Dr Dale Peterson, diagnoses, diagnostic labels

What's In a Name?

What's In a Name?

© 2001 Dr Dale Peterson; © 2006 Wellness Clubs of America.com

I was visiting with a friend last month. At a turn in the conversation she expressed concern about her niece, a young lady in her mid-teens, whom I shall call Sarah.

Sarah had recently been diagnosed as having “Social Anxiety Disorder.” She had been placed on medication, but my friend observed that after receiving the diagnosis her niece became much more withdrawn and her future plans much more restricted.

The diagnosis also changed the way Sarah is viewed by others, particularly by her immediate family. She has, in effect, become a prisoner of her diagnosis.

“Sarah can’t participate in extra-curricular activities,” her mother explains. “She has ‘Social Anxiety Disorder’. She won’t be able to leave home to attend college. She won’t be able to take any job that demands working around other people. We’ don’t know what she’ll be able to do with her life.”

I recognize that some people are painfully shy. I accept that social interaction is much more difficult for them than for those who are natural extroverts. I am not wishing to trivialize the difficult challenges Sarah and others face, but I do not believe that telling them that they have a medical problem is beneficial, nor do I believe that prescribing a medication to make them more outgoing is in their best interest.

The medical community loves labels. Physicians derive a sense of comfort in finding a diagnosis and conversely are extremely uncomfortable when they are unable to do so. Insurers demand numerically coded diagnoses as their basis for authorizing payments. I have observed that many people are more concerned about obtaining a diagnosis - being given a name for what they are experiencing – than they are in finding a solution to the challenge they are facing.

Perhaps there is some validity in seeking diagnostic labels, but there are also grave dangers. One hazard intrinsic in reaching a diagnosis is the depersonalization of the individual to which the label is applied. It is not uncommon to hear a doctor, nurse or other medical professional say, “The pneumonia in room 211 needs his vital signs taken,” or, “The diabetic in the next room needs a blood sugar drawn.”

This is a very easy trap to fall into. Time constraints play a part, particularly in a busy medical practice. It is difficult to get to know someone in fifteen minutes or less. It is virtually impossible when an illness or injury must be assessed and a plan of treatment instituted in that short period of time.

A desire to remain detached from the individual seeking care is also a factor. Although this is often unrecognized and may be denied by medical professionals, there is a definite tendency to avoid becoming “too close” to the person seeking care. Medical mythology maintains that the physician must remain detached from the person under his or her care. This is particularly true when painful or toxic treatments are being administered. Neither party gains, however, when the humanity of either is compromised.

Another pitfall intrinsic in diagnostic labeling is the manner in which it affects the individual who receives the diagnosis. All too often the diagnosis becomes the focal point of the person’s identity. Statements such as “I’m an asthmatic” or “I’m a diabetic” can dictate how people view themselves as well as how others view them. Unchecked, diagnostic labels can force people into boxes from which it is extremely difficult to break free. They can and do become hapless victims of circumstances beyond their control.

Perhaps the most dangerous result of diagnostic labeling is the tendency to believe that the job is done, that the problem has been identified, that treatment can be instituted. This is rarely the case. Nearly every diagnosis has a diverse array of root causes. Asthma, for example may be due to airway sensitivity to substances in the air. It may be secondary to a problem such as congestive heart failure, which, in turn, has its own set of root causes. Asthma can even be due to a slight rib displacement. Tragically, a number of people have been placed on tablets and inhalers and forced to limit their activities unnecessarily. They and their physicians mistakenly believe that the search for the cause of their shortness of breath ended when asthma was diagnosed.

All of which brings us back to young Sarah. She has a diagnosis – Social Anxiety Disorder – that is dictating the course of her life. She sees herself and others view her as trapped in a defective body by internal processes over which she has no control. But is this really the case?

History is replete with examples of individuals who have conquered shyness and gone on to outstanding careers in fields as unlikely as acting or public speaking. They did so not by accepting their condition as unchangeable, but by continually pushing their limits – by moving out of their “Comfort Zone.”

As we go through life we are either expanding our horizons or digging our bunkers. We are either moving forward or we are falling back. Either we are advancing or we are retreating.

Each of us is fearfully and wonderfully made. Each of us is an individual. In the history of the world there has never been another quite the same nor will there ever be another in the future. To live life to the fullest we must do two things. We must avoid placing ourselves in a box, and we must break out of the boxes others build for us.

If anyone ever had a right to live in a box, if anyone ever had an opportunity to retreat behind stereotypic diagnostic labels, it was Helen Keller. Both deaf and blind, little was expected of her, yet she chose to live her life to the utmost. As she once explained, “Life is either a daring adventure or it is nothing at all.”

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