Blindsided By Diagnosis

[SeaQuel]

Thanks for all of your comments.

Technically, it could be considered malpractice if they don't list everything.

If that were the case, then why wouldn't we have spent time doing official psychological evaluations (as well as reevaluations when new symptoms emerged)? My diagnosis has never come up for discussion since day 1. And if it were a malpractice issue, then there's no way she would just hit "delete" on a diagnosis as she did for me in that letter.

Also, I don't know why insurance coverage is getting so much focus in the thread. That's not at all what I want to talk about, what my primary concern is.

First, nothing is "obvious" to a patient, second she went against what you two agreed on.

Exactly. It was obvious in her head because this is her world and this is what she deals in everyday. There's no part of me who believes she did anything with malintent. She is a wonderful therapist. But I feel she forgot something that is a core concern for me. It would tantamount to forgetting about one of my major traumas after I worked up the courage and the words to tell her.

Have you guys created a lot of trust prior to this?

Yes, we really have. It's a taken a long time, but I do trust her and she has had my back more times than I can count. But the trust has now been ruptured.

If she put PTSD and depression, rather than major depressive disorder, t

She put Major Depressive Disorder. WTF.

I hope you don't give up on the relationship

I don't intend to. I have to wait a full week to see her again and get this sorted, though.

I'd want to understand what signs of depression she is seeing, and whether she believes it is actually a separate diagnosis

Yes, I need to ask for more specifics. But it seems like there is so much overlap between depression symptoms and PTSD. For example, isolation. This was one of the symptoms she rattled off when she said I fit the symptoms for depression.

I isolate because of my PTSD symptoms which mainly manifest physically - difficulty breathing, dizziness, etc. I don't isolate because I don't want to see anyone. I want to, it's just hard to commit to social plans and then have to back out because my symptoms are acting up. And she was the one who initially made me feel like I could give myself permission to take care of myself and just do what I need to do for me. She said that when I felt ready, I would go back to everything/everyone. I also quit some activities, namely some sports teams and grad school. Grad school was part time on top of full time work. And I just couldn't keep up, not with my symptoms the way they were. She was completely onboard with this also.

 

[Sandstone]

Now I don't feel as though I can be truthful with her about how I'm feeling.

That is the key issue, isn't it? You feel as though you have been attacked, in an unexpected place and manner. That is how it sounds anyway.

Can you unpack any more about why it is so important to you not to have extra diagnoses added unexpectedly? I can understand it from my own experience and viewpoint, but that is about liking accurate classification and labeling. This doesn't sound the same.

 

[Ed Norton]

I suppose it's just my angle of viewing things. I can't speculate as to why, exactly, your T did that.

 

[SeaQuel]

You feel as though you have been attacked, in an unexpected place and manner.

I hadn't thought of it it like that, and I think you're probably right. I had let my guard down in there, and then she rolled in a big bomb and set it off.

Can you unpack any more about why it is so important to you not to have extra diagnoses added unexpectedly?

Well it's a lot of different things, I think.

I have exceptional privacy concerns that have been reinforced by my line of work and by upbringing. Everything is vulnerable to exploitation.

I do not like the stigma.

I want to protect myself from having such diagnoses come up to bite me because of career or other aspirations.

I need my diagnoses to be accurate. Nothing else makes sense in my PTSD brain, but the diagnoses are one thing that should and must.

 

[lostforgottensoul]

Yes, we really have. It's a taken a long time, but I do trust her and she has had my back more times than I can count. But the trust has now been ruptured.

I really heard that in the orginal post and putting myself in your place, i can imagine how hurt i would be and how trust would have been lost.

Just in my opinion, in your next session, i would voice some of this (thay you havent yet) because she does own her part in it and the boundry of not diagnosing without you a part of it, needs to be agknowledged by her before trust can be fully regained.

Just my 2 cents.

Im really sorry this happened to you! :hug:

 

[lostforgottensoul]

But I really don't know / would be interested in finding out.

Me too! Im suprised i dont have a seperate diagnosis of depression/suicidal ideation, only think about suicide everyday...

 

[Leigh925]

Every time my therapist and I have experienced a rupture...whether my fault or his...and there have been both...has been an opportunity for me to grow. We have worked through them every time and as a result seem to work better and better together towards my end goal.

The first time was horrible. I couldn't make eye contact. I hated how I felt. I wanted it to be better but I didn't want to talk about but I also couldn't let it go. It still happens occasionally and I recover more quickly.

I say use it as an opportunity to strengthen your therapeutic alliance if you can. It sucks at first but totally worth it.

 

[SeaQuel]

I've been trying to let this go but I just feel totally betrayed. And confused. I will take this up with her during our next session, but it's not for several more days and I actually needed to devote that time to a different topic entirely.

All of the symptoms she listed are also symptoms of PTSD. Which is exactly what she had said all along. And then to have her slip this new "diagnosis" in, and then to just remove it. It all feels so confusing to me.

 

[EveHarrington]

I think I may know what you're going through. I recently had my psychiatrist suggest another diagnosis and as in your case, the symptoms overlapped with PTSD symptoms so I didn't believe that another diagnosis was warranted. I came home and had a bit of an anxiety episode. I felt that my doctor wasn't listening to me. I talked it over with a loved one who reminded me that doctors are human and can make mistakes. I did a bit of research into the proposed diagnosis and realized it didn't fit my symptoms. (Only one symptom fit into the diagnosis.) I finally calmed down and I'm armed with knowledge I can now use to discuss the proposed diagnosis with my doctor. He's overall a good doctor so I wouldn't leave him over this issue. I think he will listen to my reasoning at my next appointment.

 

[Sandstone]

Everything is vulnerable to exploitation.

I want to protect myself

These seem to be at the root of what you are feeling.

I just feel totally betrayed.

There would be no surprises.

she forgot something that is a core concern for me.

And these are the event that precipitated it

The big question is why those thing make you feel

Now I don't feel as though I can be truthful with her about how I'm feeling.

even though you have, up till now, built a good trusting relationship. That in itself sounds as though it was a huge step forward for you.

 

[Ed Norton]

I think that many of them do that. You never know what they are writing. Some will write bullshit. The best is to ask and clarify, she seems amenable to discussion.