The problem with labels: Understanding beyond diagnosis

In today’s world, we are quick to label ourselves and others. As therapists, we often hear statements such as, "My boss is a narcissist," "I believe my partner is a sociopath," "My friend is so autistic," or "I think my child has ADHD." "I have watched some videos on social media and I know my mother is a narcissist!" 

While these terms stem from real psychological and neurological conditions, the casual use of diagnostic labels raises important ethical and professional questions. Are we over-labelling? Do these labels provide an excuse for poor behaviour, or do they help us better understand and relate to one another?

The appeal of labels

There is a natural human tendency to categorise people and experiences to make sense of the world. Labels provide structure, helping individuals navigate complex social dynamics.

When a person struggles with a difficult relationship, labelling the other party as a "narcissist" or "sociopath" can offer a sense of clarity and validation. In some cases, a diagnostic term provides a way to explain behaviours that seem incomprehensible.

However, while labels can bring temporary relief, they also come with significant risks. When used incorrectly or without proper professional assessment, they can lead to misunderstanding, stigma and even harm.

The complexity of personality disorders and neurodivergence

Personality disorders, such as narcissistic personality disorder (NPD) or antisocial personality disorder (ASPD), are intricate and multifaceted conditions that require thorough clinical evaluation. While narcissistic traits can be present in many individuals, a full diagnosis of NPD involves a pervasive pattern of grandiosity, lack of empathy and exploitative behaviours that significantly impair functioning.

Similarly, neurodivergent conditions such as autism and ADHD require careful assessment by trained professionals. A child who struggles with focus or an adult who prefers solitude does not necessarily have ADHD or autism. These conditions involve a spectrum of experiences and cannot be reduced to a single behaviour or characteristic. When we hastily apply these labels, we risk diminishing the lived experiences of those who have received formal diagnoses and require support.

Labels as a double-edged sword

One of the most pressing concerns is whether labels justify or excuse harmful behaviours. When someone assumes that a difficult boss is a "narcissist," it can lead to black-and-white thinking, where the person is seen as inherently bad or incapable of change. In reality, human behaviour is nuanced, and people may act in self-centred or insensitive ways without meeting the clinical criteria for a personality disorder.

Additionally, when individuals self-diagnose or assign diagnostic labels to others, they may inadvertently contribute to a culture of avoidance rather than resolution. Instead of addressing conflicts or fostering understanding, labelling can become a means of distancing oneself from emotional discomfort.

Conversely, proper diagnosis and awareness can be invaluable. A person diagnosed with ADHD may benefit from tailored interventions and accommodations, while someone with NPD, if willing, may seek therapeutic support to navigate relationships more effectively. The key lies in using diagnoses responsibly and ensuring that they lead to constructive action rather than exclusion.

Moving beyond labels: A therapeutic perspective

As therapists, we encourage clients to move beyond rigid labels and engage with the underlying behaviours and emotions at play. Instead of focusing on whether a person "is" a narcissist or "has" autism, we might ask:

• How does this behaviour impact you?
• What unmet needs might be driving this behaviour?
• How can you establish boundaries while maintaining empathy?
• What support systems are available for both you and the other person involved?

By shifting the conversation from labelling to understanding, we empower individuals to foster meaningful relationships and make informed decisions about their interactions.

The urge to label is deeply ingrained in human nature, but as therapists, we must challenge the impulse to categorise people simplistically. While diagnostic terms serve a purpose in clinical settings, they should not be used as weapons or shields in everyday life. Instead, we should strive to cultivate awareness, compassion, and informed dialogue about mental health and neurodivergence.

Ultimately, the goal is not to avoid labels altogether but to use them with care, ensuring they contribute to healing rather than division. By fostering deeper understanding and thoughtful conversations, we can move beyond labels and into a space of genuine connection and growth.