Why We Need to Take a Closer Look at Our Diagnosis Happy Culture
- 5 hours ago
- 6 min read
For nearly 14 years, I've helped individuals navigate the complex landscape of addiction in order to achieve recovery. Nicknamed "The Casual Counselor", my approach is unconventional but undeniably effective.
Let’s get one thing straight, for now and forever. We are all neurodivergent. Period. Do you have a brain? Yes? Me too. Do our two brains perform similar, if not exactly the same, functions with respect to how they operate within our physiological ecosystem? 100%. Do they tell our lungs to breathe, our hearts to beat, and our other organs to keep on organing? Yes. Yes, they do.
Now, do your brain and my brain perform in the same, consistent ways respective to how we think about things (cognitive), feel our feelings (emotive), learn (processing information), communicate (communication styles), cope with difficult experiences we’ve experienced, or analyse any number of examples of different “personal stuff” that we deal with on a minute to minute basis?
Not even close. Every person on this planet is their own personal phenomenon (phenomenology). We are all deeply and literally unique, self-centered main characters in the ongoing story of life.
Everything that has ever happened has happened to you, through you, around you, within you, from a macro to micro POV, all of it filtered through the phenomenon of the lens that belongs only to you.
Just by virtue of having brains, there aren’t two brains that have ever, in the history of humankind, worked in an identical fashion across the board. There never will be, but it’s not about morality, so don’t worry. This isn’t a good thing or a bad thing, by the way. It’s just a true thing. We’re all “The Star of the Movie.”
What does have a bit to do with morality is how we view the most difficult parts of this human experience within the systems of society that we have created for ourselves and in which we try to live. Live? Shit, survive.
In the United States, we’ve got a pill for everything because we have a diagnosis for everything. I am not a licensed treater who believes that “nobody is actually mentally ill.” That’s ridiculous. I’ve been up close and personal with acute mental illness on too many occasions to count. Many mental health struggles are diagnosis-worthy.
That said, I do believe we’re a bit too quick to diagnose people feeling “ill at ease” a little too easily, and for good, albeit gross, motivations. Yeah. Privatized healthcare. Insurance companies. We’ll briefly revisit that.
The “go to” model of diagnosing someone we’ve just met, known all of 15 to 20 minutes, then describing everyday stress as an anxiety disorder, grief as major depressive disorder, and the use of coping mechanisms as substance or alcohol use disorders is incredibly shortsighted.
Why? It’s because we haven’t had time to really know and understand the phenomenon sitting across from us, beyond a bland and under-contextualized assessment about symptoms and possible genetic predisposition within the individual’s family lineage. “Does alcoholism or depression run in your family?” they will ask.
In doing so, we have constructed a rigid and simple-minded, diagnosis-centric culture. A label. A sickness. A disease, and in America? Mental health and drug and alcohol labels brand a deep scar of moralistic vilification on the individual who is trying to heal. The scarlet letter, “A.” Alcoholic. Addict.
That first assessment? Clients are absolutely not going to share with you many of the factors that are compelling them to use substances or to seek help for mental health concerns. Firstly, they don’t know or feel safe with you yet. Secondly, they will withhold crucial information because they are ashamed.
They are ashamed because, in America, we shun them punitively. There are going to be a million blind spots not revealed during session one. I once had a client who didn’t open up about the real pain they were experiencing for more than a year.
We are so focused on naming and labelling the disease, diagnosing it, and developing a treatment plan for it, that we often just acknowledge the hurting kitten rather than the actual human being, in all of their myriad complexities and multitudes that shape their role within their personal story of living life. Surviving life.
By treating diagnoses as the destination point rather than the starting point, the American healthcare system routinely pathologises what is often a very healthy and well-informed, albeit painful, human response to a very fractured world.
We treat mental health, substance use, and alcohol use disorders as chemical imbalances, as an inherited “bad hand” at the card table that was mainly just a fluke of genetic predisposition. Tough luck. Then, we impose a model of containment within the treatment paradigm, very much in the same way we would with any other illness.
Then comes rehabilitation that is often purposefully ignoring the complex web of factors that cause people to feel fundamentally “ill at ease.” It makes for a very lucrative business model, typically creating customers, “patients,” for a life sentence of professional containment and corresponding long-term care.
True human suffering does not exist in a vacuum. It is driven by a dynamic interplay of four core elements:
Biological: Genetics and neurochemistry play a role in some cases, but not with every person who is struggling. Add to that, they never tell us the capital “T” truth of that person’s human story. Genetics represents potential vulnerability, not some forever destiny.
Psychological: Internalised trauma, negative thought patterns, and a lack of coping strategies heavily dictate how we process dysregulation and stress. What’s going on at home? In their peer groups? In their hearts and minds? What conditions led to the breaking point?
Social: Loneliness, poverty, job insecurity, and our hyper-individualistic, “every person for themselves” mentality in our competitive culture create a breeding ground for despair, especially for those who struggle with a scarcity of support and tangible resources.
Relational: Humans are primates. We forget that primates need other primates to continue existing in this world. Human beings are wired for connection. We are on dangerous ground when experiencing isolated living situations, systemic inequalities, and being “othered” or shunned from our communities.
I’ve got news for you, probably 90% of a well-rounded recovery can be credited to connection to a well-rounded tribe. People need people because we all need help that cannot be self-provided sometimes. No person is an island.
When a person turns to alcohol or substances to numb their pain, a diagnosis-centric model quickly labels them with an Alcohol Use Disorder (AUD) or Substance Use Disorder (SUD). It can be a very similar model with mental health disorders, too.
It relegates the substance itself as the primary problem. Substance misuse is rarely the root illness. It is a symptom of much deeper difficulties in the world we live in, and the world within us. People use substances to quiet the deafening pain of trauma, to escape the crushing weight of isolation, or to exist within the hostile social environment of this world, wounds incurred in the past and the present, and the overwhelming worry of what might go wrong up ahead and down the road.
A treatment industry that shames and contains individuals who are using substances to literally survive what is happening within them and around them is missing the point. And the sad part of the story is that they are rarely administering the kind of treatment that can actually help them heal for real, and for the long term:
Love. Understanding. Empathy. Goodwill. A shared bond of humanness. Something that could never be diagnosed as a disorder or a fatal disease that can only be contained, but rather a venue in which people can and do change for the better. Albeit it’s a long road.
Recovery. Emotional recovery. That which gives them their life back so that they don’t get institutionalised in the fearful belief of helplessness, hopelessness, and powerlessness, one that can internalise within a client that their likely fate is already predetermined, and that it’s one of inevitable doom and gloom.
Imagine being able to support a client in believing that they can have a guaranteed chance at maybe being able to live a life beyond their wildest dreams, and boy, wouldn’t the world of free market healthcare be disappointed in that outcome? It would hurt their profit margins.
To hell with them, I say. There’s no dollar value one could ever place on helping someone learn how to help themselves and to not become just another data point in the corporate hellscape of a country without universal healthcare.
Hey, industry I work in, let’s do better. Let’s take a deeper and wider look at what we’re confronting when someone comes to us to ask for help. Let’s ask our clients what they feel they would benefit from in the context of treatment. Let’s defer to them in all of our expertise because the fact of the matter is that they are the only true experts on themselves.
Our job is to help manifest their expertise so that they can spread their wings and fly high in the direction of their healthier self. Witnessing that? That’s the true wealth of this profession. It’s the wealth of the spirit.
“Everything is cracked, that’s how the light gets in,” – Leonard Cohen
Read more from Joshua Bennett-Johnson
Joshua Bennett-Johnson, Licensed Counselor & Owner of JBJ Counseling
After working for 7 years in an amazing clinic, I launched into private practice in 2018. I love my job. I can say that without reservation. Watching people rebuild their lives is something that is worth more than any dollar amount.
