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The power of words
ARCHIVES OF
PSYCHIATRIC NURSING Vol. VII,No. 5
October 1993
EDITORIAL
The Power of Words
S
TICKS and stones may break my bones but words will never hurt me.” This familiar jingle is an oxymoron because reciting this phrase would not be comforting if words did not hurt. In fact, one could argue that the physical pain caused by sticks and stones is sometimes easier to bear than the emotional distress caused by words and phrases that ridicule, stereotype, or demean. Physical pain eventually goes away, even if a scar remains, but the hurt inflicted by words has the potential for remaining, as well as for creating a permanent, albeit invisible, scar. Words and phrases that ridicule, stereotype or demean are no longer considered politically correct, especially when applied to racial, ethnic, and religious minority groups. Does this mean that members of these groups enjoy total acceptance? Of course not. However, it does mean that persons who use such terminology will be held accountable for their speech. Therefore, individuals and groups who are verbally maligned today do not need to feel powerless, a feeling that accounts for much of the hurt associated with an epithet. Recently, my local newspaper featured several articles about a local television sportscaster who was fired because during one broadcast he used a common phrase that was deemed to be an ethnic slur by the station executives. This story created so much interest that the newspaper asked its readers’ opinions of the situation. The responses were so numerous that they took an entire page to print. The vast majority of the respondents thought that firing this gentleman was much too severe a pun-
ishment for “a slip of the tongue” although most agreed that he should make a public apology. I wonder whether these respondents weren’t more concerned about this sportscaster’s lack of political correctness than they were about the attitude conveyed by his slip of the tongue. Regardless, this unfortunate incident brought the importance of words to the attention of a large audience. One group that hasn’t benefited substantially from politically correct language is those who have a mental illness. I suppose it is no longer considered polite to refer to these folks as “nuts” or “kooks.” But we still refer to those who have a mental illness as “the mentally ill.” In fact. this phrase is used repeatedly even in professional literature. What does this seemingly innocent phrase mean? Why might it be offensive? The use of the phrase “the mentally ill” indirectly implies that all persons with a mental illness are alike and that the person’s mental illness is all that needs to be known about him or her. Therefore, it is a depersonalizing term which stereotypes a group. Perhaps of greater importance, the use of this phrase elevates one aspect of the person to a defining characteristic. For all who have a mental illness this represents a misidentification. Persons who have a mental illness have the same myriad of traits as do other persons, but those of us who refer to them as the mentally ill convey little interest in knowing or acknowledging these traits. It is not surprising that those who have a mental illness hesitate to disclose this fact. Psychiatric nursing relies on the use of words
Archives of Psychiatric Nursing, Vol. VII, No. 5 (October), 1993:
pp. 257-258
257
258
CECELIA M. TAYLOR
more than any other clinical nursing specialty. To a large extent, our clinical effectiveness is determined by our knowledge and use of carefully phrased and timed words. We use words not only with clients and families but also on their behalf. Therefore, one could conclude that psychiatric nurses would be particularly adamant about using words that affirm rather than demean. Yet it is an American Psychiatric Association (APA) publication (1993) that states: A common misconception is that a classification of mental disorders classifies people, when actually what are being classified are disorders that people have. For this reason, the text of DSM-IV (as did the text of DSM-III-R) avoids the use of such expressions as “a schizophrenic” or “an alcoholic,” and instead uses the more accurate but admittedly more cumbersome, “a person with Schizophrenia” or “a person with Alcohol Dependence.”
Of particular interest is that this declaration was made at about the same time as scientists began to show that the most severe mental illnesses have a biological basis. Is this sheer coincidence or does this etiological factor make it politically correct to acknowledge that those who have a mental illness are individuals, not depersonalized categories? If it
were determined that some forms of mental illness were caused solely by psychosocial factors, would individuals who had those mental illnesses have less individuality than those whose mental illness is biologically based? The time has come for all psychiatric nurses and all psychiatric nursing organizations to adopt words and phrases that affirm the uniqueness and value of each person who has a mental illness. It is important for us to do so not merely as a response to the APA or as a means of being politically correct, but because psychiatric nurses have the ability and the audience that could empower those persons who have a mental illness and their families. At the very least, we should hold ourselves and others accountable when we use words and phrases which unnecessarily hurt those who have a mental illness. Cecelia M. Taylor
Associate Editor REFERENCE Task Force on DSM-IV ( 1993). DSM-IV Draft Criteria. Washington, D.C. A:8.
PSYCHIATRIC NURSING Vol. VII,No. 5
October 1993
EDITORIAL
The Power of Words
S
TICKS and stones may break my bones but words will never hurt me.” This familiar jingle is an oxymoron because reciting this phrase would not be comforting if words did not hurt. In fact, one could argue that the physical pain caused by sticks and stones is sometimes easier to bear than the emotional distress caused by words and phrases that ridicule, stereotype, or demean. Physical pain eventually goes away, even if a scar remains, but the hurt inflicted by words has the potential for remaining, as well as for creating a permanent, albeit invisible, scar. Words and phrases that ridicule, stereotype or demean are no longer considered politically correct, especially when applied to racial, ethnic, and religious minority groups. Does this mean that members of these groups enjoy total acceptance? Of course not. However, it does mean that persons who use such terminology will be held accountable for their speech. Therefore, individuals and groups who are verbally maligned today do not need to feel powerless, a feeling that accounts for much of the hurt associated with an epithet. Recently, my local newspaper featured several articles about a local television sportscaster who was fired because during one broadcast he used a common phrase that was deemed to be an ethnic slur by the station executives. This story created so much interest that the newspaper asked its readers’ opinions of the situation. The responses were so numerous that they took an entire page to print. The vast majority of the respondents thought that firing this gentleman was much too severe a pun-
ishment for “a slip of the tongue” although most agreed that he should make a public apology. I wonder whether these respondents weren’t more concerned about this sportscaster’s lack of political correctness than they were about the attitude conveyed by his slip of the tongue. Regardless, this unfortunate incident brought the importance of words to the attention of a large audience. One group that hasn’t benefited substantially from politically correct language is those who have a mental illness. I suppose it is no longer considered polite to refer to these folks as “nuts” or “kooks.” But we still refer to those who have a mental illness as “the mentally ill.” In fact. this phrase is used repeatedly even in professional literature. What does this seemingly innocent phrase mean? Why might it be offensive? The use of the phrase “the mentally ill” indirectly implies that all persons with a mental illness are alike and that the person’s mental illness is all that needs to be known about him or her. Therefore, it is a depersonalizing term which stereotypes a group. Perhaps of greater importance, the use of this phrase elevates one aspect of the person to a defining characteristic. For all who have a mental illness this represents a misidentification. Persons who have a mental illness have the same myriad of traits as do other persons, but those of us who refer to them as the mentally ill convey little interest in knowing or acknowledging these traits. It is not surprising that those who have a mental illness hesitate to disclose this fact. Psychiatric nursing relies on the use of words
Archives of Psychiatric Nursing, Vol. VII, No. 5 (October), 1993:
pp. 257-258
257
258
CECELIA M. TAYLOR
more than any other clinical nursing specialty. To a large extent, our clinical effectiveness is determined by our knowledge and use of carefully phrased and timed words. We use words not only with clients and families but also on their behalf. Therefore, one could conclude that psychiatric nurses would be particularly adamant about using words that affirm rather than demean. Yet it is an American Psychiatric Association (APA) publication (1993) that states: A common misconception is that a classification of mental disorders classifies people, when actually what are being classified are disorders that people have. For this reason, the text of DSM-IV (as did the text of DSM-III-R) avoids the use of such expressions as “a schizophrenic” or “an alcoholic,” and instead uses the more accurate but admittedly more cumbersome, “a person with Schizophrenia” or “a person with Alcohol Dependence.”
Of particular interest is that this declaration was made at about the same time as scientists began to show that the most severe mental illnesses have a biological basis. Is this sheer coincidence or does this etiological factor make it politically correct to acknowledge that those who have a mental illness are individuals, not depersonalized categories? If it
were determined that some forms of mental illness were caused solely by psychosocial factors, would individuals who had those mental illnesses have less individuality than those whose mental illness is biologically based? The time has come for all psychiatric nurses and all psychiatric nursing organizations to adopt words and phrases that affirm the uniqueness and value of each person who has a mental illness. It is important for us to do so not merely as a response to the APA or as a means of being politically correct, but because psychiatric nurses have the ability and the audience that could empower those persons who have a mental illness and their families. At the very least, we should hold ourselves and others accountable when we use words and phrases which unnecessarily hurt those who have a mental illness. Cecelia M. Taylor
Associate Editor REFERENCE Task Force on DSM-IV ( 1993). DSM-IV Draft Criteria. Washington, D.C. A:8.