When Diagnosis Is More of the Same: Claiming Difference, Circumambulating the Panopticon
I’ve been writing, lately, of madness. Of the gap we feel between what is normal and what is true.
Implicit in this conversation, these days, is the question of diagnosis. Of whether one has a right to the words proving differentness means anything at all.
Fuck words.
Let me begin from a heart place. With the requisite but deeply felt disclaimer that I will not choose and cannot know what is best for your body-mind-soul. I know only and intimately the truth of my own. For now.
That too, will change. How could it be otherwise? Self is not a thing, but an expression and a process. Same goes for spirit.
I ask for grace and I ask for all of us here to recognize two things: 1) We are still figuring it out. 2) More than one truth is true.
Representing the truth of my now self, I will lay bare a few biases. Place them on the table. Let, perhaps, the flogging begin.
One: I do not bow down to diagnosis.
It’s part of a system built for profit and, more than that, built for control. It’s part of a panopticon that pathologizes experience. It is, in short, a prison and a violence.
Two: Fuck insurance codes.
They’re made up, you know. All said and done, we spend too much time constructing things and naming them in too narrow a way. Most especially, ourselves.
Such reduction is necessary they say! Such clarity brings all manner of accommodation, medication, democratization, and support!
Maybe.
I’m not convinced.
It’s a violence all the same.
Too. Many. Words.
We declare language makes us human. We declare boundaries around what language is really.
Who decides this? Drawing lines. Commanding a hierarchy of sensibilities.
You — over there — you are well.
You — yes you — you are sick.
I know. Such a shame. But we have something for that.
We have a code and a theory and you’ll feel better just knowing it. See? Look here. We made you make sense.
And that’s not all!
Or, actually, it is.
The Standard of Care goes this way.
It’s called Science.
It’s called Omniscient.
It will bring us (meaning, you) to neat conclusion.
For the record, I’m not against therapy. For the record, if I want diagnosing, many labels apply.
Sometimes I go there. Offering the expected. Naming that which shall not be named. Out of tiredness, desperation, or simply choosing to play along, I trade sovereignty for shorthand.
But there’s something colonialist in it, in this latter day diagnosis of self and soul. This authoritative laying down of narratives that, in their rush to name, close off and close in.
Your experience is this. We With The Letters (or viral TikToks) say thusly. Relax! Rejoice! We’ve got you covered.
Sometimes, I buy in. Sometimes, it seems a decent deal.
Mostly, I do not comply.
Refusing to pathologize sentient experience, I declare myself a skeptic of progress and disruptor of woke-ness. I say: No, thank you. I’ll pass on your labels for now. I’ll make it (meaning, me) difficult.
“The limits of my language mean the limits of my world,” Wittgenstein proclaimed. No language, no entry.
Yes, and, who decreed language means words?
What if, in this narrative of the moment, your accommodation and democratization are more of the same?
A hegemony of assumptions.
To which I don’t consent.
To which I say: Don’t tell me what is privilege and what is pathology. Your story refracts through too narrow a lens.
Circumambulating the control tower, we bleat for admission. Difference and dissonance, all part of the play.
No. Different sensibility is not disability. Different sensibility does not require diagnosis.
This is the ultimate accommodation. This is the ultimate upheaval.
It says no one thing is any more special. Nor any of us.
Here, in our glorious difference.
Stretching out, on sacred ground.
Note: As a doctor of Traditional Chinese Medicine, I do diagnose patients. As a college instructor and dean, I also underscore the importance of diagnosis to students. Getting clear on what you’re seeing and what you’re doing brings results.
Yet, done correctly, diagnosing in Chinese Medicine means noticing ever-shifting patterns in body-mind-spirit. Nothing’s insignificant and nothing static.
How could it be? We are a reflection and expression of Nature and beyond. Everything, and everyone, is always changing. This change occurs in relationship and unfolds as process. For more see:
Thank you for reading. I’m a doctor of Chinese Medicine and write about sobriety and soulful living. Find all my links here:
