by J.C. Schildbach, LMHC, ASOTP

One night about two years ago, I challenged a friend for describing his behavior as “schizophrenic.” In an admittedly snide tone, I asked a quick barrage of questions referencing various types and symptoms of schizophrenia: Are you catatonic? Paranoid? Suffering from delusions? Auditory hallucinations? Visual hallucinations? And so on…

Somewhat unexpectedly, my friend responded with an apology for his use of the term, and didn’t engage in any kind of defensive posturing or attempts to justify his word choice. He clarified that he meant he had changed his mind back and forth several times in relation to a particular situation.

I was a little surprised that I had reacted in such a way to what was supposed to be a self-deprecating comment from a friend. But there were a number of things weighing on me at the time, not the least of which was that my friend was seeking advice on a matter that was best kept between him and his partner, and maybe a good couples counselor. As with most of the times he sought advice, he had already made up his mind about what he intended to do, and was looking to have his intentions validated, or to have them challenged with an argument so compelling that he would have no choice but to turn from that position.

Aside from my irritation with the immediate situation that evening, I had been in contact earlier in the week with a young man diagnosed with schizophrenia. He was in some pretty serious legal trouble, and did not appear to comprehend all that much about it except in the most concrete of terms. That is, he knew what law he had broken and why it was problematic. That information had been drilled into him during his time in court and a stay in jail. But his sense of what the crime meant, and how it was going to impact him, his connection to others, and the choices he was going to have to make, both short- and long-term, was murky at best. It struck me that he was so used to being marginalized that his current situation involved just one more bureaucratic system to interact with—as if this latest set of restrictions was little more than an additional cluster of tasks to occupy his time.

Working in crisis intervention, I also have fairly frequent (phone) contact with people coping with schizophrenia and other mental illnesses that involve psychotic symptoms of varying levels of severity, and which often fluctuate over time. There are few, if any, blanket statements that would accurately cover them all, or make a nice, tidy explanation of what they are dealing with. But, unlike the popular usage of the term “schizophrenic,” the way my friend had engaged it, the behavior, thoughts, and challenges of those dealing with schizophrenia are not simply a matter of being indecisive or changing their approach to an issue.

In the time since I first barked at that friend about his use of the word “schizophrenic,” I have seen it become more and more commonly used (or, perhaps, it was used a great deal before that, and I just hadn’t noticed). Currently, in addition to the way my friend used it, to describe his somewhat erratic decision-making behavior, it is used quite often in relation to politics, and often by writers and other figures I respect or at least tend to agree with. Such uses, though, are potentially offensive, and even insulting in a way that is beneath anyone attempting to make a serious point.

For example, in recent weeks it has been relatively easy to find articles, or to come across people on television news/opinion shows, complaining of politicians behaving in a “schizophrenic” fashion toward immigration policies. Generally, what the use of the term “schizophrenic” means in such a context is that the politicians are saying one thing and doing another, or that they have changed their position on an issue multiple times. It is basically used to mean that a politician or group of politicians have been inconsistent on an issue.

But the problem with using “schizophrenic” to describe contradictory political positions is that it suggests the politicians are suffering from a diagnosable mental illness that is beyond their immediate control, and which can interfere with their perceptions of reality, rather than that said politicians are making rational decisions based on what they think will get the most traction with their “base” or constituents. Politicians shifting their political positions is something that is done with the assistance of political strategists in an attempt to get a message out to voters in a way that might provoke support of a carefully crafted message, even if that message is inconsistent over time.

Schizophrenia, on the other hand, is not volitional. It is not deliberate. People who are living with schizophrenia are not choosing one day to deal with only minimal or well-managed psychotic symptoms, and the next day to pursue the exact opposite. People coping with schizophrenia do not, for example, determine that they will change the content and intensity of their auditory hallucinations based on political polling and messaging strategies. They are not thinking of the gains to be made by crafting an elaborate delusion wherein their friends and family are colluding with various government agencies to monitor and control them.

In short, saying that one’s political opponents are “schizophrenic” is just a different way of labeling one’s political opponents with the big, sloppy label of “crazy”—of indicating that their ideas do not merit any consideration because the people presenting those ideas are not grounded in reality. But, because “schizophrenic” is being used as an insult, as a way of accusing somebody of being worthy of ridicule and dismissal, by extension, it implies that people with schizophrenia are also worthy of ridicule and disrespect. Using “schizophrenic” as an insult encourages ongoing stigma towards those with mental illness. It encourages a lack of understanding of mental illness, and of how to address the needs of those struggling with it. It is dehumanizing in the way that all insults aimed at one’s “enemies” are intended to dehumanize.

And people with schizophrenia are not our enemies. They are people struggling with something that we only barely understand. They are people who, at the very least, do not deserve to be lumped in with politicians who are fine-tuning messages of anger and outrage to try and get votes.

Now, lest anyone think I’m engaging in “word policing,” let me say that I am. As much as language is a dynamic thing, there are still right and wrong ways to use words, or rather, more and less accurate ways of using them. We still make daily decisions about whether we are going to use words to clarify or to obscure, to increase understanding or to confuse. The word “schizophrenia,” unlike a number of other words used in mental health diagnoses (anxiety, narcissistic, etc.) was coined, by Eugen Bleuler around 1908, specifically to refer to the mental illness. It literally means “split mind.”

Arguably, the literal definition of schizophrenia could easily be applied to various other situations such as the one’s already described, and it would not be inaccurate. And, arguably, the mental illness or cluster of illnesses known as schizophrenia involves a broad enough range of symptoms and presentations that the diagnosis requires specifiers for clarification in individual cases. Still, rather than taking a word created to refer to a mental illness, one that will always have ties to that mental illness regardless of how one claims to be using it, and expanding the use of that word to include any behaviors one perceives as inconsistent or otherwise in opposition to one’s own beliefs about appropriate behavior, why not pursue more accurate understanding of the word, and a greater understanding of what the mental illness means, and does not mean?

It seems to me that, rather than calling politicians “schizophrenic,” it would be much more damning to say that one’s political opponents are completely inconsistent in their approach to an issue because they feel that they can achieve greater political gains by changing their position and their message, instead of sticking with real principles or working hard to find real solutions to complicated problems.

And instead of labeling our own actions, or the actions of others as “schizophrenic,” simply because they are inconsistent, appear contradictory, or we disagree with them, why not just acknowledge that most of us are not as steadfast and true as we like to imagine, and that we often don’t make decisions unless and until we have to? Why insult people with schizophrenia by suggesting our poor decision-making skills are the result of a serious mental illness, one that involves much deeper struggles than indecisiveness or occasional mild impulsivity?

How about we all stop using “schizophrenic” as an insult?