Rethinking diagnoses - they often explain less than we think
Often, we think that when we receive a diagnosis, it means that a “thing” exists inside of us — and a medical specialist (or our own exhaustive research) has found or uncovered it. We conclude it exists in its own right, and now that it has a name, we can finally point to the source of our pain or symptoms and fix it.
For example, if you're experiencing low mood, lack of motivation, difficulty enjoying things, and feelings of guilt or worthlessness, you may be given a diagnosis of depression. That diagnosis can feel like a turning point — like someone has finally named what's wrong. But this is also where a trap can appear. You may start to believe that "depression" is a thing inside you — an entity that causes your symptoms — rather than what it truly is: a label that describes a pattern of experience recognized by clinicians.
This is what’s known as reification — treating something abstract, like a label or concept, as if it's a concrete object. It’s as if we start to believe there’s a little "Depression" sitting in our brain or bodymind, generating fatigue, sadness, and lack of motivation. But depression isn’t a thing — it’s a description. This shift in perspective is subtle but powerful, especially when we extend it to other diagnoses like fibromyalgia, POTS, or ME/CFS.
These are real experiences, and they are often deeply distressing, disruptive, and difficult. The pain, the brain fog, the dizziness, the exhaustion — none of it is imagined. But a diagnosis doesn’t always mean that a specific, identifiable disease process has been found and explained. Rather, it often means that a cluster of symptoms has been given a name.
So why does this distinction matter?
Because believing the name is the cause can quietly close the door on curiosity, nuance, and healing. It can limit our sense of what’s possible. We may stop asking deeper questions like: What is my body trying to adapt to? What environmental, nervous system, or relational stressors may be contributing to what I feel? How has my experience been shaped by trauma, inflammation, disconnection, or chronic threat?
This is where hope begins to take root — in shifting from “I have a thing that’s broken inside me” to “my body is responding in a complex, intelligent way to something it has experienced or is still experiencing. It is doing the best it can to adapt and protect me.” That shift opens the door to compassion and agency.
Let’s take fibromyalgia as an example. A person might think, “I have fibromyalgia, so I will always be in pain.” But what happens when we see the diagnosis as a snapshot — a way of grouping experiences — rather than a fixed identity? It becomes easier to ask, “What is my pain trying to tell me? What stressors is my nervous system holding onto? How can I support my bodymind to feel safer and more regulated?”
From that perspective, we might:
Begin nervous system regulation practices that help shift the body out of survival mode (e.g., paced breathing, gentle somatic work, co-regulation)
Notice how patterns of people-pleasing or repressing emotions contribute to flare-ups — and start to set new boundaries and befriend the full range of our emotions
Understand how early life adversity or chronic stress shaped our physiology, and begin to bring compassion to parts of us we once blamed
Work with a trauma-informed practitioner to shift internal narratives from “I’m broken” to “My body is wise and trying to protect me”
This shift doesn’t promise quick fixes — but it does offer something far more sustainable: a path forward that doesn’t depend on “fixing or fighting the thing” but on changing the conditions that keep the symptoms in place. And that is where real possibility lives.
As systems thinker Gregory Bateson warned, diagnoses and explanations that rely on “dormitive principles" (like saying opium causes sleep because of a “dormitive property”) may sound scientific but actually block inquiry. Similarly, saying “I’m in pain because I have fibromyalgia” might sound like an answer, but it leaves us with a closed loop — a name, not an understanding.
True understanding — and the kind of healing that’s available — comes from exploring the relationships, contexts, and histories that shape our bodymind’s response. In doing so, we move from a place of helplessness to one of relationship with our symptoms. We begin to notice patterns, shifts, moments of relief — and to grow trust in the possibility of change.
If you’d like to read Bateson’s reflections on the 'dormitive principle,' you’ll find an excerpt at the end of this blog post. And if you feel called to continue a curious, compassionate inquiry into your pain and symptoms — one that opens the door to healing and recovery — I’d be honored to support you in that process.
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Excerpt from Gregory Bateson’s book Mind and Nature: A Necessary Unit:
“A common form of empty explanation is the appeal of what I have called ‘dormitive principles’ borrowing the word dormitive from Molière. There is a coda in dog Latin to Molière's Le Malade Imaginaire, and in this coda, we see on the stage a medieval oral doctoral examination. The examiners ask the candidate why opium puts people to sleep. The candidate triumphantly answers, “Because, learned doctors, it contains a dormitive principle. We can imagine the candidate spending the rest of his life fractioning opium in a biochemistry lab and successfully identifying in which fraction the so-called dormitive principle remained. A better answer to the doctors’ question would involve, not the opium alone, but a relationship between the opium and the people. In other words, the dormitive explanation actually falsifies the true facts of the case but what is, I believe, important is that dormitive explanations still permit abduction. Having enunciated a generality that opium contains a dormitive principle, it is then possible to use this type of phrasing for a very large number of other phenomena. We can say, for example, that adrenaline contains an enlivening principle and reserpine a tranquilizing principle. This will give us, albeit inaccurately and epistemologically unacceptably, handles with which to grab at a very large number of phenomena that appear to be formally comparable. And, indeed, they are formally comparable to this extent, that invoking a principle inside one component is in fact the error that is made in every one of these cases." "[...] I will get nowhere by explaining prideful behavior by referring to an individual's "pride". Nor can you explain aggression by referring to instinctive (or even learned) "aggressiveness". Such an explanation, which shifts attention from the interpersonal field to a factitious inner tendency, principle, instinct, or whatnot is, I suggest, very great nonsense which only hides the real questions."
In the next blog entry, I will talk about allostasis, a concept that offers insights into the root cause of nociplastic symptoms.