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You are not the illness

May 1, 2013

You may have an illness, but you are not the illness. This was an important lesson I learned from my first counselling supervisor, Katherine Stetson. During my master’s program in counselling psychology, I did an internship as an Adolescent and Family Therapist. One of my first assignments was to videotape and transcribe 10-minutes of an individual counselling session. My client was an adolescent male.

I was nervous as heck. What if I say something stupid?! What if he wants to talk about a serious issue that I know absolutely nothing about?! My supervisor will laugh and fail me! These are the kinds of thoughts that ran through my head. But once the session started, I felt really comfortable. We started off by talking about school, friendships, his family, and then his mother’s illness.

“Yeah, she’s got schiza…schi…what do you call that?”
“Is it schizophrenia?” I asked.
“Yeah! That’s it! She’s got that.”
“Oh,” I replied. “So, your mom’s a schizophrenic.”
“Yeah. Sometimes, it’s tough talking to her. She’s gotta take all these meds, and I think it’s tough for her sometimes.”

We talked about his family a bit longer. The session, I thought, turned out really well. As a therapist, I felt really proud of my ability to connect with my client on an emotional level. I was also proud of creating a supportive and safe environment where he was able to talk about some really painful things. This was no small feat. To use a baseball metaphor, I felt like I had just hit a home run.

Then, I showed the clip to my supervisor. She brought me back down to reality pretty quickly.

“Richard, did you just refer to your client’s mother as a schizophrenic?”
“Yes. She has schizophrenia.”
“Richard, she has schizophrenia, but she is not the schizophrenia. She is not the illness!”

I was silent. I didn’t say a word, and neither did she. My supervisor could tell that I was processing what she just said.

We may have an illness, but we are not the illness

We may have an illness, but we are not the illness

Have you ever had a fever or the flu? If someone were to ask what was wrong with you, would you reply with, “I’m flu,” or “I’m fever?” No. That doesn’t make sense. You wouldn’t tell them that your identity was the illness. Instead, you would tell them that you had an illness. Yet, when we talk about mental or emotional issues, we often refer to ourselves as being the problem rather than having the problem. Here’s an example of what I mean.

I am bi-polar         vs.    I have bi-polar illness
I am depressed    vs.     I feel depressed, or “I have depression”
I am anxious        vs.     I feel anxious
I am AD/HD        vs.     I have AD/HD

Externalize your problem
Narrative Therapy is an approach to counselling that focuses on how we tell the story of our problems. One of the techniques used in Narrative Therapy is to externalize the problem. With this technique, the therapist helps the client see the problem as something external to who they are, rather than seeing the problem as their identity. Narrative therapy places a large emphasis on the discourse – the conversation – we have with ourselves and others about what might be ailing us.

In the examples above, the difference between the two statements was just one word (“Am” vs. “Have”). Yet, you can imagine the impact these words have on our unconscious thoughts and feelings. The point is, when you have an illness, it’s not who you are; it’s just something you have. It’s a part of your story, but it’s not your entire story. You and I are spiritual beings, and everyday we experience a wide range of thoughts, behaviours, and emotions. Sometimes, extreme emotions, thoughts, and behaviours can lead to illnesses (physical and/or mental). But, in the end, we are not the illness.

What have you noticed about the way people talk about depression, anxiety, or mental health in general? Share your comments below.

Hoping this bit of psychology helps in your personal growth….

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  1. This was one of the first things I learned in my masters program and it is so true. Its very important concept for people to understand in order to help reduce the unwarranted stigma of mental illness.

  2. Reblogged this on Chasing After Flow and commented:
    This is a very important issue within the mental health that everyone should be aware of.

  3. Donna permalink

    schiz·o·phren·ic (skts-frnk)
    1. Of, relating to, or affected with schizophrenia

    This is what I found when I looked up “schizophrenic” in the dictionary. My question is this “What is an alcoholic?” They are not their disease, their brain disease of addiction to alcohol, but their program of recovery has them repeat at every meeting…”Hi I’m ______, I’m an alcoholic” Is it splitting hairs when using language and trying to decipher language and meaning? Or can we accept life on life’s terms and just try to support each other to find and live in the solution of our individual problems? as millions of alcoholics have found in the rooms of AA meetings.

    • Hi Donna,

      Thanks for bringing up a great point!

      I agree that sometimes a word is just a word. However, as a psychologist, the aim is to teach my clients that they are much more than the word used to describe their problem.

      That’s the message I wanted to get across in this post.

      Sometimes, labeling ourselves according to our disease (diabetic, anorexic, alcoholic, schizophrenic, etc.) is helpful. It reminds us of our struggles and challenges. It reminds us of what we need to work on. It also creates a sense of fellowship with others who suffer from the same affliction. And for many, I think it keeps them humble, realistic, grounded. It’s a reminder that although they are no longer experiencing the symptoms of the disease, they are not cured. They still have the illness.

      While I can’t speak for everyone in AA, I think the use of the term “alcoholic” does most, if not all, of those things for a lot of their members.

      In the end, though, people can call themselves whatever they’d like. What matters most is to remember that we are more than just the word used to describe our problem or illness.

      Thanks again for posting…


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