Swearing by curse words

As swearing becoming more common? Certainly in the print media, there is less squeamishness about printing the full ‘f… word’. Yet on television, sports commentators are quick to apologise to viewers for swear words broadcast via the referee’s microphone. Whatever your personal use of swear words, have you become less bothered by swearing in general?

Researchers find it tough to accurately track the frequency of public swearing — partly because our definition of what constitutes an obscenity is always changing, and partly because people modify their speech if they know they’re being observed.

That said, studies have found that in certain contexts, obscenities can make a speaker seem more persuasive and more intense. When asked to consider their own speech, people tend to think that swearing makes them seem less credible, but when reading the statements of both suspects and victims in a hypothetical trial, they actually rate people who swear as more credible.

Writing in The Conversation, Prof Monika Schmid, Professor of Linguistics at the University of Essex, says that attempts to ban swearing in public places, in the workplace and even in the home, appear to be on the rise. In response, those of us who find relief in using the occasional expletive cite studies suggesting that swearing is a sign not only of being more honest and healthier, but also that regular swearers are more intelligent and have a larger vocabulary than non-swearers.

What about patients who swear? Whether we get offended depends on context: None of us want to be the butt of an expletive-laden rant about why we are such a ‘f…ing useless doctor’. But swearing also has a cathartic purpose; researchers have found that there’s a good reason why so many people swear when they hurt themselves. It helps us tolerate pain.

In a 2009 experiment, swearers tolerated freezing water for significantly longer than a control group and rated the pain as less severe. The authors hypothesise that this is due to the way swearing activates the autonomic nervous system, because the swearers also had elevated heart rates compared to the control group. In essence, swearing triggers an emotional response that serves as a distraction from the physical pain being endured.

There is an expectation also that our professional selves will tolerate swearing from a patient with Tourette syndrome.

About 10 to 15 per cent of people with Tourette’s do have involuntary outbursts of swear words and they tend to occur more often when the person is excited or anxious. A basal ganglia dysfunction is believed to be the cause, which may prevent people from controlling involuntary thoughts and suppressing them from being translated into actual words.

Some people with aphasia, meanwhile, can still swear quite easily. This may be because the brain treats swear words more like abstract symbols than words with literal meanings, so generating them doesn’t rely on the same areas of the brain used to produce other language.

In my view, swearing plays an important role in maintaining mental hygiene and sanity because it is associated with relieving unpleasant emotions, feelings and sensations. This is probably the biggest reason why the ‘language police’ will never succeed.

So does that leave us doctors off the hook when we swear in front of patients? When BMJ Careers asked doctors on Twitter whether it was acceptable for doctors to swear, some said it was in certain situations. A consultant in palliative medicine pointed out that many doctors do swear at work. “It depends on the patient and the relationship – many will use ‘fruity’ language routinely,” he said. One GP also said he swore in front of patients. “I swear fairly frequently, when appropriate,” he said. “It varies by situation, patient, and history.”

Doctors also said that swearing can help to build relationships with patients. A paediatrician, said that when he worked with hard-to-reach adolescents, “the odd well-placed swear can be rather humanising”. Another GP had a similar view. “Always adopt the language of the patient, so definitely yes,” he said. “But in context and the patient has to swear first.”

In 1999, The BMJ published a study looking at how often surgeons swore in the operating theatre. The rate of swearing differed by specialty, with orthopaedic surgeons swearing most often, registering one swear point every 29 minutes.

Once a complaint goes into the Medical Council, however, I suspect an allegation of swearing in front of patients will be hard to defend. And I certainly wouldn’t advise telling the chair of a fitness to practice committee to ‘F off’, even if you are just doing it in a genuine effort to build a relationship with them.