So, what is a diagnosis… exactly? With the exception of organic disorders which involve physical malfunctions or malformations, psychological disorders are clusters of attitudes, ideas, and behaviors, often accompanied by distressing emotions, that are disruptive to optimal wellbeing. They are sometimes long-standing and enduring, yes. BUT, the majority of diagnoses are not centered in some organic infection or physiological dysfunction. The diagnosis is, for the most part, about how you think about the things you think about, patterns that you habitually repeat, and experiences that have conditioned you to behave and think in certain ways. And all of these patterns, habits, and perspectives CAN be changed. In this sense, a diagnosis is a snapshot of you and not a portrait etched in granite.
Said differently, you are not your diagnosis! A diagnosis is rarely a fixed ontological way of being, the result of the miswiring of the motherboard that is your brain, but a description of a way of being that is subject to your determination to change. Let me say it this way, a diagnosis is not a disorder that you “have.” You may be experiencing depression, anxiety, obsessive compulsive ideation, etc. You do not “have it.” It’s more like you are in the grip of a constellation of ideas, beliefs, behaviors. It is the task of the therapist to walk with you on the path to freedom and to work with you to create the map to liberate yourself.
The task of therapy is help you know you, to explore what got you into distress, and to walk with you through the dark forest until you get out on the other side. But walking through this forest is necessary. For it is in the darkest part of the forest, filled with its own specters, that the most enlightening and liberating insights about yourself may arise. This is a journey of the soul and the therapist must know more than how to relieve symptoms to walk with you through it. This requires wisdom on the part of the therapist and it requires honesty, curiosity, self-compassion, and persistence on your part. In the words of the Greek sages, the charge is to “know thyself.” The self you discover in therapy is the gift behind the diagnosis. Ultimately, the adventure of therapy is the path to rediscovering the treasure that is you!
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