“I’m so OCD” and Other Commonly Misused Psychology Terms

As a psychologist, I often have to hold my tongue when I’m out in the "real world” and hear people saying things like, “I’m so OCD,” or “Stop being such a schizo.” We’ve come a long way toward having a better understanding of mental health disorders and psychology concepts, but unfortunately there are many terms from the field that are commonly misused. In his post, I’m going to break down five psychology terms that I hear misused often.

OCD

Let’s start with probably the most common one. Even yesterday while listening to a podcast made by licensed therapists, I heard one say, “But that’s probably just me being OCD.” Usually when people casually misuse this term in conversation, they are trying to say that they are neat and tidy, that they like things to be orderly and straightened up, or that they are very particular about how things go. That is not what OCD means.

OCD stands for Obsessive Compulsive Disorder. In OCD, you can have the presence of obsessions, compulsions, or both. Often when you have both, they are linked in some way. The DSM-5 (our diagnostic manual) defines obsessions as, “Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.” It defines compulsions as, “Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”

In OCD, these obsessions and compulsions are disruptive and cause impairment in the person’s daily functioning. Often they are also time consuming, such as spending more than one hour per day engaged in compulsive behaviors.

There are certainly circumstances where someone has compulsive behaviors that relate to cleanliness or orderliness, but it’s not a simple preference or tendency toward being persnickety. They typically feel a sense of anxiety or unease and the compulsions are aimed at reducing that stress. For instance, someone might flip a light switch on and off repetitively because it didn’t “feel right”. They may end up flipping that switch dozens of times before it feels right enough or they are redirected by someone else.

Obsessive thoughts can come in many forms including fears of contamination, thoughts of losing control, unwanted sexual thoughts, or images of violence. Many times, the compulsions are carried out with the intention of reducing the stress and anxiety caused by the obsession. For instance, someone with a obsession of their house being broken into and their family being harmed might repetitively check the locks on all the doors in the house in such as way that they often miss appointments due to taking an excessively long time to leave the house.

Interestingly, what most people refer to as being "OCD” is actually closer to a disorder called Obsessive Compulsive Personality Disorder (OCPD), which the DSM-5 characterizes as, “a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts.” But most people who say that their OCD is acting up in casual conversation are also not referring behaviors significant enough to qualify for OCPD either.

Bipolar

Thanks to a lot of celebrities that have been more open about their own struggles with bipolar, I think that this one is getting better. However, it’s still quite common to hear people say that they are, “kind of bipolar,” in everyday conversation. Bipolar does not just mean that you have mood swings.

Bipolar is a type of mood disorder that is characterized mainly the presence of depression, which your are likely familiar with, and also an experience called mania. Mania is a period of elevated, expansive, or irritable mood characterized by things like inflated self-esteem, decreased need for sleep, increased talkativeness, racing thoughts, increased goal directed behavior, and decreased impulse control.

It’s more than just having mood swings or bad days. Manic phases last at least four days and you experience the symptoms are present most of the day nearly every day. You aren’t sleepless because you have insomnia. You actually feel like you don’t need sleep. And mania isn’t always a pleasant experience. I have had patients make impulsive decisions to buy cars, start new companies, or leave their families due to the impact of their mania.

What I’ve been describing here is called bipolar I. There are other bipolar disorders such as bipolar II and cyclothymic disorders. I’m not going to get into more detail here, but if you are interested in learning more, check out this great video by Psych2Go.

Dyslexia

People seem to think that dyslexia refers to seeing things backward, writing numbers and letters backward, or having right and left confused. While there are some forms of learning disabilities that cause someone to misperceive in this way, it’s not typically what actually happens with dyslexia. Dyslexia is a learning disorder that has to do with “phonemic awareness.” Remember Hooked on Phonics? I can recall videos that went “buh… all… ball!” Those little chunks of words are called phonemes. When someone without dyslexia interprets language, they process it at the phonemic level. They can break apart the words into their individual pieces and put them back together to make a whole word. For people with dyslexia, they typically have a very hard time with this. They can learn many words and be fully able to read, but that reading is typically slower because rather than learn the small components of speech, they use a more “brute force” approach and memorize whole words. If you or someone you know may struggle with dyslexia, be sure to reach out to a school psychologist or speech language pathologist. Early detection and intervention can make a huge difference in someone’s quality of life.

Schizophrenia

If there’s something that grinds my gears, it’s people using the term “schizo” as some general umbrella term to denote that someone is “crazy”. As portrayals of schizophrenia in popular media become more common and more accurate in their depiction, this is becoming less of an issue, but for one reason or another a lot of people have misunderstood schizophrenia as meaning that you have multiple personalities. That is actually a different disorder called dissociative identity disorder. Even though this isn’t an accurate representation of schizophrenia, it’s actually somewhat understandable since according to Merriam-Webster, the word can also be used to describe “contradictory or antagonistic qualities or attitudes.” A movie or book can have a schizophrenic quality about it, for instance. Makes things very confusing.

Medically speaking, schizophrenia is from a class of disorders called psychotic disorders. These disorders feature a break from reality. Most notably, in schizophrenia you can have delusions, hallucinations, or both. Delusions are strongly held beliefs that do not match with most other people’s reality. For instance, someone might have the delusion that they are being poisoned or that they are the reincarnation of a messiah. Hallucinations are sensory experiences that are not rooted in reality such as seeing or hearing things that are not there. Schizophrenia (technically schizophrenia spectrum disorders) is a more complicated topic that I can fully explain here. There are other features such as disorganized speech, flat affect (expression of emotion), and even catatonic symptoms that can be features of schizophrenia. However, even though a person might hear voices, people with schizophrenia alone do not have multiple personalities.

Negative Reinforcement

This is a term that people use very frequently in everyday life, but it is almost always used incorrectly. When most people use the term negative reinforcement, they are usually referring to attention given to negative behaviors. Like if a child acts out at the dinner table to intentionally get their parents to yell at them because they enjoy the attention. That’s actually an example of positive reinforcement. Let me explain.

Reinforcement refers to something that increases the frequency of a behavior. If you get praise from your boss for exhibiting a certain behavior at work, you are more likely to do that behavior in the future. On the flip side, punishment refers to something that decreases the frequency of a behavior. If you receive a reprimand or suspension at work, you are unlikely to continue the behavior as often.

The part where it gets tricky is when it comes to the positive and negative parts. Don’t be fooled though, it’s actually quite simple. Positive means something is given and negative means something is taken away. A good example of negative punishment is taking away a teenager’s phone for their bad grades. Taking away something in order to reduce a behavior. Spanking would be an example of positive punishment (with kids). You are giving something to reduce a behavior.

So… putting this together, what is negative reinforcement actually? It is when you take away something with the intention to increase the behavior. A great example is taking medication. You take an ibuprofen and your headache goes away. That’s reinforcement because you are getting rid of a bad thing. This will make you more likely to take that medication next time you have a headache. Negative reinforcement actually plays a huge role in anxiety. When you avoid something because your anxiety is telling you to, you actually increase the behavior of avoidance due to the relief of not having to do that scary thing. In other words, you take away the situation, which reduces the feeling of anxiety, which makes you more likely to avoid in the future.

Try to Be Accurate

If you have found yourself incorrectly using some of these mental health terms, try not to beat yourself up. As I mentioned, it’s pretty common. In some cases, incorrect usages actually become part of the accepted vernacular. That said, I think that it’s really important to try to be as accurate as possible with your language. Both out of respect for people who struggle with mental health issues and to be a more effective communicator. So, see if you can catch yourself the next time you are tempted to incorrectly use a psychological term and instead substitute in a more accurate word or description for what you are trying to say.