Alan Melton, D.Min., LPC
The therapist Mark Solms says that we cannot know how to help someone get better if we do not know what has gone wrong in their lives in the first place. I agree. We cannot treat what we have not properly diagnosed. Diagnosis is the first step your counselor takes in trying to help you. If you come to me or your family doctor for help we will ask you, “ Where does it hurt? What hurts? How long has it been hurting?.” In other words we want to know what are the symptoms of your emotional problem? I will also begin to think with you about what lies behind your symptoms. What is the cause of your symptoms. What has gone wrong in your life that has produced these symptoms. The approach I will take sees your symptoms as results of a deeper problem. This approach tries to get to the root of the problems that are causing your symptoms.
When your therapist is making a diagnosis of your underlying problems, they look deeply into your early childhood experiences and how those experiences effected your development. Depending on the age and developmental level of the child when these unfortunate experiences occurred, the child will develop one of the three following levels of personality function. These levels are: Normal/Neurotic Personalities, Narcissistic/Borderline Personalities, or Psychotic/ Severely Disturbed Personalities. The Normal/Neurotic Personalities are fairly high functioning folks. The Narcissistic/Borderline Personalities are much more ill, and the Psychotic /Severely Disturbed Personalities are extremely ill. All three levels of personality dysfunction result from unfortunate experiences in a child’s early development and lead to painful symptoms of anxiety, depression, panic, flashbacks, obsessions, fears, etc.
The Neurotic/Normal Personalities include: obsessive compulsive, hysterical, avoidant, and dependent personalities. The Narcissistic/Borderline Personalities include: paranoid, schizoid, schizotypal, antisocial, narcissistic, histrionic, and borderline personalities proper. The Psychotic level conditions include the various schizophrenias and other condition where people have problems with reality testing. In order for your therapist to help you heal from these personality problems, they must diagnose these levels of personality disorder properly. Then these deeper problems can be recognized and worked through in therapy to a healthier mental life free of the painful symptoms that brought you to therapy in the first place.