Michael JacksonMental health professionals are required, in many cases, to give their patients a specific diagnosis. This is not always easy and in this field there are many gray areas. In order to give a clear and concise diagnosis we are trained to use the Diagnostic and Statistical Manual of Mental Disorders often referred to as the DSM. Ideally therapists will treat their patients as individuals and not as their diagnosis. Some of my patients are very interested in what their diagnosis means and what the manual says about it. Others could care less and are more focused on the treatment.
It has always been my feeling that these diagnoses are best used when professionals consult with each other. It helps to give the non-treating clinician a picture of the situation, and sometimes even the person, but it by no means tells the whole story.
The danger with rushing to give someone a diagnosis is that the treatment plan is sometimes not tailored to the individual but instead it is the standard practice of treating "that diagnosis". It is a sad reality that I have seen many individuals over the years that have been profoundly misdiagnosed and this can be harmful in many ways. Some clinicians have what I call Pervasive Labeling Disorder. This is a silly made up diagnosis to describe clinicians who have a propensity to label all their patients--and often with the same diagnosis. This is self-serving behavior and, while I don't think it is deliberate, I do believe that it lacks insight and awareness on the part of the therapist. Most, if not all, insurance companies require a diagnosis in order to pay out on a claim and this can be a motivating factor for giving a label to an individual as well.
The DSM gives clear guidelines for each diagnosis and typically lists several symptoms. If the individual has a certain number of those symptoms, well then, they fit the profile. This does not make it an exact science and there are times when people desperately want a label so they can define what is "wrong" with them. This overlooks the unique process of the therapeutic interaction and can lead to inappropriate treatment.
I am not discounting the value of the DSM all together. In many cases a diagnosis is an important tool used to understand an individual's behavior. The DSM has many valuable uses, including training new therapists and communicating between professionals. And it is certainly useful when it comes to the assessment of whether or not a person needs a referral for medication. But I caution people about getting too hung up on either the presence or the absence of a clear diagnosis. Discuss with your practitioner what the label means and know that it is only one very small part of your personal story.
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There are many stigmas psychiatric patients have to over come. The one I have never been able to over come is biased opinions and treatment from other medical doctors, medical students, resident doctors and other medical trainees. They cannot get beyond the psychiatric labels. I have one of the most derogatory discharge summaries you would ever want to read. I sent a copy of it to the Chief of Medicine.
I can't tell if the labels were right but I have proved over the years their prognosis were wrong. Had the psychiatrists been correct I wouldn't have accomplished anything since 1974. I shouldn't have gotten the social security I am receiving as it is based on earned income. I don't pay any attention to what doctors say I am incapable of doing. I would think doctors would want to encourage their patients and not write them off.
NOW...I KNOW what my CORE ISSUE is, and can start healing. Before, I felt my husband and marriage was a big cause of my distress. NOW, I know that I have individual issues to deal with, as well as he has individual issues to deal with. I never thought it was ME that had the problem in our marriage...I thought I was 'perfect.' Now, I know how big a part I am b/c of my past history.
At first I was diagnosed as PTSD vs Bipolar 2...but I knew I was not Bipolar 2. Given my past history, PTSD made more sense. NOW, I am on different meds, therapy has been tailored to PTSD...and I am healing!
Yet, I had to resign from my Nursing Career due to Cognitive Dysfunction that wasn't there prior to my Delayed-Onset PTSD. For me, I am a details person and want to know everything I can about PTSD.
I am certain that I was NOT diagnosed as part of a catch-all or part of your pervasive labeling disorder, because the center where I was diagnosed was not one that deals directly with PTSD but a university health center that deals more with separation anxiety than anything else. I have since had three other mental health screens that have all confirmed the diagnosis. This was four or five years ago and I can say that I have come a long way in my healing process since, as I am now dealing with sanding away the scar tissue rather than dealing with the gaping wounds.
For some of us, the knowledge of what we are dealing with is instrumental in us being able to research and learn, as well as heal. It allows us to become advocates for others suffering from the same affliction and guides us in being able to work towards a wholeness that we couldn't by "shooting in the dark" abyss of that place where we know that something is not right, but we can't put our finger on it. I know and respect that others don't respond to treatment the same way, but for me, I know that it works.
So there is the other side, although I agree with both.