The Acronymization of Psychotherapy and Mental Illness By Lawrence Rubin, PhD, ABPP on 6/6/18 - 4:52 PM

According to the New York State Office of Mental Health (I randomly chose New York because it is my birthplace), an acronym is a “pronounceable word formed from each of the first letters of a descriptive phrase or by combining the initial letters or parts of words from the phrase.” Actually, this definition was news to me because what I’m really referring to in this blog is an “initialism”, which according to, is “a set of initials representing a name, organization, or the like, with each letter pronounced separately.”

Oh hell, what’s in a definition anyway and what does this even have to do with psychotherapy, or mental health for that matter? Let’s PTC…. pause to consider. Sorry, I couldn’t help myself.

Psychotherapy acronyms such as EFT (Emotionally Focused Therapy), ACT (Acceptance and Commitment Therapy) and REBT (Rational Emotive Behavior Therapy) share a certain mellifluence. They roll gently from our tongue and offer no mystery to the audience, who instantly knows exactly what complex forms of treatment they represent. Psychotherapy initialisms such as DBT (Dialectical Behavior Therapy), CBT (Cognitive Behavior Therapy) and CCPT (Client Centered Play Therapy) are a bit harsher on the oral musculature, but like their grammatical half-cousins leave no one wondering about the nature of the clinical intervention.

Psychopathology acronyms like SAD (Seasonal Affective Disorder), GAD (Generalized Anxiety Disorder) and ADD (Attention Deficit Disorder) leave us with the comforting knowledge that we have adequately captured the complexity of psychopathology with a catchy shortcut. In parallel, psychopathology intialisms such as OCD (Obsessive Compulsive Disorder, BPD (Borderline Personality Disorder) and PTSD (Post Traumatic Stress Disorder), while a mouthful in their own right, equally assure us that we “know” the person who sits before us in the consulting room.

I understand the essential reason for acronyms and initialisms in place of their parent terms. They are lexical placeholders; stand-ins for their meatier counterparts that ease communication between diagnosticians and psychotherapists. They are helpers. Or are they?

I think that these otherwise well-intentioned substitutes rather than simplifying, actually obscure, obfuscate and trivialize both psychotherapy and those struggling with psychiatric disorders. Instead of conveying meaning, they commodify the human experience and trivialize psychotherapy. They scientize and sanitize the pain and complexity of human suffering while creating the illusion that the complex and often unpredictable dance of psychotherapy is easily measured and fully understood. These reified and abbreviated pseudonyms, these shallow masks of meaning mis-cast light rather than illuminate, hide rather than reveal and hurt more than they help us to understand.

The solution in my not-so-humble opinion. Call them like they are. JSN! Just say no to acronyms and intialisms and resist the downward pull of simplification and commercialization in the place of understanding and compassion.  

File under: The Art of Psychotherapy, Musings and Reflections