Therapist working with neurotypical partner in therapyEditor’s note: Sarah Swenson, LMHC is a private practice psychotherapist in Seattle, Washington, where she specializes in working with neurodiverse couples. Her continuing education presentation for GoodTherapy, titled “When Your Partner is on the Autism Spectrum: Individual Therapy for the Neurotypical Partner,” will take place on February 21, 2020 and is eligible for two CE credits. This event is available at no additional cost to Premium and Pro GoodTherapy Members (Basic Members and mental health professionals without membership can view this event live for $29.95). Learn more and register here.

Author’s note: Sometimes, of course, the neurotypical partner in a neurodiverse relationship is a man. I also work with gay and lesbian couples, and couples who are polyamorous. This article describes the client I encounter most frequently, a neurotypical woman married to an autistic man. Also, please bear in mind this guiding principle: If you’ve met one autistic person, you’ve met one autistic person. Nothing in this article will apply to everyone.

In my clinical practice as a therapist and in my international work as a coach, my clients are neurodiverse couples in which one partner is autistic and the other is not. As a result, I have come to know well one of the most misdiagnosed clients you will likely encounter. I’m speaking of a woman married to an autistic man who may or may not be formally diagnosed with autism (ASD).

When this woman comes in for individual counseling, she may have a flat affect. Her presenting concerns might sound vague, including hints of depression or anxiety. She may be self-effacing and ready to blame herself. She may stop and start, not seeming to know how to explain herself. She may appear embarrassed to be taking up your time.

Or she may seem full of rage. Her language might sound pressured, disorganized. She may be close to tears. She is the victim here, and she is furious.

Or she may simply present as hopeless.

I am not describing three separate women. You are likely to see all of this in the same woman in one session. Would you know how to understand her and offer her the support she needs?

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy.

Meeting the Neurotypical Partner in Therapy

Most often, these clients are experiencing complex trauma (C-PTSD). They won’t be able to identify a specific traumatic injury because they are in a relationship that inadvertently creates the conditions of ongoing trauma. And since in this relationship there in no intention to harm, no intention to abuse, she is confused. She loves–or did love–her husband. She will tell you he is a good man.

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy. She will tell you that she has changed. She will tell you she is not the woman she used to be. She feels less joy in life. She has let friendships fall away. She can’t muster interest in the things that used to give her pleasure. When asked, she is unlikely to be able to express her needs. She can’t remember what she needs. She knows this, however: she feels alone. And she may fear she’s losing her mind.

You’ve read her intake paperwork, so you will know that her husband is successful in his career, which may be in a highly competitive and well-respected field. When you talk to her, you’ll hear about his high intelligence and how well-regarded he is at work. As you get to know her better, she will tell you that everyone thinks that the two of them have the perfect marriage because that’s what it looks like from the outside. She realizes all marriages have problems. Her well-meaning friends certainly share enough of their stories that she feels a little guilty when inside she’s thinking, “Yes, but you don’t understand what it’s like for me…it’s different…I can’t explain it…”

She may sound petulant, self-involved, or impossible to please, due to the fact that she can express her pain but can’t put her finger on exactly what the problem is. She knows it has something to do with her husband and the way he treats her. Yet she has painted a picture of him that impresses you. You may think she is exhibiting narcissism as a result.

Another possibility is that he is a good man, but for some reason, he cannot seem to keep a job. He’s intelligent. He’s talented. But the financial strain of his chronic unemployment has pushed her to the brink. She is the sole earner. She manages the household. She supervises and provides for the children. She hides this internal familial dysfunction from her friends and her family. She has no one else to rely on. She is embarrassed. She is utterly exhausted. She can’t see a way out of her distress and she fears it may kill her. You may diagnose depression.

Sometimes, from session to session, you’ll see her condemn her husband and the way he cannot seem to do anything right, from loading the dishwasher (“I even made a little diagram and taped it to the counter!”) to listening to her when she’s upset (“He always wants to fix everything and doesn’t even notice I’m crying!”). Next session, she will be filled with compassion for him because he honestly seems to be doing the best he can. She’s just expecting perfection from him. He’s human. (“Why do I always have to be like this? Why can’t I just let him be himself?”) You may wonder if you’re seeing borderline personality.

And when she paints a complex picture of her experience with him that screams “Run for your life!” you may wonder why she can’t decide to leave. You consider codependency.

This is the woman married to an autistic man before she understands that he is autistic and before she understands what autism means in a relationship. I agree with you that it is difficult to identify her based on the information described above. Here are some important things to consider that may help you sort this all out.

Signs You’re Working with the Neurotypical Partner in a Neurodiverse Relationship

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication. Many of the women I work with identify the courtship phase of their relationship as short, comfortable, and consistent. More often than not, however, they can look back and identify what they call red flags: his quirky manners, his deeply focused conversations on things he’s interested in and silence when he’s not, his apparent discomfort at expressing emotion. At the time, they interpreted these things to be endearing eccentricity, intelligence and skill, and admirable reticence–the stiff upper lip.

For reasons of misinterpretation like this, they went forward to the commitment of marriage. Only with time did the veil slip away, and they realized they were habitually filling in with projections about what their partner’s behaviors and comments meant on the basis of what they would mean if they did these things themselves. In other words, they applied neurotypical standards and expectations to the behavior of an autistic individual. Slowly but surely, their sense of who their husband actually is erodes until they often become quite uncertain about who he actually is.

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication.

Over the course of the marriage, this woman will feel minimized and criticized. She will express her husband’s constant negativity and say that she’s begun to feel negative about everything, too. Her descriptions of their sex life will be particularly illuminating.

Generally, by the time these women come to therapy, their sex lives are completely ruptured. They have to think when you ask them about it. They’ll tell you they don’t remember precisely when or how, but at some point, things just stopped. For some, it has been months, but for most it’s been a matter of years. And, frankly, when their sex lives were more active, it wasn’t all that rewarding: it felt mechanical, always the same, with no foreplay and no sense of intimacy.

She doesn’t miss the specifics of sexual encounters with her husband, but she craves sexual intimacy. She craves intimacy, period. She wonders whether she should have an affair, though she doesn’t really want to go outside her marriage to have her needs met. She’ll just stifle them for a while, hoping they subside. Instead, she worries that they will continue to grow. She may not be able to look you in the eye at this point. She is desperate not to be viewed as promiscuous, and she fears you will judge her.

There are exceptions. Sometimes, a woman will tell you she feels like a sex doll to her husband’s routine and frequent sexual demands. She continues to participate. She hates herself for her inability to stand up for herself, but she has tried, and it just seems pointless. She continues to acquiesce. She is becoming numb to her own sexuality, to any physical sensations at all. She cannot afford to feel aroused because she knows she will be disappointed once again.

As you know, diminished sexual intimacy in a relationship is usually a sign of severed communication. In the neurodiverse relationship, this is most often the case. The woman needs emotional connection before she can feel sexually vulnerable. She is unlikely to feel this with her autistic husband. I often hear from these women that they don’t feel safe enough emotionally to present themselves sexually to their husbands. She does not feel seen or heard or known by her husband, whose sexual needs are often more physiological than emotional. He doesn’t understand her withdrawal any more than she understands the way he treats her.

Work with Neurodiverse Couples: Moving Forward

If you see enough of these signs in your client, I suggest asking whether she has considered that her husband might be autistic. In order to do this well, you’ll have to be certain she understands what you mean and why you’re asking. If she has not thought of this possibility herself, you’ll need to explain to her that autism is a result of neurological variance and not mental illness or personality disorder. You don’t want her to reject your suggestion on the basis of having misunderstood you.

Many times, though, women come in for counseling after having read articles of mine or other material on the internet and already suspect autism (some still call it Asperger’s) in their husbands. They want to know what to do. In this case, we discuss all the points mentioned above in terms of what it would mean if their husband were in fact autistic. I do not ever volunteer a diagnosis of autism without having met someone, but we do reality testing to rule it in or out as a differential. Then I suggest couple work. I help her with language for bringing this up to her husband, which is a sensitive task in itself.

Sometimes, after several sessions, we schedule a couple session, if the husband is willing to explore the possibility. It is often a watershed moment in a couple’s life to learn that there are reasons that explain their problems and that we can work together on psychoeducation and on communication strategies and skills that offer a path toward improved intimacy. The relationship will never be neurotypical or autistic, but it can become more rewarding for both partners.

Sometimes, the husband is unwilling to consider autism and will not come in for a couple session. He fears being judged. Labeled. Vilified. She cannot get through to him that this is a supportive process. He locks into his fears and there is nothing more to be done. In this case, I continue to work with the woman alone to help her understand her choices. They are not always binary. There are more options than staying married or getting divorced. We explore them all.

It is important never to minimize the experience and challenges faced by the autistic partner.

It is important never to minimize the experience and challenges faced by the autistic partner. This work is about identifying differences and creating more successful ways to communicate. There are good reasons why the autistic partner behaves the way he does and says the things he says. I have never met an autistic person who sets out intentionally to hurt his wife, and seldom have I encountered an autistic person who lies. Misrepresenting something has its own rational pathway for an autistic person, and I distinguish this from intentional lying. This is an example of the kind of subject we explore in couple sessions. Sometimes, the intense anger of the neurotypical partner can be diffused with education and compassion. Sometimes, the weight of this anger and feeling responsible for the relationship is too much for her.

If you have any suspicion about autism in a client’s partner, please tread carefully to explore the possibility. But do take the chance: otherwise, you could be missing the core challenge your neurotypical client is facing, which is the hub from which all her other apparently confusing behaviors emanate. The challenges to communication in the neurodiverse relationship are not insurmountable, but to ameliorate them requires sensitive counseling support. Educating yourself on the nature of autism, how it creates the lens through which a person experiences and interacts with reality, and how to help a couple bring implicit expectations to explicit and comprehensible statements are essential in this work. For initial solid grounding in the field of autism, I refer therapists to the work of Tony Atwood, PhD, and Simon Baron-Cohen, PhD.

Woman sitting in the driver's seat of her car, crying

Loneliness can be one of the most painful experiences in a relationship—especially when the relationship is neurodiverse. If you love your partner but still feel unseen, unheard, or emotionally distant, you are not alone. Many couples face this challenge, and understanding its roots can be the first step toward healing.

While loneliness can occur in any partnership, the dynamics in neurodiverse relationships bring unique emotional and communication challenges that deserve special attention.

Understanding Loneliness in Neurodiverse Partnerships

Many people experience occasional loneliness in relationships, but the loneliness in a neurodiverse partnership often has unique characteristics. Friends may reassure you by saying “that’s life” or “marriage is hard,” but these responses can dismiss what makes your situation different.

A person in this situation may feel guilty or wonder if they are making too much of the problem. They might try to convince themselves that things are fine—until the longing for emotional connection grows too strong to ignore.

How Autism Can Impact Emotional Connection

For some in neurodiverse relationships, deep loneliness becomes a constant presence, not just an occasional feeling. It may wax and wane, but it’s always there—woven into daily life, much like a wedding ring on your hand.

Autistic and neurotypical partners can both feel lonely, but for different reasons. A neurotypical partner may crave affective empathy—emotional attunement and validation—while an autistic partner may respond with cognitive empathy, offering solutions rather than emotional comfort. Neither is wrong, but the mismatch can create feelings of being unseen or unsupported.

Over time, these differences can lead to frustration, hurt, or even withdrawal from the relationship. In some cases, both partners feel equally isolated. 

Common Causes of Loneliness for Both Partners

Strategies for Bridging the Understanding Gap

One of the most effective tools for working with neurodiverse couples is psychoeducation (learn more). This involves exploring both the autistic and neurotypical experiences—not to label one as “better” but to understand similarities and differences.

From there, couples can:

When to Seek Professional Support

If loneliness is leading to ongoing resentment, emotional withdrawal, or repeated conflict, it may be time to seek outside help. A therapist experienced in neurodiverse relationships can help partners:

You can find a qualified therapist who understands both autism and relationship challenges.

Questions to Ask Your Therapist

The Path Forward

Every relationship faces challenges, but in a neurodiverse partnership, understanding and acceptance are the keys to a deeper connection. A neurodiverse relationship will never be entirely neurotypical or autistic—it will always be uniquely yours. By learning to navigate your differences, you can deepen your connection and create a partnership that honors both individuals.

You don’t have to navigate this alone—working with a therapist experienced in neurodiverse relationships can help you and your partner build mutual understanding and emotional closeness. Find a qualified therapist on GoodTherapy today and take the next step toward a stronger, more connected partnership.

Young couple sitting in coffee shop in disagreementAuthor’s note: It is always a challenge to choose genders when writing about neurodiverse couples. Here I use the example of an autistic man and a neurotypical woman. I don’t mean to imply there are no cases in which this is reversed. It’s just that at this time, men are diagnosed at a 4:1 ratio to women, and in my practice, it is the majority of men who are the autistic partners. This could reflect the higher frequency of autism among men, or it could mean more couples like this present for counseling than couples in which the autistic partner is female. It is also important to note that individuals on the spectrum can be susceptible to gaslighting from others, and I will address this in a separate article.

In my work with neurodiverse couples in which one partner is autistic, one of the words I hear most often is “gaslighting.” Here’s an example:

“It would be one thing if we just fought like other couples who eventually make up. But that’s not how it is with us. Instead, we argue about something, and he tells me I’m being irrational. Or childish. Or critical. Then he shuts down. Often, he storms out of the room. If I try to bring it up later, he tells me I’m imagining things, that he didn’t say that, or if he did say it, he didn’t mean it the way I took it. He says I’m being too sensitive. And he shuts down again. I’m left feeling as if I’ll explode with frustration. I’m furious. And I have nowhere to go with it. I start to wonder if he’s right about me. I don’t know what to believe anymore. Is this gaslighting?”

Gaslighting Defined

In brief, gaslighting is a term that derives from the 1944 movie called Gaslight in which a husband successfully manipulates his wife into doubting her own reality. The husband in the story has a dark secret which is at the root of everything he says and does to his wife. To him, she is not a person with her own interior life. She is a pawn in his selfish game, which until the end he plays shrewdly enough to cause her to doubt her own version of reality.

“Instead, we argue about something, and he tells me I’m being irrational. Or childish. Or critical. Then he shuts down. Often, he storms out of the room. If I try to bring it up later, he tells me I’m imagining things, that he didn’t say that, or if he did say it, he didn’t mean it the way I took it.”

In reference to the flickering gaslights in the story, this effect has become known as gaslighting: intentionally treating a person in such a way as to cause confusion and cognitive dissonance, which eventually lead to collapse into self-doubt.

Of note is that at the heart of the husband’s motivation is a desire for riches, symbolized by jewels. This part of the story is often overlooked, but it is worth consideration when we are talking about autistic behavior.

Questioning Reality in Neurodiverse Relationships

First, let’s return to the comments of the neurotypical partner I quoted above. One way to view her statement is in terms of gaslighting, just as it is laid out in the movie.

In this model, time after time, incident after incident, she is cajoled into questioning what her own eyes, ears, and heart are telling her. Finally, she gives up. She begins to believe the mirror her partner holds up to her reflects an accurate representation of who she is. In order to believe that, she has been forced to discount any impulse of her own that contradicts such an image. She collapses into self-doubt. His manipulation has succeeded. Does this make him right? His smugness suggests that he believes so. He feels clever. He has won.

What would motivate someone to treat another person this way? Such manipulation may be observable in certain personality disorders, such as narcissistic personality disorder (NPD), antisocial personality disorder, and borderline personality disorder (BPD). In short, it is not healthy to intentionally set out to dominate someone else by negating that person’s reality. Such individuals leave a trail of emotional wreckage in the lives of others. Shelves full of books and countless hours of therapy are devoted to helping those victimized by such manipulators.

Looking Beyond the Behavior: Self-Protection

Behind the behavior of the personality disordered, there is an unconscious drive to protect that which feels threatened, which is usually the person’s self-worth. In twisted logic, anything that might compromise such fragile emotional integrity must be extinguished at all costs before it can extinguish the very life of the manipulator. This may be felt as desperation.

As a result, manipulation can be rationalized. It may not be viewed as a choice but rather as a necessity for survival. Incidentally, there is no respect for someone who can be manipulated, which makes further mistreatment easier and may even be viewed as what the person deserves.

But this is not the motivation of someone with autism.

The Tragic Dance of the Neurodiverse Couple

The jewels an autistic person guards could best be described as personal integration and a sense of security in who he is. Threats may come from feeling overwhelmed emotionally in the face of what seems like unmanageable ambiguity and uncertainty, which often lead to untenably high anxiety. Reducing that anxiety, consciously or not, is the most likely driver for behavior that appears to be gaslighting in someone with Asperger’s.

Reducing that anxiety, consciously or not, is the most likely driver for behavior that appears to be gaslighting in someone with Asperger’s.

Often, this person is oblivious to the harmful effects of his behavior and doubts the validity of someone’s observation that it might be gaslighting. The fact is that I have never met an autistic person whose conscious intent is to manipulate his partner.

But the key phrase is “conscious intent.” Because even though a person with Asperger’s may not mean to manipulate (gaslight) his partner, her actual experience is the same as it would be if intent were there.

In short, we have a couple in which one partner feels as if he is fighting for survival and another partner who feels as if she is fighting for survival, and in a two-way charge, one person’s means of doing so obliterates the reality of the other. It is what I call the tragic dance of the neurodiverse couple.

Addressing the Tragic Dance in Couples Counseling

The autistic person can learn in counseling that his behavior has the effect of invalidating his partner’s emotional life. He can come to understand that even though he does not intend to inflict such pain, the effect is real. Her dismayed and perhaps argumentative behavior is how a neurotypical person might justifiably respond to what feels like manipulative behavior from someone else. She is not trying to criticize him. She is trying to express her pain.

More often than not, this realization is met with deep remorse and often guilt. In time, he can learn to understand his own way of being in the world without judging himself harshly as being wrong or defective, because that is not the correct metric. Emotional support for him is key to his growth in this area.

The neurotypical partner can learn, first and foremost, that her response to feeling manipulated is normal. Her pain and confusion are normal. They are valid. She must be allowed to acknowledge and heal her wounds, because it doesn’t matter whether she was stabbed intentionally or inadvertently: she is still bleeding.

The second step, though, is to begin to understand that her autistic partner is not trying to hurt her; instead, what she experiences as manipulation is his way of trying to reduce omnipresent anxiety, which usually derives from a lifelong experience of not quite getting things right when it comes to understanding someone else’s emotions. She needs emotional support in order to move forward. At the same time, she also has to come to terms with the fact that her partner’s way of offering this support may not align with her idea of what that support must look like.

The way to view communication in a neurodiverse couple, or any couple, is in terms of its effectiveness. This is the only metric that matters. It’s not a matter of who is right or who is wrong. The goal of communication is mutual understanding. In order to improve communication skills and strategies, recognizing differences with an effort to respect them without judgment becomes the foundation for growth in the relationship.

When I work with couples, we concentrate on slowing down conversational speed, considering linguistics and the formal logic of argument, and identifying the emotional subtext and context inherent in communication. It takes time. It takes practice. It is not always successful. When it is, it can be described as a process of two steps forward and one step back as two parallel lives learn to build bridges between two lines that will never completely merge.

Learning to trust deeply after years of being hurt, having the faith that being vulnerable one more time might be worth the risk, accepting that one’s interpretation of another’s behavior may not be the same as that person’s intent: these are the challenges.

It can’t be gaslighting without the intent to manipulate. Regardless, it can feel like gaslighting. Education about neurodiversity, skilled counseling, and communication in renewed mutual respect create the tools for interrupting this revolving door.

Reference:

Gaslight (1944). (n.d.). Retrieved from https://www.imdb.com/title/tt0036855

In the past month alone, I have had two new clients report egregious ethical violations from their previous therapists. In one case, a male therapist made repeated narcissistic advances toward a woman who came to him to unravel the trauma of her ongoing divorce proceedings. This therapist repeatedly told the client details of his personal life which had no bearing on her therapy, and which frankly shocked me both in their content and in the manner in which he presented the information. The client ultimately stopped the counseling relationship, which the therapist was reluctant to sever.

In the other, a female therapist repeatedly fended off efforts to discuss the client’s presenting trauma, sent the client a social media friend request, and invited her on a weekend getaway with no therapeutic agenda. This therapist then abruptly abandoned the client with no stated reason and no offer to refer to another counselor.

In both cases, the clients felt responsible for the well-being of their therapists. They both experienced the breach of the relationship as abandonment. Remember that these individuals sought counseling support for their own trauma and pain and were vulnerable and trusting of the professionals they chose as their therapists. Rather than being seen as individuals in distress by these therapists, they were grossly mistreated and re-traumatized.

My work with these individuals involves not only support in easing the original distress, but also creation of a strong therapeutic bond when both clients are ambivalent and defensive about exposing themselves vulnerably to another counselor.

This infuriates me, as it no doubt infuriates you. What can be done if you experience something that feels off in your relationship with your counselor?

First, trust your instincts. Trust the way you feel both during the session and particularly afterward, when you’ve had time to recognize and identify your emotional response to a conversation. Sometimes, during a session it is possible to feel flooded and overwhelmed, so your reactions may not be clear to you until later. This may be a subtle discomfort that you can’t seem to put your finger on, or a more specific discomfort about a particular comment or behavior from your therapist. You may feel misunderstood. You may feel “dirty” or shamed. You may feel confused after having asked questions that did not get answered to your satisfaction.

If you feel your therapist is behaving unethically, the first thing to consider is bringing it up in session. Express your concern. Ask for clarification of something that doesn’t make sense to you or doesn’t feel right. If you don’t feel confident in the response you get, please terminate the relationship.

Also, remember that you chose your therapist carefully. You therefore expected professional expertise and ethical behavior, so you may be holding a cognitive bias in favor of the therapist. This can lead you to doubt yourself and the validity of your reactions, instead of questioning the therapist’s behavior or treatment.

Skilled therapists can help you move forward in your life, which is the reason you seek counseling support in the first place. Most therapists are sensitive, competent professionals who hold your best interests and work conscientiously on your behalf. But every now and then, for whatever personal reasons, therapists depart from the norm into ethical violations that harm their clients.

If you feel your therapist is behaving unethically, the first thing to consider is bringing it up in session. Express your concern. Ask for clarification of something that doesn’t make sense to you or doesn’t feel right. If you don’t feel confident in the response you get, please terminate the relationship.

All licensed therapists are governed by the laws of the state that grants them the license to practice. You can file an ethics violation complaint with the licensing board. Sometimes, doing so may feel like adding more pain to your experience, which you may prefer to put behind you and move on. I understand this reluctance. But consider making an inquiry at the state board and at the therapist’s professional association (you can identify this by the letters after the therapist’s name—LMHC or LMFT, for example) to learn about the specific steps involved in submitting a complaint. Then you can decide whether to proceed. It is entirely up to you. Bear in mind, though, that if a therapist has behaved unethically with you, it is possible this is happening with others as well. Yours may not be the first complaint of an ethics violation.

One last word: Please do not let a bad counseling experience deter you from finding a skilled therapist. Search directories (such as GoodTherapy) for your specific geographical region and your specific concerns. Select a few therapists for contact, then request a brief telephone chat. Once you select a new therapist, please share your experience in session so you can get the relief you need from the burden of your previous counseling encounter, which you may still be carrying.

Author’s note: To protect the privacy of all concerned, I changed the client and therapist details while remaining true to the nature of the ethical breaches described.

Many people think sarcasm is harmless humor. But for those on the receiving end, it can feel like a subtle wound that lingers long after the words are spoken. If sarcasm has left you feeling hurt, dismissed, or misunderstood, you’re not alone. Many people find that consistent sarcasm can chip away at trust and self-esteem.  Understanding why sarcasm can hurt—and how to respond—can help protect your emotional well-being.

Understanding What Sarcasm Really Is

I was surprised recently by a discussion among a group of therapists describing how they use sarcasm in their personal lives with children and spouses. I had assumed they would understand why that’s probably not a good idea. Why? Because sarcasm isn’t humor—it’s hostility. And it makes people feel bad.

It may be challenging to accept this, especially if your first reaction is to defend sarcasm as “just joking.” Some believe sarcasm is a sign of high intelligence. Well, no. Well-developed wit is a sign of high intelligence. Wit is insightful, showing us the world in a new way. Great wit is a high art.

Sarcasm, on the other hand, comes from Greek roots meaning “tearing of the flesh.” It’s hostility disguised as humor. If you challenge a sarcastic comment, the person can quickly retreat with “What? I was just kidding!”—but it doesn’t feel like kidding. It feels like veiled criticism.

Why Sarcasm Can Hurt More Than It Helps

For some individuals who identify as highly sensitive persons (see the work of Elaine Aron), sarcasm can feel especially biting. Even those who don’t identify as highly sensitive often respond negatively to sarcasm, whether they show it or not.

Think about the last time someone made a sarcastic remark directly at you. Maybe they commented on your “ballet shoes” when you were wearing hiking boots, or said, “Take all the time you need. The rest of the world can wait.” Did you feel appreciated—or hurt? Did it help strengthen your relationship?

Sarcasm and Passive-Aggressive Communication

We often hear the term passive-aggressive to describe someone whose default mode is sarcasm. On the surface, their words may seem neutral, but underneath lies another meaning—often irritation, resentment, or disapproval. This hidden edge can make sarcasm feel deeply personal and emotionally unsettling.

These passive-aggressive undertones can make sarcasm feel especially personal, leaving lasting emotional impact. Sarcasm directed at an individual can also be a sign that the speaker is unwilling—or unable—to communicate openly about what’s bothering them.

How to Respond When Someone Is Sarcastic

If you’re dealing with someone who regularly uses sarcasm, it may have become a habit disconnected from their conscious intention. Over time, sarcasm can mask an underlying psychological pattern, making it harder for the person to recognize how it affects others.

You can respond by calmly describing the impact of their remark. For example:

Helping someone see how their sarcasm feels—without attacking them—can sometimes prompt reflection. And you can assert that yes, you can take a joke, when it’s truly a joke and not veiled hostility.

Healthier Ways to Communicate Without Sarcasm

Remember that you are entitled to feel discomfort when someone directs sarcasm at you. Sarcasm is not clever wordplay—true wit is clever wordplay.

If you find yourself leaning on sarcasm, consider what you’re really trying to communicate. Could you say it more directly? Or would it be kinder left unsaid? If you hear someone describe “biting sarcasm” as a high art, remember: the “bite” is often what makes it hurt.

When to Seek Professional Support

If sarcasm is creating tension, misunderstandings, or emotional distance in your personal or professional relationships, a therapist can help you address communication patterns and develop healthier habits. Therapy provides a safe space to explore what’s beneath sarcasm—whether in yourself or in others—and to strengthen trust in your connections.

Questions to Ask Your Therapist

The GoodTherapy Commitment

For over 17 years, GoodTherapy has connected people with ethical, qualified therapists who respect client autonomy and dignity. If sarcasm or passive-aggressive communication is affecting your relationships, you do not have to navigate the challenges alone. A compassionate therapist can help you build healthier communication habits and strengthen your connections. You can find a qualified therapist here through GoodTherapy’s trusted directory.

Autumn scenery with fantasy castle, lake and mysterious person in a boatThe specific era in which a person begins to bridge the gap between childhood and adulthood doesn’t matter, relative to one prevailing fact: it is difficult. Volumes of the world’s literature are devoted to this phase of development, acknowledging the fundamental nature of coming of age as one of life’s greatest crucibles. Psychologists call it individuation, a time in which a healthy young person extricates themselves from the known world of childhood and forges an independent personality and experience.

In a perfect world, this struggle has two distinct poles: enmeshment (in the family unit as a child) and independent identity (as an adult in the world). The result of the struggle is the psychosocial location of an individual, which is the basis for their future and the point of view from which all that is to follow is experienced.

But never in history has the world been perfect. The struggle is messy and often incomplete until well into what we would call adulthood: what becomes, for many, a life of work, mortgages, and child-rearing.

What Role Does Higher Education Play in Individuation?

The concept of psychological adolescence itself is relatively new. As most people know, children historically worked in the fields, in the mines, and later in workshops. It wasn’t until after World War II that Western cultures provided the opportunity for the extended time of self-discovery we call the teenage years, as millions of baby boomers left their burgeoning high schools for university campuses and the wide world of liberal education. [fat_widget_right]

College days were for academics, of course. But an equally significant aspect of the four years of college was the time spent exploring what it means to be human, and to be one unique human being in particular. What was studied in class was pondered and discussed and challenged. Through the informal means of sharing questions with peers, hearing converging points of view, and discovering conflicting values, coursework became integrated into personhood. College was a living science experiment, and the result was self-awareness and a sense of responsibility to others beyond oneself.

This is the part of higher education that is often left out of arguments declaring the uselessness of college degrees, specifically degrees in the liberal arts, which are at times devalued and even ridiculed. In my opinion, this denigration is a tragedy.

Liberal does not describe politics in this context. It refers to the freedom encountered by the open mind. And with freedom comes responsibility, which Freud acknowledged as the reason many fear it. Gradual exposure to and development of the notion of responsibility is one of the fruits of liberal education. Without exposure to the liberal arts, where will our thinkers come from? Who will be poised to discern the greater welfare? How will compassion erupt from a field devoid of the experiences engendered by self-exploration and exposure to the vast world presented to college students in literature classes, through philosophy, through art? And if there is no sense of history and the nature of human cycles, where will temperance come from?

Gradual exposure to and development of the notion of responsibility is one of the fruits of liberal education. Without exposure to the liberal arts, where will our thinkers come from?

Sensitive young people today continue to struggle with these questions. Many are still drawn to the liberal arts in a culture that values STEM (science, technology, engineering, and math) degrees. They may be tuned into nuance and subtlety by nature of their intelligence and emerging maturity, but they are growing up in a divisive culture in which these characteristics are often trampled in the public square, where false equivalencies seem to abound and divide.

Before they know where they stand, they may see that making determinations about their own values will probably align them, like it or not, with one side or another in the culture wars of zero-sum politics. But STEM degrees are simply not for everyone. And industry is beginning to show that more is necessary for success in the workplace than technical knowledge of a field, as Google recently revealed.

Using Fantasy to Cope with Difficulty and Distress

Many therapists may be increasingly seeing a manifestation of this heightened sense of not fitting in, not to mention the other pressures facing today’s young adults, in young people seeking help who prefer to discuss with fervor their fantasy worlds of elves, unicorns, and diverse realms of the imagination. Generally, it is not prudent for us to pathologize this. More often than not, an intense focus on fantasy indicates life distress that points directly to the difficulty of coming of age in these divisive times. As a therapist, I open a discussion to explore the personal particulars of this difficulty in the hopes of helping those I work with develop skills for understanding the world around them.

My goal is to help them bring into their daily lives the same energy and determination that allows them to challenge evil and dragons in the worlds of their imaginations, even in the face of what seems like great odds. There is power in these strong attachments to imaginary creatures and dilemmas. To channel the power into an adolescent’s path toward maturity can further personal growth and help the adolescent become a strong individual. The touchstones for confidence derived from fantasy attachments can easily last a lifetime.

The divisive nature of today’s political environment is part of a cycle, one that, I believe, will pass. History is full of examples left to us by those who faced these struggles before us. The contributions of Goethe. Michelangelo. Shakespeare stand alongside those of Galileo, Curie, and Einstein. Together, their imaginations have kept the flame lit for us for generations. As always, our youth is our hope.

If struggles in the realm of the imagination can help youth navigate reality, as a tool these struggles become powerful. Unicorns and elves have potent magic, and I believe it is of benefit to let our youth be guided by their symbolic value, not dismissed as escapists.

We can begin with the small step of acknowledging the undue pressure we place on students whose natures lead them toward the liberal arts, and we can continue by allowing them their fantasies. Middle Earth has much to offer, and who are we to judge the chosen instrument of deliverance for a generation? We are not of their time. We do not know. We can only offer support and do our best to keep from harm those who come after us.

Reference:

Strauss, V. (2017, December 20). The surprising thing Google learned about its employees—and what it means for today’s students. The Washington Post. Retrieved from https://www.washingtonpost.com/news/answer-sheet/wp/2017/12/20/the-surprising-thing-google-learned-about-its-employees-and-what-it-means-for-todays-students/?utm_term=.b9239650a30d

Sisters on the floor together, coloringMaybe there is an increase of bullying in our society. Maybe there is an increase in awareness. Either way, it is getting a lot of attention these days. Teachers and parents are sensitized to the signs of bullying and are becoming more skilled at breaking the cycle and protecting bullied children. But what happens when the bully is not a classmate or a teammate or a neighbor? What happens when the bully is in the victim’s own home? Recent research in Great Britain suggests the effects are severe and long-term.

Since time immemorial, siblings have pried their way under each other’s skin. Arguing and jockeying for position in the family are part of growing up. The problem is that sometimes parents misunderstand what they are witnessing in their children. What they view as sibling rivalry can actually be bullying. There is a simple way to tell the difference.

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When two children are sparring, it is easy to observe that they are both upset and both engaged in the clash. Parents can intervene and set the rules of engagement, teach the value of mutual respect, and offer children templates for managing disagreements at home and with those they may face in the world outside the home. But when one sibling is bullying another, it is only the bully who is engaged and seeming to delight in the taunting. The bullied child is miserable. The only response for parents is to stop the bullying. Period. There is no false equivalency: they are not equally at fault. There is no need for mutual apology. There is only stopping the aggression and offering solace and protection to the victim.

Most sibling bullying takes the form of name-calling and insults, both of which are passive-aggressive behaviors the bully can deny when confronted. “She’s taking it too seriously!” “She started it!” “If she weren’t such a brat, this would not have happened.” It is never the bully’s fault. The bully loves to play the role of victim. And the bully can be very convincing to parents who are too distracted or too exhausted to figure out what is really going on.

Meanwhile, the victim—for the purposes of this article, we’ll use young girls as our examples—feels unsafe in her own home. She returns from school with dread every day, emotionally defended and prepared for a shellacking by her sister, who can be older or younger than she is. She learns that her parents cannot or will not intervene on her behalf. She feels defenseless and begins to doubt her own perception. It is a form of gaslighting: the bully sibling makes the victim wonder whether she really is the nasty, incompetent, bratty person the bully is telling her she is.

The likely victim in sibling bullying is the child who is sensitive and thoughtful. The bully is likely to have problems which the parents do not see. These can be related to being bullied herself at school, for example, or they can be the result of transferring the effects of her own trauma onto someone else. Often in dysfunctional families where a child feels unsupported or ignored, that child will take it out on a sibling because for any number of reasons she fears that going directly at the parent would crash her own fragile world, regardless of how unpleasant it may be.

There are also other, less obvious, explanations for bullying a sibling. Children can have personality conditions, just as adults can. The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers a diagnosis of oppositional defiant disorder to describe children under the age of 18 who exhibit behaviors devoid of compassion and empathy for others. The adult version of this is antisocial personality. This is a potentially serious problem.

It is a daunting situation for a parent to face the possibility that a child might need psychotherapeutic care. Sometimes, it is more than parents can bear to face. They feel ashamed, somehow responsible, for the behavior of their bullying child. Though bullies crop up more often in families with trauma, alcoholism, or other chronic dysfunction, these components are not always in place. Sometimes, with all the best of support and parental supervision, children need help from professionals. Bullies generally are not happy people, as children or as adults.

If you’re a parent, closely monitor your children’s arguing. Be certain that’s actually what you are seeing. If the playing field is not level and one child enjoys the other child’s distress, you are not looking at normal sibling development. You are looking at bullying, and your role as a parent is to stop it immediately.

But there is plenty of material available to parents to help them disarm bullies. My concern here is with the victim. Often, it is the victim who is told by well-meaning parents either to ignore the bully or to fight back. Neither of these approaches feels possible to the typical victim child. And neither is effective, anyway: ignoring a bully is tantamount to goading her, and fighting back is unrealistic advice for a child whose temperament is neither adversarial nor combative.

She is at risk for low self-esteem, depression, and even self-harm as a result of being bullied by a sibling who renders the home an unsafe place. Where is the victim to go? Children have neither the means nor the power to remove themselves from an environment that is so painful. She is stuck enduring the grief until she can manage to leave home for college or move on to the workforce and her own apartment.

But she is insufficiently prepared. She might develop a sarcastic style, for example, which pushes people away from her when she most needs contact with others and trusted friends. She is deeply wounded. She rejects herself the way her bullying sibling rejected her for all those years. She does not feel lovable. She is deeply sad. And she doesn’t understand why. These consequences can go on for a victim’s entire life. She can forever struggle with self-doubt and negative self-talk, taking over the belittling work of the bully long after both have left home.

A sensitive and talented child can remain hobbled if sibling bullying is left unaddressed. It is not unusual for bully and victim roles to continue well into adulthood. If the victim marries and has her own children, and then finally comes to see it is in her best interest to sever relations with her bullying sibling, her own children and family may condemn her for what they do not understand, and which she is unable to adequately explain.

If you’re a parent, closely monitor your children’s arguing. Be certain that’s actually what you are seeing. If the playing field is not level and one child enjoys the other child’s distress, you are not looking at normal sibling development. You are looking at bullying, and your role as a parent is to stop it immediately. This is in the interest of both the victim and the bully.

If you are an adult struggling with the confusing long-term damage of having been bullied at home, supportive counseling can help you understand yourself better. You can address why you were unable to defend yourself as a child (likely because you didn’t understand what was happening) and that it was your parents’ responsibility to intervene and protect you (which they didn’t, for reasons unique to them). You can also unravel the roots of any current problems you may have with confidence and self-worth. Please don’t be surprised if they derive from the way your sibling treated you as a child. And please be alert to the possibility this behavior may be continuing toward you in the present. Counseling can help you identify ongoing toxic relationships in your family of origin and guide you toward setting boundaries in order to stop behaviors that are harmful to you.

It is unlikely you can disarm a sibling who bullied you as a child and who is now an adult. Adult bullies tend to become ever more adept at the plausible deniability inherent in passive-aggressive behavior (“Oh, that’s not what I meant,” for example, when you try, however cautiously, to hold them accountable for poor behavior). This isn’t to say change isn’t possible.

Finally, it is important to remember that no happy person would choose to bully another, regardless of their insistence that they are happy and you are the problem. Compassion you may feel for the bully can only take you so far, however. You must also take steps to guard yourself from the ongoing effects of their continued disrespect toward you.

Reference:

Bowes, L., Wolke, D., Joinson, C., Lereya, S. T., & Lewis, G. (2014, September 8). Sibling bullying and risk of depression, anxiety, and self-harm: A prospective cohort study. Pediatrics. doi: 10.1542/peds.2014-0832

Cropped view of arm and skirt of person who is holding a lit lantern to walk through a dim forestGaslighting is in the news these days. In simple terms, to gaslight is to treat another person in a way that makes them doubt their own perceptions. We can see this behavior on a large scale with a manipulative politician who demands acceptance of his falsehoods, as well as in the very personal realm of the intimate relationship, when one partner’s narcissistic needs create the conditions and terms for partnership.

A woman under the sway of such a person—narcissism isn’t gender-specific, but I use a woman-man relationship here for narrative purposes—faces a difficult challenge in her attempt to break away. She may be told her version of the story is false and that she is wrong, even stupid, to believe it. She may be derided and condemned in proportion to the depth of the narcissistic wound experienced by her tormentor. She may depart with only one thing: her quiet hope that breaking away from this man will be better than staying, no matter how unimaginable and unpredictable the future might seem.

To leave, she may have to muster more courage than she has ever before needed. Her sense of who she is may collapse around her. It may take quite some time for her to sort out what has happened, to release the hold that guilt and shame have on her, and to begin to feel whole once again.

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What is the greatest long-term price such a woman may pay? To answer this question, a woman might benefit by looking back to the beginning of the relationship. It is paramount she do so believing she did the best she could at any moment, though her temptation will likely be to judge herself harshly for not having seen what may now be obvious to her.

Because here is the challenge: it is the insidious nature of gaslighting abuse that makes it so difficult to identify at the outset of a relationship. To be a victim of gaslighting is to be the legendary frog in a pot of water that is placed over a low flame. The water temperature rises gradually, imperceptibly. At a certain point, however, the frog will boil to death unless it can summon the strength to jump to freedom. To escape, it must be able to recognize its extreme distress. Gaslighting, however, gradually creates an environment in which awareness of one’s own feelings becomes less and less possible. Gradually, a woman learns to dismiss her own intuitive responses. She is subsumed into the narrative created by her partner, and her role in that narrative follows his script. She becomes an actor in someone else’s play.

Sometimes, it is a trusted friend who intervenes on a woman’s behalf by helping her see and believe how much she has changed, and not for the better, since getting involved with this man. Sometimes, it is a sense of being utterly lost. Sometimes, she comes to a decision to extricate herself only after a suicide attempt.

But there was likely a time when she looked to this man for love, comfort, harmony. She felt secure in what he told her about his feelings for her and about the nature of their mutual affection. It was her nature to believe him rather than to be skeptical, even on early occasions when things might have seemed a little off to her. She rushed to understand him. She placed her faith in him. He betrayed it.

By a thousand little acts of turning away from her, by subtle yet repetitive dismissals, by overt challenges to her right to think for herself, he betrayed everything she valued. And because she loved him, she allowed these little currents to build gradually to tsunami force, telling herself she was being too critical, or that he didn’t really mean it, or that she deserved such treatment for being so cold/mean/hostile to him. Her internal voices became as critical of her as anything her partner ever said. Even after a period of healing, and once she has begun to feel a semblance of stability re-enter her life, she can still be left with the residue of this betrayal.

She may wonder whether she can avoid having to pay forever for involvement in gaslighting and hostility. The answer is yes, she can. Learning to do this is an inside job, for what is the most precious thing her manipulative partner has taken from her? It is her faith in herself, which includes her ability to trust her judgment.

The greatest price she may pay for her partner’s gaslighting is this: she now doubts her own judgment. She doubts her ability to see manipulation early enough to avoid repeating her costly mistake. She struggles to trust another partner. With this fear of extending trust once again, she risks sabotaging any future relationship due to apprehension about entering new trauma. If she begins to date again, she is circumspect. She wonders about everything her partner says. She looks for evidence of early betrayal, infidelity, lies. She becomes a person so consumed with a readiness to be betrayed that she kills any chance for a healthy relationship.

At this point, she may wonder whether she can avoid having to pay forever for involvement in gaslighting and hostility. The answer is yes, she can. Learning to do this is an inside job, for what is the most precious thing her manipulative partner has taken from her? It is her faith in herself, which includes her ability to trust her judgment. This is where true healing can begin: she must see there is no such thing as deserving to be mistreated. There is no such thing as being wrong all the time.

In fact, there is no such person as the woman her former partner repeatedly told her that she was. That person was a fabrication, a creation of an imbalanced imagination. This phantom was projected onto her as someone he needed to dominate in order to assert his own importance, to give significance and meaning to his own poorly developed version of himself. Unchecked, he may spend his life creating these personas from the raw material of those who will love him in the future. And he may continue to create landmines and battlefields that leave them in as much pain and trauma as she, herself, once experienced.

It is time for her to embrace the embattled woman, the one who shouldered all the blame and harshness from a man with low emotional capability. For his own purposes, he poured her into a mold she neither chose nor fit. She can see this now. She can move forward with compassion for herself and guard her emerging awareness that she is the equal to any person of good faith, kind heart, and empathetic involvement in the lives of others.

She is worthy. By making a promise to safeguard this realization, she can trust herself to recognize the difference between someone who is present to her in all her glory and her faults, and someone whose emotional wounds might make him dangerous to her generous heart. She will be back in touch with the intuition that guided her life before she was derailed by the driving needs of her gaslighting partner.

This former partner has no further claim on her, once she sees clearly that the net he cast around her emanated from him and did not define her. She may not have realized it at the time, but she can now see clearly that all the tumult and the drama originated on his side, which is where she left it when she walked away from him.

She will love and be loved again. She does not have to wonder about the man who hurt her, as his path is of his own creating.

Just as her own will be.

Person in gray skirt suit stands under spotlight, head bowed, in red-toned roomIn biblical lore, Aaron selected a goat on behalf of the entire tribe, cast upon it the sins of all members, and then banished it alone to the wild. The members of the tribe were then at great ease, having been freed from their cast-off sins—whatever those sins may have been.

Everyone felt better, though they had neither identified their specific sins nor atoned for them. They had simply agreed to hang them on the goat. If this spurious logic was obvious to anyone, it was not discussed. Why question an agreed-upon means of making everyone feel better?

Now about that goat. It was selected from the herd and sent forth into the wilderness for reasons having to do with the sins of others. The goat had done nothing to merit banishment. But once the ashes were cold on the rituals of dispatching it, the goat found itself alone in the wilderness, isolated from its herd, in unknown territory, suddenly forced to fend for itself. It faced dangers from predators; difficulty finding food, sustenance, and shelter; and it lived the constantly woeful insecurity of a herd animal without a herd.

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This is the story of the scapegoat.

In dysfunctional families, for reasons similar to those Aaron devised, there can also be a designated person selected for the role of scapegoat. In a family system, the selection process is less overt than Aaron’s. It is done more by consensual and habitual shunning that becomes an unspoken code of behavior: one person is chosen to bear the brunt of any psychological discomfort experienced by the family as a whole. It is justified by repeating the stories that create and then reinforce the image of the scapegoat as being a person who is worthy of disdain and disparagement.

Like the strong goat Aaron selected, the target of family scapegoating is also often the strongest and healthiest member of the family. At first blush, this may sound counterintuitive. But think about it a little more. In Aaron’s case, there would be no group pleasure derived from banishing a weak animal who might easily die anyway, because that would not gratify the needs of the tribe to send off their sins on a robust vehicle, a strong goat who was up to the task of bearing the burden. So it is in families: the targeted individual is often the most accomplished. She—and for the purposes of narrative cohesion, our scapegoat is a female here—must be strong enough to withstand the weight of the shunning voices which might easily and quickly topple a weaker person. The scapegoating would fail if the weight of the sins killed the goat before it could even get chased out of town. Catharsis is the goal. The goat needs to be strong enough to suffer in order that the tribe members do not.

Just as the goat was blameless despite being sent to its lonely death, so is the human scapegoat innocent of all charges. She may not be a perfect human being, but she is no different from anyone else in her range of faults. It is not her character or her actions that have directly caused her banishment. It is the way her character and her actions, and often her accomplishments, have been experienced by the dysfunctional family members, who for their own unexamined reasons need to dispel this person from the family realm in order to avoid looking into their own consciences. They need to punish the scapegoat for provoking by her very existence the discomfort family members are feeling that is actually a result of their own unresolved issues.

If you are being scapegoated in your family, please seek professional help. You are not likely to be able to intervene in a dysfunctional system that treats one of its own members in this way. You may continue to experience the futile attempts at explaining yourself. You may fail to understand the way you are being treated. You may begin to doubt your own version of your life story. The price is too high.

Can a human scapegoat die like the goat of yore? Maybe. If not physically, certainly emotionally. It is difficult for the scapegoat to believe that her family would treat her in this unconscionable manner if she were not guilty of some grave sin. She wracks her brain and her heart to understand, but she cannot. The reasons she is given for being mistreated seem shallow, petty, and incomplete. It is difficult for her to believe these small transgressions could warrant such heavy condemnation.

She begins to doubt her own version of reality, since consensus in her own family supports a narrative different from her own about who she is and what she does or has done. She learns that if she tries to sort this out, she will be accused of “playing the victim” or being selfish, or being a “drama queen.” She is able to hold to her knowledge that this assessment and treatment are not right, until one day, utterly discouraged, she gives up. The full weight of the banishment settles upon her. She is alone. She doesn’t try to understand or explain anything anymore. She has moved into accepting a fate that makes no sense to her.

Good mental health at this point suggests she make her peace with leaving behind the family that fails her so completely. And if she is strong and well-supported with friends, she may be able to do this. She will pay a lifelong price for sins she did not commit, however, because it is difficult and painful to extract oneself from one’s family. It is counter to the most basic of human needs for home, shelter, affiliation. It is a cruel and inexcusable undertaking for a family to scapegoat a member.

If you look at the research regarding the fate of individuals who have been relentlessly bullied, you can draw conclusions about what happens to scapegoated family members, for scapegoating is bullying with focused and long-term intensity. Some bullied children go on to become bullies themselves. Some develop social skills to divert and challenge bullying, though the scars of having been bullied may insert themselves into their lives in many ways for many years to come. Others, however, do not survive, driven to suicide.

If you are being scapegoated in your family, please seek professional help. You are not likely to be able to intervene in a dysfunctional system that treats one of its own members in this way. You may continue to experience the futile attempts at explaining yourself. You may fail to understand the way you are being treated. You may begin to doubt your own version of your life story. The price is too high. Please find a counselor who can help you unravel the fictions that subvert the truth about your life and about who you are. Good counseling support can help free you from the binding ties of pain, guilt, and shame that you did not create and which are not justified.

You were not born to bear the sins of others any more than Aaron’s goat was born for such a fate.

Black and white photo of blurred reflections of passersby “Narcissism.” This word is tossed around easily these days. Because people hear it so often, they tend to think they know what it means. This is often what happens when a clinical term enters the vernacular. But take a minute. What is your understanding of the word? Now ask three others the same question. I will bet you end up with four different answers.

Think about conversational use of “psychopath,” “sociopath,” “bipolar“, “OCD“, or “autistic,” to mention a few more. Two of those words have no clinical meaning at all, and the others are not likely to be understood accurately by anyone outside the health professions. Again, definitions likely vary from person to person.

So why is their use so pervasive?

To use a word is to align with a group that agrees tacitly upon its definition: to join the group of people who believe they understand the innuendo of its colloquial usage. You call someone a psychopath, for example, and you believe that others are likely to think you at least mean the person acts without regard to the welfare of others, often in a criminal manner. That’s just a sliver of the actual components of antisocial personality, the real clinical term that describes what people think they are saying with “psychopath,” but no matter. The word “psychopath” is unlikely to fall from the American lexicon anytime soon. The same goes for the slippery common usage of the other terms mentioned above.

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It is also a way to use shorthand to describe more complex thoughts. Speaking in buzz words such as “psychopath” or “narcissist” is to speak with semaphores, abstractions. You assume meaning is implied. Remember, for example, that people visualize different shades of color when you say “red” or “blue.” That’s why we say “crimson,” “scarlet,” “vermillion,” “azure,” “cerulean,” or “sky.” We try to be specific when we describe color in order to communicate accurately. Why not be as specific as possible when describing your own reactions?

Another possible reason for using terms like these is because it might seem more educated to call someone a psychopath rather than a thoughtless and selfish bully. If you really understand something well, however, you are able to explain it to a child. Using impressive words sometimes masks insecurities, and it can also be an unconscious attempt to deflect attention from otherwise vague understanding.

It is not just the language of mental health that gets eviscerated and co-opted in this manner. People often claim that something begs the question, for example, which is a term borrowed from formal logic. (To “beg the question” means to “assume something you’re trying to prove,” instead of proving it. It doesn’t mean forcing the question.)

People say someone is “libel” when they mean responsible, which no doubt makes lawyers cringe. And you hear climate change disparaged as “just a theory,” a dismissal that demonstrates a miscomprehension of the scientific method.

It is difficult to look at any news source without stumbling upon a discussion of the supposed narcissism of Donald Trump. Is it inaccurate to use this word when talking about the Republican candidate for presidency of the United States? His behavior suggests there is a reason the word “narcissist” seems to be everywhere these days. I suggest there are better, more specific words that would describe it with undeniable precision. No diagnosis is required to speak about him in meaningful terms.

When you hear Trump speak, what do you feel? What do you think? When you watch his posture and gestures, what is your reaction? What thoughts does his presentation evoke from you? This is interesting stuff. This is what your friends want to know about you. By providing it, you give them permission to go deeper in their own comments and articulate their own personal responses with greater discernment.

Anyone can apply insight to watching Donald Trump and describe his manner, behavior, and persistent views with knife-like accuracy. Borrowing clinical terms actually dilutes this accuracy. Go for articulating your opinion in your own meaningful language instead.

The Goldwater rule is the colloquial name of an aspect of medical ethics that the American Psychiatric Association developed after certain psychiatrists put forward their purported psychological evaluations of Barry Goldwater, the Republican candidate for the presidency in 1964. These psychiatrists claimed that because of his mental status, he was not fit to be president. He sued for libel and won.

APA ethics have since required diagnoses to be made only when someone is a patient or client, rather than based upon observations of someone in the public eye. This makes many mental health professionals duly wary about making public declarations.

It is certainly worth examining our daily language for hollow words such as “narcissist.” For example, is it really so bad to say “selfish”? Or to describe the way a person’s behavior hurt you or damaged someone else? Speaking your own truth is more powerful than any borrowed term could ever be.

It is clear that times have changed since 1964, when America had three television channels. Today, we have access to so much information about public figures that it is possible to get a profound sense of who a person is without actually having met. In fact, with the current Republican candidate for president, it is likely that mental health professionals know more about him than they know about the interactions and lives of some of the people they meet with in their offices.

So what does this mean with regard to the term “narcissism”?

First of all, there really is a clinical diagnosis called narcissistic personality disorder. Like the other personality issues, it is descriptive of pervasively distressing characteristics which impede an individual’s ability to live a fulfilling and healthy life. Such a diagnosis can be devastating, whether accepted by an individual or denied. It is a difficult path to change. Emotional wreckage lies in the wake of such persons over the course of their lives.

For clinicians who wonder about Trump, for example, there is no shortage of conversation among peers. There is plenty of material to discuss. Whether the APA Goldwater rule should be reviewed seems a fair question, considering so much accurate personal information is available. We can watch people we don’t know personally speak and interact in public. Still, most mental health professionals remain reticent about going public with their thoughts on this subject.

It is certainly worth examining our daily language for hollow words such as “narcissist.” For example, is it really so bad to say “selfish“? Or to describe the way a person’s behavior hurt you or damaged someone else? Speaking your own truth is more powerful than any borrowed term could ever be. Also, your well-considered personal statements convey more information than a word that each person is likely to interpret in a different way. The more code words, such as “narcissist,” we add to our speech, the less likely we are to be fully understood.

The mitigating fact for psychotherapists and other mental health professionals is always this: we can never truly know all that goes on inside the mind and life of another person. We study and train for years and then pass licensure examinations in order to have the privilege of offering what we hope are helpful observations to the people who come to us for help. Good psychotherapists live in deep humility, aware of the great gift of trust placed in them by people in distress.

If we refrain from making cavalier diagnoses, might it not be prudent also for nonprofessionals to consider doing the same? And if the goal of communication is to convey thoughts and feelings and observations to another person as fully as possible, why not go for the accuracy that your own personal vocabulary is able to provide? Describe. Explain. No diagnostic language is necessary. Most people would better understand your own definition of bullying and your views about a person who bullies than they would your description of the same person as “narcissistic.”

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.