Thursday, July 29, 2010

Does the Language We Use Shape the Way We Think?

by Michael J. Fitzpatrick, Executive Director

“Thought is the blossom; language the bud; action the fruit behind it,” wrote Ralph Waldo Emerson.

Recently, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has been hosting a discussion about the best language to use when talking about people living with mental illness. NAMI is also in the process of developing the NAMI language guide for our leaders and affiliates so that we can be certain that we are doing all we can to support a real-life experience of mental illness. Notably, there is not a complete agreement on what words are the best. So that we can move forward with finding the best language, let’s examine the history of language as related to our movement.

Join the Dialogue

Tell NAMI what you think about the language we use to express the issues affecting our community
The civil rights movement objected to the word “colored,” which appeared on the signs that had denied some Americans equal access to restaurants and drinking fountains. Later, “African-American,” became the preferred term because it recognized this group of modern-day Americans as being products of the African. Were these words the cause of the changes that occurred in our society? Or were they the result of it?

One thing is for certain: as writer Casey Miller wrote, “All language reflects the prejudices of the society in which it evolved.” Thus we can look back at the era in which people living with mental illness were described as “patients” and see that—with few real treatments and little understanding of the biological nature of mental illness—all one could do was patiently wait for one’s symptoms to improve.

The word “consumer” grew out of the individuals’ recovery movement. It was chosen by many advocates because it implied an element of choice in the mental health services used by people living with mental illness. Interestingly, this is the term that produced the most negative reaction in most (but not all) of the respondents to the recent SAMHSA articles.

We object so strongly to some words because they point to realities we find objectionable. Language is the bridge between how we want to be thought of and what we want done about it.

Most of us can agree that we want people to understand mental illness as an illness like any other while also helping them understand the realities and the impact that mental illness has on us as individuals and as families. How does out language express both the challenges and the reality of our personal experience? What language can we use to get us there?

NAMI’s goal is to find transparent, inclusive language that will be the bridge between the idea and the reality of the world we want for people living with mental illness. This, along with SAMHSA’s efforts, will help us define the way America understands mental illness.


Anonymous said...

As a sufferer of BWS, subset of PTSD and its accompanying symptoms of depression and anxiety; I definitely think language shapes the way we think. One important distinction I wish would be made in language is between illness and injury. Not all problems with the human body are illnesses, ie the distinction between physical chronic illness and injury/trauma. There are little to none facilities/treatments out there for mental injuries. I can call 911 when my house is burning down but who can a person call when they are having a mental health crisis. Hospitals check your temperature and blood pressure which can't determine a mental crisis. I strongly believe the language needs to be changed to change the current approach to mental crisis/trauma treatment.

Anonymous said...

I even object to modifying the term "illness" with the word "mental"! Many would disagree but only because the term "mental illness" is being used for DIFFERENT things, such as for emotional problems such as grief, personality problems, mild "adjustment disorder" for which perhaps a few counseling sessions may be all that's needs, as well as for severe biological brain disorders.

NAMI represents people with real BRAIN disorders. It is ILLNESS like any other. I object to the word "mental."

Aimee said...

Awesome! Great idea. We need to make all people feel included and stop the stereotyping!

Anonymous said...

I do not like people with Mental ilnees being called consumers. It has such a negative connotation for me as in consuming resources, consuming the family resources. I can't hardly explain why it is so yes offensive to me. And I fear even mentioning it will be offensive to others.

Anonymous said...

After attending a NAMI family support meeting and finding out about the use of the word consumer I explained it to the family member with a diagnosis explained as a mental illness. She hated it! Consumer has a negative connotation to her and being a patient does not. She is being treated with medication and counseling and participating in activities that promote mental and physical holistic wellness.

Anonymous said...

I do not like the use of consumer either - it makes us sound like we are part of the retail world ! And we consume what !? What am I a consumer of? But I am stumped for another term? Any ideas?

Anonymous said...

Where did the word cancer come from? Why can't we come up with a word that means "illness of the brain" and then we can have bipolar "illness of the brain", etc just like we have breast cancer, colon cancer etc. Everyone knows cancer means "illness of the cells" and are not ashamed of it because it is an illness and outside their control. We need a word like that for mental illnesses.

David said...

I agree that the term illness is a bad word to use. It is not a neutral term, only a negative one for the reasons already stated. Even a word like "condition" may be slightly better than illness, it is a bit less negative. Think of when DD people were called, and they sometimes still are, "mentally retarded." That was really bad, mainly because mentally was far worse than developmentally. Small change made a big difference. I came up with one at my job at a mental health center one day that will never fly but it makes us chuckle - how about - "unusual people" I love it!

Mike Katz said...

In my over twenty years as a "family member" active NAMI advocate and volunteer, language has been a subject of discussion and controversy. My family has along history of mental illnesses and my son who lives with one or more of the labels that try to describe either the illness or the individual is foremost a human being and a family member. So depending on whom I am speaking with will determine my language so as not to further stigmatize persons that live with mental illnesses and their families. Having said this I am also a FTF teacher and support group facilitator and advocate with the legislators and the system so we must speak in language that hits the target.

The comments are great but we do not want to take steps backward after the hard work of de-stigmatizing the myths surrounding what we hope that all will understand Biological Brain Disorders. My son who has his disorder since his early teens used to come home saying that his doctor said he was just “different” with the thinking that he did not like to label kids. I agree we should try not to label but we need to identify so that individuals can get what they need from schools, providers and society.

This is very important and worthy NAMI involvement. Thank you.

Mike Katz

Anonymous said...

Even though one could make the argument that a doctor is a "producer" of a service and the person seeing the doctor is a "consumer" of said product, this is not the terminology that is commonly used. The recipient of such services is called a "patient".

I think in order to help reduce the stigma of "mental illness", the same term should be used that applies to a person with any other disease. Using a different term makes these victims stand out rather than blend in.

I also agree with the second poster. The term "mental illness" is problematic because of the stigma attached to it. Finding a medically accurate replacement with no stigma is a challenge. I do not have a good suggestion at this time, unfortunately.

Personally, I am concerned with the term "schizophrenia", because not only does it carry a stigma with it that causes people to react with fear instead of compassion, it is medically wrong. No wonder the general public confuses it with Dissociative Identity Disorder when the word means "split mind".

Another problem with the term is that the general public tend associate the disease as the fundamental characteristic of the person suffering from it. We do not refer to a cancer patient as a "cancerIC". It is clear that person is still whoever s/he was before and that the cancer is an unwelcome invader.

The term "schizophrenic" implies that this is the fundamental trait of the person - what s/he IS.

When Eugen Bleuler named the disease in 1911, he was trying to distinguish it from dementia praecox, which was a good idea. The time has come to create an even more accurate, neutral term.

I suggest something on the order of "neurotransmitter imbalance disorder (NID)" or simply "neurotransmitter disorder". To distinguish Bipolar Disorder, Depression, etc., one could use a suffix: NID Type 1, NID Type 2, etc. or some other such nomenclature.Not only would such nomenclature be more medically accurate and culturally neutral, it would offer families a better opportunity to educate friends, neighbors, co-workers, etc.

Instead of saying "my son has schizophrenia" and having people recoil in fear and repulsion", I could say "my son has Neurotransmitter Imbalance Disorder Type 3", to which the response would be a curious "I knd of get what that means, but what is it exactly?" Then, I could explain that they used to call it "schizophrenia", which was a pretty bad name, and proceed to explain the disease.

Ed G

Veronica said...

I detest "Behavioral Health" so commonly used today.
It makes me feel like, I have just been misbehaving and if only I would behave I would be fine. How wrong is that!
Also "rehabilitation" gets me identified as an ex prisoner or addict. I much prefer "reintegration" as into the community!
Mental Illness should be in neurology just like parkinsons and ahlzeimers. I think the stigma would go away overnight if this dept.& language were used.

Anonymous said...

I like the anonymous comment of NId for schizophrenia. Even among us peers, there is stigma on schizophrenia. It would really be good to choose a different label for it

Sam said...

I think we should remeber about distinction in language is between illness and injury. Not all problems with the human body are illnesses. But I can also remind that everything connected with our brain. If our mind tells us we are sick our body believe it.

reset windows 7 password said...

I agree that the term illness is a bad word to use. It is not a neutral term, only a negative one for the reasons already stated. Even a word like "condition" may be slightly better than illness, it is a bit less negative.