I hold a very basic principle that guides my work as a therapist – everyone is born good, it is their actions that can be considered “bad” (maladaptive, destructive, violent, etc). Even personality disorders are developed in response to events that an individual experiences.
Take, for example, borderline personality disorder. There is a significant amount of research that correlates trauma history with borderline personality disorder. This is not solely traumatic events in adulthood, but also in childhood. Why do I bring the distinction up? Because I believe childhood trauma precedes the development and presence of Borderline Personality Disorder. Is it not possible, then, for an individual to develop Borderline Personality Disorder in response to events they have experienced?
That’s not to say that experiences and actions cannot become habits and then patterns of behavior that an individual is now identified with. William Durant (not Aristotle) once said “we are what we repeatedly do”. When an individual continuously reacts to the world around them in the same way, they may well say that it’s part of who they are. That can be a good thing or a dangerous one. I often find myself rephrasing “I’m loud” to “I talk loudly”, “I’m stupid to I do stupid things” or “I’m impulsive to “I do impulsive things”. This is, however, a difficult activity.
Why rephrase at all? Simply because we are more than what we do. The moment a person realizes that something they do does not define who they are, the behavior becomes a little less permanent and the individual now has greater power to change it. It is definitely easier for a person to moderate their volume or manage their impulsivity when it isn’t considered part of who they are but just something they do.
The distinction between identity and action brings to mind another concept – labelling. Indeed, I would probably never give a diagnosis if it wasn’t for insurance reasons. Why? Because there are no two people with the same diagnosis, meeting the same criteria for the diagnosis, whose circumstances and experiences of them are exactly them same.
Diagnoses do, however give us something – Looking at the criteria for any diagnosis, they are all associated with visible actions and reactions. If this is the case, then what I think makes even more sense; separating the “I am” from “I do” makes it even easier to address all diagnoses, including personality disorders and even psychoses. As we address behaviors, managing symptoms and utilizing healthy coping strategies become second nature as they replace behaviors that have been detached from a person’s identity and improved on. A healthier cycle of behavior develops, and an awareness of this healthier cycle then is developed within the member using mindfulness.
This is the way I have approached my work. It has worked in some cases, and not in others. Then again, who said one approach fits all? Wouldn’t that be labelling in itself?
Think Again 