Does Your Diagnosis Reflect You Or Your Psychiatrist?

"I was diagnosed and described as ‘lacking insight' – ensuring that I would never be able to legitimately represent myself or my own experiences.” - B. Filson

Mad Studies Publications have enabled the voice of consumers of psychiatry to speak up about seeking help only to have their experiences minimized, reframed, or erased according to the psychiatrist's interpretations of symptoms.

The lack of insight paradox is one such example where a patient is given a diagnosis that they lack insight into the objective reality of their own experience, and that the psychiatrist, laden with knowledge of other people's mental health experiences, is better equipped to manage them.

The Knowledge Gap.

The gap between the stories told in lived experiences and the knowledge gained through epidemiology and quantitative research, particularly prior to the replication crisis, is mostly ignored in clinical practice.

The influence of the studies over the diagnosis depends largely of course on the clinician. Some clinicians keep well-informed on the latest research trends and are holistically inclined while others may still hold twentieth century biases and, despite the legal obligation, deny their patients any rights and privileges to make their own informed choices.

I recently heard a psychiatrist refer to trauma bonds as those we built as children and that most people who have been in toxic relationships would have consistently been in such relationships. This bothered me on two levels:

1. Toxic relationships are not the same as abusive relationships and I feel that a psychiatrist should have a stronger understanding of the differences between toxic and abusive, and why this type of minimization can be harmful.

2. If we must single-out anyone's behaviour in abusive relationships, it should be the offenders. Victim-blaming and resilience-shaming are no longer appropriate perspectives, particularly given its prevalence within institutional and systemic boundaries.

Having had a happy long-term relationship prior to the short-term abusive attempt, I find the blanket idea that victims must have been victims beforehand to be shortsighted.

Greater emphasis on the addictive properties of bread-crumbing and ghosting tactics in coercive control is necessary to avoid such generalizations that are harmful to victims already battling with the inner turmoil of self and other-blame for their role in the abuse.

We also can not deny the years of valuable knowledge, skills, and experience that comes with studying and working in psychiatry, so the solution can come from a more open-minded and inclusive practice.

The Capital Gains

The group that stands to gain the most from overpathologizing are those that capitalize on our ill health, the pharmaceutical giants and their investors.

While it may be true that a few goblins are sitting on overpriced heatpads and rubbing their hands together while plotting the ultimate demise of you and I for funsies, there is a good chance human beings are afoot with humans beings in their vicinity who they care for and love deeply, above and beyond all else.

Clinical trials on psychiatric medicines are not great, longer term efficacy is often insufficient with some people opting out after years of frequent adjustments and side effects becoming more problematic than the symptoms in the presenting concern.

Trust Your Enteric Nervous System!

Nobody knows you more than you no matter how many people might like to try, other people know how you make them feel, they may even know little things about yourself that you haven't noticed or take for granted, but you're still the you living your life experience.

The mind and body is a spectacular diagnostic tool all in itself. Dementia, Parkinson's, and even some cancers have been seen prior to diagnoses in prodromal dreams.

It is important to speak up when you're not comfortable with a particular diagnosis or even when there is no diagnosis, but you know something is not right. Diagnoses are rarely developed without contributions from health records and permitted family members, though again, these can be misinterpreted without consideration from your perspective.

Whether you're the type of person who runs with a diagnosis, following each and every recommendation like your life depends on it, or you're more of a cautious type, doing your own research and self-diagnosing, a psychiatrist can not be expected to take limited information and turn that into a definitive prescription.

Most psychiatrists entered the field with good intentions for the health and well being of other people so before you consider seeking a second opinion, first do your best to work alongside the person who is already invested in you.

Thank you for reading.

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