GoodPersonEffed
Brevity is my middle name, but my name was TL
- Jan 11, 2020
- 6,727
There is always a lot of discussion on the forum about psychiatric labels and individuals' struggles with them. I decided many years ago that psychiatric labels are not identities, but designations of groups of symptoms. They are meant to be a tool, yet they are often used to define an individual, and can lead to discrimination by mental health practitioners, family and friends, and the public. Rather than being called a person with a labeled disorder, people are called -- and sometimes call themselves -- the actual labels, such as "they are"/"I am" bipolar, borderline, schizophrenic, etc.
While diagnostic labels may help to explain things, and even provide the relief of understanding symptoms and behaviors, they can also limit and even imprison a person by defining them and causing them to view themselves and be viewed as someone/something to be judged and separated from, rather than embraced, appreciated, respected, and served with a goal to overcome challenges that are not their fault. Calling someone by a label encourages condemnation and discrimination, as well as self-condemnation and self-discrimination. It is difficult to heal or progress from a place of condemnation.
I'm currently reading the book Adult Children of Emotionally Immature Parents, written by a psychologist. This quote really stood out to me:
Human emotional immaturity has been studied for a long time. However, over the years it has lost ground to an increasing focus on symptoms and clinical diagnosis, using a medical disease model to quantify behaviors as illnesses suitable for insurance reimbursement.
Please note that I am in no way suggesting anyone here is emotionally immature and needs to start viewing themselves with even more condemnation! My purpose in sharing this quote is to highlight what I put in bold font: the medical disease model, and insurance reimbursement, that is, a kind of psychiatric capitalism.
I often think of how the psychiatric/psychological system works. Many times people talk about chemical imbalances, yet where are the blood or other tests that prove this? If a condition is truly organic and is in the brain, why are people put on drugs rather than first being given brain scans? With the exceptions of vitamin D and thyroid testing, there are in general no diagnostic tests run for the pseudo-medical diagnoses given. Psychiatrists follow the DSM in the US and the ICD in Europe, matching symptoms to lists under diagnostic labels, and very often confirm diagnoses by how individuals respond to medications, not by any kind of scientifically verifiable testing such as scans. And yet, scans can clearly show things like PTSD, schizophrenia, and even sociopathy. Why use diagnostic lists and medicine to rule out certain conditions when many conditions can be proven or disproven by brain scans? It doesn't make sense if the goal is to actually pinpoint root causes of and cure ailments. A true medical model would use medical diagnostic tools.
So if you have been given a label, I empathize that for a time it may be comforting to get some answers, as well as disconcerting because it can impact one's sense of identity. In my own personal experience, as well as grad school studies focusing on mental health advocacy, and having worked in community mental health in an administrative support role, where my closest friends were practitioners, I learned that misdiagnoses are common. For example, it can take ten years for someone with bipolar disorder to get that diagnosis, after following a variety of dead-ends such as ADD, depression, anxiety, schizophrenia, etc.
So-called personality disorders are trauma-based, yet PTSD and related dissociative disorders are poorly described in diagnostic manuals and are usually not the first diagnoses a clinician refers to, and in fact are often dismissed when the patient brings them up. These very disorders require interventions to overcome the root causes and have historically proven resistant to treatment with medications, yet practitioners are more likely to push medications than effective modalities that actually promote healing such as DBT and EMDR. CBT is touted as an effective evidence-based practice, yet it is a cognitive game of sorts which may help some thought patterns, but does not get to the roots of trauma that are not cognitively based, that is, stored in non-cognitive areas of the brain. Even bipolar disorder, a seemingly organic illness, is often later discovered when medications stop working to actually have roots in trauma, and in some is an expression of PTSD and dissociation.
I am conflicted about writing this post. I know first-hand the desire to have answers, and to need relief and support. I know first-hand the pain of psychiatric and psychological ineptitude and abuse in treatment. I used to be such a believer in those models, and it was decades before I recognized I was betrayed by them. I also was fortunate enough to find other therapeutic modalities that freed me from almost all medications, such as EMDR, DBT, and energy psychology protocols, which addressed the root causes of trauma and how it caused maladaptive functioning. I admit I still require occasional support from benzos because, while I have experienced considerable healing and progress, there are times I still need something to help me regulate when the tools I have aren't quite cutting it, and the healing hasn't reached all root causes. So in writing, I am cognizant that not everyone gets opportunities to receive appropriate treatment, and it's fucking unfair. It's also fucking unfair that the system meant to serve is denigrating, abusive, and can cause more damage than the symptoms which brings people to seek its help.
This post doesn't provide any real solutions, only highlights how fundamentally flawed the systems and models are, and by extension, how many of us get screwed. I wish I could do more than highlight such things. I wish I could point to solutions that are widely available to all, and I am angry and frustrated that they are not.
My point in writing this post is to say: a person's identity is not a psychiatric diagnosis or label; the labels serve a model that does not accurately or sufficiently address what people experience, nor the root causes of those experiences; and I am sorry if you are suffering, but at the least, I hope I can help you to not suffer because of a label.
I welcome other perspectives than those I have presented here, and any discussion which this post may inspire.
While diagnostic labels may help to explain things, and even provide the relief of understanding symptoms and behaviors, they can also limit and even imprison a person by defining them and causing them to view themselves and be viewed as someone/something to be judged and separated from, rather than embraced, appreciated, respected, and served with a goal to overcome challenges that are not their fault. Calling someone by a label encourages condemnation and discrimination, as well as self-condemnation and self-discrimination. It is difficult to heal or progress from a place of condemnation.
I'm currently reading the book Adult Children of Emotionally Immature Parents, written by a psychologist. This quote really stood out to me:
Human emotional immaturity has been studied for a long time. However, over the years it has lost ground to an increasing focus on symptoms and clinical diagnosis, using a medical disease model to quantify behaviors as illnesses suitable for insurance reimbursement.
Please note that I am in no way suggesting anyone here is emotionally immature and needs to start viewing themselves with even more condemnation! My purpose in sharing this quote is to highlight what I put in bold font: the medical disease model, and insurance reimbursement, that is, a kind of psychiatric capitalism.
I often think of how the psychiatric/psychological system works. Many times people talk about chemical imbalances, yet where are the blood or other tests that prove this? If a condition is truly organic and is in the brain, why are people put on drugs rather than first being given brain scans? With the exceptions of vitamin D and thyroid testing, there are in general no diagnostic tests run for the pseudo-medical diagnoses given. Psychiatrists follow the DSM in the US and the ICD in Europe, matching symptoms to lists under diagnostic labels, and very often confirm diagnoses by how individuals respond to medications, not by any kind of scientifically verifiable testing such as scans. And yet, scans can clearly show things like PTSD, schizophrenia, and even sociopathy. Why use diagnostic lists and medicine to rule out certain conditions when many conditions can be proven or disproven by brain scans? It doesn't make sense if the goal is to actually pinpoint root causes of and cure ailments. A true medical model would use medical diagnostic tools.
So if you have been given a label, I empathize that for a time it may be comforting to get some answers, as well as disconcerting because it can impact one's sense of identity. In my own personal experience, as well as grad school studies focusing on mental health advocacy, and having worked in community mental health in an administrative support role, where my closest friends were practitioners, I learned that misdiagnoses are common. For example, it can take ten years for someone with bipolar disorder to get that diagnosis, after following a variety of dead-ends such as ADD, depression, anxiety, schizophrenia, etc.
So-called personality disorders are trauma-based, yet PTSD and related dissociative disorders are poorly described in diagnostic manuals and are usually not the first diagnoses a clinician refers to, and in fact are often dismissed when the patient brings them up. These very disorders require interventions to overcome the root causes and have historically proven resistant to treatment with medications, yet practitioners are more likely to push medications than effective modalities that actually promote healing such as DBT and EMDR. CBT is touted as an effective evidence-based practice, yet it is a cognitive game of sorts which may help some thought patterns, but does not get to the roots of trauma that are not cognitively based, that is, stored in non-cognitive areas of the brain. Even bipolar disorder, a seemingly organic illness, is often later discovered when medications stop working to actually have roots in trauma, and in some is an expression of PTSD and dissociation.
I am conflicted about writing this post. I know first-hand the desire to have answers, and to need relief and support. I know first-hand the pain of psychiatric and psychological ineptitude and abuse in treatment. I used to be such a believer in those models, and it was decades before I recognized I was betrayed by them. I also was fortunate enough to find other therapeutic modalities that freed me from almost all medications, such as EMDR, DBT, and energy psychology protocols, which addressed the root causes of trauma and how it caused maladaptive functioning. I admit I still require occasional support from benzos because, while I have experienced considerable healing and progress, there are times I still need something to help me regulate when the tools I have aren't quite cutting it, and the healing hasn't reached all root causes. So in writing, I am cognizant that not everyone gets opportunities to receive appropriate treatment, and it's fucking unfair. It's also fucking unfair that the system meant to serve is denigrating, abusive, and can cause more damage than the symptoms which brings people to seek its help.
This post doesn't provide any real solutions, only highlights how fundamentally flawed the systems and models are, and by extension, how many of us get screwed. I wish I could do more than highlight such things. I wish I could point to solutions that are widely available to all, and I am angry and frustrated that they are not.
My point in writing this post is to say: a person's identity is not a psychiatric diagnosis or label; the labels serve a model that does not accurately or sufficiently address what people experience, nor the root causes of those experiences; and I am sorry if you are suffering, but at the least, I hope I can help you to not suffer because of a label.
I welcome other perspectives than those I have presented here, and any discussion which this post may inspire.
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