Understanding, Accountability, and Change

By Naila Qureshi, M.A. | Executive & Relationship Coach | Speaker | Grief Educator | Founder MindBodySpiritss, LLC

Exploring the Intersection of Self-Awareness, Accountability, and Human Potential

Understanding, Accountability, and Change: Can They Coexist?

As conversations about mental health become more common, psychological terms have increasingly entered everyday language. Words such as trauma, attachment style, anxiety, ADHD, narcissism, emotional regulation, and boundaries now appear in workplaces, relationships, social media discussions, and personal development spaces.

For some people, this growing awareness has been life-changing. It has provided language, validation, and a pathway to support. For others, it has raised important questions about whether labels help people grow – or whether they sometimes limit the way we see ourselves and others.

The answer may not be as simple as choosing one side.

The Value of Understanding

One perspective is that frameworks, diagnoses, and psychological concepts can help people make
sense of patterns they have struggled to understand for years. A name for an experience can reduce
confusion and create a starting point for support, skills, and change.

For many individuals, having language for their experience can replace shame with clarity. Instead of
thinking, “I am broken,” a person may begin to understand, “There is a pattern here, and there may be
support available.”

From a clinical perspective, diagnostic systems are intended to create a shared professional language.
The DSM-5-TR, for example, defines and classifies mental disorders to support diagnosis, treatment
planning, and research. Used appropriately by trained professionals, diagnostic language can improve
communication and guide care. [1]

This is one reason many people defend mental health language: when used carefully, it can bring relief,
context, and direction. It can also help people seek appropriate professional support instead of suffering
silently.

The Concern About Labels

At the same time, many people express concern about the growing use of psychological labels in
everyday life. Human beings are complex. A single word can never capture a person’s history, culture, coping strategies, values, environment, relationships, and capacity for change.

When labels become identities, they may leave less room for flexibility. A person may begin to think,
“This is just who I am,” or others may conclude, “They will never change.” This can be especially
damaging when a label is used casually, outside a professional assessment, or during conflict.

A 2021 systematic scoping review found that diagnostic labels can have a wide range of consequences,
including effects on self-identity, social identity, stigma, treatment expectations, support, and behavior.
The point is not that labels are always harmful or always helpful. The evidence suggests that the impact
depends on context, use, meaning, and the person receiving or applying the label. [3]

More recent experimental research also suggests that labels can increase perceptions that someone
needs professional treatment and may increase empathy and support, while also sometimes reducing
perceptions of personal control and likelihood of recovery. In other words, labels can open doors and
create barriers at the same time. [4]

The Accountability Conversation

Perhaps the most emotionally charged part of this conversation is accountability.

Some people worry that explanations can become excuses. They may hear statements such as, “I
cannot help it,” “This is my trauma response,” or “This is just how I am,” and feel that responsibility has disappeared. For loved ones, colleagues, or family members impacted by harmful behavior, this can feel invalidating and unfair.

There is also another side. Many people who live with real mental health challenges work very hard to
understand their patterns, repair harm, seek support, and change behavior. They may already carry
shame or stigma. To assume that every person who uses mental health language is avoiding
responsibility would be inaccurate and unkind.

The diagnosis or label itself does not determine accountability. What matters is what a person does with
the information.

A framework can be used to avoid responsibility. It can also be used to increase responsibility. The
difference often shows up in behavior: willingness to reflect, repair, seek support, practice new skills,
and remain accountable for impact.

Behavior Before Identity

From an educator and coaching lens, one helpful shift is to focus on observable behavior rather than
defining a person’s entire character.

Instead of asking, “Who is this person?” we might ask, “What behavior am I observing?” Instead of
asking, “Are they good or bad?” we might ask, “What pattern is helping or hurting this relationship, team, or situation?”

Behaviors can be examined. Behaviors can be challenged. Behaviors can be reinforced, modified,
learned, and unlearned. This approach creates space for both compassion and accountability.

It also prevents us from collapsing a whole human being into a single label. A person is not only a
diagnosis, a mistake, a coping pattern, or a difficult season. People are more complex than their worst
behavior, and behavior still has consequences.

The Role of Coaching, Education, and Referral

As a coach and educator, the safest and most ethical position is not to diagnose people or debate
whether a person “has” a specific disorder. That work belongs to qualified licensed professionals who
are trained to assess, diagnose, and treat mental health conditions.

A coaching and educational conversation can still explore important questions: How does language
shape identity? What patterns are showing up? What behavior needs to change? What support may be
appropriate? What responsibility does a person have for the impact of their actions?

The International Coaching Federation emphasizes ethical practice, clear agreements, accurate statements about qualifications, appropriate professional boundaries, and referral when a client’s needs
move outside a coach’s competence or scope. ICF referral guidance is also explicit that coaches do not
diagnose or offer treatment, and that psychotherapy is outside the coaching scope of work. [5-6]

For this reason, educational writing on this topic should avoid assessing any individual, assigning clinical labels, or presenting coaching content as a substitute for therapy, counseling, diagnosis, or medical advice. It can, however, invite reflection on behavior, accountability, self-awareness, and growth.

Holding Two Truths at Once

Perhaps maturity requires holding two truths at the same time.

We can seek to understand ourselves without becoming defined by a label. We can acknowledge our struggles without surrendering responsibility. We can extend compassion without abandoning accountability. We can recognize patterns while still believing in the possibility of change.

Longitudinal research on personality pathology challenges the idea that patterns are always fixed. At the
same time, it also shows that impairment and behavioral difficulties can persist and may require
appropriate support. This reminds us that change is possible, but not always simple. [2]

The goal may not be to decide whether labels are good or bad. The goal may be to stay curious about
how we use them.

Reflection Questions for the Reader

Do labels help us understand ourselves more deeply, or do they sometimes become limitations?

When does an explanation become an excuse?

How can we offer compassion without removing accountability?

What behavior, pattern, or impact needs attention – regardless of the label attached to it?

Can understanding our patterns and holding ourselves accountable coexist?

These questions may not have universal answers. But they invite an important conversation – one that
sits at the intersection of self-awareness, accountability, and human potential.

References and Evidence Notes

[1] American Psychiatric Association. What is the DSM? The DSM-5-TR is described as the latest edition of the Diagnostic and
Statistical Manual of Mental Disorders, used by health care professionals as a guide for diagnosis. The APA also notes that DSM criteria are meant to be evaluated by trained professionals.
[2] Skodol, A. E. (2008). Longitudinal course and outcome of personality disorders. Psychiatric Clinics of North America, 31(3), 495-503. doi: 10.1016/j.psc.2008.03.010.
[3] Sims, R., Michaleff, Z. A., Glasziou, P., & Thomas, R. (2021). Consequences of a Diagnostic Label: A Systematic Scoping Review and Thematic Framework. Frontiers in Public Health, 9, 725877. doi: 10.3389/fpubh.2021.725877.
[4] Altmann, B., Fleischer, K., Tse, J., & Haslam, N. (2024). Effects of diagnostic labels on perceptions of marginal cases of mental ill-health. PLOS Mental Health, 1(3), e0000096. doi: 10.1371/journal.pmen.0000096.
[5] International Coaching Federation. ICF Code of Ethics. Current code effective April 1, 2025. The code emphasizes ethical practice, clear agreements, confidentiality, boundaries, accurate statements, and professional integrity.
[6] Hullinger, A., & DiGirolamo, J. (2018). Referring a Client to Therapy: A Set of Guidelines. International Coaching Federation. The guidance states that a coach does not diagnose or offer treatment and should refer when client needs are outside the coach’s qualifications, experience, or agreement.
[7] California Board of Behavioral Sciences. About the Board. The BBS describes itself as California’s licensing and enforcement agency for LMFTs, LCSWs, LPCCs, LEPs, and associates, with a mission to protect consumers through standards for safe and competent mental health practice.