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July 5, 2013
Pebbles, Potholes, and Perspective
The Fourth Pillar of Psychiatric Recovery: Recovery Environment (Part 2)
by Sarah Hancock

The last column focused on several ways one can create a recovery environment. These included identifying values, socializing and volunteering. This week I'm going to focus on the importance of using recovery language.

When I was really sick, people used all kinds of words to describe me including, but not limited to: psycho, crazy, freak, nut job, insane, psychotic, schizo, bipolar, schizophrenic and frequent flier (I'll explain that one later).

Although these words are acceptable by the general public, how do you think they made me feel? Answer: like a wretched smelling heap of insect- and maggot-ridden garbage festering in the sun. I'm sure that anyone using the "crazy" synonyms felt uncomfortable around me and anyone hearing people describe me in those terms weren't all that eager to get to know me either.

In short, I became further isolated by the terms people used to describe me to others, which only made me feel worse, mentally questioning whether I was really as bad as I was being described.

Slowly I concluded that the unanimous opinion must have been correct. I was a crazy psychotic schizo. I was obviously just an insanely freakish bipolar schizophrenic that had a frequent flier card to the mental hospital. Great. Talk about being counterproductive to my psychiatric recovery!

Obviously not every person describing me was doing it in an intentionally malicious way. In fact, I'm sure there were many well-intentioned people who just wanted to warn unsuspecting people about my condition. The problem? People react to the language of the environment in which they are surrounded.

When teaching a lecture to upcoming professionals I always explain this concept followed by asking them for the solution to the problem. Their faces become pensive, yet silence fills the air. I then explain that the solution is simple. People react to the language of the environment in which they are surrounded.

So, let's take a look at the language we use to describe people with mental illness.

Many times we identify people as their illness. For example, stating that "he's schizophrenic," actually takes the person out of the illness. Instead, the person is the illness! It is quite dehumanizing.

Once I sat down on a pew prior to sacrament meeting, and the person next to me got up and relocated behind me. When questioned about the move, this sweetly ignorant sister said, "She's schizophrenic and having shock treatments."

If I'd been feeling good that day, I probably would have turned around and politely explained the difference between schizophrenia and my real diagnosis, schizoaffective disorder. Maybe I'd even have patted her on the leg, reassuring her it wasn't contagious.

Maybe I would have even asked her about my electrifying personality. Instead, I wasn't feeling my best. My eyes filled with hot tears of embarrassment and I sat there wondering how many other people in my new ward already knew me as an illness.

I recently participated in a work training that described my experience perfectly, stating, "Many people feel a loss of dignity when beginning treatment [for mental illness], and the use of inappropriate language can intensify that feeling," (Therapeutic Boundaries, Telecare Corporation, Relias Learning, 2013).

So allow me help you steer clear of inappropriate language and utilize recovery language. Recovery language instills hope, creates possibility and encourages others to discover their fullest potential. Appropriate language focuses on the person, not their label.

Unless you are in charge of insurance billing or are in the process of making case notes in someone's medical file, you really don't even need to talk about a diagnosis or label. Focus on the person. Make the person first.

For example, in describing me you could say that I'm an author. Or instead of stating my diagnosis, maybe focus on a symptom, "Sarah seems down." If you just blame the illness, it does nothing to address the problem. Saying, "Sarah's bipolar," completely devalues me.

There are some of you who honestly believe telling others about someone's diagnosis is simply being informative when in reality, unless you are diagnosing an individual, writing in someone's chart or taking care of billing insurance, referring to someone's diagnosis is merely gossiping. Such gossip leads people with a diagnosis to begin seeing themselves as only a diagnosis.

In fact, when I worked at a local clubhouse (a psychosocial rehabilitation facility for people with mental illness) when new members introduced themselves the staff had to reiterate the importance of not revealing their diagnosis. Why? Because we didn't want to know. We wanted to identify people as who they really were — people.

Making patronizing comments about a person or diagnosis basically demonstrates your belief in their potential — or lack thereof. It devalues a person. If we really believe that we are children of God, we need to speak of everyone as equals, regardless of diagnosis.

Making jokes about mental illness is just plain wrong. In today's world, people describe such an attitude as bullying. The problem with making flippant comments about mental illness is that since 1 out of 4 people have a diagnosable mental health condition, your light-hearted joke may lead the person you’re joking with or someone who overhears you to not seek help.

Stigma is the number one reason that people do not seek help. (Mosby, C., Suffering in silence: Stigma over mental health issues keeps some from seeking help, October 20, 2013, The Record Searchlight, http://www.redding.com/news/2012/oct/20/stigma-holds-many-back-from-acceptance-of-mental/).

I regard terms like psycho, crazy, insane, freak, nut job (and the many others there are out there utilized to describe people who have a mental health diagnosis and many other things) like unto racial slurs. People toss around derogatory words to describe me or others with mental illness, as though they're new cool slang terms. Having "crazy skills" now means you have amazing talent (I guess I have become skilled at living with my illness).

Having a Crazy Bread means you love Little Ceasar's Pizza (I have to admit, I cannot cook bread). "Being schizophrenic" now means that you say one thing and do another (call me a nerd, but diagnostically speaking this idiom makes no sense at all). I would never say, "It was a completely a breast cancerous thing to do!" Nor would I say, "Stated like a true MS person." Yet people use derogatory synonyms referring to mental illness all the time.

So, my challenge to you is this: evaluate the language you use. Evaluate how you use it. You will be surprised how often it occurs. Now that you have knowledge of recovery language principles, it's your turn to inspire hope, change vision, motivate change and embrace potential. Create a recovery environment for yourself and others by utilizing recovery language.

If you would like to learn more about the recovery model and recovery language, feel free to check out one of my lectures on YouTube, Becoming Fluent in Recovery Language.


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