Friday June 30, 2017

Your Words Matter

Dear Mr. President:

Your words matter, and your words trouble me. It is true that sometimes people say things without thinking. We have all blurted out words that we wish we could take back. But, Mr. President, do you not realize that calling Mika Brzezinski “crazy” and Joe Scarborough “psycho,” leaves people scratching their heads and wondering, but not about their mental status.

Trump Tweet

I must admit that your behavior is not unique. When it comes to mental illness, we have a long history of erroneous naming and name calling. Psychiatrists, psychologists, parents and even princes (think William and Harry) are trying to change this – beginning with raising awareness about the language we use and the people impacted by the words we choose to talk about mental illness (which is all of us).

The following five terms highlight just how mistaken we can be in our vocabulary when it comes to mental illness. 

1.

Lunatic: Moon beams and maniacs. This lunar-sounding word describing the insane does indeed derive from the Latin word for moon, lunaticus. Until at least 1700, it was a common belief that the moon influenced fevers, epilepsy, and other neurological and psychiatric diseases. Ancient philosophers, Aristotle among them, argued that the full moon induced insanity and bipolar disorder because the moonlight interfered with sleep. The word took on a strongly negative connotation over the centuries, signaling danger, wildness, and unpredictability, thus contributing to the stigma of mental illness. Finally, in 2012, the US congress voted to remove lunatic and lunacy from the legal code.

2.

Hysteria: Blame it on a wandering uterus. Egypt, circa 1900 BCE, is responsible for the first description of what would later be described as hysteria. It was widely believed that spontaneous uterus movements within the female body were the cause of hysterical disorders. The term takes its name from the Greek word for “womb.” In Greek mythology, the Argonaut physician, Melampus, silenced the revolt of Argos virgins who refused to honor the phallus and fled to the mountains – their behavior being taken for madness caused by their uncooperative uteruses. Hysteria gained further acclaim with the work of Sigmund Freud. Again, it is a term that in the last century has become obsolete given the erroneous attributions.

3.

Schizophrenia: Misnomer after misnomer. Before 1908, schizophrenia was known as Dementia Praecox because it was thought to be an early stage of dementia. But the Swiss psychiatrist, Paul Eugen Bleuler, changed the name of this mental illness to schizophrenia, noting that that Dementia Praecox was misleading as the syndrome did not follow the course of dementia. Bleuler proposed the term schizophrenia from the Greek, skhizein, which means “to split” and phren, which means “soul, spirit, mind”. Alas, Blueler’s term was not meant to convey the idea of split or multiple personality, but this is a common misunderstanding by the public at large, and we continue to use the diagnostic term schizophrenia despite its faulty etymology.

4.

Anorexia nervosa: But I am hungry! From the Greek, an, which means without, and orexis, which means appetite, this eating disorder term implies that individuals with anorexia nervosa do not experience hunger. Not so. Instead, individuals with anorexia overcome appear to have brain circuitry that is different from those without eating disorders. Individuals who have recovered from anorexia nervosa do not show the same reward and motivation circuits in their brains when it comes to hunger, and they they don’t anticipate pleasure from eating. They also show increased activation of executive ‘self-control’ circuits in the brain, perhaps making them more effective in resisting the desire to eat.

5.

Abnormal: Ain’t so. We commonly refer to the study of mental illness as “abnormal psychology.” But Merriam-Webster defines this familiar word as “deviating from what is normal or usual.” Synonyms for abnormal are: rare, unusual, uncommon…” With one in four individuals experiencing some significant form of mental illness each year, rare, unusual, uncommon or abnormal just aren’t accurate.

 

Clearly usage of terms like abnormal, crazy (from old English meaning “full of cracks”) and psycho (from Greek meaning “mind, mental spirit, unconscious” and short for psychopath) run counter to efforts to eliminate misconceptions, name calling and prejudice when it comes to individuals with mental illness. Dear Mr. President, your words matter. Your name calling perpetuates historical errors, stigma and discrimination. Please stop.

Kathleen M. Pike, PhD - Is Professor of Psychology & Director of the Mental Health Program at CUMC kmp2@cumc.columbia.edu