The Power of Diagnosis




Over the past month, I’ve been getting soreness and tightness in my shoulder, which I assumed would go away it I didn’t do anything to make it worse. Almost overnight, I started having this all-day, dull pain in my shoulder. I felt like I could cry just sitting on the couch and I was having trouble getting in a comfortable position to fall asleep.


I decided to visit a physical therapist for an assessment. My physical therapist and her supervisor were amazing! They assessed my body and told me that I was experiencing referred pain, which means that the pain you are experiencing takes place in a different area than the actual injury. As it turns out, the problem is with my neck!


Just knowing there was a cause and solution to my pain had a major psychological effect. I felt so much better over the next 24 hours, despite just getting started with my exercise routine. I realized that I was probably working hard to make my shoulder (AKA not the problem) comfortable, while not supporting my neck. I changed my pillow setup and was instantly able to sleep through the night with no issues.


I realized my experience was such a perfect metaphor for therapy. Often, you go in feeling badly but unsure why. You might be experiencing referred mental health pain: physical (somatic) symptoms, emotions that don’t add up, or behaviors you can’t explain. Then you get a diagnosis and you realize that you’re experiencing a problem that others have shared, that has research on its origins and prognosis, and can be treated with real results. How amazing! I often find people start feeling better before they should even be experiencing the effects of therapy, just due to that increase in hopefulness.


Some therapists shy away from providing a diagnosis, because they don’t want to “label” someone or cause stigma. I completely disagree with this approach. First of all, we put more stigma on a label when we refuse to use it. Second of all, although our current DSM-5 diagnoses are definitely imperfect (I’ve got a few criticisms, and so do many experts), they are the best option we have currently for defining a mental health problem and tailoring its solution. While therapists should be cautious and culturally and ethically aware while assessing an individual and providing them with a diagnosis, once they have determined it is the best fit, it should be provided and explained in detail to the patient.


How do you feel about diagnosis? Has getting a label been helpful or hurtful for you?

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