So, I read an article today on the Mighty titled: “I’m not high functioning- and I’m okay with that”. So, this is more complicated than it seems, to quote the article. In the DSM 4, the GAF or Global Assessment of Functioning, attempts to capture the ability of a person to “function” or met certain demands in life across different domains. These domains were in fact conjured up by the people that designed this assessment scale to rate a person’s “abilities”. This is problematic for several reasons. I wont explore all these problems, or the problematic aspects of diagnosis, which, I am sure many of the readers already understand. In summary, these terms and clinical assessments are artificial, totalizing, and do not capture the organic nature of real life.
In short, people that rate highly on the GAF are termed “High Functioning”. The term has become extremely insulting, and rightfully so, for people with lived experience that understand what people are trying to say, when they make suggestions that a person is so called “functioning well or highly” in their life. These so called high functioning people are people that “hold jobs” or aren’t hospitalized often enough to pass through the public mental health system. I understand quite clearly what high functioning is supposed to mean to people that don’t understand mental health issues or stigma.
Aside from the limiting nature of inorganic summations of a person’s “abilities”. The issue of stigma persists as the article unfolds. Indeed, as this article unfolds, the author builds the argument that given his lived experience as someone labeled high functioning and later, after losing what would points on the GAF from unemployment, he is suggesting it is okay to be low functioning, as if, that is a real thing. Aside from identifying with a false identity, manufactured by the APA (American Psychological Association), which is complex on its own terms, I must pose the question: is it ever okay to lose ground in your recovery? Or, I of you don’t like to use the word recovery, is it okay to lose ground in your health? Here is where I get confused. When is it ever okay to be less okay, than you once were?
Sure, we are all human. We have “ups” and “downs” that hopefully are not so high and low that life feels like a rollercoaster, or doesn’t meet the clinical threshold for mania and depression. Either way, that is okay too. But is that the goal? To experience life as it is and be okay with the hands we are dealt? For some people, this might be okay. For others, for myself, the hands I was dealt requires constant push back on my symptoms or aspects of my health I am not happy about. The issues with my health or symptoms require daily upkeep. When I lose ground I need to figure out quickly, in no uncertain terms, why I am losing ground and how to go about a course correction quickly before my symptoms outpace my ability to cope with life.
I am writing this because I worry about people being passive with their problems. This is partly from the personal experience I just revealed but also from what I know about the nature of problems to multiply, issues to become so overwhelming when we become passive players in our mental health. Being okay with where you are at in life is one thing. Being okay with failure is another. But being okay with not being the very best you can be, well, that is where I part from the author’s message in the Mighty. I get it, lets disable these disabling terms in mental health that stigmatize. But let’s not overreact to them to the point where we say something in which the message is not only unclear its teaching people unhealthy behavior.
Author Info:
Max E. Guttman
Max E. Guttman is the owner of Mindful Living LCSW, PLLC, a private mental health practice in Yonkers, New York.
