What If the Diagnosis Is Only Half the Story?

Dynamic Deconstructive Psychotherapy and the People Behind the Labels
Tyrone sat slumped in the chair, arms crossed, jaw tight.
This wasn’t his first therapist. Not by a long shot.
He had heard it all before:

• “You’re emotionally unstable.”
• “You need to manage your anger.”
• “You have borderline traits.”

To Tyrone, these labels all said the same thing: “You’re too much.”

But the therapist sitting across from him now wasn’t rushing to diagnose. She was curious. And when Tyrone made an offhand remark—“I guess I’m just wired wrong”—she paused. “What if you’re not wired wrong?” she asked. “What if the system that raised you taught you a story about who you were—and your brain just did its best to adapt?”

For the first time in years, Tyrone didn’t feel defensive.
He felt… seen.

When Diagnosis Becomes Destiny
Mental health professionals know that diagnostic labels can be helpful. They provide structure, clarity, and treatment pathways.But when they become shorthand for “difficult,” “manipulative,” or “hopeless,” they do more harm than good.[1]

This is where Dynamic Deconstructive Psychotherapy (DDP)[2] offers something different. It doesn’t just treat disorders. It treats the emotional logic that people develop to survive a disordered world.

Tyrone had grown up in an environment of emotional inconsistency. Sometimes he was loved. Sometimes he was shamed. Often, he was invisible.

So, he did what many emotionally intelligent children do:

• He built a protective shell of anger and detachment.
• He learned not to trust.
• He rejected others before they could reject him.

By the time he reached adulthood, his behaviors were labeled “problematic.” But no one had ever said, “Of course, you did that. It makes perfect sense.”

The DDP Reframe: From Pathology to Protection
In DDP[3], we don’t just ask what someone is doing—we ask why it makes emotional sense in the context of their life.

Tyrone’s therapist helped him reflect:

• What beliefs about himself were formed through early pain?
• How were those beliefs showing up in his current relationships?
• Could he notice the moment before he reacted—and choose something different?

This process—slow, relational, grounded in emotional meaning-making—began to shift everything. Tyrone went from being treated as a diagnosis to being treated as a human being with a story worth understanding.

He wasn’t “resistant.”
He was protecting himself the only way he knew how.
And now, he was learning another way.

When Labels Fall Away, Healing Begins
Over the next few months, Tyrone began expressing emotions he’d buried for years. Shame. Fear. Grief.

He wrote letters he never sent. He started using the phrase, “That reminds me of when…” He caught himself, during a fight with his partner, and said, “Wait. I think I’m reacting to something that isn’t happening right now.” That moment? That’s DDP[4] in action. That’s the moment when someone rewrites their future.

CALL TO ACTION:
Are you working with clients who’ve been written off—or are you feeling stuck treating “diagnoses” instead of people?
Join us for our four-hour Virtual Conference on Dynamic Deconstructive Psychotherapy, and learn how to work beyond the label, build emotional insight, and help client’s re-author their lives.

Let’s bring the humanity back to mental health care.

Date: Friday, June 13, 2025
Time: 9-1pm (EDT)
Click HERE to Register

[1] Yang, Lawrence H., et al. “Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis.” Schizophrenia research 168.1-2 (2015): 9-15.

[2] Gregory, Robert J. “Manual of Dynamic Deconstructive Psychotherapy.”

[3] Jurist, Julia, et al. “Dynamic Deconstructive Psychotherapy.” Handbook of Good Psychiatric Management for Borderline Personality Disorder and Alcohol Use Disorder (2024): 233.

[4] Gregory, Robert J. “The Deconstructive Experience.” American Journal of Psychotherapy, vol. 59, no. 3, 2005, pp. 295–305.