Top 12 Therapy Words Defined
Words matter. They help us understand ourselves and convey our sentiments to others. In the therapy room, there are a handful of words that keep being said. Granted, some of them are said by me! Let’s take a look at what they really mean, and what they don’t mean, rather than using Tic Tok to help us understand.
Dysfunctional - another way to think of the word dysfunctional is very problematic. It means that a system or person is operating in a way that has arisen out of problems and is also creating further problems.
Triangulation - this is one of my favorite terms. I use it frequently and tend to confuse my clients who have no reason to know what this word means! It was developed by Murray Bowen, a family therapist pioneer to describe when two people in conflict bring a third person into the conflict. While it tends to make the conflict more stable, it is problematic for the person being triangulated because they are thrust into the middle of a conflict that they have no reasonable way of solving.
Enmeshment - This is another one of my favorite terms. It describes a relationship in which two people are too close, such that the view of oneself is directed by the view of another. For instance, a parent's view of an adult child becomes the adult child’s view of themself. It becomes problematic first of all, because we need to hold our own self-image, and secondarily, because it can lead to the adult child operating in service of their parent, rather than meeting their own needs.
Boundaries - This is the most misunderstood term in therapy. People think boundaries are a thing you say to someone else and then the other person adheres to that. That’s absolutely not correct. *You should be hearing one of those buzzers in your head when someone gives a wrong answer.* Boundaries are something that you communicate and then behave in alignment of that communication. For instance, if there is a certain topic that is off limits, that is something that needs to be politely mentioned ahead of time, and then if it comes up, note it, and stop discussing it. Boundaries are meant to help you function your best in relationships, not to create distance or avoid a topic. If you’re using a boundary to avoid, you’re probably stonewalling.
Immature Parents - this term has gained popularity due to the book Adult Children of Emotionally Immature Parents by Gibson. Simply put, immature parents act in such a way to put their needs above their (non-adult) children or act in a way that requires the (non-adult) child to meet their needs. I specify that this term pertains to parents with children who are not able to meet their own needs because it is reasonable for folks with adult children to put their own needs ahead of their capable, adult children.
Narcissist - this term, perhaps more than any other term, is often misused. It is a clinical term to describe a mental health condition, but has been co-opted to describe someone who is selfish, dysfunctional, or simply an a**hole and simultaneously paint the other person in the dynamic as a victim. It’s important to me to note that we all have narcissistic tendencies. This trait, like most others, exists on a continuum with some folks having more or less. At the far end of the continuum, is the personality disorder, which often functions as a cast over a very painful wound.
Manipulation - this is another word that tends to get thrown about, and ultimately loses it’s meaning. My definition of manipulation is using someone else to meet your needs in a way that is harmful to the other person. While this happens, it’s one of the words that I struggle with. While people do behave in manipulative ways, it’s important to note that we have agency which prevents us from being manipulated.
Toxic - I hear people use this word often, typically in the context of describing someone’s problematic behavior, and unfortunately, ignoring their own role in the dynamic. For that, it’s one of my least favorite therapy words. Clinically, it carries no meaning. “Toxic” is not in the DSM, which is the manual used to diagnose mental health conditions. It means different things to different people, and thus, I often need to clarify with my clients what this word means to them.
Parentification - When therapists are fresh out of graduate school, they are considered, "provisionally licensed” and require supervision with a fully licensed therapist in order to practice. I hope I never forget how my former supervisor described parentification. Her definition of parentification was “emotional incest.” In other words, parentification is using a child to meet, typically, emotional needs, of the parent. Here are a few examples. This can look like children comforting their parents to help the parent regulate, or using the child for championship in an otherwise lonely marriage, or telling a child things that are too mature for them to know how to cope with.
Criticism - This term is deceptively simple, leading everyone to think they know what criticism means. Telling one’s partner that they are doing something wrong is not criticism. Criticism is a character attack. It’s: “You’re a jerk.” Contempt is a global character attack: “You did that wrong because you’re incompetent, and you always do it wrong.” Given as much, one might wonder why we feel criticized when we receive feedback. The answer is that we are filtering information, for various reasons, and the filter gives rise to our feelings of criticism.
Hoarding - This is another term that tends to get thrown around without a clear meaning. Similar to Narcissism, Hoarding is a clinical diagnosis in the DSM. However, the clinical diagnosis only described symptoms. What leads to harding is variable, and probably more important overall because it needs to be addressed in order to resolve the issue. Similar to narcissistic tendencies, hoarding tendencies exist along a spectrum.
Over-functioning - Over-functioning, and its counterpart under-functioning are one of the most important terms I use in couples therapy or family therapy. It describes a dynamic where one person isn’t quite pulling their weight and the other is pulling too much weight. If not managed or remedied, it can lead to resentment and bigger problems in a relationship.
