Good terminology is necessary for good mental health treatment

Mental health consumers are rendered impotent in terms of accomplishing things in our lives by verbal and psychological tactics of many professionals in the mental health treatment system. This prevents us from building decent lives for ourselves. This must change. People with mental health disabilities deserve encouragement and empowerment to build lives for ourselves. Being subjected to beliefs imparted and forced on us that we are unable must change.Mental health consumers like me often do not have a choice concerning our involvement in the mental health treatment system. We need them more than they need us. If you have a serious psychiatric disorder, failing to be helped by doctors can spell disaster, leaving people like me with little choice but to engage with the mental health treatment system.

I am grateful for the help of the mental health treatment system. The current system, and my cooperation with it, are a far cry better than trying to tough things out on my own, or otherwise rebel. However, there are a number of things I would like to see change.

Let me begin with the word, “compliant.” The word has a number of negative and stigmatizing connotations, it implies a looming authority of the mental health system, and it insults the mental health consumer by painting us as helpless. I’d like to see that word replaced with “cooperative.” The term refers to a person who takes medication and other treatment voluntarily rather than by force or not at all. When we cooperate, the implication is that we are sensible, thoughtful people. When we are “compliant” the association is of a person who has fought and surrendered, or perhaps someone who has knuckled under due to overwhelming force.

We would do well to replace the term “decompensate,” as well. This term is used to describe someone who is losing her or his ability to maintain their mental health. This term is generally used in a derogatory manner. A better term would be something like “become ill,” or “become acutely ill.” This word by itself is insulting. Just as some words used by racists are intrinsically insulting, I believe “decompensate” is insulting. And coupled with how treatment practitioners usually say it, it is like an obscenity. When I’ve heard the word spoken, the vocal tone is always insulting and demeaning.

Words, when weaponized, can do a great deal of damage. And this happens a great deal in the mental health treatment system.

The word “client” or “mental health client” needs to change, too. We are not clients of an advertising company trying to market a product. Therefore, when the word is used to refer to us, it feels like a mockery. “Patient” was the first word that was used and was replaced with the word “client” numerous decades ago. It has to go. The term “mental health consumer” is far better. It implies that a person has consciousness.

In the mental health treatment system, the word “inappropriate” evokes shame, and it implies that we are antisocial. The word in mainstream society may not seem like that. However, when the word “inappropriate” is used to describe a behavior of a mental health consumer, it implies someone akin to a dog that is not properly socialized. That’s the best way I can describe this. Sentences containing the word, “inappropriate” should be overhauled and rephrased.

For example, if a mental health consumer, while in session had an angry outburst toward a staff member, or said something insulting, or interrupted, these could be labeled “inappropriate.” A better alternative would be to say something like, “Please be considerate of others.”

This revision is very direct and gets the point across, and it does this without invalidating the consumer.

Language, when weaponized, can do damage to people’s self-worth, it can create needless resentment, and it can otherwise do harm. When we try to pin down a practitioner on something that hurt, that was offensive or was wrong, in my experience, the practitioner invariably uses language as a shield so as not to be held accountable.

When many people, not just mental health consumers, become upset by something, it is often hard for us to substantiate the specifics of why we feel that way. Being medicated adds additional difficulty in articulating where an upset emotion has its origin. Therefore, when a therapist uses the certain words and phrases, such as the ones I have described, the consumer comes to feel powerless. This is convenient for managing consumers. Therapists and treatment practitioners often want to keep the consumers down for the sake of their jobs being easier. Rendering verbal and emotive impotence assists in this effort.

Psychotherapists also have the skill to psychologically disassemble a consumer. This is accomplished through a series of questions that analyze things like, “When did you first feel this way?” “What, in your past, might have led to this feeling?” “How did you feel when [blank]?” or “What were your thoughts at the time?” The direction of conversation is under the control of the therapist because they manage to ask questions quickly enough that the client remains tasked, preventing them from having the mental wherewithal to object. Thus, twenty minutes later, their mind is in pieces, under a microscope, nothing has been resolved, and the consumer is much worse off than before.

An analogy to the above: A surgeon starts on an operation to take out a person’s bad appendix. However, the surgeon doesn’t finish the job—instead, they have left the patient on the operating table, with an open incision and with organs not fully put back into place. The patient is released in that condition because the one-hour session has expired, and the surgeon must move on to the next patient.

Words, when weaponized, can do a great deal of damage. And this happens a great deal in the mental health treatment system.