Sociolinguistics of Naming in Mental Health: Ethics, Identity, and the Politics of Labelling

Fontanini, Walter Massimo (2025) Sociolinguistics of Naming in Mental Health: Ethics, Identity, and the Politics of Labelling. KALEIDOSCOPE: MŰVELŐDÉS- TUDOMÁNY- ÉS ORVOSTÖRTÉNETI FOLYÓIRAT, 15 (31). pp. 509-525. ISSN 2062-2597

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Abstract

This article examines the ethical, sociological, and linguistic dimensions of naming practices within mental health discourse, explicitly addressing the tension between person-first language (PFL) and identity-first language (IFL). Person-first language (e.g., "person with schizophrenia") is predominantly advocated within clinical and institutional contexts as a means to mitigate stigma and affirm individual dignity. Conversely, identity-first language (e.g., "autistic person," "Deaf person") is increasingly adopted by different communities to assert identity, autonomy, and cultural solidarity. This divergence illuminates an underlying conflict between prescriptive ethical norms imposed by institutions and emergent claims of personal and collective identity. Employing interdisciplinary theoretical frameworks - including labelling theory (Scheff, 1966; Goffman, 1963), discourse theory (Foucault, 1972; Butler, 1997), affective psychology (Lewis, 1971; Nathanson, 1992), and philosophy of language (Fricker, 2007; Shotter, 1993) - this research argues that psychiatric naming is inherently normative rather than neutral. Diagnostic labels operate beyond mere categorisation, actively shaping individual subjectivities, legitimising institutional practices, and delineating boundaries of inclusion and exclusion. Consequently, the naming process can perpetuate social stigma, induce internalised shame, or foster collective empowerment, contingent upon the specific socio-cultural context and conditions of participatory involvement. Utilising cultural case studies, including the recent controversies surrounding Disney’s rebranding of the Seven Dwarfs in Snow White and the institutional promotion of Latinx, the article underscores how language reforms enacted without community consultation risk resulting in "inclusion without participation." Such instances illustrate the phenomenon of euphemistic erasure, wherein sanitised terminology inadvertently marginalises the communities it intends to represent. This research proposes an ethical framework for medical linguistics predicated upon reflexivity, community agency, and contextual sensitivity to address these pitfalls. Rather than imposing uniform terminological standards, the article advocates for a dialogical approach: clinicians, researchers, and policymakers must foreground the linguistic preferences of affected communities and treat language as inherently relational, rather than prescriptive. The article concludes by advocating increased participatory, mixed-methods research into the influence of linguistic framing on clinical practice, self-perception, and social integration. Ultimately, it reconceptualises medical language not merely as an instrument of clarification but as an arena for ethical negotiation and epistemic justice. Naming practices, therefore, must not serve as definitive verdicts imposed externally but as open-ended questions posed relationally, with humility, attentiveness, and profound respect for lived experiences.

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