How do you and your therapist view importance of diagnoses?

Today I happened to be more observant (sometimes I dissociate so barely notice things) and noticed how different members seem to view diagnoses in different ways. What I mean is that some people don't list them, one person said in his/her sig that they are not important, other ones like to list them however.

What are your views on this? Do you think diagnoses are important so that they indicate that your problems are in fact real and understandable? Do you dislike them because they make you feel like you're a sick or ill person? How about your therapist, how does s/he feel about them? I know some therapists ignore them and try to deal with a particular feeling, like person feeling anxious or not loved. Other ones instead like to focus on diagnosis because they want to choose the right treatment for the whole illness (e.g. person with PTSD vs borderline personality might both feel similar feelings sometimes but the treatment may not be the same) .

In my therapy we deal with things as they come up. At this point it is more exploratory than really treating symptoms. Occasionally, like right now, I have a hard time with a number of stressors so I think of it in terms of my diagnosis with PTSD, that I am vulnerable to stress and have a strong stress response. That just helps me take better care of myself and realize that I need to take steps so I don't get run down or triggered. I believe that people are not their diagnoses and that most can go into remission.

Earlier on the diagnosis seemed more important because it helped me understand various things that didn't seem to go together. Now I'm more interested in the aspects of how the brain works so it's more abstract and not so personal. I think for some people a diagnosis can help them understand why they do or feel the way they do and so provide some relief or insight. But for others it is a label that they don't want to be identified by or with. It really depends on a lot of things.

Neither my T nor my pdoc place much importance on my diagnoses. They both treat what I'm experiencing, not my DSM code. All they use that for is insurance reimbursement.

If I'm taking medication I need to know why, exspeially because I question taking medication so often. So yes my dx is very important to me. It's a daily reminder of why I have to take my medication. It doesn't matter to T.

Yeah based on my own experience, getting that PTSD label helped me quite a bit. Nothing worse than feeling something strange inside and feeling like you're going crazy and not knowing what it is. A diagnosis gives you comfort. It tells you what to expect, how to treat it, how long it will take, how others responded, etc.

But later I did not like that diagnosis. I had looked at some book about PTSD and the author who was a medical doctor specializing in PTSD had said many people never get better in a significant way despite trying different therapies, that it takes many many years to get better (and other pessimistic things) and I remember having a series of terrible panic attacks after reading that. That diagnosis suddenly became my prison. I kept trying to find articles that would say otherwise and of course I did. On top of that, I had visited a forum where people complained about diagnoses being useless, that doctors who use DSM diagnoses don't care about people and just want to label them so they can drug them and charge people, etc. I can not describe to you how bad I felt.

That was many years ago. At this point I'm not sure how I feel about diagnoses. I think we need them to figure out what to do. But I think we have to be careful that they don't imprison us.

Here's an interesting read....

http://www.psychologytoday.com/blog/...bout-diagnosis

Both t's see it as low on the priority list

My diagnosis don't bother me, and I don't think they mean much. Neither does my therapist. In my mind psych diagnosis are not the same as a medical diagnosis, like AIDS for example. If you have AIDS you have AIDS, but if you have say "panic disorder" like one of the things I supposedly have then that just means you had enough of those symptoms that day.

Let's say I had a year where a close friend died, I lost my job, and was dumped by my fiancé. A month later someone breaks into my apartment and vandalizes it after stealing whatever I have of value, and I respond by walking into this scene and having a panic attack. And this panic leads to a chain reaction of worry and panic and depression...

No I don't think anyone is their diagnosis. At least I'm not. I have "major depression" and major baggage, but I maybe wouldn't have this had my parents not been so majorly f***d up and cruel. I look around and see a world of people that are nuts. I'm sure some of them think I'm nuts. It's all good.

Probably the actual diagnosis determines how much focus should be placed on it. I've said this before. A bipolar diagnosis requires different treatment than a major depression diagnosis. In fact, if someone with bipolar disorder is treated with anti-depressants because they are mistakenly diagnosed as having major depression (which is a common problem), the anti-depressants often throw the patient into mania.

My diagnosis is vital so that doctors who treat me don't make those kinds of errors in treatment.

Some other diagnoses aren't reliant on or reactive to specific medications, etc., so that kind of issue doesn't really come into play.

Personally, I feel if a therapist has a client who clearly displays symptoms of a major psychiatric illness such as bipolar disorder, schizophrenia, major depression, etc. and doesn't talk to the client about what they are seeing nor discuss what options they might have as far as specialists, etc., then the therapist is being negligent. Probably isn't so vital with some other disorders that generally don't have a medical treatment available as an option.

Therapists need to have some common sense about this issue and remember their own advice: nothing is completely black and white.

Thanks Jacq10 for that link, interesting read indeed, I liked it.

A hard question. My T likes to remind me of my diagnosis from my Pdoc to keep me from going off my medication. But then again, T also thinks there is more than just my Pdoc's diagnosis going on.

I personally try not to focus too much on my diagnosis because I think sometimes it makes things worse. It's almost like I start looking for symptoms that might just be normal reactions to events vs. being bipolar.

I don't want to BE my diagnosis, if that makes sense.

I find knowing the significance of symptoms and response to treatment be important for therapy. The specific label isn't important and if I don't quite meet dx. criteria, I don't care. My pdoc only used the specific dx. when I need documentation for accommodations. I did find the PTSD diagnosis helpful because it gave direction for therapy. Generally I think short-term CBT or IPSRT treatments tailored to each patient to be ideal, but in PTSD treatment, it's important to focus on the trauma. It's nice to know that is not only ok but necessary.

I agree that people can get stuck in thinking in terms of the diagnosis, when after all it is an illness or condition or disorder not the sum total of you as a human being. Even with PTSD, I have fought to get out of the victim mentality.

That said, I do think it varies with different types of diagnoses. They have different patterns and affect us in different ways. Some are more behavioral, some are more internalized. They respond to different treatments and different meds so there is not one answer that fits everyone. And people both clients and therapists differ on how much they use or emphasize them.

Myself, with PTSD, I think less about the actual diagnosis and symptoms and more in terms of the emphasis on trauma and its effects. I used to read lots about it. Now I just trust that when things come up they might have a residue of traumatic material along with them so I'm more attentive to that possibility and more open to working on it. It is not necessarily the diagnosis itself but the issue of trauma.

When I first stared seeing my therapist we discussed my diagnoses a lot. Now, we rarely ever discuss them since we made a treatment plan. She doesn't like to put a lot of emphasis on labels because she feels they take away from the experience.

I've seen 3 Ts and none of them have ever talked about finding a diagnosis...

Possibly the difference is if you require medication? Seems going to a Pdoc is all about getting diagnosis and possibly medication and seeing a T is to manage feelings

Not important at all, we dont ever even focus on it. I happen to have DID, PTSD, an eating disorder, etc. but those letters do not define me; they are not who i Am. I am so much more than a label.

My T doesn't think diagnostically...

I absolutely think practitioners have a responsibility to tell each patient what their diagnosis/es is, though I don't think they always record them in the medical record. Many will not write the axis II diagnosis in the medical record due to associated stigma. However, it's not fair to those who have had those types of diagnoses indicated in their chart since it can follow them for life. I noticed it's more common in nations outside of the US to add these dx in the record.

I think of dx more as educational tools but never thought of them as labels.

That's a great way to put it!

I think diagnosis is important. Treatment must be guided by diagnosis. Don't cut the patient open until you know what is wrong with him!

Madame T didn't. Diagnosis lets us think we understand
more than we really do, and makes us lazy and sloppy.

This was a major and persistent dispute between us.

Fortunately, Mr T agrees with me.