Call It What It Is: The Naming Method Explained

This is the core of how I work with people, so it’s worth getting on the page in plain English.

The Naming Method comes down to one principle. Call it what it is or it will keep running you. You can’t change what you won’t name, can’t heal what you keep dressing up in softer words, and the energy you spend keeping the truth at arm’s length is the same energy you’d otherwise have for actually doing something about it. The moment you put a real name on something, it stops being everywhere and starts being a specific thing with a specific shape, which is the precondition for any of the rest of treatment to land.

You can’t change shit you won’t name.

When you’re avoiding something, call it avoidance. When you’re lying to yourself, call it a lie. When you’re making a choice, call it a choice. When you’re using substances to not feel things, call it numbing. When you’re being a coward about a hard conversation, call it cowardice… not as an insult, not to beat yourself up, but because pretending something is something else hands it the steering wheel.

People spend enormous energy dancing around the truth. They say “I can’t” when they mean “I won’t,” they say “it just happened” when they made a choice in stages over six weeks, they say “I’m fine” when they’re falling apart, they say “I need a drink to relax” when what they’re doing is avoiding feeling anything for ninety minutes. All that softening, all the euphemisms, all the little justifications stacked on top of each other… that’s what keeps you stuck. You can’t change shit you won’t name.

A guy who came in for sleep

The pattern I run into most weeks goes something like this. Say you’ve got a guy in his forties who comes in for sleep. He can’t fall asleep before 1 or 2 AM, wakes up at 5, exhausted by Tuesday. His primary care doc has tried trazodone 50mg, then bumped it to 100mg, then added melatonin, none of it has touched the problem. He wants to talk about whether he should try a Z-drug or a low-dose quetiapine. He has a list. He’s done his reading.

About fifteen minutes in I ask him what he’s doing between 10 PM and the moment he tries to sleep. He says he works, email mostly, sometimes he’ll “decompress” with wine and his phone in bed. I ask him why he’s working until midnight. He says he has to. Kids, partner-track, no choice.

We sit with that for a minute. Then I ask him if he’d actually get fired tomorrow if he stopped answering emails at 9 PM. He starts to say yes and then stops, because the honest answer is no. The honest answer is he doesn’t trust his colleagues to think he’s working hard enough. The honest answer is he’s built his whole identity around being the guy who always responds, and stepping back from that feels like a kind of death.

That’s not insomnia. That’s a guy hammering on the work button until 11:55 and then being shocked his brain won’t go quiet at midnight. The trazodone isn’t failing. The trazodone is being asked to sedate a nervous system that’s getting deliberately revved up four hours earlier by its own owner.

The work wasn’t a Z-drug. The work was naming what he was actually doing. He was using overwork to manage a fear of being seen as ordinary. The insomnia was the third domino, not the first one. Once we called it what it was, he had a real decision to make, which is different from pretending he didn’t have a choice in the first place.

You already know the truth about yourself. You’re just scared to say it out loud, and the not-saying is doing more damage than the truth would.

What naming actually does in the brain

This part isn’t just folk wisdom. There’s a chunk of neuroimaging work from UCLA, Matt Lieberman’s group in particular, showing that putting feelings into specific words reduces the activity in the amygdala (the alarm-bell part of your brain that fires when something feels threatening). The technical name they gave it is “affect labeling.” Vague distress lights up the alarm circuit. Specific naming, even of the same emotion, dampens it. When you can’t name what you’re feeling the top of your brain can’t reach down and quiet the alarm, when you can name it the brakes start working. That’s the mechanism, in plain terms, and it’s been replicated a few times now.

This is part of why CBT (cognitive behavioral therapy, the structured worksheet-and-homework kind, not the talk-about-your-mother kind) works. It’s why the first thing a competent therapist does is slow you down and ask “what specifically.” Not “you feel bad,” but “you feel ashamed, and the shame is about the thing your father said when you were twelve.” Specific names disarm. Vague ones leave the alarm bell ringing.

The same mechanism is why journaling helps some people and helps almost nobody when they do it as a stream of consciousness. Writing “I’m anxious” twenty times doesn’t move anything. Writing “I’m anxious because I’m going to disappoint my brother at Thanksgiving and I don’t know how to tell him I’m not coming” does, because the second one is a thing you can actually do something about.

Why people resist this so hard

Because naming makes the thing real. Vagueness is a kind of pre-emptive permission slip. As long as you’re “just stressed” or “going through a phase” or “not a morning person,” you don’t have to do anything about it. The moment you say “I’m drinking six nights a week to avoid being alone with my own thoughts,” you’ve created a situation where continuing to do it requires a different kind of dishonesty. The cost of the behavior goes up.

People also resist because they’re afraid the name will be worse than the thing. The thirty-eight year old who’s terrified to call himself an alcoholic because he thinks the word will swallow him whole. In practice the opposite happens. The name shrinks the thing. Before naming it, the thing is everywhere, vague, all-encompassing. After naming, it’s a specific behavior with specific triggers and specific consequences, which is smaller and more workable than the cloud it used to be.

The name shrinks the thing.

How to do it on yourself

Sit down somewhere quiet, write down the phrases you keep telling yourself about a thing you’re stuck on. The exact phrases. “I’m just not ready.” “It’s been a busy year.” “I don’t have time.” Then ask, for each phrase, what would be more accurate. Not crueler. More accurate.

“I’m just not ready” might be “I’m afraid I’ll find out I’m not as good at this as I hope I am.” “It’s been a busy year” might be “I’ve been using busyness to avoid grieving my dad.” “I don’t have time” might be “this isn’t a priority for me and I haven’t admitted that to the people who think it is.”

Some of those will sting, which is the signal you got it right. The accurate name almost always stings a little, because the comfortable version was doing protective work, and removing the protection means feeling whatever was underneath. That’s the part nobody warns you about. Naming feels worse before it feels better, and most people quit at the worse part, which is the same way most people quit at week two of an SSRI (the standard antidepressant class, Zoloft and Lexapro and that family) before the drug has actually done anything.

If you can’t get to the real name on your own, that’s what a good therapist or psychiatrist does. Half my job, honestly, is sitting across from somebody and asking the same question four different ways until the actual word comes out. Then we work with the actual word. Wait, can I bill for that? Yes, because asking the question well is harder than people think it is.

What this looks like in the room with me

If you come in to see me, expect this. I’m going to ask you to be honest about what’s actually happening, in language that fits the thing. I’ll push back when the language gets slippery. Not because I’m trying to be hard on you… because the slippery language is the problem, and as long as we both pretend it isn’t, we’re going to spend ninety dollars of your money per session producing nothing.

On the autonomy piece, because somebody always asks: my job is the honest version of what’s going on plus the menu of what tends to work, your job is the choice. I’m a provider, not a parent. If we land on a name and you decide you’d rather keep the comfortable version, that’s a real decision you get to make. I’ll just have it on the record that we both know what’s actually happening. I hardly ever say no to anything. What I won’t do is pretend the slippery version is the true version, because then I’m not doing my job.

The patients who get better are mostly the ones willing to call things what they are. The patients who stay stuck are the ones who keep softening everything. That’s not a fancier observation than it sounds like, it’s just what shows up when you sit across from enough people. The naming isn’t the whole treatment. It’s the part that has to happen first, or the rest of the treatment is just expensive company.

Sources

1. Lieberman MD, Eisenberger NI, Crockett MJ, et al. Putting feelings into words: affect labeling disrupts amygdala activity in response to affective stimuli. Psychol Sci. 2007;18(5):421-428. PMID 17576282.
2. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognit Ther Res. 2012;36(5):427-440. PMID 23459093.
3. Wampold BE. How important are the common factors in psychotherapy? An update. World Psychiatry. 2015;14(3):270-277. PMID 26407772.