Almost every day on I see references to how to talk about mental health. All of them are written with the best intentions, for a linguist most of them are quite problematic. The other day I saw the Ten Commandments for how to talk about mental health. And given how authoritative the title of the statement is, I thought it was time to react. And so, here is the linguist’s take on how to talk about mental health.

Let me start with the first point Dr Susman makes, the difference between the following pair of sentences:

John has schizophrenia.

John is schizophrenic.

He says that the first one “puts emphasis on the person and not the illness, while the other equates the person with the illness.”  Well, the problem is that it’s not true. Linguistically, the two statements are, roughly, the same (if you want to learn more, please read about Michael Halliday’s types of processes in language). And so, I really find it difficult to understand how the first ‘focuses on the person’. In fact, both statements ‘focus on the person’. They are both about John, who is positioned as the grammatical subject of the sentence and, in terms of the information structure, as its theme (i.e. what the sentence is about). Really, there is no linguistic way in which to argue that somehow the subject/theme in the first sentence is different from exactly the same subject/theme in the other.

However, I understand that ‘is’ can be seen as introducing an almost timeless characteristic of John, while ‘has’ seems not to. Consider then the following:

Horses have manes.

Humans have two eyes.

Fish have fins.

The verb ‘have’ is used here to refer to ‘timeless’ characteristics of horses, humans and fish. I might be wrong, but I cannot see a definitive argument proposing that ‘have’ in the first sentence is radically and certainly different from the one in the other. The argument that the sentence “John has…” puts the ‘person first’ has no linguistic foundation. So that’s quite a few commandments, I think (I, II, III, V, VI, VIII?). What to say? I’ll come to that below.

I struggle with ‘commit suicide’ and I have written about it before. Once again, I actually agree with all the arguments. “Commit” does connote illegality and it is unhelpful. Except that there is no good replacement, as I pointed out in the earlier blog. There is also another problem. As I read through dozens of suicide notes, I see references to ‘committing suicide’ all the time. In the same way as I interviewed men who had attempted to kill themselves. They all talked about trying to ‘commit suicide’. I wonder what they would think, if all of a sudden I’d talk about ‘completing’ or ‘dying by’. Do I seem strange, aloof, politically correct? Do they feel slighted by such a difference in speaking?

I have no answer. I have a problem, however, with the, shall I say, ‘psy-elites’ telling people how they should speak and refer to their own experiences. What if a person who tried to kill themselves actually thinks that they tried to ‘commit a crime’. I am not entirely certain I have a right to change their world view (a problem that psychotherapy knows of very well and struggles with).

Now, there is plenty of opposition towards medicalisation of experience and the language describing it, with which most I actually agree. The psy-disciplines provide us with the dominant discourse in which to put our ‘unusual’ experiences. I wonder ( and I do mean wondering) whether the attempts to change the language in which we speak of suicide and other ‘psy-matters’ is simply an attempt to impose the elite’s sensitivities. And they  might actually not be mine! In other words, I stand up for the  right to say ‘commit suicide’ because this is the set of values I want it to reflect.

Interestingly, the most stigmatising language I have ever heard was from… the patients I interviewed. They often talked about themselves as nutcases, crazy people and all sort of other things. They used words and expressions I would never ever use. And they did, and quite happily too. Why? Well, because it was that language that offered them the possibility to distance themselves from their diagnostic categories. Indeed, I myself would prefer to be ‘crazy’ than ‘schizophrenic’.

And here is the main point of this blog. By offering the ‘ten commandments’ we are imposing our way of speaking, forgetting that people actually might want to express themselves differently. Yes, in academic discourse, medicalisation or professionalization of language makes sense. But that doesn’t mean it makes sense in a conversation with John, who thinks he is ‘crazy’ and wants to ‘commit suicide’. And it is his right to say it, I think. This is precisely why there should not be ‘commandments’ “Thou shalt not say….”. Language is contextual and abhors strict rules. Put another way, how can you on one breath be against ICE’ing people and support some strict rules how to speak?

From this comes a more general point. Whenever I read about yet another set of instructions of how to speak about mental health, I cannot help wondering whether these strict rules are actually counterproductive. I would really prefer people to communicate with empathy. Speaking for myself, I am ready  ‘forgive’ clinicians quite a lot, if I see they are trying to be empathetic and speak in good faith. Much like the “patient with wings” was happy to laugh with me even though I contravened the ‘sacred’ rule of not laughing.  

And, finally, here is the conclusion. Instead of telling me what kind words I can use, I would really rather people were told to speak sensitively, empathically, humanely. Yes, of course, they will make mistakes (who doesn’t?), but at least they will speak like a human being, not an automaton who was trained to use certain words as if they were inherently better than others. They are not. And I myself always prefer speaking to a human being.