia” in the Corpus of Contemporary American English (COCA)
(Davies, 2008). The main goals of this study are (a) to determine the frequency with which the terms “schizophrenia”,
“schizophrenic” and the nominalized form “schizophrenics” are metaphorically used and whether such metaphorical use
is ascribed to certain genres such as news or, on the contrary, it is widespread across genres; and (b) to identify the
domains that are most recurrently described in terms of this disease, the framing function that is pursued and the con-
notations and argumentative functions that it possesses. In this way, this study aims to uncover how the metaphorization
of “schizophrenia” frames the way people perceive the condition itself and contributes to maintaining the cultural con-
structs and beliefs that surround it.
This paper is structured as follows: Section 2 contextualizes this study by outlining the most important tenets of Con-
ceptual Metaphor Theory and reviewing previous research on the metaphorical use of “schizophrenia”. Section 3
describes the materials and methods utilized in this study. Section 4 analyzes the use and distribution of the terms
“schizophrenia”, “schizophrenic” and “schizophrenics” in the COCA corpus (Davies, 2008) and introduces the
predominant metaphorical mappings found in contemporary American English, illustrating them with examples and
scrutinizing their framing effects and connotations. Finally, Sections 5 and 6 discuss the results and offer some conclud-
ing remarks.

2. METAPHOR, LANGUAGE, AND THOUGHT

Conceptual Metaphor Theory, as originally propounded by Lakoff and Johnson (1980, 1999), conceives of metaphor
as a cognitive framework for talking and thinking about abstract, complex, unfamiliar, or sensitive domains of experience
(target domain) in terms of others (source domain) that are more tangible, well-structured, or familiar. For example,
“health” and “illness” are often used as source domains to talk about economic and sociopolitical issues (Charteris-
Black, 2004; Musolff, 2016), as in “we live in a healthy democracy with a robust economy but it will get sick if the cancer
of corruption metastasizes.” By mapping the notions of democracy and economy onto the domains of “health” and “ill-
ness”, the former can be viewed as living organisms that can fall ill and suffer from specific diseases such as cancer
(i.e., corruption), which may cause their deterioration (i.e., affect them negatively) if no treatment (i.e., no measure)
 E. Castaño Castaño / Lingua 294 (2023) 103596 3

is applied to prevent or halt the progression of the disease. These source to target mappings allow us to call upon our
knowledge of the source domain (i.e., illness or health) to reason and talk about the target domain (i.e., democracy,
economy), helping us to construct a representation of the target domain and make inferences about it. By rendering
complex concepts more imaginable, metaphor aids understanding and makes communication more economical and
efficient (Ortony, 1975; Lakoff and Johnson, 1980, 1999; Semino, 2008). This grants metaphor a central role in reason-
ing and makes its use pervasive in everyday language (Lakoff and Johnson, 1980, 1999).
Moreover, given the potential of metaphors to evoke different views of a particular situation by highlighting certain
aspects of that situation and backgrounding others (Lakoff and Johnson, 1980, 1999; Charteris-Black, 2005), they also
function as effective tools for framing – a process that requires “to select some aspects of a perceived reality and make
them more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpre-
tation, moral evaluation and/or treatment recommendation for the item described” (Entman, 1993:53). “War” and “jour-
ney” metaphors, for example, offer different perspectives on the experience of illness. “War” metaphors present illness
as a battle, where patients are fighters, the disease is an enemy that must be eliminated completely, and recovery, as
opposed to non-recovery or death, represents victory. “Journey” metaphors, on the other hand, focus on the obstacles,
progress, and setbacks that people face when falling sick. Although recovery is also the goal in this case, this metaphor
also foregrounds the possibility of having to live with the disease, which favors its conceptualization as a companion
rather than as an enemy (Semino et al., 2017; Semino, 2021). In this way, metaphors contribute to shaping how a par-
ticular topic is perceived, facilitating some inferences while making others unlikely and serving evaluative and persua-
sive functions that can affect how we feel, reason, and even act regarding that topic (Lakoff and Johnson, 1980;
Charteris-Black, 2005; Semino, 2008; Musolff, 2016; Thibodeau et al., 2017).
For example, in the domain of illness, there is evidence to suggest that the way a disease is metaphorically framed
covertly influences the way people conceptualize and behave in relation to the condition. As a case in point, a recent
study has shown that people exposed to the “Covid-19 as war” metaphor are more likely to support a policy of complete
quarantine than those exposed to a literal description of the disease (Charteris-Black, 2021). The depiction of cancer as
an enemy, however, has been reported to reduce people’s intentions to adopt self-limiting preventative measures such
as quitting smoking (Hauser and Schwarz, 2015). Metaphorical framing has also been found to shape people’s attitudes
toward conditions such as Alzheimer’s disease (AD) (Cuadrado et al., 2020). Describing AD as a condition that deprives
people of their minds and identities, leaving behind an intact, empty body, triggers feelings of sadness, anger, and fear
while the characterization of the disease as involving the loss of cognitive abilities, but not of identity or emotional and
sensory capacities induces higher positive emotions (Cuadrado et al., 2020). In short, this shows that metaphor is more
than a rhetorical device and that its locus lies as much in language as in thought.

2.1. Illness and metaphor

In recent years, the study of “illness” as a target domain has been very prolific, revealing that the highly subjective
nature of illness experience and the strong emotional, psychological and social implications that it carries favor the use
of metaphors as a means to make sense of the disease and describe patients’ experiences and emotions in relation to
complex medical conditions such as cancer (Semino et al., 2018; Gibbs and Franks, 2002) or mental disorders
(McMullen and Conway, 2002; Charteris-Black, 2012). Likewise, research has also provided evidence of the influence
of metaphors on people’s perceptions and attitudes toward conditions such as HIV, cancer, or dementia (Sontag, 1989;
Williams Camus, 2009; George, 2010; Van Gorp and Vercruysse, 2012). In the case of schizophrenia, manifestations of
metaphoricity have been analyzed in first-person accounts of voice-hearing (Demjén et al., 2019), as well as documen-
taries and blogs written by healthcare providers and people diagnosed with schizophrenia (Coll-Florit et al., 2019; Coll-
Florit et al., 2021).
The study of illness as a source domain has received less attention. In this case, research has primarily focused on
analyzing the use of “health”, “illness” and other related concepts as metaphors for the conceptualization and evaluation
of situations, entities, or people in the fields of politics and economics (Charteris-Black, 2004; Musolff, 2016) and the
metaphorization of “cancer” in general English (Potts and Semino, 2019). As far as schizophrenia is concerned,
research has exclusively focused on its use as a metaphor in the press, where the metaphorical use of the terms
“schizophrenia” and “schizophrenic” has been found (a) to outnumber that of “cancer” and “cancerous” in both American
and British newspapers by a margin of 28% to 1% and 11% to 0.02%, respectively (Chopra and Doody, 2007;
Duckworth et al., 2003) and (b) to have remained stable, even increasing in tabloids, in the first decade of the 21st cen-
tury (Clement and Foster, 2008; Vahabzadeh et al., 2011). These studies have also pointed out that metaphorical ref-
erences to schizophrenia can be found in areas that range from the description of weather conditions, cities, and people
(Duckworth et al., 2003) to fashion, art, sports, and politics (Chopra and Doody, 2007). However, none of these studies
offers a detailed analysis of the kind of phenomena that each of these categories includes and why they are described in
4 E. Castaño Castaño / Lingua 294 (2023) 103596

terms of “schizophrenia”. Beyond English, data from studies conducted in Italian (Magliano et al., 2011) and Greek
(Athanasopoulou and Välimäki, 2014) confirm that the use of “schizophrenia” as a metaphor in the press tends to be
connected to the description of groups, entities and abstract concepts (which are not specified) to denote incoherence,
oddness, or dangerousness and that the sections where its use is more frequent are politics, culture, entertainment and
sports. These results are supported by research in Turkish (Boke et al., 2007) and Portuguese (Rodrigues-Silva et al.,
2017), where instances of the use of “schizophrenia” as a metaphor have been found in various areas such as social
structure, politics, art, society, economy, and finances and where the metaphor has been found to carry negative con-
notations in 90% of cases (Rodrigues-Silva et al., 2017).
Previous research suggests that the use of “schizophrenia” as a metaphor exhibits remarkable consistency across
countries and languages. However, as both perceptions and attitudes toward mental illness and conceptual and linguis-
tic metaphors are culturally grounded (Kövecses, 2005; Krendl and Pescosolido, 2020), the metaphorical use of
“schizophrenia” is likely to be subject to variation, not only across languages, but also across the varieties of English
spoken around the world (WEs), which are now acknowledged “as distinct voices characterized by autonomous iden-
tities rooted in individual cultural contexts” (Degani and Callies, 2021: 2). In fact, there is evidence to indicate that vari-
ation in metaphor use and structure, encompassing differences in the use of primary metaphors and in the specific
phrasing of metaphors, exists from one English to another (Callies and Onysko, 2017). In this context, this paper con-
ducts a systematic analysis of the metaphorical use of “schizophrenia” in American English to explore its characteristics,
analyze its implications and establish the basis for future research on other varieties of English.

3. MATERIALS AND METHODS

The COCA corpus is the largest, most up-to-date, freely available corpus of American English. It consists of more
than one billion words drawn from the period 1990 to 2019 evenly divided into eight genres: TV/movie subtitles, spoken,
blogs, web, fiction, magazine, newspaper, and academic texts (see Table 1 for a detailed description of the internal
structure of the corpus and the number of words per genre that it contains). The blogs and websites included in the
COCA corpus were compiled in 2012 and derive from a subset of the American section of the Global Web-based Eng-
lish corpus (GloWbE), which was curated to ensure a fair representation of informal language with roughly 60% of the
corpus consisting of informal texts (Davies and Fuchs, 2015), and whose texts were classified into different subgenres
following “a topological approach to text typology in which the texts are described in terms of their similarity to prototype
genres” (Sharoff, 2018:65).1 As a result, these texts represent just a “snapshot” of the genre, which does not prevent the
characterization of “schizophrenia” as a metaphor in blogs and websites, but prevents the use of these data when mon-
itoring diachronic trends in the use or frequency of the target terms.
The design of the corpus lays the groundwork for examining how words are used across different genres, which,
according to Davies (2020), display varying degrees of formality ranging from “very informal (e.g., TV, movie subtitles
or spoken transcripts), [to] more formal (e.g. academic articles), and somewhere in between (e.g., magazines and news-
papers)”. This classification aligns with that of Heylighen and Dewaele (1999), who argue (a) that formality is a relative
concept, existing on a continuum between extreme informality and extreme formality (Irvine, 1979; Heylighen and
Dewaele, 1999:8) rather than being a binary concept with fixed categories; and (b) that spoken language tends to be
less formal than written language, which also exhibits varying degrees of formality with scientific and technical docu-
ments, essays, academic prose, and broadsheet newspapers targeting a highbrow audience being substantially more
formal than written sources aimed at a more general audience such as family magazines, novels, and fiction.
Given that genres such as websites, blogs, magazines, and newspapers can exhibit different levels of formality
depending on factors such as the specific publication, target audience, and content or sections involved, the data
sources in the corpus were selected is such a way that blogs and websites offer a fair representation of informal lan-
guage (Davies and Fuchs, 2015) and magazines and newspapers, being popular publications targeted at a broad read-
ership (see Table 1), occupy an intermediate position in terms of formality between academic journals, whose writing
style tends to be more technical and formal, and fiction, movies or unscripted conversations, which employ a less formal
style.
As far as the method of analysis is concerned, in order to explore the metaphorization of “schizophrenia” in the cor-
pus, COCA was searched for the terms “schizophrenia”, “schizophrenic” and “schizophrenics”. This resulted in a data-
set of 4611 concordance lines (excluding duplicates), which were exported to a spreadsheet along with their metadata
for subsequent analysis. Metaphor identification was based on the PRAGGLEJAZ (2007) metaphor identification pro-
cedure (MIP) which involved the following steps: (1) the co-text of each concordance line was read in order to establish

1
Full definitions of the genre categories can be found in https://corpus.leeds.ac.uk/serge/webgenres/defs/annot-v6.pdf.
 E. Castaño Castaño / Lingua 294 (2023) 103596 5

Table 1
Major genres in the COCA corpus, number of words per genre and data sources (adapted from Davies, 2020).
Genre Number of Content
words
Blogs 125,496,216 Blogs classified into academic, argumentative, fiction, info, instruction, legal, news, personal,
promotion and review web pages.
Web 129,899,427 Websites classified into academic, argumentative, fiction, info, instruction, legal, news, personal
and review web pages.
Spoken 127,396,932 Transcripts of unscripted conversation from more than 150 different TV and radio programs (e.g.,
All Things Considered (NPR), Newshour (PBS), Good Morning America (ABC), Today Show
(NBC), 60 Minutes (CBS), Hannity and Colmes (Fox), Jerry Springer, Oprah).
Magazines 127,352,030 Popular magazines classified into news, opinion, health, science and technology, art, home and
gardening, women/men, financial, religion, sports, etc. (e.g., Time, Men’s Health, Good
Housekeeping, Cosmopolitan, Fortune, Christian Century, Sports Illustrated, People, Rolling
Stone).
Newspapers 122,958,016 Articles from popular newspapers with wide readerships covering international, national and local
news, opinion, sports, financial, life, editorial, etc. (e.g., USA Today, New York Times, Atlanta
Journal Constitution, San Francisco Chronicle).
Academic 120,988,361 Peer-reviewed journals covering academic disciplines classified into education, social sciences,
history, humanities, law, medicine, philosophy/religion, science/technology, and business
Fiction 119,505,305 Short stories and plays from literary magazines, children’s magazines, popular magazines, first
chapters of first edition books 1990-present, and fan fiction.
TV/Movies 129,293,467 Subtitles from OpenSubtitles.org, and the TV and Movies corpora.

a general understanding of it2; (2) the contextual meaning of “schizophrenia”, “schizophrenic” and “schizophrenics” in
each concordance line was identified by taking into account what came before and after the target expression; (3)
finally, it was determined whether the contextual meanings of these terms differed from their basic meanings and, if
so, whether their meanings in context could be understood in comparison with their basic meanings. In this case,
the term was marked as metaphorical. For example, in “California has schizophrenic gun laws. While there are severe,
irrational restrictions as to what guns you can own [. . .] it has also included “Castle Doctrine” and “No Duty to Retreat”
since at least the 1920s”, the term “schizophrenic” describes the incoherent, contradictory nature of California’s gun
laws via a comparison with the basic meaning of the adjective “schizophrenic” that exploits the notion of disorganization
(i.e., incoherent, illogical thought and behavior).
Next, by identifying explicit references in the concordance lines or their co-texts, the target domains that were
metaphorically described in terms of “schizophrenia” (e.g., gun laws) were identified and classified into one of the cat-
egories that are described in Table 2 that were developed during the process of analysis.
Coding was performed by the author. Problematic cases with ambiguous contextual meanings were resolved
through discussion with two other experienced metaphor researchers. In addition, two PhD students trained on Concep-
tual Metaphor Theory coded two different random samples of 500 concordances each.3 The inter-rater reliability of
metaphor coding decisions was assessed using Cohen’s kappa. The results indicated a high level of agreement
between the coders as inter-rater agreement for the first random sample yielded a Cohen's kappa value of 0.87
(N = 500; k = 2), while for the second random sample it reached a value of 0.844 (N = 500; k = 2) (where N stands
for the number of examples annotated and k for the number of raters).
The metaphorical instances of the target terms were then categorized as having either positive, negative, or neutral
connotations on the basis of their contextual use. For example, if the target terms were used to express a positive opin-
ion, evaluation, or praise, they were coded as having positive connotations. Conversely, if they were used to convey a
negative opinion, make a sarcastic comment or a derogatory/insulting remark, they were coded as having negative con-

2
The default concordance window size in the English Corpora interface is set to display approximately 50 words, with around 25
words on each side of the node word. When this information was insufficient to determine whether a term was used metaphorically or
literally, the extended context option was used. This gives access to an expanded range of about 150 to 170 words, which allows for
examination of the term's usage within a broader linguistic context. Additionally, it was sometimes necessary to perform additional
searches using external platforms like Google to access the specific documents from which the examples were extracted.
3
Both samples and coding decisions are available at https://osf.io/6eybh/?view_only=3b3fc5dfcf9a4509bf2ee1276f9b7464.
4
Sample 1: Agreement: 96,4%; Cohen’s kappa 0.87; level of agreement: Almost perfect.Sample 2: Agreement: 95%; Cohen’s kappa
0.84; level of agreement: Almost perfect.

Table 2
Overview of the categorization scheme with illustrative examples, frequencies and connotations.
Category
People: individuals
People: religious/fictional
People:
groups
People: countries
Human experience:
ideology, beliefs, and
religion
Human experience:
identity traits and roles
Human experience:
emotions and states
Human experience:
attitudes,
behavior, and discourse
Policies, laws, and political
practices
6
Description and examples Metaphorical Connotations
occurrences
Named and unnamed individuals: 57 Negative: 84.2%
bloggers, journalists, politicians, writers, musicians, film directors, artists (e.g., Reince Preibus, Positive: 15.8%
Obama, Hillary Clinton, Nixon, De Palma, Liz Phair, a Fox News journalist. . .)
Deities, religious figures and fictional characters:
E. Castaño Castaño / Lingua 294 (2023) 103596
22 Negative: 100%
(e.g., Jesus, God, Noah, characters in a novel, narrators such as detectives or the main
character of The sound and the Fury. . .)
Society at large (e.g., American society) 91 Negative: 100%
Groups linked by a common attribute (e.g., Californians, Palestinians, voters, investors,
taxpayers. . .)
Religious groups (e.g., Christians, Islamists, etc.)
Political, legal and educational Institutions and affiliations (e.g., Congress, right-wing
parties, Tea parties, Republican Party, the Supreme Court, the University of Berkeley. . .)
Companies, financial institutions and media (e.g., Intel, Burger King, Washington Post, Fox
News, banks. . .)
Countries (e.g., USA, China, India, Africa, American society. . .) 31 Negative: 100%
Political ideology: Liberalism, Conservatism, Communism, left-wing politics, right-wing 48 Negative: 100%
politics),
Sociopolitical movements: Feminism, civil right movements, animal rights movements, etc.
Religion: Islam, Mormonism, Puritanism, Christianism.
Religious, cultural and linguistic identity conflicts (e.g., black individual on the elusive 32 Negative: 90.6%
white treadmill, immigrants’ existence, the region's linguistic schizophrenia, a schizophrenic Neutral: 9.4%
religious life. . .).
Individuals’ conglomeration of divers/conflicting roles, tasks and occupations (e.g.,
individuals’ roles as consumers and products, actors’ adoption of multiple personalities. . .)
Mixed feelings, contradictory, convulsive, or complex emotional or mental states and 47 Negative: 95.7%
situations (e.g., mood swings, love, a schizophrenic mental state) Neutral: 4.25%
Individuals and groups’ opinions/ideas about sociopolitical issues such as America’s 107 Negative: 100%
national security, immigration, women, climate.
Attitudes and behaviors (e.g., vote trends, sexuality, drugs, racial issues, immigration)
Foreign policy and political practices, especially in the Middle East, China, and India 37 Negative: 100%
(e.g., Obamas’ national security strategy against terrorism and ISIS)
Domestic policy and laws related to, inter alia, economy, gun ownership, national
security, immigration, health care, and civil rights (e.g., gun laws in California, Clinton’s
health care program, Obama’s energy policy. . .)
Finance, economy and State of global and local economy, America’s investment in foreign countries (e.g., India, 15 Negative: 100%
markets Russia) and stock markets.
Arts and media Evaluation of specific and generic instances of painting, sculpture, architecture, music, 74 Negative: 85.2%
literature, cinema, fashion, and design (e.g., the Dubliners, Ewing's designs, the album Positive: 10.8%
“Making Mirrors”, the book “Pale Fire”, Rauschenberg’s black paintings. . .) Neutral: 4%
Minor categories Inventions (e.g., pizza wheel) 3 Negative: 66.6%
Positive: 33.3%
Specified and unspecified, bounded and unbounded units of time (e.g., the schizophrenic 6 Negative: 83.3%
1990s, a schizophrenic moment for fashion. . .) Positive: 16.6%
Relationships between two institutions, Countries or regions (e.g., America and Britain) 8 Negative: 100%
or between citizens and institutions (Americans and administration, consumers and
politicians, Arab-Americans and the Bureau. . .)
Cities (e.g., California, Sicilia. . .) 7 Negative: 57.2%
Positive: 42.8%
Weather (e.g., Weather in the East Coast, Peru) 5 Negative:100%

E. Castaño Castaño / Lingua 294 (2023) 103596

Food (e.g., a soup, delicacies of the Cuban orient) 2 Positive:100%
The functioning of an object or system (e.g., plumbing, water pressure) 4 Negative: 100%
Disease (e.g., bulimia) 1 Negative:100%

7
8 E. Castaño Castaño / Lingua 294 (2023) 103596

notations. Finally, if no explicit positive or negative connotations could be inferred from the context, they were coded as
neutral.5 The coding process was conducted by the author, and any ambiguous cases were resolved through discus-
sions with the two researchers who assisted the author in addressing problematic cases during metaphor analysis.
Additionally, the PhD students who assessed the metaphorical use of “schizophrenia” in two different samples of
500 concordances also coded metaphorical cases for the connotations they conveyed. Inter-rater reliability yielded a
Cohen's kappa value of 0.77 (N = 74; k = 2) for the first random sample and 0.87 (N = 83; k = 2) for the second.6

4. RESULTS

4.1. Frequency and genre distribution of schizophrenia as a metaphor

The analysis of the frequency per million words of the terms “schizophrenia”, “schizophrenic” and the nominalized
form “schizophrenics” between 1990 and 2019 shows that “schizophrenia” was the most commonly used word over
the whole period. Its frequency varied around an average of three times per million words, showing an upward trend
since 2010. The adjective “schizophrenic”, with an average use of 1.4 per million words, has always been less frequently
used than the noun and its use has been declining almost steadily since 2014. Finally, the nominalized adjective was
the least used form with an average value of 0.3 times per million words (see Fig. 1).
As regards the literal and metaphorical uses of these terms in the corpus, the data show that the literal use of these
three terms outnumbered their metaphorical use, as the raw frequency of the three terms, when used literally, amounted
to 4,014 occurrences, while their raw frequency of use as metaphors was 597, distributed as follows: “schizophrenic”
accounted for 67.5% of occurrences, while “schizophrenia” and “schizophrenics” accounted for 29.48% and 3.02%,
respectively.
The data also suggest that the metaphorical use of these terms has decreased by approximately 45% over the past
two decades (see Fig. 2). These results, however, must be treated with caution as they do not include data from web-
sites and blogs, which, as shown below, capture a large number of the metaphorical occurrences identified in the corpus
and are excluded when monitoring diachronic trends in COCA because these subsections of the corpus only contain
data from 2012.
The analysis per genre reveals that the use of “schizophrenia”, “schizophrenic” and “schizophrenics” as metaphors
was most frequent in those genres that, according to Davies (2013, 2020), model informal language quite nicely in the
corpus, that is, blogs, websites and transcripts of conversation from TV and radio programs, which comprised 52% of
occurrences. Magazines and newspapers, which, on the basis of the design of the corpus, are argued to lie somewhere
in between the informal and formal ends of the spectrum of formality (Davies, 2020), and academic texts accounted for
38% of cases. Finally, fiction and tv/movies constituted the remaining 10% (see Fig. 3).
These results suggest that the use of “schizophrenia” as a metaphor varies in frequency on a formality continuum
with blogs and spoken data among the genres with the highest density. However, fiction and tv/movies, despite their
informal characteristics, exhibited very few examples of this metaphor because, in these genres, “schizophrenia”,
“schizophrenic” and “schizophrenics” were used as diagnostic terms either to report on the disease or to cast fiction
characters as ill with this condition. In this case, and in line with Owen (2012), although the terms were not used
metaphorically, they appeared connected to stereotypical views of the disease connected with violence and criminality,
as evidenced by the fact that these terms appear in films and series such as Psycho Beach Party, In the Mouth of
Madness, or Criminal Minds.

5
The following examples provide an illustration of how instances of the “schizophrenia” metaphor found in the corpus were
categorized based on the connotations they carried: (1) The metaphorical use of “schizophrenia” in He promises an orchestra, some
obscure Middle Eastern instruments, and pure schizophrenia. It's what System has always been, man [2004, Magazine,
Entertainment] was coded as positive as its use to describe System of a Down's music can be interpreted as complimentary. The
context shows that it is meant to convey that their music is unique, unconventional, and artistically rich, with a wide range of styles and
moods. (2) By contrast, in It's all killer with no filler, unlike 50's bloated, schizophrenic proper albums [2012, Blog, avclub.com],
“schizophrenic” was coded as negative as it was used to criticize 50 Cent's albums by suggesting that they lack coherence or
consistency and contain too many tracks or filler content that detracts from their overall quality. (3) Finally, in You're a country singer, but
you're also an opera singer now. Please explain this. Ms-CHIAVOLA: Well, I'm sort of schizophrenic, I guess. But I grew up with a love
of folk music and my mother shared her love of music with me. Both my parents were classical musicians [2002, Spoken, NPR_ATCW],
“schizophrenic” was coded as neutral as it was used to intimate that Chiavola has diverse musical tastes that span different genres and
have influenced her career, but does not convey positive or negative connotations.
6
Sample 1: Agreement: 95.9%; Cohen’s kappa 0.77; level of agreement: Substantial. Sample 2: Agreement: 97.5%; Cohen’s kappa
0.87; level of agreement: Almost perfect.
 E. Castaño Castaño / Lingua 294 (2023) 103596 9

Fig. 1. Frequencies of “schizophrenia”, “schizophrenic” and “schizophrenics” per million words in COCA corpus (excluding blogs and
websites.) from 1990 to 2019.

Fig. 2. Literal and metaphorical raw frequencies of “schizophrenia”, “schizophrenic” and “schizophrenics”.

With respect to text content, in the case of blogs and websites, the metaphorical use of these terms falls into two
main categories: argumentative and personal texts. According to the categorization of the corpus data sources con-
ducted by Sharoff (2018), the former category includes argumentative blogs, editorials, or opinion pieces, while the latter
includes posts about events in someone’s life reported from a first-person viewpoint. In magazines and newspapers the
use of “schizophrenia” as a metaphor prevails in the fields of arts, politics, religion, health, finance, women, and sports,
while in academic texts, its use has been identified in texts related to history, education, law and political sciences,
humanities, and religion.
10 E. Castaño Castaño / Lingua 294 (2023) 103596

Fig. 3. Genre distribution of the metaphorical occurrences of “schizophrenia”, “schizophrenic” and “schizophrenics”.

4.2. Metaphor analysis

The analysis of the use of “schizophrenia” as a metaphor reveals that the entities or phenomena that are most fre-
quently described in terms of this condition can be classified into six categories (see Table 2 for details).

4.2.1. People
The most frequent target domain is people which includes (a) named and unnamed individuals, (b) religious figures,
deities, and fictional characters, (c) society at large, groups of people that share common attributes (such as their polit-
ical or religious beliefs), organizations, institutions or companies, and (d) countries. Organizations, institutions, compa-
nies and countries are included into the people category because their use exhibits a metonymic pattern based on the
stand-for relationship: organization, company or country for people (Markert and Nissim, 2009). Specifically, organiza-
tions and companies’ names stand for their members, workers, or leaders, while countries’ names represent their pop-
ulation or specific members of a community such as the members of their governments.

4.2.1.1. Individuals: Named and unnamed individuals. The first group includes left- and right-wing political leaders (e.g.,
Obama, Clinton, Bush, Reince); journalists (e.g., Rush Limbaugh); sport coaches (e.g., Tedford), scientists, writers,
musicians, painters and film directors (e.g., Chiavola; de Palma) and unnamed individuals (e.g., you, this guy). All
are cast as schizophrenic because (a) the ideology that they represent or specific instances of their discourse are seen
as incoherent, contradictory, illogical, or even delusional (1, 2); (b) their behavior, decisions or managing style are per-
ceived as illogical, erratic, or unpredictable (3); or (c) their artistic work combines multiple styles or does not follow a
unified artistic trend through time (4). Occasionally (10.8%), the metaphor is also used to highlight a person’s extraor-
dinary intellectual or creative ability (5). Thus, in most of its occurrences, the metaphor serves to (dis)qualify a person
because their ideas, behaviors or work are perceived as incoherent or erratic. In this process, metaphor takes advan-
tage of a few salient characteristics associated with the condition in general folk knowledge. Some are well documented
traits such as disorganization, while others build on popular misconceptions about schizophrenia such as its connection
with multiple or split personalities which appears to be as old as the term “schizophrenia” itself (McNally, 2007) and
which has been argued to be motivated by a misinterpretation of the “splitting” Metaphor, developed to explain unpre-
dictable and strange human behavior as the result of the separation of mental functions (Berrios et al., 2003).
 E. Castaño Castaño / Lingua 294 (2023) 103596 11

1. Mrs. Clinton seems to have a case of schizophrenia. She does one thing in this country [. . .] and then she goes
down to Argentina [. . .] she plays the same old Hillary7. . . [1997, Spoken, CNN_Crossfire]
2. When someone tells you in the year 2012 that Islam is all about peace, he can be one of many things [. . .]. He can
be a schizophrenic, because schizophrenics live in an alternate reality. [2012, Website,
natashajsmith.wordpress.com]
3. Tedford used to be true to his core beliefs about football. He was always a play-action, pro set pass, run-first guy.
Now, he is schizophrenic in his approach to offense. [2012, Blog, blogs.mercurynews.com]
4. You're a country singer, but you're also an opera singer now. Please explain this. Well, I'm sort of schizophrenic, I
guess [. . .] and I'm sort of a chameleon. [2002, Spoken, NPR_ATCW],
5. Dostoevsky is a schizophrenic genius [2012, Website, mbird.com].

4.2.1.2. Individuals: Religious figures, deities, and fictional characters. The individuals category can be further divided
into a subcategory that includes religious figures and deities such as prophets, Jesus, or God, as well as fictional char-
acters that because of their special status as either worshipped, supernatural or imaginary beings are treated indepen-
dently. In this case, the metaphorical attribution of schizophrenic qualities to the members of the category serves to
highlight perceived contradictions or inconsistences in the system of beliefs associated with certain religious figures
(6) or in the behavior, ideas, or rambling discourse of a character/narrator (7). As in the previous case, this mapping
seems to be grounded not only in the notion of disorganization, but also in other popularly known symptoms of
schizophrenia such as delusions and/or mood swings, which are linked to violence in the domain of fiction (8). Likewise,
the notion of split personality is also invoked to refer to the multiple cultural representations of God that exist, to question
the Christian conceptualization of God as a triune being or to highlight the contradiction implicit in defining Jesus as two
separate persons: one divine and one human (9).

6. Atheists need not subscribe to the arbitrary customs of religious dogma. We don't have to reconcile biblical contra-
dictions nor deal with the hypocrisies of a schizophrenic deity. [2012, Website, wiki.ironchariots.org]
7. We are also presented with multiple protagonists [. . .] and erratic if not schizophrenic narrators. [2004, Academic,
Style]
8. He was a very schizophrenic character. One minute smiling, [. . .] the very same minute, murdering. [2002, movie,
Amandla! A Revolution in Four Part Harmony]
9. Two separate persons, one divine and one human, coexist in Jesus [. . .]. Unfortunately for Nestorius, his doctrine,
creates the image of a schizophrenic Christ. . . [1998, Magazine, USCatholic]

4.2.1.3. Groups. This set includes society at large (10) and groups of people who share some commonality (e.g., Cal-
ifornians, Palestinians, voters, taxpayers) (11); religious groups (Christians, Islamists) (12); political, legal, and educa-
tional institutions and affiliations (e.g., the Republican Party, the Congress, the University of Berkeley) (13, 14) and
companies, financial organizations, and media (e.g., Intel, banks, the Washington Post, Fox News,) (15, 16), which
metonymically represent their members, managers, leaders, or the people who work for them.

10. Ahhh Americans and their schizophrenia on sex... I exploded on the sexual scene very late (thank you Bible
Belt!) but the one thing that astonished me is how repressed many American women are in bed [2012, Blog,
huffingtonpost.com]
11. This is the taxpayer's schizophrenia: We don't want to pay taxes, but we want services. [1993, Newspaper, San
Francisco Chronicle]
12. The African Christian has suffered from a form of religious schizophrenia. They pay lip service to the white
Christ while sensing that their Africanness has been violated. [2009, Academic, Theological Studies]
13. Negotiating with the right these days is akin to negotiating with a schizophrenic in full psychosis -- it can't be
done. [2012, Website, billmoyers.com]
14. . . . is not just a matter of a schizophrenic and decentralized Congress falling into the grip of unelected, ideolog-
ically driven staff aides. [1990, Magazine, American Spectator]
15. I think that Fox News is a bit schizophrenic. I saw a guy on “ Hannity”, maybe “Huckabee”. . . [2013, Magazine,
New Republic]

7
The examples provided as an illustration of the “schizophrenia” metaphor are presented without any corrections for spelling or
grammatical errors. They are reproduced in their original form as they appear in the corpus.
12 E. Castaño Castaño / Lingua 294 (2023) 103596

16. Companies are schizophrenic because often they have a good piece of the Chinese market and this is more
important to them than United States [. . .]. On the other hand, they know China has plans to replace them with
Chinese companies. So, it's a very confusing situation. [2018, Spoken, CNN_International]

Pathologizing the group allows the speaker to highlight inconsistences in their actions/decisions, ideologies, religious
values and practices, business strategies, or editorial line, which are perceived as contradictory, incomprehensible,
bizarre, or confusing. In this way, the metaphor serves a derogative function as it is employed as a critique or even
an insult (17).

17. Any village idiot planning on voting for Obama [. . .] should be tested for early-stage dementia or schizophrenia.
[2012, Blog, spectator.org]

4.2.1.4. Countries. Finally, the people category also includes the countries subcategory, which can be understood as a
subtype of the group category. In this instance, “schizophrenia” is metaphorically used to negatively evaluate cultural
aspects or attitudes and opinions endorsed by the whole or majority of a country’s population or by their govern-
ments/administrations because they are considered illogical or irrational. The most prominent examples relate to topics
such as sex, alcohol consumption, gun laws, violence (18), immigration (19), and international relationships (20).

18. A wake-up call to a schizophrenic country and culture which decries violence but just can't get enough of it.
[1996, Newspaper, Chicago]
19. it is a U.S. schizophrenia, wanting to open and close your borders at the same time. [1992, Newspaper,
Washington Post]
20. The United States suffers from schizophrenia on the international front. On the one hand, it claims that Eur-
ope should assert greater international responsibility [. . .]. On the other hand, its revealed preference is to try to
maintain American dominance. [1999, Academic, Foreign Affairs]
Because the metaphorical use of “schizophrenia” to refer to people encompasses a broad spectrum of target
domains, ranging from politicians, artists, bloggers, unnamed individuals and deities to countries and political, civil,
and religious groups, instances of this metaphor can be found across all genres included in the COCA corpus. Its preva-
lence, however, was particularly notable in blogs, websites, spoken sources, newspapers, and magazines, which
accounted for 81% of examples. TV, movies, and fiction made up 12% of cases, while its use in academic texts only
constituted 7% of examples, where it was primarily restricted to publications related to foreign affairs, law, history,
and literature.

4.2.2. Cognitive, affective, and behavioral human experiences

The second type of metaphors identified in the corpus is tightly connected to the people category as it comprises
those cases where the “schizophrenia” metaphor is used to describe certain cognitive, affective, and behavioral com-
ponents of human experience. Here, the focus is not on the experiencers themselves but on particular aspects of their
cognitive, emotional and behavioral responses. While acknowledging the inherent difficulty involved in establishing pre-
cise and definitive boundaries between the different constructs that are included in this category, the examples
described here have been further classified into the following subcategories: (a) ideology, beliefs, and religion, (b) iden-
tity traits and roles, (c) emotions and states, (d) attitudes, behavior, and discourse, which are briefly defined below.

4.2.2.1. Ideology, beliefs, and religion. This subcategory contains examples that refer to the shared system of beliefs,
values, and ideas that is held by a group of individuals and contributes to shaping their understanding of various aspects
of society such as politics, economics, culture, and religion, as well as to influencing the agenda of social, political, and
cultural movements. In this case, the focus is not on the group, but on the values and ideas in which its members believe
and endorse, and which the users of this metaphor conceptualize as a symptomatologic manifestation of schizophrenia.
This category embraces a wide range of beliefs shared by large groups of people and includes the following subcate-
gories: (a) political ideology, which encompasses multiple political alignments such as conservatism, liberalism, and
communism; (b) socio-political movements such as feminism or the animal rights movements; and (c) religion, including,
among others, Christianity, Islam, Mormonism, and Puritanism. In the case of political ideologies, the data show that
conservatism in America is primarily criticized for its domestic policy and religious principles (21, 22), while liberalism
is mostly questioned for its foreign policy and its approach to domestic social affairs (e.g., discrimination, health, edu-
cation, immigration) (23).
 E. Castaño Castaño / Lingua 294 (2023) 103596 13

21. We're seeing the schizophrenia of conservatism reassert itself. For years, conservatives have said we want a
strong, confident, competent foreign policy abroad, but at home, we want the government to be as weak as pos-
sible. [1990, Spoken, ABC_Brinkley]
22. The God Obsessed Party must first see neuroscientists to address their Zombie God Belief Syndrome (Christ
Psychosis). Sick Brains only create schizophrenia, bizarre beliefs of God and sin. Sorry GOP, the brain is
the creator of the God delusions you suffer from. [2012, Website, caffertyfile.blogs.cnn.com]
23. Liberalism is schizophrenic. Yes, they want a one world government with no discrimination, but (at least in this
country) they are also all about classifying people by characteristics (race, gender, sexual orientation, religion).
[2012, Website, whatswrongwiththeworld.net]

Among the socio-political movements described as schizophrenic, feminism is contested and negatively appraised
for the model of woman that it supports, which is defined not only as schizophrenic, but also as illogical and resulting
from a disordered mode of thinking (24). In the case of religion, although the religious beliefs that are categorized as
schizophrenic are disparate, the use of “schizophrenia” as a metaphor tends to emphasize the difficulty of coming to
terms with the dichotomies “sacred-profane” and “faith-reason” or with religious beliefs that stand in opposition to cul-
tural/identity issues (25, 26). In all the occurrences identified in this category, the metaphor is used as a synonym of
contradiction, incomprehensibility and even irrationality and carries negative connotations. The main purpose of the
speaker is to highlight flaws in the ideological foundations of political, social and religious movements whose ideas
and symbols shape the way reality is perceived, comprehended, and evaluated by their supporters, making them sus-
ceptible to being censured.

24. Feminism is an inherently illogical system and women educated under it exhibit this kind of schizophre-
nia continually. There is no way to a stable, realistic relationship with a feminized Anglo-American female since
her entire educational upbringing and philosophical outlook is completely geared to irrationality in relationships
with men. [2012, Website, the-spearhead.com]
25. Most of us suffer from spiritual schizophrenia that splits the world too neatly into categories of sacred and
profane. [2015, Magazine, USCatholic]
26. Church tradition where Christianity had been received from Western sources in a period of Western dominance
too often led either to blanket rejection of all things evidently African or to a division of life into parallel streams
of “ Christian ” and “ African ” activities that never met. The end product could be a sort of religious schizophre-
nia, a fractured identity [2012, Website, dacb.org]

4.2.2.2. Identity traits and roles. The identity traits and roles subcategory includes examples that concern those aspects
of identity that are rooted in individuals’ awareness of belonging to a social group or groups, as well as in the importance
and emotional meaning associated with that membership (Tajfel, 1978). These aspects include ethnic, racial, religious,
generational, or linguistic identities, which mold and constrain the construction of individual selves (Shotter and Gergen,
1989). The metaphor is specifically employed to describe the negative feeling of being torn between two cultural, linguis-
tic or religious identities (27, 28, 29) that are seen as distant or difficult to be reconciled, causing confusion and anxiety.
In this instance, the metaphor exploits the notion of split personality to portray the experience of immigrants and certain
racial, ethnic groups in the US (30), serving not only to negatively evaluate this aspect of their lives, but also to describe
it as outside their control. It also describes situations where the same individual holds two or more roles that clash, per-
forms multiple activities simultaneously or has several different careers throughout their life (31, 32). In this case, the
connotations could be neutral or negative.

27. Mexican-American teens enduring the culturally schizophrenic life of being American citizens and the chil-
dren of illegal immigrants. [2011, Spoken, NPR_TellMore]
28. If anyone requires proof of how schizophrenic an immigrant's existence can be, this is it. In 2006, my fear that I
would lose my native tongue led to a decision to translate Philip Levine's poems into Polish. [2010, Academic,
American Scholar]
29. You were still a Catholic in your mind? In my mind I was, yeah [.. ] But I was leading a kind of schizophrenic
life because I was getting immersed in Jewish learning. [1998, Spoken, ABC_Nightline]
30. I do seminars for black people who work in corporate America. And [. . .] They're almost schizophrenics. They
drive in their cars to work, and by the time they're listening to En Vogue and all the other get-black music. But the
minute they get there, that other voice must come in, that other way of thinking. [1994, Spoken, Ind_Geraldo]
14 E. Castaño Castaño / Lingua 294 (2023) 103596

31. They exist in a state of schizophrenia, where they are both guards and prisoners. [2012, Blog,
thecommonsenseshow.com]
32. He'd had too many careers to be labeled anything other than occupationally schizophrenic. [2012, Fiction,
DontMessWithTravis]

4.2.2.3. Emotions and states. The third subcategory, emotions and states, encompasses those instances that refer to
ephemeral psychological and physiological states triggered by specific events, experiences, or thoughts (Clore and
Schnall, 2005: 438). Drawing on the traits of split personality and emotional lability, another characteristic popularly
associated with schizophrenia, the metaphor is specifically used to describe affective states that trigger a mix of feelings
such as anger, frustration, discomfort, or love (33), which can unleash joy, excitement and happiness, but also vulner-
ability. This metaphor is also used to portray the emotional turmoil caused by challenging life events, such as a breakup
or loss and the rapid shifts in mood that people in such situations may experience, passing, for example, from sadness
to anger and from anger to guilt in a short span of time (34). It also serves as a vehicle to describe emotional and mental
states that are contradictory and demand a considerable amount emotional and/or cognitive flexibility such as maintain-
ing a balance between control and spontaneity (35) or dealing with internal disputes that make someone feel torn
between contradictory feelings or responses to a situation (36). Finally, the data also provide evidence for its use in
describing the repression or denial of certain aspects of a person’s identity when those aspects are deemed incompat-
ible with the circumstances they are facing (37). In this way, the metaphor highlights the complexity of situations that
cannot be controlled, involve detachment of the true self or demand effort, thereby loading the term with negative,
and only occasionally neutral, connotations.

33. A gentleman never takes advantage of an altered or schizophrenic state. Love is an altered and schizophrenic
state. [2011, Fiction, NewEnglandRev]
34. Is it normal to feel... schizophrenic? I mean, one second I feel... really sad, like, 100% sad. And then I get furious,
you know, at Noel for what he did. And then I get... totally guilty about me, for what I did . [1999, TV, Felicity]
35. If you're directing, you should be a little bit in control, but you shouldn't be totally in control, so you're in
control of being out of control or out of control of being in control. It's schizophrenic. [1990, Spoken, CNN_King]
36. The movie we are discussing today, made you schizophrenic. Expand on that. ALEXANDER HAIG: Well on the
one hand, it's cast beautifully, the film [. . . ] but the historic portrayal of events is totally off the wall and wrong, in
some instances, insidious. [1995, Spoken, ABC_Brinkley]
37. Enjoyment of traditional masculine humor puts a woman in what Lisa Merrill calls a schizophrenic mental
state. To be amused (or amusing) she must discount and devalue her own experience. [1995, Academic, Amer-
ican Studies International]

4.2.2.4. Attitudes, behavior and discourse. This subcategory includes examples where the use of “schizophrenia” as a
metaphor highlights specific instances of inconsistences in the attitudes, opinions, behavior and discourse generated by
individuals or reflected in the content of books, newspapers, and mass media. Hence, in this case, the target domain
refers to enduring evaluative tendencies that, unlike emotions, persist even when one is no longer actively thinking
about the object of the attitude (Clore and Schnall, 2005), are typically acquired through upbringing, and involve a pre-
disposition to act in a certain way (Allport, 1955). It also refers to contradictions in behavior and discourse that can be
understood as observable manifestations of patterns of thought and evaluation.
As in the case of ideology, beliefs, and religion, it is not the person or group that exhibits these inconsistences that is
cast as schizophrenic; it is the actual attitude, opinion or behavior which is conceptualized as schizophrenic (38). The
data show that in such cases the metaphor is mainly used to refer to controversial sociopolitical issues which are not
necessarily linked to the ideological agenda of a group or movement such as the description of a person’s view on cli-
mate issues (39), alcohol and tobacco consumption (40), media representations of women’s roles and responsibilities
(41), or particular ideas and attitudes displayed by politicians in their political campaigns/speeches (42). Through this
metaphor, notions such as unpredictability and distrust are evoked, as the inconsistencies and/ or contradictions that
the metaphor profiles suggest a lack of continuity in the message or behavior of the person/group that is being scruti-
nized. This raises skepticism, doubt, and even suspicion, as shown in (43), where Michell Obama’s “eat healthy” cam-
paign was perceived as a psychological tactic, a “mind game”, used to manipulate people. Once again, the metaphor
carries a negatively valenced view of the situation being described that feeds into the notions of irrational, illogical think-
ing, and behavior.
 E. Castaño Castaño / Lingua 294 (2023) 103596 15

38. We have a very schizophrenic public attitude right now where on the one hand, we are dependent on the labor
of farm workers to put food on the table, and yet, people are demonized because they were born somewhere
else. [2014, Movie (documentary), Food Chains]
39. How many schizophrenic “scientific” reports do we have to suffer thru? [. . .] Antarctic ice is shrinking and
contributing to known sea level change... but sea level rise is on a near straight line since the end of the Little
Ice Age.... [2012, Website, wattsupwiththat.com]
40. Too many young people assume the fact that the government permits cigarettes to be sold [. . .] (means)
that cigarettes usage does not present a clear danger. If people want to smoke cigarettes some of the conve-
nience that elevated tobacco usage to the height of its popularity should be removed. I believe failure to do so
sends a schizophrenic message to young people.” [2012, Blog, scienceblogs.com]
41. Schizophrenic media discourse about women exemplified by, for example, Cosmo: on the one hand be liber-
ated, on the other make sure you get a husband. [1998, Magazine, HarpersMag]
42. (Bush) His campaign seems schizophrenic. On Tuesday, for example, he launched his most systematic attack
yet on Governor Clinton [. . .] Then, Wednesday, he retreated back to presidential mode. [. . .]. On Friday, he
tried both approaches at once. . . [1992, Spoken, ABC_SunNews]
43. Michelle Obama's eat healthy/slim down campaign, kind of strikes me as mind games or mass schizophre-
nia. She tells us to observe good nutrition while her husband's corporate backers concoct more poisons to sell us.
[2012, Blog, willyloman.wordpress.com]
With respect to distribution across genres, the use of “schizophrenia” to describe ideological movements, values and
religious beliefs was found to be particularly prolific in websites, the transcripts of unscripted conversations from TV and
radio programs and magazines comprising 62% of cases. Academic texts only accounted for 12%. The remaining 26%
was distributed among movies, fiction, blogs and newspapers. Using the metaphor to refer to conflicts regarding identity
traits and roles and to describe emotions and affective states was especially common in blogs, websites, spoken
sources, and fiction, comprising 67% of cases. Finally, the metaphorization of “schizophrenia” to refer to attitudes,
behavior and discourse was more evenly distributed across genres, although blogs, websites, and TV and radio pro-
gram transcripts also accounted for more than 57% of cases in this category.

4.2.3. Policies, laws, political practices and strategies

This category is also closely linked to society and human behavior and includes laws, policies and regulations that
are binding on citizens and perceived as illogical. The occurrences identified in the corpus relate to the following topics:
American foreign policy, with a special emphasis on the Middle East (44), national security and the rise of violent
extremism associated with Islamic groups (45), corruption (46), gun and drug laws and the discrepancies between fed-
eral and state laws (47), and social policy concerning topics such as healthcare (48). Through this metaphor, attention is
drawn to perceived erratic shifts in American geopolitics and the importance of maintaining an unequivocal and stable
foreign policy to preserve national security. As for policies concerning domestic affairs, the data reflect culturally specific
concerns such as the long-standing debates on the regulation of gun ownership or drug use, which are negatively
appraised and described as schizophrenic because they are contradictory and send mixed messages. In this instance,
the metaphor occurred most often in blogs and transcripts of conversations from TV and radio programs, accounting for
62% of cases, followed by magazines and newspapers (27%) and academic texts, where four instances in total were
identified in journals about foreign affairs, and Arab and feminist studies.

44. In what can only be described as a schizophrenic foreign policy, Obama authorized logistical and intelli-
gence support to Saudi Arabia as they bomb the Iranian-led rebels in Yemen. But at the same time, the U.
S. supports Iran-led forces in Tikrit against ISIS. [2015, Spoken, Fox: Hannity]
45. It's the most schizophrenic National Security that I've ever seen [. . .] the idea of destroying ISIS is crazy, it's
not going to happen. They have been around since 1720. [2014, Spoken, Fox: The Five]
46. American policy toward corruption in Central Asia is thus exposed as schizophrenic. On the one hand the
United States purports to be opposed to corruption [. . .] But on the other, the United States is itself one of the most
staggeringly corrupt actors in the region. [2012, Blog, harpers.org]
47. Our federal marijuana policy is increasingly out of step with both the values of American citizens and with
state law. The result is a system of justice that is schizophrenic. [2012, Blog, dailypaul.com]
48. A battle looms in Congress among lawmakers who favor tougher regulation to contain health costs and those
who prefer to bet on a restructured market; currently, Clinton's plan contains a schizophrenic mixture of both.
[1992, Magazine, News and World Report]
16 E. Castaño Castaño / Lingua 294 (2023) 103596

4.2.4. Finance, economy, and markets

This category includes references to issues related to national and global finance and the economy (49), as well as to
the swings of stock markets (50). This is especially apparent in the context of inflation concerns and economic uncer-
tainty; for example, during an economic crisis. In this case, the metaphor exploits the notions of unpredictability and
erratic behavior popularly attributed to schizophrenia to refer to the volatile state of finances and the economy, as well
as the perceived chaotic working of stock markets, which are also described as a “rollercoaster” in an attempt to stress
the need for caution. The metaphor is once more applied in a negative light with examples almost exclusively found in
transcripts of TV and radio programs, newspapers and magazines, together representing 92% of cases.

49. I would say that the economy is very schizophrenic. [. . .] It's up and down and unpredictable. [1990, Spoken,
PBS_Newshour]
50. I don't love stock options. They're too schizophrenic. [2006, News, San Francis Chronicle]

4.2.5. Arts and media

This category encompasses references to specific and generic instances of painting, sculpture, architecture, music,
literature, cinema, and fashion trends where the metaphor highlights the unusual, eccentric, or odd nature of the refer-
ent, which is described as schizophrenic because it is unconventional, combines different, contrasting, styles or artistic
traditions or mixes forms in an unexpected way. Here, the metaphor feeds into the pervasive but also widely contested
link between creativity and mental illness (i.e., mad-genius hypothesis) in popular culture (Kaufman, 2014; Sawyer,
2012) and is used either to praise the originality of the work being described, conveying positive (51) or neutral conno-
tations (52), or to criticize it, hence, carrying negative connotations (53). Its use was found to be common in websites,
blogs, magazines, and newspapers, with a strong focus on art, music, and popular culture, including film, television, and
entertainment, accounting for 76 % of cases overall.

51. He became a crate-digger, buying albums regardless of genre and scouring them for sounds he could weave
together into new songs [. . .] The result was his third album, Making Mirrors, a pleasantly schizophrenic
set. [2012, Magazine, RollingStone]
52. The film's structure, though, seems oddly schizophrenic [. . .] but stay well within a hybrid style... [2012, Web-
site, cinema-scope.com]
53. Saturday's first half of KROQ's 23rd annual Almost Acoustic Christmas weekend played out exactly like
the schizophrenic mess it looked like on paper. [2012, Newspaper, Orange County Register]

4.2.6. Minor categories

Finally, “schizophrenia” is also used as a metaphor to describe oddness, unconventionality, and weirdness in con-
nection with domains such as cities, relationships, or the working of an object as in (54, 55, 56). These categories (see
Table 2) are grouped together because there were fewer than 10 occurrences per target domain. In this case, there was
no discernible prevalence or concentration per genre.

54. Santa Cruz. The town had always been schizophrenic. Couldn't decide if it was a retirement community or a
Mecca for hippie nostalgia and political radicals. [2006, Fiction, Idolon]
55. Washington's relationship with Wall Street is growing more schizophrenic by the day. [2012, Blog,
wallstreetpit.com]
56. Plumbing in that house is nuts. It's like the water pressure's schizophrenic. [2006, TV, Ghost Whisperer]

5. DISCUSSION

The analysis reported in this paper shows that as a metaphor “schizophrenia” features particularly strongly on the
internet. Websites and blogs, written by individuals in their own name or as members of a community or organization
(e.g., commongood.org), contributed the largest proportion of metaphorical utterances (215 examples) in the corpus. As
stated above, according to Sharoff’s classification (2018), the highest density is found in argumentative blogs, opinion
pieces and first-person narratives about personal life events. This suggests that the metaphorical use of “schizophrenia“
is well established outside traditional media (i.e., newspapers and magazines) and that its use is particularly frequent in
 E. Castaño Castaño / Lingua 294 (2023) 103596 17

those cases where personal stances and opinions are permissible and where there is room for a personalized and sub-
jective writing style. The data also suggest that an inverse correlation exists between the level of formality of the text and
the metaphorization of “schizophrenia“, which is in line with Clement and Foster's (2008) findings that the metaphorical
use of “schizophrenia” is more prevalent in tabloids than in broadsheets.
The results also indicate that “schizophrenia” is metaphorically exploited to describe a wide range of phenomena,
some of which have been previously identified in the literature (i.e., politics, economy, finance, culture and entertain-
ment, society, weather conditions, and cities (Duckworth et al., 2003; Boke et al., 2007; Chopra and Doody, 2007;
Athanasopoulou and Välimäki, 2014; Rodrigues-Silva et al., 2017)), while others such as religion, law, sex, identity
issues related to immigration and race or conflicting emotional and mental states, to mention just a few, have not yet
been reported. The data also show that the phenomena metaphorically described in terms of “schizophrenia” reflect cul-
turally specific concerns related to foreign and domestic affairs such as the US concern about its foreign policy, violent
extremism, and economic relationships with other countries, especially in the Middle East and China, as well as national
attitudes toward topics such as immigration, gun and drug legislation, or cultural tensions between religion and sexual-
ity. All of this suggests that, as pointed out by Potts and Semino (2019) regarding cancer and its ability to reflect what a
society perceives as the greatest evils and threats at particular points in history, the metaphorical use of “schizophrenia”
reveals what American society perceives to be the greatest incongruencies in their system of values, beliefs, policies,
and ideologies at certain points in time.
As in the case of cancer (Potts and Semino, 2019), the results also show that, although some of the target domains
described in terms of the “schizophrenia” metaphor are inherently negative (e.g., violence, economic crisis), many
others are neutral or not intrinsically negative (e.g., artistic productions, multicultural identities, political ideologies, reli-
gious beliefs), yet their metaphorical depiction triggers a negative evaluation. In fact, in line with previous research on
Portuguese (Rodrigues-Silva et al., 2017), the results indicate that the metaphorical use of “schizophrenia” usually car-
ries negative connotations (94% of occurrences), although, for example, its use to praise the unconventionality of an
artistic piece or the genius of an artist also allows the metaphor to convey positive connotations.
The examples in the corpus also indicate that this metaphor can be instrumentalized in different ways including its
use as a derogatory or dismissive remark, a word of caution, a form of flattery or an expression of anxiety. For example,
the results show that, as in French or Portuguese (Rodrigues-Silva et al., 2017; Lampropoulos et al., 2017), when the
metaphor is used to describe people, it not only elicits negative connotations, but also serves as an insult against the
person or group with whom the speaker disagrees. When used to otherize a person or group, it allows the speaker to
categorize them as abnormal and contributes to bringing discredit upon them or on the ideas and beliefs that they rep-
resent. Furthermore, when used to emphasize that a person or group acts or thinks in a contradictory fashion, often
against their previous acts or sayings, it helps to present those labeled as “schizophrenic” as untrustworthy and unre-
liable (Lampropoulos et al., 2017). Finally, when used to highlight the incongruence or unreasonable nature of a system
of beliefs, an ideology, policy, law, or argument, it contributes to justifying its dismissal and presenting alternative views,
ideologies, or laws not only as desirable, but also as necessary. This suggests that “schizophrenia” as a metaphor also
has an ideological dimension as it is used to support certain views while censuring others. Finally, the data also indicate
that, in the case of economy and finance, among other topics, the “schizophrenia” metaphor is employed to highlight
that a situation may entail a risk, and, therefore, to advise caution. Moreover, when dealing with artistic manifestations
and identity issues or emotional and cognitive states, it is used as a form of praise or a way of expressing anxiety.
The data also suggest that “schizophrenia” as a metaphor builds on a stereotypical conceptualization of the disease
that draws on (a) symptoms that, although prevalent in schizophrenia, are somewhat distorted in the lay understanding
of the condition (e.g., disorganized thinking and behavior, delusional episodes, or mood changes (American Psychiatric
Association; 2013; Høegh et al., 2021)), (b) misconceptions about the disease (e.g., split personality) that feed into
symptoms of other mental disorders such as dissociative identity disorder and reflect the long-standing confusion of
the splitting of mind with splitting of personality (Duckworth et al., 2003); and (c) prejudices derived from stereotypical
portrayals of the disease that correlate schizophrenia with violence or outstanding creativity (Clement and Foster, 2008;
Kaufman, 2014; Pescosolido et al., 2019; Sawyer, 2012). This stereotypical conceptualization of the condition is effec-
tive in presenting a person, group, idea, behavior, or state as incoherent and consequently liable to be criticized, cen-
sured or discarded. As argued by Musolff (2012) in reference to the use of the “body” and “illness” as source domains,
this gives users of the “schizophrenia” metaphor an advantage in argumentation by allowing them to prompt hearers/
readers to access their knowledge about the negative and undesirable aspects of the condition rather than having to
provide evidence for their claims.
Regarding metaphor research, the findings reported here build on previous literature on the use of “illness” as a
source domain by providing new evidence that, although “illness” by default does not conform to the typical character-
istics of a source domain, (i.e., concreteness, simplicity and clear structure (Lakoff and Johnson, 1980, 1999)), its
metaphorical use may still be remarkable if, as suggested by Potts and Semino (2019)in the case of cancer, it evokes
18 E. Castaño Castaño / Lingua 294 (2023) 103596

common cultural experiences (i.e., knowledge that is shared by the members of a linguistic community and plays an
essential role in establishing metaphorical mappings (Thibodeau et al., 2017)). In the case of schizophrenia, as demon-
strated previously, this shared knowledge includes a few salient characteristics (e.g., incoherence, irrationality, odd-
ness, bizarreness, unpredictability, or potential to violence) that can be mapped onto multiple and very different
target domains, evoking inferences that are well suited to the rhetorical purpose of conveying a sense of fragmentation,
confusion, or duality in a situation or idea, thereby suggesting a loss of touch with reality or criticizing a person or group
for behaving in a way that is perceived as disordered or irrational. All of which would explain why “schizophrenia” con-
tinues to be used as a metaphor despite its contested status among scholars, practitioners, and patients.
Finally, it should be noted that, whilst key findings have emerged from this study, they should be treated with caution
in terms of generalizability as the medium of data collection, COCA, necessarily skews the representativeness of the
study in geographical and diachronic terms as it is biased toward American English and data from blogs and webs were
only drawn from 2012.

6. CONCLUSION

In conclusion, this study offers new evidence to indicate that the use of “schizophrenia” as a metaphor serves as a
vehicle for speaking and potentially thinking about those aspects of our social, political and emotional lives that are per-
ceived as incomprehensible, contradictory, bizarre, or unconventional. It also shows that, given the influential role of
metaphors in shaping people’s feelings, thoughts and actions (Landau et al., 2014), analyzing the metaphorical use
of a condition beyond the media helps to elucidate how it is conceptualized by the different members of a linguistic com-
munity and how its non-literal use contributes to modeling its perception and understanding. This information may be
useful for counteracting stigmatization as it can be used to inform anti-stigma campaigns targeted at those misconcep-
tions that the metaphor reveals are integrated into the folk knowledge of the condition so as to promote a more open,
less partial and stereotyped frame of thinking about the condition and those who live with it.

FUNDING

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit
sectors.

Data availability

The articel is based on data collected in the COCA corpus, which is freely-available online. A sample of the data used in
this article has been made available on Open Science Framework.

Declaration of Competing Interest

The author declares that she has no known competing financial interests or personal relationships that could have
appeared to influence the work reported in this paper.

ACKNOWLEDGEMENTS

The author is grateful to the editor, Marta Dynel, and two anonymous reviewers for their comments and suggestions
on previous versions of this article, as well as to the members of the UB program in Linguistic, Literary and Cultural
Studies for their assistance and advice on aspects of metaphor identification and connotation coding. Any remaining
shortcomings are solely my own. Finally, the author thanks the University of Barcelona for funding the Open Access
publication of this work.

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