Do you think there is an over-diagnostic component to our culture, so that being needy means I’m codependent, eating cake means I’m an over eater, etc? Can’t we relax a little bit on all these recent labels?
Rita Milios: I believe our culture currently over-uses labels in general, and that includes the use of diagnostic labels in mental health and addictions medicine. So, yes, I think it would be a good idea for everyone to “relax a little bit on all these recent labels,” and on mental health labels as a whole.
In some ways, labeling is helpful. If addiction disorders were not included in the “medical model” approach, their treatment would not be paid for by insurance. However, these diagnostic mental health labels have long been the focus of controversy. Many critics, including the National Institute of Mental Health, argue that descriptions presented in the DSM (Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, and used extensively by mental health clinicians to codify mental health issues for insurance purposes) are not backed by sufficient scientific research and they rely too heavily on subjective, clinical opinion.
It is important to remember that a diagnosis is really just a snapshot of a person’s symptoms at a particular time, and DSM coding is just one model (although it is currently the prevailing one). There are many other models, including strengths-based and positive psychology models. Such alternative models might view substance use as a learned coping mechanism, which early on can provide some relief from mental health-related distress symptoms. Substances are often used for such self-medication purposes. However, substances can easily become over-used and move from a problem-solving tool to a self-destructive habit/addiction. As a therapist, I encourage clients to resist “leaning into” a particular diagnosis and over-identifying themselves with it. The more important issue is not what you call a problem, but how you go about solving it. If a heavy-handed mental health label deters some people from seeking help, then there is something wrong with the labeling system. Stigmatization does not further the goals of either the patient/client or the mental health field as a whole.
Rita Milios, LCSW, is a psychotherapist in private practice, author of more than 30 books, and frequent professional lecturer and on-camera expert. She also facilitates workshops and training for clinicians, therapists, writers, holistic practitioners, businesses and associations. She is known as "The Mind Mentor" because of her unique approach to “mind tools training." RitaMilios.linktoexpert.com Full Bio.