Looking Beyond Labels: Why Diagnoses Don’t Always Help
If you’ve ever gone to see a therapist or psychiatrist, especially if it’s been covered by your insurance, you’ve likely received a mental health diagnosis. This type of diagnosis is derived from The Diagnostic and Statistical Manual of Mental Disorders, or DSM. The manual, currently in its 5th edition, is intended to be a means by which mental health professionals can assess an individual’s functioning based on predetermined criteria that are decided upon by a council of medical and mental health professionals. At its best, the DSM offers professionals a way to understand their patients’ needs more clearly, in order to provide targeted and effective clinical care. But the truth is, this diagnostic system often doesn’t function at its best.
Realistically speaking, every diagnosis in the DSM is a snapshot of normal human behavior at a certain degree of intensity and duration. Take Major Depressive Disorder, for example. To meet criteria, a person needs to exhibit at least 5 of 7 specific symptoms over the course of at least 2 weeks. These symptoms include insomnia, depressed mood, loss of interest or pleasure in most activities, poor concentration, and changes in appetite. The truth is, most of us have, at some point or another in our lives, exhibited these “symptoms.” Sure, we may not all go through several of those things at once, or for as long a period of time; but what’s described by that diagnosis is well within the spectrum of the typical human experience.
What tends to happen far too often is that diagnoses become labels that serve as markers of identity. Professionals, if they aren’t mindful, think of their patients as disorders rather than people. They focus so much on symptoms and criteria that they fail to see the unique, dynamic, multidimensional human being in front of them. They fail to consider important and highly relevant factors such as context, culture, and environment; and, most unfortunately, they assume their patients’ experience and needs, rather than being curious about them. For people on the receiving end of these diagnoses, getting labeled as “depressed,” “anxious,” “bipolar,” “ADHD” or “borderline” can feel stigmatizing and damning. It’s not to say that people aren’t helped by getting a clear diagnosis; it can certainly be relieving to put a label on what you’ve been experiencing. But when that label starts to dictate how you see yourself and what you believe to be possible for your life, it’s a problem.
At Evergreen, we take a non-pathologizing approach to therapy. This means that, though we’re knowledgeable about the DSM and have a firm understanding of diagnostic criteria, this isn’t what we lead with in our work with clients. We believe that each person who comes to therapy is a unique individual having a distinctive experience in a specific context. We don’t listen to find out what’s wrong with our clients; we join with them in a state of sincere curiosity about what’s been happening in their lives and what they desire for the future. We listen to identify their strengths and resources, and we collaborate to discover solutions. The way we see it, every diagnosis—just like every part of the human experience—can be broken down into separate pieces. So, instead of working on your depression, we’ll focus on your guilt and explore it in ways that offer clarity and relief. Instead of working on your anxiety disorder, we’ll look at the mental, emotional, and physical dimensions of the anxiety you’ve been experiencing. With that understanding, we’ll collaborate with you to design solutions that will help you feel more grounded and less overwhelmed. Our aim, with each client we meet, is to honor their unique experience and look beyond labels to create new possibilities.
