We’ve all heard it before: “It’s not what you say, it’s how you say it.”

And although the how normally refers to intonation, research in narrative psychology suggests that there is much more to it than that. The way you narrate the events in your life can serve as an indicator of self-acceptance, personal growth, and overall mental well-being.

It is no surprise, then, that how you speak affects you. But the “how you say it” is just as relevant when considering those around you–particularly when those individuals are experiencing a mental illness.

The growing field of narrative psychology emphasizes the importance of learning how to narrate one’s life. A “narrative identity” is said to be the highest form of development [1], wherein the individual can tell a constructive and coherent story of the events that take place in his or her life.

In terms of what catalyzes such story telling, language and culture play a huge role in how we are taught to develop our narrative identities.

Language, for its part, dictates when actions (i.e., verbs) appear in sentences alongside persons (i.e., nouns) by way of syntactic rules.

Culture, on the other hand, dictates the sequence of events in our story. Specifically, Western societies tell stories by starting at the outset of the situation, narrating actions that lead to the main problem, explaining the main conflict, describing the solution, and finally by adding a take-away message.

Accordingly, narrative identity is measured by analyzing its content, structure, and function. In these cases, researchers can focus on the explicitness (i.e., how directly individuals allude to conflicts and solutions in a story), elaboration (i.e., how much detail is included), and emotionality of language (i.e., positive or negative connotations associated with words) to evaluate the quality of a narrative identity [2, 3]. Research in narrative psychology suggests that the more adept individuals are in creating these types of stories–especially in creating meaningful “take-home messages”–the higher their scores of psychological well-being (defined in part by self-acceptance and personal growth) [3, 4].

Clearly, these criteria are important for our own mental well-being, but how is “how you say it” relevant to others around us? Particularly those who are affected by mental illness?

In the emergent discussions of mental health, many individuals find themselves struggling to find neutral, inoffensive words to refer to persons with mental illnesses – and with good reason. Not only is the terminology in constant flux, but there is a broken telephone effect between clinicians and the general population. Changing the language we use when speaking about mental health is the first step towards creating a more non-judgmental, accepting, and supportive environment for persons with any mental illness. In fact, researchers have investigated the variety of ways in which language can be used for discriminatory purposes, both blatantly (e.g., when two individuals switch to a language that the third cannot speak) and subtly (e.g., sexism in language; words such as mankind allude to male dominance) [5]. So, language is also key in eliminating these biases.

Reducing emotionally-charged terms is a great start. Individuals should be careful to use neutral words (e.g., mental illness) rather than words with overtly negative connotations (mental problem).

Likewise, the concepts of explicitness and elaboration, as studied in narrative psychology, may help in the accurate and supportive discourse about mental health.

For instance, rather than alluding to an individual’s condition in vague terms (e.g., he has a problem, he has a disease), it is best to refer to their condition specifically (e.g., he has schizophrenia, he is diagnosed with ADHD). Explicitness also alludes to accuracy: An individual has, or is diagnosed with, schizophrenia (not schizophrenic, not suffering from schizophrenia).

Elaboration goes hand in hand with the idea of explicitness. The most effective way to become comfortable and proficient with any language is to use it, and to use it often. So, rather than shy away from the details of mental illnesses (e.g., the symptoms, difficulties with daily functioning), they should be explored and elaborated upon.

This talk about the how in speech is not to underemphasize the role of behavioural language. Gestures, mannerisms, and intonations are equally important to our well-being and impactful to those around us (perhaps even deserving an article of their own!). Along with oral language, they should stem from a place of patience, respect, and understanding.

So, don’t just watch what you say, watch how you say it. Because in matters of mental health and supporting those afflicted, all language matters.

By: Alisia Bonnick
Edited by: Veerpal Bambrah
Image by: Samer Lazkani



[1] McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology, 5(2), 100–122.

[2] King, L. A. (2001). The hard road to the good life: The happy, mature person. Journal of Humanistic Psychology, 41(1), 57–72.

[3] McAdams, D. P., & McLean, K. C. (2013). Narrative identity. Current Directions in Psychological Science, 22(3), 233–238. doi:10.1177/0963721413475622

[4] Ryff, C., & Keyes, C. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719-727. doi:10.1037/0022-3514.69.4.719

[5] Ng, S. H. (2007). Language-based discrimination: Blatant and subtle forms. Journal of Language and Social Psychology, 26(2), 106-122.


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