Concept Creep Gives Me The Creeps

Semantic shape shifting of psychotherapy language that gives me the creeps. Attachment concepts are creeping, nervous system terminology is creeping. And FFS, even falling in love now has a clinical name.

Not long ago, a new client, a man in his twenties, came to see me. He seemed quite worried about his state. I waited for him to settle down, and we engaged in a little small talk while I waited to sense that we both felt comfortable enough to broach the real reason he was there.

Eventually, he looked at me, sheepishly, and said: “I think I have limerence”. He said it as if he were confessing to some deeply shameful trait or crime.

He glanced at me from the corner of his eye, waiting for my reaction. Waiting for the hammer to fall. As if he were expecting to be told that he was a deviant. A degenerate freak.

When I heard more about the circumstances - and that his “limerence” was, in fact, reciprocated by his limerent object - it became clear that the man was very sick indeed.

I diagnosed him alright, and with a dire prognosis: the man had fallen head over heels. Oh my. Incurable condition of human infatuation. Only time can help, I said.

As for our therapy, he was absolved after one session, with the encouragement to go and embrace the pleasures of the early stages of his infatuation, seeing that it was reciprocated.

What I learned from this is that even the simple act of falling in love - admittedly one of the most common human experiences - is now not off limits when it comes to pathology speak.

If I share this story, it is to illustrate a broader trend that others before me have noticed and documented. Limerence is just the latest in a string of concepts from the world of psychotherapy that made their way into the general public speak, where their meaning quickly out of hand.

This phenomenon of semantic shapeshifting has a name: concept creep.

The Concept Creep

In his paper Concept Creep: Psychology's Expanding Concepts of Harm and Pathology, Nick Haslam, introduces the idea of concept creep. Defining it as a

"a set of psychological concepts have undergone a progressive semantic expansion in recent decades so that they now refer to a much broader range of experiences, actions, or people than they did previously"

He documents this transformation of meaning looking at different concepts from psychotherapy talk such as abuse, trauma, mental disorder.

The author makes an in-depth analysis of the phenomenon, the possible reasons behind it and speculates on the impact that this drive will have. The papers around the topic are all referenced at the bottom of this piece.

The figures below show how the creeping of concepts of trauma and abuse over the past 60 years or so:

Data on the relative frequency with which particular words appear in Google’s Ngram database of approximately 5 million books. For details see the paper: Concept Creep: Psychology's Expanding Concepts of Harm and Pathology.

I think this is an important concept for us, as a profession, to be aware of, and I think it is a very bold proposal to study this, despite the possible backlash that such an enterprise might entail. Kudos to the author(s).

Attachment Concept Creep

In my work, both in conversations with clients and with colleagues, I see concept creep emerging in the area of attachment. Personally, I have always viewed attachment as relating to a fairly limited set of presentations (bear in mind, I work with a non-clinical, fairly average population in the UK).

In my case, although I love working with attachment, and some people come to see me specifically for that, I only typically have 10 to 20% of my caseload that is attachment related.

Yet I have heard and read psychotherapists saying that “everything is in attachment” and everything, in psychotherapy, comes down to attachment.

Also, worryingly, clients come already convinced of their catastrophic insecure attachment. In fact, I feel that every micro-departure from the ideal and cannonical secure behaviours is labelled as anxious or avoidant and of course, worse yet, disorganised.

So, I feel that attachment is being pathologised, and that the reasons for developing insecure attachment are also being overpathologised within our professional community, as stemming from childhoods where children were "ignored, criticised, rejected or utterly neglected". Yet, insecure attachment is very common, and while not an optimal strategy, it is hardly the end of the world. Around 40% of the population will have an insecure attachment and by the same token, it would mean that the 40% of parents would have subjected their kids to utter neglect and rejection. C'mon.

Aside from revealing how sloppy learners we can be as a profession, I find this troubling because it undermines human resilience and adaptability, pushing clients unnecessarily into the realm of pathology and disorder.

Moreover, this overextension is not supported by attachment research.

Autonomic States Concept Creep

A similar, though not quite identical, form of concept creep is occurring in the domain of neurobabble around autonomic nervous sytem (ANS). Within this neuro-jargon flourishing in psychotehrapy it is also commonly reffered to as autonomic states.

What began as a bona fide attempt to integrate neuroscience into psychotherapy through discussions of autonomic arousal has since morphed into an overstretched metaphor. It now means something quite different from its original intent.

This language often refers to people being stuck in a state of 'freeze' or 'fight-or-flight' on a permanent basis, and then speculates on the psychological and behavioural ramifications of such a state.

But no one can remain in a single autonomic state permanently. Moreover, the 'freeze state' is frequently confused with the state of 'playing dead' - which is a different physiological and behavioural response altogether. The result is a conceptual mess: cross-wired, overly broad, and increasingly meaningless.

It ends up being applied to everything and anything. And in doing so, it becomes divorced from the very foundation it was meant to draw upon, the neuroscience-informed psychotherapy. The original purpose of introducing these concepts into therapeutic language is lost in metaphorical translation.

Back to Limerence Creeping

Now let's look into the idea of limerence brought to me by my client. The word and idea seem to have been coined by the psychologist Dorothy Tennov . She describes that "to be in a state of limerence is to feel what is usually termed 'being in love'". So far, so good. One article from The Guardian on the topic says that this concept was introduced "to distinguish between these overwhelming emotions and the more stable, domestic feelings experienced by long-term couples who are only too aware of their partner's failings, Tennov coined a new term: limerence."

The concept is understandably striking, as it captures one of those phenomena of human nature that never cease to fascinate: the process of falling in love.

But then comes the concept creep. If you care to Google it (here is just one example among many), you will find countless websites explaining why limerence happens, how to distinguish it from “true love,” and, my personal favourite, what causes limerence. I love that one; it feels a little like reading a horoscope. Hello, Barnum effect.

"Past experiences, such as childhood trauma, neglect, or unrequited love, can make some individuals more vulnerable to limerence. Those who have experienced emotional neglect or feelings of inadequacy may seek validation through limerence, focusing obsessively on another person to fulfil emotional needs that went unmet in the past."

I see this as an example of a concept creep, with a twist. Something that is traditionally considered as part of human nature now is given a clinical name and is slowly (but surely) pathologised.

Nothing Is Off Limits of Pathology: Why It Happens And Is It A Problem?

Am I being alarmist here? Is this simply what happens whenever new concepts are introduced into human language, gradually spreading and acquiring broader meanings? I would not know, and someone who dabbles in the history of semantics would be better placed to offer some insight.

All I can say is that it feels like a feature of zeitgeist, reflecting broader cultural dynamics of our time. It seems that, in our drive to uncover ever more hidden facets of human nature and to create a kind of fail-proof life (which is, in principle, a noble goal), we sometimes run out of material and start spinning our curiosity turbines around things that do not necessarily need fixing.

Some of this is likely tied to how knowledge is now disseminated. What was once the domain of scholars and psychology experts is now widely available to anyone with a smartphone and an appetite for TikTok videos. This is not inherently a bad thing: it is the price we pay for the democratisation of knowledge.

But when it comes to how much our profession (psychotherapy) contributes to this trend, the cynic in me would argue that it conveniently aligns with a tendency to inflate the general relevance of our own areas of interests and make our profession, and the specific areas we work in, seem more universally important. In other words, it is self-serving (says the cynic in me).

I feel it is a mix of false consensus bias and the self-relevance effect. And to be fair, in the era of attention economy, it's kind of understandable. Everyone has to hype themselves and their work. More seems to be always more. Even scientists do it, it's on record.

But is it a problem? For me, yes. I believe the pathologisation of life is a real concern. Following this trajectory, life end up being a catalogue of dysfunctions.

Humans are complex, contradictory, narcissistic, dysregulated. That is how nature made us. To frame all these tricky, uncomfortable and very human traits as symptoms of pathology is to appeal to a fantasy - a kind of imagined Garden of Psychological Eden that never existed. It is a lot of pressure, and, in the end, not even true. Even if it happens to be good for psychotherapy business.

There. That is my two cents. But I am sure you have your own thoughs on all of this, and I would be really curious to hear them.

As always, thank you for reading. You can follow me on BlueSky , via my substack  or subscribe to my mailing list.

Recomended reading

• Concept Creep: Psychology's Expanding Concepts of Harm and Pathology

• Six psychiatric concepts that have mutated: for better or worse

• The Body Keeps the Score: how a bestselling book helps us understand trauma – but inflates the definition of it

• The cultural dynamics of concept creep - PubMed