Free Speech and Therapeutic Speech


Sticks and stones may break my bones, but words can never hurt me…




“Sticks and stones may break my bones, but words can never hurt me.”

On the contrary, words can hurt us. Despite the bravado of this childhood idiom, words can potentially be harmful. Salman Rushdie certainly knows that once again.

After years of hiding and cautious public exposure due to death threats for what he had written in a novel, he recently felt that his life was becoming more normal again. Hence, he was scheduled to be a featured speaker Friday at the Chautauqua Institute, which puts on programs that celebrate diversity, religious pluralism, and free speech. However, his optimism and health, as well as Chautauqua’s desired open ambience, were shattered as he was shockingly attacked and stabbed by a man who rushed to the stage as he was about to lecture.

For any writer, including myself, what happened to Rushdie had to be chilling. Moreover—at its essence—when, how, and what to say can be a challenge at times for everyone. Now that Rushdie is able to talk again, what will he publicly say about what happened to him? And what will his assailant say, if anything, about his motive?

Of course, there are legal limits in the United States to free speech, whether written or spoken. The main one is jeopardizing public safety. Perhaps other than in a manic or intoxicated state, many of us often try to censure our own speech to not say something wrong or that which would hurt other people. Thinking murderous thoughts or fantasies is one thing; carrying that out is quite another. Nowadays, wokeness sensitivity to inappropriate public remarks has escalated. Job loss can be the consequence. Telling the truth can be quite risky, as conveyed by the Yugoslavian proverb:

“Tell the truth and run.”

Clinical psychiatry values hearing anything and everything from patients. Freud encapsulated that in his recommendation for “free associations” during analytic sessions. On the other hand, we psychiatrists have to be very careful of what we say in order to maintain a therapeutic alliance, and not have the patient run away, by conveying compassion, empathy, and timely insights, even in brief medication checkups. In public, we are constrained by the Goldwater Rule so that harmful and inaccurate statements about public figures are not made. Rushdie and our own field make it clear that speech is not always free of potential psychological and physical cost.

Psychiatry, at our sensitive best, can be a model, if not for free speech, for more therapeutic speech. Therapeutic speech is getting into the habit of keeping the well-being of the listener in your mind.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.

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