Tag Archives: communication

Part 3: More on Buzzwords

Therapy Gems ©

More on Buzz Words Versus Meaningful Words

Buzzwords III: Why We Use Vague Buzzwords, Psychobabble, and Vague Jargon

The precipitating event for this article is the following comments in an article by Columnist Rex Huppke on how buzzwords are used in the business world.  Huppke wrote “Author explains buzzwords for office English speakers” in the Chicago Tribune, April 17, 2016.  Quoting James Sudakow, author of a book about buzzwords in the business world, Huppke wrote,

‘I think it becomes like this language and it allows people to look like they’re part of a special group that knows what this stuff means’ … [Sudakow] said. ‘I think that’s why its [sic] so prevalent in consulting.  They’re brought in to be experts on stuff and if they have their own language that makes them seem like they’re even greater experts.  It’s the opposite…. It’s like their credibility actually goes down because people wonder, “Why you can’t just use normal words?”’  (Section 2, p3) [italics added].

After reading those comments, I thought I should write about our motivation, as buzzword1Psychotherapists, to use buzzwords.

The Buzzword Motivation

I have observed eight motivations for using buzzwords.

Shorthand communications

Ease of making a statement

Identification with others who use them

Status or Appearance of being knowledgeable

Credibility, sounding expert

Distance from the object of the buzzword

Purposeful obfuscation, vagueness, or lack of clarity

Lack of understanding of appropriate professional language

Shorthand – The simplest, most benign reason is that we think we are communicating a large concept in a small package.  We may think we are using a robust term in order to convey a complex situation.  We imagine “can’t handle it” or “acting out” shrinks a lot of information about client behavior into a single term that communicates substantial meaning.  If we can access or picture the meaning, we think the word has communicated the meaning we have imagined.  If we see the client’s distress when she uses a buzzword, we think or assume we know what she means – with a lot of emotional disturbance packed into one or two words.

Of course, each person has his or her own connotative imagery for the buzzword. Therefore, what makes it a buzzword is that it no longer has a specific shared meaning.  The ‘large concept in a small package’ is actually ambiguous!  Often it is also pejorative.  The word usually has been co-opted to mean broad categories of meaning which lack the clarity required for professional communications.

Indeed, many of these words developed from meaningful professional jargon. They became ambiguous once they were used imprecisely by professionals.  Or they came into common parlance in which specificity is not only downplayed, it is often avoided!   For instance, when Hans Selye applied the word “stress” – formerly used mainly in engineering — to describe an internal physiological state in which certain organs are activated and bodily damage results, the meaning was clear and specific.  Now, the word is most often used to describe either external stressors or an emotional state of feeling pressure or feeling overwrought with too many challenges.   You can see it has lost most of its connection with the original professional jargon.  It no longer has one clear and specific meaning.

Let’s examine an analogous problem. Jet propulsion, for example, still means causing movement by forcing gasses to travel at high speed.  Imagine if we used it to have emotional meanings such as, “I feel a lot of inner propulsion, jet propulsion.”  “Too much propulsion is coming at me!”  Oh, yes, I can relate to that idea.   But after the term from physics becomes co-opted as an ambiguous term for a mental state, then we would soon have to find a new term for whatever it is that jet engines do.

Many of us worked in settings where buzzwords were commonly used and accepted. In those settings, a buzzword may have had a short-hand meaning understood by practitioners in that institution.  Sometimes, the culture of the workplace includes a meaning for a buzzword, that is, a meaning shared within the institution.  So, for many clinicians in many settings, using the word “issues” or “acting out” may appear to sound professional and comprehensible, a shorthand way of communicating  with other professionals in that setting.  I can imagine in a residential treatment center a statement such as “Because he has so many issues [i.e., emotional conflicts, painful or traumatic experiences with hostile feelings], he acts out [i.e., displays angry feelings and perhaps destructive behavior] when he is frustrated.”   Most of the staff in that setting know the behavior to which the statement refers. bw1

However, in an outpatient setting, those same terms could have a variety of meanings. When I hear “issues” or acting out,” I often find myself asking, “What do you mean by that?”  The shorthand has ultimately failed to communicate.

Buzzwords obscure deeper understandings.  Buzzwords gloss the surface so the clinician does not have to think more incisively and deeply.  Recently, an Intern used the word “issues” several times in a diagnostic report.  Careful reading of the text showed four meanings for “issues.”  In one place, “issues” meant all the person’s internal conflicts or emotional problems.  In another, “issues” meant foci of concern.  Another meant very serious emotional problems.  The last meant significant deviance from expectations.   I explained that using “issues” obscured the richer thoughts she may have about the client.

I asked her to work to avoid “issues.” That proves to be a challenge; such is the compelling pressure to use imprecise language.  I asked her to re-write those sentences to specify the meaning more exactingly, without using the word “issues.”  The first use of “issues” became “emotional symptoms most distressing to the client” (which she then specified).   That has a more specific meaning than “he spelled out his issues.” The second became “symptoms for which we set treatment goals.”  That has more precision than “he has serious issues.”  The third became “unusual mannerisms, such as frequently tapping bw2on his forehead.”  That also is more specific and more useful.  The fourth became “disagreed with therapist’s assessment of his symptoms as being consistent with PTSD, arguing that something that long ago could not be as crucial to his health as the therapist had asserted.”  The Intern had proven the point that buzzwords obscure more than they reveal.  She also proved that a richer meaning can be hidden behind a buzzword; a little clinical thought leads to deeper insight into the client’s functioning and dynamics.

Ease of making a statement  – Similar to a motivation to use shorthand language, the clinician may find it easy to use buzzwords.  They readily ‘roll off the tongue.’  We often use them in common conversation.  But in the clinical situation, the motivation could also be to allow the clinician to avoid having to stop to think more deeply or even to let the clinician gloss over a client emotion.

Buzzwords can also be used in a highly pejorative or dismissive way. It’s much easier to say “Attention-seeking” than to think out the true dynamics and explain them, such as, “Anxious attachment, leading to behaviors which elicit a response from mother so he knows he has value to her.” So this easy and often pejorative use of buzzwords is a bw3particularly important failure of clinical thinking.  Easy use of buzzwords is inevitably unhelpful to the client, who becomes somewhat distanced.  It causes the therapist to think on the surface rather than fully grasp the client’s emotions and dynamics.

Identification with other professionals – A natural tendency amongst trainees and newer therapists is the quest to know how professionals behave, how to become socialized to the work.  Identification with valued professionals is a process for acquiring those behaviors.  So if a supervisor uses buzzwords, the trainee is likely to do so.  If the supervisor does not ask for clarification of those terms, that omission tacitly reinforces the usage.  It also teaches the trainee to stay towards the surface of behavioral observations.  When I challenge the use of buzzwords, trainees and, sometimes, licensed professionals, tell me they have never before been asked to stop using those words.  I then ask them to look more deeply into the client’s behavior, a task which will lead to better understanding and more effective selection of interventions.

Status or Appearances – As Sudakow pointed out, we may feel a need to enhance our appearance of possessing a) professional status in the mind of the clients or our colleagues, b) a sense of importance in our own minds, or c) belonging in the in-group of the institution, being a member of the team.   If, however, the organization does not support buzzwords, using them reduces status!  If the organization supports them, the clinician can lead by avoiding them, speaking with more depth, and asking others to clarify meanings.

These use of some of the buzzwords may often be judgmental and pejorative! The team objectifies the client by the use of terms which place the person in a pejorative category.

We can counter that by re-framing the behavior upon which we are focusing as protective, adaptive, the best the client can do, motivated by positive purpose, or in other terms which shift the focus to what the client is doing effectively. Recently, for instance, a client whose former use of opiates was extremely heavy lapsed twice in one week.  Rather than use buzzwords such as ‘addict,” “resistance,” or “weak,” I described his behavior as a success in that he cut down his use by 75% in just a few weeks.  The focus of discussion shifted from his pathologies to how to assist his sobriety to get to 100% abstinence.  In fact, he progressed more rapidly than his history and challenges might have predicted.

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Credibility – Similar to a motivation of special status, the professional may try to sound more like an expert.   But, when using vague language, have we communicated an unmistakable message which the client can use effectively?  Expertise used for show just does not connect well. It leaves room for misunderstanding.   I once sat with a group of professionals observing a consultant through a one-way mirror.  He told the distressed woman in his office phrases such as “You’re projecting.” “That is passive aggressive behavior.”  “You are needy.”   The observers nodded.  Yes, her behavior could be adequately described by these terms.  But I didn’t think she understood any of it.  In terms used in Motivational Interviewing, the consultant’s labels produced more sustain talk which led to more of these interventions – which seemed more confrontive than interpretive.  That may have gratified the consultant and impressed the professionals, but I did not think the interchange helped the client.  She may have found the doctor to be a credible psychiatrist, but the language did not seem to help her.

Buzzwords obfuscate deeper meanings. They lead us to the surface rather than the depths. They lead us to objectify the client – which is incompatible with core therapeutic conditions.

So, just as we want the client to be clear and to express feelings and thoughts with some clarity, and just as we push the client to probe feelings and thoughts, so we should expect the therapist to think and speak with clarity and accuracy.

Distancing – Buzzwords can be used to maintain emotional distance from another person.  Such words as “over-reactive,” “needy,” or “attention-seeking” set the therapist at a seeming distance – a judgmental distance — from the distress or emotional whirl of the client’s life.  We frequently see this kind of response when the client has a Borderline Personality Disorder, bipolar symptoms, attachment difficulties, substance abuse, or hostile behavior.   By labeling them, respectively, as needy, moody, cold, weak, or full of anger, in effect we are being judgmental and dismissive of the client’s personhood.  The person becomes the disorder rather than a person who is affected by the disorder. The paradox is that the therapist’s emotional distance, which may lead to more punitive or directive interventions, may also be a stimulus for the very emotional reactions the therapist is labeling!  

Purposeful obfuscationOften, we are intentionally vague.  Perhaps we are writing a bw5report and we conclude the client will be upset by a statement in the report.  Perhaps we create a document that is going to a reader who is unfamiliar with mental health jargon.  Perhaps we want to present the client in a favorable light.  We have many reasons for writing or speaking in vague terms.  But, just as we would not let the client use the defense of vagueness in order to suppress painful feelings and thoughts, we should not let professionals use vagueness in order to obfuscate.

In a recent report to a pediatrician of a seven year-old boy, the psychologist did just that. He used obscure language, such as, “On scale three, the client scored two standard deviations from the mean for global behavioral scores.”  The pediatrician sent the letter back with a note that she could not understand it!  The motive for the original letter was to disguise the worst findings from the client’s mother, who received a copy of the note.  But then she appeared at the clinic asking for an explanation of the letter.   The re-written letter clarified each point in plain language.  “On a scale measuring behavioral problems, such as disturbing others, occasional hitting of other children, and breaking or throwing objects in anger, J’s score suggested he is in the top two percent, meaning only 2-3 children in 100 show disruptive or aggressive behavior to that degree.”

Lack of understanding of appropriate professional language.  A mental health bw6professional has a Bachelors degree with a major or minor in psychology, social work, or an overlapping field, then a Masters degree in a mental health discipline, an internship, and a post-Masters supervised training experience.  The latest standard for a Masters is around 60 graduate hours of course work.  A Psychologist has completed several more courses than that and original research.  During all that intensive training, the professional learns an enormous number of psychological terms, theories, research findings, methods, and principles.  To learn how to apply all those terms to the labeling of client behavior takes years.  I try to model how a professional ought to be able to explain all behavioral phenomena and patterns.  In these papers on buzzwords, a consistent theme has been the proper use of professional terminology.  One reason for the use of vague terms is that trainees may not have been held to the standard of proper labeling of all their observations.  Further, they have learned so much of the jargon in the abstract and may not have enough training in applying terminology to real situations.  Let’s make sure we communicate that learning to explain the client’s actions and one’s own interventions in appropriate professional language is a goal.  We understand this skill is always a work in bw7progress.

In summary, most often the use of buzzwords derives from the needs of the clinician, not the benefit of the client. The clinician may presume the words communicate what the clinician intended.  But that is not often the case.  Clinicians may have learned to use buzzwords in a training situation, but the time has come to stop using them.

I will confess that it is a challenge. In a typical day, my trainees will hear me start the word that sounds like “iss…” or the word “handle” may emerge.  Fortunately, I am able to catch myself and to find a clearer way to explain.  We hear these words so often that we have to work to avoid them so we can speak more clearly.  Doing so will pay off in more effective clinical work.

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© Don D Rosenberg, Version 1.0 2017

In the News: 30,000,000 Words

At a child’s birthday party one afternoon, while a few of us older folks were watching the kids play words pic1soccer and color masks, we were in essence discussing child development. The advancing skills of these children, aged four to six, amazed us. They were learning to play by rules, kick the soccer ball with authority, paste stickers in neat designs, cooperate, share, and focus. They made up cooperative rules for competitive games. They played together without frustration, aggression, or injuries. They played with almost no adult supervision.

Disparity in Childhood Verbal Experiences

Just as amazing is the realization that most children in this age group could master many of these self-control, self-regulation, and social interaction skills. The children we watched are from professional families. That brought to mind a remarkable piece of research. I referred to the study contrasting these children of affluence, from highly educated families, with the many children we see in the clinic who come from less well-off families which have less educational attainment. As I recalled, a study showed a three million word difference between how much verbal input higher income-higher education families provide their children by age four as compared to low income- lower education families. These are the words of interaction from the parents.

I was startled just repeating the number. The others were astonished by that magnitude of difference.

Later, a teacher at the party pointed out my mistake. That figure is not the enormous number of 3,000.000.

No, I was off by a factor of 9, namely, 27,000,000 words. The true figure is 30,000,000.

Thirty Million Words

I double checked the information. Indeed, a long term study by Betty Hart and Todd Risley found the difference by age 4 is 30,000,000 words, about 1200 words per waking hour throughout the first 4 years. Even if we criticize the study on the basis of a small sample or the manner of extrapolation from the limited observations in this study to the child’s entire early life experience, and even were we to do the study with a larger sample, the difference likely to be found in subsequent studies is still going to be so very enormous.   Plus the difference between these class groups is fairly stable over time.

The impact is that by age three, the vocabulary of children from the highest educated group exceed that of the lower economic group by a factor of 2 or 3.

Not only did the less advantaged children have smaller vocabularies. They added new words more slowly. In other words, the gap continued to expand.

Gaps remained mostly stable when the kids who were 2 or 3 were measured again at age 9 or 10. We know that vocabulary size is associated with higher levels of income and attainment. Hart and Risley raised the concern that children in the least advantaged circumstances may not have the vocabulary needed for understanding standard books and high school textbooks.

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Furthermore, educational efforts to overcome the disparities were dwarfed by the impact of family communication patterns. Educational experiences did not significantly close the gap.

The children in the study were observed interacting with their families. The children were equally nurtured and well cared for regardless of economic status.. So the findings cannot be attributed to factors other than the amount of verbal communication in the family.

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A Discouraging Word

We know that positive reinforcement, celebration of achievements, approval, recognition, and the expectation of succeeding are powerful motivators. Children often need a push in order to try tasks that are difficult. They need positive reinforcement for their new skills and learning. What might happen if they received less of those important positive words and far more negative words – words which prohibit activities, criticize performance, or point to what was not going well?

Children tend to live up to (or sometimes down to) what is expected of them. Expectations of success are often met with greater effort. Expectations of failure can be demoralizing. So the study’s findings about positive versus negative motivators were also astonishing. In the study, it was not merely the volume of words which differentiated the groups. Along with the sheer number of words, Hart and Risley counted words of encouragement and praise versus words of discouragement. They found a large difference in how much praise and encouragement children receive. Higher economic status was associated with about six words of encouragement to each word of discouragement. In working class families, the ratio was about 2:1, meaning life for those children was far less encouraging.

For thirty years, the authors had been focusing efforts on helping children from poorer families to achieve higher educational attainment. Much of their work was at a center which worked with children from poor families or on welfare. So, in what they termed “welfare” families, the ratio of encouraging-to-discouraging words was reversed from other families, that is 1:2, meaning twice as many discouraging words which, in effect, totally dominated the positive words. The authors observed a phenomenon we often see in the clinic, namely, these families used far fewer parent-child interactions, with more of the focus of interactions being centered on prohibiting behaviors, on socialization, and on disciplining. It is not that other families neglect these interactions, but they are more likely to control or socialize by reinforcing desired behaviors and encouraging appropriate responses.

Furthermore, higher economic class families spend a lot more of communications expressing encouragement, with its connotation of higher expectations.   In the professional families, the children heard 560,000 more words of encouragement than discouragement over four years. The gap for a working class family was only 100,000. The raw number of positives was less than half of that in the higher income families. So those children received a great deal less of positive reinforcement and positive expectations.

Children in the ‘welfare’ families received 144,000 less encouraging words than discouraging words. That means they heard 300% more discouraging words than the children from the more educated homes. The number of encouraging words was also far less than those heard by working class families, actually about 140,000 fewer.

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Lastly, the authors report the ‘welfare’ families showed far fewer “back-and-forth” conversations, more one-way conversations. This tends to sound as if effort, abstract reasoning, presenting a reasoned argument, discussion, and listening to children were less valued in those families.

We know that a baby’s brain over-produces neurons, those potential connections it will need in life. Then the brain prunes away potential connections which prove to be unnecessary for adaptation to the child’s environment. We know that an enriched early environment leads to more connections, meaning more memory, more verbal capacities, more learning. The brain whose adaptation is stretched in order to manage a richer environment should be better able to manage a variety of environments in the future and to accomplish more problem-solving, more achievement. In earlier life, this would translate into higher school readiness by age 5. In the study, it translated into higher educational outcomes across the board.

Clinical Implications

We want to put these stunning findings to use in our work. Where Hart and Risley are concerned with early childhood education, we are concerned about mental health and behavior change. Psychotherapy has often been mainly a verbal endeavor. But this study is a reality check on the methods clinicians value.

  1. Our methods must be adapted for children who may not be as verbally-oriented as may be needed for standard individual therapy or even for cognitive therapy. Clearly, in clinical work with children, we should always check that the child fully understands the clinician’s comments. Children may take language which is figurative in its concrete sense. We also assume children use oral, verbal methods for thinking through problems and making changes. But that may not be the preferred channel for behavior management for the child and family where the child is not used to positive verbal management of behavior.
  2. Also cogent is the finding that the parents and children are highly matched in verbal patterns. More of the families in the study relied on approaches which are only somewhat positive and encouraging or predominantly not positive at all. Since we know that positive reinforcement of behavior increases its frequency, and we know it is a more effective strategy than punishment, so our methods must help transform family interaction toward the positive. That means reinforcing both generations for positive behavior, the parents for positive strategies and words as well as the children.
  3. Many parents will expect a “disciplinary” or punitive or negative approach. We do not want to argue about that. It may be that the alternative we offer is outside the family’s framework. The clinician will need to find ways to demonstrate a new approach and to shape new interactional behavior without using persuasion or argument.words pic5
  4. When we use play or activity-based methods of therapy, it seems we should verbally mediate the play – labeling every feeling being expressed, re-stating the child’s actions in words, highlighting in words each skill used by the children. By verbalizing, we are demonstrating a new way of interacting. We are also increasing the reproducibility of the behavior. The same principle applies to the behavior of parents!

I leave it for others to think of even more creative or effective ways to use the 30,000,000 word findings.

For more information, check these sites.

Hart, B. & Risley, T.R. “The Early Catastrophe:The 30 Million Word Gap by Age 3” (2003, spring). American Educator, pp.4-9 http://www.aft.org/sites/default/files/periodicals/TheEarlyCatastrophe.pdf

http://centerforeducation.rice.edu/slc/LS/30MillionWordGap.html

https://www.facebook.com/TMWproject

http://thirtymillionwords.org

https://bridgethewordgap.wordpress.com/white-papers-other-resources/

 

Therapy Gem: Reification and Action with Comments on Anger Management and Intervention

Freud’s Study in Vienna

Two Errors in the Application of Psychological Constructs. Since psychoanalysis and psychology first became popular decades ago, the public has absorbed many of their tenets into popular thinking.  Many of those adoptions no longer represent the scientific or exact meaning psychoanalysts or psychologists gave to these terms and ideas.

For example, “ego” means the organization of personality functions which adapt a person’s needs and drives to his or her guiding ideals and/or reality constraints.  These personality functions of self-control, coping, sensation, perception, thinking, judgment, and will, among other functions, help us to satisfy our needs given the realities we face. So “Ego” only means an organized use of these functions in service of satisfying our drives and needs while adapting to 1) our physical and cultural environment, 2) all of our past learning, and 3) our internalized ideals.  “Ego” does not actually refer to any place or thing inside of us.

But since the late 1960s, the term “ego” in common parlance means something quite different, namely, narcissism or egotism, self-absorption.  When we say, “You have a big ego,” meaning something on the order of “You think you are important” or “You are self-centered,” we are almost implying the ego is a place inside of us.

So, many ideas in psychology have become popular, but the precision of meaning has been lost in the translation.  In some cases, the idea has been treated as if the concept represents a real thing.  For example, the term “ego,” as in “Your ego,” implies a tangible structure, a stable characteristic.  Whether people mean by “ego” merely self-absorption or whether they cross a line and treat the “ego” as something tangible certainly is an important discrimination!  As we shall see, the latter is an example of a fallacy named reification, treating a theoretical construct as if it is a reality.

So we have two errors in the popular use of psychological constructs.  First is that the meaning changes from a more precise construct to a more general, imprecise trait or characteristic of people.  The second is the reification of constructs.  That means the constructs are treated as if they were real parts of us.

Note: Before we become psychotherapists, we professionals are members of our culture.  So we grow up using language in these imprecise and sometimes reified ways.  We need to be much more careful in our use of constructs and language.  After all, as therapists, empathy and language are two of our very most crucial tools for promoting change.

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Therapy Gems: Leave Yourself Out

Often we hear therapists begin a reflection, clarification, or suggestion with one of these stems:

I hear you saying…

My opinion is…

What I am getting is…

It seems to me…

I guess that…

I’m impressed that…

Sometimes clinicians end a statement with these questions:

Do I have it right?

What do you think?

These introductions or add-ons to an intervention seem superfluous and even counter-productive. These statements shift the focus onto the therapist and away from the client’s internal world.   Consider these two formulations of the same intervention.

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Therapy Gems: Buzz Words Versus Meaningful Words

LEARNING TO BE SPECIFIC AND DETAILED

One of my supervisors once told me, “Never ASSUME you know what the client means.  Ask and analyze.”

As I was presenting the details of a case to another supervisor, he often would ask me to stop my presentation and to talk about the meaning to me of a client’s comment.  He asked me to freely associate to the comment.  From those intense, lengthy explorations, I learned about the riches contained in every comment… if we teach ourselves to think deeply about each one.  Every comment represents a depth of understanding of our client and our own reactions, all of which can help us to help the client.

I once attended a staffing led by Karl Menninger.  He stopped the presenter after each fact or sentence and invited the group of us therapists to bring out all the meanings we could think of for each fact or detail.

Another influence upon me was the writings of the famous analyst Theodore Reik, who wrote long involved treatises exploring his thoughts, which had been stimulated by a client’s single gesture or comment.

The Solution Focused therapist, Insoo Berg, developed detailed future scenarios with her clients.  Carl Rogers reflected specific emotions, working to be accurate and empathic.

All of these supervisors and masters had a common message to understand the client, to achieve specific, detailed knowledge of the meaning of the client’s words and ideas, and to communicate with the client in specific language.

So, we see that everything the client does communicates all of herself or himself.  Psychotherapy works best when the client experiences the therapist’s empathy and understanding, which in turn requires a depth of understanding.  We need a specificity of knowledge about the client and clear thinking about what each client uniquely presents.  Therefore, to repeat, never assume you know what the client means: ask, ask, and ask.

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