Labelling

1

• Labelling
• Theory and Clinical Casework
• Counselling Psychology MSc
• School of Psychology and Therapeutic Studies,
  Whitelands College

2
Origins of Labelling

• Integral part of language
• Almost any noun or adjective could be considered
  a label
• Used as a short-hand way of referring to an
  experience
• But like all summaries can become hard-edged and
  can the be self-fulfilling

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Self-fulfilling labels

• Trust me Im a doctor
• I have a prison record
• (Contentiously and sometimes in the media) It is
  a well known fact that people who have been
  abused also abuse
• I am dyslectic, so dont expect too much of me

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Think about NATs and schema as labels

• Im a wimp
• I am a failure
• I am unlovable

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Importance of labels in diagnosis

• Purpose of diagnosis at its best is to make
  possible the most appropriate treatment
• There is an attempt to create criteria that
  delineate the diagnosis or label e.g.

6
Brief Psychotic Disorder according to DSMIV

• Brief Psychotic Episode in DSM 1V
• Delusions, hallucinations, speech that is
  markedly disorganised, behaviour that is markedly
  disorganised
• Symptoms for up to a month followed by complete
  recovery
• Symptoms must not be due to mood disorder,
  Schizophrenia, or Schizoaffective Disorder
• Not caused by general medical condition , use of
  substances

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Some problems

• Caution and protocols can give the impression
  that they must therefore be right
• What is ultimately a shorthand for a description
  becomes reified. It becomes an object in itself,
  like a tree, or a bus or a hand
• Holistic, or alternative explanations can then be
  ignored or ranked lower c.f TEETAM Tried
  everything else, try alternative medicine

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Influence of underlying philosophical thinking

• Positivism a mental condition is the same as a
  physical condition and can be positively
  identified in the same way e.g. some takes on
  Freud
• Social Constructionism that sees all labels,
  indeed all experience as a social construction
• Post-modernism Tries to do away with monoliths.
  What can I do for this person, as they present
  and in terms of the symptoms that are causing
  them and other people difficulty

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Perhaps most relevant is Social Constuctionism

• Is agnostic about the reality of otherwise of
  phenomena
• Considers all phenomena to be products of
  perception
• These perceptions are conditioned by culture,
  political forces and other social influences

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Major proponents are Peter Berger and Thomas
Luckman

• They talk about the Social Construction of
  Reality (1966) Harmondsworth Penguin
• They analyse all knowledge as emanating from that
  which guides conduct in everyday life
• They emphasise social factors in influencing what
  we consider important when we concur with these
  guides
• They emphasise the importance of language as a
  regulator

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Danger is that we label, unaware that subtle
influences make maybes into fact

• E.g. This person has BPD so therefore.
• This person is a lesbian so wont have motherly
  feelings
• This person is criminal and is therefore
  dangerous
• So we could say that the very act of giving a
  label carries with it the potential for
  prejudicing that persons relationship with you
  and with the world
• Yet we cannot do without labels

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So what does the clinician do about labelling?

• Proceed with caution
• Act with courage regarding the awarding of a
  label when it is meant to be done collegiately
• Look constantly for new evidence that a label may
  have been constructed which is inaccurate, or
  even self-serving
• Give treatment to the whole person