It was probably just a simple misunderstanding between a physician and her patient but it had life-changing consequences.
The woman being diagnosed recalled: “The doctor at the hospital kept asking me if I heard voices.
“I didn’t know what she meant by this. Was she checking my hearing, my awareness? Was she using a metaphor? I didn’t know. I said yes as I could hear the voices of nurses and patients on the ward down the corridor.
“That sealed my fate.”
This was an account submitted to an independent panel of legal and academic experts and service users investigating the impact a ‘schizophrenia’ label can have on people.
It is also a stark example of something recently highlighted by a man The New York Timesonce dubbed “the most powerful psychiatrist in America”, who recently gave a lecture to a London audience about “the father of psychoanalysis”, Sigmund Freud.
During the talk, Dr Allen Frances warned that in the world of mental health care a label “can begin in a moment and live on for the rest of your life”. It was vital, he said, that the labelling of mental health challenges was always undertaken very responsibly.
If that’s true at the level of doctor-patient diagnosis, then what if you’re crafting a mental health “bible” that can impact millions of lives around the world, as the recently published fifth revision of the Diagnostics and Statistics Manual is destined to do?
Frances has been a persistent critic of DSM-5, his most significant broadside being a book called: saving normal. Its cover describes the contents as “an insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of normal life”. It condemns the “diagnostic inflation” of labels – such as calling grief a “Major Depressive Disorder” – given to what should be regarded as normal human experience.
Such criticisms, and others, were rebutted by DSM-5 Task Force chairman David Kupfer, MD, during the San Francisco launch of the American Psychiatric Association’s 947-pageManual. In particular, responding to questions about promoting excessive reliance on drug therapies, Dr Kupfer said he didn’t expect physicians treating mental illness only to prescribe drugs but also to recommend nonpharmacological interventions.
In his Freud Memorial Lecture (presented by the Freud Museum and King’s College, London) Dr Frances gave an impressive example of such a drug-free intervention. He told of someone he consulted with only briefly, who later thanked him for a profound turnaround, telling him: “You said something in that 10 minutes that changed my life”.
He now enters each consultation asking: “What can I say in this interview that will change your life?”
If such profound potential can reside in sharing the right thoughts at the right time, doesn’t that point to the power of ideas to take us beyond our labels and help steer us home to the normalcy of wellbeing?
Life-changing ideas are also the stock in trade of a more spiritual approach to healthcare that has helped several people I know find a way out of symptom management to full freedom from mental and physical diseases, some of which had loomed as life sentences. They have found it liberating to grasp something of the divine essence that endures beyond all the labels we adopt – or resign ourselves to.
The desire to get beyond ways we identify ourselves that seem to restrict us isn’t just for those facing health struggles, of course. Some friends and I participated in an exercise in which we each made a list of all the labels we associate with ourselves – from the negative to the most positive – and then quietly considered what is left if we mentally set them all aside.
“All that remains” – as one of those described what she found, in a beautiful, healing, poem– was the sense of individual, spiritual worth that we live out in our more positive labels such as parent, sibling, artist, author, co-worker, healer, and so on. But it is not confined to these. Her poem concludes:
I walk my spiritual story and claim
the good in every landmark…
I am enriched, free at last to see
all my Father Mother God gives to me.
The publication of DSM-5 raises urgent questions about the extent of the diagnostic labels we attach to various mental states. But whether or not any particular stress or strain deserves to be called mental illness, we still want to be free from whatever would cloud our wellbeing.
One way to achieve that is to probe beyond all the the materialistic labels we consciously or unconsciously identify with, and explore whether we have an underlying divine identity that offers us more serenity, more satisfaction and more security.
Because if we do, then uncovering that new view can indeed be life changing.
This was first published on the Huffington Post UK as “Beyond Mental Health Labels Through a New View of You”.