The Weight of Words

The Weight of Words

What Are We Really Saying?
How language shapes what we hear, and why naming isn’t always neutral.

“I just don’t want to be labeled" is a familiar feeling. In therapy, we come to heal. So then—what is a diagnosis? A clinical label, a stigma, or a way forward? The simple act of naming an experience can leave us feeling judged, dismissed, and exposed—naked in our vulnerability. Misunderstood. Unseen. Unacknowledged. And yet, we’ve come to therapy to heal.

After all, the words we use to convey intention matter a great deal, because they influence how a message is received. For example, a simple but can easily change the perception of any well-intentioned concern: “I think you're doing great, but it needs some work.”

Now—what did you hear in that sentence? Naturally, the former ("you're doing great") instantly becomes disposable, and the latter is understood to be the absolute truth ("it needs some work"). The speaker's intention is to inspire confidence, but the result is a painful critique of how we’ll never get it right.

And if that's the bottom rung of the proverbial ladder when it comes to the mindful use of language and intention, then how do we—as clinicians, clients, fellow human beings—even begin to broach the topic of diagnosis?

Take, for example, the experience of what is called hypomania: pressured speech, mildly racing thoughts, the experience of elated mood after a period of what appears to be depression.
Without meeting the criteria for clinical mania, it doesn’t cross the threshold into the dangerous—and may not fit neatly into a diagnostic category. Would it—or would it not—help to name the experience as a symptom, or as part of a larger mental health diagnosis?

From a strength-based, holistic approach, it's important to refrain from reducing the complexity of our emotional experience to a diagnosis. We are more than that.

But from a cognitive-behavioral perspective, giving the experience a name helps cognitively restructure the thought: “It doesn’t define me—it’s what I experience.”

A diagnosis can help. Or a diagnosis can hurt. It can either shut us, as observers, out of the experience—or deepen our understanding of it. And here's why:

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The Primitive Brain and the Tiger

Fear, Safety, and the Ancient Brain
How rejection can feel as dangerous as a saber-tooth tiger—and why trust is the first intervention.

As a clinician, I don't always get it right. And that's because holding space for real human connection means attending to genuine human interaction, empathy, and cognitive planning all at once. What do you focus on first, and all at the same time?

The work starts by collaboratively building a foundation for any therapeutic modality: trust. The therapeutic space must be safe, non-judgmental, and—most importantly—comfortable.

After all, without trust, there is no safety—an incredibly important and motivating force for all human behavior. The primitive brain, left over from our ancestors, never fully rests in silence. It cries out for attention: “Where is the threat? Am I safe?”

In an instant, the therapeutic space can revert to a battle from the Neolithic age. The primitive brain, like a frightened Neanderthal, defends its life from the clutches of a saber-tooth tiger. Except—the modern human fears something far more dangerous: rejection. An emotion in which vulnerability, shame, and a perpetually self-blaming narrative coexist. We are par-to-par with the saber-tooth tiger. And it’s so threatening that, subconsciously, we’ll do anything to avoid it. That means we don’t go wandering where there are tigers. Tigers could be anywhere, couldn’t they? It’s best to play it safe.

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Why Trust Comes First

The Real Work Begins with Trust
Why we can’t think, reflect, or heal until we feel safe enough to be seen.

We are, of course, more than our primitive brain—we’ve expanded into streams of consciousness our ancestors couldn’t have imagined. We are also, at our core, insightful, connected, and courageous human beings.

Though the soul is resilient, its ancient wisdom still calls out for safety—because that’s how it’s always thrived. We must feel safe enough to open up; strong enough to allow ourselves to be vulnerable. This is where the work begins: the therapeutic relationship—no matter the modality—begins with trust.

After all, if the metaphorical tiger is always lurking, it’s awfully difficult to engage in therapy with openness, willingness, and reflection. What do you focus on first, and all at the same time?

It’s only after we feel safe enough to disclose, connect, and heal that we can motivate positive and healthy change. Built on the therapeutic foundation, there is hope for insight, healing, and growth.

As a wise mentor once told me: “Take what you need and toss the rest.”

We can challenge a diagnosis—or we can dig deeper into its meaning. Because beneath every diagnosis, there is a human being. And connecting with that—that’s what makes the work work.

Our goal is to quiet the tiger, so that the real conversation can begin.

Thanks for reading. May you continue exploring the space between where you are and who you’re becoming—with care and curiosity. Because healing isn’t just clinical—it’s deeply human.