Silly Diagnostic Labels

As a Licensed Professional Clinical Counselor, I am expected to assign labels to clients based on their “symptoms.” I put that word in quotes, because the bulk of my counseling hours are spent helping people navigate their way through situations. The “symptoms” are their perfectly normal responses to abnormal circumstances. Did you suffer abuse as a child and now have issues with trust, and/or PostTraumatic Stress? Sounds like a normal reaction to me, though the diagnostic label would likely be PostTraumatic Stress Disorder. Seriously, is it a disorder or a normal reaction you would like to mitigate or overcome?
Of course you want to feel better. I am here to help you process your issues so you can do exactly that. I’m just not sure how helpful a label is in that process. After all, each of you is unique, and though some labels may apply to you, they certainly do not define you.
To be fair, these diagnostic categories do give us a better feel for what we are dealing with, which of course leads to better ideas as to what approach will be most helpful. Just as a reputable medical person would never suggest treating asthma the same way they would a broken bone, I would never advocate that all clients be treated in an identical manner.
As I write this, I am reminded that there is valid overlap. I was about to bring addictions into the previous paragraph, when I was pretty much gobsmacked by the thought that there is almost invariably a link between addictions and previous trauma.
In one of my more rebellious moods, I came up with my own diagnostic system—one which is definitely not validated by any professional research. But in some ways it does cut to the chase. It refers to everyone being on a continuum, between NWC and JFN. NWC is my shorthand for Nothing’s Wrong wit Choo—you are unhappy and want to feel better, but you are mentally stable so there is that. JFN, my shorthand for Just Flippin’ Nuts, is not one I have given anyone; it is just there for comparison. My clients are not crazy, and I don’t say that to be facetious. If someone comes to me with a pervasive problem, such as psychosis of any type, I am likely to refer them to someone with a specialty in that area. This is not to be critical of that client; they simply deserve a therapist who specializes in their specific issue. I do not have enough experience in those areas and attempting to treat those potential clients would be doing them a disservice.
So here is my final word: We are all on the continuum between NWC and JFN, and in any normal lifespan we will move around a bit on the continuum, depending on our current situations and stressors.
Will it pass academic muster? Probably not, but I still like it and I hope you do too.

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