Disagree with therapist

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FauxLiz

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Do you ever get the impression that your T is going down a path toward adding a new diagnosis that you completely disagree with and don't know how to bring it up and discuss further without getting overwhelmed and highly agitated? I don't know if part of the struggle is that we are currently having to do teletherapy as the relocated to follow his wife for a semester graduate certificate program, if part of it is I feel like he disapproves of my decision not to attempt another inpatient trauma admission for my three week vacation next month but to go visit my dad instead. I don't know if it is just my distortions, my shame my denial that yet another mental health diagnosis may apply to my already highly screwed up life.

How do I figure out if he is trying to slowly acclimate me to the idea without actually naming the diagnosis, if I am just reading into things/overreacting or what.
 

scout86

MyPTSD Pro
How do I figure out if he is trying to slowly acclimate me to the idea without actually naming the diagnosis
There are probably a lot of ways, depending on the people involved. My T isn't a big fan of labels, so we don't talk about diagnosis much. (That's between him & the insurance company, basically.) But, because he & I seem to share a rather warped sense humor, if i was thinking what you are, I'd go with something like, "Are you trying to say I'm schizophrenic too???" (Although he also makes a deal about how we aren't our diagnosis, so there'd be a discussion about language too.)

I don't think there's any real harm in just asking, is there?
 

FauxLiz

Sponsor
Is he worried you will decompensate if you go visit your dad?
Yes he probably is, my parents (mom is dead now) were neglectful, emotionally disconnected, permitted significant bullying by my siblings and created an environment which enabled my older brother to abuse me by forcing me to share a bedroom with him until I was 6. My hometown is also the location of the majority of my sexual traumas with at least one perpetrator (other than brother who is dead now) still living in that community. I understand his disappointment but in my mind the visit next month to my dad is better than the alternative which would have been a command family appearance/performance during the holidays with all of my living siblings in attendance which I have honestly not managed to attend even remotely sober in over a decade. I have made major strides in reducing my use of alcohol and prescription medications to numb and avoid in the last two years a holiday full family visit I don't believe I am prepared for yet.

I don't think there's any real harm in just asking, is there?
There isn't any harm in asking, he is also not one that really discusses/emphasizes diagnosis but that is where I struggle. If I know that I have had an additional diagnosis added my self esteem becomes worse. I feel more broken, worthless and unlovable because I just can't seem to be healthy on any level. I denied my ptsd right up to the moment that I was admitted to River Oaks in 2018, and have verbally and emotionally fought against additional diagnosis because in my mind I don't want to accept everything that is wrong with me, my physical health requires me to have so many diagnosis I guess I just balk at the idea of additional mental health diagnosis.
 

Lumos

MyPTSD Pro
I would have to just ask, I'd probably end up getting angry/crying while asking. But then I'd know, and if I thought therapist was wrong, I'd tell them.
 

Muttly

MyPTSD Pro
Why do you think he's going to add a diagnosis? And if it's not something he typically discusses, does it matter? Could you be focusing on the idea of diagnosis to avoid other things going on in therapy? And is he disappointed that you are going or concerned for you?

Sorry for all the questions. If they don't help certainly disregard.
 

grit

MyPTSD Pro
I can honestly imagine the burden that is put on you for this mysterious go around thing in therapy. Gosh, why would a therapist ever swim around for another diagnosis and what would be the benefit?
Are you finishing your therapy and may be he is doing this for insurance purposes?
From my point of view from afar, I think probably your best bet is to bring your fear of having so many diagnosis and the amount of energy you are spending to avoid them...that itself could open the door for real therapy work about this particular fear. This is my take and I am sorry if this has already been discussed with your therapist and it is obsolete now.
 

mylunareclipse

MyPTSD Pro
I guess it depends on the diagnosis? Is he suggesting you have a substance abuse problem? Maybe he is just trying to make you aware of the symptoms, without necessarily meaning they warrant a diagnosis. ie. they could still fall under PTSD but it's the way PTSD manifests for you so he's trying to bring awareness for you?
 

FauxLiz

Sponsor
Why do you think he's going to add a diagnosis?
I guess it depends on the diagnosis?
I think that he is going to add another diagnosis because for the last three sessions he has referenced reading material related to a diagnosis that I don't currently have. The diagnosis is not a Substance Use disorder it is actually codependency which I find confusing and distressing (especially as the research that I have done I don't see how it could apply). For my upcoming vacation he plans to give me a reading list which I am fine with I plan to read quite a bit during my vacation and I prefer to be very informed and research the heck out of everything.

Are you finishing your therapy and may be he is doing this for insurance purposes?
I have only been in therapy with him for about 10 months and my insurance doesn't limit the number of visits by year or diagnosis which is good so it is not an insurance issue.

is he disappointed that you are going or concerned for you?
It could be both, I just feel guilty that he may be disappointed and I am not willing to change my mind.
 

mylunareclipse

MyPTSD Pro
I think that he is going to add another diagnosis because for the last three sessions he has referenced reading material related to a diagnosis that I don't currently have. The diagnosis is not a Substance Use disorder it is actually codependency which I find confusing and distressing (especially as the research that I have done I don't see how it could apply
Maybe he is trying to highlight you codependency tendencies to help you break out of them (this might not mean necessarily another diagnosis). I had(ve) a lot of codependency issues but I think that comes with the territory when it comes with trauma/depression. I think working on codependency issues helped me to gain control of my relationships, but changing the role I played in them, and made me feel more powerful. Don't be scared! You got this.
 

scout86

MyPTSD Pro
If I know that I have had an additional diagnosis added my self esteem becomes worse. I feel more broken, worthless and unlovable because I just can't seem to be healthy on any level. I
I totally relate to that!

The thing is, that way of looking at it is a problem all by itself. Or, maybe, it's indicative of a basic problem with the way you see yourself.

You aren't worthless or unlovable. You just aren't, even if you feel that way. I'm not sure what to do with "broken". I understand the feeling. Feel that way myself, if I allow myself to go there. I've just begun to suspect it's not a useful place to go.

From what you've said about him, I'm leaning in the direction of liking your current T. I think it might be good, really beneficial, to directly talk this through with him.

I had a bit of a meltdown when my T cheerfully announced that he thought I had alexithymia a few years back. For exactly the reason you gave. I think I went on a bit of a rant about "how many more ways are there going to be that I'm f*cked up?!" He really had no idea, until then, that particular issue was eating at me like it was. It was useful information for him and having it had made it possible for him to do a better job helping me work through it. It was a pretty good example of a situation where confronting a "problem" ended up being build the therapeutic relationship.
 

susannahsays

Confident
Just try to remember, "adding" a "new" diagnosis doesn't actually add anything new. You're already dealing with whatever you're dealing with. No doubt you already know that, but sometimes we have to remind ourselves of stuff like that.

Personally, I wouldn't like it if I felt like a therapist was tiptoeing around trying to get me used to the idea of a diagnosis before springing it on me. However, I am also not as diagnosis-averse as many people are, even when I disagree with a particular diagnosis.

I have had my own unwelcome process with the therapist I see regarding a diagnosis I did not accept. I mostly accept it now, although I find it kind of hurtful because I feel like it means I'm some sort of fake person. And that's hard, because I feel like a real person, like Pinocchio, only I'm a girl.

Anyway, to answer your question, I would just ask him what's up. There's no reason you need to try to figure this out in an indirect way - unless, of course, you're trying to find a way to obtain a particular answer.
 
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