Mental Health and the Diagnosis-Happy Professional

Recently, I heard of the following story: a woman, distraught and led by a close friend (who's also a mental health professional) to seek mental health assistance was diagnosed with Borderline Personality Disorder at the third session.Granted, it was an intern who approached the diagnosis (haphazardly, at best) with the client and it was her supervisor (supposedly) that gave her the idea. But, really. Who are we to be slapping a label onto someone who comes in asking for help?

To be more specific about the needs of the woman, she was going through an extremely tumultuous divorce. Given the following symptoms of Borderline Personality Disorder and we could see why a (insight-lacking) intern might make the call to say the woman had BPD:

1) Frantic efforts to avoid real or imagined abandonment.

      Note:  Do not include suicidal or self-mutilating behavior*** covered in Criterion 5.

2)  A pattern of unstable and intense interpersonal relationships characterized by alternating between  extremes of idealization and devaluation.

3)  Identity disturbance:  markedly and persistently unstable self-image or sense of self.

4)  Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

Note:  Do not include suicidal or self-mutilating behavior*** covered in Criterion 5.

5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior***.

6) Affective [mood] instability.

7) Chronic feelings of emptiness.

8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9) Transient, stress-related paranoid ideation or severe dissociative symptoms.

See how the symptoms mimic what many people go through during the course of a breakup? To be sure, the woman did not have Borderline Personality Disorder. And, thanks to her friend, she was able to be reassured that she didn't. But the effects of having a "professional" label someone like that is much more damaging than it may initially seem and it stays with the client.

A lot of mental health professionals think they have the magic diagnosis stick and can bop any readily-available client on the head with it and be correct. This is so wrong on so many levels. True, diagnosis is needed for insurance purposes. But, to label a human being with a disorder when all they wanted was a listening ear, is a tragedy at the very least. It's no wonder non-professionals do this labeling every day -- even with themselves. The label is not the point. Being a good therapist/friend/listener is.