In my previous post, we examined some drawbacks to my profession’s reliance upon psychiatric diagnostic labels. To illustrate further drawbacks, I have invented a diagnostic label. This I term PDID, or Psychiatric Diagnostic Identity Disorder. It is, I contend, a core malady of countless Americans. PDID has two subtypes–PDID, Fragmented Identity Type and PDID, Lack of Identity Type.
First the Fragmented Identity Type. Here patients subscribe to psychiatry’s attempts to parse them into multiple entities, each seemingly with its own ontological standing. For instance, many patients have seen me for an initial
evaluation saying something like, “I’ve been diagnosed with Bipolar Disorder and Generalized Anxiety Disorder, and I’m taking Zoloft for my OCD and Ritalin for my ADD. And I think I may be borderline…”
This is a wine connoisseur’s model of diagnosis that psychiatry underwrites, one that analyzes patients like glasses of Cabernet. Accordingly, one can imagine a learned diagnostician nibbling canapes while describing a patient who is redolent of Dysthymic Disorder with undertones of Major Depressive Disorder, a soupcon of PTSD, and a distinct aftertaste of Axis II pathology.
Well, what is the problem? some may ask. After all, these are terms that encapsulate clusters of symptoms and signs that recur throughout the population and inform treatment. True. Unfortunately, as noted in my previous post, only a whole, integrated individual can become well and remain well. A living, breathing patchwork of multiple disorders cannot. Thus does psychiatry forego the possibility of cure by fragmenting the identity of the previously intact individuals it treats.
In PDID, Lack Of Identity Type, individuals camouflage their deficient sense of identities as unique human beings with diagnostic labels. Such a patient may announce to me or others, “I’m an anorexic,” or “I’m a schizophrenic.” We have
already seen the problem with such a belief: if your identity equates solely with sickness, you can never get well.
The availability of such labels tempts vulnerable patients to seek refuge in diagnostic pseudo-identities. It encourages lost souls to further lose touch with reality as they identify themselves with abstractions that refer only to certain of
their parts. Dmitri, for example, laments that he is an obsessive-compulsive, a statement that makes no more sense than if he complained that he is a hemorrhoid or acne.
Imagine if the American Psychiatric Association were to include in its manual a set of diagnostic criteria and codes not only for disorders but for healthy characteristics as well. Imagine such terms in its nomenclature as courage,
intelligence, creativity, street-smarts, wisdom, generosity, devotion, capacity to love, diligence, honesty, and altruism.
At least then an individual, instead of saying merely, “I am an obsessive-compulsive,” could add, “with loyalty to my loved ones, a strong sense of responsibility, and I can freaking wail on the tenor saxophone.”
Why not include in a given diagnosis whatever makes that person different from others, unique, special? That may be the information we need to cure them, or the realization they may need to cure themselves.
Who knows? If psychiatry recognizes the two PDIDs as bonafide problems, it may yet heal itself.
But if in the meantime you have been diagnosed with a psychiatric label, I have two recommendations. First, that you continue whatever treatment helps you or helps those with similar problems without equating the label itself with reality, and certainly without equating the label with you as a whole person. For you cannot be defined by any noun, especially one that is as subject to change as a DSM diagnosis. Remember, these labels change every few years. They are merely words voted in or out of the official canon by committees of psychiatrists who have no access to Ultimate Truth and who do not, at this stage of my profession’s evolution, comprehend the need for more useful alternatives. And I also recommend that you consider other treatments that can actually cure you by utilizing your inner healing resources and treating you as a whole, unique individual.
Originally published at http://www.greenpsychiatrist.com/twopsychiatricdiagnoses/.
This is Part 2 of an earlier blog, Why Psychiatric Diagnoses Are Bad For Your Health.
Steven Goldsmith obtained his M.D. from the Columbia College of Physicians & Surgeons. After experience in general practice and internal medicine he completed a psychiatry residency at Boston University Hospital. Certified by the American Board of Psychiatry & Neurology, he has held faculty and staff positions with the Boston University, NYU, and Tufts Schools of Medicine. He has authored the books, The Healing Paradox: A Revolutionary Approach to Treating and Curing Physical and Mental Illness and Psychotherapy of People with Physical Symptoms: Brief Strategic Approaches. In addition, he graduated from the International Foundation for Homeopathy training program and the North American Homeopathic Master Clinician course and has been practicing homeopathic medicine since 1992. His private practice in Portland, Oregon emphasizes natural solutions to health problems.