Individual Counseling

Care With Labels

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The fact that these days people receive a diagnostic label they must carry around for the rest of their lives based on a one hour interview is mind boggling. There are so many variables in play, like how the client is feeling that day, how active symptoms are, what the clinician has been reading and focusing on of late, and of course the theoretical paradigm being used. If you get a psychoanalyst, existentialist, cognitive behavioral therapist, and narrative therapist in the same room to look at the exact same set of data they will all view the case through a different lens and probably come to different diagnostic conclusions. Plenty of studies have borne this out.

We are not saying that mental illnesses don’t exist, just that diagnosing them is extremely complicated because you’re dealing with a living human being, a moving target whose history and life circumstances are complex beyond the scope of what a one hour interview can possibly hope to ascertain. This is why you’ve got to take care with labels, whether you’re a clinician, friend, family member, or the person who has actually received a diagnosis, because a label is more like a tentative starting point than it is a definitive answer.

A diagnosis of mental illness is really just the recognition of a constellation of symptoms. It can’t possibly encompass all that a person is or can be. It’s subjective, even arbitrary, and what it really comes down to is whether this diagnosis will help a person live a better life or not. Some are desperate for answers, they really want to pin down what is going on with them, and in these cases a label can be a good thing because it lowers anxiety and gives a sense of direction for how to get better. Others don’t want to know and the burden would negatively affect their self-image forever. For these people it might be better to make the diagnosis more ambiguous since there is no guarantee that diagnosis is objectively valid in the first place. Soren Kierkegaard said “When you label me you negate me” and I always think about that line when thinking about mental illness diagnoses and really about all labels, about how some people feel this insatiable need to classify a living, breathing, complicated human being as if doing so were as simple as classifying a rock.