Cognitive Pearl #031 Tevet 21, 5775 January 12, 15

Cognitive Pearl

Yesterday, I left off with a cryptic one liner: that we professionals can often make matters worse for the politically silenced. Allow me to explain.

When clients seek us out they are looking for the relief of discomfort, pain, and suffering. Even if they’re seeking our help under duress (such as when a school or spouse doesn’t throw them out), they’re still looking for help. For better or for worse, one aspect of the sought-for-help is a diagnosis. This is well and good; diagnosis informs us of what we’re trying to relieve. 

Yet the moral and ethical (and Halachic, for some) problem emerges when diagnosis is used to marginalize. Here are a two examples of how diagnosis can cause marginalization:

  1. A diagnosis (most often in my experience, borderline personality disorder) is used to silence the legitimate voice of pain. By calling someone a ‘borderline’ or ‘narcissist’, the family, school, or other system need not do any soul-searching. In it’s most crude manifestation, I’ve met professionals toss about these labels as curses especially when the client doesn’t cooperate with the whims of the professional. These labels are no different than putting a gag over someone’s mouth so as to not hear what they’re saying.
  2. A diagnosis, often of depression and the spectrum of anxiety disorders, marginalizes the effect of lifestyle on mental health. Oftentimes, medication and psychological treatments have the unintended effect of ‘anesthetizing’ the client to the pain that their lifestyle is causing them. Akin to a dentist treating a painful cavity with aspirin, in doing so we are failing our clients, ourselves, our professions, and society.

How can the effective therapist can avoid these unintended consequences? We’ll get into that tomorrow and in future posts. And don’t forget about Pinocchio; his story has much to teach us!


Be well,