The Problem with Diagnoses (Part 2)

In yesterday's blog, I wrote about how inclusions of mental disorders shift with different editions of the Diagnostic and Statistical Manual (DSM), and how this process is influenced by the marketing efforts of pharmaceutical companies and other lobbying groups. A few hours after publishing the post, I came across an article online that illustrates perfectly how arbitrary definitions of mental illnesses is. (And, if I may say so, how institutions such as the APA oppress the working poor, the have-nots in the society--but I'll save that discussion for a later blog.)

To be sure, the DSM is not all bad. It gives us the language to communicate with other professionals (and yes, insurance companies too) when discussing client needs and in coordinating services. Many people also feel relieved about being able to name their condition and understand that the condition is only a part of themselves ("I'm not crazy; I have bulimia.").

For others, a diagnosis especially one of a personality disorder, is not unlike a life sentence and even a convenient excuse to NOT try to change their behavior ("I'm borderline, don't expect me to behave rationally!"). It may also affect how others perceive them. Human beings are consistently looking to filter information--it's what keeps us from being overwhelmed and confused by the barrage of stimuli around us. However, what happens when we name something is that we tend to look at it out of its context and attach permanent characteristics to it. Similarly, when we hear about a mental disorder in a person, the person's other characteristics (e.g., of a loving mother) may fade into the background.

With adolescents who persistently defy authority and break rules, it is not uncommon to find dysfunction in the family; labelling the teen as "oppositional defiant" may unduly place shift the focus away from the family to the offending youth. Family members often fail to see the role they play in creating or maintaining the unwanted behavior and thus miss out on the opportunity to help create lasting changes in the adolescent by changing the dynamics in the family system.

Therapy is a meeting of two or more people, each with his/her rich characteristics and unique qualities. No one deserves to be seen through the tunnel vision offered by the label of a mental disorder.