When Diagnosis Becomes a Narrative Technology: Diagnostic Capture, Recognition, and Interpretive Authority

A psychiatric diagnosis is often treated as simply a descriptive account of symptoms. But diagnostic labels also function as narrative technologies that shape how patients, clinicians, and institutions understand and respond to distress. Over time, interpretations made through a diagnostic category may come to function as evidence for the category itself. This paper examines the afterlife of a diagnosis: what happens to an interpretation after the clinical encounter in which it was formed. Although related to looping effects, the present analysis focuses on a different mechanism: how provisional interpretations become embedded within records, workflows, and classificatory systems, acquiring institutional durability across subsequent encounters. I write from the dual perspective of clinician and former patient. The framework I propose is not meant as a clinical intervention, but a tool for thinking about how diagnostic interpretations acquire authority, persist over time, and shape subsequent understanding.