A psychiatric diagnosis is a cluster of psychological and behavioral conditions as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Over the years, there has been numerous revisions of this manual. With each revision, there tends to be significant changes to the different menus of diagnoses and how each diagnosis is defined. For example, in the most current manual the diagnosis of "Asperger's disorder" has been removed and is now considered as a part of the class of "Autistic Spectrum disorders." In one of the earliest manuals there was diagnoses termed "Neurotic disorder." The term " neurosis" is no longer considered a proper diagnostic disorder and it has been eliminated from the manual.

So what happens to an individual who has a diagnosis that the American Psychiatric Association decides no longer should exist? What happens to the child I work with who has been labelled "Aspergers" for the past several years and now has a new diagnosis? What about poor Woody Allen? If he can no longer be considered a "Neurotic" can he still make movies?

As several of the great existential thinkers have pointed out, psychiatric diagnoses are not objective disorders, but rather are social constructs that change over time (i.e., Szasz, Lang, Foucault).

When I worked in a psychiatric hospital 25 years ago, the most popular diagnosis was "Schizoaffective Disorder." What did that diagnosis mean? Basically the person was having problems with his or her thought process (schizo) and well as his or her mood (affective). I remember doing an inpatient group with 10 individuals, all diagnosed with "Schizoffective Disorder". All of the people in group did have something in common -- they were not thinking clearly and had mood issues. However, the similarities stopped there. Each person was unique. Each had a different reason for being in the hospital as well as different backgrounds and issues. In fact, at the time, I remember thinking to myself, I would not be thinking clearly or be in a very good mood if I was hospitalized in a psychiatric hospital against my will either.

Today the new popular diagnosis is "Bipolar." Almost everyone coming out of a psychiatric hospital comes out with a diagnosis of "Bipolar." If you are not thinking clearly or having mood issue you are now identified with this now popular disorder. The other widely popular modern day diagnosis is "Attention Deficit Disorder (ADHD)". So many kids these days are being put on speed to improve their attention. Does speed improve one's attention, most definitely. Should all children who have focusing issue be diagnosed with "ADHD" and put on speed? I personally feel it is a significant social problem.

Psychiatric diagnoses are clusters of symptoms. They change over time dependent upon what is popular in the current culture; and more specifically the psychiatric community. Diagnoses are tools people in the field of mental health use to describe a cluster of symptoms and behaviors. There are many theories as to what causes a person to be and act a certain way, but these theories also change over time and are historically dependent on the culture and trends in the psychiatric field.

So what is my point? You should not define yourself by your psychiatric diagnosis. Diagnoses are helpful in understanding psychological symptoms and patterns of behavior. They can be a great tool for the clinician or the psychiatrist in determining the best treatment or medication. A person diagnosed as "Bipolar" is an individual who is possibly struggling with his or thought process or mood. Therapy and medication can help. However, having these cluster of symptoms, thought or behavioral patterns, do not define who you are as an individual with unique personal issues and struggles.

I Tell It Like It Is
Expressions people use can tell you a lot about how they think, act and relate to others. One expression I often here in my work is: "I tell it like it is." On the surface, what I think the person is trying to convey is that he or she is a " straight shooter" -- honest, does not play games and only speaks the truth.

But if one digs a little deeper, and explores the psychological assumptions that underlie such a statement, a more revealing meaning of how the person sees and understands his or her surroundings becomes apparent. The expression: "I tell it like it is" signifies that the person truly believes that he or she is seeing things how they really are -- i.e., objectively.

Common Sense Verses Subjectivity
Many people who say statements like "I tell it like it is" also believe they possess what they refer to as "common sense." They believe they are able to see things the same way other people see things who are down to earth, level headed and don't have their heads up in the clouds. But are these people actually seeing things as they truly are in an objective manner?

As a psychologist, the idea that someone believes they see things "objectively" is always suspect. Can a person actually see things as they are or does each person have a particular perspective?

Existential philosophers refer to the concept of perspective as "subjectivity." They often use the analogy that each individual sees the world through a tinted lens. We all know that some of those lens can be dark, others grey or red, and for the fortunate ones perhaps rosy.

When I contemplate the concept of "common sense" I always think of the proverbs my parents and grandparents taught me. They spoke as if they were fundamental truths and rules to live by. However, If you analyzes these proverbs, one discovers that many of them actually contradicted each other and did not have much in common . To make my point, here is a short list of some common sense proverbs that contradict each other:

He who hesitates is lost.......................................All good things come to those who wait

You are never to old to learn...............................You cannot teach an old dog new tricks

It is better to be safe than sorry'..........................Nothing ventured nothing gained

The best things in life are free.............................There is no such thing as a free lunch

Opposites attract ................................................Birds of a feather stick together

Actions speak louder than words.....................The pen is mightier that the sword

A rolling stone gathers no moss..................... Stop and smell the roses

A penny saved is a penny earned...................Penny wise and pound foolish

As you can see, the wisdom of common sense is not always consistent or objective. There are many perspectives and some of them are contradictory. When someone says "I tell it like it is" what they are really doing is telling it as they see it -- and how they see it is colored by their own subjectivity. When someone say "I have common sense" what he or she really is saying is that they believe their perspective is the right one -- the point of view that others should also take as truth.