In the early aughts, you would’ve been lucky to encounter words like triggered, boundaries, toxic, codependent, or gaslighting outside the therapist’s office. But nowadays, you’d be hard-pressed not to hear them, whether you’re at the coffee shop, scrolling through social media, or sitting down to the dinner table. “Therapy speak,” as it’s become known, has become virtually inescapable.
Surely the public’s embrace of therapy words is a good thing, right? After all, many of us can still remember the days when simply the word psychotherapy was spoken in hushed tones, not seen as a pathway to healing and self-improvement as much as some sign of personal failure. Fortunately, not only has much of the stigma around therapy largely dissipated, but our clients are coming to us better informed about diagnoses and other mental health issues—and the language shows it. Great news, right?
Well, not always, says clinical psychologist, EFT-certified couples therapist, and bestselling author Isabelle Morley, whose expertise has been quoted everywhere from The New Yorker to Business Insider to The Boston Globe. In her recent book, They’re Not Gaslighting You: Ditch the Therapy Speak and Stop Hunting for Red Flags in Every Relationship, she writes about how the proliferation of armchair diagnoses—from “my boyfriend is a classic narcissist” to “my wife is a borderline with a trauma bond”—often does more harm than good. Rather than helping identify and clarify problems, many of the partners she works with weaponize these terms to help win arguments and avoid blame rather than to heal and connect.
So what are therapists to do? How can we call attention to this behavior and set the record straight on these terms without offending, invalidating, or damaging the therapeutic alliance? Morely shared her thoughts on this and much more.
Ryan Howes: What inspired you to write They’re Not Gaslighting You?
Isabelle Morley: I saw more and more couples in my practice using therapy speak to diagnose each other in front of me or calling me before a first session to let me know they’d identified all sorts of clinical characteristics in their partner that they’d learned about on social media. I realized just how pervasive therapy speak had gotten, how misused and weaponized it had become. After speaking with colleagues and realizing that they were experiencing the same thing and also had no idea how to respond, I felt like I had to write something about it.
RH: It seems like therapists should be glad that the public is becoming more aware of psychological issues and even trying to use some clinical terminology. Is the problem with how and when they’re using it?
Morley: Overall, it’s good there’s more exposure to these words and more awareness of how and when to seek treatment or get a diagnosis. Therapists shouldn’t be gatekeepers in that way. But I think the pendulum has swung too far, to the point that people are viewing everything in their relationships through a clinical lens, which then over-pathologizes every experience in life to people’s detriment.
RH: What do you think makes the use of these terms so problematic? And isn’t that a little OCD of you?
Morley: [Laughs] Very funny. Some people still use these words with me even after they know I’ve written this book, but they do it with a laugh of like, “I know it’s not the real definition of gaslighting, but what I’m saying is . . . .” I understand that language evolves, and I’m trying to balance accepting that with defending some of the more important clinical definitions and diagnoses because they have really important meanings.
When we start to use clinical terms in an expanded, amorphous way, then this semantic bleaching happens where we lose the actual definition of a term. Then we’re depriving people who experience a disorder or abuse of having a way of explaining it in a true and accurate way.
RH: Semantic bleaching reminds me of what’s happened to the word trauma these days. If they got your order wrong at Starbucks, that’s not trauma.
Morley: Funny enough, my next book is called You Don’t Have ADHD, and it’s all about inaccurate self-diagnosis. One chapter covers trauma, because people have misused this term to the point where those who’ve gone through undeniable trauma are losing the ability to speak to their experience.
I think it’s hard to undo this watering down of language once it’s in the zeitgeist. There’s a lot of community building around these words online. Whether it’s trauma, gaslighting, ADHD, or OCD, you don’t want to take that away from people, but you want to make sure they’re being accurate in how they’re describing themselves and others.
As therapists, we were trained in how to use these terms to convey information while knowing that there’s a lot of nuance and complexity to diagnoses, and diagnoses can change. I don’t think the general public has that same understanding of nuance or understands the pitfalls of defining people by diagnoses.
RH: In your book, you say that your goal as an EFT-trained couples therapist is to help people communicate their feelings clearly rather than hide behind weaponized diagnostic terms.
Morley: Yes. These labels have helped people understand and define their experiences, but they’re also shields people hide behind to avoid being vulnerable, sharing painful experiences, and doing the deeper, harder work of being in a relationship. It’s easy to say, “You’re such a narcissist. I can’t believe you were late again,” versus “I was so embarrassed that you were late again and I was standing by myself.” People avoid that kind of emotional risk by slinging a label, laying the blame on the other person, and making it their problem to fix. And I see couples doing that a lot.
I was getting certified in EFT as I was writing this book. EFT is all about unearthing your attachment wounds, sensitivities, the most painful parts of you, and being able to voice that to people you love in safe settings, usually a couples therapy setting. I see these words as barriers to doing that.
This is a next-level defense mechanism. Most people who go through therapy training go through a phase of wanting to apply clinical terminology to everyone. We want to be able to say, “My mom was borderline, and that’s why she got upset with me” because there’s something reassuring about that. It takes the responsibility off of us. Then we’re trained out of doing that and told instead to explain how we see people not as diagnoses but as complex creatures who have complex histories. The general public isn’t given that kind of training.
RH: If a couple came to you and pointed fingers at one another, saying that the problem is that he’s a narcissist and she’s borderline, how might you handle that from a clinical viewpoint?
Morley: There are times when I stop people and times when I don’t. When people use red flag and toxic all the time, I generally know what they’re saying, so I don’t stop them. But it’s worth pausing when people come in slinging diagnoses. I’ll say, “These are pretty serious diagnoses. They have a lot of weight. They would change our work together.”
I want us to make sure we’re on the same page about what the disorder is, why you think this person has it, if they’ve been assessed for it, or if the way they’ve treated you has hurt you so much that this word just helps you make sense of it. Usually, we end up with the latter: no, they’re not actually a narcissist, but they often act selfishly and it’s hurting you deeply. And it turns out they do have empathy, but it’s been buried beneath their own hurts and resentment.
I’m not trying to make it a gotcha moment. But with a lot of warmth and empathy, I’ll say, “It’s okay if you’re saying it because it’s conveying something, but we need to make sure we’re using this word correctly. And if it’s not relevant, we should find a new word.”
RH: Are there any terms you considered for the book that didn’t make the cut?
Morley: The next book is going to cover all the self-diagnostic ones, like autism, multiple personalities, insecure attachment, even anxiety and depression. I think people are having a hard time determining what’s actual depression and what’s just a human being feeling down. I’d like to provide some clarity in a nonjudgmental, noncritical way.
RH: Several years ago, therapists started to talk about big-T Trauma and little-t trauma. It sounds like that might have been an early attempt to address the same kind of problem you’re tackling.
Morley: None of us get out of life without suffering, right? We don’t get to escape that part of existence. But when we say it’s traumatic to have gotten dumped, when maybe it’s just a normal human experience, we’re taking away some of the power of the word trauma.
RH: That’s true. So maybe it will all be about the capitalization: “Are you talking about a big-N Narcissist or a little-n narcissist?”
Morley: [Laughs] I kind of love that idea.
RH: People want to know their Myers-Briggs type, their Enneagram, their diagnosis, to be able to say “This is who I am.” So much of our identity can be tied up in these terms, for better or worse.
Morley: But there’s an optimization element at play, too: If I just know what’s wrong, I can take all the suffering away. I can predict the future and make all the right changes. And a validation element too: I’m a part of this big group of people who get the way I am and won’t judge me for it.
It’s understandable, but I hope more clinicians will feel empowered to address their clients’ use of these words. I think there’s a fear of therapeutic rupture or of getting sidetracked, but I think we can address the issue with clients in a way that’s validating and helps them ease up on their reliance on therapy speak as a shield and focus instead on actual feelings and needs and growth. 
Ryan Howes
Ryan Howes, Ph.D., ABPP is a Pasadena, California-based psychologist, musician, and author of the “Mental Health Journal for Men.” Learn more at ryanhowes.net.
Isabelle Morley
Isabelle Morley, PsyD, is a clinical psychologist, EFT-certified couples therapist, and author of “They’re Not Gaslighting You.”
