Humanistic and Integrative Psychotherapists can get very squeamish about the use of diagnosis in psychotherapy. Diagnosing characterological or personality types is seen as a step too far towards the medical model: clients are pathologised in the diagnosis and subsequently treated as if they have a psychological flaw that requires ‘fixing’ or ‘curing’. We tend to believe that diagnosis treats people as if they had something wrong with them when in fact we are all just imperfect creatures doing our best given the hand we have been dealt.
I’d like to offer a different view of diagnosis: one that equally rejects the paradigm of pathology but that rehabilitates the use of diagnosis as a tool for empowerment for both therapist and client.
Don’t we all have one: the internal voice that judges our actions and behaviours against a moral compass to keep us on the right path? Or do you also have a more persecutory and pernicious version that tells you that you are stupid or talentless or embarrassing or a big head or ugly or unloveable or…….? (You may add your own particular self-punishment here!)
When people come to therapy they eventually get to the point where they acknowledge their internal self-loathing, as this is the aspect of self that has driven them to therapy in the first place. Sometimes they hear the voice. Sometimes it is a little more hidden.