Why do therapists “label me” by giving me a diagnosis? The truth about diagnoses.


There is a real fear in being diagnosed by a clinical psychologist and I do not blame people for feeling that way. Having some difficult diagnoses like bipolar or schizophrenia attached to my name would be utterly terrifying! So terrifying in fact that it may keep me far away from seeing a therapist until I absolutely needed it. If you ever had those kind of thoughts, you’re not alone. I recently had a discussion with a close friend who told me that his first experience with a therapist was not the greatest because the therapist really quickly diagnosed him as being depressed. He told me that it came so suddenly that the diagnosis made him even more depressed! I am really proud of him for not only switching therapists because the compatibility and fit were not good but he had to courage to try a couple more therapists until he found one that was very helpful.

Let’s talk about the purpose of diagnosis. I’ll be the first to admit that I do not like to diagnose people. In the early days of my graduate school training, this was an issue that I had to wrestle with because of that very reason of not wanting to shame and label people as something negative. As I became a more seasoned psychologist, I have come to peace with the whole idea of diagnosing because of the purpose it serves. In short, the only reason why a clinician would diagnose is because diagnosis informs and guides treatment. That is it. It is like someone who is suffering from a stomachache and goes to see a doctor. We would probably be shocked if the doctor said “I don’t really want to give a name or understood WHY you are having a stomachache. Let’s just try this medicine to ease the pain.” We should be concern about the medicine and ask “how does the doctor know what medicine to give?” If the stomachache is caused by food poisoning as opposed to stomach cancer, the doctor’s approach on treatment would be vastly different. But if the doctor refuses to acknowledge the source of the stomachache, it would be negligent care because the best the doctor could do is try to decrease symptoms without actually treating the illness. This is also true in mental health treatment. Again, diagnosis informs accurate treatment.

I also want to talk about what diagnoses are NOT. A diagnosis is not the identity of a person. Far from it! There are so many aspects of who you are and your diagnosis is not one of them. Someone may be feeling depressed but that person is not depression. It is a challenging experience someone is having for a reason but it does not define you. There is so much more to you than just your experience. For someone who is suffering from depression, that does not stop that someone from being a good husband, a caring friend, or someone who is into comic books for example. Diagnosis describes an experience for the only purpose of defining treatment and not the individual.

As a side note, the mandatory nature of actually documenting a diagnosis differs from setting to setting. Providers who work in a hospital and deal with insurance have to put down the diagnosis in documentation to show that the counseling is a “medical necessity.” This may prove challenging if you have certain aspirations for careers such as the military where specific diagnoses may disqualify you from getting into those careers or promotion after. The great thing about seeing a provider out-of-network (meaning the provider does not report any of your private information to any insurance panel) is that the diagnosis does not have to be documented. That means you can be treated in full confidentiality and safety. Either way, there is nothing more valuable than getting the treatment you need so that you can enjoy the most out of your life. Please don’t let a potential diagnosis keep you from living your best! For more entries like this, please visit me on my blog.

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