What's In a Name: Decoding Diagnostic Labels - Part One of Four

Mental health is a continuum As we deal with personal loneliness, demanding bosses, shaky finances, or just an intense bout of the blues—whatever the personal hurdle of the day—we maintain an illusion that somewhere someone else is having a perfect life. If only we could be like them or even change one thing, like losing weight or earning more money, life would be perfect for us, too. This is simply not true. Everyone has problems. Remember a poem many of us read in high school, Richard Cory, about a man who seemed to have everything but, to everyone's surprise, killed himself.

Most of us are sane people who merely experience occasional rough patches when life becomes so difficult that we feel that we are going crazy. Every year one out of five families has a family member who seeks help. We all go through periods of upheaval or life stage transitions that produce physical or emotional symptoms of distress. If we do not cope well under duress we may temporarily regress and experience periods of instability. Sometimes we are caught in the web of a loved one's issues resulting in the conjuring up of feelings and behaviors of our own that are new and unwelcome. Do we "gut it out" alone, or ask for help? If we ask for help, we fear that we may be labeled, that the information will be recorded as indelibly as our personnel, academic, or traffic violation records.

The unrealistic images regarding mental health that we see on the big and little screen and other forms of entertainment and media do little to allay our fears. We laugh at Woody Allen's characters, analysands who amuse us with a never-ending smorgasbord of neuroses, who are hopelessly less together than we are, even on our worst days. We watch Ally McBeal as she goes through therapy, charmed by her delightfully wacky I-am-woman-hear-me-obsess truthfulness. Yet, we wind up in an internal war as part of us identifies with her and cheers her on, while another part of us assures us we are more together than she. Instead of being bombarded year after year with the same old neurotic clichés, it is refreshing to see a character who benefits from psychotherapy, like Will from the movie Good Will Hunting, who is a hurting human being and whose transformation we can see and understand. We feel sane when we can identify with an individual who is not a caricature or a joke.

We gain encouragement from real live people who talk easily about how therapy has helped them. In her performances, Barbara Streisand sings about how psychotherapy has helped her handle her insecurity. Presidential candidate George McGovern has written about how, in the tragic aftermath of his alcoholic daughter's suicide, his family benefited from professional help. With hindsight, he suggests ways he might have lived his life differently. The writer William Styron's memoir helps us to understand that, with help, one can continue to be creative even after a total break-down. When well known and well functioning people whom we admire and respect speak out about their own mental health journeys, it illustrates that mental health is not a static condition but a continuum that we all travel, and that it does not necessarily mean that we are damaged or dysfunctional.

While it is true that there are people at one end of the continuum who most of us consider truly "ill," they are the exception and not the rule. Loosely speaking, this is the difference between neurosis and psychosis, sanity and madness. We all share human qualities and human foibles, and how these qualities are assessed by professionals and how we ourselves perceive them affects where we place ourselves on the mental health map. The psychiatrist Thomas Szasz explained the difference this way. "If you talk to God you are praying; if God talks to you, you have schizophrenia." Those of a mystical bent might argue that even this distinction is not clear-cut.

To be continued:

Life is too hard to do alone,

DR. D

Dorree Lynn, PH.D.
Nationally Syndicated Talk Show Host
On The Couch

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