There is a great deal of concern among some people working in the mental health area that we are seeing over-diagnosis of mental illness, particularly among young people influenced by social media.
Psychologist and author Professor Tanya Byron has herself just written You Are Not Your Diagnosis: The Therapy-Speak Trap and the Lost Art of Listening to Ourselves argues in The Times that normal human distress—such as stress, sadness, anxiety, and grief—is frequently mislabelled as a clinical disorder.
American psychiatrist Dr Suzanne Garfinkle-Crowell’s Girlhood, Translated: Understanding Girls in the Age of Therapy Speak and Self-Diagnosis brings the focus sharply onto teenage girls, using her patients in New York as living, breathing examples of the fear and unhappiness that has brought them to seek a therapist’s help.
In a nuanced, empathetic argument Dr Garfinkle-Crowell unpicks the recent deluge of diagnoses. She sees these labels not so much as literal illness, but more a bid for serious attention and help by young women, so that their erratic behaviour or unhappiness is acknowledged and seen, rather than ignored or wished away by worried parents.
As she wrote recently in the New York Times, in a column that seemed to be aimed at such girls’ Mums and Dads: “Small acts of translation can help. Someone who says she has ADHD may or may not fit the clinical definition, but she’s probably telling you she feels scattered, overwhelmed or afraid she’s a mess. If someone says she has anxiety, you can be pretty sure she’s nervous, uneasy or unsure of herself. If the word “depressed” freaks you out, consider instead why the person using it feels hopeless, lonely or in despair.”
The book is divided into chapters devoted to anonymised young female clients, such as Chloe who believes her restaurateur father’s problems with staff who have claimed sexual harassment have left her traumatised. Now she wants ADHD medication and also to be treated for anxiety and depression. In one session she also talks about her OCD. Her parents think this is extreme, the author’s supervision group is sceptical, but in the end Garfinkle-Crowell sees the high school girl’s demands for diagnoses as a way of being heard in a home where she isn’t taken seriously.
“Chloe, I learned was using these words for control. She was a person who felt helpless and afraid, and found power through diagnostic language. She was ultimately able to shift from this place, but I had to meet her where she was, first.”
The book’s American style may rankle with some, but as social media and pop culture is global in this age group, it’s easy to find equivalents in the UK. The fear of saying the wrong thing, looking different, being open to shameful photo-sharing can make girlhood much more perilous than many adult women remember of their teens.
Dr Garfinkle-Crowell’s aim in the end is clear and admirable. She wants to free girls from constant comparison and doubt, to shift them from self-objectification to them being the object itself. For this “you need to figure out who you are, and how to become the main character in your story.”
