Stigma: The Language We use

One of the things I try to be careful about in my work with people and other clinicians is paying attention to the language we use. Language is powerful - it’s loaded with meaning. When we work with people, are we referring to “addicts”, “alcoholics”, “schizophrenics”, or “clean/dirty” both inside and outside of sessions? Why would it matter?

It matters because it influences how we think about things. I was called out early in my career by a loving colleague who discussed the ramifications of my noting in reference to a “dirty ua”. Does this imply people are dirty? That use is dirty? Does it imply a judgment? You bet it does and I wasn’t even aware of the implication. How we think and communicate recovery and our perspectives matters. If you are precisely defining a behavior without judgment, you can feel a lot more hopeful when discussing a situation. For example, if someone is struggling with use and we use “they continue to be dirty for their urinalysis” vs. “they are testing positive for _____” - it takes the emotional and negative perception of a behavior right out of the equation.

In addition, when we label someone as in “denial” we are judging a very real stage of change that is needed for anybody considering a change in their lives… We make it something ugly when we’ve all been there. Denial is just feedback, feedback a person isn’t at a point they are ready to make changes or aware of the need to make changes and respond accordingly with our clinical intervention. Respecting autonomy and stage while having open/honest discussions without judgments can get a person a lot further in your work with them.

When people say “that’s so gay” - what does that really mean? It means it’s bad, ugly, stupid, and results in hurt and perpetuation of stigma. People who say things like this usually aren’t even aware they are doing it because it’s ingrained in our culture - until we stop it.

I challenge both helping professionals and those we are serving to avoid labeling yourself or others. Be specific. There’s a lot more to a person with alcohol dependence than being labeled an “alcoholic.”
They are often fathers, Veterans, artists, children, and someone for whom it is worth defining things differently.

Communication can make or break a relationship. Be aware.

Read more about this: http://www.unleashthenoise.com/2013-summit-findings

http://www.theguardian.com/science/brain-flapping/2012/sep/06/crazy-talk-language-mental-illness-stigma

Jill Lehmann-Bauer, MSW

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