In 2003, when I was doing my master’s in psychology, we had to prepare a case file with the case histories of 10 clients, along with a possible diagnosis. When I was telling a close friend, who was doing his master’s in physics, about this, he asked, “Tell me, is the identity of these clients just their diagnosis?”
In that moment, I realised how labelling was reducing people’s sense of self to the mental health concern they were trying to deal with. We become the labels that are put on us. When it comes to mental health, these labels can be damaging and come in the way of treatment.
A lot has changed when it comes to mental health in India, yet so much has not. We now talk about it openly on social media, psychiatrists and therapists are part of pop culture narratives and so much of the mental health vocabulary has become part of conversations among urban youth. It wouldn’t be wrong to say we are living in a time where #mentalhealth is trending, yet I feel we are losing the nuance, the complexity associated with mental health conditions and the therapeutic landscape.
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In the last three years particularly, a lot of people who have reached out for therapy already come with a diagnosis in mind, either for themselves or for their loved ones. Words such as “codependency”, “boundaries”, “self-compassion”, “narcissist”, “borderline” or “histrionic” are commonly used to describe the behaviour of partners/parents/siblings and other relationships people may struggle with. While it’s wonderful that the awareness is helping people reach out for therapy in a timely manner, this labelling, either from a self-narrative or in relation to others, can come in the way of processing our emotions and understanding the unique life circumstances.
As a therapist or mental health practitioner, one chooses to work with a client over a period, observe patterns, look out for the frequency and intensity of symptoms before reaching a tentative hypothesis. This is then explored and discussed in a way that allows clients to find their own answers and figure out what it would mean to lead an authentic life that allows them to experience satisfaction and flow in their daily life.
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The therapeutic process involves a check-in about the areas clients may want to work on and areas one may need to park for the time being. It becomes complicated when clients have reached a conclusion about their own diagnosis. All diagnosis, and even the mental health vocabulary, needs to be contextualised. Whether it’s the larger discourse on boundaries, trauma or self-compassion, these concepts need to be understood and explored in the context of choices and personal value systems. We can’t be absolute in our understanding of these terms. As a therapist friend says, “The trouble with social media and therapy is that we are at risk of falling into a binary.” Binaries of either/or are limiting and don’t allow us to see people as they are.
Human beings are complex; so is the human mind. We are constantly in the process of becoming. Sometimes, when we put a label on others or ourselves, we operate with a larger lens of pre-formed judgements and assumptions, instead of a hypothesis. When we look at people with the so-called labels, we end up collecting evidence that fits the label, rather than seeing people as they are.
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It may be useful to see therapy as an invitation to explore how other people’s behaviours, actions and repetitive patterns impact us and pay attention to what is evoked in us. In a world that’s becoming more and more divisive and polarising, we can be kinder to ourselves and others if we see how our labels control us and our relationships.
Sonali Gupta is a Mumbai-based clinical psychologist. She is the author of the book Anxiety: Overcome It And Live Without Fear and has a YouTube channel, Mental Health with Sonali.
