- For autism-related challenges, people can use hypnosis to stay calm, reducing anxiety about that "label."
- You can view an upsetting incident as a confrontation with a destructive viewpoint rather than as a "victim."
- Authority figures should reframe patient labels from having a “disease” to “dealing with a disease.”
How we label ourselves often dictates how we feel about ourselves and the actions we choose to undertake. Sometimes, our self-labeling leads us down unhelpful paths.
- Some people diagnosed with asthma feel that whenever they develop shortness of breath with a competitive activity, this must mean that their asthma is disrupting their efforts and that they need to take their asthma medication or stop the activity. However, asthma medication in that setting may not be appropriate as the shortness of breath might be related to increased metabolism because of physical exertion, lack of stamina, or even anxiety.
- Children with dyslexia may come to believe that they are of low intelligence because of their inability to read well. As a result, they may choose to avoid making an effort in school, as they think they will be incapable of academic success. In turn, this leads to poor school performance, further convincing these children that they are of low intelligence.
- People sometimes label themselves as being the victim of circumstances, for example, because of mistreatment by others, a diagnosis of a serious illness, or an inherent fault in their character. In these situations, assuming the victim role can imply that a person is helpless without an effective coping strategy and that life is unfair and will continue to be so. Thus, like children who believe they are of low intelligence, a victim may not even try to improve their lot.
Because of the negative implications of many kinds of labels, I encourage my patients to avoid assuming such labels and to think of challenging situations as opportunities for growth and empowerment.
Three examples from my practice illustrate the usefulness of this approach.
A highly intelligent 11-year-old with autism experienced frequent emotional “meltdowns” at school when he became overwhelmed. His triggers included the loud noises in his classroom, stress in dealing with his classmates, and anxiety about doing well academically.
When he became upset, the boy would yell, cry, and sometimes throw objects. Talking with him about his behavior, as well as instituting rewards and consequences for his behavior, did not help. The boy said he felt he could not help himself and could not be a good student because of his autism.
As the boy’s behavior was disruptive to his class, he was transferred to a school for behaviorally challenged students. Unfortunately, at that school, many of his classmates were also cognitively challenged, and my patient with autism became quickly bored because the instruction was geared towards his classmates’ level of cognition. This situation led him to develop behavior issues because of his lack of attention to his teacher’s instructions.
When I met the young man, I explained to him that he could deal well with his autism-related challenges. I taught him how to use hypnosis to calm himself and how to think about his anxiety about doing well at school as a mark of being a good student.
I encouraged his family to transfer him to another school that would provide him with appropriate academic instruction and in which he would have the assistance of an aide who could coach him to react more appropriately when he became overstimulated. Subsequently, this patient did very well and was admitted to law school.
Victim of Antisemitism
One of my patients, a Jewish boy with anxiety who attended middle school, became upset when a classmate confronted him with the Nazi salute and said, “Hitler had it right.” The boy reported the incident to his school officials, who said they would discuss the matter with the classmate in question.
When the patient came to see me at his next scheduled appointment, his mother introduced what happened with the statement, “My son was the victim of an antisemitic incident.”
I responded that viewing my patient as a victim could imply that there was nothing to be done about the incident. I suggest instead that the patient think of the situation as a confrontation with a destructive viewpoint and consider how he might best respond and what he could learn from the incident. We agreed that reporting the incident to the school officials was a great first step.
As part of our discussion, my patient wondered whether a good solution was to switch to another religion, as then he would not have to deal with people who did not like Jews. When I asked him if he could tell me a reason he might remain Jewish, he was unable to answer.
As a Jewish clinician, I was able to give him some reasons he might value being part of the Jewish people. (If I were not Jewish, I might have referred his family to speak with a local rabbi).
Following our discussion, my patient said he was happy to be part of the Jewish people. I observed that by thinking about what he could learn from the confrontation with his classmate, my patient was given an important opportunity to learn about his identity. I hoped his classmate might learn something useful about himself and perhaps realize that bigoted comments do not have a place in a civilized society.
Poor Artistic Ability
A 5-year-old girl was referred because of her irritability, which was made worse by her elevated blood sugars because of insulin-dependent diabetes. It was very important to this girl that things work out the way she wanted them to work out, perhaps because she did not feel in control of her chronic illness. When things did not go her way, the girl would scream, throw objects, and sometimes stay angry for a half hour or longer.
One of the main triggers of this patient’s anger was when her drawings did not turn out the way she thought they should. When this occurred, she would become upset with herself for being such a poor artist, crumple up the drawings, and become furious.
Her parents had implemented multiple measures to help her become calmer, including encouraging her to breathe slowly, hugging a favorite stuffed animal, and reading a story. However, once she became enraged, she did not want to cooperate with calming techniques.
Perhaps she would respond better by learning how to prevent her anger in the first place. Therefore, I explained to her that there was a different way of thinking about her drawings.
I showed her a kintsugi plate that I have in my office. Kintsugi is a Japanese technique through which defects in pottery are repaired by applying a lacquer mixed with a precious metal, such as gold. With this method, the repaired pottery can be admired for its beauty, which includes the obvious repairs.
My patient smiled as she appeared to grasp the concept immediately. I suggested that she adopt this approach to her drawings. Painter Bob Ross taught a similar concept.
At her next visit, I showed her the book Happy Little Accidents: The Wit and Wisdom of Bob Ross, in which Ross explains how to take an accidental mark on a painting and change it into something beautiful. Subsequently, this patient brought me examples of her artwork and proudly showed me how she incorporated her mistakes into her creations.
As a clinician, I am careful about telling patients about their diagnoses because I do not want the diagnostic label to define them. Often, I say to my patients that rather than focusing on treating a diagnosis, we should work on improving their symptoms.
I help myself and my colleagues avoid labeling patients in a harmful way by thinking and talking about them as “patients dealing with a disease” instead of “diseased patients.”
Parents, teachers, bosses, and other people in authority should be equally careful about how they label people in their sphere of influence.
When we accept a label for ourselves that has negative connotations, we sometimes restrict our ability to think, act, or improve in certain ways. Therefore, if we want to take on a label, consider one that will inspire us to better ourselves: go-getter, creative, intelligent, wise, or capable.
And if we feel that a positive label does not yet apply to us, we can tell ourselves that we want a particular positive label to apply to us. Such an expressed desire to improve will propel us in a good direction.