Words and Phrases to Drop From Mental Health Speak


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I’m writing to share an interesting article —There’s some useful advise here about some useless, meaningless, overworked & overused terms.

Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrase

From the list, here are a handful of my favorites:
 
1. Antidepressant medication. Medications such as tricyclics, selective serotonin reuptake inhibitors, and selective serotonin and norepinephrine reuptake inhibitors, are routinely called “antidepressants.” Yet there is little evidence that these medications are more efficacious for treating (or preventing relapse for) mood disorders than for several other conditions, such as anxiety-related disorders (e.g., panic disorder, obsessive-compulsive disorder; Donovan et al., 2010) or bulimia nervosa (Tortorella et al., 2014). Hence, their specificity to depression is doubtful, and their name derives more from historical precedence—the initial evidence for their efficacy stemmed from research on depression (France et al., 2007)—than from scientific evidence. Moreover, some authors argue that these medications are considerably less efficacious than commonly claimed, and are beneficial for only severe, but not mild or moderate, depression, rendering the label of “antidepressant” potentially misleading (Antonuccio and Healy, 2012; but see Kramer, 2011, for an alternative view).
 
2. Gold standard. In the domains of psychological and psychiatric assessment, there are precious few, if any, genuine “gold standards.” Essentially all measures, even those with high levels of validity for their intended purposes, are necessarily fallible indicators of their respective constructs (Cronbach and Meehl, 1955Faraone and Tsuang, 1994). As a consequence, the widespread practice referring to even well-validated measures of personality or psychopathology, such as Hare’s (1991/2003) Psychopathy Checklist-Revised, as “gold standards” for their respective constructs (Ermer et al., 2012) is misleading (see Skeem and Cooke, 2010). If authors intend to refer to measures as “extensively validated,” they should simply do so.
 
3. Hard-wired. The term “hard-wired” has become enormously popular in press accounts and academic writings in reference to human psychological capacities that are presumed by some scholars to be partially innate, such as religion, cognitive biases, prejudice, or aggression. For example, one author team reported that males are more sensitive than females to negative news stories and conjectured that males may be “hard wired for negative news” (Grabe and Kamhawi, 2006, p. 346). Nevertheless, growing data on neural plasticity suggest that, with the possible exception of inborn reflexes, remarkably few psychological capacities in humans are genuinely hard-wired, that is, inflexible in their behavioral expression (Huttenlocher, 2009Shermer, 2015). Moreover, virtually all psychological capacities, including emotions and language, are modifiable by environmental experiences (Merzenich, 2013).
 
4. Acting out. Numerous articles use this term as a synonym for any kind of externalizing or antisocial behavior, including delinquency (e.g., Weinberger and Gomes, 1995). In fact, the term “acting out” carries a specific psychoanalytic meaning that refers to the behavioral enactment of unconscious drives that are ostensibly forbidden by the superego (Fenichel, 1945). Hence, this term should not be used interchangeably with disruptive behavior of all kinds and attributable to all causes.
 
5. Closure. The term “closure” was introduced by Gestalt psychologists (Koffka, 1922) to refer to the tendency to perceive incomplete figures as wholes. This term has since been misappropriated by popular psychologists (Howard, 2011) and social scientists of various stripes (e.g., Skitka et al., 2004) to describe the purported experience of emotional resolution experienced by victims of trauma following an event of symbolic importance. For example, many advocates of the “closure movement” contend that the execution of a murderer assists the loved ones of victims to put an end to their grieving process. Nevertheless, this use of the term “closure” is hopelessly vague, as it is rarely if ever clear when trauma victims have achieved the desired emotional end-state (Radford, 2003Weinstein, 2011). Nor is there research support for the proposition that many or most victims experience this end-state after events of symbolic significance, such as executions or funerals (Berns, 2011).
 
6. Fetish. A fetish, formally referred to as “Fetishistic Disorder” in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013, p. 700), is a psychiatric condition marked by persistent, intense, and psychologically impairing sexual arousal derived from inanimate objects (e.g., shoes) or non-genital body parts (e.g., legs). This term, which is technically a paraphilia, should not be used to refer to generic preferences for specific objects, ideas, or people. One writer, for example, described the national fascination of the Japanese with smartphones as a “feature phone fetish” (Smith, 2015).
 
7. Mind-body therapies. The term “mind-body therapy” (e.g., Naliboff et al., 2008) refers to a panoply of treatments, such as relaxation, meditation, Reiki, yoga, and biofeedback, that purportedly harness mental functioning to enhance physical health (Wolsko et al., 2004). This term implies erroneously that the “mind” is materially separate from the “body” and thereby endorses a simplistic version of mind-body dualism. Rather than conceptualizing such interventions as making use of the mind to influence the body, we should conceptualize them as making use of one part of the body to influence another.
 
8. Personality type. Although typologies have a lengthy history in personality psychology harkening back to the writings of the Roman physician Galen and later, Swiss psychiatrist Carl Jung, the assertion that personality traits fall into distinct categories (e.g., introvert vs. extravert) has received minimal scientific support. Taxometric studies consistently suggest that normal-range personality traits, such as extraversion and impulsivity, are underpinned by dimensions rather than taxa, that is, categories in nature (Haslam et al., 2012). With the possible exception of schizotypal personality disorder (but see Ahmed et al., 2013), the same conclusion holds for personality disorders (Haslam et al., 2012). Hence, if authors elect to use the phrase “personality type,” they should qualify it by noting that the evidence for a genuine typology (i.e., a qualitative difference from normality) is in almost all cases negligible within the personality domain.
 
9. Scientific proof. The concepts of “proof” and “confirmation” are incompatible with science, which by its very nature is provisional and self-correcting (McComas, 1996). Hence, it is understandable why Popper (1959) preferred the term “corroboration” to “confirmation,” as all theories can in principle be overturned by new evidence. Nor is the evidence for scientific theories dichotomous; theories virtually always vary in their degree of corroboration. As a consequence, no theory in science, including psychological science, should be regarded as strictly proven. Proofs should be confined to the pages of mathematics textbooks and journals (Kanazawa, 2008).
 
10. Multiple personality disorder. Although the term “multiple personality disorder” was expunged from the American Psychiatric Association’s (1994) diagnostic manual over two decades ago and has since been replaced by “dissociative identity disorder” (DID), it persists in many academic sources (e.g., Hayes, 2014). Nevertheless, even ardent proponents of the view that DID is a naturally occurring condition that stems largely from childhood trauma (e.g., Ross, 1994) acknowledge that “multiple personality disorder” is a misnomer (Lilienfeld and Lynn, 2015), because individuals with DID do not genuinely harbor two or more fully developed personalities. Moreover, laboratory studies of the memories of individuals with DID demonstrate that the “alter” personalities or personality states of individuals with DID are not insulated by impenetrable amnestic barriers (Merckelbach et al., 2002).
Noah Clyman, LCSW-R, is the founder and director of NYC Cognitive Therapy – a psychotherapy practice in Manhattan that specializes in Cognitive Behavioral Therapy (CBT). We have a highly trained team of male and female clinicians that provide services for individuals, couples, and groups. We work with adolescents, adults, and older adults. To learn more, or schedule an appointment, click here.


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