Psychological Labels: Read Carefully Before Applying

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For better or worse — no, actually for better and worse — psychology has developed a huge number of labels for classifying and describing human behavior. It’s up to all of us to make sure these labels are used constructively.

Will the Real Narcissist Please Stand Up?

I believe that anyone working in therapy long enough will collect a list of labels and their common misapplications. One of my favorites is “narcissism.” Real narcissists are massively hungry for praise and admiration; it bothers them not to be the center of attention. On the other hand, people with high self-esteem but poor social skills often get pegged with the narcissist label when they let others know (accurately or inaccurately) how good they are. The behavior is annoying, and it’s boorish, but it’s not narcissism.

In a similar vein, there are those skilled at negotiating. And after an encounter with one of these crack negotiators, one often gets the feeling that they got the better in the exchange. Perhaps they did! It’s tempting to reach for the “manipulation” label at this time, but beware: real manipulation is far more than just good negotiation. Real manipulation is more about threats either veiled or overt, and exploiting a victim’s weaknesses.

Clients in therapy often disagree with the therapist or don’t follow through with homework assignments. In cases like these, therapists often reach for “passive aggressive” or “resistant to treatment” as labels to describe what’s going on. Sometimes the shoe really fits. But at other times, the client may disagree not because they’re being deliberately difficult but because they’re not aware of what the therapist is pointing out. And the truth is that a good fraction of the time, the therapist’s interpretations or assessments are off-target to a greater or lesser extent. I’m grateful when a client disagrees with me because I’ve just been informed that I may have missed something and now have the opportunity to get it right.

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For school-age children, Attention-Deficit Hyperactivity Disorder (ADHD) is now the label du jour. While I have little doubt there is a real condition that we call ADHD, the symptoms are nearly all exaggerations of normal child behavior. Worse still, I believe ADHD-like symptoms would crop up eventually in nearly 100% of the student population if you insisted these students sit still and endure dry instruction for long enough. I have yet to hear of a quantifiable boundary between “normal” inattention or fidgeting from ubiquitous factors in a child’s life, such as fatigue or lack of exercise, and a diagnosable ADHD condition. Until there is such a dividing line, I wish that this label would be used with greater care and discretion.

The Big Book of Mental Health Labels

Not all labels are psychological diagnoses, but many are. Psychiatrists, psychologists, and therapists of many kinds refer to the Diagnostic and Statistical Manual (DSM-IV-TR) for a ready-made list of labels we can use to communicate patterns of behavior to one another. This can be a wonderful thing, because many psychological problems are complicated, and describing all the aspects of a disorder is a lot more work than using the clinically-accepted label such as “Major Depression” or “Avoidant Personality Disorder.” Better yet, once a pattern is recognized, other yet-unseen features of the disorder may be anticipated. The course of a disorder can be explained and people suffering from mental disorders can take some measure of comfort that what they’re going through is common enough that it has a name.

So far I’ve painted a rosy picture of the DSM and the labels it contains, but there are two big caveats to observe. First, at least in my part of the world, only psychiatrists and psychologists are allowed to diagnose using the DSM. So when a coworker says “she’s so Bipolar”, even if your office-mate happens to have her facts right, she’s not qualified to make the call. Second, while it’s easy to focus on the mapping of behaviors and symptoms to psychological labels, there’s a passage in the DSM that gets overlooked, and what it says is that all the behaviors in the world don’t add up to a psychological disorder unless this complex of symptoms is “…associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.” That’s some dire language, and I believe it was put there to set a very high bar for the use of these powerful labels.

Before You Apply a Label

To reinforce my earlier point: labels aren’t all bad. When used correctly, labels are a great way to convey a lot of meaning in just a word or two. When misused, they can become weapons for dismissing, denigrating and dominating others. Here are some ways to become more conscious about the labels we use and why we use them.

When you notice yourself about to label someone’s behavior, first take your own “emotional temperature.” What are you feeling at the moment? Second, try to be as objective as you can about the behavior that’s about to earn this person a label. What is it, precisely? Can you describe what a fly on the wall could see, or does your description depend on your beliefs or interpretations of why this person is behaving a certain way? Third, is the behavior causing a problem for either you or this person, and can you describe this problem concretely and objectively? Last and most important of all, if you use this label, will this benefit you or the other person, or will it do damage? Using this thought process will help ensure you use the power of labels appropriately.

Your Turn

Do you have a “favorite” or “go-to” label for people? If so, what is it and how did you come to decide someone merits this label? How does the label change how you relate to people in your world? Feel free to share your ideas in the comments section below.

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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