The stigma around schizophrenia reached a breaking point in Japan not long ago, when a survey of doctors found that 37 percent were not informing patients of their diagnosis. The most common reason given by the doctors was the “negative impression of the term schizophrenia.” The stigma was so great, the metaphor so buried, that in 2002 the foremost Japanese society of psychiatrists agreed to change the name from seishi buntetsu byo (“mind-split disease”) to togo shiccho sho (“integration disorder”).
An equivalent is unlikely to happen in the United States with schizophrenia (schizo- “split”; phren- “mind”). The DSM-5—the new revision of the psychiatric bible—comes out this year with minor changes to schizophrenia subtypes but no change to the term itself. Each version usually stands for about 15 years, so we can expect “mind-split disease” to still be around for at least that long.
If doctors will not change their ways, who will? According to a 2003 study, U.S. newspapers use schizophrenic metaphorically 28 percent of the time they publish the word. By my count, the New York Times used the metaphorical version 38 percent of the time in 2012. Slate has used it about three dozen times since 1996. Even the scientific journal Nature called topsy-turvy electrons schizophrenic in a news piece.
A solution, then: The secondary, metaphorical definition of schizophrenic should no longer be used in online and print media.
But media style guides tend to reflect linguistic attitudes rather than drive them. So if doctors won’t change, and the media won’t change, it remains that we must change. Politely remind people that if Congress was indeed acting schizophrenic, it would have flattened emotions; social withdrawal; and be prone to delusions, hallucinations, paranoia, and occasional disordered thought. If this seems prescriptivist (which it is), the precedent is already set: derogatory, stigmatizing words are commonly removed from both media vocabulary and from polite conversation. In this case, the harm is clear and the solution simple.