Here’s a perspective-stretching exercise in tapping the flipside of diagnosis. It’s also an invitation for contributions to developing a diagnostic language around what going right for people. Call it a life-affirming balance to the DSM-5. Get to the end of the article, and there’s a fun and rewarding activity that can be done, safely, at home.
I have noticed just how ‘powerful’ the clinical diagnosis can be. A client, on telling me that they’ve been diagnosed as having a ‘depressive disorder’, seems oddly to radiate a sense of relief in that “phew, at least I know what is wrong with me!” Then any behaviour that falls within, or even close to, that proscribed by ‘depressive disorder’ can conveniently be ‘relegated’ to the ‘personality deficit’ manifesting itself. It’s a cognitively neat and tidy process. But how helpful is it?
On closer scrutiny, a diagnosis serves only to provide the therapist with a generalised orientation and does nothing for the client (it was Carl Jung who said that). So the therapist has a name for the basket of symptoms presented and can apply the latest evidence-based treatment. The client, however, gets to focus on what’s not working, and unfortunately the more focus that gets, the more it tends to not work.
Thing is the diagnosis, with its appearance of truth, keeps insurance companies happy, but fails to answer the real question for the client, “what brought you to this place, and how can you move away from it?” But I don’t really want to go into all that right now. What I’m really interested in leveraging is the tendency for people to put their faith in their diagnosis.
So, considering that people do in fact find a sense of security and belief in diagnosis, what happens if we say: “Okay, how about we use that faith you have in diagnosis in a life-affirming manner?” Then we go on to explore a branch of diagnoses that describes, clinically, the behaviours and beliefs that support wholesome living? I am aware that this moves into the realm of positive psychology, in developing a taxonomy focused on strengths, or what’s ‘right’ about people instead of just what’s ‘wrong’. So be it. I’m also interested in promoting a clinical language that supports positive diagnosis.
For instance, someone who weathers various life stressors successfully can be diagnosed as ‘emotionally resilient’; or someone who believes things will go their way has ‘recurrent optimism’. (I notice, in writing this, how my mind struggles to find positive names for the new diagnoses, and how I must fight to get away from the implied assumption that personal strength is so much more than the absence of disorder).
Here’s another one, a client who sets a goal one week and achieves it can be diagnosed as having ‘follow through efficacy’. And another one, someone who has good mates can be a ‘strong social(ist?)’ or some such. So, the person who has ‘accurate vocational orientation’, when told at the water cooler that they appear to be enjoying their job, can blame it on the diagnosis! And have a good laugh in the process.
I wonder how much better people would feel, and how their behaviour would change, if they wandered around with positive life-affirming ‘clinical’ diagnoses inserting itself into the self-talk going on the back of their minds, rather than allowing negative impressions of self to generally trump positive emotions?
Here’s an extract from GK Chesterton’s The Man with Two Beards
“My good sir, said the professor in remonstrance,” don’t you believe that criminology is science?”
“I’m not sure,” replied Father Brown.
“Do you believe that hagiology is a science?”
“What’s that?” asked the specialist sharply.
“No; it’s not the study of hags, and has nothing to do with burning witches,” said the priest, smiling.” It’s the study of holy things, saints and so on. You see, the Dark Ages tried to make a science about good people. But our own humane and enlightened age is only interested in a science about bad ones.”
So, here’s the promised perceptually-stretching activity: What diagnoses can you add to the DSM-S, the Diagnostic and Statistical Manual of Mental Successes? Think about a character trait that you have, that increases the authenticity of your life, come up with a name for it, and post in the comment box. Happy days.