On the latest Got Therapy? Dr. Dan Rose described a moment every clinical supervisor has watched and few of us name. A trainee is sitting with a client, and somewhere in the session they "suddenly become capital T therapists."
You can hear when it happens. In Dan's words, it "usually happens when they start using polysyllabic words." The jargon arrives, and in Dan's reading it is rarely about the client. It's an expertise "often in the service of quelling their own anxiety about the person in the room with them."
Here is the position: our profession should treat clinical jargon in the room as clinical data, something to be supervised the way we supervise any other defense, not as a mark of competence.
Dan's rule of thumb is exact: "when the big word comes in, you're like, okay, there's suddenly something being defended against." The supervisor's question isn't whether the word was correct. It's what produced it. Is this the therapist's countertransference? Or is the client doing what they do with everyone, arriving "hoping for emotional connection, but there are these reflexive behaviors that they indulge in that cause the very thing they're trying to keep from happening"?
Either way, the big word is a clue, and supervision is where the clue gets followed.
This matters beyond technique. In the same conversation Dan argued that real knowledge "generates a helpful uncertainty," and that certainty is "a form of defense." The depressed client is certain of their worthlessness; the anxious client is certain of doom. Our job is to loosen that certainty, to move a person from "I am" to "I feel." It's hard to do that while hiding behind vocabulary of our own.
The pattern also travels. As a family systems clinician, I've seen "that repeating of those processes from the client and the therapist up to the supervisor." A supervisor can answer a jargon-heavy trainee with more jargon, or, as Dan put it, "break the chain." His prescription: "Speak in as much common parlance as you can, right?"
None of this is an argument against expertise. Two well-trained clinicians, Dan noted, rarely talk to each other in big words. Fluency sounds plain. What we should be suspicious of is the sudden shift.
So listen for it. When a supervisee's language climbs, slow down and ask what just happened in the room. And before you choose your own words with a client or a trainee, do the simplest thing I know: measure the person.
As Dan said of our profession, "We're just trying to help and get out of the way."
Michael Baltimore co-hosts Got Therapy? with Dan Rose Psy.D. on Columbus Television.