A social work peer recently shared this article, titled "Is Therapy-Speak Making Us Selfish," about what he describes as a "noticeable trend," and I have to say that I agree with him. For generations in the United States, shame and stigma about mental illness and substance use disorders prevented people not only from getting treatment, but from even discussing them openly. Families buried details of bizarre, harmful, or otherwise upsetting behaviors, in part due to fears of being ostracized. Over the past few decades, there's been a shift away from the cultural norm of secrecy around psychological dysfunction. In general, that shift has been a good thing -- knowledge is power, name it to tame it, and so on. Diagnosis and treatment can be more efficient and effective when family histories are known. Assessing for risk of disorders with a known genetic component at critical times in an individual's life cycle is protective and proactive. It can improve access to appropriate treatment, thereby decreasing the likelihood that tragedies occur as a result of untreated symptoms. But more and more often, I find myself worrying that the pendulum has swung too far past the point of reason when it comes to the social acceptability of a proliferation of mental disorders, especially in kids.
On the one hand, getting a formal diagnosis from a licensed professional can be such a relief -- there's a reason why I'm like this! I'm not alone in my discomfort/pain/weirdness! I'm part of a community! Or, more practically, I can now afford to get treatment because my insurance company got the right code from my provider. But once we've been assigned a diagnosis, we can and we should put some thought into deciding what to make of it. We need to decide what it means to our identity. Will we come to regard it as the bulk of who we are, or is it one slice of us? Will we use it as an excuse to get out of things we don't want to do? Will we publicly proclaim our membership in a group of similarly afflicted people? These questions are especially critical to consider when the person receiving a diagnosis from the DSM-5-TR is a child or an adolescent.
The urgency and uncertainty with which teenagers typically stitch together their new, almost-an-adult identities leaves them more vulnerable to outside influences. A formal diagnosis of a mental illness can be like a tattoo on some kids, a heavy cross to bear. It can stay with them and plague them for years, informing nearly every decision they make. Caregivers, friends, teachers, and other influential figures in a young person's life will impact their identity formation, for better or worse. Most parents mean well and have no intention of harming their child, and yet if they are not self-aware, if, for example they're too defensive, insecure, or ashamed to process their own feelings about their child's diagnosis, they may be over-protective and dissuade them from taking on challenges, thus thwarting the child's ability to develop autonomy. If I'm always caught before I fall, how will I know whether I'm able to pick myself up or not? I won't get the chance to practice using my own voice to self-advocate and potentially change a situation's outcome. This is hard for parents to do, especially those of us who are anxious or had overprotective parents ourselves.
The line between letting your kid make a mistake and rushing in to save them before they even have a chance to make it is not always clear, but being aware of one's own tendencies, wounds, and unfulfilled needs can help us make more thoughtful, balanced decisions. As a peer told me a few weeks ago, "I was a much better parent before I had kids." Additionally, seeing how other parents respond when their kids are struggling can help us refine our own approaches. What about that person's parenting style resonates with you? What about it seems wrong to you somehow? Certainly it's a lot easier to see other people's parenting mistakes than it is to see our own, but being exposed to different family dynamics, arrangements and styles can lead to useful perspective shifts. Having a flexible, rather than a fixed mindset is a key component of effective and satisfying parenting.
I'm not suggesting we keep children away from therapists and doctors, mislead them about their symptoms, or prevent them for getting treatment for mental illnesses, substance use or behavioral disorders, but I think parents need to talk at length with their kids about what it means to get a diagnosis like OCD, Social Phobia Disorder, or ADHD. Explain to them that experiencing dissociation doesn't mean they have DID. Tell them that a person with narcissistic tendencies does not necessarily have NPD.
We all know what it's like to go down the rabbit hole of trying to diagnose oneself based on what we dig up online, and that trajectory often starts on social media (I've been moaning about having undiagnosed ADD for years now). In her article titled I Am Increasingly Ambivalent About My Autism Diagnosis, Emma Camp writes, "everywhere I look online, someone is trying to diagnose me with something, using 'symptoms' unrelated to clinical diagnosis criteria. Videos with titles like '6 Signs You May Have A.D.H.D.' and 'Signs That You Might Have O.C.D.' can rack up millions of views. In them, 'neurodiversity advocates' encourage me to consider which of my personality quirks is instead a sign of mental illness or neurodiversity." Camp highlights a point I often make to my clients -- pathologizing every tendency or behavior is just not helpful. It can lead to over-identification, rumination, and cognitive distortions, such as all-or-nothing thinking.
Parents and caregivers can also be curious about their child's attitude toward a diagnosis. Is it something they're pursuing after making a discovery about it on social media? Are they hoping or expecting it will make them feel more connected to a certain group? Will it have a liberating effect on them or the opposite? Sometimes the root of problem behaviors, i.e. symptoms, in people of all ages has little to do with brain chemistry or genetics, and everything to do with lifestyle. Some of us are too quick to ignore the context of our dysfunction on both a micro and macro level. Young people today are lonelier than old people (check Ezra Klein's podcast and Sheila Liming's new book Hanging Out for more on that), and longing to feel more connected to others, which I'm convinced has led so many of them to latch on to online communities centered around specific pathologies (or perceived pathologies).
So, talk to each other! Join a peer support group, or a take a PEPS class. Strike up a conversation with another parent in the playground who you don't know. Run the risk of saying the wrong thing to the mother of the child with special needs rather than ignoring them or pretending their differences don't exist. Take the time to question your motives before rushing your teenager out the door to be evaluated by a specialist, take psychotropic medication, or pay for their parking ticket. Ask yourself if your ego, guilt, or anxiety are weighing in too heavily in your parenting decisions. If the answer is yes, maybe it's time to admit that you made a mistake and consider making a course correction. Or maybe just notice it and try something a little different next time. Meanwhile, I'll keep wondering if "therapy-speak" is making us selfish.
Related reading:
To read more about the relationship between social media and mental health, check out this article. It was published in 2019, but it still challenged some of my assumptions.
To read more about why many of us are too quick to pathologize undesirable or uncomfortable behaviors, have a look at this article.
No comments:
Post a Comment