A reader asked the following question:

In your opinion, do you think someone only has a personality disorder if they’ve been officially diagnosed? Would you believe that someone had a personality disorder or other mental illness without a diagnosis?

I responded with the following:

The answer I give reminds me of Plato’s allegory of the cave. There are those in the cave that can see only shadows of the outside, reality if you will, because they are chained and can only see walls.

The shadows represent a perception of actuality. Actuality is no less real due to that blurred perception. Only by breaking free and seeing the outside can actuality be identified in full.

One who is undiagnosed can only see shadow. The clarity of that shadow may vary in form and shape, but nonetheless reflects some reality. Maybe the cave dweller can associate certain ideas with that shadow, maybe she is informed by others’ perception of the shadow. The point is that there is much to be learned. Does the mass the shadow belongs to need feared? Does that mass bring further knowledge?

That said, some shadows may be worth keeping as shadows. It takes great bravery to go seek the fanged and clawed creature whose shadows are in front of you.

A shadow (or lack of diagnosis) does not make reality any less real. It just makes it less clear.

The same reader then gave a follow up question:

Do you think it’s better to be in the shadow? Do you think it’s better to not be diagnosed?

Response:

It depends on the person and that which the shadow reflects.

Read this first.

Does the uncertainty negatively affect the individual?  Are there consequences to be had if the shadow is named?

I chose to seek diagnosis for my own “disorders” because I wanted to know more about myself.  A very weak sense of self was agonizing. I realized that I was very different than others.  I wanted answers.

I don’t think there is a catch-all answer to this question.  There are tradeoffs.  Dealing with a diagnosis of psychopathy, for instance, is playing with fire.  I could lose it all if some circles found out.

Ultimately, the knowledge was worth it for me.  Even had I tested negative, that, in and of itself, would have been knowledge worth having.  I must stress though, that once someone seeks that knowledge, they must be prepared for the consequences.  Seeing the outside world rather than shadow can be earth-shattering.

There are no silver bullets in life, but knowledge comes close.

I have had a chance to think a bit more about their questions since that exchange.

Knowledge is power.  Only by tackling one’s demons head-on can one learn how to function at their best.  The sufferer of chronic disease cannot mitigate those symptoms without first knowing that they have something that needs mitigated.  The academic cannot contribute new knowledge without first learning the status quo.  Only by accepting one’s condition can one create a better life possessing ownership of, and over, that condition. 

I’ve known several people with Asperger’s (or that identified with such) over the years.  It took introspection on their part to learn their strengths and weaknesses.  These people that I knew, having made that journey, are now able to embrace their strengths – such as obsessing over and learning specific subjects – while mitigating their weaknesses – for instance, learning social skills.  They were not able to enhance their lives until they embraced that they were different.  Some of those people sought formal diagnoses, some did not.  The point is that they realized that they could not make corrections nor improvements to their lives until they tackled the uncomfortable.

I am a diagnosed psychopath.  I sought that diagnosis voluntarily.  I did that because I realized that I was different from others in ways that I could guess but not know for certain.  I realized that I was dangerously reckless, notoriously short-sighted, and a parasite in many ways.  I just did not know why.  I knew that there was something fundamentally striking about my differences, but did not know what.  Without knowing what those differences were, there was no chance to mature.  It would be trying to hit a bullseye in a room without light.  Even if my motives are not entirely pure, I now realize that I must own my psychopathy rather than it owning me.  I must seek responsibility for that which is always at my side.

The only way to know yourself better is to break free of the cave.  Shadows reflect reality but are insufficient for modeling that reality.