Words I have no use for, as a therapist

There are ways of speaking that sound descriptive and prescriptive, but actually help us very little to understand and change ourselves. These words can fail to help by being too vague or ambiguous, by directing us away from a more useful focus of attention, and even by making us feel ashamed. All of these-- vagueness, ambiguity, misdirection, shame-- get in the way of productive self-exploration and creative problem-solving.

In my work as a therapist, I (consensually) discourage clients from getting stuck on these words and phrases, and guide them towards more useful language.

“Overthinking”

The label “overthinking” seems to imply that less/no thinking would be better, when what’s actually needed is better thinking. “Overthinking” means thinking for a long time (thus the “over” part) but not getting anywhere. The “overthinker” doesn’t get far because their thoughts are repetitive, cyclical, or too narrowly focused-- in all cases, these signify that the thinker is having too few thoughts, and so is actually underthinking.

So let’s call it “underthinking” instead-- this identifies the problem in a way that goads us towards newer, varied, and possibly more useful thoughts.

“Acceptance”

The word “acceptance” is too ambiguous to be useful. Acceptance can mean resignation (“Accept your fate”), affirmation (“Challenge accepted!”), approval/belonging (“You are accepted here”), or acknowledgment (“Accept the facts as they are”). When Carl Rogers says “When I accept myself as I am, then I can change,” he’s likely saying that he’s acknowledging who he is, but not approving himself as is-- if he were approving, there’d be no reason for change.

Without disambiguation we create confusion. So, let’s stop telling people to “accept” things, and instead use the verb we specifically mean.

“Confidence”/”Self-esteem”

Clients come to sessions, and say “If only I were more confident!” They want to be confident in order to make an effort (ideally, to succeed) at some public task-- speaking to a group, socializing at a party, and trying anything new in a place where they might be seen. There are plenty of resources on these words already, but I find them unhelpful in my work with anxious people. My anxious clients already suffer from a paralyzing level of self-consciousness, and it feels misguided to simply flip this self-consciousness from negative to positive.

Instead of building a client’s confidence or self-esteem for these tasks, I’d rather help them identify their passions, what excites them, what feels so engaging that they lose themselves in it. At a job interview or a public presentation, I try to relish the opportunity to talk about something I love, to be asked questions about it-- basically, to share my excitement. As far as I know, the “confident” people aren’t walking around focused on their own confidence; they’re just focused on their passions.

“Hope”

I won’t challenge clients who say they hope. But as a therapist I feel ethically obligated not to promise anything about the future, so if a client doesn’t have hope, I don’t try explicitly to instill or hold it for them. Hoping can also be problematic when it feeds a two-step cycle in tension with despair, each term competing with (and thereby triggering) its opposite in escalating intensity.

What words would I rather use instead? Mostly “desire” and “action.” Desire can persist in the face of despair; we often want even if we can’t hope. Ditto with our capacity for action, some form of action. I take inspiration for this from Dr. Melissa Raphael’s The Female Face of God in Auschwitz, in which she documents acts of loving-kindness committed in concentration camps, helpful acts of witnessing and “being with,” even when no overall salvation seemed possible.

“Deserve”

Similar to hoping, I don’t oppose the client who says “I deserve happiness.” But for clients convinced they don’t deserve happiness, I explain that the question of “deserve” is actually independent from the fact of “desire.”

A young (enough) person simply wants; whether we “deserve” or not comes later on in life. In order to bypass questions of personal value, especially those internalized voices that deny our deserving, we can return to this primordial desire, to see it as an innate for-self-ness which persists before and beyond self-critique.

“Will-power”

What the heck is a will, and where the heck does it get its power?! “I don’t have enough will-power!”-- ok, so what’s the plan? This word is used so often, and yet does very little to highlight how progress is made or obstructed.

When a client talks about lacking will-power, I redirect them to talk about their internal conflicts. When we want conflicting things, it’s difficult to act consistently! We can only make changes by coming to terms with our resistance, and to make an actionable (see “negative actions” below) plan for dealing with it when it arises. Relapse is not a failure of the will; it stems from a failure to learn and prepare for obstacles.

“Lazy/Procrastination”*

“I’m just lazy.” “I always procrastinate.” Both of these words describe a behavioral pattern, but do little to clarify the internal dynamics in play. Just like “will-power,” “laziness” gives us nothing to work with in order to change.

Laziness and procrastination are not inherent traits; they are products of conflicts we have not yet dealt with. So instead, talk about motivational tensions! Talk about understanding, preparing for, and committing to your potential discomfort in taking action.

*Big thanks to Dr. Mimi Arbeit, for inspiring this blogpost by sharing her take on “laziness” some years ago.

Negative Actions Don’t Exist!

When I say “negative,” I don’t mean “bad,” but rather, I'm talking about any kind of inaction. There’s the descriptive “I didn’t do anything this weekend,” and the prescriptive “In order to quit smoking, I just won’t smoke.” The descriptive has no substantive meaning, since there’s no such thing as “doing nothing”-- even “just sitting there” is more descriptive. And the prescriptive contains no substantive advice-- one can never

“not smoke,” one can only do something instead of smoking.

So, what words do I want to use instead? Say what you actually did; say what you’ll actually do. Only then do we have a narrative/plan to work with.

Ending

I hope you found this interesting and useful!