Fifteen Eighty Four

Academic perspectives from Cambridge University Press


Why words matter

Chris Maloney, Julia Nelki, Alison Summers

Hands holding a pen next to paper covered in writing

Whilst writing the book ‘Seeking Asylum and Mental Health’, we had to think a lot about words.

At the outset we decided to avoid the term ‘asylum seeker’. It is problematic on two counts. Firstly, it defines the whole person by one aspect of their predicament, and secondly it carries negative connotations, largely by virtue of its use in emotive, hostile narratives  This first problem is an important and enduring one and can be attended to. The second is not so easily put right. Any new term, as it becomes widely adopted, can be used in the same prejudicial way as the one it replaces. For this reason, we tried to avoid using any one specific term for people in the predicament of seeking safety – whilst largely avoiding ‘asylum seeker’.

In any health text there is another issue: what do we call the person who we are trying to help? ‘Patient’, ‘client’, and ‘service user’ are frequently used. Each term has both advocates and those who view it as demeaning. Often, the preferred usage is also a matter of professional background: psychotherapists may be happier with ‘client’, GPs largely hold on to ‘patient’. But, in any case, should we even use terms that define a person solely by their being in receipt of ‘care’? However, packaging too many considerations into the terms we use risks them becoming unwieldy.  The approach we have adopted in our book is to use a plurality of accepted terms, with the main proviso being that their meaning is clear in context.

Other words also carry a range of meanings, and implications. The word ‘victim’ is scarcely used nowadays.  In some settings it has given way to ‘survivor’, but this is also not without its problems, albeit different ones.  In Chapter 3 of our book Norma McKinnon and Chris Maloney take issue with the paradigm of ‘trauma’ itself, and in the rest of the book we often use the term ‘adversity’ instead.

The word ‘symptom’ is also problematic – it implies pathology and so may not be the right word for what might well be part of an overall healthy response to a horrible experience. In the absence of a better, more concise alternative, we stayed with ‘symptom’ as it is so widely used, but we tried to make it clear that we were not presupposing pathology by doing so.

In political and media discourses some terms are used, too, with the intention or effect of justifying policy: ‘illegal immigrants’, ‘foreign criminals’, ‘sovereign borders’, for example. These also fuel hostility towards broader groups of migrants. National borders, however, can still be maintained effectively while treating people with respect and humanity. Vilification and self-righteous hostility can needlessly (apart from their appeal to some potential voters) ‘up the stakes’, provoke confrontation, and make difficult situations worse. How readily can the ‘hostile environment’ become the ‘sadistic environment’?

About The Authors

Chris Maloney

Chris Maloney is a psychiatrist, psychotherapist and General Practitioner. He worked as a GP with people seeking asylum for many years, and has been an expert witness in asylum cas...

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Julia Nelki

Julia Nelki is a child psychiatrist and family therapist. She has set up services for families and unaccompanied children seeking asylum in Liverpool, is a trustee of a Refugee cha...

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Alison Summers

Alison Summers is a general psychiatrist and psychodynamic psychotherapist. She has worked with people seeking asylum since 2008 as a psychotherapist and more recently a medico-leg...

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