Twenty years ago, you had to walk into a therapist’s office to hear words like narcissistic, borderline or trauma. Today they are everywhere. We come across them in the videos we scroll through, in conversations between friends, in team meetings. And I want to say it from the outset: on the whole, this is excellent news. People are less ashamed of taking an interest in these subjects, they seek help more readily, they arrive in session better informed. I will not defend an era when psychotherapy was spoken of in hushed tones.

Many mental health professionals will tell you that this vocabulary is misused most of the time. My position is slightly different. I think people use it very well, for a very specific reason. And it is that reason that damages relationships.

What words do

We first need to ask a simple question: what do words do? If we follow the idea of social constructionism, words do not merely describe the world, they build it. Through the vocabulary available to us, we condition the way we perceive. Having a word for something, or not having one, partly decides what we will see or fail to see.

Words condition the way we apprehend the world, right down to a sensory input. Every system of propaganda knows this mechanism. In 1984, Orwell shows how a Newspeak gradually takes hold: words are removed from the vocabulary, replaced by others, and a whole way of perceiving the world shifts with them.

In a completely different register, the sociologist and clinician Vincent de Gaulejac describes in Le capitalisme paradoxant (“paradoxing capitalism”) how, imperceptibly, a redundancy plan became a “job protection plan”. How can you be outraged by a protection plan? Except that this plan is attacking you, your work, your equilibrium.

The psychologisation of suffering

This is where the vocabulary of mental health enters the stage. People start to suffer from a dysfunctional system, and the system leads them to think that they are the problem. An employee will be said to be too stressed, to be burnt out, and will be offered coaching. Responsibility for the suffering is placed on the person instead of being put back into its context.

You can see where I’m going. Most suffering emerges in a relational, social, economic, political context. Deploying an arsenal of psychologising labels on symptoms is a way of saying one thing rather than another.

After a while, we end up confusing symptoms with illnesses. Take a child who is said to have “oppositional defiant disorder”. We could also see that his provocative behaviour is the symptom of a distress, and perhaps even that it serves a function in the system he lives in. While he draws all the attention to himself, he acts as a lightning rod in a family that is dysfunctioning, and that manages, whenever he causes trouble, to come together and solidify around him. This child is in fact extremely loyal to his family. It is the same logic that makes a crisis a catalyst for transformation in human systems: what disturbs is often what holds things together.

When the label becomes a filter

I don’t want to demonise this vocabulary. When someone puts words on what we are going through, it is an immediate relief. It is what we look for in therapy, that moment when the therapist says something that makes us feel understood. The question is not whether these words are good or bad, but to look at what they produce.

Take a couple in which, at some point, one says to the other: “You’re toxic. You’re hysterical. You’re a narcissistic pervert.” A reality has just been created. It becomes a filter through which every one of the other person’s behaviours will be decoded, so as to make sense of the initial hypothesis.

There is an immense responsibility on therapists here. If in session I slip in to the person consulting me “might your husband not be a narcissistic pervert?” or “isn’t your wife a bit hysterical?”, I have just created in her mind a reality that will go on to produce a great deal of dysfunction in her couple. Professionals are, in principle, aware of this responsibility. But since this vocabulary has spread so widely, all it takes now is for me to talk to a friend for him to use it to describe my couple relationship or my relationship with my manager. All it takes is for me to come across a video while scrolling through my feed to think: “Hey, that’s exactly what my wife does. Could she be borderline?”

Two paths

At this point, two broad paths open up. The work of Frank Fincham and Thomas Bradbury on couples has documented them at length.

In Pragmatics of Human Communication, published in 1967, Paul Watzlawick and his colleagues formulate an axiom that I still find just as accurate: the nature of a relationship depends on the punctuation of the communication sequences between the partners. Concretely, we attribute a different meaning to an event depending on where we place its beginning. It is the same move as the one that reminds us that one cannot not communicate: the relationship is read in the sequence, not in the people taken one by one.

This is what the language of therapy can do when it lands in a relationship: the defeat of systemic thinking by the vocabulary of psychology. Where a change of level would let us look at the loop, the label brings us back to the individual.

Why it works so well

If these labels are so successful, it is because they render three services.

The American psychologist Isabelle Morley says it plainly: these labels are escape hatches behind which people hide to avoid being vulnerable, sharing painful experiences and doing the deeper, harder work of being in relationship. She speaks of a higher-order defence mechanism. She also describes a semantic bleaching: by using a clinical term in a broad and vague way, we end up losing its meaning.

This vigilance about words joins what we elsewhere call an ecology of cognitive vigilance: restoring the conditions for nuanced thinking, including in the most ordinary language.

I go into this at greater length in the video below, in French.