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There’s no denying that the news of the world these days is rather depressing. Weird weather patterns, weirder political happenings, war, famine, pestilence, death—just the kind of world to make the well-heeled hedge fund billionaire start thinking about bolt holes and bunkers in New Zealand, according to The New Yorker. With such a raft of social ills to navigate, it’s no wonder that mental health issues are reportedly on the rise, and have been for some time, and that drug addiction numbers are likewise on the rise—thanks to an unhealthy bump in heroin use from North America.

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Depressing? Well, it’s enough to make you want to sit down and have some kind of a chat about it.

In fact, in times of trouble, one of the things we humans seem to do best is just that: talk. And as a panacea for all ills, healthy talk is often promoted as the way for us to become even better humans.

Language seems like such an unremarkable part of our lives that we don’t often realize the very real effect it can have to make us feel better (though perhaps sometimes worse) through the wonders of the “talking cure.”  In an age of supposed openness, we’re expected to talk, and talk in a particular way, to demonstrate to others that we have, in fact, healed. We might talk over problems with friends and family and these days, even into the echo chamber ether that is the internet, with completely anonymous strangers. Online, those same strangers can share their most private and personal experiences and support each other—all through the therapy of words. Language: it cures what ails you.

Particularly in North America, therapy through talk, no longer as stigmatized as it once was, has become an increasingly popular and blandly normal way or people to address the health of their inner lives, whether individually with a therapist or as part of a support group. Though it’s much less of a commitment than having holes drilled into your skulls or electric shock treatment as past cures for mental distresses, it’s not uncommon for some patients to have pretty long-term commitments with their therapists. So does it help, and can therapists track how well patients are improving through talk alone?

For many, there’s no doubt that working through difficult personal issues through talk can be very helpful, revealing, and cathartic. Studies have certainly shown how successful therapy through personal narrative can be in dealing with addiction, such as in organizations like as Alcoholics Anonymous.

But as we learn to use the right language to open up about ourselves are we ever in danger of mistaking healthy talk about good health, for the cure itself?

Most people, when asked how they are, having learned the unwritten cultural rituals of small talk, would not dream of talking literally about the state their health. Hearing that a friend, perhaps one step removed via social media, is more or less “fine” allows us complacently to think nothing more about it, whether that one word masks a different reality or not. This is interesting considering use of social media networks such as Facebook has been linked to increasing unhappiness and depression. Language, especially when it comes to describing and negotiating the inward life, can easily end up reflecting certain social and conversational customs, reinforcing ideologies of longed-for states instead of actual facts. So how can you tell if someone is cured of a mental malady? If they tell you they are, using the words that sound right?

In New York City alone there have been many calls for increased mental health funding, and millions have been poured into tackling the very real issues with mental health and addiction, particularly affecting the homeless population. There’s no doubting the good intentions of social workers, police, and case officers who try to help people get back on their feet, but tracking how well institutionalized therapy is working out for their clients can be fraught with difficulty, because usually it’s all about the words they use, are actively heard to use, and that they’ve been trained to use, in an inherited ideological framework of therapeutic talk, the foundations of which are rarely questioned in the field. Healthy language.

E. Summerson Carr’s fascinating ethnographic study on language use in a drug treatment center (known as Fresh Beginnings) for homeless women underlines how drug rehabilitation treatment very much revolves around a drug user’s language use, in a context where they’re aware they need to achieve certain steps in order to be considered successfully treated. Carr points out the familiar discourse structures, opening with “Hi, my name is X and I am an addict,” and the structured stories of very personal histories, using the right kind of guided therapeutic language, creates an account for their problems and makes it easier for therapists and social workers to do their work within the inner lives of their patients.

In this kind of methodology, Carr states that “many drug treatment scholars propose that autobiographical talk helps addicts break through the ‘denial’ thought to characterize addiction and thereby ‘find’ themselves.” The way to be cured is to talk about yourself and your problems, and if you don’t talk “authentically” in the way expected of you, you’re in denial. Self-referential language, honesty, openness, and willingness to tell secrets, even private business unrelated to the addiction, are seen and assumed to be evidence of “healthy” language. Secrets are seen as things that “make you sick”, not only for what they hide, but as evidence of denial or reluctance to come to terms with addiction that generally relies on secrecy and keeping information away from others.

With all the best reasons behind it, this kind of ideology can start to develop into a system of codified checks and punishments as clients can end up being forced to leave the program for not participating linguistically in the right way. Carr describes Allan Young’s study of Vietnam vets in a psychiatric unit which showed “the clinical demand for patients to verbally disclose the ‘contents’ of their trauma-laden memory and the punitive measures reserved for those who do not engage in the work of authentic linguistic representation.” A program like Fresh Beginnings, even if young, very fresh, and well-intentioned, may often come pre-saddled with ready-made ideological and institutionalized assumptions about “healthy” language in the same way. While some social workers and therapists, systematically working with a endless stream of those who need help, may not always be aware of these assumptions, Carr points that their homeless clients, anxious or forced to complete a program that would grant them a clean (linguistic) bill of health, are often acutely aware of the ways they’re meant to authentically talk about their personal issues and narratives, with some finding it an intrusive, painful struggle to reveal even the smallest detail that could be used as a healing explanation for addiction. Those who choose to engage with the treatment process authentically and use the expected language reportedly do find it helpful, but for others, there is often not much of a choice between revealing inner secrets or being accused of being in denial, “a major barrier to recovery.”

It turns out there’s a lot of work, or “metalinguistic labor,” involved in bolstering up these assumptions about healthy language use, by therapists, case officers and by willing clients. From “secrets keeping you sick” to “Honest, Open and Willing,” recited mantras at places like Fresh Beginnings allow therapists to legitimize, guide, sanction and filter talk, with highly restrictive rules, without “protest or critique,” in the belief that words can only heal if they also reveal. This is not an uncommon belief, if you look at the culture of talk shows, juicy tell-all memoirs, and even internet forums where secrets are revealed. There is a relief to unburdening, when a person chooses to. Certainly it’s not in dispute that articulating inner struggles and stories can go a long way to resolving ongoing problems.

But it’s not just about content—speakers must also adopt and learn the highly structured “language game” of healthy talk. Some therapists not only believe the right discourse can start to heal long-term problems, but at the same time they can more easily track how successful their clients are at moving through the steps of a rehabilitation program or therapeutic methodology, through how well these healthy speakers are able to play this therapeutic language game. This shows how successful that particular program might be at treatment, through how many healthy speakers have successfully navigated through it. Without denying the advantages of this kind of talk therapy, it does seem a little circular.

While the healing power of talk has had many clinical successes, it’s important for therapists to be aware of how easy it is to impose their institutionalized ideological beliefs on language use, particularly on clients who may lack choice and power, on the healing process itself. On the other side, for the many in frantic pursuit of mindfulness in times of ever-increasing uncertainty, how does this linguistic code of therapy, naively absorbed from day time talk shows and formulaic narratives, obscure what it means to be mentally healthy? How might a reductive, sanitized language of therapy, in systematically translating all the quiet secrets of a unique inner life into easy to swallow labels, actually hide real understanding of the causes of mental turmoil? It’s certainly something to be aware of, that words, as powerful as they are, may not always tell a complete story. It’s a mistake to think that the cure is always the same thing as talking about the cure. Even the best articulated words of health can’t be used as an easy substitute for a sound mind and body.


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Language in Society, Vol. 35, No. 5 (Nov., 2006), pp. 631-653
Cambridge University Press