Bad names are bad precisely because they force you to read a bunch of irrelevant code to have any hope of understanding what the code is doing. It's the same problem that over-abstracted code presents. In both cases, there's no forest I can look at -- just millions of individual trees.

In a weird way though, bad names are actually better than many real-world problems. Once I find that code, I can change the name and the problem goes away. If you have a 100 line function full of one-letter variables, that's probably terrible. But I can spend a week poring over that function, figure out what they all do, and change the names. From that point, the function is fixed.

I have no hope of fixing the problem with a big mess of fetishized design patterns. The confusion in many of these systems is baked into the core of the architecture in the form of a dozen layers of abstraction and indirection between me and figuring out the behavior of the system. Usually the only way to fix that is "rm -rf" and starting over from scratch.