A few days ago, I had a Twitter exchange about the expression ‘language of illness’. I’ve been bothered by such expressions and so, perhaps it’s time to write about them. Language matters – let’s keep it in check then. I suspect this post will again be controversial.
It all started with this tweet and the claim about the ‘need to stop using language of illness’. Well, as I said in my response, I don’t think there is any ‘language of illness’. And I actually wish ‘we’ stopped talking about such things as the language of illness, suicide, disease, brain, dementia and whatever other medical categories you can think of. There are two reasons why it makes no sense to use such expressions.
The first reason is that such expressions are meaningless. What is a ‘language of illness’. In the very short tweet exchange, the expression is taken to refer to medicalisation of certain emotions. But ‘language’ is not ‘medicalisation’! There is no doubt that language can construct certain experiences as illness, this, however, does not mean that a language of illness has been created in the process.
‘Language of illness’ must be way wider than medicalisation of (an) experience. Yes, it must refer to situations in which doctors talk about illness, but it also must refer to those situations in which patients talk about it. It also must refer to all those situations in which we talk about our illness to our close ones. And to infinite other contexts. And if so, to say that there could be a ‘language of illness’ makes no sense at all. There isn’t and, indeed, there cannot possibly be any uniform ‘language of illness’.
Just commonsensically, ‘we’ speak differently of the common cold, depression and terminal cancer. Needless to say, there are multiple social, cultural and psychological reasons why this is so. Moreover, apart from a huge variety of contexts in which we talk about such illnesses, as I suggested above, we also have goals upon goals we want to achieve with such talk, from apologising for not putting the rubbish out, through reassurance all the way to expressing love and compassion. And these are stereotypical situations just for starters. What about getting a sympathy date, self-humiliating to get an audience to laugh, making a point in a lecture? Which of those communicative acts constitute the ‘language of illness’ beats me.
However, yes, I accept, ‘language of illness’ sounds cool. The expression suggests that something unhelpful, counter useful, perhaps even sinister is going on. All of a sudden, ‘we’ need to pay attention, watch out, be vigilant, after all the ‘language of illness’ is upon us. The phrase is attractive, its ambivalence makes it very flexible, but it warns that something is afoot. And so, the reason why I really dislike such expression is to do with power. And (particularly) medicine’s attempt to police and control the way I speak about my experiences. And this is a significant issue in my view.
Every time I hear a medic, psychologist reject or support the ‘language of illness’, I take exception. This is because I always feel there might be something wrong with how I speak. There is, in my view, an implicit value judgement placed on a way of speaking which doesn’t conform to how you, a group you belong to, speak. And such language pronouncements go way beyond discussions of the ‘language of medicine’. I always read them as referring to me. And I, if you don’t mind, can speak of my experiences in any way I want. You do not own the language, doctor, and so, please do not tell me how to speak about, as in the original tweet, my depression. Of course, I do understand that also as a patient I am submerged in the dominant discourses of (mental) healthcare, I cannot escape them. But I can reflect on them and I reject the idea that I am simply a mindless conduit for psychiatric language, critical or not, or psychology, also in its critical or regular version. Moreover, I really don’t think I am the only one.
There is a reservation here. I fully understand and accept that there are genuine and significant theoretical differences between those constructing certain experiences in terms of disorders/diseases/illnesses and those who reject such constructions. And I enjoy reading those discussions. But even though I tend to side with one of the options, I think such discussions tend to go nowhere. I also accept that medicine or psychology might want to work out a ‘way of speaking’ which it considers appropriate.
But such discussions should not, in my view, be generalised and extrapolated onto how ‘we all’ speak about ‘our’ experiences. And just because you chose to speak in a particular way doesn’t mean at all that I should take it up. This is because, as I said above, there isn’t one, uniform, homogenous way of speaking about, for example, emotional distress! And for all you know, for me personally ‘language of illness’, full-on medicalisation of how I feel, might be the most useful way of accounting for what happens to me. Just as, I’m getting more controversial here, it might be precisely the expression ‘commit suicide’ (with all its potential negative connotations) which might actually be protective for me!
And here we come to a paradox. Attempts to control the way ‘we’ speak by healthcare professionals are, I think, aimed to be useful for me, the patient. But because they are so general, they ignore all the complex contexts in which I find myself, and are, in fact, fairly useless from my individual point of view. And so, I think, they serve two functions. First, they are a way in which to assert the ideological assumptions within which a particular professional group operates. Second, and more important, they are attempts to extend the clinician’s power onto the way I speak and through this make sense of my experiences. And I object to it.
Language matters and that’s why the fight for language between the assorted camps in medicine, psychology and others will continue. But I really would prefer if you all did it without putting a value judgement on how I myself speak. And if I choose to see depression in terms of signs (I can’t believe I am writing it) and symptoms, diagnostic criteria, disease of the brain and, if this medical model helps me cope with it, you should all say: good for you.
So perhaps, just perhaps, instead of wondering about the language I and others speak, you might want to consider asking me what, including language, helps me. And I might say things you don’t like. Tough.