Don't Diagnose

The perils of trendy assessments

It’s pouring rain.

I live in Seattle. Rain is not a surprise. I’ve lived here most of my life. Although now the news says that this steady rain is part of an “atmospheric river.” That’s a relatively new phrase, to me. But weather forecasts are often hyperbolic in this town where a few flakes of snow on the ground becomes Snowmageddon.

We like catchy names, diagnostic sounding appellations, new phrases that parse old behaviors or narratives. It’ll get a click or a share or a link, the coins of the social media realm. For the lucky coiners, they may get an article that includes a number – “Five Problems in an Insecurely Attached Team,” “Eight ways to tell if your partner is a narcissist.”

Remember that old Ramones lyric “I want to be sedated”? Nowadays we want to be diagnosed. Or to diagnose others.

I’ve had plenty of friends who were suffering from difficult physical or mental health issues who, finally, got an accurate diagnosis and were able to get treatment that helped them. The importance of a real diagnosis and the relief at being accurately diagnosed so you can be treated isn’t what I’m talking about.

What I’m talking about is this tendency for people with no medical or psychological training to assign a diagnosis to another person. I recently heard a podcast (Savage Love by Dan Savage – I can’t now find the specific episode to link to, so if you know it, please put it in the comments). Savage interviewed an author about an article she wrote about the dangers of diagnosing someone in your personal life. For example, the woman who decides her difficult ex isn’t just a selfish jerk, he’s a narcissist.

People do this at work all the time, declaring that different individuals have narcissism, an eating disorder, ADHD, post-partum depression. They throw these labels around casually, over drinks or in a management team meeting.

Why is this a potential problem?

If you suspect that a person who works for or with you is suffering from a serious illness, you should do something. Start with HR to find out the best way to approach this.

The problem comes about when you don’t really think the person has a serious illness, you’re just tossing out a diagnosis.

First, unless you have a medical degree or a PhD in Psychology, you’re not an authority. Acting like you are one is never a good look.

You are putting the blame on the other person. Their illness makes it their problem.

Which means you abdicate any responsibility you may have. If you say Joan has ADHD and that’s why she’s not organized, you’ve made it a medical condition. Which means you don’t need to consider your skills or lack thereof as a manager and how you delegate and prioritize assignments for your direct reports. It is entirely possible that Joan is not organized because you are lacking as a manager. It can’t be you. Because, it’s, you know, clearly them.

You’re not considering the system. If someone is struggling when they return from parental leave and you decree that it’s post-partum depression, then you don’t need to consider the impact of you company’s return to work policies for people who have just given birth. How available and hospitable are the breast pumping facilities? How many hours is that person expected to work? Do they have to jump right back into a grueling travel schedule with a newborn at home? Throwing a label on them gives you an easy way to avoid the responsibility to dig deeper into what’s actually going on.

Narratives are powerful. Why would you make up a story about a person you work with? I suppose someone might think it is an attempt at compassion – maybe she has a psychological issue. Maybe. But that’s the kind of thing you keep to yourself, or share with a partner. Not at work.

Human beings are complex. We all operate from multiple frameworks of identity, culture, personal experience, and our mental, emotional, physical, and psychological systems. I love that complexity, it’s creative and chaotic and delightful. Let’s revel in it, or, at the very least, accept it, and not rush to push everyone into a diagnostic box with a tidy label on it.