Diagnoses

I thought I’d take a moment to discuss some words that my therapist has thrown around. I’m also curious to know what other’s experience is with diagnoses and how they’ve gone about it.

From my experience, the mental health world is different than physical health. I think it has to do with how society sees each kind. Mental health seems far less definitive, and for the majority of its existence it was seen as more of a pseudoscience than a hard science. This was mainly due to our inability to explore the brain in depth, and is a cloak yet shaken off.

So, in contrast to getting told that my finger was broken in such a definitive manner after getting it x-rayed. My therapist has mainly just used the terms as discussion points and has rarely if ever just said the words, “You have ______”.

Instead, the words sometimes get used, and these are the words I’ve heard her say to describe some behaviors:

So, while she hasn’t gone right out and said it as definitively as the doctor had about my finger being broken, I treat these words as diagnoses.

However, another reason that I think my therapist, specifically, hasn’t said it is the notion that we seem to think of mental health issues as more permanent. It can be something that is a combination of physical and mental manifestations, and that makes it harder to fix.

Due to the way that the brain works, you can’t just wait for it to heal. You have to actively try and change the connections in your brain. People tend to talk about brain elasticity as something that can just be done. It is a lot of work, patience, and determination. It doesn’t happen overnight, a few days, weeks, or maybe even months. It’s slow-going, and it can be hard to separate it from identity. Having someone say: “You have depression” can sound like you will have it forever and it can stick with you as a label.

A label like that can be detrimental. In Dialectic Behavioral Therapy (DBT), there is a principle dialectic between acceptance and change. This dialectic can be appealing to people because a lot of therapies just focus on change. Personally, if someone told me that I had to change everything, not only would it overwhelm me, but they would meet a lot of resistance.

Even in DBT, I’ve been stubborn sometimes about change (see Stability blogpost). However, after debriefing with my therapist about those times, even she will bring up that there probably needed to be more of an acceptance of where I was at and validation. However, without change there is no challenge.

Accepting your mental illness as a label or part of your identity can hinder that change. It can be hard not to embrace it. I think that comes from finally having an answer to a problem that has gone on for awhile. Especially for someone who has been battling this for years, when you finally have a label, you kind of add it in retroactively. Not to mention, you hardly remember a time where you didn’t feel this way. So, how can you separate the way you’ve been feeling for so long from your identity?

To be honest, I’m not sure of the answer. However, I’m sure it involves acceptance and change. A whole lot of change. I know I’ve changed a lot over the years, and I am getting better. Discovering who I am has been crucial to this recovery. Learning to love and accept myself for who I am is hard, but I am learning.

Throughout it all, these diagnoses have been a relief. It’s been so validating for another to acknowledge what I’ve been going through, to help put a name to it, come up with a game plan, and help me through it. Therapy has been invaluable to me, and these diagnoses are not sad things for me.

I truly believe that I am where I am supposed to be right now. And I’m so grateful to have the counseling of such wonderful people. Thank you all for your support! Please let me know what your experiences are with this! I’d love to hear from you!

 

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