if i was sure of having a specific mental ilness, can i tell my therapist?

I get how annoying (for the therapist) and dangerous it can be to "self diagnose", especially with something like quiet BPD, but if you suspected you have it because you meet all the criteria, and over the years showed very strong symptoms of it, would suggesting it to your therapist help or would it just annoy them and push them to look for sonething else just to "prove you wrong"?
Asked by Sarah014
Answered
12/06/2021

Hi Sarah, what an interesting question!  Therapists are all very unique human beings, just like their clients!   So we can't ever predict for certain how a given therapist might feel or act when faced with a given situation... it would depend on so many things, like the therapist's philosophy of practice, approach to counseling, and his or her values and personality.  It's true that when people feel annoyed (which is a mild form of anger) they sometimes cope with that discomfort poorly, by lashing out.  But a well trained will be able to recognize if he or she ever feels annoyed with a client, and will know what to do about that, rather than lashing out at you by doing something like selecting a diagnosis in an "oppositional" manner, just to prove you wrong.  My suggestion is to talk about the elephant in the room, Sarah!  In other words, let your therapist know that you have this worry that he or she might become annoyed with you if you suggest a possible diagnosis.  I think that genuine disclosure on your part would go a long way in to helping to ensure that your therapist keeps an open mind to suggestion of a diagnosis.   

 

But can we go a little deeper here and talk about the whole concept of "diagnosis?" The practice of labeling/categorizing people and their psychological problems, oh boy!... I know it's a very popular practice, but it's definitely got its pros and cons, Sarah.  It can be helpful in some ways but can really be counterproductive and growth-sabotaging in ways too.  I wish I had time to say more about the potentially damaging effects of "diagnosing" someone.     

 

The diagnosis of psychological issues is FAR from an exact science. If you went to 5 different therapists, I'd be amazed if they all diagnosed you with the same "mental illness."  So how can we then say that self-diagnosis is "dangerous" if it's so highly subjective to begin with?

 

  The only real problem I see with self-diagnosing is that many people might not be able to look at themselves very objectively, meaning they might be in some level of denial or self-deception regarding their thoughts, emotions, or behaviors.   But you are saying that you feel you have "BPD," or its latest flavor/incarnation "quiet" BPD.    So evidently you're not in denial, but do guard the opposite problem, Sarah!... OVER-identifying with a potential diagnosis.  Diagnosis is just a theoretical construct, ONE way of "seeing" the unique being that is YOU.  To over-identify with that theory, as if is some fact, would be limiting at best.   Bear in mind, the Medical Model (which includes diagnosis) is just one way to look at people and their challenges.  It's a problem-saturated way, rather than an empowering way, in my view. 

 

The diagnostic categories and criteria change every so often.  Supposedly that's based on emerging research but it seems likely that all sorts of factors (including cultural ones, politics, and the pharma industry) impact WHAT is studied and HOW it is studied and how we as a society choose to view and label human challenges.  After all, not all that long ago homosexuality was seen as a mental health disorder!

 

A diagnosis won't resolve anything.  It's just a shorthand way of identifying a group of symptoms that tend to "travel together."  At best, a diagnosis can help you and your therapist apply some potentially effective solutions, based on what's worked for other people who have a similar set of symptoms.  And yes, that can be helpful!   But don't let the diagnosis limit you or define you. don't take it all that seriously.  Treat it like an interesting acquaintance, don't fall in love with it.      

My best advice:  Make a list of specific positive changes you wish to see in YOURSELF, and in your relationships with others, and in your life.  Get to work on those goals with a supportive and empowering therapist who takes an approach that resonates with you. You can do that with or without a diagnosis, at least in my view!   Good luck to you!   Maya    

(MS, LMFT)