Posted by alexandra_k on February 3, 2004, at 7:38:12
In reply to How to tell someone about diagnosis, posted by gardenergirl on February 2, 2004, at 21:01:44
Hi, sorry, more thoughts... Clinicians are starting to think that the current diagnostic categories or syndromes are a bit of a dead end with respect to research anyway. The DSM does not carve mental illness at the joints like biological taxonomy or the periodic table of elements. If the DSM V goes the way of the symptom I for one will sleep better at nights. If they consider symptoms to be on a continuim from mild to severe I may well have to revise my current opinion on diagnosis as a way of opressing people who provoke counter-transference.
My point (I am getting there I am getting there) is that most of the 'labels' that the diagnostic criteria provide do little more than promote stigma and encourage clinicians to assume rather than assess symptoms. Diagnoses can also be unhelpful with respect to predicted treatment outcomes and liklihood of improvement (what is the likely consequence of one believing they will not get better till they are in their 40's I wonder???) I found that in my case clinicians assumed symptoms I did not exhibit and I became paranoid and thought I was in denial for a long time until I met a clinician who told me that in their honest opinion - though I met the criterion - I did not seem to exhibit that particular symptom.
What are supposed to be the benefits of diagnosis?
1 - It leads to appropriate treatment.
2 - It can help people understand what is going on for them and help them access useful information and feel like they are not the only ones struggling out there with this.Why do this on the syndrome as opposed to symptom level I find myself wondering.... Why not assess her symptoms and address those symptoms with the best treatment for them that you can offer her. If that is DBT then so be it. What does the grand title 'borderline personality disorder' add to the equation other than prejudice and judgement of dinosaur clinicians with counter-transference issues?????
I don't see how the diagnosis would help one to feel less alone either. People with mental illness (even the dreaded borderline personality disorder) are not categorically different from the rest of humanity. Who does not exhibit borderline symptoms every once and a while, are we supposed to be such freaks of nature that we can only be understood by other such freaks? It is a difference in degree that is all (though I fully acknowledge that a big enough difference in degree CAN lead to a difference in kind I don't think BPD has evolved for long enough in isolation from adaptive functioning so as to be TOTALLY divorced from it).
Sorry this is a big long rambly rave.
Just a mad philosopher :-) .
poster:alexandra_k
thread:308679
URL: http://www.dr-bob.org/babble/psycho/20040131/msgs/308799.html