Can We Replace Misleading Terms Like ‘Mental Illness,’ ‘Patient,’ and ‘Schizophrenia’

“When I use a word, Humpty Dumpty said in rather a scornful tone, it means just what I choose it to mean — neither more nor less. The question is, said Alice, whether you can make words mean so many different things. The question is, said Humpty Dumpty, which is to be master – that’s all.” – Lewis Carroll, Through the Looking Glass

You may recall that Humpty’s complacent confidence in the power and precision of his words just preceded his very great fall — and all the king’s horses and all the king”s men could not repair the damage done.

Those of us who worked on DSM IV learned first-hand and painfully the limitations of the written word and how it can be tortured and twisted in damaging daily usage, especially when there is a profit to be had.

The DSM IV was intended to be a very conservative document — we rejected all but two of 94 suggested new diagnoses. We also field tested carefully to ensure there would not be dramatic and unexpected impacts on rates.

This did not stop the widespread misuse of the terms Attention Deficit Disorder, Asperger’s Disorder, Bipolar Disorder, PTSD, Paraphilia and others. The lesson: If some wording in DSM can possibly be misused for any purpose, it almost certainly will be.

We made Humpty’s fundamental error, believing it possible to remain master of our words and to control their usage by, and connotations for, others. Words tend to take on a life of their own, often enough becoming ambiguous and misleading in the process. And once an incorrect usage acquires the tenure of long and wide acceptance, it can be very difficult to control or to replace.

This brings us to some of my least favorite words that paradoxically I find myself unavoidably using a lot — —> Read More