The Words We Use

I’ve been trying to write this post for a couple of weeks. My thoughts and feelings balked at being committed to paper. I think I’ve worked through it enough to write now, so we’ll see…

First, I read an article on Migraine.com (https://migraine.com/expert/fighting-for-migraine-with-words/) by Dr. William B. Young about how the words we use affect how we see our own battles with chronic illness, but also in a more far-reaching way affect how other people view us and our illnesses.

Dr. Young made the point that a condition is fundamentally different than a disease, and migraine is so much more than a headache. By using words like “migraines” or “migraine headache” we change the perception for ourselves and others and minimize a serious neurological disease. Also, using the term migraineur reduces the person to their illness much in the way the terms epileptic or schizophrenic do.

It’s more than political correctness, it’s about the perception these words create. I’ve used the term migraineur for years. Like other labels, it’s simple and concise. I like simple and concise language, and have always resented political correctness being thrust upon me and my choice of language. However it’s important for me to recognize the impact of the words I choose. This is like choosing to say rheumatoid disease instead of rheumatoid arthritis or psoriatic arthritis. The word arthritis dilutes the full impact and implication of rheumatoid disease.

Incidentally, I’m not trying to tell my readers or anyone else what words they should or shouldn’t use. I’m just offering some food for thought, and offering an opportunity to think about the language you choose to use.

Part of my challenge in processing this is that I still tend to not think of migraine as the neurological disease and disability that it is. It’s been just another fact in my life since I was a teenager. It runs in our family – my sister, nephews, and daughter all have it. Sis and I suspect our Mom has it based on our observations (though Mom disagrees).

I’ve written before that I never considered myself to have chronic illness until my rheumatoid disease was diagnosed. As I became more educated on the subject of chronic illness, I realized that I’ve lived with multiple chronic illnesses for most of my life. While my asthma is fully controlled with medication, I still have to make decisions in order to keep from having an attack. I cannot exercise in cold air without a mask, I cannot go to smoky environments, and I have to exercise caution when dusting or cleaning, and I can’t go to concerts (second hand marijuana smoke has forced me to leave too many concerts early). I’ve had migraine attacks since my late teens, and it’s affected my life to varying degrees ever since. Rheumatoid disease and fibromyalgia are just the two latest entries to my list.

So while I was still digesting and processing the information from Dr. Young’s article, I watched the film Unrest (https://www.unrest.film/) and it reduced me to tears. It’s available on Netflix and other streaming media. If you or anyone you love deals with chronic illness, I highly recommend that you watch this film, though I will warn you in advance it is hard stuff. It chronicles Jennifer Brea’s experience with Myalgic Encephalomyelitis (ME) which has been associated with chronic fatigue syndrome. (Note: this association is disputed by some ME researchers.)

While the film is specifically about ME which I do not have, so many of the themes struck home with me, as I believe they do with all people who have chronic illness. People not believing us when we share our symptoms and struggles. Doctors telling us it’s a mental condition (and even prescribing depression medication). Fighting to get referrals to specialists or specific testing. Feelings of guilt from placing burdens on our family and friends because of our illness, and of not “pulling our own weight”. Relief when we finally get a diagnosis, even if it’s incurable, because it means there’s tangible proof finally. Grieving the person you once were and can never be again. Worrying about missing too many days of work, or not being productive when we drag ourselves in. Wondering if you will ever have a pain-free day again.

I’ve had to catch myself several times while typing out these paragraphs, as I tend to write that people “suffer” from chronic illness. This is yet again one of those words that changes perceptions. Certainly there is suffering that goes along with chronic illness. For some of us, it’s intermittent. For others, it’s fairly non-stop. But the term is passive, it’s being subjected to something. It’s like using the phrase “victim of” and while some people use it, others hate it. I don’t embrace being a victim, even though the legal term applies. Similarly, I don’t embrace suffering from anything. I prefer more active terms. I survived abuse, I fight chronic illness. It’s also important to recognize that some people don’t like the active verbs, either, and find being labeled a “fighter” or a “warrior” demeaning. Dr. Young probably offered the best advice, in that we can use any term we want when relating our own experience, but we should try to avoid applying labels to other people as only they define their experience.

The biggest word I struggle with, however, is “disability”. When I think of someone with a disability, I think of wheelchairs, canes, severe impairment of a sensory system like sight or hearing, or like some of the people in Unrest essentially being bedridden. I have a strong aversion to calling myself disabled or saying that I have a disability. Part of my resistance is because I don’t want to minimize what those with the more severe impairments deal with. I am still able to hold down a full-time job. I recently finished a master’s program while continuing to work full-time. That doesn’t fit the picture in my head of someone with a disability. Never mind that while doing that, I was completely unable to keep up with even minimal housework or cooking, and every weekend was spent recuperating from the week before. Part of it may be a fear that someday the impact on my daily life will be much more severe.

Perhaps the other thing about words is that while they can change perception, we can maybe create a change in how certain words affect us and others by changing the dialog around them. Especially when dealing with hidden or invisible disabilities, talking more about them and how disability is on a continuum can change how we and others see the concept.

There’s one word I won’t give up, though. Spoonie. The story by Christine Miserandino (https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/) in which she explains to a friend what it feels like to have lupus has given all of us who deal with chronic illness a touchpoint around which we have built communities of support for each other. It gives us a shorthand to use with each other and our allies. It might be reductive, but for me it’s an identity within a community and that’s an important thing to have, especially when you have a chronic illness.