Even though itʼs #spookyszn, I’ve never been into  Halloween: I donʼt like candy, I’m not a costume person, and I hate scary movies. The one October  tradition I am loyal to is watching the Sanderson Sisters terrorize the town of Salem in the 1993 cult classic, “Hocus Pocus.” If youʼre not a 90s baby, let me summarize it in three sentences: a snarky virgin accidentally brings three witches from the 17th century into the present using dark magic. Hilarity ensues. Good triumphs over evil. Bette Midler, Sarah  Jessica Parker, and Kathy Najimy play ancient witches, and their elderliness is made clear by their fear of modernity and their archaic manner of speaking.  “Thou hast waited in vain!” Midlerʼs character cries  to her feline archnemesis, Thackery Binx, “and thou  will fail to save thy friends, just as thou failed to save  thy sister!” I was reminded of the Sanderson Sistersʼ unique vernacular when I made my friend watch the  sequel with me, and it also gave me a great excuse to hyperfixate on a topic thatʼs been on my mind lately:  the evolution of language.  

In Anthropology 101, I learned the capacity for  language separates humans from other lifeforms.  Thatʼs all I can remember from that class, so the rest  of this paragraph is mostly pulled from Wikipedia:  the development of language is thought to have  coincided with the evolution of larger brains, and  was an adaptation specifically developed for social  cooperation. Language is processed in the Brocaʼs  and Wernickeʼs area of the brain, and is acquired  through social interaction from birth. There are now  an estimated 5,000-7,000 languages, but itʼs difficult  to predict an exact number, because languages evolve  so rapidly. (Much faster than biological evolution.)  Consider this: humans havenʼt changed much over the past two thousand years, which is why we still have multiple vestigial organs. Contrarily, language  has evolved so rapidly that witches speaking colonial  English from three hundred years ago would seriously  struggle to understand a teenager telling them to buzz off in the present. 

There are also different kinds of language. There are dialects and vernacular. There is formal language,  and colloquial language, or slang. Now that Iʼm thirty,  Iʼm starting to feel like I canʼt speak youth anymore.  For example, a teenager recently told me that my Birkenstocks were “drippy.” If you also had to Google  whether or not that is an insult or a compliment,  congratulations, youʼre old too. (Or, as the kids would  say, “cheugy.”)  

Like Birkenstocks, slang goes in and out of  fashion. If you also went to high school in the early  2000s, (once again, aging myself here) you probably  heard your friends overusing the word “gay.” “Thatʼs so gay” was a phrase that was as ubiquitous to  millennial high schoolers as UGG boots and hot pink  Razor cell phones. Luckily, Hillary Duff was there  to single-handedly cure the world of homophobia.  Her infamous “Think Before You Speak” campaign  instantly became one of the worldʼs first memes, but it also kind of worked. Like low-rise jeans, using the  word “gay” as a slur mostly went out of fashion in the United States. 

Similarly, words that once served a purpose can be twisted into something sinister or lose their  deeper meaning. Language can be used to cooperate,  innovate, repair, and create, but it can also be used  to harm, tear down, and marginalize. A constantly morphing cultural glossary can be a good thing, but  not everyone is always notified of these transitions.  

For example: When I was a student at the  University of Wisconsin in 2013, my father, who also  happens to be a professor, called me and dove into  a rant about one of his evaluations. “Jamisen!” he  shouted into the phone. “One of my students called  me offensive for using a medical term! Mentally  [r-word] is a medical term describing a condition.” Heʼs not completely wrong, although his information  was a little outdated. The r-word was used as a  medical term in the late 19th and 20th centuries to  refer to intellectual disabilities. It stems from Latin  and French, with roots in similar words meaning “to  hold back” or “to slow down.” Unfortunately, nobody  updated my Dad that the word was tainted by harm  and ableism in the early 2000s. When I was in high school, the r-word was hurled around as an insult  daily. In 2009, disability rights activists Timothy  Shriver and Soeren Palumbo started the campaign  “Spread the Word to End the Word,” urging the world  to replace the r-word with pro-disability, social  justice-oriented language. By the time this phone call happened when I was in college, the original meaning of the r-word was completely clouded by its negative history, and the original meaning had  become destitute.  

The words we use are important. So important I donʼt feel like there is a word strong enough to emphasize how important it is. How we speak shapes the  way our brains think. The way we think molds how we communicate, and through communication we build relationships. Relationships make up communities, which form cities, states, and civilizations. It is imperative that we use respectful terminology to describe  others in our society, especially when those people  have been historically marginalized, and functional  words become twisted into a tool for harm or violence. Having better words to communicate is always a net  positive. But– what if we “cancel” words and we canʼt  agree on a worthy replacement? 

When I started graduate school to become a therapist, I added many new words to my vocabulary.  I learned that when modern psychiatry began as psychoanalysis, the subjects were called “analysands.” I read about transference, triangulation, and dialectics. (Oh my!) I also discovered that a lot of practitioners have problematized the usage of the  word “patient” in the past few years. “Patient” is derived from the Old French word “pacient,” meaning  to suffer or endure. The origin of the word “patient” in the field of psychiatry most likely stems from the prevalence of mental asylums that arose in the 19th century to treat neurodivergent people. As Iʼm sure you can imagine, plenty of harm and abuse occurred in asylums. The word “patient” still contains that  history, which is why many clinicians have chosen to  stop using it. This shift also represents a distancing from the United States medical model of care and the desire to dismantle power hierarchies present in the  therapeutic relationship. 

And yet, (to play the ever-unpopular devilʼs advocate) we donʼt always cancel words just because  they are attached to a problematic history or imply  an imbalance of power. “Father” and “son,” “boss” and “employee,” or “student” and “teacher” are all titles that signify a hierarchical relationship, but we donʼt consider these words to be offensive. Politicians and  mothers and doctors and teachers and scientists have  all been guilty of abusing their power, but we havenʼt replaced those words either. I suspect the discomfort associated with the word “patient” is closely entwined  with the ideas we hold about neurodivergent people, or needing treatment. 

When I go to the doctor, Iʼm still a patient, but when I see my therapist, she most likely calls me her “client,” like most current psychotherapists. In my (brief) time working in mental healthcare, Iʼve also heard a cornucopia of other words to describe people  in therapy, including “consumers,” “members,” and “participants.” None of these words feel right to me. (For the record, “patient” doesnʼt either.) I began my  practicum a few months ago, so now I am a practicing  therapist, but I donʼt know what to call the people in  my care. “Client” feels too transactional to me; a little  too impersonal; a little too capitalist. The therapeutic  relationship is intimate and unique. Plus, I work with  children. The kids Iʼm treating range in age from 4 to  13, and the word “client” gets stuck in my throat when Iʼm talking about a person wearing velcro Spider-Man shoes instead of loafers. Participants? Too generic; too  Girl Scouts; too craft circle. Members? Members of  what? Consumers? Analysands? None of these words  are wrong or bad, but I donʼt feel like they describe the  relationship I have with the children I see.  

I canʼt help but wonder, Carrie Bradshaw-style: if  we are replacing words in the interest of social justice  without tackling the deeper problem behind the problematization, will we need to continue coming up  with new words? Will I ever have an accurate word to describe the children Iʼm caring for? And if not, what are the potential consequences of that? 

For now, the children I work with and their families  have a word to describe who I am: I am their therapist. We all know exactly what that means and what that title holds, and perhaps thatʼs good enough. Luckily, language evolves quickly, so maybe someday soon Iʼll have a word for them too.

Jamisen Paustian (MAATC 2024) colors more than  most adults, but she rarely stays inside the lines. @jamis3n