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More on Terminology

Medina, Ohio

I share the annoyance and concern that Dr. James Blevins expressed in the June 20 issue about the "customerization" of medicine and pressure on psychiatrists (particularly in community psychiatry; even the JCAHO uses the term "behavioral health"—ugh!) to refer to patients as "clients." In addition to the dictionary definition Dr. Blevins found ("one leaning on another person for protection"), someone (probably at Menninger in the 1960s) told us that the Latin derivation of "client" is "cliens"—"freed (Roman) slaves who are still dependent on their masters." (Latin scholars, correct me if I’m wrong.)

I also remember (vaguely) Carl Rogers as a gentle soul and a "Mr. Chips" type around campus during my years at Ohio State University in the 1950s. Suffice it to say that we now know that his "unconditional positive regard" or "starting where the patient is" need not preclude us from our important tasks of reality testing with our patients—or encouraging good judgment and "the habit of making good choices" (Aristotle).

It also remains to remind younger colleagues, as implied by Dr. Blevins, that dependency or "babysitting" are usually antitherapeutic for individual-psychotherapy patients suffering from neurosis and/or personality disorders.

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