Psychologists should avoid using phrases such as ‘you’re nailing it’ when trying to encourage patients because it could be interpreted as violent.

That is according to a new psychology language manual that lists dozens of everyday phrases that should be swapped out for more ‘inclusive’ terms.

Phrases such as ‘take a shot at’, ‘target population’  and ‘you’re killing it’ should be avoided because they are microaggressions, the guide says.

Meanwhile, ‘stand up for’, ‘turn a blind eye to’ and ‘lend you voice to a cause’ should be axed because they are ‘ableist’ and offensive to disabled people.

The manual released in December by the American Psychological Association (APA), which has nearly 160,000 members, including scientists, clinicians and consultants.

The guidelines aim to ‘dismantle the destructive hierarchies that have marginalized people from equitable representation and participation in society,’ the organization said.

SCROLL DOWN FOR THE FULL LIST OF TERMS

But Dr Sarah Hill, a professor of psychology with expertise in women, health, and sexual psychology at Texas Christian University in Fort Worth, told DailyMail.com that restricting language would only make communication between patient and doctor harder.

‘It just creates a situation where people don’t want to talk,’ she said.

‘All it does is make well-intentioned people afraid to speak, because they’re afraid of hurting people’s feelings.’

Dr Hill had received an email about the new language guide, she said, having previously been a member when she was a practicing clinician.

The guide not only includes violent language but also identity-related terms, gender terms and socioeconomic terms.

For example, ‘poor’ and ‘blue-collar workers.’

‘Sold down the river’, which means to betray someone or do something which harms them in order to gain an advantage for yourself, is also recommended against.

It is now said to be racist. The APA said: ‘This expression belittles the painful history of millions of enslaved people sold and literally transported via the Mississippi or Ohio rivers to perform brutal manual labor on cotton plantations further south during the 19th century.’ 

‘Betrayed’ should be used instead, the APA added. 

Psychologists should also refrain from saying the word ‘obese,’ and opt for ‘higher weight’ instead.

This switch should be made to ‘avoid perpetuating weight stigma.’

‘Use neutral terms that affirm and respect the dignity of all individuals regardless of their body size,’ the APA said.

‘Obese is a clinical term. To try to obfuscate that is not smart. It’s inaccurate, it’s essentially taking what’s a precise term, and then trying to make it less precise,’ said Dr Hill.

‘I don’t know why that would ever be a good idea. Precision in language is always important.’

Psychologists are not even allowed to use compliments, and should also ‘ask consent’ from patients before commenting on their appearance.

Compliments like ‘Wow, you’re looking great!’ should be avoided, and psychologists should instead ask, ‘Is it alright if we talk about your weight?’

‘This prevents unintended consequences or mixed messages about people’s health or appearance,’ the association said.

Dr Hill said: ‘They’re common [phrases]. Nobody gets upset about them. And if people do get upset about them… I think everybody just needs to learn to relax.’

‘It just creates a situation where people don’t want to talk,’ she added. 

‘It becomes harder and harder for me to teach my classes every single year because of things like this, and I’m not an asshole. 

‘I’m not somebody who tries to make people feel bad or to discriminate. I certainly don’t feel harbor any ill feelings for people who have a different sexual orientation or race, ethnicity or ability level than I do.’

‘Killing it’ or ‘nailing it’ are deemed unacceptable because they are violent, the APA claimed, and should be replaced by the ‘great job’ or ‘awesome’.

Psychologists should also refrain from saying ‘take a shot at’, ‘take your best shot’ and ‘take a stab at’. 

‘Give it a go’ or ‘try’ are safer alternatives, the APA said.

‘Although these terms and idioms may seem innocuous ways to signal achievement,’ the organization said, ‘it is notable how pervasive violent or militaristic language is seen as positive when it should be the opposite.’

‘Even when used in medicine, violent metaphors have been described as “ironic, unfortunate, and unnecessary”,’ the guide added.

‘What’s awful about [the language guide] is that it doesn’t actually solve the problem, because people who are actually jerks, this isn’t going to change their behavior,’ Dr Hill said.

‘Creating a list like this is just going to make it harder for people who are well-meaning.’

The APA’s own chief diversity officer, Dr Maysa Akbar, who even penned the foreword to the new language guide, used some of the ‘violent’ phrases herself in 2019 on X, DailyMail.com found. 

Her friend ‘killed it’ at the Hispanic Federation Gala, she tweeted.

‘I think that goes to show just how harmless and mindless saying these things is,’ said Dr Hill.

‘People say these things and they’re not saying it with an ill spirit. It’s hard to avoid saying these things. 

‘These are just like part of common language. The more rules that we get about what’s offensive and what’s not offensive, all that it does is quiet people with good hearts, because then nobody wants to say anything.’

The APA's own chief diversity officer, Dr Maysa Akbar, who even penned the foreword to the new language guide, used some of the 'violent' phrases herself in 2019 on X

The APA’s own chief diversity officer, Dr Maysa Akbar, who even penned the foreword to the new language guide, used some of the ‘violent’ phrases herself in 2019 on X

The APA is a scientific and professional organization that represents psychologists in the US, with over 157,000 members.

It serves as a source of guidance for clinicians who are practicing with patients.

The association criticized the phrases ‘stand up for’, ‘lend your voice’ and ‘fall on deaf ears’ for being ableist.

‘Support’ or ‘champion’, ‘support’ and ‘be willfully ignorant’ or ‘deliberately ignore’ are suggested as replacement terms.

‘I don’t think people are actually going to be offended by these phrases,’ Dr Hill said.

‘I think that it would take somebody who’s just looking for something to be upset about to be offended by them, honestly. 

‘I know people who are in wheelchairs, and I have relatives who are on the autism spectrum and all these other things. Most people, even if they’re in a marginalized group, generally don’t feel bad [when hearing phrases like these],’ she added.

‘It’s other people who are in usually positions of privilege and power that go on and start telling people how offended they should be by this language. It’s really not a good thing.’

Dr Akbar, the APA's chief diversity officer, also used the phrase 'stand up for' in 2018, which her own language guide has deemed ableist

Dr Akbar, the APA’s chief diversity officer, also used the phrase ‘stand up for’ in 2018, which her own language guide has deemed ableist

‘Turn a blind eye to’ should also be swapped with ‘ignore’ or ‘refuse to notice,’ the APA said, to be more inclusive to people who are blind.

Psychologists should say ‘show unconscious bias’ instead of the ‘ableist’ phrase ‘have a blind spot for.’

The phrase, ‘everyone should have a voice [in this matter]’ should also be abstained from, and substituted with ‘everyone should have input.’

The term ‘be shortsighted’ should also be exchanged for ‘ignore’ or ‘miss’ due to its discrimination in favor of able-bodied people.

‘Ableist terms and phrases are pervasive in everyday language,’ the association said.

‘Although the use of these ableist terms may be unintentional, be thoughtful about how to avoid language that denigrates disabilities.’

‘Birth sex’ should also be steered clear of and ‘assigned sex’ should be used instead to avoid making assumptions about someone’s sex.

‘With birth sex, biological sex is biological sex,’ Dr Hill said. ‘It is not what’s assigned, it has to do with the size of your sex cells. If you’ve got big ones, you’re a female. If you’ve got little ones, you’re a male.’

‘You can also have gender. The two are not mutually exclusive and they’re not always the same. I think that we can recognize that and still be accurate with our language and calling biological sex, biological sex.’

The term ‘blue-collar worker’ should also be avoided, the APA said, and should be swapped for ‘skilled tradesworker’ or ‘manual laborer’.

This term is considered ‘somewhat outdated as they originated in the early 20th century,’ the APA said.

A blue-collar job relates to someone who performs physically-demanding manual work, such as agriculture, manufacturing or construction.

The term stemmed from the blue denim or chambray shirts the workers wore as part of their uniforms. 

‘Poor’ is another word deemed unacceptable by the psychologists’ organization. 

‘People whose incomes are below the federal poverty threshold’ is their recommended phrasing.

The APA said: ‘Many people find the terms “low-class” and “poor” pejorative.’

‘Conversely, class solidarity exists in “poor people’s movements” and many individuals proudly identify as “working class.” 

‘Define specific income brackets and levels if possible (e.g., “low income”).’

‘As always, there should be room for nuance and flexibility when using these terms,’ it added. 

Dr Hill said: ‘We should trust that most people aren’t terrible and give people a little bit of grace with their language. This language policing is really hard. 

‘I can’t tell you how many people in academia are absolutely exhausted, because of how much we have to monitor what we say in the classroom.’

In recent years, academics have increasingly come under fire for using language that has be deemed inappropriate or discriminatory. 

‘It’s not like we were going around on these terrible rants,’ she said. ‘We’re all well-meaning, very liberal minded people. 

‘Now, it’s not even fun to teach, because you have to monitor every little thing you say, because you’ve been told that everything that you say could possibly be offensive.’

According to the APA, ‘target population’ should also be switched with ‘specific population or group of focus.’

The term ‘target population’ may be offensive because ‘many communities are targeted for violence,’ the association said.

Using the phrase ‘suffering with… [disability or condition]’ should be replaced by ‘person with a disability or person with a diagnosis of…’ due to its negative connotations, said the APA.

Dr Hill said she would not be implementing the recommendations in her work.

‘I always try to be very careful with my language, to say things in a way that is precise and not unkind,’ she said.

‘I’m not an unkind person and I wouldn’t say anything that was intentionally hurtful to somebody. 

‘But I can’t look at that list of things and try to embody it or else I’m never gonna be able to open my mouth again. We can’t keep doing this.’

APA’s inclusive language guide 

PERSON-FIRST AND IDENTITY-FIRST LANGUAGE

wheelchair-bound → person who uses a wheelchair

confined to a wheelchair → wheelchair user

mentally ill/crazy/insane/mental defect/suffers from or is afflicted with →  person living with a mental illness/person with a preexisting mental health disorder/person with a preexisting behavioral health disorder or person with a diagnosis of a mental illness/mental health disorder/behavioral health disorder

asylum → psychiatric hospital/facility

drug user/abuser or addict →  person who uses drugs/person who injects drugs/person with substance use disorder

alcoholic/alcohol abuser → person with alcohol use disorder or person in recovery from substance use/alcohol disorder

person taking/ prescribed medication-assisted treatment (MAT) → person taking/prescribed medications for opioid use disorder (MOUD)

person who relapsed → person who returned to use

smoker → person who smokes

homeless people/the homeless/transient populations → people without housing/people experiencing homelessness/people experiencing unstable housing/housing insecurity/people who are not securely housed/people experiencing unsheltered homelessness/clients/guests who are accessing homeless services/people experiencing houselessness/people experiencing housing or food insecurity

prostitute → person who engages in sex work/sex worker

prisoner/convict → person who is/has been incarcerated

slave → person who is/has been enslaved

IDENTITY-RELATED TERMS

Age

 the elderly/elderly people/the aged/aging dependents/seniors/senior citizens → older adults/older people/persons 60 years and older/older population/older individuals

geriatric pregnancy → advanced maternal age/pregnancy at age 35 or older

silver tsunami → age-related population changes/age-related demographic changes

Body Size and Weight

ideal weight/goal weight/“Your preferred weight is…”/“Your ideal weight is…” → “Your weight is…”/“The health indicator(s) for you to be aware of is/are”

underweight/fat/obese/morbidly obese → lower weight/higher weight

“Wow, you’re looking great!”/“Look at how much weight you’ve lost! I’m so proud of you!”/“You’re getting so big!”/“What happened, you’ve lost/ gained so much weight?” → “Is it alright if we talk about your weight?”/“Would you feel okay [or comfortable] if we discussed your weight?”

Disability

special needs/differently abled/multiabled/physically challenged/mentally challenged/mentally retarded/handi-capable/handicapped/suffering with… [disability or condition] → person with a disability/person who has a disability/disabled person/people with intellectual disabilities/child with a congenital disability/child with a birth impairment/physically disabled person/person with a physical disability

mentally ill → person with a mental disorder/person with a mental illness/person living with a mental health condition

person with deafness → Deaf person/person who is deaf

hearing-impaired person/person who is hearing impaired → hard-of-hearing person/person who is hard-of-hearing/person with hearing loss

person with deafness and blindness → Deaf-Blind person/a Deaf person with low vision/a person who is deaf with low vision

person with blindness → blind person/person who is blind

visually challenged person/visually impaired person/vision-impaired person/person who is visually impaired/person who is vision impaired/sight-challenged person → person with low vision

wheelchair-bound person/confined to a wheelchair/cripple/invalid/gimp → wheelchair user/person who uses a wheelchair/person with a physical disability

AIDS victim/HIV patient → person with AIDS/person with HIV/person living with HIV/HIV-positive person

brain damaged → person with a traumatic brain injury (TBI)

defective/nuts/crazy → person with a mental disorder/person with a mental illness/person living with a mental illness

alcoholic → person with alcohol use disorder

addict → person with substance use disorder

stand up for → support/champion

turn a blind eye to → ignore/refuse to notice

be myopic or shortsighted → ignore/miss

have a blind spot for → show unconscious bias

blind review/blind coding → anonymous review/masked review/masked coding

color blind → deuteranomaly, achromatopsia (or other type of color-vision deficiency)/color-vision deficiency

fall on deaf ears → be willfully ignorant/deliberately ignore

tone deaf → insensitive/out of context

midget → little person/person of small stature/dwarf/having dwarfism

lame → boring/mundane/uncool

lend your voice → support

everyone should have a voice [in this matter] → everyone should have input

make your voice heard → express your perspective/opinion

able-bodied → nondisabled

Sexual Orientation and Gender Diversity

birth sex/natal sex → assigned sex/sex assigned at birth

born a girl, born female → assigned female at birth (AFAB)

born a boy, born male → assigned male at birth (AMAB)

female to male → assigned female at birth (AFAB)

male to female → assigned male at birth (AMAB)

hermaphrodite/she-male/he-female/tranny/transvestite/transsexual → intersex/LGBTQ, LGBTQ+, LBGTQIA+, etc./transgender person/transgender people/trans and gender nonbinary folks or folx/genderqueer/queer

transgendered → transgender

Socioeconomic Status 

the poor/poor people → people whose incomes are below the federal poverty threshold

low-class people/lower class people → people who are of low SES/ socioeconomic status

homeless people → people without housing/people experiencing houselessness/people experiencing housing insecurity or food insecurity

blue-collar worker → skilled tradesworker/manual laborer

white-collar worker → salaried professional

ghetto/the ghetto → underresourced area/low socioeconomic area

Culturally Appropriative and Pejorative Language

sold down the river → betrayed

Violent Language

killing it/nailing it → great job/awesome

take a shot at/take your best shot/take a stab at → give it a go/try

target population → specific population/group of focus

off the reservation → disagree with the group/defect from the group

Language That Doesn’t Say What We Mean

committed suicide/suicided failed/successful suicide/completed suicide/killed themselves → died by suicide/death by suicide/lost their life by suicide/survived a suicide attempt

child prostitute/sex with an underage person/nonconsensual sex/date rape or acquaintance rape → child who has been trafficked/child who has been raped/rape/rape or sexual assault

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