Isha Nagpal
Diagnosis is a process of determining the nature and extent of a psychological disorder. In other words, it means assigning the label of a psychological disorder to a case on the basis of observable symptoms and various assessment techniques. Given the nature of psychological disorders, it is a fairly complex process to assign a name to some problem that a person is going through. Unlike medical diagnosis, psychological diagnosis involves understanding not only the tangible causes but also looking for certain intangible triggers that can affect a person’s mental health.
When it comes to diagnosing a patient with a mental illness there are a number of problems that can arise. Susan Heitler in her article titled ‘Psychological Diagnosis: Dangerous, Desirable, or Both?’ talks about some of these problems. One problem that she highlights here is that of the emergence of a self-fulfilling prophecy when a patient is diagnosed with a psychological disorder. For example, if a patient has been diagnosed with anxiety, they will be at a high risk of only focusing on the times when they feel anxious and completely ignoring the moments that make them feel more relaxed. She writes, “…using a label heightens our awareness of confirmatory data.” (Heitler, 2012) These problems can actually defeat the purpose of diagnosis by aggravating the symptoms of an issue due to labelling. However, some patients seem to think otherwise. Popular writer and poet, Joanne Limburg, wrote an autobiography called, ‘The Woman Who Thought Too Much: A Memoir’ in which she describes her struggles of battling with Obsessive Compulsive Disorder. She writes about her diagnosis as well, in an article, ‘What’s In A Label?’, in which she goes on to explain that getting the label of OCD was a relief for her as she could finally put all her symptoms into a box and know what the right kind of treatment will be.(Limburg, 2011) Patients often find a sense of belonging when they find that their psychological issues can be labelled.
This labelling can also help psychologists to understand the problem and find better treatments for them together. The help that they provide becomes more uniform and effective if there is a standardized diagnostic criteria present. Diagnosis can help psychologists anywhere in the world to be able to understand the kind of symptoms that one must have manifested to be diagnosed with something which helps them understand their patients better. It can also be helpful for the patients as they become more self aware and acknowledge their problem better with the help of an appropriate diagnosis. However, this self-awareness might also bring with itself stigma that the society might attach to a psychological issue. In the journal article, ‘How Clinical Diagnosis Might Exacerbate the Stigma of Mental Illness’ the author, Patrick W. Corrigan has classified the stigmas that people with mental illnesses face into three categories, namely - label avoidance, blocked life goals and self stigma.(Corrigan, 2007) He also goes on the explain how this stigma can arise due to diagnosis and deteriorate the patient’s condition even further. They often stop therapy and buy into the stereotypes that the society sees them in. These stigmas are directly attached to putting labels on people’s problems and putting them in categories which are seen to be homogenous. This reduces the patient and their problems to merely a word that might not be inclusive of all the issues that they face.
Another problem with diagnosis is that there can be instances of misdiagnosis in psychology and that can become a critical mistake. One such case has been described by Marilyn Wedge in her article, ‘Six Problems with Psychiatric Diagnosis for Children’ where she narrates the instance of a little boy who was, in a course of time, diagnosed with ADHD, then ODD, and then finally Bipolar disoder. The young boy had been taking psychotropic drugs for all these problems at some point or the other. This just worsened his situation and he had to be finally sent to a residential treatment home when everything else failed.(Wedge, 2011) This is not just one instance, these things happen to a lot of children in whose cases psychologists find it difficult to recognise the problems first and later change their diagnosis as the child grows.
Considering all of these things, we cannot reach to a conclusion on whether diagnosis should or should not be done. Doing away with diagnosis once and for all is bound to cause confusion and chaos among mental health professionals and the patients but continuing the same procedures of diagnosis is also leading to a number of issues that we can see here. We can merely say that it is a a necessary evil which might have unintended consequences as well.
References
Corrigan, P. (2007). How Clinical Diagnosis Might Exacerbate the Stigma of Mental Illness. Social Work, 52(1), 31-39. Retrieved from http://www.jstor.org/stable/23720705
Heitler, Susan. (2012). Psychological Diagnosis: Dangerous, Desirable, or both?. New York City, NY: Sussex Publishers. Retrieved from https://www.psychologytoday.com/us/blog/resolution-not-conflict/201202/psychological-diagnosis-dangerous-desirable-or-both
Limburg, Joanne. (2011).What's In a Label?. New York City, NY: Sussex Publishers. Retrieved from https://www.psychologytoday.com/us/blog/the-woman-who-thought-too-much/201109/whats-in-label
Wedge, Marilyn. (2011).Six Problems with Psychiatric Diagnosis for Children. New York City, NY: Sussex Publishers. Retrieved from https://www.psychologytoday.com/us/blog/suffer-the-children/201105/six-problems-psychiatric-diagnosis-children
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