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As a psychotherapist, part of my job is to provide people with a diagnosis. I see a diagnosis as helpful only if it is a discernment and not a judgement. The difference is relevant because the ability to discern is fundamental to making decisions that lead us to happiness, and judging can get in the way of doing that.

Many of us do not use our ability to be discerning because we are afraid of being judgmental. Or we are so judgmental we do not get the benefits of discerning. Either way, we can miss out on the insightful power of being a discerning person.

What is the difference between discernment and judgement?

Firstly, discernment always comes before judgement. To discern is to simply gather information. The ability to discern information is fundamental to making decisions, and decisions get us through life. We make an enormous number of decisions each day, and the quality of our decisions hinges on the quality of our discernments. For example, the weather report predicts rain today and so I will bring an umbrella.

Secondly, discerned information is discrete, it is bounded, it is a piece of the puzzle. Judged information, on the other hand, has added assumptions and extrapolations, “good” or “bad”, “better” or “worse”, about the whole puzzle. For example, the weather report predicts rain today, I will bring an umbrella, and so the day will be awfully gloomy.

I practice cognitive behavior therapy, and in CBT, we discern. We begin by identifying cognitive distortions, also known as stressful thoughts. An example could be, “There is something wrong with me because I am suffering.” Then, once the stressful thought is identified, we question it. “Is it true that there is something wrong with me because I am suffering?” There are only two things a person can do with a stressful thought, only two; we can either believe it or we can question it.

Practicing CBT, we use mindfulness to notice our thoughts, without judging them. We notice and discern whether the thoughts are stressful or not, without judging ourselves for having stressful thoughts in the first place. Everyone in the whole world has stressful thoughts that they believe sometimes.

So, CBT is a practice to alleviate suffering based upon straight forward information about how our minds work and what causes our suffering. This is discernment. There is no judgment in CBT because no one is believing a stressful thought on purpose.

One time I was working with a teenage boy who had recently gotten the diagnosis of autism. I asked him how he felt about this diagnosis? He said he didn’t like it because he had heard that to have autism was bad. He was judging it and so he was judging himself. He was believing the stressful thought, “autism is bad”.

I asked him what he knew about the diagnosis and he admitted he knew next to nothing about it. I suggested we look at it together and he thought that was a great idea. So, over the next few months, we went to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) the current authority for psychiatric diagnoses (published in 2013), and we read through the criteria for the autism diagnosis.

At a certain point this young man told me that he felt differently about it. He could see that without judging the information it had relevance to him and that the diagnosis did explain certain things to himself about himself that previously he had found incredibly confusing. Now he was discerning the diagnosis, and found he could take some of it and leave some of it, some of it fit him and some of it didn’t, but he no longer judged himself for being neurodivergent. He could see that he was simply wired differently than his brother and sister and parents. He could also see that this did not define him. It was simply a part of who he was. He was also a very talented and passionate musician. He was also a great writer. He was also a dog lover. He was a lot of things and having a diagnosis of autism was simply a piece of the puzzle of understanding himself.

A diagnosis is comforting if it provides a framework, a community, a lineage, a treatment. A diagnosis says that “I am the way I am but in a particular way”, one that has been experienced and recorded in historical and modern times. If a diagnosis is a “box” or a “label” then it is not comforting or helpful. Essentially, in my view, as a discernment a diagnosis is meant to be a map out of the woods.

When someone is suffering, I am moved to help. I ask what is the ailment? Does a diagnosis help answer this question? A diagnosis can offer an opportunity to begin to follow a path out of the woods, towards openness and transformation. Asking what ails someone can be a transformational question.

Maybe for all of us getting lost is part of finding our way. We all have ailments at one time or another in our lives. But when we judge ourselves, or others, for having an ailment we don’t get very far. No one has autism, anxiety, depression, alcohol use disorder, or any other psychiatric diagnosis on purpose. When we discern instead of judge, we find ways to heal and grow. We find the most beautiful discernment is self-discovery.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC

Suris, A., Holliday, R. And North, C.S. (2016). The evolution of the classification of psychiatric disorders. Behav. Sci, 6(1)