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ENDING STIGMATIZING LANGUAGE

According to the Linguistic Society of America (LSA), “inclusive language acknowledges diversity, conveys respect to all people, is sensitive to differences, and promotes equal opportunities” (2016). The LSA (2016) created a guideline for inclusive language, stating inclusivity is important to reduce unintentional marginalization of people, misrepresentation, or perpetuate stereotypes. This guideline recognizes it is “not a matter of intention but of effect” (LSA, 2016).

A brief synopsis of the guideline includes:

  • avoiding generic terms and focus on clarity, especially regarding identity-based groups
  • oversimplification of characteristics can lead to reinforcing existing stereotypes even when positive
  • normative descriptions reinforce divisions and stereotypes (i.e. “normally-developed”)
  • be sensitive to community and/or author-specific preferences for terms (“deaf vs. hearing impaired, disabled vs. person with disabilities, autistic vs has autism”)
  • Using current, rather than outdated, names/descriptions (In cases where there is a lack of consensus or change is still in progress, referring to variation and contextualizing the alternatives is helpful.)
  • Avoid systematically using examples which associate roles/professions with one gender or reinforce arbitrary gender roles (“policeman vs police officer”, “stewardess vs flight attendant”)
  • Avoid gender specific terms or other demographically-oriented terms which are not relevant
  • When referencing individuals whose gender is not known, specified, relevant, or lies outside traditional binaries, use appropriate alternative pronouns that do not specify or presuppose gender (e.g. s/he, one, or the now-common and accepted singular gender-neutral they). (LSA, 2016)

Following these guidelines, HIV North Society is dedicated to reducing stigmatizing language. Starting within our own agency and throughout our community, through conversation and education.

It is important to recognize language is fluid and changes over time. Therefore language/terms/descriptors once considered acceptable or appropriate may now be considered inappropriate or unacceptable, and in some cases, downright offensive. It is important to remain flexible to this change. It comes from the desire to include marginalized groups and reduce harm to individuals and identifiable groups.

Wakeman (2016), states “the use of ‘abuse’ and ‘abuser’ has been shown to increase stigma even among highly trained clinicians, who recommend more punitive treatment when an individual is described that way” (para. 3). Language directly impacts how we view and treat others. Not defining individuals by their illnesses or circumstances is important as it recognizes the individual first and foremost; “describing patients as having a substance use disorder demonstrates their illness does not define them, just as we should no longer call a person with schizophrenia a ‘schizophrenic’” (Wakeman, 2016, para. 3). Wakeman (2016) argues the language around treatment matters for stigma as well and referring to methadone as a ‘replacement’ can worsen a mistaken notion such medicines are a way to substitute a legal opioid for an illicit opioid. This is problematic as

Addiction is a behavioral syndrome characterized by compulsive drug use despite negative consequences. Patients successfully treated with methadone no longer meet the criteria for active opioid use disorder. Taking a medication to manage an illness is the hallmark of chronic disease treatment. Individuals taking medication to successfully treat addiction are physically dependent, just as someone taking insulin for diabetes requires a daily shot to be able to function normally. Both will get sick if they stop their medication. (Wakeman, 2016, para. 4)

B.C. Mental Health and Substance Use Services (2017) put forward tips for changing language:

1)      When speaking to someone about their substance use, avoid using language that could make them feel judgement or shame. Try to focus on specific instances and behaviors:

“I am concerned about your drinking” instead of “you’re an alcoholic”

“I noticed it’s hard for you to control how much you drink” instead of “you abuse substances,” or “you have no control”

2)      Always use person first language.  Using stigmatizing terms like “abuser” or “addict” suggests these are the permanent, whole identities of people:

Use ” a mother who is struggling with alcohol use”, rather than “addict” or “alcoholic” which misses other important parts of a person’s identity

By saying someone is an “addict”, it’s implied they will always have this same behavior and change isn’t possible. Recovery is possible, and there is hope: the influence and effect of substances on someone’s life can change significantly

Instead try using language like:

Someone WITH a substance use disorder

Someone WHO uses cocaine

3)      Avoid using other stigmatizing, judgmental terms like “dirty” and “clean” to describe substance use or recovery.  Think about what is being implied about a person when using those terms.  Instead use more objective, factual terms like “use” or “don’t use”, or “in recovery”.

4)      Try to correct others who use stigmatizing terms (e.g. abuse, addict, dirty, clean, etc.). Many people don’t understand the very real power that language can have.  Have conversations about the power of language, and how it may contribute to stigma and prevent people from seeking help, receiving help, or staying in treatment.  People who use substances and/or who have substance use disorders don’t want to be judged, shamed or treated with a lack of understanding.  Language is an important part of this.

These tips serve as an excellent guide on how to adjust our own language, how to interact with individuals who may be part of marginalized groups, and how we can shift problematic language in a very real way. The impact of language is undeniable. Therefore, awareness of how our chosen words impact friends, family, clients, community members, and even ourselves, is crucial in eliminating stigma.

For more resources, check out the following:

https://www2.gov.bc.ca/gov/content/overdose/reducing-stigma

http://www.bccdc.ca/about/news-stories/news-releases/2017/language-matters

http://cmha.calgary.ab.ca/mental-health/your-mental-health/what-is-stigma/

https://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/stigma.html

Reference

B.C. Mental Health Services and Substance Use Services. (2017). What’s in a word? How language can destigmatize substance use. Retrieved from: http://www.bcmhsus.ca/about/news-stories/stories/whats-in-a-word-how-language-can-destigmatize-substance-use

Linguistic Society of America. (2016). Guidelines for inclusive language. Retrieved from: https://www.linguisticsociety.org/resource/guidelines-inclusive-language

Wakeman, S. (2016). Words matter: the language of addiction and life-saving treatments. Harvard Medical School. Retrieved from: https://www.health.harvard.edu/blog/words-matter-language-addiction-life-saving-treatments-2016081510130