Language Barriers

I seem to have a very distinct idiolect. People who know me relatively well can identify writing by it. I also have a decently large working vocabulary. I like language and I like using fun words and I like to try to use the best word for the job, even though that might be an unusual word. I think it adds interest, rather than repeating the same tired words. I do exercise some moderation in this; I don't use synonyms just for the sake of variety when it would feel artificial. Most of the people I interact with a lot are smart with fairly large vocabularies of their own. I do know to adapt to certain audiences; I'm good at doing that with children and people with limited English skills, though I might sometimes realize I've used an unusual word and will follow it with a synonym to explain. Outside of those situations, I usually speak and write in my own customary idiolect. I suspect most people use their normal speech patterns most of the time. I have a few friends who regularly ask me to define words that they aren't familiar with. I am totally okay with that.

Another apparently unique aspect to my use of language is that I try to avoid absolutes, often to an unnecessary degree. Sometimes I will catch myself framing something in absolute terms and then I will add that what I've said isn't strictly true because of other possibilities. "Yes, I am going to be home for dinner tonight. Well, unless something terrible happens, like I never make it home or our house falls into a sinkhole." Sometimes, I can be a bit ridiculous about this and my family and friends will say things like, "Yes, we know. Can we move on?" In avoiding absolutes, I often think in terms of possibility, as in, "This is what I am expecting or believe happened or believe is happening and has the highest probability, but I can't know for sure, yet." I don't want to commit myself to something I am not sure about. I don't want to commit to something that will contradict someone else, implying that they have lied, when I am not sure about it. I don't want to have lied about something because what I expected was not what happened. I spend a lot of time with the subjunctive mood.

When I was in the partial hospital program in February, I mostly talked like my normal self (I did adapt for some of the adolescents, as it was often a mix of adolescents and adults). I figure that the adults and staff could act like adults by telling me that they don't understand me or asking me to define words or whatever they need. I didn't think this explicitly before I went to the program, but it is my general approach to interacting with most adults. When I had the atrocious staffing where I was reprimanded for not going grocery shopping, I realized that the staff weren't understanding me in a basic way. They were not listening to the words I said. When I said, "I am thinking about going grocery shopping," they heard a commitment to grocery shopping. I don't know if they were inserting unwarranted assumptions, or only listening to the gist of what I said and missing the nuance, or something else entirely. I was communicating carefully, choosing the words that would convey the message I intended; they were not listening to my words nearly as carefully. I wondered if I needed to give them a lesson on the subjunctive mood.

I was in the partial hospital program for three weeks. In the last week, during one group, I said that I wouldn't know what to choose as my ideal body size, because I really didn't want to have a physical body at all and mentioned that I think of people as abstract entities of their non-physical characteristics. People were confused as to what I meant by that, so I explained. In the ensuing discussion, I learned that many other patients often understood very little of what I said because of the words I used. I had defined words for people a few times, when they asked (and only other patients asked), but didn't realize how much people weren't understanding. In this discussion, the staff members seemed to agree with the general consensus that I use too many "big" words. I don't know for sure that any staff members needed any of my words defined, but no staff members had asked for definitions, and since so many other people weren't understanding my words, I began to suspect the staff weren't understanding my words much better.

I'm willing to give other patients a pass on not bothering to ask me for clarification so that they could understand me. Their job being in the hospital program was primarily to get better themselves. However, I am not willing to give the staff the same pass, because part of their job is to understand me. It seems they didn't understand my use of the subjunctive mood and avoidance of absolutes and that they probably didn't understand all of the words I used. While I often tried to clarify with them my understanding of what they were saying, I don't remember them asking me for clarification much, even though there were many misunderstandings. When I knew I had been misunderstood and wanted to clear things up, I sometimes managed to get them to let me clarify for them, but I often did not. I doubt that is good practice for a mental health care professional.


  1. You are definitely right - if the staff didn't understand what you were saying, then it was their responsibility to ask you to repeat it using simpler language or if it was just one specific word they didn't know, then to ask what that meant. I am sure the reason they didn't, was because it would have made them feel inferior in some way - for not being as intelligent or having as a wide a vocabulary as you. I often find within the mental health system that you are expected to be less intelligent than the professionals you are working with, as someone intelligent couldn't possibly think in the irrational way that mental health problems often lead you to think in, which is obviously bollocks. I have been told numerous times that I am a very intelligent girl, or something along those lines, by professionals, and although in some cases it has been intended as a compliment, sometimes it has almost seemed like an accusation - you are intelligent, you must know this is crap, you must be able to make yourself think differently etc. I think it all related to the us and them division that often exists - professionals just aren't sure what to do with patients who are more intelligent than them, and would never admit to not understanding a word a patient used. Obviously this doesn't apply to all professionals - just the more insecure ones, who may well be less intelligent. I find they often like to patronise me by asking me if I know what a word means - usually a pretty basic, every day word. I feel like screaming at them that I have mental health problems, not IQ problems.

    I never think of my vocabulary as particularly impressive - there are lots of people who use a far wider vocabulary than I do, but I am always suprised by how often people (in every day life, rather than MH settings) ask me what words, that I consider really fairly simple, mean. Most people seem uncomfortable with any words of more than 2 or 3 syllables. Even people who are very intelligent often have really atrocious vocabularies.

    'Sometimes I will catch myself framing something in absolute terms and then I will add that what I've said isn't strictly true because of other possibilities. "Yes, I am going to be home for dinner tonight. Well, unless something terrible happens, like I never make it home or our house falls into a sinkhole."'

    I liked that - it made me laugh. I think that should be put in the dictionary as a definition for pedantic!

  2. I completely agree. It is a very interesting phenomenon. There seems to be a mindset, not just a lack of vocabulary or an inability to parse, that prevents some people (including some mental health professionals) from hearing what is really being said, or from wanting to hear. I wonder if 'prevents' is the right word. Perhaps it protects them from hearing.

    There's more on this today from Zoe, by the way.

  3. @Bippidee-
    I do often think that it has to do with the professionals expecting that they will be smarter than all their patients. I hesitate to attribute it all to that, though. I try to be diplomatic. I try to say, "here is the problem," make no assumptions as to what causes the problem, and let the professionals tell me why the problem is happening. But it is hard. I have looked for, and not found, any research studies that look into therapy outcomes as related to the intelligence relationship between patient and professional. Do patients do better when the professional is smarter than they are? When they are equally intelligent? When the patient is more intelligent? Obviously, I have my suspicions.

    What I talked about in my post is experience from an ED treatment unit. I have been in general psych hospital units and they have been far worse in this regard, treating everyone like they are mentally retarded. Then wondering why I leave during a rousing game of "let's collectively do this third-grade level crossword puzzle." In both places, I have been told by the staff that I am very intelligent, that I have a broad vocabulary. But they seem able to use that information only to compliment me, not to inform the way they interact with me.

    More on pedantry later!

  4. @CBTish-
    Oh yes. I definitely think there is more to the barrier between patients and staff than this language barrier. There are probably a lot of patients who don't have this kind of language barrier with the staff at all. Ugh. I want to grab them by the shoulders, shake them, and scream, "What the hell is the problem here!" I write about it and I talk to them about it, and I feel like I haven't really gotten anywhere.

  5. I think that usually, they just consider it their job to shut you up-- especially if you dare to mention something that they don't know more about than you do. Why bother to understand you when they can browbeat you?

    I'm sorry, reading your blog is getting me absolutely furious. That's furious for you, not *at* you, but it's still making me want to harm someone. Preferably a hypocritical therapist. Or a hornworm-- harming hornworms is certainly more socially acceptable. But much grosser and not as satisfying. Your experiences are eerily reminiscent of my own.

    (And you know what else I hate? When my spellchecker protests something that is correct. Like hornworm. Why does my spellchecker think that there's a such thing as a "horn worm" and a "horn-worm," failing to realize that it's "hornworm"?! Oh yea, because it's a computer and doesn't think. A bit like those therapists..)

  6. Thanks, Maggie. I thoroughly appreciate knowing I'm not alone in this frustration, though I am sorry that you've had to deal with this.