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.
