THE BLOG
10/02/2010 11:14 am ET | Updated Nov 17, 2011

You Are Not a Diagnosis

Recently, I heard from a client who I hadn't spoken to for two years. So when he left a message saying he was "struggling with anxiety," I was quick to get back to him. When we connected, the first words I heard were, "I'm depressed Jeff, I found out that I am ADD (attention deficit disorder) ... and the meds I've been taking just seem to make the situation worse."

"Whoa," I replied, "What do you mean you are ADD?"

He continued, "Well, I hired a professional organizer and when I showed her my routine and environment, she declared that I 'probably' had ADD. She recommended a psychiatrist, whom I met for about 20 minutes. He asked me a series of questions, agreed that I had symptoms of ADD [or ADHD--attention deficit hyperactivity disorder] and prescribed a cocktail of drugs for me to take. I've been on the meds for a couple of months but they don't seem to be working. I always feel uptight and wired. I do get more work done than before but I'm more irritable and edgy. I don't know if I should go off the meds or what. Help!"

I wish I could say that I rarely hear this kind of story. But the opposite is true. More and more often, people come to me already burdened with a "diagnosis" -- some form of label ascribed to them by a well-meaning doctor who must place them in a diagnostic "category" in order to satisfy the insurance company and prescribe medications.

Yet, as helpful as it may be to know your affliction by giving it a label, I'm highly suspect of this tendency to dumb down our symptoms to a simple (and rather artificially constructed) diagnostic category. Too often, we fall into a sort of trance, marching to doctor's orders, and "I am unfocused or anxious at times" becomes, "I AM ADD."

My client -- and I think most people in similar circumstances -- are much more complex than a simple one word label. This is why I appreciate the work of forward thinking psychologists who use innovative tools to help patients see through their diagnosis and reconnect to their deeper selves.

In a book called "Mindfulness and Psychotherapy," clinical psychologists show how mindfulness practices derived from the Eastern contemplative traditions may be helpful for depression, anxiety and other psychological maladies. In one chapter, there is a wonderful anecdote about how one therapist used the power of one single raisin to break through the all-powerful diagnostic label, "clinical depression."

A patient comes to the therapist saying that he has been depressed for years, and knows "no other state of being." After a few sessions in which they build rapport, the therapist asks him if he is willing to do an experiment with mindfulness. In the experiment, the therapist has the patient practice 10 minutes of silence, breathing deeply, focusing attention on the breath, all while guiding him into a state of deep relaxation, so that he gains awareness of his thoughts and his physical body.

The therapist then takes a single raisin and asks the patient to put it in his mouth and slowly roll it around, to feel the sensations in his mouth, and to focus all his attention on the experience of flavor, texture and movement of the fruit. After experiencing the raisin for a few moments, the patient swallows it (we assume the patient liked raisins) and is brought back gently into a state of present awareness.

The therapist then asks the patient to describe the encounter with the raisin. The patient uses words like pleasurable, sensuous, tasty and delicious. The therapist asks the patient, "While you were savoring the raisin so intently, did you feel depressed?" The patient reflects for a moment and says, "Of course, I am always depressed." Yet, when asked again to reflect a bit more deeply, the patient acknowledges that during the meditative moment with the raisin, he experienced pleasure, not depression. It was as if the raisin shone a light -- of hope -- on this patient's overidentification with the label, "depressed."

I love this story because it illustrates one of the foundational principles of my approach to healing and self-renewal: We are not our labels. So much of our self-worth is wrapped up in how we identify ourselves -- our titles, our possessions, our jobs, even in some cases, our diagnoses! Yet, it is only when we wake up and realize that we are much more than our surface identifications that we become open to possibility and free to choose other options.

In that same call, my client with the ADD diagnosis shared that over the past two years, in spite of downsizing and a merger, he had managed to keep his job, and even finished going to night school to complete his bachelor's degree. Perhaps, he had reason to feel anxious, scattered, even unfocused at times. Surely, he could use help with grounding and balance. But by smacking the label of "ADD" on him, and sending him off to the doctor, his personal narrative suddenly became suffused with a sense of dread, and he saw himself as "sick."

Now don't get me wrong. I'm all for helping people with medications when the pain is severe and it is truly difficult to function. But, here's the rub: by fostering a strict bio-medical approach to mental health in which we quickly pathologize our symptoms as a clinical disorder, we risk losing touch with a deeper truth: Human beings are much more than machines of malady.

We are adaptable, flexible, bountiful sources of creative energy--mental, emotional and physical--with the freedom to reinvent our "story" at any time. The solar energy that miraculously produces a raisin runs through our veins as well.

Sometimes all it takes is a tiny, wrinkled nugget of golden sunshine to provide an opening, a space--a glimmer of hope--reminding us WHO WE REALLY ARE.

Dr J