Posted by gardenergirl on March 7, 2004, at 13:43:10
In reply to ???s about Borderline dx, posted by Racer on March 7, 2004, at 13:10:24
Racer,
I think the pdoc who threatened you with a diagnosis was totally out of line and contributes to the stigma of the borderline dx. I feel angry every time I read that. How dare him or her? I'm sorry that happened to you.I think, in a way, your T's refusal to name it also contributes to the stigma, but I can relate. I have a couple of clients who meet the DSM criteria for the dx, but I have not officially given it to them or told them. I think it is more important to work with the person, not the dx. Only occasionally do I wonder if someone would have a sense of relief at hearing that the troubles they are having are related to a cluster of symtoms that has a name and that others have the same group of problems and issues, too.
I go back and forth on this. I think for someone more stable, and with whom I have a good working relationship, and IF they ask, I might hand them my DSM pocket guide and have them look over Axis II disorders, PTSD, and mood disorders and see what they come up with.
I am lucky that I don't have to worry about reimbursement at the placement where I am training. Thus, I do not HAVE to give anyone a diagnosis. Although putting something that is definitely there on paper is helpful for other practioners, it does not give the complete picture of the client. And there is always the chance that another helping profession may request the records. If the client agrees, and I release them, then the dx is out there for others to see and react to and who may respond less sensitively.
The stigma in general makes me angry, because I love working with clients with borderline traits or diagnoses. I guess I have not experienced a long-term relationship with a client in which I became the object of devaluation (if I did, I did not know it.) That is one of the reasons some professionals don't like to work with clients with borderline. But I like to think that I would use that therapeutically and would have access to good supervision to cope with my countertransference.
Regarding your T, I'm sorry things aren't going well. She does seem like she thinks in terms of diagnoses. I'm not sure what she intended with her statement about Peter Cook. Have you shared your concerns with her?
I feel like I am rambling here, but I hope this helps!
gg
poster:gardenergirl
thread:321635
URL: http://www.dr-bob.org/babble/psycho/20040303/msgs/321647.html