There is a lot of information available on the web cautioning against identification with a mental health diagnosis. Labeling oneself or others as being ‘bipolar’ or ‘on the spectrum’ is a seductive shorthand that conveys a lot of information with very few words. If we describe ourselves with a diagnostic label, we might be trying to show we are open, secure, self-aware, unguarded, or trusting. However, we may signal insecurity, negative judgment, or fatalism; we can't always be sure how a listener may react to the information.
When someone states, “I’m so ADHD!” they speak to themselves as much as the members of the conversation. Narrative Therapy makes use of our ability to recognize the stories we tell ourselves and the world. Most important is that we can harness the power of that story and use it to build a positive self-image and foster self-esteem.
Creatives may use the power of self-narrative intuitively as a way to extend the reach of our creative influence. The stories we tell about ourselves and our art frame how others interpret our work. When I am doing initial intake sessions with new patients, information about mental health diagnoses is particularly telling. The data helps assess a working diagnosis, but it is often more helpful to gain insight into how someone thinks of themselves. Do they speak about their mental health challenge apologetically? With some degree of pride? Or are they challenging me to agree or disagree? Creatives are usually very intentional communicators, whether they are very verbal or not!
When working with creative patients, I always use the phrase ‘working diagnosis.’ This shifts the label from confirmation of one's identity in treatment to an invitation to explore why that working diagnosis might be helpful. The inference is that one's diagnosis is not the primary context of therapy; instead, it's a point of departure. A business plan is subject to modification as we gather more data.
Most important in my work is that a diagnosis is something the patient and I work on together. Psychodynamic work with creatives is almost always very relational. I’m the experienced guide walking the patient’s path. Our narrative of the problem—diagnosis—becomes what is helpful to use in that journey. This is a frame that usually engages my creative clients where they wield the most power, the ability to identify patterns, make sense of those patterns in different contexts, and find the narrative that is intuitive, useful, and aspirational.
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