Therapy Speak

Some parts below are excerpted from June 2023

In recent years, conversations about mental health have thrived on social media platforms like Instagram and TikTok.

In turn, phrases previously used mostly in psychiatrists’ and psychologists’ offices—collectively known as “therapy speak”—are now heard in casual conversations with friends, family members, and maybe even coworkers.

In some ways this represents a positive shift as folks are very interested in learning these concepts and words. As a clinician/author, coach and interventionist, it is fascinating to see how folks label one another

Yet some folks use clinical terms the wrong way and can be inadvertently damaging. This can come across as manipulative or create a distance between two people or families.

This can be particular harmful when someone without an in-depth understanding of mental health knowledge casually calls someone a narcissist because they are self-centered. This isn’t the first time people have used words and phrases that have specific connotations within the world of mental health to stand in for everyday occurrences. “I’ve noticed there tends to be a trajectory of people misusing these terms,” he said. For example, “back in the ’90s, if anyone was emotional, they were called ‘bipolar,’” Nowadays people tend to know that being emotional doesn’t mean that everyone is bipolar.

Here are some of the most common “therapy speak” phrases being used incorrectly or out of context.


Gaslighting is a type of psychological manipulation. It often occurs in abusive intimate relationships and results in the victim questioning their own perception or reality. An example, said Albers-Bowling, is one person convincing another that something—a fight, for instance—is all their fault.

But more recently, people have been hiding behind the term “gaslighting,” using it as a way to keep from reflecting on the role they played in a given dispute

“It’s used incorrectly when it doesn’t allow someone to look at their own behavior and gain insight from that,” she explained. “It’s easy to say, ‘You’re gaslighting me,’ and not take responsibility for your own actions.”


Narcissistic personality disorder (NPD) is a specific diagnosis,. It is characterized by a need for admiration and a lack of empathy.

But lately, many people online have been describing any behavior that seems rude as narcissistic. “People use ‘narcissism’ broadly. That’s big right now, calling someone a ‘narcissist,’” he explained. “But I don’t think people understand how long-term and pervasive of a pattern [narcissistic behavior] is.”

No one can deduce a diagnosis of NPD by watching a 60-second clip showing or summarizing another person’s behavior. When the terms “narcissism” or “narcissistic” are used in these contexts, they’re speculative at best.


“Boundaries is an interesting one, because on the one hand, we want people to set good boundaries,” said Albers-Bowling. This could mean speaking with your partner or friend about what you need or want at a given moment, and how that fits in with their current needs and wants.

Yet  people are frequently ignoring that second piece of the puzzle and focusing only on their own desires, said Albers-Bowling. “The piece that’s often missing is when you only set a boundary that takes yourself into account,” she said. Rather than a healthy communication strategy, she added, this can turn into a display of self-centeredness.


The last few years have brought an increased focus on trauma, and with good reason: The pandemic created innumerable challenges. But some have become fixated on the concept of trauma and how it fits or doesn’t fit into their own lives.

“Some of the ‘trauma’ [people are casually referring to] is often normal experience,” Albers-Bowling said. As such, labeling those normal experiences as “traumatic” may make them more challenging to process, she added.

If someone is having a difficult time defining an incident that has had a significant impact on them, it might be helpful for them to speak with a licensed mental health professional who can help them work through their experience

Attachment Styles

The psychological concept of attachment theory states that how you develop an attachment to your primary caregiver as a child could affect how you relate to others as an adult. Therefore, knowing your attachment style may help you work through certain relational challenges, said Albers-Bowling.

“Understanding your attachment style can be really helpful,” she explained, adding that it can give you insights into how you date or parent. But your attachment style doesn’t always dictate your behavior, though many speak about it as if that’s the case.

Specifically, some people use their attachment style to justify certain behaviors,: “It can provide an excuse.” An example could be, “I have an anxious attachment style, and therefore I ghost people,” yet  the former doesn’t adequately serve as a reason for the latter.


Like bipolar disorder, obsessive-compulsive disorder (OCD) is a clinical diagnosis. It’s a chronic condition that causes a person to have uncontrollable, recurring thoughts and behaviors. (The thoughts are referred to as “obsessions,” while the behaviors make up the “compulsions” component of the diagnosis.)5

But, as with narcissism, many people refer to a single action or behavior as “OCD.” Oftentimes, they’ve never been diagnosed with OCD, but their use of the term leaves others to wonder, “Do you actually have OCD, or are you just having a moment?”

Referring to a certain set of behaviors as OCD without having been diagnosed with the condition isn’t just incorrect,: It can also stigmatize people who have the condition.


The concept of self-care is simplistic in nature. “Self-care is taking care of the basics: enough sleep, water—just paying attention to what you need,” Albers-Bowling said.

But in popular culture—especially on social media—the phrase is often used synonymously with socioeconomic privilege. “It can be a status symbol,” added Albers-Bowling. “It’s often associated with very expensive spa days, and having the time, money, and energy to do that reflects something.”

Despite contemporary portrayals of “self-care,” mental health experts use the term to help people determine how their basic needs can be met, Albers-Bowling said.

How to Navigate Therapy Speak in Important Conversations

When people incorporate these words into their everyday vocabulary, they’re not necessarily being malicious. “If someone is using a high number of these therapy terms, they might be in therapy, and it’s part of how they process,” Albers-Bowling said.

But for clarity’s sake, you may need to ask the person you’re speaking to what they mean when using these phrases. Examples of those questions include: “How would you define what a narcissist is?” or “What do you mean?”

Always ask what a client means, ‘Could you define what that means?’ What does the person door say to make you think that.  Our descriptions of actual behavior help us clarify what we see and the platform for more accurate ways of communication and intervening with others.

Basch CH, Donelle L, Fera J, Jaime C. Deconstructing TikTok videos on mental health: cross-sectional, descriptive content analysisJMIR Form Res. 2022;6(5):e38340. doi:10.2196/3834