Both psychology and medicine insist on the ‘right’ way to speak and increasingly attempt to control the language both clinicians and other stakeholders use. Such guides range from article suggestions of replacing certain words to more comprehensive and formal guides of how to communicate (e.g. the guide of the BPS’ Clinical Psychology Division’s Guidelines on Language). In this chapter we explore constructions of language and clinical communication in clinical language guides. Methodologically, our study is anchored in the constructionist view of discourse, taking a qualitative critical discourse studies perspective on the data. Our argument is twofold. First, we argue that the guides represent language and linguistic communication as outside any context, either situational or societal. Second, as the guides focus solely on lexical material, ignoring the grammatical form, they ignore a significant aspect of the communicative interaction. Analysing interactional clinical data, we argue against such assumptions. We end the chapter by making a point of the futility of clinical language guides, stressing the negotiability of clinical communication.