Why (Not) Therapy? The Case for Psychoanalysis in an Age of Therapy-Speak
By Arturo Bandinelli
Browse through any social media feed today and you will stumble across a familiar mental health vocabulary. We talk about boundaries and triggers, about attachment styles and diagnostic labels. Words that not long ago lived mostly in consulting rooms and specialised journals now circulate everywhere, from classrooms to offices, from group chats to TikTok reels. As a society, we have become remarkably fluent in the language of therapy, in what is now often referred to, not without a touch of irony, as therapy-speak.
The rise of therapy-speak
It helps to remember that this is not really one uniform language, and that it has a history. It is a strange cocktail, and not always a well-mixed one. Psychiatric categories such as ADHD, OCD, and ASD sit beside the looser vocabulary of various therapeutic models which speak of personality types, attachment styles, and the inner child. All these notions have passed through the ordinary process by which specialist terms are simplified once they travel beyond the field that coined them. Every discipline develops its terminology within its own framework of thinking, an epistemology; popularisation keeps the word while letting the thinking fall away, so the term arrives loosened from the context that once held it in place.
This is not, in itself, a problem; indeed, it is an essential characteristic of language, its fluidity and plasticity. Besides, attaching a word to what has felt formless and troubling can often offer relief. Language lets us name our pain, share it, and recognise ourselves in others. To be able to say anxiety, trauma, or burnout may let us feel less alone with it. Furthermore, a label such as ADHD or ASD can open the way to workplace and educational adjustments, or grant access to communities and services. This is no small thing.
And yet something curious happens when this vocabulary travels back into the consulting room. People increasingly arrive equipped with an array of diagnostic labels and therapeutic terms. I’m anxiously attached. I have ADHD. I keep ending up with narcissists. I find myself wondering what those statements mean, for the person in front of me. And I ask. This is often met with surprise, even a flicker of irritation at times, and understandably so. Aren’t you supposed to be the expert? Don’t you already know?
The truth is, I do not. In my experience, a label often tells us more about the cultural context that supplied it than about the particular suffering of the person reaching for it. No two anxieties are alike: the word is shared, but what it circles, when it arrives, the images it carries, is unique to each person. When we favour the explanation given by a label over the way each person relates to that label, in singular and unrepeatable ways, we miss a chance to engage with the uniqueness of their being.
The courage of not understanding (too soon)
So, in a world saturated by mental health discourses, what is the psychoanalytic therapist for? Not, perhaps, what is hoped for, at least if we follow the flashy slogans of some multinational therapy platforms. Beyond a safe, non-judgemental space, what the psychotherapist offers is, at least initially, a kind of reluctance: an unwillingness to understand too quickly.
There is an old name for this: learned ignorance. Not the absence of knowledge, but the discipline of not ‘closing’ knowledge into understanding. As counter-intuitive as it may seem, understanding, when it comes too soon, can be reductive at best and oppressive at worst. It is tempting to file a person under a type we have met before, to feel we have grasped them. When that happens, we reduce otherness to sameness.
To nurture a position of not-understanding is not to abandon the desire to know; it is to stay curious longer than is comfortable, to attend to how someone speaks rather than hurrying to what it ‘means,’ to take seriously the slip, the hesitation, the stray phrase. This is the peculiar compass of a psychoanalytic orientation. The aim is not simply to help people understand more or know better. It is to work at the edge of what can be known, following the material that escapes it. Not-understanding, held this way, is not a loss of orientation but a form of attention, one that declines to close the case.
There is a therapeutic point to all this, not only a theoretical one. When the particular shape of human suffering is given room, and slowly finds the words and logics that fit it, the suffering itself tends to loosen its grip, and a space opens in which something can truly change. In my experience, change of this kind lasts longer than standardised, one-size-fits-all interventions, precisely because it originates from each person’s singular way of being in the world, their history, experience, and desire. A protocol may bring real relief to a particular symptom, yet it often leaves untouched its root, so that what is quietened in one place may return, sooner or later, wearing a different face.
What therapy is for
As a practising therapist, I am cautious about the fact that the world outside the clinic increasingly uses the language of therapy, borrowing its vocabularies and concepts. My wariness is not about conceptual purity; it is not the therapist’s role to police how words are used. On the contrary, it comes from something perhaps unexpected: it can be comforting, even flattering, when everyone suddenly ‘speaks’ your language. But both comfort and flattery risk closing knowledge into understanding. Instead, it is worth all of us asking, therapists and clients alike, how this language came to settle so deeply, and whose interests are served when every difficulty is relocated inside the individual brain, or explained away through a fixed model.
I would also take with a pinch of salt the idea that therapeutic categories offer privileged knowledge of human suffering. Useful as they are to clinicians, labels and models are often static. Used outside their context, they rarely capture the movement and contradiction of a lived life. What if we instead turned to art, literature, film, poetry, dance, or music? The novel that does not leave you, the film watched over and over, the poem that cannot be paraphrased: these detail the human condition more poignantly, in all its dimensions, than any clinical model ever could.
For me, the task is to welcome all the bits of knowledge people bring, whether linked to therapeutic vocabularies or not, but not to stop there, to treat them as gateways through which something else, unknown to both therapist and patient, can emerge. Perhaps that is the better measure of attention: not how quickly a therapist can name what troubles a patient, but how long they can bear not to. This is, in the end, the unfashionable thing psychoanalytic therapy can offer. Not more expert-knowledge in a society besotted with expertise, but a space in which one is not immediately explained, sorted, and filed; one in which singularity is the point; and one in which the therapist’s willingness to resist understanding grants permission to become a new question to oneself.
Frequently asked questions
What is therapy-speak?
Therapy-speak is the everyday use of psychological and clinical vocabulary outside therapeutic contexts. Terms like boundaries, triggers, attachment styles, gaslighting, and trauma have moved from consulting rooms and academic journals into social media, workplaces, and everyday conversation. The words are often used without the conceptual framework that originally gave them meaning.
Are diagnostic labels helpful or harmful?
Both. A label can offer relief by naming something that felt formless, allow access to support and services, and connect people with shared experiences. It can also flatten the particularity of a person’s experience, especially when the label arrives before the experience has been properly explored. The question is not whether to use labels but how much weight to give them.
What is psychoanalytic therapy?
Psychoanalytic therapy is a depth-oriented form of talking therapy that pays close attention to the unconscious dimensions of a person’s experience, including thoughts, feelings, and patterns of relating that sit outside everyday awareness. Rather than offering quick explanations or fixed protocols, it works at a slower pace, attending to language, repetition, and what each person brings as singular to them.
How is psychoanalytic therapy different from CBT or other short-term approaches?
Short-term approaches like CBT tend to target specific symptoms through structured protocols. Psychoanalytic therapy tends to be longer-term and less prescriptive, working with the underlying patterns from which symptoms grow. Both can be useful. They answer different questions and suit different people at different times.
Why does a therapist sometimes resist using labels their client brings in?
Not to dismiss the label, but to make room for what the label might be covering over. The same word, say anxiety or trauma, means something different for each person who uses it. A therapist who pauses on a label is often trying to find out what it specifically means for you, rather than assuming they already know.
How do I find the right psychoanalytic therapist in the UK?
Look for a therapist with formal training and registration with a recognised UK body such as the UKCP, BPC, BACP, or BPS. Directories of verified, independent therapists, like The Therapist Finder, can help you find practitioners who have been checked rather than platforms that list anyone who signs up. An initial consultation is usually the best way to see whether a particular therapist feels like the right fit.
About the author
Arturo Bandinelli is a London-based filmmaker, independent researcher, and psychotherapist in formation. A registered UKCP Trainee Psychotherapist, he continues his formation at CFAR London. Besides his private practice, he has worked clinically in specialist services focusing on psychosis, racial trauma and suicidal experience, and in higher education as an in-house therapist. His academic research bridges psychoanalytic and psychosocial ideas, with a particular interest in questions of epistemology, desire, and the visual field. He has published in academic journals and edited collections, and serves on the editorial team of JCFAR.
