Are the semantics of “freedom,” “goodness,” “power,” and “belonging” characteristic of the stories narrated in psychotherapy by individuals respectively with phobic, obsessive-compulsive, eating, and mood disorders? To verify this hypothesis, put forward by Ugazio's model of semantic polarities, the Family Semantics Grid (FSG) was applied to the transcripts of 120 individual video-recorded systemic therapy sessions, the first two sessions carried out with 60 patients with phobic (12), obsessive-compulsive (12), eating (12), and mood (12) disorders and asymptomatic patients (12) with existential problems who made up the comparison group. The results confirm the hypothesis. All but one patient were correctly assigned to their diagnostic group only by drawing on their narrated semantics. The semantics alone therefore seem capable of defining the correct diagnostic group to which each patient belongs. We suggest considering the semantics as contextual and cultural diagnostic dimensions, expressions of the bonds but also of the resources of people, and above all useful for a diagnosis aimed at fostering processes of transformation and change.