'Boundaries', 'toxic', 'narcissistic' - should we be using therapy terms in everyday speech?

We project, catastrophise, diagnose. Our identity shifts. Our supposed trauma is highlighted to us by strangers on the internet. 

We manipulate and are manipulated as we use words and language that we potentially do not understand or have the foresight to recognise as harmful, despite being overtly well-meaning and well-intentioned.

Therapy-speak has become a new way of communicating as this decade's mental health crisis has become mainstream as mental well-being declines. Are we expected to understand these terms meaningfully outside of the therapy room? Should we be using them at all?

“Therapy-speak is often overused, inaccurate and not reflective of in-session dialogue,” says Niamh Delmar, Chartered Registered Counselling Psychologist. 

“On the plus side, terms such as ‘boundaries’ and ‘attachment’ can help people identify what might be healthy or unhealthy. However, terms can be used inappropriately or in a derogatory way. There is a danger that people may not take personal responsibility for their part in a relationship or be too quick to dismiss or write off others as ‘narcissistic’ or ‘toxic’. Self-diagnosis or labelling others flippantly can minimise real mental illness symptomatology. Keeping at the superficial level of a term can disconnect from a deeper emotional experience.”

As we share more about our well-being with friends, family, and followers online, the world of therapy has opened up. 

However, the colloquialism of the clinical terms that have become commonplace misjudges the complexity of those terms.

“We are quite a complex species, and our emotional and feeling ranges are quite vast and individual,” says Bethan O’Riordan, psychotherapist. 

“Having phrases which join the therapy world, and the day-to-day world can be a helpful way of beginning to make sense of things. But they are not an identity piece, but rather a way of trying to explain something that can be quite complex.”

“Campaigns by high profile people talking about their mental health struggles, charities like Pieta House, places of education and even workplaces have all raised the profile of difficulties that we are all so vulnerable of experiencing,” continues O’Riordan.

These terms are misunderstood without support from a counsellor or therapist, and the full story has not been read or heard. 

Therapy speak acts more as a confessional, a call for help, a request to be heard, a web of met and unmet needs that we can’t quite figure out for the loudness of life.

“A classic one I hear is ‘I am anxious’, and I would kindly ask, ‘OK, so what if the word anxiety didn't exist? What would you say then?’ People usually say, ‘Oh, I am worried, scared, or nervous’, which is different to anxiety. We must do our best to normalise all the things we feel. It's not good or bad that we have a myriad of sensations going on inside, but it's important not to put what is rather a complex tapestry of feelings under the one umbrella of anxiety.” 

She adds that the word ‘boundaries’ is another example of out-of-context meaning. “Boundaries means to show ourselves, and others, how we would like to be treated. I see it everywhere as the solution for everything.”

We should not be expected to truly understand the terminology of therapy speak without the guidance and support of professionals. But as these terms become filtered into modern vocabulary, the danger of therapy-speak is highlighted when there is a lack of authority and inaccuracy ensues.

“Using therapy-speak can give a person a sense of grandeur and professionalism that they simply may not have the practical skills to help a client,” says O’Riordan. 

“There are many languages which have more than two variants of the word ‘knowing.’ A great example of this is in German, where there are two kinds of knowing - Kenntnis and Wissenschaft. Wissenschaft knows from books, to know about something for example, ‘I know what boundaries are.’ But Kenntnis is the knowledge and wisdom we get from the experience of doing something.”

O’Riordan tells us that as a therapist, she is not so much interested in how words are used but rather the intent and meaning behind words and what they mean for an individual, their understanding and messaging around specific words. 

“Moving past the words and making it a more tangible part of someone’s life is the most important part of language use,” she says. 

“Therapy-speak can give a dangerous illusion that someone has travelled a path that they may not actually have, and this impression can be deeply misleading to others.”

“As psychologists working in mental health, we try to reach beyond labels and terms to the individual’s emotional, environmental, and psychological world,” says Delmar. 

“A meaningful therapeutic relationship empathises yet challenges. This takes time and goes way beyond therapy speak.”

Delmar advises not jumping to conclusions or dismissing another with a label that appears so much more accessible now that therapy speak has found its way into everyday life. 

“Use emotional states to describe experiences on a deeper level,” she says. “Step back from self-diagnosis or pinning labels onto someone. A full assessment takes time and is best done by experienced and qualified professionals, as it is in medicine.”