More Miss Treatment: On Labels

What good are diagnoses, labels, categories? **blows raspberry**  Not much. I suppose they’re a necessary evil for insurance purposes, but in other ways, they probably do more harm than good. In the U.S., diagnoses are too frequently turned into nouns—diabetic, schizophrenic, alcoholic, depressive, etc. Do you really want your identity to be defined by what’s “wrong” with you?

The most valuable thing I learned in pharmacy school was this: Treat the patient, not the numbers!  This could also be said: Treat the patient, not the diagnosis. Even when people have the same diagnosis, their difficulties and needs may be vastly different. So not only can these labels have a negative effect on self-image, they can complicate the very problem they’re intended to solve: how to HELP the person in question.

In addition to different people with the same diagnoses presenting very differently, when it comes to so-called mental health labels, different evaluators often give different diagnoses for the same presentation. One provider may call a set of symptoms “dysphoric mania” while another calls it “agitated depression,” for example. And the DSM (Diagnostic and Statistical Manual) they typically use for diagnosis is little more than a work of fiction, not an objective guide. (I imagine there will be more ranting about this later.)

So, what do we do for help? The person paying the provider, i.e. the patient/client, is the boss and the provider is the employee. I am responsible for telling my providers what’s troubling ME, what I want help with, specifically. A term like depression could mean just about anything and a professional might focus on aspects that really aren’t of concern to me. If a provider is not addressing what I want addressed and especially if he’s trying to address something I don’t even see as a problem, I can redirect (to use “their” terminology) the provider or, if he’s non-compliant (again, to use their terms), I may fire that one. And I let them keep their diagnostic codes to themselves and the insurance company.

Cure mental disorders: Burn the DSM!

Miss Treatment

A therapist once accused me of being a connoisseur of treatment centers. While I didn’t exactly take it as a compliment, the comment did help me realize I might have some valuable inside dope on some of these institutions. I don’t care to name names, but I can say that many of the problems I encountered are almost universal, or at least common enough for me to get an idea of several things I’m on the lookout for when evaluating a facility.

My experience relates to treatment for addictions— including substance dependence, eating disorders, and other behavioral compulsions— and for trauma. Plenty of treatment centers claim to treat trauma or be trauma-sensitive. However, almost all the places I’ve been or even just investigated have serious drawbacks when it comes to actually HEALING traumatic wounds, at least as far as I’m concerned.

In future posts, I’ll talk more about different aspects I find problematic, but one of the most important —and VERY common—issues is throwing very sensitive people together, in group “therapy” and/or roommate situations. Hearing others’ horror stories in groups can trigger adverse responses and lead to vicarious trauma. Then there’s the “feedback” from other clients in groups that’s supposed to be helpful, while it’s often a projection of THEIR difficulties and can feel like brutal criticism.

Don’t even get me started on the rooming troubled people together. The bad vibes can be overwhelming….

Now, if I’m looking for residential/inpatient care, I look for places with private rooms and minimal, if any, groups. Educational groups are OK with me and I want facilitators to keep a tight lid on sharing traumatic experiences explicitly and on group members expressing ANY judgments toward one another. When vulnerable and struggling, I want nurturing, compassionate, NON-JUDGMENTAL help from people who are truly sensitive to MY sensitivity.

I want my own safe space and not to have to deal with other peoples’ problems. I have enough of my own. I believe most trauma work should be done individually. Privacy is very important because of the amount of shame I already feel. Comfort is also important, in part because I have so many physical problems, but also because I’ve suffered enough and healing is hard and uncomfortable work often. I DESERVE a break. I deserve treatment that makes things better instead of worse!

(I wrote this in first-person, not because I think I’m special, but because I don’t. I think these thoughts are true for most people; I just don’t want to speak for others whose opinions may differ. I find having my ideas invalidated or disagreed with very distressing, so I want to respect others who have had different experiences.)

Komfortable Kitty.
Komfortable Kitty.

We ALL survive trauma.

B. Kliban was right. (see below)Klibanhell

No of us reaches adulthood unscathed. There are things that happened that we wish hadn’t; there are things we wish had happened that didn’t. So much is out of our control, and, especially when we’re young, beyond our comprehension.

And throughout our lives, we suffer wounds—physical, mental, emotional, & spiritual. We all have times when we need to recover from the slings and arrows of outrageous fortune. REAL health, whole-person health, comes from allowing ourselves to take the time and space needed to process these events.

This can’t happen only at the intellectual level. Our bodies respond beyond the control of our higher brain functions. So, the work is to heal at all levels, to FEEL the pain and move through it.

So. How do we do this?……..