The Case Against Jargon in Psychotherapy

I don’t have many hobbies, but one thing I like is to imitate therapists (even though I’m one myself). Soft voice, talking slowly—many breaks—a serious, concerned look on my face. No joking around, time is standing still, everything is profound. “What brings you here today, Valery?”

I do it with friends, I do it with colleagues. Sometimes… I do it with patients. Why, you might ask? Because I resent the jargon and mannerisms and because I think it’s dangerous and damaging. I’ll try to convince you in this blog series that good therapy is necessarily jargon-free. That we don’t have to act as therapists to be therapists; in fact, we must be ourselves, talk in a normal, regular way. No artificial pausing, no weird facial expressions or words we wouldn’t use outside of the room. Scale down the profoundness, smile—everything’s normal. It’s a human interaction, let’s make it real.

When I was in graduate school, which was not that long ago, I had a professor whose last name was Geller. He told us once that he became a "Gellerian” when he was 50. He spoke directly to our anxieties as novices that we weren’t ‘real’ therapists, or even more importantly perhaps, that we didn’t appear as such. He argued that we all begin that way: trying on a therapist’s persona, afraid of being found out as ordinary people with little experience and not much to offer the struggling person in front of us. To conquer that anxiety, we use jargon to appear more professional—as if we know certain things that the patient doesn’t. But as we grow more confident, he argued, we become more like ourselves; moving away from a caricature of a therapist—who talks like a therapist, sits like a therapist, and sighs like a therapist. The gap between how we are in the treatment room and how we are outside of it, narrows.

Why is this transition crucial?

Imagine two scenarios. Scenario A: A deeply depressed, suffering person, in tears, tells you how the same problem occurs time and time again—how he is humiliated by his boss, feels that it’s petty of him to even be bothered by this, but what can he do, it keeps happening, and he hates that and feels weak and pathetic and can’t do anything about it. Therapist’s response: “It must be so hard for you to experience the same, repetitive pattern, again and again, and I would actually emphasize the word ‘pattern’ here. I suggest we examine together your core belief that this is inevitable.” Scenario B: Same person, same story. Therapist’s response: “Brian, you know what suffering is? Exactly that: a black hole, stuckness, a feeling that it will never change, that we will never change. Nonsense, that’s our fight—to get out of there. We’ll figure it out.”

The question of which scenario is better for the patient is a question of what psychotherapy is, or rather, how psychotherapy heals. Whether it is a theoretically inspired understanding of the patient's problem and its conveying using a specific 'technique’, a distinctive language. Or whether it is something else… something more akin to a good human interaction. Yes, with theory. Yes, with an understating that is not just 'intuitive' or emphatic. But primarily, a deep (as deep as possible) human connection, an assurance that the person is not strange, alone, or can’t cope with his sorrows. You, the therapist, have to be real there, throw away the protective shield of professional-sounding words and professional-looking stares. Because when we jargonize psychotherapy, we distance ourselves from the person in front of us, becoming more of a ‘therapist’ but less of a human being that you actually want to be with.

Jargon comes in many forms. It can be psychoanalytic jargon, it can be cognitive behavioral jargon, it can be any of the hundreds of abbreviations (which are jargony in themselves) that are used to depict psychotherapy. For young therapists the challenge is how to make psychotherapy feel non-amateurish, special—more special than just a deep conversation with a friend, let’s say—without turning into a cliche. A nodding, somnolent, gravely serious creature who is far, far away from the person in front of him in deep, at times insufferable, pain.

In future blog posts, we’ll try to figure out if it’s possible.