Rethinking Diagnosis

I woke up this morning thinking about diagnosis for some reason. It’s something I’ve given a lot of thought to in the past after training in the use of the DSM, the psychological bible for diagnosing just about any mental/psychic ailment that one can suffer from. The only problem is that the book is all mixed-up. While some of the diagnoses are paramount to cancer or even the common cold, others are simply the translation of symptoms into “disorders” — like calling a runny nose that might result from a cold an illness unto itself and then treating it as such.

The Jungian approach to psychology, like the Chinese medicine approach to treating the body, brings the question of balance to the forefront. Implicit in all explorations of psyche from a Jungian standpoint is “what is out of balance in your psyche?”, “what needs more or less attention?” Certainly, questions of Major Depressive Disorder, Borderline Personality Disorder, Bipolar Disorder etc. are woven into the work and typically treated with standard forms of treatment (by law and ethics, they need to be). But in general, symptoms are seen as indicating that something is out of balance, not that something is implicitly wrong. Chinese (and Tibetan) medicine does the same thing with the body: stomach problems, skin problems, pain, things that would be treated directly in Western medicine are seen instead as indications of something being out of balance so that the root cause can be treated, instead of the symptom.

I hope someday to be able to explore common diagnoses in regards to the relationship between aspects of psyche to seek to understand what, in each case, is out of balance. The base line for this exploration would be what is known as the Ego-Self axis, the relationship between the ego complex in psyche and the Self, the archetype of wholeness, the sort of catch-all name for the expanse of everything else in psyche out of which our individual personality (ego) is born. This developmental relationship can get thrown-off throughout growth (or due to biological causes) and can produce narcissistic (ego too distant from Self), psychotic (ego too immersed in Self), or borderline traits (ego mixed-up a little in between). The ideal is for a strong, independent ego that can take cues from Self and accept that it is not the single actor in the landscape of psyche. This is the core component of the inner space of a healthy psyche. A diagram of healthy ego-Self axis development (albeit rather simple) is here, in addition to some further discussion on this topic.

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