Do Therapists Actually Use Therapy Speak?

I’ve been reading a lot lately about regular people using 'therapy speak' in their day-to-day lives — everything from 'setting boundaries', 'holding space' and 'rejecting toxicity' to people calling all sorts of things gaslighting, narcissistic or love bombing. It made me wonder what your perspective on it is. What do you think of 'therapy speak'? And how can you recognise if it’s being misused?

Well, in my experience, therapists themselves don't often use this language. I've had four therapists in 17 years and I’ve been seeing my current therapist for 15 years. And I really can count on one hand the number of times that any of these terms have been used in a session.

So 'therapy speak' is language that people believe therapists are using and which is then popularised to the point we use it in our everyday conversations. This happens a lot on social media, particularly thanks to pop psychology accounts that summarise these concepts. These terms get shared and seem to become quickly embedded in our zeitgeist. Interestingly, we've had psychology terminology used in this way before. For example, we used to talk a lot about people being neurotic, hysterical, egomaniacs. The focus and use has just changed. We don't hear those terms so much anymore. Instead, we're seeing a lot of talk about narcissists, toxic people, bipolar, and then particular terms about lack of boundaries, personal space being invaded, self-care.

There are similarities between the ways the old and new terms are used. For example, 'egomaniac' and 'narcissist' hint at the same thing; 'gaslighting' is another one. What they have in common is creating a dichotomy between 'us' and 'them' — a bit of black-and-white, polarising thinking. It’s a way to describe someone's behaviour as unacceptable or outside the limits of what you can tolerate. And then in order to separate and maybe preserve the self, people use terms like 'toxic' or 'neurotic' to distance themselves. There are some themes there about in-group/out-group going on.

It’s not like therapists don’t ever use 'therapy speak'. These are theoretical terms that are often written about. You'll find it in published papers, perhaps in supervision when therapists are discussing cases with their supervisor, and maybe training sessions or therapy education — but far less with clients.

In an actual therapy session, therapists do a lot more listening than they do talking, but they also mirror the client's language and words. So much of their work is about reflecting or interpreting and meeting the client where they are. It's an empathic relationship so you're not going to foist words on a client that are new to them and then have to explain what they mean. It's easier to explain things in much more basic language. So for example with 'toxicity' or 'rejecting toxicity', if a client is associating with someone who might be causing them distress, we would ask probing questions but we wouldn't add labels to it.

I think the difference in our popular culture and day-to-day discussions is that it’s helpful to have shorthand or labels that make a conversation simpler. It makes it a little bit easier to be on the same wavelength. But that is very different to how we communicate in therapy. These terms, if used at all, are introduced as an inquiry where the meaning is explored, rather than a definitive label.

I think there are lots of pros to having this terminology popularised because psychology and therapy has also gone mainstream. It normalises it, and it means that a lot of people who could benefit from therapy might feel that there's less stigma to it. We find in our clinics that fewer people are reticent about going into therapy and giving their contact details. That is really, really wonderful. It also introduces an element of self-reflection in talking about relationships between people: gaslighting or love bombing wouldn't take place unless there was another person involved. So we're looking at people or maybe considering a little bit more about their inner world and the relationship to other people. 

The downside is that this form of labelling can start to create a wedge between the self and others. These phrases can be applied to lots of situations without making any room for the nuances of what they truly mean. I think it's great by way of introduction but the danger is that it could be overused and it could be used judgmentally and as a divider rather than a unifier. It should be a starting point. There's much more to therapy than just the vernacular. I'd be far more comfortable if people were using these terms after reading some deeper writings on the subject.