Monday, May 2, 2016

Rhetoric and Jargon in Health Care Policy, Part One: "Stakeholders"

Jargon bothers me.  It reduces the enjoyment and engagement we have with languageIt can be a barrier for others to even understand what is being said.  

The term "stakeholder" is part of contemporary jargon in the area of policy development and corporate planning.  According to the Google NGram viewer, this word was very rarely used before 1975.  Since 1975, its frequency of use in printed language has increased by a factor of 10 000!  The words "stakeholder" or "stakeholders" surpassed the prevalence of the word "honesty" in written language as of the year 2000, and since then the prevalence has almost doubled again!  

Before 1975 "stakeholder" was primarily used as part of legal jargon, including one definition as follows: 

"A stakeholder is a person who is or may be exposed to multiple liability as the result of adverse claims."  
(McKinney, W. M. (1918). McKinney's Consolidated Laws of New York Annotated. West Publishing Company.)

Since 1975, the meaning has evolved to:
"a person or company with a concern or financial interest in ensuring the success of an organization or business"   (Oxford English Dictionary) 
The etymology of the word "stake," relates not to its meaning as a sharp wooden stick, but rather to another meaning, dating back to 1540,  as "the money risked on a game of dice."  (Oxford English Dictionary) 

The honourable spirit of the word "stakeholder" has to do with respecting different groups, positions, and points of view while discussing an issue in an organization.  It may invite a shared view of complex systemic matters, as though all the different interested individuals figuratively have "money risked on a game of dice."   It invites group decision making, rather than a dictatorial approach.

My complaint about this word has to do with its reflexive use as part of jargon.  There are connotations of a group of people gathered around in a betting game  (which is literally where the word originates).   There is an image of wealthy property-holders (with "stakes" in the land) debating about real estate dealings.   Another unintended connotation is of a group of people holding sharp sticks, waiting to confront a vampire! 

Finally, I wish that people in a discussion could simply be referred to as people, or by name, rather than as "stakeholders." 

I believe that the honourable spirit of respect, intended by using the word “stakeholder,” is vitally important.  But sometimes jargon brings us farther away, rather than closer, to this honourable spirit.  Many policy discussions can be so laden with this, as to be content-free, muddled doublespeak.

I invite us all to express ourselves in an articulate, engaging manner, while letting go of any need to use jargon.   Jargon can be a divisive tactic in language and debate:  many listeners become inured to it through repetition.  The jargon becomes a short-cut to be persuasive, while not leading the listener with any new thought.  It becomes "filler" in a dialog, which can distance and bore the audience.  This type of rhetoric can fool an uneducated audience into believing that the speaker is bestowing more wisdom than is actually the case.  It can also have a suppressive effect on a dissenting voice, therefore stultifying debate and free thinking. 

In cognitive therapy, we see that our minds can create various types of "inner jargon," which can perpetuate anxious or depressive states.  While cognitive therapeutic theory is laden with its own jargon, one healthy principle it encourages is to practice awareness of our "inner jargon," to "talk back" to it, and to create new, imaginative, constructive, mindful, and reasoned inner dialog or self-talk. 

I believe that cognitive therapy doesn't tend to encourage one thing enough:  to practice expressing our thoughts, or forming new inner dialogue, in a way which is rhetorically beautiful.  

In cognitive therapy, we are encouraged always to garner the courage to offer a dissenting voice!  In the case of cognitive therapy for depression, we must bravely speak back, in our thoughts, to a storm of negative, pessimistic, self-critical thinking. Let us make the "speaking back" full of eloquence, poetry, and beauty.  Let us step away from using jargon or other forms of empty talk. 

We are "stakeholders" of our own minds!   Or, different points of view held in the mind are all "stakeholders" of self.   But perhaps we can let go of the "stakes" and simply work with ideas, without using jargon, in a frank, articulate, compassionate dialogue.  


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