Narcissists, Addicts, Homeless, and Other Labels

I am coming in hot on this one. It is such a source of frustration for me when people fling around labels such as “narcissist,” “homeless,” or “addict”. When I worked in schools, the language used was “conduct disordered” and “oppositional defiant.” If we want to destigmatize mental health, and get more people to participate in therapy, let’s stop with the labels. After all, there is a human on the other end of your label. 

It would be great if we all used people-first language. It recognizes that this is a person standing in front of you WITH a particular condition or set of circumstances. Here are some examples:

• Person with Narcissistic Personality Disorder (of traits of)
• Person with addiction
• Person experiencing homelessness
• Student/child with behavior concerns/impairments/challenges

As a clinician I don’t pride myself on my diagnostic skills. This isn’t because I lack the skill, it’s just not the most important part of my work with clients. Having strong diagnostic skills will help you bill insurance, and it can help guide your assessment and treatment. But I think if all you care about is arriving at a diagnosis, you are missing the big picture.  

Assessment is critical: aka getting to know what happened to the person sitting in front of you. If you are not a mental health professional, please stop with the street diagnostics. You don’t have the depth of understanding to assess someone properly, and the more we have people wielding labels as weapons, the less likely people with impairment will want to come to treatment. 

If you are struggling with someone, what you can do is take a more compassionate approach. For example, set boundaries with them and with yourself. If someone is hurting you, not having them in your life is a practice in self-compassion and might be the best for the both of you. If you choose to maintain a relationship, boundaries are still important. Use assertive communication to share the impact their behavior has on you, and/or assist the person in getting connected to help. They may not listen, but that doesn’t mean you revert to dysfunctional behavior along with them.  

Most of the “symptoms” that warrant these labels are typically maladaptive behaviors that the person has developed as a means to reduce suffering and survive. I am not diminishing the negative impact of what they do or the tornado of damage they may cause, nor am I letting them “off the hook.” But I do want to make the world a better place, and to me that means helping as many people as possible find their way through their suffering so they can arrive at a better place. I have yet to see how labeling someone will do that.