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ECHOES: Many times I just call the office number, listen to her voice on the recorded message, and that is enough to help me feel calmer and safe again. I told her I do that and that was okay too.

I used to do something similar except in my case it was an online recording of Pema Chodron speaking about Tonglen (meditation) practice. I found tonglen to be helpful when I was in a lot of pain, but there were times I found it especially soothing simply to hear another human voice. I would deliberately seek out the audio version of the online article for that reason. That little audioclip made a handy addition to my personal toolbox because I could use it for self-soothing. It sounds as if you're using your therapist's voice for essentially the same thing.

alexandra_k: Ian Hacking talks about a phenomena that is distinctive to people. It has a paralell in physics, however called a 'paradox of observation'. The notion is that when we are categorised in a certain way (by other people or by ourself) then this causes us to behave differently. The very act of diagnosing a person can alter their behaviour so they conform to the stereotype that we have of their diagnosis.

You're probably also familiar with the Rosenhan study...<blockquote>In 1973, academic psychologist D.L. Rosenhan sent himself and seven friends and colleagues to the psychiatric emergency rooms of 12 different hospitals. Each told ER workers that for several weeks he or she had been distressed by voices saying "empty," "hollow," and "thud." The testers gave false names and occupations but otherwise accurately reported their histories, which did not include mental illness. In all 12 instances they were admitted to a psychiatric ward. At that point, they stopped pretending to have symptoms. Nonetheless, they were held for an average of 19 days (their stays ranged from seven to 52 days) and were all released with a diagnosis of "schizophrenia, in remission," or something like it. Rosenhan titled his study "On Being Sane in Insane Places" and argued that psychiatric diagnosis has more to do with the presumptions of clinicians, and their tendency to treat ordinary behavior as pathological when it occurs on a psych ward, than with a rational assessment of symptoms.

Source: Take the Shrink Challenge</blockquote>
The difficulty of reliable and consistent diagnosis has been an ongoing problem for those practicing within the field for a number of years...<blockquote>In 1949, the psychologist Philip Ash published a study showing that three psychiatrists faced with a single patient, and given identical information at the same moment, were able to reach the same diagnostic conclusion only twenty per cent of the time. Aaron T. Beck, one of the founders of cognitive behavioral therapy, published a similar paper on reliability in 1962. His review of nine different studies found rates of agreement between thirty-two and forty-two per cent. These were not encouraging numbers, given that diagnostic reliability isn’t merely an academic issue: if psychiatrists can’t agree on a patient’s condition, then they can’t agree on the treatment of that condition, and, essentially, there’s no relationship between diagnosis and cure.

...

Another study, whose primary author was Spitzer’s wife, Janet Williams, took place at six sites in the United States and one in Germany. Supervised by Williams and some of the most experienced diagnostic professionals in the world, the participating clinicians were given extensive special training before being split into pairs and asked to interview nearly six hundred prospective patients. The idea was to determine whether clinicians faced with the same client could agree on a diagnosis using the DSM. Although Williams claims that the study supported the reliability of the DSM, when the investigators wrote up their results they admitted that they “had expected higher reliability values.” In fact, Kutchins and Kirk point out, the results were “not that different from those statistics achieved in the 1950s and 1960s—and in some cases were worse.”

Source: The Dictionary of Disorder</blockquote>

alexandra_k: If you tell youself you have a severe and chronic condition and there will be many years before you improve...

I have absolutely no doubt that if I had presented to an emergency room in the state I was in, I would have received a diagnosis in line with "schizo-something". I consider it to have been an act of extremely good fortune that I didn't discover the "name" for my experience in this culture until more than a year had elapsed. At the point that I did discover that name, nearly everything I read told me I would never recover, that I would never get better. Fortunately, I was already well on my way to recovery by then. I don't think I'd have gotten there if I'd been told earlier in that process that I'd never get better -- that there was no hope for me.