Glossary

Ableism

Treating non-disabled bodies and minds as the normal standard, so disabled people are excluded, doubted or seen as lesser. It can be built into buildings, rules and services as well as attitudes.

For example: A therapy room up a flight of stairs, or a therapist who assumes a client can’t make their own decisions.

Ageism

Treating people unfairly or dismissively because of their age. For older disabled people it often combines with ableism, so real needs or distress get put down to “just getting older”.

For example: Low mood after losing sight in later life being dismissed as normal for someone of 80.

Countertransference

The feelings, reactions and assumptions a therapist has towards a client. Some approaches use these as information about the relationship. For disability, it includes a therapist’s own pity, fear, discomfort or wish to rescue.

For example: A therapist notices they feel tired and hopeless with a client who has a long-term illness, and asks themselves how much of that is their own fear of illness.

Psychodynamic and Jungian approaches treat it as a central tool. Many other approaches don’t use the term, though most expect therapists to notice their own reactions.

Crip time

A phrase from disability communities and disability studies for the way disabled lives often run on a different clock: extra time to get ready, travel or recover, unpredictable days, and life milestones that come at a different pace or not at all.

For example: Needing a day to recover after a hospital appointment, or reaching a life milestone at a different age from friends.

“Crip” is a reclaimed word. Some disabled people use it with pride; others dislike it. You don’t have to use it to use the ideas on this site.

Diagnostic overshadowing

When a new symptom or difficulty is put down to someone’s existing disability or condition, so the real cause is missed.

For example: A person with a learning disability is described as “challenging” when they are actually in pain.

Epistemic injustice

Being treated as less believable or less able to know about your own life, often because of who you are. The term comes from philosopher Miranda Fricker.

For example: A disabled client’s account of their pain is doubted, while a relative’s account is taken as fact.

Fluctuating condition

A condition whose effects change from day to day, week to week or over longer periods, often unpredictably. Someone may manage a lot one day and very little the next.

For example: Multiple sclerosis, lupus, Crohn’s disease, endometriosis, POTS and bipolar disorder can all fluctuate.

See Hidden and Fluctuating Conditions.

Formulation

A shared working explanation of what’s going on for someone, and why. It’s a draft to revise together, not a verdict.

For example: “Your low mood might be connected to losing work after your diagnosis, and to how little support you were offered.”

Each approach builds formulations differently. CBT links thoughts, feelings and behaviour. Psychodynamic work looks at patterns from the past. Pluralistic practice agrees the formulation with the client.

Functional neurological disorder (FND)

A common, genuine condition in which the nervous system has trouble sending and receiving signals. It can cause seizures, weakness, tremor or problems walking. It is not imagined or faked.

For example: Someone with functional seizures being told “it’s just stress” and sent away.

Hidden disability

A disability that other people can’t easily see. Sometimes called invisible or non-visible disability.

For example: Diabetes, HIV, chronic pain, cystic fibrosis, hearing loss, autism, or a long-term mental health condition.

People with hidden disabilities often face disbelief, and have to decide over and over whether to tell people.

Interdependence

The idea that everyone relies on other people, and that needing support isn’t a personal failure. Disability communities often use it in place of “independence” as the goal.

For example: Choosing who helps with what, rather than trying to manage everything alone.

Internalised ableism

Taking in society’s negative messages about disability and turning them on yourself.

For example: Feeling you have to apologise for needing a break, or that you’re “lazy” when you’re actually in pain.

Masking

Hiding or toning down signs of a disability or difference to fit in, such as hiding pain or copying other people’s social behaviour. It can be useful, but it often costs a lot of energy.

For example: Smiling through a meeting while in severe pain, then needing the evening to recover.

The word is used most by autistic and neurodivergent people, but the experience is wider.

Pacing

Planning activity around the energy you actually have, rather than pushing through until you crash.

For example: Splitting a task across two days, or resting before an appointment rather than after.

Pluralistic practice

A way of doing therapy that doesn’t follow one school. Therapist and client agree together what the goals are, and which methods to use.

For example: Deciding together whether to talk, use a worksheet, try an exercise, or do something else entirely.

Psychosocial disability

Disability that arises when a long-term mental health condition meets barriers in society, such as stigma or inflexible services. It’s the term used in the UN Convention on the Rights of Persons with Disabilities.

For example: Someone with bipolar disorder who needs flexible session times around medication and a plan for becoming unwell.

Not everyone with a mental health condition thinks of themselves as disabled. See Psychosocial Disability.

Reasonable accommodation

Changes made so a disabled person can take part on an equal basis. This is the term used in Irish equality law and in the UN Convention on the Rights of Persons with Disabilities.

For example: Online sessions, a ground-floor room, or written summaries after sessions.

In Ireland, the legal term is “reasonable accommodation”. See also reasonable adjustments.

Reasonable adjustments

The UK term for the same idea as reasonable accommodation: changes to remove disadvantage for disabled people. It’s the term used in the Equality Act 2010 in Great Britain.

For example: A longer session, a different time of day, or communication by text.

In Northern Ireland, different laws apply. Reasonable adjustments is the usual phrase.

Rupture and repair

A rupture is a strain or breakdown in the relationship between therapist and client. Repair is noticing it and working it through together. Repaired ruptures can strengthen therapy.

For example: A client feels misunderstood after a comment about their disability. The therapist raises it next session and apologises.

Social model of disability

The idea that people are disabled mainly by barriers in society, such as inaccessible buildings, attitudes and rules, rather than by their bodies or minds alone.

For example: The problem isn’t that someone uses a wheelchair. It’s that the building has no lift.

Many people find it useful alongside the reality of pain, fatigue and illness, which the social model alone can leave out.

Spoon theory

A way of describing limited daily energy, from Christine Miserandino’s 2003 essay. Each activity costs a “spoon”, and when they’re gone, they’re gone. People who use it sometimes call themselves “spoonies”.

For example: “I’ve only got two spoons left today, so I can’t do the shop and the phone call.”

It’s a community term, not a clinical one. Some people prefer batteries, percentages or their own words.

Therapeutic frame

The agreed arrangements that hold therapy together: time, place, length, fees, contact between sessions, and confidentiality.

For example: Agreeing that sessions are 50 minutes, online, and can move to text when speech is tiring.

Some approaches treat changes to the frame as meaningful in themselves. On this site, adapting the frame for access is treated as ordinary good practice, not as something to analyse.

Transference

When feelings and expectations from earlier relationships are brought into the relationship with the therapist.

For example: A client who was often doubted by doctors expects their therapist to doubt them too.

Central to psychodynamic and Jungian work. Other approaches may notice the same thing without using the word.