Repression of emotions is common, but it does not necessarily indicate a psychiatric disorder.

Identity is plural, and people naturally perform different roles depending on social context.

Understanding the difference between individuality and pathology depends on control and social acceptability.

Some identifying details have been altered to protect confidentiality.

I took a psychiatry class years ago, and during lectures my professor used to say, “We all have a diagnosis.”

We used to laugh at that. It sounded provocative. But what if he wasn’t joking? What if diagnosis is not something “they” have, but something that exists on a spectrum we all live on?

When we started our practice at a psychiatric facility, I saw an unsettling scene in the hallway. A janitor was arguing with a patient about a painting. The janitor was screaming, “Give it to me, it’s mine.” At first, I thought maybe she was just having a bad day. Later I learned she had worked there for more than 10 years, closely with patients.

That was the first crack in my understanding. Who was the patient in that moment? The woman diagnosed with schizophrenia (a psychiatric disorder involving psychosis, disrupted thinking, and altered sense of self; Estroff, 1989), or the woman who had worked there for years and had slowly lost emotional boundaries?

Before entering the patients’ rooms, we were told to remove earrings, rings, and to tie our hair back. The rooms had no doors, just curtains, beds, tables, and windows. There were no mirrors or sharp objects because some patients were suicidal. I learned that psychiatric patients can be physically strong; their grip is powerful.

I was standing in the phone room, where patients could call relatives by request. One woman had already made a call but wanted another. The doctor, our professor, refused. She stood behind me, placed her hand on the phone, and would not let go. She screamed, “Give me the phone.” Helpers came, big athletic men........

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