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Language Matters

Today to we are re-bloging and article by Julie T from Teasing the Edge: A Borderline Life, titled The Importance of Using Strength-based Language. It is about why language in mental health is so very important.

Monday, March 16, 2015

The Importance of Using Strength-based Language
“Sticks and stones will break my bones, but words will never hurt me.” We have all heard this saying, but if you are like me you have always known that it isn’t quite right. Sometimes words can hurt us much deeper than any weapon could. Those of us who have been exposed to verbal and emotional abuse know just how much pain words can cause, yet we use words that hurt to talk about ourselves and others all the time. Many times we don’t even realize how much our word choice is impacting how we see ourselves.

“I’m a borderline”, “he’s schizophrenic”, “she’s bipolar”, “I’m too low functioning to hold a job”, “John is dangerous when he has a meltdown”, “Susan is depressed”. The way we talk about ourselves and others affects the way we see ourselves and them. These kinds of phrases have no hope in them, and hope is essential for those struggling with mental health issues to take control of their own lives and believe they can get better.

Most of us are familiar with the medical model:
· a narrow focus on treatment goals which are dictated by our care providers
· mental illness as a chronic problem with low expectations
· behaviors are seen as pathology
· symptom focused and only works to stabilize
· self-directed care is seen as “non-compliance”
· techniques are more important than the therapeutic relationship
· focus is on symptom categorization rather than individuals
· the provider is in control and responsible for fixing things
Back in the 1980s and 90s some of those struggling with mental health issues and not finding what they needed in the “system” they began to fight back. The psychiatric survivor’s movement was born and consumers of mental health services began to strategize about what needed to change for healing to begin. They discovered that some helpful things were missing and some existing things in mental health care were actually harmful- and this was the start of the recovery model.

The recovery model of mental health emphasizes a self-directed journey toward wellness, empowerment and hope. It includes:

· Basic needs met- access to food, shelter and appropriate clothing for the weather is essential before any real effort can be put towards improving spiritual, educational or mental health states (Maslow’s hierarchy of needs).
· Hope that recovery is possible- without hope that things will get better, those experiencing symptoms of emotional distress have no motivation to try to make any changes.
· Self-responsibility- taking personal responsibility for our own lives and recovery.
· Education- learning as much as you can about yourself and becoming aware of your triggers and warning signs, learning more effective coping skills.
· Self-advocacy- learning how to ask for and find help when you need it
· Support- finding positive people who believe in you and your ability to get better and reaching out to them when you need them.
“Great, but what does all this have to do with language and me?” you are probably thinking. Well, medical model language and attitudes can be stigmatizing and marginalize the people that are supposedly being helped. When someone is described as “a borderline” they are seen only as a set of symptoms. Their humanity is not even considered. No one considers the damage done to make a person “borderline” or what is going on inside of them that causes their behavior. When you instead describe that same person as “someone who experiences extreme emotions” you put their humanity first-they are someone- and then describe their actual experience rather than simply labeling them. Someone who is emotionally overwhelmed elicits more sympathy than someone who is “borderline”. It is the same when we think of ourselves with stigmatizing language.

If I think of myself as being “borderline” when things aren’t going well I am judging myself. What my mind hears is “bad, I am just bad”. If I instead think of myself as experiencing overwhelming emotions I am able to see myself more compassionately and have fewer negative feelings about myself in the process. The same thing when others react to me. If someone reacts by calling me “crazy” or “psycho” or even says I am “acting borderline” I feel even worse about myself. Their negative reaction combines with my own negative self-talk to double team me. My feelings are invalidated by the stigma. If those around me react by asking me what is upsetting me and validate my feelings though, then I feel empowered and more in control of my journey.

Some people believe that in order to truly gain power over these words we need to accept them, to reclaim the words that have been used to marginalize us. I have no problem with attempts to reclaim your power by playfully using words that stigmatize. I even jokingly refer to myself as “crazy” sometimes. But I would never call anyone else “crazy” because when someone else says it, it hurts. For years I was known as “the crazy lady” in my hometown. The people who called me that were not trying to lift me up. Let’s try to be aware of how our choice of words can affect others. You don’t have to be perfect, just do your best!

Some examples of strength based alternatives to stigmatizing language:

Harmful language                                   Strength based language

A borderline                                              someone who experiences extreme emotions

An addict/junkie                                       a person struggling with an addiction

High functioning                                       really good at…

Low Functioning                                        has a tough time caring for themselves right now

Acting out                                                     person disagrees with treatment team

Unrealistic                                                    person with high expectations

Denial/unable to accept illness                person disagrees with diagnosis/

that they have a mental illness

Resistant/non-compliant                           not open to… chooses not to… Has own ideas…

Weaknesses                                                   barriers to change; needs

Unmotivated                                                 person is not interested in what system has to

offer/preferred options not available

Relapse/failure                                             person is re-experiencing symptoms/ re-occurrence

Maintaining clinical stability                     promoting and sustaining recovery

Puts self at risk                                               takes chances to grow and experience new things

Noncompliant with meds                             prefers alternative coping strategies

Patient                                                               individual, person receiving services, consumer

Enable                                                                empower through empathy and encouragement

Frequent flyer                                                   takes advantages of services as needed

Dangerous                                                          specify the behavior

Manipulative                                                  resourceful, getting needs met,

really trying to get help

Entitled                                                            aware of ones’ rights

Baseline                                                           what someone looks like when doing well

Helpless                                                           unaware of capabilities

Hopeless                                                          unaware of opportunities

Grandiose                                                        has high hopes and expectations of self

User of the system                                         resourceful, good self-advocate

Mentally ill                                                      lives with a mental illness

Manic                                                                has a lot of energy right now/hasn’t slept in 3 days

Paranoid                                                           experiencing a lot of fear

Delusional                                                       worried about someone hurting them

Difficult                                                            not on the same page as me

Committed suicide*                                       died by suicide

Successful suicide                                           suicided

Completed suicide                                          ended their own life

Failed suicide attempt                                  non-fatal attempted suicide

Unsuccessful suicide                                     attempted to end their life

Unsuccessful suicide                                      attempted to end their life
*There is also a movement to stop using the term “commit/ted suicide” when referring to someone dying by suicide. There are a couple of reasons for this, the most common being the idea that people “commit” crimes and suicide is not a crime. It adds even more stigma. The other reason is that when someone commits to something it implies that they made a rational, logical, well thought out choice. Many people would argue that except for cases of euthanasia, someone taking their own life is never rational -hence it is not factual to say someone “committed” suicide.

Original article

http://teasingtheedge.blogspot.com/2015/03/the-importance-of-using-strength-based.html

Sources:

http://www.scottishrecovery.net/WRAP/wellness-recovery-actions-planning.html
http://www.ct.gov/dmhas/lib/dmhas/publications/PCRPLanguage.pdf
http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc~mental-pubs-i-nongov-pri
http://www.naswwv.org/dmgnt_files/K12%20Weinberg%20VA%20Mental%20Health%20Care%20-%20THE%20RECOVERY%20MODEL%20OF%20MENTAL%20HEALTH%20VS%20THE%20MEDICAL%20MODEL.pdf
http://en.wikipedia.org/wiki/Recovery_approach
http://mob.mhcc.org.au/media/5902/mhcc-recovery-oriented-language-guide-final-web.pdf

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