The Power of Language

The language we use indicates how we view someone else. We show value or disdain by how we communicate with others.

Below are some common examples of phrases that may be used. This is not an exhaustive list. While reviewing this list, think about the language, tone and messages and ask yourself:

  • What types of messages might be communicated by the language on the left?
  • What is the impact of using the recovery-oriented language on the right?
  • Are there other words or phrases in your documentation or language that you would like to change?

What message does each convey?

  • Deficit vs. hope
  • Passive vs. active
  • Past vs. future oriented
  • Judging vs. affirming
Deficit-Based Language Recovery-Oriented Language
1) Attention seeking 1) Connection seeking
2) Refused 2) Declined
3) Suffering from 3) Experiencing; Living with
4) Resistant 4) Has different priorities; Not open to…; Chooses not to…
5) Non-compliant 5) Not in agreement with treatment plan;

Chose not to follow treatment recommendations

6) Unmotivated 6) Interests and motivating incentives are unclear; Not interested in resources we have to offer; Preferred options are not available
7) Unrealistic 7) High expectations for self
8) Acting out 8) Prefers to use alternate coping strategies such as…
9) Poor judgment 9) Taking actions that create instability, such as…
10) Enable 10) Empower the individual through empathy, emotional authenticity and encouragement
11) Frequent flyer 11) Utilizes services and supports as necessary; Familiar face
12) Dangerous 12) Specify behavior
13) Manipulative 13) Resourceful; Unconventional; Seeking alternate methods of meeting needs
14) Relapse prevention 14) Recovery management
15) Relapse 15) Recurrence of symptoms
16) She is schizophrenic 16) She is a person living with schizophrenia
17) Drug/alcohol abuse 17) Problematic substance use; Harmful substance use
18) Clean/Dirty 18) Negative/Positive screen for…
19) Habit or drug habit 19) Pattern of active non-medical use of substances
20) Clean/Sober 20) In active recovery; Alcohol free; Free from non-medical use of substances
21) Opioid replacement therapy 21) Medication-assisted treatment
22) Strung out, messed up, smashed, cracked out, hammered, etc. 22) Debilitated from substance use; Acute substance intoxication
23) Entitled 23) Aware of one’s rights
24) Helpless 24) Unaware of capabilities; Unsure of ability to manage the situation
25) Hopeless 25) Unaware of opportunities; Currently unable to see positive aspects
26) Grandiose 26) Has unrealistically high hopes and expectations of self
27) User of the system 27) Resourceful; Good self-advocate
28) He is mentally ill 28) He is showing symptoms of …
29) Low-functioning 29) Person’s symptoms interfered with their (personal relationships, work habits, etc.) in the following ways…
30) Compliant 30) Actively participating
31) They are managing their illness 31) Individual is experiencing an improved quality of life and promoting recovery
32) She is labile 32) She went back and forth between crying and laughing several times during our conversation and couldn’t say why
33) He is a cutter 33) He sometimes cuts himself and has explained that is a part of how he copes with his emotional pain
34) Anger issues 34) Has had outbursts and interpersonal conflicts with neighbors
35) Depressive symptoms 35) Lacks the energy to take care of basic household tasks
36) Patient hears voices 36) Ms. Smith said, “God speaks to her,” which her daughter reported was an important part of her religious beliefs
37) Good judgment 37) Taking actions that improve stability in…
38) Increased insight 38) Taking the following actions to more effectively support their recovery:
39) Decompensate 39) Experiencing an increase in symptoms
40) She is a high-functioning schizophrenic. 40) She has schizophrenia, but has no history of violence nor medication non-compliance
41) Weakness 41) Barriers to change
42) Lacks insight 42) Has not had the opportunity to fully understand their circumstances
43) Patient believes that … 43) Patient said that …
44) Delusional 44) Experiencing delusional thoughts
45) Paranoid 45) Experiencing paranoid symptoms
46) Discharged to aftercare 46) Connected to long-term recovery support
47) Graduated from treatment 47) Entering the next stage of their recovery
48) Addict; Alcoholic, Junkie; Pot head; etc. 48) Person experiencing chronic symptoms of a substance use disorder
49) CD/Psych 49) Substance use disorder; Mental health disorder
50) Recovering Alcoholic/Addict 50) A person in recovery
51) Denial; Unable to accept illness 51) Experiencing ambivalence; Person disagrees with diagnosis; Person in the pre-contemplative stage of recovery

“Words are important. If you want to care for something, you call it a “flower”; if you want to kill something, you call it a “weed.” – Don Coyhis

Whenever possible, professionals helping individuals in recovery should make every effort to communicate the individuals’ responses verbatim or specific symptoms as they are being exhibited, rather than translating the information into clinical jargon, to be more recovery oriented in documentation or case presentations.

“Through my angry indignation, I was affirming that ‘I am more than that, more than schizophrenic.’ … My angry indignation was a sign I was alive and well and resilient and intent on fighting for a life that had meaning and hope. What some would have seen as denial and a lack of insight, I experienced as a turning point in my recovery.” – Excerpt from “Recovery is a Journey of the Heart” by Patricia Deegan

There are many other words that stigmatize and judge that simply need to be retired:  user (stigmatizing because it labels a person by their behavior), habit (instead, describe the effects of the patterned behavior if it is problematic), etc.

There are also words that may be used by recovery support or mutual aid groups that are appropriate for that setting, but not appropriate in a professional clinical setting.  A few of those are referenced in the above comparison list.  An individual may choose to use a label for their own benefit and recovery, but that does not give us permission to attach that label to them (e.g. a person may self-identify as an “addict” or “alcoholic,” but that does not give us the right to use that term when speaking to or about them in any written or oral communication.)

“This is not about superficial political correctness. It is about the future of recovery in America. It is time we embraced a new language that helps us talk about how we heal ourselves, or families in our communities. It is time we abandoned the rhetoric that declares war on our own people.” – Excerpt from “Language and the Recovery Advocate: Why We Worry About the Words” by William White

Our challenge is to use language that supports individuals in their recovery, not language that is stigmatizing their illness. It is our duty to communicate in a way that is individualized, humanizing, respectful and healing.

“The difference between the right word and the almost right word is the difference between lightning and a lightning bug.” – Mark Twain

If you or someone you love is experiencing symptoms of mental health or substance use disorders, please contact UofL Health – Peace Hospital for a no-charge assessment and assistance with treatment options. Call 502-451-3333.

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Article by: Michael Gosser, LCSW, LCADC

Michael Gosser, LCSW, LCADC, is the director of Adult Outpatient for UofL Health – Peace Hospital, where he works as a licensed clinical social worker and a licensed clinical alcohol and drug counselor. He has been working in the behavioral health field for more than 25 years and at Peace Hospital since 2015.

All posts by Michael Gosser, LCSW, LCADC
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