Thoughts on Diagnoses

Prospective clients frequently ask what I specialize in.  Often they are looking for terms like Depression, Anxiety, Phobias, OCD, Substance Abuse, ADHD, PTSD, Borderline Personality Disorder, or Disordered Eating to name a few.  While I work with people struggling with these illnesses, this is not how I see my work or my clients.  

Diagnoses are important for many different reasons.  Having a name for our suffering can be validating for the client and useful for their family and friends.  Having an accurate diagnosis helps clients who wish to pursue medication as part of their healing.  I am not anti-psychiatry or someone who rejects the medical model of mental illness.  I have witnessed profound and positive effects of diagnosis and appropriate medication.  I have encouraged clients to seek psychiatric care when I believe it would be helpful.  

Diagnoses are labels given to a cluster of symptoms.  The labels and the criteria to qualify for a specific diagnosis change over time.  Outside of medical interventions (typically psychiatric drugs), the diagnosis loses its salience as a road map to healing.  While a diagnosis is a cluster of symptoms that cause someone distress, it rarely gets at the underlying issues creating and maintaining the distress. My work, as I see it, is about identifying and alleviating the root causes of distress.  Obviously, learning techniques that help manage symptoms and reduce immediate suffering are invaluable, not only for the impact on the immediate discomfort but also for creating the space and calm for the client to dive deeper for the source of the turbulence.  

This is why, when people ask about my specialties, I respond that I focus on helping clients identify the negative beliefs, core wounds, and habitual patterns that are preventing them from achieving the change they desire.  Therapy is about the inner psychological, emotional, and historical.  It is about unraveling stuckness, rewriting our personal narratives, and developing curiosity and compassion for ourselves.  Therapy is about reenvisioning our place in the world and our relationship with ourselves and with others.  Anxiety might be a good description of how you feel in the moment and the aspects of your experience that are getting in the way of living the life you want.  It is a starting point, but it is not the roadmap towards healing.