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Upper Valley Counseling: Working with a Diagnosis

Patients in treatment us with sometimes report that they have been given a diagnosis at some time in the past, recent or otherwise, and they report that the diagnosis is a source of worry. Diagnosis is a critically important procedure in medicine: it is the essential first step in planning a course of treatment. Whether a physician is treating a rash or a life-threatening condition, the correct diagnosis points the way to the correct way to treat the illness. 

Some diagnoses are extremely reliable, usually because they are based on highly specialized tests which produce consistent, verifiable outcomes.  Tests based on the presence of substances in the bloodstream such as sickle cells, or the absence of other substances such as vitamin C are very reliable and therefore very useful.

However, when it comes to our behavior or internal mental states, diagnoses are often much less precise. In the past we’ve observed a team meeting in which a social worker, a behaviorist, and a psychiatrist were unable to agree on a diagnosis for an individual. They all had the same facts, but they could not agree because they were basing their diagnoses on how the individual was behaving. Observations of behavior and of statements a person makes are simply not as precise as blood analysis, and therefore yield more subjective results.

This is especially true for young people. Adolescents who have been repeatedly evaluated during their childhood may carry numerous behavioral or psychiatric diagnoses. This may be because their behavior at eight or thirteen suggested those diagnoses to one or another evaluator. That person may have outgrown those behaviors long ago, yet these outmoded diagnoses, carried on their school records, can influence how they  are perceived and treated from the time of diagnosis on.

In the mental health field, a diagnosis may be quite accurate, but it can also be thought of as one possible explanation, or perhaps as a possible guide for further inquiry. Or it may be something that has been outgrown and left behind, and good riddance to it.

A person who has been troubled by a diagnosis may want to discuss it fully with their therapist.  A diagnosis, especially one in the world of the mind, is not a life sentence that dooms the patient to repeat some of their life’s past mistakes. And it does not mean they can never change and learn new strategies to improve their life. A Vermont Talk Therapy professional can help with these worries. If you or someone you know is in this situation and would like help working through it, let’s talk about it.   

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