{"id":6691,"date":"2025-12-15T09:38:24","date_gmt":"2025-12-15T14:38:24","guid":{"rendered":"https:\/\/curesz.org\/?page_id=6691"},"modified":"2025-12-15T09:38:24","modified_gmt":"2025-12-15T14:38:24","slug":"the-importance-of-language-for-psychiatry","status":"publish","type":"page","link":"https:\/\/curesz.org\/zh\/the-importance-of-language-for-psychiatry\/","title":{"rendered":"The Importance of Language for Psychiatry"},"content":{"rendered":"

<\/span><\/div>

Carol North, MD<\/strong><\/p>\n<\/div><\/div><\/div>

The importance of Language for Psychiatry<\/strong><\/p>\n

By Carol North, MD,\u00a0MPE, DLFAPA
\nAdjunct Professor in Psychiatry (volunteer), The University of Texas Southwestern Medical Center, Dallas, TX, USA<\/p>\n

Members of older generations learned standard rules of grammar in elementary school. The main offender I recall hearing in those days was the word \u201cain\u2019t\u201d to mean \u201cis not.\u201d The word ain\u2019t<\/em> has never emerged as accepted standard language and is not part of formal scientific writing. I also remember learning to say, \u201cHe and I went\u2026,\u201d rather than \u201cMe and him went\u2026.\u201d There are 2 grammatical problems with \u201cMe and him went\u2026\u201d: 1) passive (object) pronouns are reserved for indirect (received) transactions, whereas active (subject) pronouns are used for direct actions,1<\/sup> and 2) reference to the other person properly precedes reference to self.2<\/sup><\/em> Based on these rules, it would be incorrect to say, \u201cMe and him went to the store\u201d but correct to say, \u201cHe and I went to the store.\u201d It would also be incorrect to say, \u201cThe teacher gave he and I each a book\u201d but correct to say, \u201cThe teacher gave him and me each a book.\u201d Lately I have been hearing grammatical aberrations on these rules with appalling frequency in circumstances where you wouldn\u2019t expect them (such as from the mouths of national news commentators). This has led me to the sad realization that the grammatical Pandora is out of the box and probably won\u2019t be going back inside anytime soon (or ever). Changes in common language usage are accelerating at dizzying speeds.<\/p>\n

Consonant with the above recent trends in popular language, the language of medical specialties has also been changing with amazing rapidity. Experts in psychiatric nosology\u2014the science of classification and diagnosis of psychiatric disorders\u2014understand that formal terminology is essential to the conceptualization and understanding of foundational psychiatric constructs. The American Psychiatric Association has been responsible for formally defining psychiatric illnesses since 1952 (American Psychiatric Association, 1952), and during the ensuing decades, the formal name for reference to psychiatric illnesses has been \u201cmental disorders.\u201d By at least 1990, however, rogue phrases had begun to creep into psychiatric terminology. A noteworthy example is the cringe-worthy term \u201cmental health disorder.\u201d Joining the word \u201chealth\u201d with words implying pathology (\u201cdisorder,\u201d \u201cdiagnosis\u201d) to create phrases such as \u201cmental health disorder\u201d and \u201cmental health diagnosis\u201d is oxymoronic. The words health<\/em> \u548c illness<\/em> conceptually don\u2019t belong together. Combining words for health and illness into a single entity is not the style of terminology for other medical specialties: for example, diseases of teeth are not \u201cdental health disorders\u201d and heart diseases are not \u201ccardiac health disorders,\u201d but rather dental and cardiac disorders respectively. Because psychiatry is a branch of medicine (Guze, 1978), there is value and utility in following these broader medical conventions.<\/p>\n

The last few decades have witnessed an alarming increase in terminology joining health and disease, in both lay and medical usage. I lamented about this trend in a scientific article I recently coauthored (North and Pfefferbaum, 2022). In my published article, I facetiously suggested the most absurd example I could imagine to illustrate the ultimate in preposterous terminology: \u201cmental health illness.\u201d Lo and behold, in the last month, to my astonishment, I heard not just 1 but 2 different national news commentators on different networks utter those exact words, \u201cmental health illness<\/em>\u201d<\/p>\n

Such distinctions may strike lay readers (and mental health professionals as well) as the unnecessary product of nitpicking over terminology. But, in psychiatry, words matter. Language referring to mental illness is a reflection of our understanding on a fundamental level and drives how we behave toward people with psychiatric disorders. I imagine that the recent changes to common phraseology referring to psychiatric illness must be driven, at least in part, as an effort to combat the stigma of mental illness. Inserting the word \u201chealth\u201d after the word \u201cmental\u201d may have been meant to soften the blow of psychopathology for those who cannot bear any mention of mental illness. If anything, however, this convention confirmed that for many people mental illness is too awful to validate by even acknowledging it. By avoiding its mention, we inadvertently further stigmatize it.<\/p>\n

Given all this, what are we to do? Ideally, I\u2019d like us to ratchet our language back to its previously intended form. However, it seems the language train has already left the station years ago, and that is not likely. Regardless, we can be leaders in mounting a campaign to re-insert proper terminology in our language and alerting others to the dangers of language creep in psychiatry. I\u2019d like to invite others to weigh in with their own observations and thoughts about psychiatric terminology, and perhaps a discussion on this topic can start here.<\/p>\n

“Dr. North\u2019s article is both interesting and cogent for our field. I have thought about this issue (mental health disorders as an oxymoron) a million times. I also recall joining a group of psychiatrists many years ago demanding that NIMH (National Institute of Mental Health, established n 1949)\u00a0 be renamed as National Institute of Mental Illness, to no avail.” Henry Nasrallah, MD<\/em><\/p>\n

Notes<\/strong><\/p>\n

1<\/sup>He<\/em> \u548c I <\/em>are subject (i.e., active) pronouns, but him<\/em> \u548c me<\/em> are object (i.e., recipient\/passive) pronouns. A simple test to know which pronoun to use is to strip one person from the sentence and see if it makes sense. For example, \u201cHe went\u201d and \u201cI went\u201d are grammatically correct; \u201cHim went\u201d and \u201cMe went\u201d are grammatically incorrect.<\/p>\n

2<\/sup>\u201cI and he\u201d (active) and \u201cme and him\u201d (passive) are grammatically incorrect because the other person should precede the first person.<\/p>\n

\u53c2\u8003<\/strong><\/p>\n

American Psychiatric Association (1952). Diagnostic and Statistical Manual of Mental Disorders<\/u>,\u00a0 First edition. Washington, D.C.: American Psychiatric Press, Inc.<\/p>\n

Guze, SB (1978). Nature of psychiatric illness: why psychiatry is a branch of medicine. Comprehensive Psychiatry<\/em> 19(4):295-307.<\/p>\n

North, CS and Pfefferbaum B (2022). The need to clarify professional terminology in psychiatry. Annals of Clinical Psychiatry<\/em> 34(3):149-151.<\/p>\n<\/div><\/div><\/div><\/div><\/div>

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