What`s in a name?

“Sticks and stones may break my bones, but names will never hurt me!”

Aren’t we all familiar with that childhood taunt? And, given our training and expertise, don’t we really know that it is a defensive response to a deep psychological hurt? Why else would parents be so concerned about what to name their child?

I know this well. If you ever wondered—and you probably have not—what the “H” in H. Steven Moffic, MD, stands for, it is my given birth name, which happens to be Hillard. Never heard of such a name? Can’t say I have, either, and I’m still not sure where it came from. Sometime long ago (when and why I must have continued to repress), I decided I did not like that name. But I apparently liked Steve, so everybody knows me as Steve, at least in a casual sense. Maybe I was teased mercilessly as Hillard, but nothing even emerged about that in my personal psychotherapy.

Ironically, now I have come to like the name Hillard. It seems unique and distinguished. But it is too late. Everybody knows me as Steve, Stevie, or Steven. Too bad all my formal documents are mixed up: Hillard Steven Moffic, Steven Hillard Moffic, or H. Steven Moffic are the most common designations. I’m slowly working to consolidate my identity.

“Children used to play Doctor; now they play Provider!”

Maybe this is why I am so sensitive to the names we use for ourselves and who we serve. I continue to like to be called Dr. Moffic. Yes, I know many professions use the “Doctor” designation, and some think it is too paternalistic, but to me it has a long and illustrative tradition in medicine. For a nickname, “Doc” is fine, as I find it endearing. But “shrink” is too stigmatizing, though when it is used, it may communicate a certain message that is helpful to hear.

However, ever since managed care rose to prominence, I’ve been called a “provider” more and more. A provider of what? Medication, advice, food? Pretty nondescript, if you ask me. Maybe that is the purpose; lump all providers together. If we needed some sort of common term, I would much prefer “caregiver.”

Sometimes, since I work in academics, I’m called a “professor,” which I am. But what relevance does that have to direct treatment?

How about who I serve? I’ve always called them patients. Again, to me, a time-honored designation. Yet, over the years, it’s been suggested that I use consumer or client. Or, in the case of Clubhouses, a member. Or, at the prison where I work part-time, inmate or offender. Why, I heard recently that in the California prisons, all those terms feel demeaning, so “individual” is the term of choice.

All these terms, and maybe others that I missed, I saw in the April, 2010 hard copy issue of our own Behavioral Healthcare. Come to think of it, how did this publication get this name? Why not Mental Healthcare? Was it because behavior could be seen and measurable?

Are these variations a reflection of the individuality and particular politics of the United States? I’m not sure, though in Great Britain, patient, client, user, and survivor all vie for attention.

Is somehow all this confusion a reflection of the stigma of mental illness? You never ever hear such variation about those receiving care for cardiac illness, do you?

To me, a patient is someone who suffers and endures an illness. That’s what I like to be called when I go to a Doctor. Client implies a different kind of relationship, more of a business, such as a client of an architect or even a call girl. A provider of such services wants to keep the client or customer happy. The goal of medicine is to relieve suffering or, if possible, cure an illness. We have antidepressants, not happy pills (at least not yet).

I certainly respect the right of anyone to choose their own designation. Surely, the consumer movement in the USA has had great political success in improving care and recovery. In a meeting devoted to a political cause, I would join in the use of consumer, but not for someone in my office.

“A rose is a rose by any other name.”

What do you like being called and why? Since we are now all adults, is this just (as Shakespeare wrote) “much ado about nothing?”