I almost didn’t write this piece. Almost.

I feared it might be seen as provocative like I was asking for trouble. But that is exactly the attitude that has silenced victims of harassment and stalking for too long.

The short version of the story is that an unwanted presence continues to plague my life, bringing only turmoil and vitriolic spite with every intrusion. In his eyes, our “dynamic” was “volatile” (what dynamic?), and hearing him speak, you’d think we’d had a more meaningful association than we did. “This is the definition of erotomanic delusion,” said my coworkers. We’re all psychiatrists.

In reality, we were never particularly close; we were transiently members of the same friend group, and I found his personality and sense of hygiene wanting. I’d filed a no-contact order against him years ago, physically took longer routes around campus to avoid him, ignored him, and explicitly told him that he was unwelcome in my life.

To no avail. My most recent rejection of his unpleasant overtures – last month – met with his classic malice. My tormenter resorted to a tired, misogynistic trope: “She’s crazy.” Variations include “the crazy ex-girlfriend” and “the psycho.” It’s all the same insulting nonsense.

For the crime of setting boundaries yet again with him, he angrily labeled me as an “untreated borderline” and “unbearable monster,” a ridiculous edict that had me and my co-residents laughing hysterically.

I was frantically reviewing the DSM-5 diagnostic criteria for borderline personality disorder: “What could I have done to warrant that one?! I’m not impulsive, I don’t have a chronic sense of emptiness or unstable identity, I don’t have a pathological fear of real or perceived abandonment …”

Until someone interrupted me. “Chloe, you’re giving him too much credit. Do you think he actually knows what borderline personality disorder is?”

The reality dawned. And its implications were serious.

Although I am a mental health professional, I sometimes naively forget that people, including health care professionals, use mental health terminology as pejoratives. I hear the word “bipolar,” and I think “increased goal-directed activity and decreased need for sleep in the setting of a sustained period of elevated energy and mood.” But the colloquial use of “bipolar” often means, “They changed their mind, and it frustrates me.”

I don’t mean to restrict free expression. Certainly, there are descriptors that have entirely valid everyday uses but constitute very specific diagnoses in psychiatry: “anxious,” “depressed,” and even “narcissist.” I use these terms both casually and in the hospital, and they mean different things in each setting.

But labeling a woman who says no to you as “borderline” – in fact, the entire crazy ex-girlfriend trope – is a different kind of callous.

In the first place, misuse of mental health terminology to insult someone presumes that people who struggle with mental illness have something intrinsically wrong with them. It presumes that having a mental disorder is something to be ashamed of, to mock, or that makes the recipient of the label inherently undesirable and contemptible.

As a psychiatry resident, I despise this attitude. It drives people who genuinely need help with their mental health to avoid seeking care, afraid of being shamed. They suffer silently. Their quality of life deteriorates drastically. They might even lose their life. Shame is a powerful and destructive enemy.

Furthermore, the weaponization of mental health is a trite but effective tool of control by people with abusive tendencies.

People who harass and stalk the people they feel entitled to – former intimate partners or unwitting targets of their erotic delusions – use these labels to undermine their victim’s credibility when faced with accountability. It’s a tried and true tactic that Jennifer Freyd, PhD, identified back in 1997 in which the perpetrator reverses the victim and offender roles, claiming that the victim is, in fact, the aggressor in the abusive dynamic. Though originally studied in sex offenders, DARVO (deny, attack, reverse victim & offender) is a common dynamic in an abusive relationship.

It’s a way of saying, You’re challenging me? Let me show you what else I can do to you.

She’s crazy, and he’s crazy! You can’t possibly believe them! Look how unstable she is, and look how ridiculous he is!

What’s absolutely terrifying for victims of abusive power differentials is that these tactics work.

I’m not the only one. I’ve had loved ones tell me stories of controlling people’s fixations with them and their terrifying spite after rejection. One of my very best friends and I connected over this shared experience during our senior year of college.

Harassment imposes an impossible mental burden. I felt perpetually anxious and restless, unable to focus or to be at peace, slipping further and further from myself with each passing day. I kept asking myself, “Why? Why did I deserve this? I just want to be left alone. What’s wrong with me that this is happening to me?”

But my logical brain kicked in after a few weeks. And I realize that the only contemptible thing in this dynamic – in fact, in any dynamic in which one person relentlessly and viciously pursues another without any consideration for their victim’s happiness or sanity, thinking only of their own desire for control – is the aggressor who perverts mental health terminology to insult their victim.

The victim is not unreasonable for having boundaries. The only shame belongs to the aggressor who perpetuates the stigma of a highly stigmatized population in a selfish, abusive effort to control a person whose worst infraction was to say the word “No.”

Chloe N. L. Lee is a psychiatry resident.