The Person, Not the Diagnosis

In spite of psychology’s vast empirical literature on the importance of individual differences, the current trend in the field is to treat a symptom as a “thing” in-and-of-itself rather than an expression of a client’s complex and unique subjectivity. So, this has produced a generation of therapists and patients whose main response to suffering is, “Oh, there’s a manual for that!” But people who have similar symptoms but different personalities cannot be given a one size fits all treatment.

The dominant culture undermines the paradigm of psychotherapy, which used to be generally conceived of as a healing relationship, but now is defined as a set of techniques to be applied to discrete types of suffering. The dominant culture also undermines psychotherapy by asking therapists to be an instrument of a commercially driven mass society and to improve behavior so that it is no longer “inconvenient,” dare I say, to the larger community. This is part of the trend of calling mental health services “behavioral health services,” as if the internal aspects of experience are secondary to an emotionally satisfying life.

Think about it in terms of a simple analogy. In medical disciplines, no self-respecting physician would define a so-called “cure” as a reduction of symptoms. When a person comes in with a fever and doctors try to figure out what’s causing the fever, they don’t assume getting rid of the fever is all that has to be done. As psychologists, we’re being asked to do the same thing.

There’s several criteria considered by mental health clinicians as features of people who are growing healthier and maturing. They are not categorical, they are dimensional—meaning they can be better or worse, not perfect or nothing. Rather than reducing ourselves to neat categories of symptoms, treatment should, in my opinion, build on our capacity to living a richer and more humanizing life.

People aren’t capable of conceptualizing what exactly the picture of mental health is. For example, people don’t often come into therapy and tell the therapist what they are lacking. We ought to have an idea of what is good enough, or at least better for us individually. Therapy is a vehicle to know and understand human suffering that goes beyond diagnostic categories and focuses on the challenges of living a fuller life.