A Word About the Words We Use

The behavioral health field has become more sensitive to the impact our language has on vulnerable persons.  This promising, but still relatively recent, development reveals our emerging awareness certain words, phrases and labels betray pejorative beliefs and perpetuate stigma.  They also shape and reinforce the identities of those to whom they are applied.  How many of us have referred to individuals entrusted to our care as “schizophrenic,” “bipolar” or “borderline?”

Thankfully, we have dispensed with such appellations in favor of “person-first” language that no longer equates individuals with their diagnoses.  A “person with schizophrenia” is not defined by his condition any more than a “person with blond hair” is defined by his.  (That is not to suggest there is not something inherently insidious in the application of any label (such as “schizophrenia”) even if it is applied in a more enlightened manner.  But that is a subject for another post.)

Nevertheless, certain words and phrases remain entrenched in our professional lexicon that would have been eradicated long ago had they been subject to the same scrutiny that applies to our diagnostic labels. 

These phrases summon some particularly odious images of warfare…

“On the front lines…”

“In the trenches…”

Countless soldiers died horrific deaths on the Western Front, portions of which remain toxic and strewn with unexploded ordinance more than 100 years later.  Conventional artillery claimed the lives of most combatants, but many who actually served “on the front lines” or “in the trenches” succumbed to the asphyxiating effects of mustard gas. 

How have we come to compare our service to society’s most vulnerable individuals with some of the most ghastly events in modern history?

With whom are we at war?  Our service recipients?  Each other?

Social service surely poses significant challenges at all levels, and it is not surprising we should feel under siege at times.  As we endeavor to meet the increasingly complex needs of an aging population amid dwindling resources and mounting administrative burdens we might even feel as if we are at war.

But to invoke military metaphors trivializes the horrors of actual warfare and casts our service recipients as adversaries and opponents.  Neither is acceptable.

We should be applauded for regarding our clients as individuals with unique needs, preferences, goals and dreams who just happen to have certain diagnoses for which specialized supports are needed…but only if we cease to approach them on a metaphorical battlefield.