“Sticks and stones will break my bones, but words will never hurt me.”
We have all heard this saying, but if you are like me you have always known
that it isn’t quite right. Sometimes words can hurt us much deeper than any
weapon could. Those of us who have been exposed to verbal and emotional abuse
know just how much pain words can cause, yet we use words that hurt to talk
about ourselves and others all the time. Many times we don’t even realize how
much our word choice is impacting how we see ourselves.
“I’m a borderline”, “he’s schizophrenic”, “she’s bipolar”, “I’m too low
functioning to hold a job”, “John is dangerous when he has a meltdown”, “Susan
is depressed”. The way we talk about ourselves and others affects the way we
see ourselves and them. These kinds of phrases have no hope in them, and hope
is essential for those struggling with mental health issues to take control of
their own lives and believe they can get better.
Most of us are familiar with the medical model:
- · a narrow focus on treatment goals which are dictated by our care providers
- · mental illness as a chronic problem with low expectations
- · behaviors are seen as pathology
- · symptom focused and only works to stabilize
- · self-directed care is seen as “non-compliance”
- · techniques are more important than the therapeutic relationship
- · focus is on symptom categorization rather than individuals
- · the provider is in control and responsible for fixing things
Back in the 1980s and 90s some of those struggling with mental health
issues and not finding what they needed in the “system” they began to fight
back. The psychiatric survivor’s movement was born and consumers of mental
health services began to strategize about what needed to change for healing to
begin. They discovered that some helpful things were missing and some existing
things in mental health care were actually harmful- and this was the start of
the recovery model.
The recovery model of mental health emphasizes a self-directed journey
toward wellness, empowerment and hope. It includes:
- · Basic needs met- access to food, shelter and appropriate clothing for the weather is essential before any real effort can be put towards improving spiritual, educational or mental health states (Maslow’s hierarchy of needs).
- · Hope that recovery is possible- without hope that things will get better, those experiencing symptoms of emotional distress have no motivation to try to make any changes.
- · Self-responsibility- taking personal responsibility for our own lives and recovery.
- · Education- learning as much as you can about yourself and becoming aware of your triggers and warning signs, learning more effective coping skills.
- · Self-advocacy- learning how to ask for and find help when you need it
- · Support- finding positive people who believe in you and your ability to get better and reaching out to them when you need them.
“Great, but what does all this have to do with language and me?” you
are probably thinking. Well, medical model language and attitudes can be
stigmatizing and marginalize the people that are supposedly being helped. When
someone is described as “a borderline” they are seen only as a set of symptoms.
Their humanity is not even considered. No one considers the damage done to make
a person “borderline” or what is going on inside of them that causes their
behavior. When you instead describe that same person as “someone who
experiences extreme emotions” you put their humanity first-they are someone-
and then describe their actual experience rather than simply labeling them. Someone
who is emotionally overwhelmed elicits more sympathy than someone who is
“borderline”. It is the same when we think of ourselves with stigmatizing
language.
If I think of myself as being “borderline” when things aren’t going
well I am judging myself. What my mind hears is “bad, I am just bad”. If I
instead think of myself as experiencing overwhelming emotions I am able to see
myself more compassionately and have fewer negative feelings about myself in
the process. The same thing when others react to me. If someone reacts by
calling me “crazy” or “psycho” or even says I am “acting borderline” I feel
even worse about myself. Their negative reaction combines with my own negative
self-talk to double team me. My feelings are invalidated by the stigma. If
those around me react by asking me what is upsetting me and validate my
feelings though, then I feel empowered and more in control of my journey.
Some people believe that in order to truly gain power over these words
we need to accept them, to reclaim the words that have been used to marginalize
us. I have no problem with attempts to reclaim your power by playfully using
words that stigmatize. I even jokingly refer to myself as “crazy” sometimes.
But I would never call anyone else “crazy” because when someone else says it,
it hurts. For years I was known as “the crazy lady” in my hometown. The people
who called me that were not trying to lift me up. Let’s try to be aware of how
our choice of words can affect others. You don’t have to be perfect, just do
your best!
Some examples of strength based alternatives to stigmatizing language:
Harmful language Strength based language
A borderline someone
who experiences extreme emotions
An addict/junkie a
person struggling with an addiction
High functioning really good at…
Low Functioning has
a tough time caring for themselves right
now
Acting out person
disagrees with treatment team
Unrealistic person
with high expectations
Denial/unable
to accept illness person
disagrees with diagnosis/that they have a mental illness
Resistant/non-compliant not
open to… chooses not to… Has own ideas…
Weaknesses barriers
to change; needs
Unmotivated person is not interested in what system
has to offer/preferred options not available
Relapse/failure person
is re-experiencing symptoms/
re-occurrence
Maintaining clinical stability promoting
and sustaining recovery
Puts self at risk takes
chances to grow and experience new
things
Noncompliant with meds prefers
alternative coping strategies
Patient individual,
person receiving services, consumer
Enable empower
through empathy and encouragement
Frequent flyer takes
advantages of services as needed
Dangerous specify
the behavior
Manipulative resourceful, getting needs met,
really trying to get
help
Entitled aware
of ones’ rights
Baseline what
someone looks like when doing well
Helpless unaware
of capabilities
Hopeless unaware
of opportunities
Grandiose has
high hopes and expectations of self
User of the system resourceful,
good self-advocate
Mentally ill lives
with a mental illness
Manic has
a lot of energy right now/hasn’t slept in 3
days
Paranoid experiencing
a lot of fear
Delusional worried
about someone hurting them
Difficult not
on the same page as me
Committed suicide* died
by suicide
Successful suicide suicided
Completed suicide ended
their own life
Failed suicide attempt non-fatal
attempted suicide
Unsuccessful suicide attempted
to end their life
*There is also a movement to stop using the term “commit/ted suicide”
when referring to someone dying by suicide. There are a couple of reasons for this,
the most common being the idea that people “commit” crimes and suicide is not a
crime. It adds even more stigma. The other reason is that when someone commits
to something it implies that they made a rational, logical, well thought out
choice. Many people would argue that except for cases of euthanasia, someone
taking their own life is never rational -hence it is not factual to say someone
“committed” suicide.
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