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.

Ask Everyone

Ask everyone

You all know I have a Masters Degree, since that is required for me to get my license. What you may not all know is that I was in my 50s before that degree was conferred. I would be a liar if I said I knew from the age of 5 that I wanted to be a counselor. I started my freshman year of college with only very vague goals, and that is surely part of why it took me so long to complete even my Bachelor’s degree. Any excuse to drop out and I took it, until I didn’t.
I was 32 years old when I got my Bachelor of Arts Degree, and a divorce. Once I found a counselor I really liked (to process the divorce), I started thinking how much I would like to go into that same field. Then I quickly started un-thinking that, because I could not see my way clear to how I would ever pay tuition while I raised my child. I didn’t even tell anyone my goal; I just fumbled along the best I could with the generalized degree I had, working at jobs I didn’t much like but that I was pretty good at. There was also the one job I did like, self-employed, performing personalized singing telegrams. It required my creative side, which was what I loved about it.
Even after my son was fully grown, I would take stabs at figuring out how to finance graduate school, but I kept looking in the wrong places. It is especially curious that I never darkened the door of a college Financial Aid office. Now wouldn’t that seem like a logical place to go?
My mistake was simple: I thought I should be able to figure it out for myself, so I did very little asking for advice, even from experts. Blaming myself for not knowing what I had not been told, I just kept fumbling along without that degree. After enough years passed, I decided it just wasn’t in the stars. One favorite excuse? I won’t have enough working years left to justify the investment.
Then an opportunity pretty much smacked me in the face. I took it, started classes, and learned by Week 2 how most of my fellow students were funded: They had jobs in social service fields, with companies that paid for graduate school as an inducement. These were all companies I had been perfectly well qualified to work for; it just had never occurred to me to even try.
The point of this vignette is simple: Don’t follow my example. Had I swallowed my pride just the teensy amount it would take to ask questions, I would have either gotten into graduate school sooner or made an informed and rational decision to be content with the formal education I already had.
I doubt I would have started graduate school the minute the ink on my divorce papers was dry. Working full time while attending classes part time would mean I would miss out on too much of my child’s growing up. The years running the singing telegram company gave me plenty of latitude to be a more involved parent, for which I will always be grateful. But it would have been nice to have a plan for following a new career path when the time was right.
The short version of all this? Ask around. A lot. And read. And brainstorm, accepting even the worst ideas as ideas that may lead to better ones. There is no shame in not knowing, only in not bothering to learn. Whatever your age, you still have all the years ahead of you to change your path or just tweak the one you are on, to evaluate and re-evaluate your direction in life. The embarrassment of asking for advice and information pales next to the frustration of continuously thinking “If only.”