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The Problem With Labels and Diagnoses: The Truth About Mental Health

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Labels like “autistic” and “anxious” and “ADHD” might seem like helpful categorisations that lead people to the correct treatment for their illnesses and disorders. But labelling people based on their psychological or physical symptoms is a slippery slope. There are multiple downsides to allowing yourself to be labelled, and in this video we talk about what those are.


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Full transcript (unedited)

Today we’re going to talk about labels, specifically labels that we get in psychology for various disorders and illnesses, but also from the medical world. And what these labels do to us and whether or not they’re helpful. Start with a little story. I did a degree in psychology many years ago. And one of the first things I noticed when I started doing the papers on that degree, was that a large percentage of my classmates were insane, absolutely mad. And I felt like I was in a circus, you know, half of them were just normal students eager to university, but the other half were just crazy, very, very crazy. And I hadn’t seen that in the papers for other degrees, you know, communications or advertising, I didn’t get that kind of crazy vibe. What I came to realize quite some time later, was that a lot of the people who got into psychology, were trying to figure out what the fuck was wrong with them. Right, they came to psychology to explore themselves, you know, more so than to become a psychologist. You know, they’ve had very warped and painful traumatic brains their entire life. And they want to try and understand it, which I understood, I got it. Because as judgmental as I sound, I was actually one of the crazy ones. I just didn’t look like that. And what happens pretty early on in a psychology degree to get introduced to the DSM, Diagnostic and Statistical Manual, which is the basic bible of psychology for psychologists and psychiatrists when it comes to diagnosis, and labels. And what happens when you first get your hands on this book as you read through it, and you start diagnosing yourself as having like 60 mental disorders, right? By the end of it, you’ve got like four separate personality disorders. Turns out, you’re schizophrenic, and bipolar and you’ve got ADHD, and you’re histrionic, and you’ve got all these things. And every student does this. And it’s kind of an in joke in the psych community, every student goes through and diagnosis themselves as having everything, I’m sure it happens in the medical community as well, like medical students probably end up thinking they have all these illnesses and injuries and stuff. And hold on to that example, because it applies later, on a start by talking about a client whose prompted the idea for this video, I’m not gonna say who it is. But like many of my clients after working with them for a little while, when they struggle socially, in particular, I start hinting that maybe they need to look into getting an autistic diagnosis. Because there’s a lot of high functioning autism out there, you know, Asperges, and so on. And so a lot of people who struggle socially their whole life don’t realize that they’re on the spectrum. And that that’s why they’ve struggled, and once they understand it, and once they understand that there’s ways to work with it, and work around it, they can function quite well and quite successfully, socially. But if they don’t know about it, they just battle against it their whole life, and they feel like an alien. They feel like there’s something wrong with them, fundamentally, that’s different everybody else. And they just don’t realize they’re, you know, then neurodivergent. Now, like many people, this client of mine when I told him about this, and then when he looked into it, he was initially very relieved, like, oh, that’s the fucking problem kind of thing. And I get this a lot. When I sort of point people in the direction of a particular label that might apply to them. They’re relieved, like, all this thing has a name. I’m not a freak. This has been studied. There’s, you know, ways to deal with this. There’s ways to live with this. And like, there’s answers to these questions that I thought were impossible. But like many my client starts with their relief. And then a few months or even years later, they’ve declined into a kind of madness or an obsession with the label. And this is very common occurrence. It’s one of the things that makes me very hesitant to point people in the direction of these labels, because on one hand, they are initially helpful. But once people cling to them, and identify with the label, they can become incredibly unhelpful and incredibly limited. I’ve seen this with many of my clients, me and my clients end up getting a formal diagnosis for having ADHD, attention deficit and hyperactivity disorder, which is a highly contested diagnosis in the psychological community. There are top psychologists who don’t believe in it. And there are others who think everybody’s got it and everything in between. nice guy syndrome, which is not a formal disorder of any kind. It was a term made up by a psychologist, Dr. Robert Glover. I think it should be in the DSM it’s that legit. But you know, once I tell guys about nice guy syndrome, or they identify with it again as the initial relief, like ah, that’s what I’ve always struggled with woman or that’s why I can’t stand up for myself. Then later on, they’re like obsessed with being a nice guy or obsessed with trying to get away from being a nice guy which can be equally harmful. And I’ve seen it with medical diagnoses as well. My client also had a number of physical issues. And within a bit of research and diagnosis from certain experts who may or may not be legit, had become obsessed in waves of having a different physical illness, you know, it’d be this one and then it’ll be this other one, there’ll be this other one and just each month or every few months is a new obsession with a new illness. While I was talking with him the other day, I gave the example which I’d made up totally off the top of my head of he eyebrows, I said, you can turn anything into an illness, anything can become something you’re obsessed with and that you’re suffering from. You know, I just, I just made it up in the session. And after the session, I went and googled itchy eyebrows, and yes, of course, is a GI brow syndrome. And there’s communities of people who suffer from itchy eyebrows and this health website saying if you don’t deal with the Archie eyebrows, right now, you’re gonna fucking die. And I just made that up off the top of my head, I bet I could do with anything I could do with my ear lobes are too small, which mine really are. Or anything, anything that bothers me about my body, anything that’s even slightly uncomfortable about my body or the way my mind functions, I can find a disorder for it, we discovered that insight psychology with the DSM, that any mental process you find uncomfortable, has a label, it’s a disorder. There’s treatments for it, right? I mean, there are many psychologists who call anxiety, a disorder, a normal human emotion, they call it a disorder, right? Somebody who gets angry often has anger management issues, right? Even if they’re successful, and I function, and so on. So anything you have somebody’s made a label for it. Some of those labels are sort of legitimate and scientific, like in the medical community, and others a total horseshit that somebody made up, and everything in between. Because these days, we have the problem of the internet, which is anything that you can think of has a label, it has a community, it has 1000s of people that will validate your suffering and say, Yes, you are special, you are a victim, you are sick, and you are therefore limited in these ways, and therefore obliged to undertake these treatments and pay for the services and so on. The internet is just garbage nowadays, isn’t it? It’s just full of crap. And the ability to distinguish between something very legitimate, and something very fucking horseshit is almost impossible on the internet. The websites look the same. Everybody’s a doctor, apparently, you know, a doctor, this is their doctor, this is that and which one’s the real doctor and which one’s a fraud? How am I supposed to know? I thought doctor was something you had to really earn. But turns out they give their label to anyone these days, right? So becomes really difficult when you’re trying to figure out what’s going on with you and you get on the internet. Within a few pages of Google, you’ve got an illness now, right? You’ve got a label, you’re one of these guys, and you’re one of those things, and now it’s permanent, and you’ve got to join the community, and you’ve got to limit your life. You’re very unlikely in your research on the internet to find someone say, oh, that’s just normal shit. Don’t worry about it. Very unlikely. I mean, it’s tucked away in there by the more rational humans amongst us, but it’s drowned out by the noise of the people go, Oh, no, there’s something really wrong with you. This is really bad. And the internet also drives a kind of research porn addiction isn’t, which is you become obsessed with researching. You can see this the rabbit holes that people go down and say, well, it’s conspiracy theories or various things like that, as the internet has an endless, bottomless pit of information on any topic you want. And it’s delivered in very interesting and entertaining ways. So you get into something you start getting into a deep you find all the rabbit hole has many branches, and you just go down, you can lose a whole day on something that doesn’t even exist or isn’t even legitimate. I think we’re driven by a fear of insignificance. I think this is one of the greatest fears that humans have that nobody talks about. We desperately have that nihilistic existential crisis of oh my god, do I even matter? Am I just another grain of sand on the beach and my just another ant in the ant colony that is indistinguishable from the other ends. It’s a very suffocating, panicky feeling to think I’m not special. And we are constantly driven to try and disprove that to try and find a way to convince ourselves that we are significant individuals that we are special. And those who can’t do it with achievement who can’t do it by winning and succeeding. We’ll do it yourself. Free and steed, if you notice that. So the people who are really good at something and win a lot, though, they’ll create the significance that way, they’ll become the gold medalist, they’ll become the CEO, they’ll become the, you know, the guy shakes, or the girls or whatever, they’ll do the thing that they do really well, and they’ll win that way. But someone can’t find their thing. They can’t quite get into the top 10% of the pack and say, I’m the best. And I’m significant. Because of that, they’ll find, like, the path of least resistance is where can I be the worst? Where can I be the victim, and be significant in that way. So I’m significant because I have long COVID, and only a few people get long COVID. So you know, I’m in the special group, and we are really suffering, we are significantly suffering, maybe more than anyone in the world, I don’t want to say that. But you know, maybe it’s true. And we get this kind of thing, like, I’m part of this special elite group of people who suffer more than others. And that kind of makes me a hero. Right, and more importantly, makes me special, I have a label, I am at this thing now. And you must identify me as that, and recognize me as a special thing. I mean, I think this is the problem that drives a lot of the cultural wars. Everybody wants to be part of the specialist group, you know, the most special group and be able to say you must use this, you know, the preferred pronoun thing. The only people who seem to be obsessed with it, are the ones who are like, you must recognize me as a special thing. I’m not even talking about trans people, because they’re the ones who are mostly quite quiet about it. It’s there and voted for advocate. So they’re going on about it. I’m not I don’t want to go down that rabbit hole. But the point being is into this drive, people say, identify me as a special individual. And that drive leads us to try and find labels, where’s the thing that can say I exist. And then I’m unique. And that I met her in some way that I’m some part of the puzzle that the puzzle can’t live without, you know, I think we’re driven deeply by that. And I think that’s what leads us to be obsessed with these oversimplified labels. Now, psychology, this is the worst. One of the things that kind of occurred to me as I was doing my last year of the degree, which is where we do a lot of research and stuff was how immature psychology is, as a science, if you compare it to say, a well established science, like medical science, okay, which is essentially been studied for 1000s of years, 1000s of years. And because it’s medicine, it has to work, like of technique, or a chemical doesn’t do what it’s supposed to do a medicine the person dies. So it’s a it’s quite a scientific field to study because the results don’t lie kind of thing. And it’s been going on for many 1000s of years. So when somebody says you have cancer, you really do have cancer, you know what I mean? Like, the science is very solid, the science of how the liver functions in the lungs function, and then the arms and legs function, you know, that’s been studied really, really strongly. For many, many, many years. Psychology compared to that is almost witchcraft. Right? I mean, psychological studies sound legit, and they use scientific language, but many of them really just aren’t at all. You know, if you look at any scientific studies, this study shows that people are too anxious when they do this thing, right? Makes it sound like as legit, as a study shows that too many enzymes in the esophagus cause the blood, you know, it sounds almost as legit as or as legit as medical science. But have you ever looked into the study? Like down to the detail of who are the experimental group or the control group? How was the experiment done? Because when you do, it looks bizarre. The sample size for Assam and most psychological studies, university students, because that’s the only people they can get to do the study. Right, usually from a single university. So they’re all in the same culture, roughly in the same age group. And the university students which is a specific type of mentality, quite an arrogant, shitty mentality, to be fair. And the studies itself are generally self report. How did you feel what do you think you are? Now the tests have tried to design to remove lying, but if you believe the lie in your head, then you’re not really lying. Right? So it doesn’t really help if you if you’re delusional about who you are, and you fill out a self report study, then the result is going to be delusional. Or like I saw a study recently that was about honesty. Dan Ariely and it was this situation in the classroom where people doing a test and then they had to pay money. Need for, you know, sort of how well they thought they did on the test, or they they get paid. And they get to self report how well they done the test. So if you lied, you could get paid more kind of thing. But like not once have I been in a classroom where I was paid to do a test. So what is the study, it’s not studying something that happens in real life. But in Psychological Science, so so called Science, they will present that as if that represents a normal situation in life, you know, when people are paid more, they are more likely to lie. So that’s not how it works in real life, nobody goes into a classroom and gets paid to report their results on a test that doesn’t represent real life. So when you go about labeling yourself as autistic, or schizophrenic, or manic depressive, you’ve got to hold in mind that the science behind that label might be quite flimsy. Or there might be a lot of gaps and few 100 years more work needs to be done before that diagnosis can be really valid. Because one of the things I noticed more than anything else, is you take 100 people with the same exact diagnosis, say 100 People with the Aspergers diagnosis, you’re not going to get 100 clones, you’re gonna get vastly different people, right? You’re gonna get a person who plays with light switches and screams all day at one end of the spectrum, you know, through to a person who’s fucking the national champion at chess, and slays it with the ladies. And they’ll all have the same diagnosis. Right? So how relevant is their diagnosis of the individual differences are so severe, whereas if you get 100 People have stayed for lymphoma, cancer, whatever, they’re all going to be pretty similar, right? Because it’s medical science, they’re all going to be suffering about the same amount, that we’re going to be having very similar symptoms, that we’re going to be in very similar states of health and energy and so on. Whereas in psychology, they’re going to be vastly different on the diagnosis compared to the individual. Just take a look at this. Okay, this is the DSM symptoms criteria for ADHD. So I’ve got two lists here, we’ve got ADHD symptoms of inattention and symptoms of hyperactivity or impulsivity. Now, there’s some conditions about how many are supposed to have and how often so um, but just have a look at these symptoms. Makes careless mistakes lacks attention to detail. You ever done that? Difficulty sustaining attention? If you’ve been in a situation where you had that does not seem to listen, when spoken to directly. It had been a situation where you weren’t paying attention to the person speaking, fails to follow through and tasks and instructions. If you ever procrastinated and on and on in depending on the situation, you will answer yes to all of these, particularly, if you’re in a situation you don’t want to be in. Now quite often, these are used to diagnose children in school. You take a child and you put them in a subject they hate the most at school, you’re going to get these even if they don’t have ADHD. Right. And you take a child who’s not academic, say, friend of mine, who’s now a mechanic, a very successful mechanic. You know, if the subject was mathematics or English history, he was all of these things. But when it was metalwork, woodwork, none of these things. So does he have the disorder or not? Because they certainly thought he did. Right? While we’re gone this one hyperactivity, fidgets with hands, taps, feet squirms. Have you ever done their leave seat in situations remain remaining seated as expected? We ever walked out of something you didn’t like? Experiences, feelings of restlessness. Does any of this stuff sound bizarre? Or rare as a human trait or condition? No. So at the right time, if I look at you at the right time, and in the right situation, I can assess you as having a vast majority of these symptoms. Yet, if I was to look at you at a different time and different situation, you would exhibit none of them. So How valid is the shit? How reliable is it? Even medical labels have an issue? Let’s say you’re labeled as a cancer patient. Does that mean you should limit your life? Does that mean you should wallow? Does that mean you should lie in bed with tubes sticking out of you? And going well was me I’m gonna die. Because that’s the same as the connotation you get with that label. Right? Whereas if you just say I’m a bit sick at the moment, these options open up. And incredibly what you’ll find is said the more a person identifies With a label or a condition, medically speaking, I think you’ll find the more they exhibit the traits and the kind of psychosomatic thing comes in, they become more sick. Now there’s certain things that cannot be denied. If you’re paraplegic, for example, you can just suddenly get up and walk by the power of your mind. But how mobile you are, might depend on how much you identify as being handicapped. Right? So I’ve got a friend, an old friend of mine, who was paralyzed from the waist down and motorcycle accident, he still raises motorcycles, he goes out on pub crawls, you know, like, the wheelchair is no barrier to him, he lives a full life more full life than many people I know, who have both their legs functioning. And yet, I knew another girl and university, she was on like one of them little scooter type things, she didn’t have the pocket wheelie thing, she had the electric run. And all she talked about was being disabled, you know, and she would get really outraged when she didn’t get the parking, when you know, she would then their special chair up the front of the classroom. And she was actually kind of obnoxious about it. Right. And I really think it was her identification with the label, she was like, I’m as wounded victim, you should be taking special care of me. Whereas my other friend was more like, Don’t treat me different. Right? I’m fine. I’m fucking doing better than you can, you know, and he was he liked it. And he did, he did a lot better than other people. You know, despite only having half a body to function with. So their image of their guy climbing Mount Everest, and he’s got blades for legs, you know, it’s kind of like, what’s your excuse. So how much you identify with your label will probably determine how well you actually function with that particular illness or injury. An example happened to me just the other week, I tweaked my knee, putting my daughter down in a kind of dumb position. And I was so bad, I couldn’t put any weight on my foot, like I was fully just crippled for at least a while. But I’ve been having this kind of conversation thinking about this kind of stuff. And so I thought I can either be the guy who has an injured knee and I can lie down and put my leg up and whinging complain and make my wife do all the work. Or I can limp around, I can do that. Instead, I can just do the most that my leg will let me do, which I did. And within four days, my leg was fine. If I had laying around and not moved about, maybe my leg would have stayed bed, I don’t know. But I have had this in the past where I’ve had an injury and like treated that area of my body like it’s made out of fragile thin glass. And the injury is sustained for ages. And other times like there, I’ve had an injury, I’ve just being a bit more careful, but carried on living is normal, kind of like 80% of what I’d usually do. And that seemed to actually help the injury heal. And I’ve no doubt that the similar for sickness, if you go about living your life and having a good life socializing, exercising, eating as healthy as possible, doing the work that makes you satisfied. Having relationships, you’re probably going to be in a better state to heal from an illness than if you lie in bed going what was me, alright, so while labels can help to direct treatment, or self improvement, give you an idea of what you need to work on. At some point, the label has to be dropped. You know, because at some point you have to go who doesn’t feel this way. Sometimes even if you’re like, let’s say you got cancer, and you’re really tired and sick. When there are people with out cancer who also feel really tired and sick, is bizarrely brutal as a sound, you’re not actually that special. And thinking that you are is not going to help. And it’s particularly relevant to psychological labels. You have I have ADHD, you bet you, you can focus really well when you’re working on a car. So don’t say you have ADHD, if you can get a car job done for three hours without losing focus, you don’t have an attention problem. You have a activity problem, right? You’re doing the wrong stuff, and you’re bored. So do the right stuff. And then you don’t actually have a problem. I have nice guy syndrome, you will you just stood up to your mother, a nice guy doesn’t stand up for himself. And you just did. So what were you in that moment, you weren’t a nice guy. What I find is the most helpful thing to do is focus on quantum symptoms, individual symptoms that are causing you pain, focus on dealing with those without collating them into a broad label without making it a thing, right. So rather than trying to solve nice guy syndrome, just realize you’re not so good at assertive confrontation. So spend a month being assertively, confrontational. And so just focus on this one little niche, specific skill set that you want to develop. It’d be the same, you know, if I have an injury, my knees busted out. Okay, well, I’ll work out the rest of my body then rather than sit around worrying about my knee and going I’m a knee injured person, where’s the knee injury support group? Because they go well, I guess I’ll do one legged squats on the other side and stick to push ups and pull ups and do many years better and just carry on with my life. I find that that’s a far more effective, helpful, healthy approach than going I am a label Woe is me. Right. Hope that helps get in touch if I can help any more than@brojo.org See you guys next time.

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