top | item 33624032

Psychological and psychiatric terms to avoid

326 points| limbicsystem | 3 years ago |frontiersin.org | reply

332 comments

order
[+] lofatdairy|3 years ago|reply
Honestly, I'm a bit disappointed by the level of discourse this post has generated. I'm also an outspoken skeptic of findings in the field of psychology, but the article is quite well formed and well argued. If anything, accepting the nitpicking from a lot of these comments would result in psychology being _less_ rigorous and precise. A lot of psychology's problems comes from how readily available it seems to be to everyday experience. We're only 100 years from Lewis Terman and H. H. Goddard thinking they could measure intelligence by having people circle a face judged to be "more attractive", it's a young science and improving the rigor of how things are expressed is essential to advancement. Not only are a lot of these terms being used incorrectly, hence why this paper was even published, but because they carry a colloquial and historic baggage that don't reflect academic understandings, or even philosophical understandings of the epistemological concept of science. Words have definitions, and if two people don't share the same definition, then communication breaks down, research is misunderstood, and the field is worse off. This is for people operating within the field to consolidate knowledge, I don't know why people insist that lay understandings of language and a field of study need to be reflected in the terms of art.

To put it in terms that engineers are more likely to appreciate, a lot of these terms would be like "man-hours". Man-hours is obviously a useless term because it 1) implies that increasing workers scales production linearly, 2) implies each individual produces at the same rate, 3) inherits from a factory mode of production that engineers typically don't believe fits their situation, and 4) generally results in poor estimations of cost and delivery times. Obviously if you're trying to be productive as an engineer, your managers only using man-hours as a term invites ambiguity and worse working conditions. Same goes for things like the lay understanding of attention vs its specific meaning as an implementation template within deep learning, or even AI more broadly vs specific neural network techniques.

[+] johannbok|3 years ago|reply
As a psychiatrist, I'm just going to tip my toe into this conversation:

I have not read the entire list. I read a good chunk of it. Almost everything on it is -not- stuff I see among my colleagues, and appears to be how psych stuff is presented /in popular media/ rather than in the profession. Which is fine if one targets this for the science media/science communication types, but it seems very odd to apparently have a target audience of psych professionals. So of course there's a list of 'inaccurate and misleading' terms - you can't simplify something without losing /something/ of its complexity, but it still needs to be communicated.

The other thing to point out is that some of their criticisms are just ... well, outsiders commenting on things they don't know about. It's a team of academic psychologists. Psych PhDs generally don't do frontline stuff - they do targeted 1-on-1 therapy, or group therapy, but they tend to parachute in and out, they're not doing the days-long care-and-feeding of these patients where some of the terminology they're criticizing comes from. For instance, they take issue with the use of splitting, but ... clearly don't work on the unit. Splitting isn't just about wanting to avoid the thoughts of your loved ones being flawed beings; it's about the emotional hyper-sensitivity of a BPD patient resulting in them condemning as awful anyone that is less than entirely positively oriented towards them, because they can't take any negative interaction (see paragraph 1 about "I'm oversimplifying shit to communicate to people outside my profession", so don't come at me to pick nits. I know it's simplified-into-wrongness.) The result is that when they a unit staffer enforces boundaries, they're instantly terrible; as opposed to that "other" staffer that didn't have to enforce boundaries with them, who is wonderful, can I talk to them now please instead of you, you awful monster? And so the psychodynamic 'splitting' leads very quickly into 'pitting staff against each other'. It's not a mis-use of the term, it's a specific manifestation of the term that you deal with on the unit. Which the authors would know, if they were frontline workers rather than consulting therapists.

And the section on pleonasms is just nit picking for the sake of nitpicking.

This article doesn't do anything in the way of making psychology nor psychiatry more precise. This article is a lot of nit picking, in ways that look valid externally but would have anyone familiar with these things wondering why this was worth writing.

[+] ttpphd|3 years ago|reply
I feel the same way and I think your comment hits it right on the head. We should always be curious about how our language misleads us.
[+] vorpalhex|3 years ago|reply
Accuracy vs speed.

Yes we can deep into the weeds on how to best estimate a task.. or we can ask "How many man-hours is this going to take roughly?" and you give a number and then WE DO THE THING.

The argument about "man-hours" is bikeshedding.

Language is to be heard and understood. It carries both it's technical meaning and it's subjective meaning. If you're arguing, as the article argues, that words that are subjective have to be removed then you are left without any language at all.

[+] 0xedd|3 years ago|reply
What a load of nonsense.

If one reads the article, one would find the absolute majority of the arguments are plain empty claims with little supporting evidence. Citing a single paper, usually over a decade old, is simply proving the opposite; as what they're saying is "out of the thousands of researches done on X (especially medicine), we only found one paper supporting our modern and liberal claim".

And your example of manhours is utterly detached from reality. Only daft personnel think your points are axioms. Of course manhours are a rough estimate! Of course 9 women don't make a baby in a month. Unless you became an engineer last night, I can only assume you are a liberal warrior regurgitating favorable pieces.

What's next, laws on how to think?

[+] strogonoff|3 years ago|reply
It is good to see awareness being raised of accidental philosophical positions, sometimes unwittingly assumed through word choice.

For example, I was starting to doubt whether anyone realizes that they make a leap whenever they imply physiology/biology is the cause of what happens in our consciousness (or indeed causes consciousness to happen), but entry 29 reassured me not all hope is lost (emphasis mine):

> Nevertheless, conceptualizing biological functioning as inherently more “fundamental” than (that is, causally prior to) psychological functioning, such as cognitive and emotional functioning, is misleading (Miller, 1996). The relation between biological variables and other variables is virtually always bidirectional. For example, although the magnitude of the P300 event-related potential tends to be diminished among individuals with antisocial personality disorder (ASPD) compared with other individuals (Costa et al., 2000), this finding does not necessarily mean that the P300 deficit precedes, let alone plays a causal role in, ASPD. It is at least equally plausible that the personality dispositions associated with ASPD, such as inattention, low motivation, and poor impulse control, contribute to smaller P300 magnitudes (Lilienfeld, 2014).

I believe the equal likelihood of such reverse causality and its implications are severely underexplored in modern medicine.

Similarly appreciated the warning against accidentally assuming mind-body dualism (entry 40) and a fundamental point about natural sciences—that there is never definitive proof, only limited to various degrees models (entry 45).

[+] matheusmoreira|3 years ago|reply
This uncertainty stems from the lack of rigorous proof. Medicine these days is all about statistics and correlation. It's "we gave drug A to people with B and we observed effects C occurring D% of the time". In way too many cases there is no exact model or understanding of how things actually work, just inferences from observed effects.
[+] abarker|3 years ago|reply
The relation is virtually always bidirectional, and often forms complex, dynamic feedback loops. Simple causal analysis can fail in such situations.
[+] ImaCake|3 years ago|reply
This is a massive problem right across biology. When we talk about heritability people assume we mean causal genetics for some trait. What we actually mean is all the genetic variation that is causal and all the genetic variation that is correlated (by chance) with the trait. The latter are effectively instrumental variables that are predictive but not causal.
[+] xmddmx|3 years ago|reply
I think the aritcle is pretty good (I have a strong disiagreement with one of the 50 terms, but otherwise I think they did a good job).

I'm relatively new here at HN, but as a psychologist (who also dabbles in hacking) some of the reactions do support, sadly, the stereoytype that computer/engineer-types suffer anoagnosia (the lack of knowledge of what you do not know).

Some engineers do not understand that the world of human behavior is far more complex than the world of atoms, molecules, components, chips, software, etc.

Behavioral and social scientists are, you may be surprised to learn, aware of this fact, and actually lead in scientific investigation of the difficulty, specifically: dealing with constructs, and figure out how to define and measure them.

"Soft sciences" actually are much harder than "hard sciences" in many ways.

[+] devwastaken|3 years ago|reply
Some are working at making soft science more of actual testable, isolateable, repeatable, predictable science.

To be in psychology requires you to accept the ideas and culture of the "soft sciences". The system of universities and higher education, largely aligning with political and financial interests. One cannot be against it and be apart of it. That is the grand filter that removes dissent.

In current day all any diagnosis requires is a few 30 minute meetings and the right words in accordance with the dsm5. They'll get a diagnosis that's wrong, and be on their way with medications not proven effective. Ask me how I know. That's not science, it's a paycheck.

[+] andirk|3 years ago|reply
With no definitive right answer but still a clear outcome from choices made, yeah that's a moving target compared to the solid rock of most math and CS work.
[+] rayiner|3 years ago|reply
> Soft sciences" actually are much harder than "hard sciences" in many ways

Because of that complexity, the methodologies used in those fields can’t be called “science.”

[+] NickM|3 years ago|reply
Glad to see "chemical imbalance" make the list. It is very common to see people use terms like "dopamine hit", "endorphin rush", "low serotonin", etc. in ways that don't make scientific sense.

I assume people do it to sound knowledgeable or to make it sound like their ideas are backed by science, but neurotransmitters are vastly more complicated and subtle in their effects than is implied by these kinds of usages, and emotions and behaviors are tremendously more complex than the "my neurotransmitters made me do it/feel it" narrative would suggest.

[+] avgcorrection|3 years ago|reply
Using inappropriately technical jargon (especially “dopamine”) is one of my pet peeves (which I just get more of the older I get).

Why, say, describe fond feelings or affection as “oxytocin”? Do you know anything about this neurotransmitter? Or are you just using it as a fancy synonym for love and affection? Is the vernacular English language—but I guess pop-neurotransmitters are vernacular now—too impoverished to talk about love and affection?

Same thing goes for “dopamine”. Did reading a factually wrong comment make you angry, or did you get a “dopamine hit” that motivated you to reply to it? Were you validated by the upvotes, or did you get a “dopamine hit”? Why describe pleasure, anger, comfort, etc. etc. as just “dopamine”?

It seems to me that fetishizing things by pinning pleasure on something ostensibly tangible like dopamine is just too irresistible. Now we can pretend that we actually know ourselves in the ancient Greek self by talking about our indulgent and sinful behavior as just “dopamine”.

For similar reasons I don’t like when people in meditation circles obsess over “the ego”. Every little mind-wandering and slip-up becomes the fault of the fetish that is “the ego”.

Edit: Of course this is how laypeople relate to neurotransmitters while the submission is about psychologists. So this is a side-topic.

[+] stared|3 years ago|reply
While I agree that the term should be on the list (as it is a catch-all term unlikely to describe a given phenomenon), it is not that "chemical imbalance" does not exist.

For example, dopamine-related drugs relatively consistently lower ADHD symptoms.

A given example that serotonin-reducing drugs can alleviate depression hardly makes the point.

One common (and false) belief is that "depression is caused by low serotonin". It is certainly way more complicated than that; otherwise, SSRIs would be as effective for depression as dopamine-increasing drugs work for ADHD.

[+] quickthrower2|3 years ago|reply
At the same time we have a need to make sense of things. And having a rough relatable framework can be part of the therapy. I can also see why it might be dangerous “e.g. dopamine hit good, what foods/drugs will give me that”
[+] matheusmoreira|3 years ago|reply
I don't see anything wrong with the term "dopamine hit". It's the main neurotransmitter involved in the brain's reward system. Rewarding stimulus is exactly what is meant by popular use of the term.

I really don't understand attempts to problematize the use of this term. Sure, there are other neurotransmitters involved and dopamine is also present in other systems and even in the rest of the body. Nobody denies that.

[+] lisper|3 years ago|reply
Another term to avoid IMHO: "jingle jangle fallacy". It's catchy, but both the word "jingle" and the word "jangle" have established meanings in English neither of which has anything to do with what is being referred to here. To say nothing of the fact that the "jingle jangle fallacy" is not a fallacy, it's just bad choice of terminology.

Much better words than "jingle jangle fallacy" are "ambiguous" (for one word that has multiple meanings) and "redundant" (for multiple words that have the same meaning) terminology.

(I find it supremely ironic that this needs to be pointed out in an article whose central thesis is that wise choice of terminology is important.)

[+] scubbo|3 years ago|reply
This is the first time I've heard of the word "jangle" existing independently of the onomatopoeiac phrase "jingle jangle"! That said, I definitely agree that this is an ironically-poor choice of name due the lack of relation between the name and the referent.
[+] runarberg|3 years ago|reply
The authors seem to use the term them selfs in this very article, they apparently don’t see it as a problem.

> Psychology has long struggled with problems of terminology (Stanovich, 2012). For example, numerous scholars have warned of the jingle and jangle fallacies, the former being the error of referring to different constructs by the same name and the latter the error of referring to the same construct by different names (Kelley, 1927; Block, 1995; Markon, 2009).

[+] raxxorraxor|3 years ago|reply
Looks like Psychologists came up with something as complicated as the human mind. I found this very strange:

Symptom: (under Oxymorons) (41) Observable symptom. This term, which appears in nearly 700 manuscripts according to Google Scholar, conflates signs with symptoms. Signs are observable features of a disorder; symptoms are unobservable features of a disorder that can only be reported by patients (Lilienfeld et al., 2013; Kraft and Keeley, 2015). Symptoms are by definition unobservable.

I am surprised that English medicine seems to differentiate observability here since I never heard it expressed in that way. Seems to make sense to differentiate though, psychologists probably know best why this data maybe needs a different evaluation.

[+] denton-scratch|3 years ago|reply
/me not a MD, and from UK, not America.

I have always understood symptoms to be the patient's reported experience; and signs to be observable manifestations of a condition. So yes, a symptom is by definition not observable, and therefore "oxymoron" is correct.

[+] matheusmoreira|3 years ago|reply
The author is right from a medical perspective. There is a technical difference between observable signs and reported symptoms. Most people conflate both terms and there's nothing wrong with that but people in the field should understand the difference.
[+] 1970-01-01|3 years ago|reply
I'm confused about (47). Isn't "empirical data" based on observation or experiment. Is this a typo? And non-empirical data is defined as an observation that one cannot formally measure, e.g. "I love/hate it."

     (47) Empirical data. “Empirical” means based on observation or experience. As a consequence, with the possible exception of information derived from archival sources, all psychological data are empirical (what would “non-empirical” psychological data look like?). Some of the confusion probably stems from the erroneous equation of “empirical” with “experimental” or “quantitative.” Data derived from informal observations, such as non-quantified impressions collected during a psychotherapy session, are also empirical. If writers wish to distinguish numerical data from other sources of data, they should simply call them “quantified data.”
[+] l0b0|3 years ago|reply
The "steep learning curve" entry is bizarre. Is it so difficult to envision that it's a straightforward analogue to real life? Climbing a steep mountain (that is, a steep slope or curve), if you manage (since a difficult traverse is going to turn away a lot of people, just like a steep learning curve), you are going to end up with a good view (or understanding of the field). It was never about a X=time, Y=distance mathematical curve.
[+] nonrandomstring|3 years ago|reply
The fine article begins with this rather humble aim that;

> The goal of this article is to promote clear thinking and clear writing among students and teachers of psychological science

How many published papers, or even undergraduate essays contain such simplifications and misunderstandings?

I rather think the piece is aimed elsewhere, to the press, science jornalists, politicians, mid-ranking deciders, mass media, and pundits whose language is awash with this stuff.

[+] irrational|3 years ago|reply
It's strange that they don't offer "recommendations for preferable terms" for every term. Or, at least example sentences with the terms to avoid removed and replaced with more appropriate language. Clearly these terms are being used because authors find them useful. Without guidance on how to replace them, authors will probably keep using them.
[+] analog31|3 years ago|reply
An urban legend from physics is that Murray Gell-Mann deliberately chose whimsical terms for his ideas, such as "quark" and "up, down, charm, strange, truth, and beauty." The rationale was to prevent any possibly application of a familiar definition or social implications of the terms, such as was applied to "relativity."
[+] enneff|3 years ago|reply
A lot of the terms on this list describe things that simply don’t exist, so the implicit suggestion is to not make shit up. To, y’know, research what you’re writing about rather than just repeat mistruths.
[+] soledades|3 years ago|reply
>authors find them useful.

main use is to mislead self an dothers

[+] badrabbit|3 years ago|reply
> Furthermore, there are ample reasons to doubt whether “brainwashing” permanently alters beliefs

This person needs to look at interviews of mk-ultra experiment survivors. Brainwashing is very real and permanent.

[+] ndr|3 years ago|reply
> (27) The scientific method. Many science textbooks, including those in psychology, present science as a monolithic “method.” [...] Contrary to what most scientists themselves appear to believe, science is not a method; it is an approach to knowledge (Stanovich, 2012). Specifically, it is an approach that strives to better approximate the state of nature by reducing errors in inferences.

Mmmh is this Psychology opting out of the scientific method?

[+] mcBesse|3 years ago|reply
The article doesn't suggest that at all, as far as I can tell. None of what you quoted indicates that is.
[+] eckza|3 years ago|reply
What about the rest of this, that you didn't quote, do you take issue with?
[+] dmerks|3 years ago|reply
Probably refers to epistemology, a branch of philosophy related to theories of knowledge
[+] halpmeh|3 years ago|reply
I love that they make an assertion that “Science is not a method, it is an approach to knowledge” and cite something from 2012, as if science didn’t exist before that. And the fact that they conflate “science” and “scientific method” is quite hilarious as well.
[+] typon|3 years ago|reply
See absolutely nothing wrong with this quote. The "scientific method" is almost a meaningless term because it means different things to different branches of study - discouraging its use for more accurate terminology makes perfect sense.
[+] mistrial9|3 years ago|reply
there are three pillars of communication in action at once here, it seems.. one is the accepted technical language of the trained, credentialed specialist; second is the common language used daily to navigate our personal lives; third might be the language used in public discourse, in the media, and in a classroom to non-specialists..

The high-effort piece of writing adds citation-based examples of semi-specialist wording.. like someone that is a credentialed school counselor, but is not in the health professions per-se. Well guess what, you now have religious schools and also splinter educational environments to deal with as your audience.. good luck with that, Science is not going to settle cultural commitments in all cases. nor should it, I will argue.

Psychology has always been seen as a pseudo-science in some corners, unlike hard sciences backed by math. This well-intentioned and somewhat urgent writing tries to corral the "three pillars of communication" listed above, and as usual, will only get so far IMHO ..

[+] photochemsyn|3 years ago|reply
I wouldn't call psychology a 'pseudo-science', more that it's at a level of development comparable to 19th century medicine, when the concept of infectious disease being due to transmittable microbes or viruses was not understood.

Most 'psychological disorders' today are not diagnosed based on specific physical-chemical tests, i.e. one can say with high certainty that a patient has drug-resistant tuberculosis using a PCR test. In contrast, there are no definitive tests for everything from ADHD to schizophrenia to bipolar disorder to depression, although more diagnoses lead to more pharma drug sales...

[+] vvpan|3 years ago|reply
For the sake of the Hacker News audience I wish "introvert" was its own category and not under "Personality Type". It is baseless pseudo-science but comes up in tech-related circles all too often.
[+] kensai|3 years ago|reply
I am surprised there is no mention of the word "histrionic" which is completely out-of-date and insulting to women.
[+] tacitusarc|3 years ago|reply
I disagree with the "steep learning curve" point. The X axis is acquired knowledge, and the Y axis is the effort required. I don't know why people assume the X axis is time. Not all graphs are temporal.
[+] FollowingTheDao|3 years ago|reply
(2) Antidepressant medication.

"Moreover, some authors argue that these medications are considerably less efficacious than commonly claimed, and are beneficial for only severe, but not mild or moderate, depression, rendering the label of “antidepressant” potentially misleading"

Love it!

(7) Chemical imbalance.

Hate it!

Of course there is such a thing as a chemical imbalance. I would say serotonin syndrome is a good example. That is way too much serotonin. And when I am manic, I am sure I have a chemical imbalance (glutamate).

[+] stewbrew|3 years ago|reply
How about "subconscious"? It's interesting to see how some statements are based on wrong translations and misunderstanding.
[+] yannk|3 years ago|reply
Not on the list: "Oh, it's just my OCD" -- Either you have been diagnosed (and consequently suffer from OCD) or you have an obsessive personality (sometimes a quality).

But OCD is a diagnosis, abusing it do describe a personality trait doesn't serve the many many people impacted by the disorder.

-- From someone with an affected loved one.

[+] jrm4|3 years ago|reply
If anything, I find this to be a, perhaps unintentional, damning indictment of psychology and psychiatry in general.

If your discipline cannot clearly define things in a reasonably concrete and provable way, such that it is readily apparent to the patients and the public at large, and also such that the language effectively clarifies itself out of necessity, then much of what you do needs to be strongly questioned -- and often not taken too seriously.

I'm reminded of e.g. the term "neurodivergent." It's a good thing to look at, but how do you falsify it? Who can stand up and say "I'm definitely not neurodivergent?" If you can't do that, the term is not very helpful.