What Defines Me as a Person?
Is it when I’m at my best? Or at my worst? Is it my history - what has happened to me or what I’ve done?
Is it how I’m feeling and behaving in the moment?
I know I’m not the only person to ask these questions of themselves. Society too, demands that we continually identify who we are and what we stand for. It also asks, that the person we present to the world, be coherent and stable. But as a human being, I am a loud, contradictory stream of thought and sensation. I am conflicting parts that emerge and front depending on the circumstances. I am awareness itself, and am not easily confined to a single definitive feature.
But what if there were a much simpler label I could use to identify myself by?
What if there were a concise explanatory system for who I am, widely used and accepted in the world today?
I am here talking about psychiatric diagnosis. And I see it frequently – people who are suffering, taking on their diagnostic label as an explanation for who they are in the world. I too have become fixated on my diagnoses.. And although I felt validation in that my pain was sufficient to warrant a label, the diagnoses were also problematic in a number of ways.
Firstly, I did not recognize that these labels were just the opinion of one psychiatrist, designed as a shorthand summation of my difficulties, not to be used outside of a medical context. Instead, I took them to heart and claimed them as my identity. I began to see myself as defective, particularly with a diagnosis of personality disorder traits. I felt like I had a shameful secret, and that if I was not careful to hide my true thoughts and feelings, that others would pick up on my brokenness. At one point, my difficulties were such that I was misdiagnosed by the inpatient ward as having schizophrenia. Sectioned and in hospital, I felt like the very definition of crazy. And I had a ready excuse when I made mistakes – I believed I had little control over my behaviour, and did hurtful things because I was unwell. I also avoided connecting with others on a wholehearted level, because I related to them through the lens of my diagnoses, and not according to my authentic inner voice.
Furthermore, having a name for my distress kept me stuck in feeling and behaving in ways consistent with my labels. As time passed, I became unsure of who I was outside of psychiatric terminology, and was terrified of the uncertainty and nuance, out there in life beyond labels. I dealt with enormous fear and grief in learning to loosen the grip I held on my diagnoses. I also grappled with low motivation to change, as I did not really want to find out who I was beyond the familiarity of my labels.
Did you know that one in five New Zealanders today have a diagnosable mental illness?
This statistic does not shock me so much as the fact that we use a contextless, medical term to quantify the level of distress felt today in our nation. New Zealand has serious societal issues - poverty, family violence, loss of employment, lack of meaning and social connectedness, and physical health problems, particularly so-called lifestyle diseases. I am not so sure that understanding our nation’s problems in terms of the prevalence of mental health issues allows us to connect to its root causes.
Furthermore, using diagnosis as both the classification for the behaviour, and the explanation of the behaviour, is problematic. Let me illustrate what I mean in the following example: ‘why is John depressed? Because he has the symptoms of depression!’ ‘and why does he have symptoms of depression? Because he is depressed!’ This is circular logic, and it functions to prevent us from looking beyond the label to the reasons behind the behaviour, to the person’s history. Perhaps John is grieving the loss of a friend, which is complicated and prolonged by the grief he never resolved over his father’s death. Perhaps John harbours deep anger that he feels unable to express to those around him, and so he turns it in on himself in the form of vicious self-criticism.
I would say that this blogpost is the tip of the iceberg in terms of the problems that come from understanding and categorizing human suffering according to symptoms and diagnosis. And these are on top of the problems associated with this such as the overprescribing of medication, especially to the young and very old, the unrelenting and largely fruitless search for the so-called biological basis of mental illness, and the prevalent idea that these conditions even exist as actual disease identities, instead of a set of ideas grouped into arbitrary criteria and set out by a group of psychiatrists.
In conclusion, after much hard work on myself, I am proud to say that I no longer meet criteria for a diagnosis - I am 'subclinical' as it is called. But I am also so much more than any label. I am a loving daughter, sister and friend. I am someone who shrieks when she laughs and who tries new things, though not always succeeding. I am passionate, creative, and excited. I am me.