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This is the Allusionist, in which I, Helen Zaltzman, can smell language’s barbecue wafting through the window. Tantalising! How can I get invited round?
In today’s episode we’re talking about some mental health words that have snuck into our everyday vocabularies. In the second half of the show there is some mention of eating disorders, so if that’s not what you need to hear about today, tap out at the ad break.
Don’t forget to sign up at Patreon.com/allusionist by the end of this month of June 2021 if you want me to record the word or phrase of your choice that you can use as your phone alert or alarm. You will also get access to all the recordings people have asked for; you could put them together for one massive alarm, I suppose. Some of you have been stressing about what to pick, but don’t worry, it’s anonymous! You can even submit more than one! I don’t mind! Anything for you, sweet patrons, in gratitude for you funding this show. I’ve also been enjoying the performance directions that some of you include with your word requests, such as “said with Bette Davis style vexed enunciation” and “said like you're my very best hype-up friend who maybe also actually has a crush on me”. I’ll do my best to get into character! Go to Patreon.com/allusionist by the end of June if you want in on this fun.
On with the show!
HZ: It’s interesting, I think, that the words ‘crazy’ and ‘insane’ are currently used to mean several different things. The sense of mental health, of course, but both can also be complimentary or the opposite. For instance, calling a woman crazy or insane is usually derogatory, but to call her body crazy or insane would be a complement. Even though both words originally meant a physical sickness, a long time ago. And ‘crazy’ meant broken or cracked, a sense that survives today in crazy paving or crazy quilting, or crazed pottery glazes - but I digress! It’s not about crafts… Crazy big, insanely big - these words that in some contexts can be very strong and condemnatory, or stigmatising or ableist, are often just repurposed as intensifiers. We so many intensifiers, as well; when one has been around enough that it doesn't feel so intense any more, we reach around in our vocabulary for another. I’m just not sure that it should have been these ones.
LILY SLOANE: Those words work so well to describe - they're hyperbole in a way, but it feels like there aren't enough words that I'm aware of, or that aren't in my regular vocabulary, that describe the experience of something being ra really big feeling. I think that's really what it is: a really big feeling either in myself, like "I feel so like crazy happy or crazy sad or crazy angry. Like it's, it's like this thing feels so big, I feel crazy." Or "that person is acting in a way that's so overwhelming to me that they are crazy."
HZ: Or that I can't absorb those feelings.
LILY SLOANE: Yeah. So it's, it's communicating that, I think; this thing is so big.
My name is Lily Sloane and I am a licensed psychotherapist in San Francisco. And I'm also the host and creator of the podcast A Therapist Walks Into A Bar.
HZ: Do you think people have an accurate idea of what therapy means?
LILY SLOANE: No. I think that some people do, because they've gone to therapy. But even people who've been seeing me for a while as a client will sometimes say something about what therapy is to them, and I think, huh, oh, that's what you think we're doing? Interesting!
HZ: Like what?
LILY SLOANE: Well, usually, usually the typical one that I hear is that, “It's good to have a place to get these things off my chest.” And that is a part of what they're doing, but there's so much more to it, because you could just go talk to a friend.
HZ: Or pot plant or something.
LILY SLOANE: Exactly, or a bartender. Yep. Or your hairdresser. But there is a reason why we charge more money than that. And that, you know, people come to us for a long period of time and commit to that kind of relationship. There's a lot that goes into it, including the relationship itself, and the therapist's ability to look at what's happening in the room and look what's happening in the relationship that's formed, and bring in other kinds of expertise to help somebody not just get things off their chest, but actually process all the stuff that's going on inside.
HZ: The term therapy tends to appear in many other contexts, say in ‘retail therapy,’ and I'm just wondering whether that rebounds onto the reputation of psychological and emotional therapy.
LILY SLOANE: Yeah. I mean, many things in life are therapeutic. Sometimes listening can be therapeutic for people. Sometimes going for a walk in the park is therapeutic. Sometimes buying stuff you don't need is therapeutic. But it's not therapy.
HZ: So it's just important to keep the adjective and the noun separated.
LILY SLOANE: And I think the word psychotherapy can be a bit of a turnoff for people seeking therapy. So I'll just say 'therapy' and then they don't know what I'm talking about. Even if it's on a subtle unconscious level, I think it alludes to the stigma of having any kind of mental health issues; that that makes you psycho. Early in the Greek and Latin roots of the word, the word psyche comes from the story of Eros and Psyche. And it's this love story between the two of them, though, like a lot of the myths, it was -
HZ: Not a healthy relationship.
LILY SLOANE: Not a healthy relationship.
HZ: The story of Psyche and Eros - Eros was the Ancient Greek god of love and sex, the roman analogue was Cupid. Psyche was a mortal woman so beautiful that people started worshipping her - which pissed off the goddess Aphrodite, Eros’s mother, who sent him to anoint her with vials of magic potion that, depending on which version you trust, would make her fall in love with a gross person or prevent anyone falling in love with her. But whoops, whilst on this mission, Eros scratched himself with the tip of one of his arrows that make people fall in love, so fell in love with Psyche himself. Ooh mum’s not gonna like that! Fast forward through Psyche being left on a mountain top, either to die or marry a hideous flying snake-creature, instead a divine wind whisks her off to a palace where she’s married to Eros - but she doesn’t know his name, and she can’t see him because he is always shrouded in darkness. Psyche’s sisters are like, “What, you don’t even know what your husband looks like? Put the lights on FFS!” and she does, and sees that her husband is not a hideous snake-creature but hot god Eros, but whoa, that gets Psyche into a load of trouble with Aphrodite, history’s pissiest mother-in-law, who punishes her by making her complete four impossible tasks, which she does, culminating in a box full of death. At which point Eros is at last, “Enough is enough,” calls up the big boss, Zeus, and asks him to make Psyche immortal. They lived happily ever after, and had a child, the goddess of pleasure Hedone - yes, hedonism.
Anyway that’s Psyche, the Greek goddess of the soul. Mid-17th century, the word is documented in English to mean the human spirit or soul, and shortly afterwards we got the word ‘psychology’, the study of the soul, although it only really started to be used to mean behavioural sciences in the late 19th century. ‘Psychosis’ and ‘psychopathy’, both mid-19th century; ‘psycho’ turned up in the 1920s as an abbreviation for psychology and psychologist - then just a few years later as a shortening of psychopath. Psychology and psychopathy are things that ought not be confused or conflated.
LILY SLOANE: The word 'psycho' is really interesting. I think in mainstream language, you know, we'll say somebody is psycho when their behavior is extreme in some way, or we feel threatened by it, or, "My psycho ex-girlfriend who won't stop texting me." It's a very broad term for "that person is acting weird or inappropriate".
HZ: Or overly emotional - overly, in their interpretations, emotional.
LILY SLOANE: Exactly. You're being too much, so you're psycho. As a prefix it could be a psychotherapy, it could be psychobabble; psychosomatic, when somebody is having some kind of physical issue going on, that is derived from an emotional place. And then also, using the word psycho could be like a shortening of the word psychopath or psychotic. Definitely when we say someone's being psycho, usually it's not an accurate description of someone being psychotic.
HZ: Yes. And there's a significant difference between psychosis and psychopathy.
LILY SLOANE: Right. Psychosis has to do with delusion and hallucination and just complete breakdown of reality. Psychopathy and being a psychopath is a personality disorder, which is actually called antisocial personality disorder. And there's so many ways where I could tangent because 'antisocial' has its whole whole issue too. But antisocial personality disorder, also called a sociopath, is all under that psychopathy thing. And that's somebody who is incapable of remorse; they lack feeling.
HZ: Do you think the film and book Psycho have led people to associate psychopaths with murderers who have mother obsessions?
LILY SLOANE: Probably. Yeah. I mean, I think even I do.
HZ: I saw a film - I think it was a 1960s film - called The Psychopath, and that was about a serial killer with a doll obsession.
LILY SLOANE: Oh, interesting.
HZ: So the terms in popular culture don't seem to be helping the real comprehension of what these all mean.
HZ: ‘Schizophrenia’ is another term that gets used vernacularly in a slapdash way, to approximate that someone or something is multifaceted in a negative way. In fiction, schizophrenia might be portrayed by an actor cycling through their full catalogue of characters. But that's not schizophrenia. If we're diagnosing it at all, it would likely be disassociative identity disorder, or what used to be called multiple personality disorder.
LILY SLOANE: That change is helpful because it does say a lot about what is underlying it, which is, it's a dissociative disorder. So dissociation is a defense, a psychological defense where your mind completely dissociates from one state to another, where you're maybe completely cut off from your body or whatever it might be. So in this case, it's, you're so broken into these different personalities that you can be in one and have no idea what happened when you switched to another.
HZ: Maybe multiple personalities as signifier of schizophrenia mistakenly arose because the etymology of schizophrenia is from Greek words that meant "splitting of the mind" - the same schiz- as in 'schism'. The word ‘schizophrenia’ is from around 1908, and is attributed to the Swiss psychologist and eugenics advocate Eugen Bleuler, who also coined the terms 'autism' and 'ambivalence' - and since we're talking about words misused, I confess I have often misused 'ambivalence' to mean 'indifference', although it's supposed to mean simultaneous conflicting feelings. Eugen Bleuler identified ambivalence as one of the major signifiers of schizophrenia.
LILY SLOANE: I think that it was really based in a time when they thought about schizophrenia differently than they do now. So I wonder if maybe the term will even change at some point. But the idea is that the mind was split. It was intended to describe the separation of function between personality, thinking, memory and perception, and for somebody to be schizophrenic, they have to have delusions and hallucinations and that's a psychotic disorder. But often in popular culture, people are saying "someone's so schizo" in the way that they might say "someone's psycho" and none of these things are reflective of what's actually going on.
‘Schizo’ as a prefix is attached to a lot of things. So there's also a personality disorder called schizoid personality disorder. And that's more what a lot of people in the general public would call 'antisocial'; but antisocial in therapy is about being hurtful to other people. Whereas what people are talking about in popular culture is somebody who's more avoidant and averse to be around other people. And that's what schizoid is. And that's somebody who's more of a hermit, would really rather just be alone most of the time.
HZ: Do you have any feelings about the term 'disorder'?
LILY SLOANE: I think if we look at it from a very literal place, disorder, like something is out of order, I think sometimes again, it can be useful, like any kind of label to say, okay, something is awry here. And then there are times where I think it can feel very pathologizing. I think for instance, personality disorders: for someone to have a personality disorder, it's a very, very extreme version of traits that we all possess. And I see these personality kind of structures, or character structures, as something that's happening on a continuum, and anything that becomes too extreme or too rigid and unmovable is problematic. I think I would be careful about using the word 'disorder' with people and notice how it impacts them, how it feels.
HZ: Yeah. Cause I was wondering if some people are like, "Well, this is my personality. The word ‘disorder’ implies that it's wrong."
LILY SLOANE: Right. Right. Well, and that, that kind of brings up a couple of interesting terms that we use: there's egosyntonic and egodystonic. When something is egosyntonic, it means that it fits with your sense of who you are. This shows up in the personality disorders a lot, when someone's not at a level of having any kind of insight or awareness about their behavior being off in any way, it's like, well, no, this was just the way I am, and this is the way it should be. And that's egosyntonic. If I was always kind of “meh” about everything, then that would be egosyntonic to me: like this is just how I am, everything is meh. But if I have depression and it comes and goes, you sometimes hear people talk about, "I'm not myself right now." And that's where it's egodystonic, this doesn't fit my sense of who I am as a person.
HZ: Hmm. That's interesting. I hadn’t heard those words.
LILY SLOANE: Yeah, I love those words. Yeah. And so we often talk about like the anxiety disorders, like depression and OCD, anxiety, all of those being more egodystonic and that the person that has some awareness that it's not fully them and it's not how they want to be. And that often in the personality disorders, things are so much more deeply ingrained into the personality structure that it's egosyntonic, and it's hard for the person to even see that there's something that isn't right there. And in popular culture, we'll often - I've even said this about myself, so many times, I've said, "oh, I'm so OCD" or someone said, "you're so OCD," because I'm tidy. I'm very tidy. I like things organized. I do spreadsheets. And, um, you know, my pillows should be arranged with the zippers facing down and all of that.
HZ: So they don't spike your face.
LILY SLOANE: Right. It's practical. So what people are talking about when they say, "oh, you're so OCD," they're actually talking about obsessive compulsive personality. There is an obsessive compulsive personality disorder; that's when it's gone so far that it's beyond reasonable, and it affects the person's life negatively to be that obsessive compulsive about their world. But OCD involves true obsessions and compulsions that have magical thinking as part of it. And it's an anxiety disorder, and it is a way that somebody. With a tremendous amount of anxiety is trying to find control and manage things in their lives. But when I say “magical thinking”, it's stuff like if you step on a crack, you'll break your mother's back. And they even know it's not real, but they can't help themselves, needing to flip the light switch ten times, you know, whatever form that may take. And that's different than just being really particular or, you know, uptight about your space being clean. It's kind of doing a more extreme version of a thing we're experiencing. Same with, people will say that about PTSD: "I have so much PTSD from the last time I went shopping at Macy's." It's like, well, you don't have PTSD, but you didn't enjoy it, OK, and you don't want to go back. But you don't have severe trauma, real trauma. So there's the hyperbole side of things. And then there's just more things are just completely misused. And both are happening a lot. And they're kind of separate issues in a way.
HZ: Do you think, because a lot of people associate these words with extremes of mental conditions, them using them as slang is almost a reassurance to themselves that they're fine, because they don't have multiple personalities, or they're not in a real state of mania?
LILY SLOANE: It's something that we do a lot in life when we are faced with things that we don't like. We talk about that a lot as othering. And so if I can distance myself as much as possible from this thing that is making me uncomfortable. And actually in the world of psychology, one way of talking about that is “the shadow”. Carl Jung coined that term 'the shadow', and the shadow is all the stuff about yourself that you don't want to look at, that you don't want to have any association with, and we often project that out into the world. And sometimes it's helpful to think about the people that scare us the most, or repulse us the most, or that we are the most critical of, often actually contains something of ourselves that we want to get as far away from as possible. And so I think that that kind of othering is part of that. Like, I don't want to be that.
HZ: And also I can't be that, because look at me, I'm sane.
LILY SLOANE: Right. I'm totally sane. And I think you often end up in - you know, this happens with gaslighting, for instance: you end up in a situation where one person in a relational dynamic can be doing that othering and distancing from what they're deeming too much or crazy. And it can cause the, quote, "crazy" person to feel even more, like, insane because this person's being so calm over here, and maybe even start acting more frantic; and the other person gets even more like, "Whoa, whoa, whoa, calm down." And the other person's like, "No, I can't calm down!" And it just keeps building into this polarization.
HZ: A tension that I often encounter when considering medical terminology is this: on the one hand, it can be very validating to have a term for your condition, you know it's a Thing, it's real, it is recognised; perhaps there are paths to treat it. On the other hand, to put a name on things can pigeonhole them, pathologise them, in ways that sometimes aren't so helpful.
LILY SLOANE: I've found some labels to be really helpful for me in my life. Like when I thought that certain behaviors with food and diet and weight, thinking about that stuff were normal because they're normalized in culture, I was really harmed by those things. But when I saw them as disordered, and when I even associated it with a form of an eating disorder, I was able to actually start healing and stop engaging in those things, even though they're normalized in culture. So that's one way that a label can be really helpful.
HZ: How did things change for you when you discovered that there is actually wording for those things?
LILY SLOANE: I was able to see what was happening when it was happening inside of me. I was able to say, that's actually not what I want to be supporting in myself; I want to be supporting this other thing. And I could say, okay, that's the eating disorder talking. And that was very, very helpful. And I think people find that helpful with depression: they can say, "The depression monster,” you know, “the sludge monster is here" or whatever, whatever names - the label doesn't even have to be what's in the diagnostic manual. It can be just naming things in whatever way you want to. And I like getting really creative with it, and I like clients coming up with characters for these parts of themselves and fleshing them out, giving them names as much as possible.
HZ: Is that a bit dissociative?
LILY SLOANE: That's a risk, but I think what happens, I think it's the first step. So the first step is that you start to parse out the parts, and then through that process, you can reintegrate them into being a whole. And actually, dissociative identity disorder is a very extreme coping mechanism, usually in response to horrific trauma and it was the right thing for that child to do or whoever to do to survive the trauma, is to dissociate. So then the key is, when they're not in that traumatic situation anymore, to help them honor the usefulness of that thing, that's now become this weird kind of difficult life circumstance to deal with, and then to actually reintegrate the parts of the self into one, into a whole, that you can live a life where you don't have to be split off.
And so I think in healing, for instance, from an eating disorder, a lot of it is parsing out the part that we talk about as the inner critic, and then you can make it your own in whatever way, and to be able to know, "That's the inner critic talking" or "That's my inner child talking" or "That's my inner manager talking" or whatever it is. And then as you get to know the parts, you can start to change your relationship to them. And then I think at a certain point you don't have to have them all separated like that.
I think that labels can be also damaging because people get misdiagnosed a lot, and there's the stigma that goes with the diagnosis, which I think we should get rid of, but at the same time, that's the reality. And it can also just misinform treatment. And so one thing that happens is, children of color who end up in the foster system, for instance, are often getting diagnosed with bipolar disorder or ADD because of their behavior. It's not taking into account the trauma that they've been through and it's not taking into account cultural differences. So there's a lot of problems with this sort of top-down psychiatric diagnostic world. And some cultures, people might present with symptoms that we would call schizophrenia here and it's just seen in a completely different paradigm. And if you live in a context where those behaviors aren't a problem, then they aren't a problem. I think labels are helpful. And also we have to be able to recognize when they're not helpful anymore, or we have to hold them loosely.
HZ: So, not saying don’t use these words. Use them; just use them accurately, appropriately, with compassion. But don’t hide them away, that’s unhelpful in its own way.
LILY SLOANE: Yeah. I think the more people hear other people's stories and experiences and the more that it's talked about in the world, I mean, that's been my own process of growing up around the words that I use, and being sensitive to other people is just learning more about them.
HZ: Totally. And the more I realized there are words I shouldn't use to the point where I'm thinking, "Will there be any left?" But then would it be so bad if I just shut up? No.
LILY SLOANE: Right, How many words do you need to use?
HZ: I dunno, ten?
LILY SLOANE: And I think that we end up with new words. Like comedy isn't dead, just because people aren't being as horribly offensive. There's new comedy, and it's great.
HZ: You just have to be better at it.
LILY SLOANE: Right. You just have to be a better comedian.
HZ: That's the problem.
LILY SLOANE: That is the problem. Yeah. And a lot of people with certain kinds of privilege have gotten away with not having that kind of standard imposed on them. And yeah, when I think about these terms, even just this conversation is helping solidify for me how much more I need to keep working on that in myself, just catching myself using crazier or whatever, and trying to understand it more.
The Allusionist is an independent podcast, and another show to add to your playlists is the Mubi podcast, a series of audio documentaries about films that were massive cultural phenomena in their home countries, but never gained traction elsewhere - why did these films captivate so many people in just one place? The host is Rico Gagliano who used to present one of my all time favourite podcasts, The Dinner Party Download, and this is a great show about films I had no idea about. Find the Mubi podcast in your podding app.
Your randomly selected word from the dictionary today is…
fartlek, noun, athletics: a system of training for distance runners in which the terrain and pace are continually varied. Origin 1940s from Swedish: ‘fart’ speed + ‘lek’ play.
Try using ‘fartlek’ in an email today.
You heard from Lily Sloane, who is a therapist - so if you’re in California and seeking a therapist, you can find her at lilysloane.com. You can also hear her on the podcasts A Therapist Walks into a Bar and Radical Advice at at lilymakessound.com, where you can also obtain her music, which is, frankly, exquisite.
This episode was produced by me, Helen Zaltzman; the music is by Martin Austwick of palebirdmusic.com, and the podcasts Song By Song and Neutrino Watch.
Our ad partner is Multitude. To sponsor an episode of the show, contact them at multitude.productions/ads.
Don’t forget to go to patreon.com/allusionist and sign up by the end of June 2021 if you want me to record words and phrases for you! And regular behind the scenes intel about each episode. You can also find the show on Twitter, Instagram and Facebook @allusionistshow. And to hear or read every episode, links to each guest and more information about each topic, and to see the full dictionary entries for all the randomly selected words, visit the show’s forever home theallusionist.org.
