Neurologist Suzanne O’Sullivan, in her book The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker, warns that “borderline medical problems are becoming ironclad diagnoses and normal differences are being pathologized,” and “ordinary life experiences, bodily imperfections, sadness, and social anxiety are being subsumed into the category of medical disorder.” The latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the so-called bible of psychiatry, lists 297 conditions. One in nine American children has now been diagnosed with ADHD — a million more than in 2016, with adult rates doubling in the past decade.

Of course, diagnoses can be life-saving. They can help build communities of shared experience and enable access to essential treatment. As O’Sullivan observed in a recent interview, a diagnosis “empowers people to be kinder to themselves and to make changes they found difficult before.” But a useful explanation is not an identity. 

How stories save and trap us

As Rachel Aviv writes in Strangers to Ourselves: Unsettled Minds and the Stories that Make Us, “There are stories that save us, and stories that trap us.” The danger comes through overidentification. The stories and labels that help us can also box us in, shrinking our reality. Or, as Wittgenstein put it: “the limits of my language mean the limits of my world.”

This dynamic goes well beyond medical diagnoses. Indeed, any job or role that utterly consumes us can lead to what sociologists call “role engulfment.” Studies show athletes who center their identity solely on their sport suffer mental health consequences when their roles change or end. Employees with high “work centrality” struggle to detach and recharge outside office hours. Workaholism and burnout are closely tied to this narrow sense of self. And retirees whose main source of identity was their jobs often face a painful sense of purposelessness when they leave the workforce.

When your whole identity and sense of self is parked in your job, your whole self rises and falls with the job. I saw this in action recently when a friend with a very successful husband who was miserable at work told me that she suggested he quit. “But who will I be without my job?” he asked. When we can’t imagine who we are without a given title, we miss the opportunities to grow that lie beyond the label. The labels become our ceiling. 

You see this play out in American public life, too. It’s hard to imagine today that in 1797, George Washington chose not to run again for President. And it’s particularly hard when we watch elected officials like Dianne Feinstein, who clung to office despite her clear cognitive impairments, or Mitch McConnell, who clung to office despite a series of health scares (including twice freezing on camera). As retired Senator Tom Harkin advised his colleagues to ask themselves: “Is this all there is to my life? What am I missing out there?”  

Clinging to a single label exacts real costs. Studies show that the more we define ourselves by one group or role, the less tolerant and adaptable we become — something our polarized culture can ill afford. Social media multiplies this effect, pushing us into echo chambers that reinforce a limited sense of self.

When we define ourselves by our success or our looks, failure or aging become existential threats. Carl Jung wrote about the dangers of overidentifying with our personas: “… the professor with his textbook, the tenor with his voice. Then the damage is done.”

Diagnoses and job descriptions tell us what we have or what we do — never who we are. If Teilhard de Chardin was right, and “we are spiritual beings having a human experience,” then our possibilities are limitless. No label, however authoritative, and no job, however important, can ever contain the full constellation of who we might become.

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