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The Problem With Using Therapy Speak

More often than not, we’re using words we don’t really understand.
An illustration of two heads facing each other with tangled bands overhead (Illustration: iStock)

Have you ever dated a narcissist? Or silently judged two people who were clearly trauma bonded? Or maybe it’s your roommate whose OCD really triggered your PTSD from living with your sister.

These days, casually tossing about complex mental health terminology is part and parcel of our online and offline lexicon. Google search rates for terms like “trauma” and “gaslighting” have steadily creeped upwards in the past decade, with peaks in early 2022.

It’s a phenomenon that Hillary McBride, a psychologist based in British Columbia, ascribes in part to social media and how easily we’re now able to learn and share information. She says it may also be related to the rise in coaching culture, where online personalities feel compelled to deliver “meaningful bite-sized pieces of insight that help others.”

Either way, mental health language has become a way of understanding ourselves and our experiences, and subsequently translating those experiences into neat, concise, easily-recognizable categories.

“People [are] using really specific clinical diagnoses in their everyday language,” says McBride. “Things like ‘the weather is bipolar’ or, ‘I'm OCD, I've been cleaning my house a lot.’”

There’s a difference between a diagnosis and an opinion

Talking openly about mental health is important. Still, McBride explains, the downside to these concepts being used more colloquially is that they are often stripped of their actual meaning, or worse, applied in place of otherwise normal tendencies like mood swings or a penchant for tidiness.

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For the professionals who are trained in diagnosing these conditions, there is a clear distinction between a clinically significant phenomenon that requires special intervention and treatment, and an everyday occurrence that is part of the human experience.

Take, for example, the way we talk about narcissism. Narcissism, when diagnosed as a personality disorder, can look like extreme self-importance, a lack of empathy, and on the most extreme edge of the spectrum, aggression and manipulation.

The thing is, most of us have shown narcissistic traits at some point in our lives. But that doesn’t warrant a diagnosis. “Narcissistic personality disorder [is] a very rare, infrequently occurring personality disorder in the typical population,” explains McBride.

When average, non-mental health professionals essentially “armchair diagnose” other people, they are both diminishing the significance of the specific person's suffering and also the suffering of the people who actually meet those diagnostic criteria.

According to Dr. Saunia Ahmad, director and clinical psychologist at the Toronto Psychology Clinic, being wrongfully labelled can also have a deep and long-lasting emotional impact on a person.

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“It can lead to more stigma and shame, especially for a society where we don't really treat mental illness [like] other health issues that are physical in nature,” she says.

When we use mental health terms mindfully, we can ensure people are supported

While it’s important to make sure we’re not misusing mental health lingo, McBride says it’s equally important to keep those terms in our vocabulary. Discussing these terms openly, online or offline, means more people have access to this language—but we just need to understand the concepts better and apply them correctly.

And if that language is more accessible, she says, people might be more inclined and able to identify their experiences, and get help.

“When we distribute language around mental health, that reduces the barriers to access for care for understanding,” she explains. Once we can openly discuss mental health, we can start asking questions about how to become healthier and how we can support each other.

Listen to the experts

Chatelaine asked McBride and Ahmad to share some often misused mental health terminology, along with their actual meanings.

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What we think it means: A difference in how two people perceive reality.

What it really means: A specific kind of abuse aimed at making victims feel “crazy,” to create a surreal interpersonal environment where they continually learn to mistrust themselves and their experience of violence as a means of perpetuating more violence against them.

Trauma bonding

What we think it means: A connection between other people for having gone through a trauma together.

What it really means: A profound, neurobiologically-driven emotional attachment between an abuser and their victim. For example, sex trafficking victims often continue on in the relationship of exploitation and protection of the person who is trafficking them, because the trauma bond has them feeling like this person is both meeting their needs and providing for them while perpetrating abuse against them.

PTSD

What we think it means: Feeling like we're not 'over' a scary or big event, or having a disproportionately big reaction to something that happened.

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What it really means: An exposure to actual or threatened death, serious injury or sexual violence, usually resulting in a significant change of mood, the presence of flashbacks or nightmares, avoidance and hypervigilance.

OCD

What we think it means: Excessive cleanliness or an exaggerated need to have things in a particular order.

What it really means: A mental health disorder where a person experiences either obsessions, compulsions or both. Obsessions are unwanted thoughts, images or urges that a person finds distressing and tries to ignore or suppress, while compulsions are repetitive behaviours that a person feels driven to perform in response to an obsession or according to a set of rules that must be applied rigidly and are meant to reduce a dreaded event or situation.

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