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How important are the words we choose to use when we speak to one another?
Exceedingly important -- and not just from a grammarian's point of view. Science also tells us so. Research out of Stanford has proven that the words a person uses affect the way that person thinks. Now, turns out the words we use affect the way others think, too, particularly on the topic of mental illness.
A new study published in the Journal of Counseling & Development looked at the ways in which people respond to descriptions of those suffering from mental illness. Researchers at the Ohio State University issued a Community Attitudes Towards the Mentally Ill (CAMI) survey to more than 600 people. Half were given statements associated with "the mentally ill," and the other half were given the exact same statements using "people with mental illnesses" instead.
Overall, the study found that tolerance decreased when describing people as "mentally ill" instead of "having mental illness." (Though it varied by age group: Adult respondents, for example, were more likely than younger respondents to want "the mentally ill" to be separated from the "normal" community.) As a result, the researchers concluded that, going forward, when talking about the mentally ill, we should avoid saying "the mentally ill." (And that no, it's never okay to want to "separate them from the 'normal' community.")
The takeaway from this study is certainly well meaning. When it comes to mental illness, tolerance is paramount, considering that studies show many people don't get the help they need -- that they are afraid to or don't even know how or where to seek it -- because of the certain stigma attached to mental illness. And yet in this case the solution may also be misguided. The real problem is less how we talk about mental illness, and more how we don't talk about it.
Language has an impact on how we view people and things, not to mention ourselves; how we choose our words is, and should always be, very important. And this isn't the first time this issue has come up in health care. It's easy to see how talking about "people who have cancer" or "those with diabetes" might feel more empathetic than talking about "cancer patients" or "diabetics." The person, and not the disease, becomes the focus, while the group impacted -- the cancer patients, the diabetics -- become the "other." In this case, the static term "mentally ill" implies a fixed state, whereas "having mental illness" implies fluidity and change -- the possibility of getting better. One puts the patient as a victim, and the other does not.
This is why psychologists have long advocated the person-first approach when talking about those afflicted with any illness -- it's a way to separate a person's identity from his or her disease. But the person-first approach is not an absolute, and it needn't be the rule, especially if it risks not talking about a topic we already too often avoid talking about. What's more, there's a danger in reinforcing the message that tolerance is most easily achieved in cases where a person has a chance of getting better, especially since while there is treatment -- in many cases, very good, very impactful treatment -- for many forms of mental illness, there is no cure.
There is no shame in having or seeking treatment for mental illness, no matter what we call it -- and no matter whether or not those suffering from it will get better. Increasing the dialogue around, and on behalf of, those who experienced it, should not include raising levels of fear, which will only discourage discourse. Few of us want to be intolerant. Most of us have the best intentions. Parsing words to such a degree will only encourage silence. And that's when the real damage occurs.
And, well, the wrong choice of words isn't really what's helping perpetuate the stigma surrounding mental illness anyway. What's perpetuating the stigma is the persistent fear surrounding it -- not just in experiencing it ourselves but also in witnessing it in others. Instead of changing the words we use to refer to mental illness, we need to change how we react to those words, and how we let them make us feel. What can help? Conversation. Open dialogue. The opportunity to bust myths and expose truths. That won't happen if we become too fearful of the topic. Or, for that matter, if we bow to those with prejudice by letting them force us to parse our words. That's not a long run solution and, in fact, will likely only strengthen the idea that, when it comes to mental health, there's something to hide or be ashamed of when there isn't.
Language helps shape perception, but so do other things. When it comes to mental illness, the problem isn't how we describe those who suffer but how we as individuals ultimately choose to view them, which is just that: a choice. Instead of renaming the conversation, how about reframing the entire body of thought around the topic? How about changing our philosophies and not just our phrasing?
Peggy Drexler, Ph.D. is a research psychologist, Assistant Professor of Psychology at Weill Medical College, Cornell University and author of two books about modern families and the children they produce. Follow Peggy on Twitter and Facebook and learn more about Peggy at www.peggydrexler.com
