Language in the Clinician's Office

This week I return to my favorite theme -- the power of language.  Those of us who have a mental illness deal with the power of language every day.  Notice I didn't call us the mentally ill.  Language forms who we are in this world.  It underpins the terms of our treatment.  It structures how we pay for our treatment.  Diagnosis is where language meets money.  And money is power, power over our lives.

Reframing is a process of becoming conscious of the power of language.  This is a standard tool in Cognitive Behavioral Therapy.  The term is used in a variant of CBT called Neuro-Linguistic Reprogramming (NLP).

When you reframe, you look at an event and the way you describe the event in a different way to discover a different meaning.  My thesis is that language itself is an event.  When you speak a word, you assign a meaning.  You create a reality.

I know a mental health professional who calls the DSM The Book of Behaviors That Make Therapists Nervous.  That is an example of reframing.  It invites one to turn the process of diagnosis on its head.  Instead of asking what is wrong with the diagnosee, what would happen if we ask what is going on inside the diagnoser?

This mental health professional also said that the personality disorder section of the DSM is useful as an examination of conscience. -- For those of you who don't speak Catholic, examination of conscience is when you compare your thoughts and behaviors to your values and beliefs, in order to find, repent and address the discrepancies.  One often uses some sort of list, such as the Ten Commandments, to assist bringing these thoughts and behaviors to mind.

So when you examine your conscience while reading the symptoms of personality disorders, you reframe the diagnostic categories, as behaviors to be repented and resisted.  In this case I suspect the dart hits the diagnosee again.  But it was intended to refer to everybody.  Try it some time.  Actually, I think the DSM's whole personality disorder section is about what the diagnoser dislikes about the diagnoseeSymptoms of various personality disorders sure sound like character defects to me: impulsive, aggressive, clinging...

A Prozac Monologues reader brought my attention to the work of Mayer Shevin, who has a PhD. in Psycholinguistics -- my kinda major, doncha think?  The following is a compulation of lists he uses in inclusion training.  Those of us who have a mental illness have heard these phrases before, from our families, friends, mental health professionals.  I recognize some of these.  What about you?

The Differences Are Obvious -- 
                    The Art of the Convenient Reframe

You like things --
          I obsess on objects.

You try to make friends --
          I display attention seeking behavior.

You take breaks.
          I display off task behavior.

You stand up for yourself --
          I am non-compliant.

You have hobbies --
          I self stim.

You choose your friends wisely --
          I display poor peer socialization.

You persevere --
          I perseverate.

You like people --
          I develop dependencies.

You go for a walk --
          I run away.

You insist --
          I tantrum.

You need time to yourself --
          I am being anti-social.

You move on to better things --
          I run away from problems.

You change your mind --
          I am disoriented and have a short attention span.

You dislike being mistreated or disrespected --
          I am overly sensitive or paranoid.

You ask people for help --
          I use people as a crutch.

You are human --
          I am ???

by Mayer Shevin, Syracruse University.
His profile is found here.
from Autism Voices and Choices Yahoo! Group.

Time for some reframing?

Photo by Ed Yourdon, available through the Creative Commons.
I have cropped the original to make my point.
The photographer has a lot to say about the photo
and what it meant to him to take it.  Read the story here.


  1. Hello, Willa, This blog and especially these examples of phrases and the perceptions they reflect are such eye-openers. I learn so much from every blog you write. Thanking you and giving God thanks for you today and always, Margaret Weiner

  2. I dared dream I would making a living doing what I do - had to be grandiose.

    I achieved that dream - must be arrogant.

    I sometimes actually enjoy my life - has to be hypomanic.

    I communicate my feelings - I have to be crazy and out of control.

    Thank heaven I have friends who see me differently. :)


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