Our name as a key to wholeness
Journal of Psychiatry Reform vol. 10 #1, January 2023
Caroline Giroux, MD, FRCPC
Professor of Psychiatry, Psychiatrist, University of California, Davis Medical Center, Department of Psychiatry and Behavioral Sciences, Sacramento, California, USA. [email protected]
As a vehicle of longing when whispered into a lover’s ears, as a culmination of birth to celebrate a new arrival, as a stamp of authenticity on the corner of a painting, in its poetic nature both from its sound and its meaning, a name often catches attention. It points in a certain direction: of our fond memories when we hear someone called the same as a beloved, of our daily planning when it is used to provide instructions, and of safety when it is said loud enough to alert someone of a danger and get their attention by addressing them by name instead of just a generic, like “sir” or “hey”. It binds one person to another when used to start a conversation, as if to seal a particular moment of total mutual attention following exchanged greetings. In our clinical settings, we ask patients about theirs to test the level of consciousness or orientation. Hence, the name we carry as label of our identity has multiple functions. We cling onto it as young children and it is so significant, it often precedes the “I” in early childhood to refer to oneself (“Diana wants to eat”, “Diana is tired”). I found it so endearing when my oldest son used his own name until he was about 5 years old. We get attached and defend it like a treasure when hearing it massacred if it is unusual or from a foreign culture (my youngest son got upset in pre-K when on his folder he noticed that an apostrophe and an s were added by the teacher after his name, to signify a possessive of the specific folder. I had to put a sticker on it to hide those intruders on his name!). We appreciate the effort of others who thoughtfully verify what is the correct or preferred pronunciation of our name, like a way to meet the other on their familiar land. We change it when we feel we need a different one to be aligned with our experienced gender and other intersecting identities. And our name is probably the word we will write down the most in our entire life: signatures on greeting cards, on forms, on exam sheets, on badges at a conference etc. Our written name leaves a trace in the tangible world. Our uttered name can mean cohesiveness of being, putting our pieces back together in one sequence of sounds and symbols.
During my many years of clinical practice as a psychiatrist, I have frequently come across patients who, after having suffered trauma or a psychotic illness, report hearing their name called as a perceptual disturbance. I think this manifestation is not random or insignificant, given that a name can be tied to our sense of identity or our self-concept. It is a cue tied to our childhood and our parents’ first gift to us after life itself. Maybe they even invented it, offering us the additional gifts of their creativity and originality. Hence, hearing it might be a soothing way the brain has found to emphasize one’s sense of existence, to counteract the dissociation or sense of annihilation and disempowerment after trauma or when one loses contact with reality during a psychotic outbreak. It could also be a form of auditory flashback if a trauma involved having heard someone else threatening us or trying to warn us by calling us by name. It can have a negative connotation and make someone resent their name if they have heard it too often in the context of being reprimanded in childhood, leading to the selection and preferred usage of a diminutive or nickname instead.
Even before knowing their full story, starting a first encounter by asking our patients how they prefer to be called is not only part of bedside manners but a decent way to approach people in society in general. After all, among personal attributes and characteristics, a name may be the constant that lasts the longest in one’s life. Our physical appearance, our voice, our digestion, our muscular strength, our house, our relationships, our tastes, all of that change at some point or another. But our first name generally doesn’t. Its perennity situates us in the mental representations others have of us: family of origin, offspring, significant other, friends and colleagues. It is anchoring in times of life turmoil. It is an unshakable fact to go to anytime and lean against when we feel dismissed or alienated. It carries another person’s emotions to us like irritation (when said loudly) or tenderness (when whispered).
Making the effort to remember the name of people we meet and trying to address them by their name is a sign of consideration and respect. I would go as far as to say that it may help restore a person’s dignity. So, it should be used whenever we greet our patients because the name conveys the message “I see you” and “you matter”. The need to feel accepted is universal yet often overlooked. To refer to someone by name implies that we at least accept a co-presence with each other. It personalizes it and allows a degree of intimacy that goes beyond neutral encounters when we ask a stranger for directions for instance. It helps us all feel like our status in a particular moment is worthwhile and distinct from the status of a passerby in the eyes of the other voicing our own name. Hearing one’s name called gives some legitimacy to one’s own being too, as we may silently reply: “Yes, I am in attendance. I showed up to life again today”. It makes people feel they have their place on earth. Another fond memory concerning names was when we were traveling in Vancouver many years ago and my middle son, who had not started school yet, was noticing letters and exclaiming “this is my name!” every time he saw a sign with a big A. Our names are one way we become visible or invisible to those around us . It transcends shortcuts like “patient”, “client”, “customer” or “passenger”. People who have gone through divorce can speak of the dehumanizing aspect of being referred to as the Petitioner or, even worse, Respondent (because the other party filed, therefore there seems to be a power dynamic already just with these two different appellations).
I noticed that I became especially sensitive and attached to my name after migrating. My name acts like a stabilizing factor, something that has traveled with me, while I left so much behind. Hearing my name, especially when it is pronounced close enough to my native French, gives me a sense of familiarity, of “homeness” that feels very reassuring. Over the past few years, as an icebreaker, I started asking people to share the story of their name (who chose it, and why). This way to get more acquainted is fascinating. Every time, I am astounded to hear about a deeper aspect of a person, how they feel about their names, and to discover a foreign culture a little bit more. Besides birthdays and death, a name is one of the few justices in life: everybody has one or can claim one.
I don’t think there is controversy in stating that a name is a powerful element of our life. Whether we are attached to it or resent it, it can shape our sense of self and impressions others have of us. Choosing one or clinging to it can be a way to restore one’s wholeness and reclaim power. I will always remember the scene in the movie about the life of Tina Turner where while in court for her divorce, even though she was entitled to a fortune, she said all she wanted was to keep her name (Turner), her married name, the name that was now associated with her fame, and which she had worked so hard for. As we can see, there can be a lot carried or hidden in someone’s name. There can be an inspiring story of resilience, power reclaiming and healing. And making a point of using something seemingly as simple as a name can unlock countless possibilities of bonding and thriving.
- Lebensohn-Chialvo F. That’s not my name. Families, Systems, & Health. 2021 Mar;39(1):163.