Diagnosis....so subjective

On the face of it, it is so frustrating!

My ex T came back to me with some explanations of his diagnosis, quite in depth which is helpful. I can see where difficulties lie when making a diagnosis, and it is completely bloody subjective! He said other clinicians may formulate a diagnosis that is different, but he has not!

He ended with this....."I guess both sides hold some truth. I’m sorry I cannot be more clear as it isn’t always clear."

The more I think about this though(excepting of course those diagnoses that are very clear).......does it really matter? Does it really make a difference to me what the specific label is? Or does it not matter more that whatever therapy I undertake actually makes a positive difference in my life?

I think I am leaning towards not really caring what my label is, but I still have this huge.......If I don't get the right label then I won't get the funding to continue with therapy and that would be really not good at this point!!

Therapy, and diagnosis, it really is not an objective science at all! Don't you think?

It is not an objective science at all from what I have seen. I have clients who have their diagnosis changed all the time depending upon the hospital or md who saw them last. Even the judge jokes about if it is Dr. X then the client will have Y - or -- if client is held at Z hospital then the diagnosis will be X.
Sometimes then when the md gets up to testify and says what we predict, it is hard not to start laughing. Once, it was so obvious the md had not met with the client before making the diagnosis but was trying to come up with stuff, even his own attorney started laughing.

Yeah, totally subjective. Even those tests they sometimes make you fill out, YOU fill out subjectively.

Yes totally subjective, diagnosis made on basis of symptoms which are unobservable. I have no diagnosis / label. My T steered me away from getting one and as I pay privately for treatment I didn't need one for insurance purposes.

I know I can get very low, scared, zone out, have difficulty naming / feeling emotions......etc......all these things may be given a label by someone but it doesn't change my symptoms.

Diagnosis is very subjective for mental health. In fact, it even is in medical illnesses in a lot of cases. Not everything has a definitive test to confirm. Often diagnosis is made by a compilation of observable symptoms, a process of elimination, etc.

It matters because that's all we have until you've looked at your life and story in depth, than it doesn't matter. It simply becomes "well of course I'm like this, who wouldn't be given the same circumstances".
Than we become more interested in our human condition, not a dx or of a book.

It's great if therapists in UK can do that. Here, in the US, whether the therapist is on the insurance panels or not and whether therapy is covered by the insurance, they are still legally obligated to give a diagnosis. Many of them don't do that, but if someone files a complaint against them they'd better have a diagnosis in their records or else they'll get in trouble. It's amazing that many therapists don't know that. They believe that if they don't deal with insurances and all their payments come straight out of pockets they don't have to use the DSM and keep their records according to the medical "diagnosis-treatment" model. Not so. If they don't go through law and ethics course again, they are in for a rude awakening when someone files a complaint.

Are MA level therapists in the US qualified to diagnose? Here you have to be a PhD level clinical psychologist or a psychiatrist.

Yes, they are. Not only qualified but required to. There is no difference between the type of credential and the type of license when it comes to diagnosing. Everyone has to do it.

The reason for it, I think , is because psychotherapy is more regulated here, ans so when complaints come, the boards have to have the criteria by which they will evaluate the therapist's actions, and diagnosis and treatment are one of the criterias.

Yes, it can be subjective. But it doesn't necessarily follow then that it is without merit.

This is an argument I often hear in academic circles about those of us who teach in non-quantitative fields. Just because there isn't incontrovertible proof within an assessment doesn't necessarily mean that the assessment has no merit. It comes back to the skill and experience of the assessor.

Should you care about a diagnosis? It's a personal, philosophical decision. A diagnosis can be used as a tool for a professional--usually as a "working" diagnosis. As additional info is gained, the diagnosis should accommodate that. But either way, it's important as a guiding framework (not an inflexible box) for a professional in planning treatment (assuming you accept some sort of broadly evidence-based model for therapy).

Sometimes they give you a diagnosis based on some issues then see you through the lens of that diagnosis, forgetting that categories are simplified while individuals stubbornly remain complex.

I agree that non-quantitative approaches to many fields, especially those that include coming to understand human beings in their settings, are equally as valid. In fact I think this is the crux of the dilemma, which paradigm does the clinician sit in? And what if that is at odds with the service they work for. What if the service demands evidence based quantitative diagnoses, however in understanding the depth of the person in front of them this is impossible?

I think flexible frameworks are vital when working with people. And I guess this is where m ex T sits. Who knows though. But coming to understand me can't have been easy!! LOL

Mouse....I love your last statement about the human condition. Thank you.

I do think it comes down to how people are viewed by clinicians, from a deficit based perspective as individuals with problems, or human beings with inherent value that's have it within them to change grow and flourish in their own way.

I do think it comes down to how people are viewed by clinicians, from a deficit based perspective as individuals with problems, or human beings with inherent value that's have it within them to change grow and flourish in their own way.

This^. This is why I like the approach inherent in Counseling Psychology, as opposed to Clinical Psychology (assuming a good practitioner). While clinical skills are important, they are viewed within a greater paradigm of human development, rather than to define human illness.