[kirby777]

Hi-

Had a second session w/ a new T yesterday (through the County). I asked her about my diagnosis. T: "You aleady have one.". Me: "MDD?". T: "Yes, but i also think you have a personality disorder.". Me: "Really? WHich One?". T:" Oh forget about labels.". End of session. How can she just through that term out and not specify where she is going with it?? (Sorry about the red font)

I am anxious about this and find it hard to believe after less than two hours of talking w/me and interupting, she threw that phrase out...she has already put down my past therapists/counselors...finished my sentances and basically has no idea who I am nor what my issues are.

What should I do?

[winter4me]

She sounds afraid...and she could be wrong...but she needs to answer your question honestly. And remember, you aren't the one who said it first---she is doing the labeling.
Once you "know", you can do your own research and decide...

Perhaps she is leaning that way but hasn't reached a final conclusion. Sounds like it is a discussion you need to have.

[amandalouise]

Originally Posted by kirby777

Hi-

Had a second session w/ a new T yesterday (through the County). I asked her about my diagnosis. T: "You aleady have one.". Me: "MDD?". T: "Yes, but i also think you have a personality disorder.". Me: "Really? WHich One?". T:" Oh forget about labels.". End of session. How can she just through that term out and not specify where she is going with it?? (Sorry about the red font)

I am anxious about this and find it hard to believe after less than two hours of talking w/me and interupting, she threw that phrase out...she has already put down my past therapists/counselors...finished my sentances and basically has no idea who I am nor what my issues are.

What should I do?

her reluctance to place a personality disorder name on you may be because...one the diagnostic criteria of what each mental disorder is just changed here in the USA (your profile says you are in eastern US). if she or her agency does not have thier new DSM 5 book (which is the book treatment providers here in america use for diagnosing mental disorders) she may not know what each of the mental disorder diagnostic criteria is now. she may not want to tell you one mental disorder and then find out you dont meet that mental disorders new diagnostic criteria for having that disorder..

another reason she may not want to name your personality disorder is because most if not all therapists in the USA are ....not....allowed to make a diagnosis for many of the mental disorders. Usually it is a psychiatrist that does diagnostic evaluations and then tells the client what their mental disorder is..

suggestion...if you really want to know what your mental disorder is talk with your treatment provider, and ask for a referral to a psychiatrist for a psychiatric evaluation. once that evaluation is done you will know if you have a personality disorder and which one according to the new diagnostic criteria in the DSM 5.

[kirby777]

I DO apologize for all of the spelling errors.....Thanks for the responses...i did google her and she has been in her "therapy" position for 3 months. I do not think she "gets" me as of yet....which is understandable since we have had two sessions. DUring our first session she brought up sexual activity which I thought was odd as I can barely function, sex is the last thing on my mind. She wants me to do thought logs and share them with her...I think that may be good down the road, however when a patient/client presents as myself~cannot do ADLs, is self isolating, cannot work, poor sleep...I just do not know.....

I can see DPD (sort of) and some others...Her report will go to the NP whom I will see next week , then WHO knows when I will actually see a psychiatrist.

Does any of this make sense?

[Perna]

She has her opinion (and is welcome to it :-) If you don't like this T, tell your agency specifically why (she interrupts, puts down your previous helpers, etc.) and get a different one that you can work with better.

Diagnoses are for the therapist, to help focus them, they aren't for the client and aren't worth collecting in my opinion, you can only work on one thing at a time; concentrate on the MDD or whatever issues you perceive and want to work on. If this T has only seen you a couple times, she just has an idea and will need to see you much longer to see if what she thinks she sees plays out. You don't have to know which one for personality disorders, just thinking it is a personality disorder can be quite helpful right there if you really want to work on it.

In general, having a personality disorder means you have a rigid and unhealthy pattern of thinking and behaving no matter what the situation. This leads to significant problems and limitations in relationships, social encounters, work and school.

From: Personality disorders - MayoClinic.com

[dillpickle1983]

I know at my clinic, where they offer doctors, therapists, PA's , CRNP's and groups etc. The therapists are very reluctant to diagnose somebody with anything. They would rather have a doctor or PA diagnose a person with said disorder. I think it has to do with mal-practice stuff and or just legal stuff in general. That's just my personal observation, I may be completely wrong.

[Favorite Jeans]

I think being very quick to diagnose a mental health issue (other than say acute psychosis or another emergency) is often the mark of a novice. It takes a lot more confidence to say "I don't know yet" or "let's figure it out together." Unless she has a lot of info about you from old charts or other sources, I don't see how she could possibly make a call like that in 2 sessions. Especially when you're also depressed.

[googley]

Originally Posted by amandalouise

another reason she may not want to name your personality disorder is because most if not all therapists in the USA are ....not....allowed to make a diagnosis for many of the mental disorders. Usually it is a psychiatrist that does diagnostic evaluations and then tells the client what their mental disorder is..

This may be true where you work, but everywhere that I have had work with clinicians the therapist diagnosis the client. The psychiatrist can give a different diagnosis for the client and if there is a difference in opinion those are then discussed. At least that is for people with degrees in clinical psychology. I don't know what it is for people who are professional counselors or social workers.

[kirby777]

I appreciate all of the responses. Who knows who diagnosed me at this place...I know I am depressed, anxious, have panic attacks, have PTSD (childhood trauma), agoraphbic, social phobic, angry, sad, etc.....

The med session with the NP should be interesting....

[wotchermuggle]

What type of therapist do you have? Official diagnoses here are only made by people with a PhD. So, my therapist can't technically diagnose me, but my Pdoc can.

[kirby777]

She has a masters degree.

Another statement I thought was odd: "I guess you are intelligent enough to read suggested book". I just stared at her wide eyed....

[Littlemeinside]

It´s very rare that someone get dxéd, with a personality disorder after only two sessions. Seems strange. I hope she is willing to clarify this in the long run. .... Even saying " personality disorder" is a label"...If she´s unsure/ not wiiling to name it, why put that label on you. I would run as fast as I can. Sorry

[wotchermuggle]

Originally Posted by kirby777

She has a masters degree.

Another statement I thought was odd: "I guess you are intelligent enough to read suggested book". I just stared at her wide eyed....

Yeah, unless the laws/rules are different between our countries, she can't technically give you an official diagnosis. You need a Pdoc or psychologist to diagnose you. Mine T has a masters too and while he's said "I think you have X", it's not official unless my Pdoc gives the diagnosis to me. That said, having a good T/Pdoc relationship can help your Pdoc to better diagnose you.

I would be wary of reading too much into this. I'd definitely question your T about what they are talking about. In regards to being smart enough to read a book, I'd honestly say, "Uh....should I take that as a compliment..?"

[Perna]

It could be she's just working/parroting off your file from other people in the organization that have seen you before her. I had a student therapist once that was big on that and all excited saying I had "classic signs" of Borderline Personality Disorder. I did not know/care enough at the time (only in my 20's) to realize he wasn't a very good therapist and I probably should have asked for someone else, sooner (eventually he moved on and my group leader recommended my therapist who was right for me and who I stayed with).

[peaches100]

It's possible that your t doesn't want to give you a diagnostic label that could prove to be discouraging for you.

A had a psychiatrist diagnose with me BPD after a short hospital stay. However, when I asked my t about it, she said that she and my own psychiatrist do not use the BPD diagnosis because there is such stigma and negative attitudes toward it. Also, she said that while I had features of BPD, she believed they were manifestations of my PTSD and that once the PTSD calmed down, so would the BPD traits.

[amandalouise]

Originally Posted by googley

This may be true where you work, but everywhere that I have had work with clinicians the therapist diagnosis the client. The psychiatrist can give a different diagnosis for the client and if there is a difference in opinion those are then discussed. At least that is for people with degrees in clinical psychology. I don't know what it is for people who are professional counselors or social workers.

like I said ....most if not all....meaning not every treatment provider is the same.

[FeelTheBurn]

Sounds like she's making a bunch of rookie mistakes. Understandable, but you aren't obligated to be her training tool if you're not comfortable. If it was just the Dx question, I'd cut some slack and recommend talking it out. But you've listed a number of ways she just isn't clicking for you, and hey, you're in a vulnerable place and feeling a lot of pain. You don't need a therapist who can't catch your rhythm and make you feel safe and heard.

If you have the option to change, I say PUNT! Let her train with someone with whom she connects. You need effective treatment, and that doesn't come with a T who is consistently rubbing you the wrong way or making you feel upset or confused. Life's too short; move on.

[sunrise]

Originally Posted by googley

This may be true where you work, but everywhere that I have had work with clinicians the therapist diagnosis the client.

Yes, this is the way it is in my state too (I live in the U.S.). The master's level therapist is trained in assessment and diagnosis and is usually the first to see a client at an intake appointment and so is the first to put a diagnosis in the chart. Later if the client sees a pdoc or NP for assessment and possible meds, that practitioner also makes a diagnosis. It may or may not agree with the therapist. As providers get to know the client better, the diagnosis may change. But in order for reimbursement, there has to be a diagnosis in the chart early. Where I have worked, one would rarely diagnose a personality disorder so soon. There would be a more symptoms-based diagnosis given, such as MDD, Anxiety disorder NOS, PTSD, etc. At most, "Axis II traits" might be mentioned in the write-up, in addition to the other diagnosis.

I am surprised this therapist would mention a personality disorder so soon, but since she did, I think she should explain.

[kirby777]

Thanks Sunrise-

There is poor continuity of care, right off the bat...a "psychotherapist" (per her business card) did my intake...She has a BS...then I was scheduled with the T (master's, in practice at this location for a few months). I had two sessions...and the PD was mentioned at the end, very casually when asked...Once she mentioned it, I inquired "really, which one?". Then it was the "deer in the headlights" face on her.

I had mentioned my dermatillomania during out first session, and I know I do it when I am in her office. She did ask if it made me feel better, which it does.