Читать книгу Ethics in Psychotherapy and Counseling - Kenneth S. Pope - Страница 60

We hold the power of naming and defining. To diagnose someone is to exercise power. In an ingenious study, Lam et al. (2016) showed clinicians a video of a woman describing how she experienced uncomplicated panic disorder. They then asked the clinicians to rate her problems and describe her prognosis. Research participants had been randomly assigned to three groups. One was given the woman’s personal details and background information, the second was also given a behavioral description consistent with borderline personality disorder, and the third was given one piece of additional information that included the label of a borderline personality diagnosis. The results showed the power of a diagnosis to affect perception and judgment. Their study found that “the BPD label was associated with more negative ratings of the woman’s problems and her prognosis than both information alone and a behavioural description of BPD ‘symptoms’” (p. 253).

In one of the most widely cited psychological research studies, “On Being Sane in Insane Places,” Rosenhan (1973) wrote, “Such labels, conferred by mental health professionals, are as influential on the patient as they are on his relatives and friends, and it should not surprise anyone that the diagnosis acts on all of them as a self-fulfilling prophesy. Eventually, the patient himself accepts the diagnosis, with all of its surplus meanings and expectations, and behaves accordingly” (p. 254).

Caplan’s description (1995) of psychiatrist Bruno Bettelheim’s analysis of student protesters reveals the potential power of diagnosis and other forms of clinical naming to affect how we view people:

In the turbulent 1960s, Bettelheim … told the United States Congress of his findings: student anti-war protesters who charged the University of Chicago with complicity in the war machine had no serious political agenda; they were acting out an unresolved Oedipal conflict by attacking the university as a surrogate father (p. 277).

The power of naming and defining has been particularly harmful to BIPOC and members of other oppressed social groups. For instance, naming “homosexuality” as a mental illness, being gatekeepers of gender-affirming terms for transgender people, over-diagnosing Black children with externalizing behavioral disorders and Black adults with more severe forms of mental illness (e.g., bipolar disorder, schizophrenia) has contributed to the pathologizing of communities who are already suffering as a result of discrimination and hatred.