Shifting Language

“Once you label me, you negate me.”  ― Søren Kierkegaard

Medical language

Medical language refers to the standardized terminology that medical professionals use when referencing to “anatomy, bodily functions, diseases, diagnoses, treatments, procedures, and more”1.

Medical language is often helpful because of its universality of definitions, but it is not conducive to respectful communication. This is due to its nature of defining and labeling a person by their struggles and deficits, rather than their strengths and self-defined identities.

Person-centered language

As opposed to the medical language’s perspective of defining people based off of their problems, person-centered language aims to help refer to people with a more respectful focus on the person’s beliefs, realities, and strengths. When implemented, person-centered language “leads to services where ‘continuous healing relationships become the centerpiece of widespread health care transformation to address the needs of people with … health conditions by fostering wellness”2.

Common Medical Terms

A medical term that describes a collection of behaviors and thoughts whereby a person’s reality does not align with the dominantly-accepted reality in their society.

Someone who is experiencing psychosis may not understand that their reality is different to others, and may become frustrated or defensive when their reality is challenged3 (see ‘Anosognosia’).

A medical term that describes the belief that someone is perceiving something that does not align with the dominantly-accepted reality in their society.

Hallucinations can manifest through several different types of sensory inputs, including:

  • Auditory/Hearing (ex. hearing voices others don’t)
  • Visual/Seeing (ex. seeing people or animals others don’t)
  • Tactile/Touch (ex. feeling bugs that no one can see)
  • Olfactory/Smell (ex. smelling fire when none is around)
  • Gustatory/Taste (ex. tasting gasoline when none was ingested)

A medical term that describes someone’s beliefs that do not align with the dominant-reality in their society. These beliefs must also interfere with a person’s ability to function in their everyday life, such as school, work, or self-care.

There are two major types of delusions:

  • Non-Bizarre Delusions
    • Beliefs that have the potential to be true given a person’s physical or social orientation.
    • Examples: Someone’s partner cheating on them; being videotaped in their home.
  • Bizarre Delusions
    • Beliefs that would be implausible/impossible given the physical limitations of their environment.
    • Examples: A person with male genitalia being pregnant; someone’s blood being replaced with hot sauce.

Pronounced “anna-sug-NO-sia”, this medical terms refers to the situation where someone who is living in an altered state does not understand or accept that their reality is different than the dominantly-accepted reality, even after being shown evidence4. (See “The LEAP Method” page to learn how to effectively collaborate in this situation.)

Example:

Bobby, a cisgender male, believes that he is pregnant even though he does not have reproductive organs. Nobody is able to convince him that he is not pregnant, even after receiving a negative ultrasound.

Often called “honest lying”, confabulation is a memory error referring to when a person unintentionally creates a memory that helps fill in the holes of their understanding5. Individuals affected by this genuinely believe that these false memories are real; because of this, there is no benefit to arguing against them.

Example:

Louis reports that he has a migraine because his pet cat hit his head with a hammer.

Alternate Person-Centered Terms

Replacing the term ‘psychosis’ with ‘altered/extreme state’ respects the individual’s own interpretation of reality. It also helps reduce/remove the stigma that the medicalized term is associated with. 

This term is preferred when working from a person-centered approach due to its respect towards the individual’s personal interpretations of their experiences (such as hearing voices or seeing visions that no one else can observe). Since there is no one absolute truth (see the “What is Reality?” page for more information), everyone’s individual experiences can be considered Real and thus deserving of respect and consideration.

Similarly to ‘Unusual Experiences’, ‘Unusual Beliefs’ encapulates the idea that all beliefs are deserving of respect and regard, no matter how strange they may be. Just because you may not believe them doesn’t mean they are not real to the other person.

The term ‘Consensual Reality’ is used to describe the different beliefs/expectations/norms/understandings that someone’s dominant society or culture believes to be true and real. These things vary between different societies and groups, and are determined based off of historical context.

‘Non-Consensual Reality’ refers to having beliefs that do not align with the dominantly-accepted version of reality that their society accepts to be true.

the problem with "psychosis"

Dictionary.com describes psychosis as “A mental disorder characterized by symptoms, such as delusions or hallucinations, that indicate impaired contact with reality”. Looking through a social constructionist lens, this definition is riddled with discursive language that perpetuates the patient model and reduces people’s experiences to undesirable symptomatology (pathologizing the human experience).

 Social constructionism describes the concept of reality as conventional understandings of the world through an individual’s culture, language, and history, and that there is no such thing as objective reality or truth. The idea of having “impaired contact” with reality infers that there is one linear idea of reality, and others are false or nonsensical. (Read more about social constructionism here) 

Translated through a postmodernist lens, the definition could alternatively be stated as ‘a state of being where an individual’s interpretation of reality does not align with the primarily-accepted reality of the culture in which they live’.

Alternative Phrases
that Support a Person-Centered Framework

Illness-First/Medical Terms

Person-First Terms

Psychosis/Psychotic

Altered State/Extreme State

Hallucinations

Voice Hearing/Seeing Visions/
Seeing or Hearing Things Others Can't

Schizophrenic Person/A Schizo

Person Diagnosed with Schizophrenia/
Person with Unusual Experiences

Non-Compliant

Chooses Not To

Refuses/Denies

Unable to Understand/
Unable to Comprehend

Lost Touch with Reality

Living in a Non-Consensual Reality

Honoring individual preferences

Everyone has different connotations to words and phrases based on their personal historical/cultural/societal experiences and contexts. It is recommended that you use the language that the person you are working with prefers when talking about their experiences. 

If someone you work with utilizes language that could be considered medicalized/oppressive, you may want to ask about and explore their own meanings to those words in order to better understand what they mean by them. Never force anyone to use specific language, as this undermines personal understanding and meaning and reinforces a power heirarchy that harms the relationship.