A medical diagnosis relating to mental health can be helpful in many ways, but it is never consistently accurate. This is partly because the symptoms are generally not physical measures, such as temperature or platelet counts, but are either reported experiences or interpretations of observed behaviours – either being subjective and occurring in a unique context, and partly because people are not consistent from one day to the next in their experiences and interpretations – that’s just part of being human.
It should not be used as a way to define who someone is, particularly when considering what they might be capable of achieving.
I meet people all the time whose diagnosis clearly doesn’t fit with their current presentation. Sometimes a diagnosis was given a year or more ago and things have changed (this could equally apply to a month, week or even a day ago), but the person hasn’t had a medical review and/or they still identify with the label.
My personal take on this is that diagnosis is a step in a medical process, and the way I work follows a different process. It’s not that I don’t believe in diagnosis, it’s simply that diagnosing or knowing a diagnosis given by another professional isn’t something I find necessary for my work.
The experiences people describe and the behaviours that people display which contribute to their being diagnosed are definitely very real. The diagnosis itself, however, is a construct with little useful clinical application beyond informing prescription.
In my work, I encourage people to define themselves and others by the qualities and skills they possess, as evidenced by how they’ve overcome difficulties they’ve faced, their achievements and their priorities. This can help them recognise how future difficulties might therefore be negotiated, in a way that’s typical of them.
One of the biggest advantages of adopting the Solution Focused approach that I’ve found as a mental health professional is that I am confident in being able to offer a potentially useful interaction to absolutely anyone.
Exclusivity based on diagnosis doesn’t feature in my referral criteria. I’m very happy to work with anyone, no matter what they might have been diagnosed with.
This is in stark contrast to the way most mental health services are organised, where certain diagnoses tend to lead to comparatively longer waiting times because each diagnosis leads to a different care pathway which relies on the availability of specialists.
Everybody has an idea of what they want and who they want to be. These are hopes about the future – the starting point for a Solution Focused conversation.
If you have been given a mental health diagnosis, there’s a potentially unhelpful consequence in identifying with what you may have learned about it. It can shape your expectations around what you may and may not be able to do, and even dampen your hopes.
It’s important to remember what you know from your experience about what you are capable of doing (particularly in relation to any challenges you’ve overcome), and not rule out the possibility of achieving something that at the outset seems practically impossible. People achieve all sorts of things which in theory shouldn’t be achievable for them whilst their diagnosis is applicable – they just find their own way of doing it which the theory doesn’t take into account!
Belief in your capability is so often the thing that makes all the difference, and suspending disbelief based on intellectual knowledge/theory, allowing yourself to dream about how your growth in the direction of becoming who you’d most like to be would show up in the details of everyday life, can really help you to believe, and therefore achieve.
And when you’re noticing those details – that’s who you are.
Keep Calm and Solution Focused 