Therapy Speak: When Clinical Language Goes Casual

1. Words like gaslighting, narcissist, trigger and trauma bonding are now in everyone's vocabulary. From a clinical perspective, is this casual use a sign of progress, or a concern?

There are a few things to consider. First, this comes out of a larger push to make psychological education widely available. The problem is that most of the information online about mental health and psychiatric conditions is false. It's misinformation, and there are plenty of studies that back that up.

So my main criticism, and where I think we are right now, is that this language is in some ways hurting more than it's helping. Very complex phenomena are being reduced to very simple explanations.

One of my favourite examples of a misused term is trauma bonding. When most people say it, they mean, "We bonded because we've been through similar difficulties."

But trauma bonding comes from clinical language, and it has a very specific meaning. A trauma bond is the bond that forms between the abuser and the abused. It's closer to Stockholm syndrome: one person traumatises the other, and a bond is created between them.

There is already a word for connecting with someone over shared experiences. It's just bonding. The way "trauma bonding" now circulates, incorrectly, shows how psychological language has entered our everyday vocabulary. Where we once would have said, "We really bonded," which is what actually happened, we now reach for a clinical term.

This is damaging on a few levels. It pathologises a lot of ordinary day-to-day life. And in some cases it takes away from the seriousness of what people are actually suffering. Take OCD. Someone who once would have said "I'm a neat freak" now says "I'm so OCD."

Severe OCD is one of the hardest mental illnesses to treat. Some people wash their hands for hours a day, to the point where their skin is damaged. Some struggle intensely with obsessive thoughts and the compulsions that follow. There's also trichotillomania, where people cope with that distress by pulling out their hair, sometimes leaving bald patches they work hard to cover.

Now imagine someone living with that opens up: "I have OCD. I take psychiatric medication and I go to therapy." And the person next to them says, "Yeah, I have OCD too, I like things to be in their place." That's very dismissive. It may not be their intent, but that's what happens.

2. You moved to the UAE a little over two years ago. In your practice, here and back home, which therapy terms come up most often? And what do they tell us about how people consume information online?

Honestly, I don't think they're that different. Therapy speak is a global phenomenon that spread through social media. Even if it started somewhere in North America, it has since travelled everywhere, with local colour, of course. Every place has its own flavour.

It's also in media more broadly. When writers create TV characters, they write the language of the day, so more psychological language is seeping into scripts because that's how people talk now. Media both reflects how we speak and shapes it. It's a feedback loop.

3. Which terms do you hear most?

Trauma bonding, narcissism, toxic. Even "healthy" and "unhealthy": "That's very healthy, thank you," or "That's a very unhealthy thing to do." There's a general preoccupation with what it means to be healthy, and at the same time our vocabulary for describing ourselves has shrunk.

Often we use a label where it would be far better to describe what we feel. Compare "We trauma bonded" with "We spoke, we really connected over a lot of things we'd been through, and we realised how similar our experiences were." How much more substance does the second sentence have?

These terms were meant to be used responsibly within the clinical field, to communicate very specific things between practitioners. The paradox is that, in pop culture, they've become casual words thrown around as if we all mean the same thing. We don't. The picture of a narcissist in one person's head is very different from another's.

4. Does your head spin when someone uses these words in conversation?

You have to pick your battles, and it can be tiring. Usually I just ask, "What do you mean when you say that?" People aren't doing this intentionally. Language always adapts to popular culture. So yes, it can be frustrating, but it's a consequence of how language works, and asking is the best response.

5. Take gaslighting. It describes a serious form of psychological abuse, yet it's been diluted to the point of stand-up comedy. When someone says "My friend gaslit me" because they cancelled dinner, what does that cost us, clinically and socially? And how do you, as a clinician, interpret these words when you hear them?

I'll start with the last part. It's important never to presume we mean the same thing when we use the same word. In my clinical work, people use more and more psychological language. Someone might come in and say, "I'm anxious" or "I'm depressed," and I want to see whether they can tell the difference between sadness and depression, or stress and anxiety.

So I might ask, "Can you remember the last time you were stressed but not anxious?" The answer tells me how they use the word. If they can't identify such a time, it suggests every moment of stress is being labelled anxiety, something that shouldn't be there, even though stress is a natural part of daily life. It keeps broadening what we consider unhealthy, and we end up pathologising ordinary variations in emotion. The same goes for sadness.

As for gaslighting: there are times when people genuinely are being gaslit. I never want to dismiss someone who uses the word, as though nothing like that could be happening. I have to investigate. If real gaslighting is taking place, that's very important, and we need to establish whether the person is safe in the relationship.

But if someone isn't actually being gaslit, and there's simply a disagreement about how a conversation went, or a difference of opinion, then labelling it gaslighting says there is something wrong with the other person and they are doing something wrong to me. That takes away our ability to resolve conflict in a healthy way.

Every close relationship has conflict embedded in it. A relationship that does well is one that can recover from conflict. In our field we talk about rupture and repair, usually in terms of the relationship between clinician and patient. There will naturally be ruptures in every relationship. The question is whether both people can come together to repair them. Relationships usually end because the rupture couldn't be repaired. Using these terms casually takes away from our ability to repair.

6. Narcissist may be the most overused term of all. How do you actually diagnose narcissistic personality, and how different is that from the way we use the word casually?

Here's something a lot of people don't understand about the field. Psychology and psychiatry are young disciplines, and there isn't even agreement within the field on the definition of narcissism. I'll go one step further: there's no agreed definition of intelligence, personality, or even psychology itself.

That doesn't mean we know nothing about narcissism or personality. It means there's far more variation of opinion in the field than people realise. So when someone with a PhD or an MD speaks about narcissism online, it's understandable to presume that what they're saying is the truth about narcissism. But that misses the complexity.

There's the definition in the Diagnostic and Statistical Manual of Mental Disorders, the DSM, published by the American Psychiatric Association. It's a book with its own controversies and a history going back decades. Then there's the Psychodynamic Diagnostic Manual, the PDM, used by clinicians with psychoanalytic training, which is another modality of psychotherapy. Psychoanalysts understand narcissism in very different ways. And academics may measure narcissism in research differently again.

That's what we need to do: add the complexity back in. In everyday language we use these words as though they have agreed-upon definitions, when within the field they don't.

Even the way it's said, "You're a narcissist," sounds like an accusation. In my observation, when people call someone a narcissist they usually mean that person is selfish, and "selfish" would be the more appropriate word. Just as people use the term “trauma bonding” it usually means bonding.

We've taken complex language, with a lot of debate and history behind it, and used it to muddy everyday conversation. Language that was meant to help us understand deeper psychological phenomena is now helping us misunderstand each other.

7. Let me ask about another word: boundaries. It feels particular to my generation. "I'm putting down my boundaries." Is it a healthy, reflective word, and is it being used correctly?

I'm far less critical of "boundaries." Clinicians don't own that word; it's not really a clinical term. It's used in psychological language a lot, but it isn't a diagnosis and it doesn't carry a specific clinical meaning, the way trauma bonding or gaslighting do.

8. Do you see it as a positive outcome when clients use it?

None of these words are positive or negative in themselves. It's how you use them. If someone says, mid-argument, "You're such a narcissist," that's damaging. But if two clinicians discussing a case they share, say a psychiatrist and a psychologist, note that the patient seems to have narcissistic tendencies, that's not an accusation. It's a way of describing something, between people who understand each other, so they know which areas to investigate further. We need these words in clinical language.

Another good use: if you have genuinely experienced narcissistic abuse, it's entirely appropriate to say, "I was in a relationship with someone who was very narcissistic." That does happen. Naming it can help you identify and process what that relationship was. So it's not the words themselves. It's the context they're used in.

9. Many people feel this language is being weaponised. Phrases like "You're being toxic," "That's a red flag" or "I need to protect my energy" can shut down accountability rather than open a dialogue. Have you seen this in practice?

Language has always been weaponised. Every era has its own way of doing it, because language is how we communicate, at the policy level, the institutional level and the interpersonal level.

When someone comes into the clinic using a lot of psychological language, the first few sessions are often about helping them unlearn it. I might gently interrupt: "You just said narcissism, or gaslighting. Can you describe to me what you're trying to say instead?" You have to help them realise the word may not communicate what they think it does. There's a process of unlearning.

In general, people aren't very careful about what they say, and it's hard to engage critically with everything we see online. You'd be double-checking every other post. We're not living in an ecosystem that encourages critical engagement. Social media isn't built that way. It banks on you not double-checking.

10. Some terms focus on relationships: love bombing, codependency, situationship. Do they help people recognise unhealthy patterns, or do they create unnecessary suspicion?

Again, it depends on how you use them. If you use them accurately, they're very helpful. If you can identify that love bombing or gaslighting is happening, good for you. That's a valuable skill, and it can make you less vulnerable to emotional abuse.

But if you use these words to shut down conversations without checking, without really knowing, you're misusing them, and that will be damaging for you. Understanding these terms is useful. How, when and in what context you use them is what makes them helpful or harmful.

11. What would you say to someone who genuinely finds these terms helpful for making sense of their experience? Where's the line between empowering self-awareness and harmful oversimplification?

The line is when using these terms costs you your curiosity. When you jump to them immediately, without holding them a little more softly, and become presumptuous.

One of the people who may struggle most to connect with others is the person who thinks they're very good at reading people. Their confidence in that skill can be so high that they look for moments that confirm their view and dismiss those that don't. It makes them less curious about others, because they've already decided they know them.

When these words start limiting our ability to be curious about other people, and about ourselves, that's when we're in real trouble.

12. Isn't that close to the Freudian idea of projection? If someone tells me I'm a very negative person, many would say the accuser is the negative or insecure one. Is the language we use about others also a projection of ourselves?

This is an important question, and it ties everything together, so allow me a minute.

Projection happens, every single day. The whole point of projection is that it's unconscious. But even if we adopted a simple rule that people say things because they're projecting, what if the other person really is being negative? There may be truth to it.

This is my point. We tend to pick up a complex idea and apply it as a rule across all human beings. That's not how it works in the clinic, and these are clinical terms. Can projection happen? Yes. Is it always happening? No. When someone says something about another person, is it always secretly about themselves? It can be. It doesn't have to be. It depends.

Whether it's narcissism, projection or gaslighting, these things exist and they do happen. But they aren't always happening. The trouble comes when we pick up a principle we like and constantly look for it, especially outside the field, without the depth to understand it.

Wouldn't it be better to just say what you're actually trying to say? Part of what people do with these words is borrow the credibility that psychological language gives them: "I understand the human mind, so I'll use this word because I know what this is." But do you? That's what I'd really ask people to reconsider.

Muhammad Ali Ilyas is a DHA licensed clinical psychologist who works at Novomed Marina Plaza and Nafsi Health. You can also reach out to Ali on LinkedIn