When diagnoses become a label
Medical practitioners use the ICD-1- CM Diagnosis Codes – International Classification of Diseases and the American Psychiatric and Statistical Manuel. These are designed to assist health care professionals in identifying presenting symptoms, making an educated diagnoses and formulating a treatment plan. A combination of those codes and the codes for procedures performed are used to bill insurance companies, to help judges and juries make decisions and to give some guidance to patients, family member and the community.
Sadly, often the diagnostic codes become labels to define the person. Many of those for/with whom I work present with symptoms such as violence, addiction and those associated with PTSD. Many arrive in my office with a history of various diagnoses. One of the diagnoses which all too often arrives with a person or which some family member uses to express concerns about another family member is that of Narcissist. We have been trained to hear this diagnosis as a label which often tells us all we think we need to know about a person. I was thinking of those who present with such a label after reading the most recent blog by Maria Popov, Brain Pickings. She is a brilliant thinker and writer whose blog I would highly recommend. This one discusses the humanistic philosopher Erich Fromm with particular emphasis on his thought provoking book, The Art of Being which she stays is “a sort of field guide, all the timelier today, to how we can shift from the having a mode of existence, which is systematically syphoning our happiness to a being mode.”
In this blog, she focuses on Erich Fromm’s definition of narcissism. The first sentence of his definition is “Narcissism is an orientation in which all one’s interest and passion are directed to one’s own person; one’s body, mind feelings, interests…”. I certainly could not and would not want to argue with that definition or orientation. Yet, I would suggest a slight change in the wording. Consider this possibility:
Narcissism is a condition or orientation which arises out of a fear of not being emotionally, spiritually or emotionally safe in being a member of the wider community; a person who is unable to consider the needs of others. The narcissist does not trust others to give them the unconditional regard they need and/or does not trust the sharing of one’s talents is enough.
In other words, the narcissist is a deeply lonely person who is constantly focused on taking care of themselves because they cannot trust others to do so. The narcissist may, in fact, have convinced themselves that their worth is dependent on deserving to have a vastly unequal share of resources: money, things, praise, power. Diagnosing someone with a narcissistic disorder can, in this context, lead one to identify some of the factors which led to this orientation or life dance or to, at the very least, ensure that one approach this person with enormous compassion. The label tells us nothing about the pain of the individual. The individual, himself or herself might have no idea that there is another possible life dance. The person with these symptoms should not be in a position of power or authority although they frequently are. The challenge might be to relate to them as a person in pain while attempting to prevent them from using power or authority to mistreat others. Labeling them as a bad or unworthy person is not appropriate, accurate or helpful. Labeling them as mentally ill person is also not helpful or kind. That person deserves our love and emotional support; not our political support.
I believe that it is important to use medical labels as a guide to designing and implementing a treatment/healing plan and not as a definition of the essence of a person. Erich Fromm is accurate in suggesting it is an orientation to a life dance; one I maintain the person was taught and or stumbled onto.
There many such labels which tell us something about symptoms and which may offer a direction for treatment but which tell us nothing about the essence of a person. I believe we must be vigilant in not confusing the two.
Written May 14, 2020
Jimmy F Pickett
coachpickett.org
Medical practitioners use the ICD-1- CM Diagnosis Codes – International Classification of Diseases and the American Psychiatric and Statistical Manuel. These are designed to assist health care professionals in identifying presenting symptoms, making an educated diagnoses and formulating a treatment plan. A combination of those codes and the codes for procedures performed are used to bill insurance companies, to help judges and juries make decisions and to give some guidance to patients, family member and the community.
Sadly, often the diagnostic codes become labels to define the person. Many of those for/with whom I work present with symptoms such as violence, addiction and those associated with PTSD. Many arrive in my office with a history of various diagnoses. One of the diagnoses which all too often arrives with a person or which some family member uses to express concerns about another family member is that of Narcissist. We have been trained to hear this diagnosis as a label which often tells us all we think we need to know about a person. I was thinking of those who present with such a label after reading the most recent blog by Maria Popov, Brain Pickings. She is a brilliant thinker and writer whose blog I would highly recommend. This one discusses the humanistic philosopher Erich Fromm with particular emphasis on his thought provoking book, The Art of Being which she stays is “a sort of field guide, all the timelier today, to how we can shift from the having a mode of existence, which is systematically syphoning our happiness to a being mode.”
In this blog, she focuses on Erich Fromm’s definition of narcissism. The first sentence of his definition is “Narcissism is an orientation in which all one’s interest and passion are directed to one’s own person; one’s body, mind feelings, interests…”. I certainly could not and would not want to argue with that definition or orientation. Yet, I would suggest a slight change in the wording. Consider this possibility:
Narcissism is a condition or orientation which arises out of a fear of not being emotionally, spiritually or emotionally safe in being a member of the wider community; a person who is unable to consider the needs of others. The narcissist does not trust others to give them the unconditional regard they need and/or does not trust the sharing of one’s talents is enough.
In other words, the narcissist is a deeply lonely person who is constantly focused on taking care of themselves because they cannot trust others to do so. The narcissist may, in fact, have convinced themselves that their worth is dependent on deserving to have a vastly unequal share of resources: money, things, praise, power. Diagnosing someone with a narcissistic disorder can, in this context, lead one to identify some of the factors which led to this orientation or life dance or to, at the very least, ensure that one approach this person with enormous compassion. The label tells us nothing about the pain of the individual. The individual, himself or herself might have no idea that there is another possible life dance. The person with these symptoms should not be in a position of power or authority although they frequently are. The challenge might be to relate to them as a person in pain while attempting to prevent them from using power or authority to mistreat others. Labeling them as a bad or unworthy person is not appropriate, accurate or helpful. Labeling them as mentally ill person is also not helpful or kind. That person deserves our love and emotional support; not our political support.
I believe that it is important to use medical labels as a guide to designing and implementing a treatment/healing plan and not as a definition of the essence of a person. Erich Fromm is accurate in suggesting it is an orientation to a life dance; one I maintain the person was taught and or stumbled onto.
There many such labels which tell us something about symptoms and which may offer a direction for treatment but which tell us nothing about the essence of a person. I believe we must be vigilant in not confusing the two.
Written May 14, 2020
Jimmy F Pickett
coachpickett.org
RSS Feed