We Are More Than Our Diagnoses: Speaking About Mental Illness with Compassion and Respect

It was a friend of mine who said it – a therapist, in fact. In talking about her husband’s very difficult ex-wife, and, by way of dismissing her as a mother – or even, really, as a person one could take seriously at all – she said, “She’s borderline.”

She was referring to borderline personality disorder, a real and oftentimes difficult mental health diagnosis. People with this diagnosis may experience depression, fear of abandonment, unstable yet intense relationships, feelings of emptiness, mood swings, suicidal thoughts and gestures, and more.

Yes, that may indeed make them difficult to deal with at times – but no one chooses to “be borderline” any more than one chooses to have cancer. A psychiatric disease is not someone’s fault, nor is a diagnosis meant to be a weapon. Its purpose is not to label, but rather to help.

Is there a difference between labeling and naming? And why does it matter?

Torah teaches us that naming is a powerful thing.

In Genesis 2, God allows the newly created person, Adam, to name the animals that God has just created. Genesis 1 teaches that this person, Adam, is created in the image of God, b’tzelem Elohim. Adam’s first act, naming the animals, might reasonably be understood to be an echo of God’s own actions: God creates and names Adam; God creates the animals, and Adam is permitted to name them, imitating the Holy One of Blessing.

Naming is a part of creating. A name reveals, or even generates, who or what the person or thing is – or has the potential to become.

Adam, for example, is so named because he comes from adama, the earth. Later in the Torah, names are given or changed to reflect a person’s character. Perhaps most famously, Jacob is so named not only because he emerges from the womb holding his brother’s heel, aqab, but also because he is a “heel” of a different kind, a usurper. Later, as Jacob matures, an angel changes his name to Yisrael, one who wrestles with God.

Names reflect who we are and can challenge us to become more. Labels, however, can be less of a blessing.

Labels home in on one part of a person and say, “This is all there is to you.” They can be a way to dismiss a person or to pretend to know all there is to know about a person. But can we ever really know everything there is to know about someone?

In traditional Jewish liturgy, when we pray for healing, we ask for a refuah sh’leimah, a complete healing; a refuah hanefesh, a healing of the soul; and a refuah haguf, a healing of the body. Hearing these words spoken aloud, especially from the pulpit by clergy members, is powerful, reminding us that true healing involves both body and soul.

But that is not enough. There is so much stigma around mental illness that we also must speak of mental illness from the pulpit as an actual illness, just like heart disease or cancer.

Like these other illnesses, mental illness affects a person; it does not define a person. As with other ailments, sometimes people with bipolar disorder or schizophrenia are ill and suffering from their disease; other times, they are in remission, and symptoms fade. Sometimes a person with anorexia or alcoholism is in recovery; other times, they may have a “slip.” The person, however, is always there, underneath, waiting to be found and seen as more than their labels.

Think of the time, the effort, and the joyousness that goes into choosing a name for a child. For whom might this baby be named? What will the name mean? How does it sound? Babies’ names are given in the context of a blessing, at the b’rit milah (ritual circumcision) or at a naming ceremony of some kind. The name itself is a kind of blessing.

Of course, psychiatric diagnoses are not made the same way we choose names for our children – but in many ways, they are given with a kind of love and respect for the people receiving them. Just as a name carries meaning – and perhaps also memories about others for whom the person is named – psychiatric diagnoses describe illnesses, giving people names for what they are experiencing, as well as information about what else might occur, what treatments might help, what others have experienced, and so forth. In that way, labels, as it were, can help.

Precisely because of what they are and what they mean to individuals who are being treated for such ailments (but are not defined or diminished by them), psychiatric diagnoses are not terms we should use lightly. Rather, it’s up to each of us, both individually and in our communities, to be careful with our words. When we casually call someone a narcissist, are we striving to understand them or trying to dismiss them? When we jokingly refer to ourselves as “a bit OCD,” does that label diminish the pain of those who live with obsessive compulsive disorder?   

Our words can hurt or they can heal. Let us choose wisely.