A diagnosis is just a label – it doesn’t define you
Ever wonder about how true the statement “You are what you eat” is? It kind of implies if we eat what’s good, we’re good, and if we eat what’s bad for us, we’re bad. It also implies there’s a good way and bad way to be, to live. That idea lends itself to judgment, criticism, and maybe even punishment, from others and even more so from ourselves. We all have positive and negative, healthy and unhealthy, aspects of ourselves, things we like and things we don’t like about ourselves. We may like and value certain personality characteristics—honesty, compassion, empathy— and at the same time we might have some ugly and dark aspects of our character that we’re not proud of–selfishness, greed, or pride. These are just aspects or parts of ourselves, and they in and of themselves do not define who we are in the world.
So often, we, including us clinicians, refer to clients by their constellation of personality characteristics or traits in saying somebody is borderline and someone is a narcissist. We think we’re just being clinical and accurate, but in reality, we are buying into the assumption that they are their disorders, or in these cases that their personality traits are not descriptors, but unchangeable and inflexible facts. We need to be more mindful and realize ‘Jessica’ may have borderline characteristics or traits and may have Borderline Personality Disorder but she’s not just a diagnosis. This hurts when you really think about it and invalidates the good parts or the aspects of ourselves that we like and want to keep.
The same can be said about our behaviors and habits. We may have healthy behaviors that we value and appreciate about ourselves—helping others, exercising regularly, maintaining good eating habits, a love of learning. At the same time, we may have unhealthy, more problematic behaviors, or “bad habits”—using substances, smoking cigarettes, practicing unsafe sex, self-harming. Again, we are not our behaviors.
Rather, our behaviors are a PART of who we are.
The reality is, someone may have schizophrenia and somebody may struggle with bipolar disorder. These may be facts, but the fact of the matter is we are again defining someone by their condition, which in turn, some may use to assign worth.
Furthermore, often when we talk about people who have mental illness like schizophrenia or bipolar disorder, we define others and for some, ourselves, by the mental illness. We say “So-and-so is schizophrenic,” or “So-and-so is bipolar.” Whether you think of schizophrenia as a disease, a condition, or a mental health issue, it’s just a label. Individuals with schizophrenia might as well walk around with a sign around their necks that say “I am schizophrenia” or “I am bipolar”. This happens a lot now with all the shootings and terrorist acts we hear about in the news. We rush to judgment that the shooter must be crazy with schizophrenia and the schizophrenia made them blow people up. Mental illness doesn’t make people blow others up. There are a lot more additional factors to consider including environment, what he was exposed to growing up, genetic factors, etc. The reality is, someone may have schizophrenia and somebody may struggle with bipolar disorder. These may be facts, but the REAL fact of the matter is we are again defining someone by their condition, which in turn, some may use to assign worth. There are countless more individuals with schizophrenia who wouldn’t even consider much less think about blowing others up. This invalidates and dismisses a lot of other good traits, strengths, and abilities that are valuable, some of which may even be an aftereffect of having a mental health condition. Labeling someone schizophrenic can lead to judgments, criticisms, and even darker issues like prejudice and discrimination, which we already have enough of in this world. We have feelings (sensations), emotions, and interpretations.
But there is a flip side….Diagnosis in and of itself is not a bad thing, but rather it is important and necessary for a few reasons…
Despite all the problems with using diagnosis to define a person’s mental health issues, there is a flip side, and as much as we don’t like it, the facts are there are some benefits to the practice of diagnosis. Diagnosis in and of itself is not a bad thing, but rather it is important and necessary for a few reasons. Again, however, we need to be careful not to define someone by their diagnosis. Here are some things you need to know about diagnoses, whether you see a psychologist, therapist, medical doctor, or specialist:
- Diagnosis points us in the direction of treatment.
The number one reason why professionals diagnose clients is to guide treatment. If we have a client with Borderline Personality Disorder, we know the standard treatment protocol is DBT (Dialectic Behavioral Therapy) as it is the most effective treatment for that constellation of symptoms.
- You will get better quicker and more effectively with the right diagnosis.
Misdiagnosis can cause problems including applying inappropriate treatment, a slowing down of treatment effectiveness, prolonging the symptoms, and an intensification of symptoms and misery.
- You have a right to ask questions.
Just as the health professional needs to ask you questions during the evaluation, you also have a right to share your perspective of the problem and ask questions, whether or not you know the diagnosis. It’s imperative too that you be honest with your clinician and share what you are experiencing. Don’t leave out important symptoms or issues b/c they may again point to misdiagnosis or inappropriate treatment.
- Diagnosis reduces blame, shame, and loneliness.
Diagnosis can help you to make sense of or better understand your symptoms, and understand the reasons why your level of functioning is different from others, which in turn, reduces the desire to blame others and more importantly, reduce the shame, guilt, and loneliness you may feel.
- Diagnosis is needed for insurance.
Lastly diagnosis is a necessary evil when it comes to payment for treatment. Insurance, Medicare, and Medi-Cal will always ask for a diagnosis in order to facilitate payment to the professional or reimbursement to the client. Diagnosis may also be necessary in securing payment for additional or outside services.
In summary, you are not your diagnosis, it’s just a label, and it doesn’t define who you are. We commonly think of diagnosis as a negative thing, the process of figuring out what’s wrong with a client, but diagnosis also tells us what is right with you, and helps identify your strengths and abilities, which are just as important. Diagnosis contributes to your healing and recovery but don’t use it to define who you are as a person, or anyone else for that matter.
Dr. Jennifer Bruha, PhD
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