labels and identity

Once you get your masters in something like counseling (or, I'd imagine, nursing, physical therapy, etc.) you start getting these really loaded questions from your friends and family. Lots of them kind of end up like this: So, do you think I have ______? That blank can be lots of things: depression, OCD, ADHD, bipolar, an addiction, the list goes on. The implication is pretty clear- I'm [supposedly] the expert now! That's a whole lot of responsibility! And, really, it's up to me to answer however I want.

"Yup, sounds like you've got ADHD."

"I think you're right, your friend has an eating disorder."

"Yeah, if I were you I'd encourage my mom to get therapy for depression."

I put those words in bold because that's how they sound coming out. Like a final pronouncement on who you are. Like you need to start introducing yourself "Hi, I'm John and I'm depressed".

I've been doing some research on ADHD for my final (yessssss!) assignment for my online class and came across this quote, that I thought was really helpful:

"These categories are abstractions we have created, not entities we have discovered in nature. Diagnostic categories can be useful tools to help us talk about ... behavioral and emotional disturbances, but we need to remember that they are tools created by us. We – doctors, parents, teachers, and others – set the threshold between behaviors and moods in need of pharmacological or behavioral treatment and differences that should be left alone or dealt with in other ways."* (emphasis mine)

In the end all these weighty words are simply human creations. Psychologists started to see a whole lot of people acting the same way and thought, "Hey, let's call those behaviors obsessive compulsive disorder. That way, when we talk about it, we'll all know what it looks like".

The symptoms are real, the relational hurt is real, and the difficulties associated with all of these things are very real. I would never try to take away from the immense damage that psychological issues can cause. BUT, diagnosis doesn't mean anything about identity. It doesn't imply permanence. And it certainly doesn't have to be central.

That's just a little caveat/soapbox that I'd like to get on every time I hear that question. :) Sure, that sounds like a diagnosis, it's still up to you to decide if you want help or not.

* from Parens, E., & Johnston, J. (2009). Facts, values, and attention-deficit hyperactivity disorder (ADHD): and update on the controversies. Child and Adolescent Psychiatry and Mental Health

on worry

i'm reading a couple recent articles on treating anxiety. specifically Generalized Anxiety Disorder, which is persistent anxiety (with other qualifiers) for a period of 6 months or more.

i'm reading about this because, honestly, i am awful here as a counselor. more than any other area this is one where i want to chime in with a resounding, "i KNOW!"

here are some things i've learned:

the very best therapies for anxiety only work about half of the time.

among the half who find therapy effective, many relapse.

so, less than half of anxiety sufferers who receive therapy are helped long term.

yipes.

but, i did like this idea proposed by one researcher:

An ‘‘intolerance of uncertainty’’ is the core cause of uncontrollable worrying (Dugas et al. 1998). He demonstrated that chronically anxious patients preferred to experience negative outcomes, rather than face uncertainty about future threats, thus creating an illusion of certainty and predictability.

that seems so ineffective... who would do that?? 

... 

*hand raise*