Hey. I think that labels are of limited utility. Of limited utility indeed. I suspect that the driving force behind the proliferation of labels endorsed by the American Psychiatric Association is partly a function of how much money they make off sales of the DSM and partly a function of political agenda with respect to legitimating distress (e.g., post traumatic stress disorders for war vets) and most importantly channeling funding into treating and researching such conditions.

What does this mean?

The driving force isn't science. There aren't different labels because they have found 'different kinds of people' with similar aetiologies, inner causal mechanisms, treatments that work, and course of illness.

As such... Diagnostic categories are of limited utility with respect to their predictive power of how someone is likely to respond to treatment and what course their illness is likely to take.

Ian Hacking talks about a phenomena that is distinctive to people. It has a paralell in physics, however called a 'paradox of observation'. The notion is that when we are categorised in a certain way (by other people or by ourself) then this causes us to behave differently. The very act of diagnosing a person can alter their behaviour so they conform to the stereotype that we have of their diagnosis. This is known as the 'categorisation effect' or 'self fulfilling prophecy'. It is like if you are repeatedly told (or if you repeatedly tell yourself) 'I can't do math I can't do math' then you will stop trying to do math and you won't be able to do math. If you instead told yourself 'I think I can get a lot better at math if I work hard' then you will work hard and get a lot better at math.

If you tell youself you have a severe and chronic condition and there will be many years before you improve...

What are the likely consequences of that?

Sometimes people find the labels validate them. Labelling yourself as having a personality disorder might help you not blame yourself for not having improved in a way you would have liked. But there are other things you can do with respect to that without condemning your future...

I was diagnosed with borderline personality disorder. I read about how it is fairly much a lifelong way of interacting with the world. About how people often show improvement later in life but how there wasn't really a great deal to be done about the whole way of interacting...

I'm 28 now and when I was 26 I was told I no longer met criteria for borderline personality disorder. Instead of putting me down as someone who was borderline who got better they put me down as a case of initial misdiagnosis. Talk about altering the data to suit the theory!

I think labels are harmful for the most part. They provide something to run away from but they don't really provide anything to work towards. I've found it really helpful to put the diagnoses to one side as much as possible (not internalise them, see them as political agenda and don't take them on board) and instead... Work towards being the kind of person I want to be...