{"id":1578,"date":"2021-07-19T00:25:05","date_gmt":"2021-07-19T07:25:05","guid":{"rendered":"http:\/\/blog.stevenreidbordmd.com\/?p=1578"},"modified":"2021-07-28T17:00:07","modified_gmt":"2021-07-29T00:00:07","slug":"retronyms-teletherapy-and-implicit-bias","status":"publish","type":"post","link":"http:\/\/blog.stevenreidbordmd.com\/?p=1578","title":{"rendered":"Retronyms, teletherapy, and implicit bias"},"content":{"rendered":"\n
\"\"<\/figure><\/div>\n\n\n\n

What is a retronym?<\/h4>\n\n\n\n

 Retronyms<\/a> are adjectival qualifiers, like “acoustic\u201d guitar and “snail\u201d mail, that were previously unneeded — because all guitars were acoustic and all mail was slow.  We only added qualifiers when alternatives arose.  As these two examples illustrate, retronyms can be nearly neutral \u2014 the status and popularity of acoustic and electric guitars are roughly equal \u2014 or plainly judgmental.  Snail mail is explicitly inferior to faster email. \u201cSnail\u201d is not a neutral term.<\/p>\n\n\n\n

Psychotherapy conventionally occurred between two people in one physical room.  Although teletherapy \u2014 psychotherapy conducted over telephone or video \u2014 is not new<\/a>, it was previously a special case.  As such, it required specification while regular therapy did not.  Consider an analogy with \u201cskateboard\u201d: without a qualifier, the word clearly refers to the kind operated by foot power.  An electric skateboard is an innovation that must be specified.<\/p>\n\n\n\n

However, as alternatives become more established, we often employ retronyms.  In contrast to \u201cskateboard,\u201d it is less clear what we mean by \u201cscooter.\u201d  There are kick scooters, electric and gas scooters, even \u201cstand up\u201d scooters in contrast to those with seats.   Now we routinely disambiguate the word \u201cscooter” by specifying which kind.  Likewise, the growing popularity of teletherapy, which was greatly accelerated<\/a> by the pandemic, now compels many of us to disambiguate \u201cpsychotherapy\u201d with a retronym.<\/p>\n\n\n\n

 Which words should we use to describe these alternatives?  And what do our word choices imply about how we judge each alternative’s quality, desirability, and legitimacy?<\/p>\n\n\n\n

How do we feel about teletherapy?<\/h4>\n\n\n\n

When it comes to psychotherapy, many argue for value-neutral contrasts such as \u201consite\u201d versus \u201conline,\u201d terms carefully chosen not to telegraph a preference.  In particular, \u201conline\u201d therapy avoids the implicit negative bias in alternatives like \u201cremote\u201d or \u201cdistance\u201d therapy.<\/p>\n\n\n\n

But using \u201consite\u201d as a retronym levels the playing field awkwardly and artificially.  \u201cOnsite\u201d obscures real differences between talking face-to-face with another live person in the same room, versus through screens and microphones.  (And technically speaking, therapy could be onsite and online at the same time, say in adjoining rooms connected electronically.)  Even an alternative such as \u201cunmediated,\u201d which more accurately contrasts the two options, tiptoes around the essential differences between them.  We\u2019d be more honest simply sticking with \u201cin person\u201d despite its positive emotional bias.  Or we could use no qualifier at all, and rely on the assumption that psychotherapy is in person unless otherwise specified.<\/p>\n\n\n\n

Expressing honest values is not a hard-sell<\/h4>\n\n\n\n

It’s nearly impossible to scrub value judgments from natural language.  If a term doesn\u2019t already come with an explicit value judgment, it often develops one over time.  \u201cJuvenile delinquent\u201d and \u201cmentally retarded\u201d were both introduced to replace prior stigmatizing terms \u2014 and then became stigmatizing themselves.  In similar fashion, the fortune of \u201conline therapy\u201d as a term will rise or fall depending on how the public comes to feel about the practice.  Meanwhile, \u201cin person\u201d or \u201cface to face\u201d therapy sounds superior because intimacy is inherently good, especially in a healing context.  No linguistic contortion can change that.<\/p>\n\n\n\n

Of course, there are competing goods.  \u201cNew, improved\u201d teletherapy also sounds attractive, as does teletherapy that is \u201ceconomical,\u201d \u201caccessible,\u201d or \u201chassle free.\u201d  Descriptions of therapy from any angle can sound like an advertising pitch.  As healing professionals, we walk an ethical tightrope between presenting alternatives realistically, even though this reveals our values and biases, versus crudely touting our own approach and denigrating others\u2019.<\/p>\n\n\n\n

Face to face therapy is<\/em> different<\/h4>\n\n\n\n

In walking this ethical tightrope, some try too hard to be carefully neutral.  The result is dry and unrealistic.  The essential difference in the two types of therapy is not that one is onsite or even unmediated.  It\u2019s the difference between talking to a person<\/em> and talking online to a person<\/em>.  <\/p>\n\n\n\n

Subjectively, we all know these are quite different experiences.  Moreover, barring practical considerations, the former is usually preferred. When family members meet on Zoom or FaceTime, they typically look forward with anticipation to their next meeting in person (or reminisce about past such meetings).  The reverse is not true.  When family members meet in person, they do not typically look forward with anticipation to their next virtual encounter.  This asymmetry holds in other relationships as well, e.g., in business and romance.<\/p>\n\n\n\n

Note that humans have been talking to one another for decades using telephones, and more recently computers.  Yet we often don\u2019t employ a retronym to disambiguate \u201ctalking\u201d when we mean in person, face to face \u2014 the original kind of talking.  \u201cI talked to Mary\u201d is usually clarified by context, e.g., where Mary is located, not by an adjective.  By extension, \u201cI had a therapy session with Mary\u201d naturally connotes doing so in person, unless the context suggests otherwise.  The choice to use (or not use) a retronym is essentially a political act: a way to grant or deny status to the new, as compared to what came before.<\/p>\n\n\n\n

This isn’t going away<\/h4>\n\n\n\n

Looking to the future, we may someday feel pressure to specify \u201chuman\u201d therapy in order to distinguish it from computer-generated \u201cAI\u201d therapy. This pressure will come from those who aim to grant AI therapy a legitimacy comparable to the human default. Advocates may even complain that “human” is unfairly positive, and suggest something more neutral.<\/p>\n\n\n\n

Does \u201chuman\u201d carry positive connotations, an implicit bias?\u00a0 Of course it does.\u00a0 This is inevitable \u2014 and it stands in clear contrast to putting our thumb on the scale with terms like \u201cmeatware therapy\u201d (to denigrate the traditional type, see \u201csnail mail\u201d) or \u201cinhuman therapy\u201d (to denigrate the new type, see \u201cjunk food\u201d).\u00a0 Sometimes accurate descriptors such as \u201chuman\u201d or \u201cin person\u201d sound more attractive because they really are \u2014 if we choose to use them at all.<\/p>\n\n\n\n

 Image courtesy of zirconicusso at FreeDigitalPhotos.net<\/em>
<\/p>\n","protected":false},"excerpt":{"rendered":"

What is a retronym? <\/p>\n

 Retronyms are adjectival qualifiers, like “acoustic\u201d guitar and “snail\u201d mail, that were previously unneeded — because all guitars were acoustic and all mail was slow.  We only added qualifiers when alternatives arose.  As these two examples illustrate, retronyms can be nearly neutral \u2014 the status and popularity of acoustic and […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[8],"tags":[81],"class_list":["post-1578","post","type-post","status-publish","format-standard","hentry","category-psychotherapy","tag-online-therapy","odd"],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1578","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1578"}],"version-history":[{"count":5,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1578\/revisions"}],"predecessor-version":[{"id":1584,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1578\/revisions\/1584"}],"wp:attachment":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1578"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1578"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1578"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}