Ep 3.10 - What We Talk About When We Talk About Diagnosis

A Therapist Can't Say That

In my last episode, Dr. Awais Aftab and I explored the controversial nature of Borderline Personality Disorder as a diagnosis.

One of the reasons I wanted to discuss BPD is that it opens the door for digging into psychiatric diagnosis itself, and that’s part of what I want to discuss more today.

What is our purpose in using diagnosis? How does it benefit us as clinicians and the clients who receive that label?

Getting more clear about the constellation of things we may be referring to when we talk about diagnosis, in general, is a crucial prerequisite for using specific diagnoses wisely, especially for using highly controversial and stigmatized diagnoses like BPD.

Even if you never use diagnosis, the language and concepts of psychiatric diagnoses are out there. It shapes our professional discourse, past and present, and increasingly impacts our clients’ thinking when they arrive in our offices. Diagnosis is complex, multifactorial, and profoundly impacted by context, and we must contend with it.

Listen to the full episode to hear:

• Why it is vital that we understand diagnoses and their value–or lack thereof–as constructs and constructs as tools
• How holding diagnosis as a lens, not a label, allows for more flexibility and curiosity
• The heavy lifting we expect from diagnostic constructs applied across multiple contexts
• Why it’s not always necessary to share how you’re applying a diagnostic construct to your therapeutic relationship with a client
• Why we have to learn to uncouple “difficult” from “bad” with our clients

Learn more about Riva Stoudt:

• 
  Into the Woods Counseling
• The Kiln School
• Instagram: @atherapistcantsaythat
  
  

Resources:

Management of Countertransference with Borderline Patients, Glen Gabbard