[lostwonder]

I've mentioned before that I see a Pdoc for T. He refuses to share a dx with me. He says it is because he doesn't want to pathalize things. I'm not quite buying it. I think I know what it is and that is why he isn't sharing. I would bring it up ... again, but it would just be me avoiding issues at hand. Anyone else ever been in this boat? How did you handle it, and what would you do differently?

[HazelGirl]

I think that a T or Pdoc is being irresponsible if they don't tell you when you ask. You have a legal right to know, so I would demand that they tell you what they think is going on and let them know it's within your legal right to know.

If he files with your insurance, just ask for the insurance invoice. The diagnosis code will be on there. Otherwise, I would have a real problem with a medical doctor (which he is) who refuses to tell me what diagnosis he is at least leaning toward. It may very well be that he hasn't decided on a firm diagnosis and is working on ruling out several, but personally, I would also want that information.

[lostwonder]

I'm sure that he bills GAD or something of the sort, so that would be useless. He has made mention that if he were to dx me I would fall somewhere in the dissociative range. Not as severe as DID. So that would leave PTSD (too much twisted thinking for that honestly) or BPD with psychotic features (this is what I'm thinking.)

[HazelGirl]

Can you just directly ask if you have BPD? Also, you could have both PTSD and BPD. And also, PTSD has a TON of crazy twisted thinking.

[lostwonder]

I could ask, but that would be me simply avoiding the work we are doing.

[UnderRugSwept]

Hi lostwonder,

When I pay and check out after my pdoc appt, I get the receipt from the front desk person (the insurance invoice) and it has the diagnostic code on it at the very bottom. I know that I have more than one diagnosis however, so that is where it gets tricky if your pdoc is not forthcoming with you as you may only get partial info from it...you definitely have a right to know your diagnosis!

ETA: Wanting to know you diagnosis isn't avoiding anything IMO...I would be uncomfortable with a pdoc trying to hide something from me! It would be like going to any other dr. and them refusing to tell you what they think you have.

[lostwonder]

From what I understand, a doc has the right to withhold a dx if they do not feel it would be helpful or could be detrimental for the client to know?

Originally Posted by lostwonder

From what I understand, a doc has the right to withhold a dx if they do not feel it would be helpful or could be detrimental for the client to know?

I've heard that in terms of reading your files, but not in terms of knowing your diagnosis. I would have a serious problem with that, especially if he is treating with meds. Is he prescribing meds at all?

[lostwonder]

Originally Posted by Elsewhere

ETA: Wanting to know you diagnosis isn't avoiding anything IMO...I would be uncomfortable with a pdoc trying to hide something from me! It would be like going to any other dr. and them refusing to tell you what they think you have.

In this case, I really think it is. I'm basically becoming fixated on something that would take us down a non-productive rabbit trail, because we are attempting to work on difficult material I do not want to address.

[HazelGirl]

Originally Posted by lostwonder

I could ask, but that would be me simply avoiding the work we are doing.

I don't agree with this. If you start the appointment with this as a quick question, it might only take a few minutes to answer.

[lostwonder]

Originally Posted by 1914sierra

I've heard that in terms of reading your files, but not in terms of knowing your diagnosis. I would have a serious problem with that, especially if he is treating with meds. Is he prescribing meds at all?

No meds for over 4 years now. If he were prescribing meds I would not be ok with this at all. He said he thinks the DSM is a load of crap, and he would rather treat the client and not a disorder.

This is from the AMA:

Opinion 8.082 - Withholding Information from Patients

[HazelGirl]

Originally Posted by lostwonder

No meds for over 4 years now. If he were prescribing meds I would not be ok with this at all. He said he thinks the DSM is a load of crap, and he would rather treat the client and not a disorder.

This sounds like it is more his theoretical framework to not diagnose. Which is still wrong because clients have a right to know what is going on in their treatment and why.

[Wysteria]

Personally, I think he has tried to keep the focus on you and your healing...from what you have written, he has given you some general idea, but "does not see you as a diagnosis but as a person". I think this is actually okay in some situations and as he is not treating you with medications. The dx codes are really just a list of characteristics of a certain disorder that help professionals talk to other professionals in order to give a RANGE of behaviours and thought processes to deal with. Also to tell insurance companies so that he will get paid for his services and if they have questions about why they are paying for a particular procedure/med/service etc...

I like that that he is keeping the focus on you. I have had to "deal" with some dx and it took me months to get over how I was told, what it entailed, how I disagreed/agreed, researched the dx...etc. Better to look towards treatment and future of healing in many cases...NOT ALL...but many. I put T and pdoc through the wringer trying to come to grips with some things.

In the end, they both finally convinced me that they don't subscribe to the "reputation" of the dx or believe that I have every characteristic or that I AM the dx....I am just a person that needs some help.

I do NOT know about the legalities, and I'm sure you could force their hand...but in the end, does it make a dang difference? Not particularly except where said DX might influence future care or my rights.

Just think carefully and take it all with a grain of salt.
I do not think it wrong to want to know...I just wonder sometimes if it is really worth it?
Just thinking out loud...I really don't have any right or wrong opinion. You have been given a lot of advice, and theirs is probably more correct...

Gentle hugs,
- WB

[Lauliza]

Originally Posted by lostwonder

I've mentioned before that I see a Pdoc for T. He refuses to share a dx with me. He says it is because he doesn't want to pathalize things. I'm not quite buying it. I think I know what it is and that is why he isn't sharing. I would bring it up ... again, but it would just be me avoiding issues at hand. Anyone else ever been in this boat? How did you handle it, and what would you do differently?

I understand when they don't offer up the information. But if you are an adult and want to know your diagnosis, your pdoc/T should tell you. I think a formal diagnosis is part of the service you are paying for.

[Salmon77]

Maybe it's worth talking about what you hope to gain by knowing the diagnosis. Do you think it would help you understand yourself better? Are you looking to feel understood by others? like part of a group? Would it make you feel like the problem was defined (and treatment defined, too)? What would the diagnosis do for you?

I always think of the time I went to a doctor for a rash. He looked at it and said, "Yep, you've got contact dermatitis."
"What's that?" I asked.
"Your skin is irritated."
"So... I've got a rash."
"Yep."
The moral of the story being: a diagnosis is just a word that describes what you're dealing with. It doesn't really cure anything by itself.

[Lauliza]

Originally Posted by lostwonder

No meds for over 4 years now. If he were prescribing meds I would not be ok with this at all. He said he thinks the DSM is a load of crap, and he would rather treat the client and not a disorder.

I think the primary dx they need to tell you if you ask. After that it's harder to sort out since you could have traits of many other disorders, especially where so many of them overlap. I think some doctors are reluctant to give personality disorders as a dx if they don't believe it adds value to the client's treatment. Of course some give them out all the time, and end up misdiagnosing people (like female clients dx'ed with BPD when they are really Bipolar or have Aspergers). If they aren't 100% sure it may be better to treat the symptoms as they arise but avoid giving too many labels.

What a diagnosis can do is allow you to have a clear frame of reference for what you are going through. It can allow you to find an understanding of your symptoms in the framework of a particular diagnosis rather than living in that limbo-land of not really knowing what the heck is going on. Being able to put a name on what I was experiencing, being able to do a bit of research and reading that was directed for people living with what I was dealing with every day was hugely helpful. I could read and see that what was happening was "normal" for that diagnosis. It was definable rather than feeling like I was trying to understand whisps of elusive smoke all the time. I have never felt like my diagnosis "defined me", but my diagnosis DOES help me understand me and accept me a great deal better than living all the time with not knowing for sure what the heck was going on.

[lostwonder]

I don't think that I will gain anything by it except another wasted session. If I do really well with it I may be able up waste 4-5 sessions. I honestly started seeing him about five years ago with a long break in the middle, and it has never been something I cared about before. I was just so relieved when I was told that I didn't have shizaphreina as I was previously dxed, that I didn't care. I don't ever want to become a dx, because often providers forget to the see person through the the dx.

So, I am wondering I guess why you asked the question if it isn't something you want to know anyway. I'm confused.

[Lauliza]

I think if there are particular symptoms that are really distressing to you, you can discuss them with your pdoc and go over what more can be done to help you. That's better than getting stuck with a run of the mill treatment plan for a certain dx, which your doctor seems to want to avoid.

[lostwonder]

Originally Posted by 1914sierra

So, I am wondering I guess why you asked the question if it isn't something you want to know anyway. I'm confused.

It is something that has been popping up quite a bit in my mind. If I were to analyze this, I would say that I am attempting to avoid what is really bothering me.

Originally Posted by lostwonder

I could ask, but that would be me simply avoiding the work we are doing.

I am so in agreement with your Therapist. Just from this forum I have rarely seen anyone go from point A to point B by knowing their diagnosis. Many times I wonder if this is not what hold many people back from healing. These are my opinions only.

If your therapist gave you a diagnosis will you then be satisfied to read everything you can about it, then work on each symptom you have based on the DSM? Then you will be cured?

My therapist was like yours, no diagnosis. She treated the symptoms of what I was experiencing, and presenting. Yes, she has a theoretical base that she leans on, yet, her treatment was individualized for me.

People on this forum pathologies others based on diagnosis. Can you be different? will you be different with yourself? Your Therapist is offering you a great opportunity to work on what you bring to him, no preconceived notions on how he has to work with you or treat you because of some label. Labels can be very powerful in all cultures — negative or positive, but very seldom neutral.

Interesting tidbit: I paid out of Empty pockets ($$$$) for testing to get a diagnosis once I completed therapy. It was planned previously to wait when I was haranguing my therapist for a diagnosis based on what a poster and her bandwagon said. Well that was a waste of time and precious funds. She had no diagnosis; depression did not register, very minimal anxiety, but patient knows how to regulate these brief moments, no axis ll, a medical disorder, that does not interfere with daily living. I wish I did not throw the paper work away, so that I could quote directly — it's long gone in the ash can. My ex therapist spoke to the testing psychologist after the fact, briefly and didn't even want a copy for my files, because it provided nothing new.

My ex therapist refuses to take insurance, including providing a super bill, because she does not believe in labeling, and she wants to always be truthful when she puts her name on it.

Best of luck to you diving into your work at hand.

[lostwonder]

Thank you for placing that into perspective there.