Sibylla Bostoniensis

Canonical link: https://siderea.dreamwidth.org/1773806.html

There's a thing you probably have encountered and maybe haven't really registered as it went by. It usually plays out like this. Somebody else takes a noun phrase – usually there's an adjective or two involved, sometimes multiple nouns – that seems perfectly ordinary and makes sense on the face of it, and which refers to something in the real world, and the speaker makes some bold assertion about it that strikes you as really weird, and possibly highly prejudicial. What they've said leaves you thinking, "wait, how could that possibly be true?"

That's all you get. That's all the sign of what's happening. That's the glitch in the matrix.

There's a lot of reasons that people make ridiculous claims about all sorts of things, and you will always be tempted to write it off as just ridiculous people saying ridiculous things and thinking no more about it.

But if you can catch yourself in that moment, and not reflexively dismiss it as silliness, you could, instead, ask yourself: "Hey, is that noun phrase maybe a technical term of art which means something much more specific and possibly quite different from what the individual words literally mean?"

Doing this? Is a super power. Lots of people can recognize specific technical terms that they are acquainted with. Few people cultivate the more general ability to recognize – or just suspect – that a noun phrase is a technical term they aren't familiar with.

It's easy to recognize a technical term as such when it's clearly from a foreign language or has a personal name embedded in it. If you're told someone has Throckmorton's syndrome, you may never have heard of it before nor have the slightest idea of what it consists, but you know it is A Thing, and, interestingly, know by the unfamiliarness of the name that, unless you know it by another name, you are unfamiliar with it. And it's not that hard to recognize as a term of art a noun phrase that has some incongruous assemblage of words: the incongruousness signals that the words are carrying more than their literal weight.

But we have this thing going on in English – ubiquitous now, but I blame the Cognitive turn in psychiatry – of using what seem to be perfectly banal, ordinary, everyday sorts of words to name technical things.

Such technical terms pass out from their communities of practice into the general discourse where they do two things: sow chaos and function as shibboleths. The chaos is probably obvious: technical terms being misused by the general public is not a recipe for clarity in word or thought, and words that are being read by some as having an unobvious technical referent and by others as literal absolutely guarantees mutual incomprehension and discourse-wide games of Telephone. The shibboleth thing is less obvious: these phrases by their correct (technical) use and comprehension sort the insiders from the outsiders. The proper uses of such bivalent phrases is thus one of those knowledge boundaries around groups of people I like to talk about.

My favorite simple, benign, and slightly incorrect example comes from MIT. If you go there, or hang out with people from there in some context with spoken word communication, you may eventually hear someone mention a location that will sound to you like "the green building".

There is such a building on campus. Building 54.

It is not green.

It's beige.

Or whatever you call it when you start with ecru and rub air pollution on it for a few decades.

It is, of course, named after Mr. and Mrs. Green. The Cecil and Ida Green Building is referred to as the Green Building for short.

There is, in fact, at least one green building on campus – to whatever extent you agree that verdigris is "green" – but it's not the Green Building. It's Kresge Auditorium. If someone tells you to meet them at the Green building and you go to the building that is green, you will not see them there.

Everyone at MIT knows this. Most people not affiliated with MIT don't know this.

It would be understandable if upon hearing someone refer to "the green building" for the first time you assumed that you could identify the building of which they were speaking by wandering around campus looking at buildings until you found the one that was green. That is what that noun phrase literally says. That is how adjectives work. But it would be a wrong assumption because the building isn't green, it is Green. Both the personal name Green and the building name Green are proper nouns, designated in writing with initial capital letters to make that clear – a marker that is absent the spoken word.

This illustrates a difference between proper nouns and common nouns. Common noun phrases describe their referent. Proper noun phrases do not describe, they merely designate. A woman named Joy can be in a bad mood; a man named Ernest can dissemble; and building named Green can be a light brown tinged with crud.

But as I said, this example is slightly incorrect for what I want to bring to your attention. So let us imagine an alternative MIT, in some near future perhaps, where because they have closed the campus, they have a color coding system for buildings, as to how open to the public they are. We can imagine in this counterfactual that there are "red buildings" into which the public is never admitted and there "yellow buildings" in which the public can be admitted if accompanied by staff or student. And then maybe there's one building – the Student Center, say – where the public can wander unsupervised, which is designated "green" because of that. And because it is the only one such building, it is referred to as the green building.

It's not green either. Not in the literal physical sense of reflecting electromagnetic radiation in the 495–570 nm range of wavelengths. But it is, shall we say, conceptually green, in the color-coding system of security designations we are imagining – an entirely internal jargon.

To people inside the knowledge boundary – alternative-MIT affiliates who know the color-coding system – the phrase "the green building" is still somewhat descriptive, but only insofar as they make salient the conceptual color-coding security system. The green building is the building that can be described as green in the security color-code system. But it doesn't describe the building in the more salient sense of the word "green", meaning physical color. And to people outside the knowledge boundary, who know nothing about the security system, calling the building "the green building" describes it not at all. That name is entirely a designation – apparently an arbitrary one. In being a designation, not a description, it's working like a proper noun phrase, not a common one.

(Indeed, we could imagine a far-future alternative MIT in which, across the galaxy, all MIT campuses have a building in which the public is made welcome, which is always called "the green building", though the security system was left behind on Earth and nobody remembers why such buildings are called "green buildings". Analogous to how we wound up with the term "green room", the origin of which is lost to history, or at least Wikipedia.)

That's what I want to bring to your attention: noun phrases that work like proper nouns, but look like – and are easily mistaken by outsiders for – a common noun phrase.

Call them improper nouns. It's like a stealth proper noun: like a proper noun phrase, it designates, without describing, but it sure looks like it's just garden-variety description.

It has none of the ordinary indications that proper nouns do that twig us it is designating without describing. Proper nouns, for instance, are designated with capital letters. In real-world MIT, the confusion fostered by the name of the Green Building is strictly an aural artifact. There's no confusion that the Green Building is not merely a green building in writing. Of course, we have no capital letters in spoken English, so there's ambiguity aloud. In our hypothetical color-coded MIT, that ambiguity persists in writing, because "the green building" is not just not a building that is physically green, but not capitalized either: it's an improper noun.

Likewise, if you heard someone had "dysthymia", you might have no idea what it meant, but you would recognize it was some sort of technical term, quite simply because you didn't recognize it, it being an entirely unfamiliar word. You might not realize the same thing if you heard they had "persistent depressive disorder" – which can be taken descriptively to just mean "a depression that sticks around a bunch" – which is a synonym for it. "Persistent depressive disorder" thus is an improper noun.

We have ways of indicating or at least suggesting a word is a proper noun or a term of art, and an improper noun uses none of them.

An improper noun is a phrase that has been recruited – or perhaps appropriated – from colloquial language by some technical people to designate a concept or thing important to them, but which is not only inscrutable to outsiders, it's nigh-invisible, in that it's easily mistaken for an ordinary descriptive phrase.

Now, I know, right now, there's someone out there reading this, rolling their eyes, and thinking, "this is all just semantics", and I want to let you know, whomever you are, that for once in your miserable excuse for an existence you have finally used the word "semantics" correctly.

But make no mistake, there's no "just" about it. It may sound like tedious, hair-splitting pedantry; that would be because it is. But it's powerful tedious, hair-splitting pedantry. Tedious, hair-splitting pedantry about semantics is to our word-ensorcelled, semiotically treacherous, bureaucratic, hyper-siloed civilization what the great tracking skills of hunters of yore were to the wilderness: an art by which sense is made of a great tsunami of information through the recognition and reading of some of the subtlest of signs. It is nigh magic. Tedious, hair-splitting pedantry about semantics is one of the most powerful weapons available to you; let me put it in your hands.

And this is no academic exercise.

This post was occasioned by three examples that crossed my desk in the same narrow window of time.

First, over on Reddit's r/science, somebody posted an article about research into the "highly sensitive person". A lot of commenters were very upset and bewildered by what they took the research to be saying about people who were particularly "sensitive", in some sense or another.

The problem here is that "highly sensitive person" doesn't just refer to people who are sensitive. Perhaps it should be in initial capitals, as a proper proper noun – "Highly Sensitive Person" – but in the popular press article, it wasn't. It's a psychological construct proposed by psychologist Elaine Aron. It is a technical term, with a technical definition and criteria. It is, in other words, an improper noun. The findings do not concern sensitivity per se, they concern people who meet the criteria for this psychological construct designated, non-obviously, by the improper noun "highly sensitive person".

One commenter angrily asked why would a researcher assume someone who is very easily annoyed by subtle physical sensations would also be prone to emotional rejection sensitivity. The answer is simple: the researcher didn't assume that. That's definitional to Aron's HSP construct. If you don't have both, you don't meet the criteria. Highly Sensitive People aren't just highly sensitive people, they're people who meet sufficient criteria for the Highly Sensitive People construct.

(As an aside, I keep using the word "construct", because if what Aron had proposed was a pathology, we'd call it a "psychiatric diagnosis" or "psychopathology". But one of her big points is that it's not a pathology. Had she written it later, she might have termed it a form of neurodiverity. We don't have a generic term for abstractions structured like diagnoses which don't describe pathologies. So I'm stuck with the vague term "construct".)

Aron's designation of her construct, "highly sensitive person", is an improper noun: it is a term of art which appropriates colloquial language to describe a technical construct which can't possibly be derived from the conventional meanings of the words used. It functions like a proper noun, but doesn't look like one, and has nothing intrinsic about it that suggests it is one.

Next example: in July, the federal government passed a law that PolitiFact described as "Gun safety ‘wrapped in a mental health bill’" (article), of which PolitiFact said:

The new law also provides up to $8.6 billion in funding over 10 years to support the build-out of certified community behavioral health clinics in every state in the U.S. These types of clinics, which already exist in 10 states as part of a pilot Medicaid program, are required to see people regardless of their insurance coverage and treat them for mental health or substance use issues. States would need to apply to participate in the program, which would begin in 2024.

In this paragraph, "certified community behavioral health clinics" is invoked as if that phrase were actually meaningful in and of itself. If you don't know how the federal government and mental health care facilities and money interact, that paragraph raises questions like, "Wait, only 10 states had behavioral health clinics that are in communities and are certified?" Of course not. Every state in the Union has what are called "community mental health centers", which are funded (poorly!) by the Feds.

Both of these terms, "certified community behavioral health clinics" and "community mental health centers" are improper nouns.

If you do know how the federal government and mental health care facilities and money interact, like me, this paragraph raises questions like, "JFC, have they invented an alternative to community mental health centers, or is this a rebranding of them? What even the hell is this?" Even if you know quite a bit of the context in which this the noun phrase "certified community behavioral health clinics" is dropped, you still can't figure out just from the words of the noun phrase what it means – because it's an improper noun. It looks like an ordinary noun phrase that can be read literally, and it is not, it's a jargon term functioning like a proper noun.

Again, the string, "certified community behavioral health clinics" should perhaps be in all caps – "Certified Community Behavioral Health Clinics", or a CCBHC – not unlike how "community mental health centers" (CMHCs) should be in all caps. What makes a CCBHC a Certified Community Behavioral Health Clinic is not that it's a behavioral health clinic that is certified and in/serves the community, but that it's a clinic that meets the Federal government's legal standard for what constitutes a CCBHC, which, I am informed by a random alleged-therapist I met on the internet who claims to work for one, is that a CCBHC, unlike a CMHC, includes primary care, and is apparently kind of like, or actually is, a medical home.

("Medical home" is another improper noun. It means a medical practice, usually but not necessarily a primary care provider, who coordinates all one's medical care. Mostly used for patients with complex medical problems and an army of treaters whose efforts need to be orchestrated.)

None of which is explicit in the description "certified community behavioral health clinics".

Likewise, I worked for a mental health clinic that served a neighborhood, but it wasn't a community mental health clinic. It even had underpaid clinicians serving indigent patients, like CMHCs generally do. But, no, CMHC is an improper noun that refers to a Federal program created in, IIRC, the 1970s. It was supposed to be what took up the slack when they emptied out the asylums and defunded the mental hospitals, and which was egregiously under-funded. The clinic I worked for was privately owned and not funded directly by the feds – though better than 95% of our clientele were on Medicaid or Medicare, so it was all Federal dollars under the hood – and not part of the CMHC program. So it was a community mental health clinic but not a "community mental health clinic".

Third example. A friend posted in confusion about her health insurance benefits, asking what was going on that mammograms are not considered "medically necessary", per her insurance, but instead "preventative care" – as if "medically necessary" and "preventative care" were mutually exclusive categories – and that furthermore "preventative care" is covered but "medically necessary care" would not be.

By now you probably see where this is going: those are improper nouns. She quite reasonably heard them to be saying that preventative care, such as mammograms, is not medically necessary.

I explained it was a legal artifact, constructed of those two categories:

All medical care that an insurer will pay for is "medically necessary care" – I promise you, insurance companies are real hard-asses about not paying for any medical care they can possibly argue isn't medically necessary – it's just some medically necessary care is also "preventative care".

"Preventative care" is not just preventive care, but preventive care that the government requires they cover in full no matter what your plan otherwise says. Put another way, "preventive care" is that subset of medically necessary care that insurers can't legally get away with not paying for by gimmicks like deductibles, copays, coinsurance, or any other terms and conditions. It's a fixed list of things they are legally on the hook for paying 100% for, no matter what.

In American health insurance both of these terms, "medically necessary care" and "preventative care", are technical terms of art which do not mean what the words colloquially mean. They are improper nouns. You cannot possibly know what they mean from their literal meanings. They are functioning like proper nouns, and have none of the indicators that they are proper nouns.

I expect some of you, confronted with these examples, are getting pissed off that improper nouns are even a thing. For what it's worth, it pisses me off too. I don't think it's deliberate deceptiveness, but I do think it's the rhetorical equivalent of negligent malpractice. It's a pattern of language usage which casts more shadow than light, and, as far as I can tell, has absolutely no upside unless you can find some benefit to causing misunderstanding and confusion.

I don't think there's a lot of point to raging about it now; the horse is well and truly out of the barn. We can endeavor not to coin new improper nouns, ourselves, and encourage others not to either. But the reason for me explaining all this is not to cast aspersion on it, but alert you to it so you can defend yourself from it.

As I started out saying, above, there's a magic in realizing that improper nouns are a thing, and happening all around you. By their nature, they're easily mistaken for ordinary noun phrases. But if you're aware that improper nouns are a thing, it becomes possible to listen for them. Not just to recognize specific improper nouns that you're hip to, but phrases going by that you don't recognize as improper nouns – but that you might notice were used in an odd way, a way that made you go, "that makes no sense."

Like I said, that's all you get. That sense of incongruousness, about what was said about the thing. Why would someone say that about highly sensitive people? Why would someone say most states don't have behavioral health clinics that are community based and somehow certified? Why would someone say mammograms aren't medically necessary care because they're preventative care? Why would someone call the building green?

That's all you get, but if instead of dismissing it as ridiculous people saying ridiculous things, you catch yourself and say, "Hang on, is this a public discussion of a technical thing? Is there something around here that's maybe an improper noun?"... suddenly you just crashed through the knowledge boundary. You're an outsider who just picked up on the insider signal. You might not know what it means, but that's what Google search is for. Use quotation marks. Include a word to indicate the context, e.g. "preventative care" insurance. It may take some digging. But with sleuthing, you can decode the improper nouns and, voila, you have hacked into the rhetoric of some community of practice you don't belong to. You are an outsider understanding their insider communications.

You're welcome.

Furthermore, just knowing the concept of an improper noun will empower you to discriminate between an improper noun's literal and actual meanings. When you think that insurers think "preventative care" isn't medically necessary, it's bewildering and enraging. Even if you know your insurance claims – through their customer service agents – to know that preventative care is medically necessary, the way they keep determinedly using the two phrases as mutually exclusive is an endless provocation to want to check in, testily, "You know preventative care is medically necessary, right?" – unless you have the concept of the improper noun. Without it, it's hard to keep the literal and actual meanings separate. They tend to keep crashing back together; one tends to regress to the mean of the literal meaning. Having the concept of the improper noun, understanding an improper noun designates, not describes, while looking like it describes, blows away the glamour improper nouns cast. The improper noun is just a buzzword, a euphemism, jargon – it has a meaning other than its literal one – and grasping that stops it being a rhetorical divide by zero error.

Now, I've said there's very little but a sense that someone has said something that made no sense to let you know to start looking for improper nouns. But there's some other sign posts to maybe start being suspicious that improper nouns might be around. I am less certain about this.

I am inclined to say that one should be extra alert to the possibility of improper nouns when discussing anything about people, and especially so for anything concerning psychology, medicine, or healthcare – extra especially if the government is involved. But that might be a kind of sampling error: those are topics I spend a lot of time and energy on, and perhaps I find them there because that's where I am, and really they're everywhere.

Perhaps another sign post is a noun phrase with too many vague, bland terms in it. Something that sounds particularly corporate or governmental. The phrase "certified community behavioral health clinics" does invite the question "why did those words need to be in that order, strung together like beads on a string"?

Perhaps there are others; I shall report back if I find or suspect them.

I commend the concept of the improper noun to you. There are all sorts of things I would like to explain to you, that will be much easier if you have this concept already.

---

This post brought to you by the 172 readers who funded my writing it – thank you all so much! You can see who they are at my Patreon page. If you're not one of them, and would be willing to chip in so I can write more things like this, please do so there.

Please leave comments on the Comment Catcher comment, instead of the main body of the post – unless you are commenting to get a copy of the post sent to you in email through the notification system, then go ahead and comment on it directly. Thanks!