People are complex beings having to go through a rollercoaster of experiences in life which mould them into who they are as individuals. These experiences make them go through various stages of life where one faces different range and extent of emotions. People experience mental health problems around us on a constant basis. Statistics illustrate that mental health problems affects so many of us, so much so that one in four of us of require professional help.
With so many people going through such distress, research shows that one of the major factors that prevent them from seeking help or further avert them from the professional help they receive, is the social stigma around mental health problems and people experiencing them, the stigma that is further propagated by the language and words we use.
The language that we use to refer to mental health issues and related topics, with the intention of conveying compassion, providing hope, empowerment and optimism, under closer inspection, ironically reveal to express messages that divide and stigmatise.
Using medical terms to refer to such experiences, lead us to view the individual as a sum total of the symptoms that they experience, and this gets in the way of understanding the reason(s) which led someone to develop these symptoms in the first place. And how we think about mental health problems can have implications for how the problem is tackled, for the individuals concerned, and for society as a whole.
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Receiving a diagnosis is definitely helpful; having a label and a diagnosis for the experience might help an individual to validate their distress and provide a route by which they can access mental health services and receive support. But imposing this psychiatric diagnosis, by referring to a person experiencing such issues by their diagnostic labels, equates the person with their problem and can feel stigmatising. Diagnostic labels tend to have certain negative stereotypes linked with them about having a particular mental health condition, making individuals diagnosed with these conditions have to undergo a series of assumptions of their situation. For example, ‘Schizophrenia’ has unfortunately frequently come to be seen as a negative term that refers to certain clusters of symptoms of mental ill health and therefore labelling somebody as ‘schizophrenic’ can mean that an individual immediately has to deal with many misconceptions.
Using terms like ‘illness’, ‘treatment’, ‘risk assessment’, etc. when referring to mental health conditions can send the message that the individual has little control over their own mental health and portray mental health problems as abnormalities that need to be ameliorated. As many academics, including Joanna Moncrieff (British psychiatrist and a leading figure in the Critical Psychiatry Network), argue, approaches in mental health are not like treatments for physical illnesses. Mental health approaches shouldn’t be called ‘treatments’ and rather must be addressed as ‘interventions’, since they involve doing something to an individual regardless of the likelihood of it making a difference.
The article “Mind your language!” [1] by Peter Kinderman and Anne Cooke provides a more detailed/convincing(?) argument in favour of the same. They mention how the use of the term ‘illness’ has significant downsides like risking perpetuating the frightening, yet unproven, idea that mental health distress is caused by brain damage, and obscuring the fact that psychological distress, however it manifests, is often an understandable reaction to the events and circumstances of our lives.
Apart from using diagnostic terms to refer to people, there are many other instances where we do not realise the repercussions of the language and words we use. As highlighted in the article, “Mind your ‘C’s and ‘S’s: The Language of Self-harm and Suicide (and why it matters)” [2] by Emma Nielson, even words and phrases like ‘committed suicide’, ‘cutter’, etc. inflict a sense of blame and negative approach. Expressions like ‘failed attempt at suicide’, which is a quite common phrase unfortunately, tend to give out the wrong message, as though the individual lost at something, whereas on the contrary, they have another opportunity at life.
When asked questions like ‘What is wrong with you?’, with reference to psychological experiences, can give the individual a sense that something must be wrong with them for them to experience what they are going through. Even though this question is asked by many, even psychologists, with the intention of helping the individual, it could make the individual perceive their condition as idiosyncratic or one that is abnormal and, in some cases, this thought can lead to worsening of the situation.
Something obviously insensitive and hurtful, but sadly often overlooked, are hashtags like #IGetDepressedWhen, [3] which went viral all over Twitter in 2017, but for all the wrong reasons. The hashtag became a huge controversy and was called out on by service users and people who were experiencing depression and many others, for being highly insensitive and blatantly ignorant of mental health issues.
Words have the power to inflict self-blame and rumination among people, which can have a more negative effect which probably wasn’t the intention of the person who used the phrase. Phrases like “Just cheer up”, “you just need a different mind-set”, etc. can tend to invalidate the distress one is going through, and rarely turn out to be helpful to the individual. Our responses to someone confiding in us during a time of distress, if negative, can even instil fear in them with regards to what they are experiencing, which can at times avert them from being able to find coping mechanisms.
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Our language and our words hold immense power, and it’s time we acknowledge this. As we all know, with great power comes great responsibility, and we all have the responsibility to be more aware of the words we use, both in real-life as well as in the virtual world. As Dr Eleanor Longden (Postdoctoral Service User Research Manager at the Psychosis Research Unit in Manchester) says in her interview with Jon Ronson from the Guardian newspaper,[4] “I do think life events play a vital role in determining who becomes distressed and overwhelmed and who doesn’t. This might include experiences of abuse, trauma, inequality, powerlessness and so on, but it can also include the immediate reactions of the people around you. If you don’t have people who will accommodate your experiences, support you, and help you make sense of what’s happening, then you’re probably much more likely to struggle.” There are many more instances where people undergoing mental health disorders have come across unhelpful/insensitive comments. The currently trending viral hashtag #ThingsPeopleHaveSaidAboutMyMentalIllness on Twitter [5] gives many instances of this.
So, what can one say? Do we really need to guard our words that much when speaking about mental health distress? Yes and no. No, we do not have to feel like we’re walking on eggshells, when it comes to talking about mental health. That would just reduce the amount of discussions regarding mental health issues that we have, and we most definitely do not want to do that. But yes, we need to be more conscious of our words and responses.
This is a wake-up call, to be more aware of our words and language, to acknowledge the power they hold, and to make an effort to use proper, non-stigmatising, sensitive language and provide a welcoming and comforting space for individuals who open up about their psychological distresses, assuring them that their experience is understandable and not something they should fear. Just like one’s language could seem insensitive and have other repercussions, it also holds the power to help reduce the stigma around people experiencing such distresses as “abnormal” or “crazy”.
One such form of language we can put to practice is the “person-first language”. In this approach, one places importance on the person rather than the symptoms of the psychological distress and gives the person a sense of individuality. For example, rather than saying a “person is bipolar”, say “this person has bipolar disorder”. Despite these guidelines, we need to remember to still respect each individual’s preference on how they wish to refer to their own mental health status.
There are multiple articles available online which elucidate more on the terms and phrases that are more appropriate with regards to mental health, which are written by professionals experienced in this field like David Sussman, Ph.D. (Assistant Professor in Psychology at the University of Kentucky) in his blog “Ten Commandments for How to Talk About Mental Health” [6] , Emily Bulthuis (Licensed Clinical Social Worker) in “Mental illnesses: Terms to use. Terms to avoid” [7] and many more.
By changing how we talk about mental health issues, we can begin to impact the negative attitudes and behaviours which adversely affect so many people. Such changes within the society will contribute to the cyclic transformation between optimism and pessimism that influence the understanding of mental health.
Bibliography:
- [1] https://livrepository.liverpool.ac.uk/3022118/2/mind%20your%20language%20v7.pdf
- [2] https://imhblog.wordpress.com/2016/01/22/emma-nielsen-mind-your-cs-and-ss-the-language-of-self-harm-and-suicide-and-why-it-matters/
- [3] https://twitter.com/igetdepressed
- [4] https://www.theguardian.com/technology/2013/aug/08/ted-talk-eleanor-longden-schizophrenia
- [5] https://twitter.com/search?q=ThingsPeopleHaveSaidAboutMyMentalIllness
- [6] https://www.psychologytoday.com/us/blog/the-recovery-coach/201706/ten-commandments-how-talk-about-mental-health
- [7] https://www.healthpartners.com/hp/healthy-living/healthy-living-blog/mental-illnesses-terms-to-use-terms-to-avoid.html
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