The unsayable: a concept analysis


Correspondence to K.L. Schick Makaroff:




To report an analysis of the concept of the unsayable.


Within nursing, there is recognition that not all experiences of illness can be fully voiced and therefore may be unsayable. However, focus has been on that which is sayable, those experiences that can be communicated through language, leaving the unsayable unexamined. There is little examination of the meaning or relevance of the concept for nursing practice.

Data sources

The literature search was not limited by date and includes English, peer-reviewed texts in the databases CINAHL, Web of Science, and PsychINFO from 1959–2011.


Rodgers' method of evolutionary concept analysis was used.

Review methods

References were read and analyzed according to surrogate terms, related concepts, attributes, antecedents, and consequences.


Three surrogate terms, one related concept, four attributes, four antecedents, and two consequences were identified in this concept analysis. Based on this analysis, the unsayable refers to what is not expressed yet alluded to through language and may be conscious or unconscious. The meaning of this concept differs substantially between psychology and nursing.


Although literature on the unsayable has been developed primarily outside the discipline of nursing, exploration of the concept within nursing may assist nurses to consider situations and experiences that are challenging, elusive, and perhaps impossible for patients to language while living amid illness.