DIAGNOSES MAKE YOU SICK

"Diagnosis makes you sick"

Yes and no; diagnoses can provide clarity, but in their effect they have more potential to stigmatize people with their complaints, to "write" them into it and to inhibit the process of recovery than the other way around. Basically, it is not the diagnoses themselves but the meaning that is given to a diagnosis in our culture. They essentially describe abnormalities, visible physical changes or states of mind from which the affected persons or their environment subjectively suffer.

Why diagnose?

Doctors* and all other therapists* take care of illness. This is their job, their mission and therefore also the focus. Nowadays diagnoses have to be made mainly for accounting or legal reasons and of course to exclude something "bad". In addition, many patients now also demand a "clear" diagnosis from their therapist, which explains their complaints.

Why no diagnoses?

It would make sense if diagnoses led to logical and comprehensible steps towards recovery. Unfortunately, many diagnoses and the mostly unquestioned, reflexively expressed therapy offers are not able to do this. Often diagnoses do not really describe the suffering or the illness of the affected person but are word wrappers that ensure the smooth running of the therapist - patient relationship and the billing system in everyday medical life. In this context, diagnoses lead to the pathologization of an essentially temporary condition. Even when the symptoms have gone, many patients still have their diagnosis. Today we know better than a few decades ago that, for example, the signs of age-related wear and tear, which are described in many strange-sounding words by doctors or therapists, have only a limited and often only temporary connection with the patient's symptoms. They are often the expression of a concept and a very limited or one-sided view of the person. The arthroses of the facet joints and intervertebral discs in the back, for example, which are detected in the imaging procedures, continue to exist even years after acute or persistent complaints, without the affected person having to suffer any pain or limitations in this respect. It is also known that more than 80% of all knee, shoulder and back operations performed are unnecessary and healing can also be achieved by conservative means such as exercise, attention, changes in behaviour and diet and others. Already in the Spiegel of 2017 there was a detailed report:
Here go to the SPIEGEL article

What does diagnosis do?

Perhaps you know this from your own experience: knee pain comes and knee pain goes. We listen to our body, let the knee dangle occasionally, change or reduce the load temporarily, refrain from all painful movements, apply some oil or gentle massages etc. regularly and after a few months we are fit again. In any case, this is how it has worked well for mankind over thousands of years.

Diagnoses established by MRI or other methods then take on a lot of space and energy for most patients, and the diagnosis becomes solid and serious. The fact that we have excellent imaging diagnostics available today is certainly useful, effective and necessary in some cases in order to make serious diseases visible or to exclude them. However, in my experience, the suggestion that one must have a diagnosis in order to carry out a meaningful treatment, or that many affected people first need a diagnosis in order to motivate themselves to implement changes in their everyday life, job or sport, are developments that hinder and are not conducive to recovery.

When would diagnoses be useful?

So the question is, how useful is the current diagnostic system still today? And which means would help to find the way out of a disease?

My experience in this regard and the prevailing insights of modern research suggest that it makes sense to put diagnoses into perspective first. Diagnoses belong in a clear context, often they are temporary conditions that are simply intended to motivate us to act. As therapists we are allowed to help to reactivate common sense and to show the affected person a way to confidence and self-efficacy. For this purpose it is often necessary at the beginning to disenchant or disempower the diagnosis. On closer inspection of the pictures, there is "no hole in the knee" and it "does not rub bone on bone" as is often claimed. "Her back is not that of an 80-year-old" and many other, often eloquent comparisons and images need to be transformed into possibilities for action. If we succeed in giving patients who trust us a slightly different view of their complaints, their own body, their feelings and thoughts, and teach them the skills they need to be able to influence these themselves, then it is easier to make the changes that are usually necessary in everyday life, work, sport, lifestyle or relationships.

Complaints, including pain, are never against us, but valuable information and signals from our body! To learn to understand these, to read them and then to show possibilities of influencing them would be a way out of powerlessness and into shaping one's own recovery. The much-used and perhaps worn word of self-responsibility in this design is still an important key to me. You cannot delegate healing or health to others. We ourselves can and must work on it, and of course we always need help from outside, from people who have experienced similar things or have dealt with these conditions professionally. Many modern therapy models take into account our physical, mental, emotional and social connections and offer meaningful and sustainable ways to recovery. In the context of Yoga and Ayurveda (the traditional Indian medicine), which certainly represent only one of the possible treatment approaches, the person is regarded and advised as a "whole" in this way.

NEWSLETTER