In part 2 of this Exclusive Interview, Drs. Dickinson and Guzman talk with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the psychology behind the words that are innocently spoken and share examples of problematic terminology.
Jane K. Dickinson, RN, PhD, CDE is the Program Director and faculty for the solely online Master of Science in Diabetes Education and Management program at Teachers College Columbia University. Susan Guzman, PhD is a clinical psychologist specializing in diabetes. Her clinical and research focus areas include overcoming barriers to management, family issues, and promoting attitudes that support living well with diabetes, from diagnosis throughout the lifespan.
Transcript of this video segment:
Steve: Are there specific words that cause a problem?
Jane: Well, the reason I got interested in language and diabetes actually was way back almost 30 years ago at diabetes camp. We started talking about how the words that we were hearing and reading and even saying really had an impact on people’s experience with diabetes, and so at the camp we started looking at a few words in particular, and the first and foremost was “diabetic” and we really eradicated the word “diabetic” from camp and we started calling it the Ick word. and then we stopped saying “test” and we substituted test for checking blood glucose or blood glucose monitoring. The reason for that is because it’s not a test; it’s not a pass-fail or a good/bad, which was another set of words we got rid of at camp, which was good and bad. And there’s a lot of shame blame and judgment connected to those words like good and bad and compliance and adherence. “Control” is another one that can be very heavy for people with diabetes, so those are some of the words that I have noticed and mentioned, “denial…”
Susan: Yeah, “in denial” is another one of them. It’s not necessarily the words that we want to focus on, it’s the meaning behind them. Because words evolved and what we really want to communicate is that how we talk to people and about people with diabetes really matters and the words that we use have had an impact. They can contribute to stigma. They can push people away from wanting to take action and yet other words can really make people feel more included, more listened to, and not pushed away.
Steven: You guys are doing a good job because when I first started the newsletter I used the word “diabetic” a couple of times and must had a thousand complaints.
Steve: Yeah. People are well aware of words like that. Are there other specific words that you find problematic?
Jane: You know, believe it or not, and it’s a tough word to get rid of, but “prevention” is hard for people, especially people with type 2 diabetes. We had a conversation with a gentleman recently who said: “You know, if you do everything by the book and you do everything that they say, it will prevent type 2 diabetes” when you get it anyway, you feel like a complete failure,” and so what we try to say is “risk reduction” or “reducing risks.” Then “failure” is another one when you hear and read all the time somebody failed metformin or somebody failed sulfonylureas. They didn’t fail, the drug failed them. It didn’t work and so we try the next thing
Steve: So, it’s really the psychology of the word that really makes the difference. Would you say?
Susan: I would say it’s the meaning that it communicates, a lot of times these words like prevention are communicated with good intent, so it’s not necessary that they intend to be harmful but then, that whole stigma of diabetes is that that you did something to bring this on yourself and now you’re being punished as a result. So, when we say words like “prevent,” people think if you’ve done what you’re supposed to do he wouldn’t have diabetes and that unfortunately it’s not true for a lot of people, in fact most people.