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Sticks and Stones


While working in an assisted living facility, one of the residents happily reported to me that he had a job interview. He was obviously excited about the opportunity, but he admitted being nervous about the interview. I offered to help him, and we decided to role play the upcoming scenario, with me playing the role of the interviewer. I began by asking, “Jessie, tell me about yourself.”  Jessie nervously answered “Well, my name is Jessie, and I’m a schizophrenic.”

Paralyzed, both by the shock of that answer and by the sinking of my heart, I wondered why that was the only way he could think to describe himself.  Was that the only way that Jessie saw himself?  Had the years of being in the system of mental healthcare eroded his sense of self and personal identity?  Sadly, the answer is yes.

Language matters and the way we use words matter. When we identify someone by their illness instead of by their personhood, we are then essentially replacing their identity with a diagnosis.  Jessie had heard people identify him as a schizophrenic, and that’s what he assumed his identity had become. No longer was he a Gators fan, a gifted artist, or just a guy with a good sense of humor; he was a schizophrenic.

A recent study showed that there was a direct correlation between participants’ attitudes about mental illness and their choices of words to describe people who live with mental illness.  Participants who were exposed to fictional vignettes that depicted people with mental illness as violent tended to choose to use the word “schizophrenic” to refer to the subject, while those who were first exposed to less violent vignettes were more likely to use the words “man with schizophrenia.”  Negative attitudes and preconceived notions — including how the media depicts mental illness — seem to be directly related to how we use words when we refer to people with mental illnesses.[1]

This is why the American Psychological Association, along with other suggestions about wordings, encourages the use of person-first language.[2]  “She is not a bipolar; she is a woman with bipolar disorder.  He is not a schizophrenic; he is a man who has schizophrenia.”  The difference may seem small, but it makes a big difference to a person who is living with one of these disorders.  There is a lot of misguidance in the old adage “sticks and stones may break my bones, but words will never harm me.” Let’s be cognizant of the language we use to describe those with mental illnesses, and focus more on using person-first language.

[1]Krzyzanowski, D. J., Howell, A. J., & Passmore, H.-A. (2019). Predictors and causes of the use of noun-based mental disorder labels. Stigma and Health, 4(1), 86–97.