Don’t Let a Diagnosis, Disability, or Prescription Become WHO YOU ARE!

RxPlanBBy Dr. Allison Belger

Yesterday I was talking with a friend who also happens to be my A.R.T. (Active Release Technique) provider.  For those of you who don’t know, A.R.T. is a form of manual bodywork that targets and releases problems with soft tissue.  Like so many practitioners working one-on-one with clients (think personal trainers, massage therapists, even hairdressers), this guy secretly knows a ton about being a psychotherapist and about how psychological functioning finds expression in our bodies.  So when I was seeking a topic for this week’s article, I knew Dr. Doug would be a good person to ask for a suggestion.  He did not disappoint: “Don’t become your disability or your diagnosis,” he suggested.

During my years as a psychologist conducting assessments, I have evaluated and diagnosed many people.  I have stamped their written reports with codes from the Diagnostic and Statistical Manual and have typed up various explanations of how their functioning is impeded by some sort of “condition” for which we psychologists have a name.  In the thick of my private practice, my area of specialty was assessment of children, adolescents, and young adults.  Work with young people meant that optimism was often still present, and a diagnosis usually came as a welcomed way of understanding something that had previously been a frustrating mystery and nebulous haze of struggles and troubles.  The articulation of a set of common issues regarding behaviors, challenges, patterns of performance, and thought processes that had previously gone nameless can be hugely therapeutic for those involved.  Labels often lead to relief.  Still, something about giving a diagnosis and putting it in writing always gave me pause; I knew all too well that the label and code I applied would follow the person for a lifetime.  This is no small thing.  In fact, it’s quite big.

Bullying also has big and long-lasting ramifications.  The problem with bullies has gotten a lot of attention recently, as educators, psychologists, and other professionals working with children have recognized the enormity and repercussions of bullying at schools around the world.  To my mind, outside of horrific physical abuse, the most insidious aspect of bullying is the potential for a nickname or categorization of a young person to stick with that person far beyond the walls of the schoolyard and far longer than he or she sports a backpack.  Think about it.  Even if you were never the target of outright bullying, do you remember any of the labels that were thrown at you when you were a kid?  Were you the “fat” kid because your body was soft, or the “loser” because you were shy, or the “nerd” because you were smart, or the “faggot” because you liked art, or the “rich” kid because your dad drove a Mercedes?  Despite your best intentions, did the label set up shop in your psyche and stay with you even when you were at home watching TV or playing with your Lincoln Logs?  If you think back and are totally honest with yourself, can you see how any of those labels ever affected your actions or thoughts about yourself?  Maybe you are someone who can even say that childhood name-calling and labels escalated to the point that they have impacted your development and personality over the long haul.  If so, you’re not alone.

Back to Dr. Doug’s office earlier this week–we talked about how people often hold tightly to previous diagnoses and recommendations from all sorts of “experts,” to the extent that they end up manifesting those labels and sets of deficiencies, closing off alternative ways of being and significantly limiting their overall functioning.  In some cases, it’s as though the diagnosis was some kind of oracle or prophecy that has become their destiny.  We seem to hold fast to a pervasive cultural and human yearning that specialists and experts will be able to tell us what is wrong (and right) with us and to prescribe some sort of script for how we should function in our lives.  Whether we seek out doctors of Western medicine, acupuncturists, shamans, psychologists, what have you, many of us want to know the secrets to what ails us, and we want a plan or program to follow–sometimes for the short-term, but sometimes forever.

We hear it all the time when newcomers enter our gyms: “I was told by my orthopedist years ago that my knees are a mess and I can never squat again.”  Or “I am just really inflexible and can’t reach my arms straight above my head.  My doctor told me I shouldn’t lift weights.”  Or, Dr. Doug’s personal favorite, “I have a disc problem and suffer from chronic back pain, so I can’t really exercise.”  Read between the lines and they are actually saying “I can’t do much of anything in my life.”  For these people and others with similar personal stories, there is often some truth about an underlying and real physical malady that causes pain or discomfort and needs to be addressed.  However, it is also often the case that proper movement and technique can ameliorate these preexisting conditions and that the hard-and-fast diagnosis and prescription is actually far too limiting and totally counter-productive.  The reality is that a diagnosis is an opinion.  It is one person’s theory about what is causing physical discomfort.  The prescription given is also an opinion (and not always the right one, as in the source).  It is important to always be aware of this truth and be sure that if we take on a diagnosis as our own and follow a prescription accordingly, we have done our homework, received multiple opinions, and have come to decide for ourselves what works best for our bodies and our lives.

My father is a physician specializing in infectious diseases.  If my daughters had a nickel for every time someone walked into his office self-diagnosing Lyme Disease or Chronic Fatigue Syndrome or Epstein Barr Virus or some other all-encompassing condition that limits functioning and capacity in myriad ways, I’d not have worry about a college fund for my girls.  Are such diagnoses sometimes legitimate and representative of serious and real medical issues?  Absolutely.  But they are also plenty over-used.  Once again, such diagnoses are opinions, not facts.  It’s a slippery slope here, and all too frequently, these labels get confused with identity and become some kind of self-branding that follows people wherever they go and whatever they do.  Risk-taking, outside-of-comfort-zones, pushing to limits, challenging oneself, living fully—these all go by the wayside quickly, effortlessly, and far too easily via the simple declaration that one suffers from such a malady.  This can be exceedingly frustrating for friends, relatives, and professionals wanting to help people who have once been given this kind of diagnosis.

Dr. Doug, himself, is no stranger to diagnosis or true malaise.  After a number of months noticing a decline in the quality and decibel level of his voice, an instrument exceedingly important to his relationship with his patients (less so than his thumb, but still critical to the communication of what is going on in people’s bodies), Dr. Doug was diagnosed with vocal cord paralysis.  This is a condition affecting one’s ability to speak and breathe, resulting in a hoarse voice and difficulty projecting, despite plenty of effort.  You can read about it here if you’re interested.  Relieved he didn’t have cancer—again (been there, done that), this fearless healer now faces the prospect of a declining ability to communicate effectively using his voice as a tool—no small problem.  Since being diagnosed, Dr. Doug has noticed how easy it is for him want to hide in the corner of a crowded room or to hold back comments in conversations, since he knows how much effort it will take to be heard.  Although his is a legitimate medical condition whose physical manifestations cannot be denied, Doug is fully aware that he needs to fight the temptation to disappear into it, so that he does not become “The guy who lost his voice and cannot participate socially like he once did.”  Outside of his healing hands, Doug is known for his quit wit and impeccable timing.  He is working hard to remain engaged and not let his audience down.  Doug, for one, is actively fighting against the possibility that he will “become his disability.”

Maybe it’s your inner fat kid that became your identity and you’ve unconsciously fallen for the trap, yourself.  Always struggling to eat well and commit to a workout routine, you’re afraid to make changes because at least your identity as fat person is a known quantity.  Maybe it’s the learning disability diagnosis you were given at the age of eight—helpful as it was for getting the services you needed to perform in school, it has also dictated so much of your path beyond formal education.  While yours is a real and significant difficulty reading the printed word, you may have allowed it to take hostage of other parts of yourself in a self-limiting manner.  Maybe, upon some deep soul-searching, you can see how you have become your disability by allowing it to be a larger part of your identity–of who you are in total–than it actually needs to be.  You are not always reading, and you are not always disabled, but you may be carrying yourself through life as the learning disabled kid who isn’t quite like the others and who can’t quite do things in the same ways.

Maybe for you it’s the bulging disc in your back that was diagnosed by a chiropractor when you were 28.  Now in your 50’s, you realize how much of your adult life has been defined by that diagnosis and how much you’ve limited your physical experience.  Indeed, you might recognize upon further reflection, that you have, along the way, also limited your psychological experience.  You have held back, retreated, cautiously navigating the world as a fragile and tentative observer—a walking “disc problem” functioning at limited capacity without ever fully questioning the diagnosis, challenging it, or even letting it go upon discovering new ways of moving and treating your body.

Maybe you suffer from depression.  At least that’s what your therapist told you when you were 18 and your parents got divorced.  Since then, you’ve been depressed on and off, and when life gets complicated, you tell people you suffer from depression.  You even have the official diagnosis stamp from years ago to prove it.  But maybe you have contributed to the spiraling of your “condition,” and maybe there is more you can do to outwit it than you think.  Maybe you can acknowledge the reality of some of your symptoms while still challenging the notion that depression is your identity.  Maybe there is more you can do proactively to live a fuller life than you have, as a “depressed” person.  Maybe it’s time to shake up your status quo and challenge that story somebody created for you a long time ago.

The message here is this: be proactive in investigating yourself—whether it’s your body, your mind, or your psychological functioning.  Don’t fall hook, line, and sinker, for a label somebody once gave you.  Be sure if you’re following a prescription based on an opinion, it is one you have challenged and researched fully.  It just may be that your broken knee would actually benefit from squatting correctly, or that your sensory integration problem diagnosed way back when might actually be related to an early social anxiety from which you have since found relief.  Even if you have a legitimate condition, disability, illness, or other limitation, it can’t hurt to challenge its hold on your identity.  Become more than your label and be sure you are pushing the limits and testing (safely and intelligently, of course) the can’s and cannot’s that accompany it.  Be sure you are writing your own story to the fullest extent possible and not following an outdated or poorly researched script that has been limiting your possibilities for far too long.

 Author’s note:  See my previous article “What’s YOUR Story” if this topic interests you.

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