Diagnosis and understanding
I am not a big fan of diagnoses.
From 1997-2007 I worked for mental health institutions. I have seen the same person diagnosed as manic-depressive, then depressive, then borderline personality disorder, then back to depressive. I have seen more than 100 people who carried the diagnosis ‘schizophrenia’, not one of them the same. Their symptoms might have had some resemblance, and their individual behavior was so different that the diagnosis could only partly help you help them.
Diagnoses reduce human beings to a uni-dimensional view of their being.
I believe in seeing whole humans. People with different backgrounds, different vulnerabilities, different potentials. People trying to meet precious, human, universal needs in different ways.
I do believe that diagnoses can help us understand people.
We can use a diagnosis as a working hypothesis for what might be going on. If this person is diagnosed with schizophrenia, does that help me understand that their aggression is a result of them seeing people I don’t see? If this person is labelled autistic, does this explain why they don’t make eye contact? Can I better accept that someone is in bed 18 hours a day, if I know they have clinical depression?
My compassionate response to a diagnosis is that – while incomplete – it might help me better understand what another person is experiencing. When one of my clients thought there was another person in the room, and talked to him while we were in conversation, I was respectful until he finished. I didn’t tell him there was no one else but us, because I accept that his reality is different and no less valid than mine.
With this unconditional acceptance, I can step into their reality and try to see the world through their eyes. When I know my friend has delusions, I accept that his truth is that the Suriname Embassy is trying to kill him. I might try to distract him, offer this moment right here as an alternative to his delusions, and reassure him that his life has meaning to me. If someone with an Asperger’s diagnosis, needs structure and predictability, I can try to be complete when I tell him my schedule. If my friend is diagnosed with Borderline, I support a clear sense of boundaries in our connection and open myself to the beauty they have to offer, and deflect their anger.
Diagnoses do not define people. They can be an incomplete starting point for understanding.
And I am a big fan of understanding. Anytime. Anywhere.