“Sticks and stones will break my bones but words will never hurt me.” Many of us remember that saying repeated often throughout our childhood. As we matured we began to realize that though no bones were fractured by the spoken word, we have all known instances of words being used to defame, denigrate and label others. Some words have developed such a history of hate and stigma (for example; the “N” Word) that most of our society has greed that they are no longer to be uttered. Many of the words used to label others in a negative and hateful manner relate to a person’s nationality, ethnicity, religion, sexual orientation, or gender identity. This is certainly an incomplete list, but you get the point. 

There are many other instances where words once considered without prejudice have come to be recognized as stigmatizing and demoralizing. As society has matured we have come to realize that words used to label individuals have frequently identified these persons according to a narrow perspective of their experience. We use labels such as schizophrenic, retarded, crippled, and diabetic, to identify people according to a single, often problematic aspect of their lives. This has come to be seen as stigmatizing and reduces individual identities to an incomplete picture of their full personalities and potential. Many of these words conjure up an image of an individual who is “different from us” and often create distance. People often use labels for others to make ourselves feel better or more socially acceptable than “those others.” Sometimes these labels provide a false sense of security by creating distance and assuring ourselves that we “are not like them.”  Conversely, using “person centered terminology” means identifying an individual first as a whole person, comprised of much more that a single aspect of their experience. We should now say “a person with schizophrenia” rather than calling them a “schizophrenic.” This allows for respect that they are much more than their illness. 

Many words related to addiction carry negative connotations. Calling someone a junkie, loser, scumbag, or an addict conjures up stereotypical and inaccurate ideas about that individual’s character. The person being referred to often internalizes negative beliefs about themselves which contributes to and reinforces their poor self esteem. For people in active addiction, who often struggle with self loathing, self blame, and shame, their self worth is further diminished by other’s attitudes and prejudices.  Referring to those individuals using “person centered terminology” such as a “person with substance use disorder”, demonstrates respect and understanding that that person is so much more than their addiction. This term also recognizes the long understood evidence that addiction is a medical and psychiatric illness and not a character or moral defect. 

Another word that is often used to blame and shame others is “enabler.” This concept is much misunderstood and often used in a pejorative manner to blame some for contributing to another person’s addictive behavior. Certainly, family members who continue to deny their loved one’s substance use disorder, are covertly supporting that individual’s refusal to see their behaviors as problematic and unhealthy. This becomes a barrier to getting help for those afflicted with the disease of addiction. 

However, when people are referred to as enablers, this is a way to lay blame on them as if they were “supporting” and “encouraging’ their loved one’s harmful behaviors. This results in family and loved ones becoming victims of stigmatization. Parents, especially, feel inadequate  in not protecting their children from harmful conditions. Such derogatory terms serve only to further isolation and self blame for individuals with substance use disorder in the family. Families are doing the best they can to help their loved one stay alive as long as possible so that recovery may become an option. This means sometimes allowing them to stay in the family home when other’s would throw them out. The philosophy called “Tough Love” would support putting someone out of the house without any assistance. This belief supposes that letting someone in addiction suffer the worst kind of consequences will only serve to motivate the person into treatment. This may or may not be the case. 

I know a family whose daughter was staying in a downtrodden neighborhood of a major city and was prostituting herself for heroin. Her parents would at times pick her up and bring her home for a hot meal and clean bed for the night. They would bring her back to the city the next day, knowing that she would go on her own, but driving her was safer. Some would judge the parents as enablers and say they were supporting their daughter’s dangerous behavior. The parents lived in hope that one of these days their daughter would prefer to stay home and kept the invitation open. This approach is considered “Harm Reduction.”  The idea is that helping someone reduce the harm in their behavior keeps them alive and safer until they are ready to get treatment. Calling the parents “enablers” as a pejorative term is inappropriate and hurtful for families that act in desperation to help keep their loved ones alive.

The words we use to refer to others can, and often do, have hurtful and stigmatizing effects. When we practice using words with less stereotypical judgmental  and blame, we show tolerance  and understanding for those that are suffering. This will result in increased support and compassion for others when they need it the most.