What’s In A Name?

A friend and colleague has begun making plans for a private practice and was recently kicking around company names with a few of us over e-mail. As often happens in the field, the decision about how to refer to the work arose. Counseling? Therapy? Mental Health? Behavioral Health? At my various Social Work internships and jobs I’ve worked under each one of those departments, the role being the same but the name always changing. In my experience the name choice is always purposeful, can sometimes date the organization, might give you a quick glimpse into the mission, philosophy and style of the folks in charge, and might even give you a sense of the type of client a company or agency is trying to attract. That is of course, if you know what you are looking for. More often, it creates a great deal of confusion for the average consumer, client, patient, or however else you wish to be described.

As you can tell from my website address and my business cards, if I’ve ever given you one, I refer to myself as a therapist, the work as psychotherapy, and the field as mental health. My goal is to convey that I work to promote the health of the mind. My description would freak some providers or executive directors out. The fear is that saying things like “mental health” and “psychotherapy” scare clients away, make them think of crazy people, make them worry that you think they’re crazy, or that by coming to see you it means they are crazy by default. I have been told by former supervisors that “counseling” or “behavioral health” makes people less anxious, and more likely to come in.

>SIGH<

I’m not a fan of euphemisms. I don’t use nicknames to refer to body parts when talking with children, don’t like saying “passed away” or worse the medical term, “expired” when someone has died, I don’t whisper the word cancer, and I don’t refer to “the incident” when something terrible has happened. The whole point of a euphemism is to substitute a more comfortable word or expression for one that could make people feel uncomfortable or represents something unpleasant. But that’s the problem right there: many things people discuss in therapy, events from their past or their current worries ARE unpleasant. You don’t usually see a therapist because life was and is totally awesome. My worry is that euphemisms in the therapeutic setting support and promote shame, and so I want to avoid them. I think that’s where my knee-jerk objection to using “counseling” as a substitution originates. Why are we removing terms like “mental health” and “psychotherapy” out of fear they make people uncomfortable? How do we begin to destigmatize mental health if we avoid these terms ourselves? Shouldn’t we be leading by example, letting our clients know that working on your mental health is not something you need to be embarrassed or ashamed of?

Since I think they are good at everything, I’ll leave you with the World Health Organization’s definition of mental health for inspiration.