“They are so narcissistic!”: The Use of Clinical Terms to Describe People

by Yemi Lekuti, Ph.D., LPC, CGP

I remember sitting in my psychopathology course during graduate school in my clinical psychology program and hearing the professor give a disclaimer before diving into the newly released DSM 5. “As we go into the DSM, you might think you have every symptom or disorder in the book. Of course, it is normal to think this, but we encourage you to go to the counseling center if you need more guidance or insight.” However, it wasn’t until I connected it with how we use WebMD that I understood the beauty and dangers of clinical diagnosis. I greatly appreciate his disclaimer to this day.

The beauty of being a therapist is the level of awareness people have when they take inventory of their thoughts, feelings, and behaviors; when they start making profound connections, understanding the nuances and complexity of the human brain, and are mindful of how to create a necessary balance of things. They have grasped the context and concepts of their lives and make conscious decisions about navigating difficulties.

The dangers come when we encourage using clinical terminology without due diligence. We encourage it by minimizing the power of psychoeducation and maximizing the trends of how people describe themselves or others using clinical terms. We have all heard it.

“I think my parents are narcissistic. They only think about themselves.”

“I am so OCD. I have to keep it clean.”

“Your brother must be depressed he did not get asked to the dance.”

“My boss was gaslighting me by saying I did not know what I was talking about.”

There is power in being informed, and careful consideration is necessary when we gravitate toward using clinical terms to describe people. For example, there is a difference between being egotistical, self-centered, and narcissistic; organized, detailed, and having obsessive-compulsion disorder; and sad, upset, and depressed; deceptive, manipulative, and gaslighting. Can you imagine not having a history of mental health struggles to crying uncontrollably about something only to hear someone say, “wow, yesterday they were happy, and today they are crying? They must be bipolar.”

Let’s try another example. Two friends are eating dinner, and one says their side has been aching. Without being equipped to assess the ache, the other friend informs the other: “Oh, you must have appendicitis.” Again, this is a plea of encouragement for the greater public to use descriptive terms to describe people instead of disorders or diagnoses. Diagnostic symptoms overlap, and there are many factors of a person’s life, family history, relationships, personality, and temperament to come to the most accurate and appropriate diagnosis.

This can also apply to individuals self-diagnosing, which can be another thorn in the sides of many therapists. To be diagnosed, in a sense, entails a level of dysfunction taking place that negatively impacts a person’s ability to do day-to-day things. So when they are diagnosed, the professional creates an appropriate treatment plan with the client’s collaborative input, and we continue to assess to determine the effectiveness of this treatment plan.

With that in mind, let’s make our English or Language Arts teacher proud by using descriptive terms or adjectives to describe a person, place, or thing.