Diagnoses Have No Place in Psychobiography

November 8, 2012 § 4 Comments

This is something that comes up all the time, a sort of thought error, or logic error, and so I figured, for the record, I’d write a post about it.  Though in both my Capote and Arbus books–especially the Arbus one–I go out of my way to say, more than once, that DIAGNOSES ARE VIRTUALLY WORTHLESS IN PSYCHOBIOGRAPHY, some readers still feel as if my focus was on Arbus’s or Capote’s “mental illnesses.”  No.  It wasn’t.

 

Two things:

 

1)  Mental illness diagnoses are not explanatory.  Period.  They are names for feelings, thoughts, and behaviors, and names do not, cannot, explain.  It’s just that simple.  If I call someone, say, a borderline, I have not explained WHY he or she is a borderline.  Really, in the most precise sense, diagnoses add nothing, nothing, to understanding.  A says:  Why does Kathy cut herself?  B replies:  Because she’s a borderline.  A asks:  How do you know she’s a borderline?  B answers:  Because she cuts herself.  See?

 

2)  In my books I have no interest at all, not the slightest, in arriving at a diagnosis.  In the Arbus book, for instance, I explicitly reject that path, for reasons mainly related to #1 above.  What psychobiography REALLY aims to do is a) assess personality–functions, dynamics, patterns, scripts, strategies–b) identify possible motives behind behavior, then c) explore how those motives led, in part, to the creation of art.  A diagnosis is not a motive.  Really, it’s a way of not understanding a person, because it oversimplifies, and it masquerades as meaningful when in fact it’s more or less meaningless.

 

Personally, I like complexity and ambiguity.  So diagnoses bore me, too.  Plus, having worked for more than 20 years, moonlighting really, one weekend per month, on a locked inpatient psychiatric unit in Portland, I’ve seen over and over again the vacuity, partiality, misuse, and destructive potential of labels.

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