Why would my therapist ask this?

I asked my therapist if he thought I was a certain diagnosis and he started questioning why I wanted to know. He then at some point asked "do you want to be ______?" I said no, I don't. He didn't give me a yes or no answer and pretty much danced around the question. I left accepting this, but now I feel uncomfortable as to why he asked that. It's driving me crazy and I won't be seeing him for two weeks.

I cant answer why your therapist would ask you if you wanted to be a certain disorder, only your therapist can answer that...

what I can tell you is that most treatment providers (mine included) that I know get a bit concerned when their clients come in asking whether they have a specific disorder. if I walked in to my treatment providers and said do you think i have such and such, they would ask me questions to find out why I am wondering this or if I possibly may have a mental disorder called fictitious disorder imposed on self or if I actually do have the symptoms and have been researching and trying to self diagnose.

its just normal for my treatment provider, and those that I know to question when someone walks in their door asking if they have a specific mental or physical health problem.

example if a friend of yours walked up to you and said "do you think I have the measles?" what would you say...

most people would say " why are you asking me that?" "do you want to have the measles?" "do you know someone with the Measles?"

All kinds of questions like this to find out why your friend is asking you if you felt they had the measles right.

in normal life people dont just walk up to their friends, family, and doctors asking whether they have this or that problem, especially if they dont want to have it. so when it happens it raises caution flags and questions as to why someone is doing that.

my suggestion is sit down and think about why you asked your therapist if you had a specific mental disorder. whether it was something you read about and felt it matched you, or whether you knew someone with it, or you have been researching that disorder... or..... well there are lots of reasons why someone may think and focus on a mental disorder.

then talk with your treatment provider and let them know why you asked about whether you had that specific disorder.

I think he is avoiding labeling which for some people can be a real downer. Some people tend to concentrate on the stigma of a label rather than on recovery. He may for some reason or another feel you might be such a person. It might help if you are able to articulate why it is important to know.

It bothers me a bit. I'm just confused as to why he asked "do you want to be this?" Why would I want that? Is he thinking I want to be miserable? It really only started bothering me after the session and now I feel like he was scolding me in someway because he may think my problems are less significant. Like "kid, you don't even know". But if that's the case, I would at least think he would say "no."

There are some T's that just don't like labels... mine is one of them. Some believe that labeling can lead to that diagnosis becoming a major part of how a person is viewed or how they view themselves. It can more or less become a self fulfilling prophecy. There have been studies where a diagnosis can lead to dehumanization and a lack of individualization.... it becomes more about what the client has and less about who the client is. It used to really bother me that T wouldn't give me a diagnosis but I have embraced that fact now.

I didn't just walk in saying I had something. I've been working with him for over a year, I've looked up the disorder and felt I related to a good chunk of it. I also have OCD, so yeah, I can get obsessive. I just wanted him to say no, now I think he's thinking I'm trying to **** with him.

I think it's also not unheard of for people to convince themselves they have a condition that they don't really have. Especially with mental health problems where symptoms aren't as easy to measure as, say, fever/no fever, vomiting/not vomiting or whatever. Someone can read the DSM description of bipolar or something and think, "hey, I have some of those symptoms, that explains everything" when some symptoms might occur in lots of different conditions. I doubt your T meant to scold you or act like your issues aren't important, but it's worth telling him how it made you feel. Your sense that your problems don't matter to him is important to bring up.

I don’t feel it’s out of place for a client to want to know their diagnosis or to examine if a diagnosis may relate to their situation.

When therapists are filling in their notes on clients, don’t they have to indicate a diagnosis for insurance purposes, etc.?

When people see their Primary Care Physician, don’t they expect a diagnosis?

It may be your therapist was genuinely asking why you want to know...or, perhaps it was a delaying tactic because they had not firmed up a diagnosis in their mind yet.

In the past when a therapist has said, ‘why do you want to know?’ I have taken it to mean they are reluctant to answer my question but didn’t want to say so.

I would bring it up again. Sorry you have to wait two weeks.

Similar but not the same situation but it might help...
When I had my first session with Awesome T I told him I had elected to have a psych evaluation and that I had a Dx that I was concerned that he would not feel comfortable working with. I asked T to meet me before I disclosed the Dx so that he had a chance to see me not the stereotype. We talked about it about half way through, I have Autism. He felt that I was high enough functioning, knowledgeable enough and open enough that we would be OK... but some T’s don’t have the training to work with certain Dx.
T also has me listed on my paperwork as “adjustment disorder with depression and anxiety” because this Dx is the least potentially damaging/limiting to me with insurance or in life in general down the road... even though I have the Autism Dx and clearly qualify for complex PTSD... both could negatively impact my insurance at the very least.
Third my T my T is very anti label. He knows I am afraid of interpersonal connection and he wants me to feel safe. He doesn’t need to make it into a disorder... there is a very valid reason(s) I am afraid of connection... it is a healthy, protective response... it isn’t like pneumonia or strep throat... it has just out lived its usefulness.

It kind of seems like he didn't quite think that diagnosis fits, so he was wondering why you brought it up. Either, he thought perhaps you would provide more specific insight about your symptoms that perhaps he hadn't picked up on (they only see us in a very limited setting), or he was being sure you weren't a google "expert" trying to self-diagnose (and perhaps incorrectly). Just ask him about it again.

Diagnosing from the dsm is not an exact science, the dsm itself is not that great and keeps changing because it is not an exact (or even to some real) science, and those guys are not all that good at it.

Exactly . . . or google . . .

You might just ask him, or show him your post.

Some patients to go into treatment wanting a diagnosis. There can be a lot of reasons for that. Seeking attention is one. Wanting disability benefits is one. Obsession with an illness is one. I think the therapist's question is pretty reasonable. She doesn't know from what direction the question is coming from so she asked an open question to get more information.

Maybe the T was curious or asked you for the reason so that he could frame the answer in the context you wanted?

I wouldn't be ok with not getting a straight answer. It's your service/treatment, which they are getting paid to provide. Keeping you fully informed is part of their job. I think the DSM diagnoses are crap, but if one is being recorded in your record or sent to insurance, that's more the reason to ask what diagnosis is being used.

To not tell the client because a T suspects a client may have a sinister reason to ask for one is ridiculous. The client has a right to know no matter what reason they ask.

Some Ts are anti-label, and that's fine. And to ask about your intention in wanting to know a diagnosis is also fine. But the asking if you "want" to be a certain diagnosis I find weird and patronizing. It would be not useful to ask such questions of a friend who has no expertise with which to answer them; but to be asking a professional who should both be able to pose an answer and has an obligation to do so, seems reasonable to me. To pathologize such a request seems absurd.

I have had multiple conversations (and disagreements!) with my providers about my diagnoses . This is an important part of their care for me. I would not keep seeing a healthcare provider who wouldn't discuss my diagnosis.

It is not unreasonable to want to know a provider's diagnosis for you, and why they're using that diagnosis - that is, why they think it fits you and/or why they're recording that rather than perhaps some other diagnosis (e.g. "adjustment disorder" vs "major depression").

Also, I do go in to my primary care doctor (or any other specialist) and present my symptoms and then I may say "so I've done some reading and I wonder if this is related to X". It is important to be an informed patient.

Raising questions about diagnoses can help clarify where the issues are - and that can direct treatment. EMDR may not make sense if your T thinks you have major depression, but if you have cPTSD it may be something worth considering.

Hi Cartdown,

Which disorder are you referring to?

It is possible that maybe you identify with that specific illness? I know I identify with Complex PTSD. Does that mean I want it? No - but I sure as hell want an accurate diagnosis that leaves me feeling validated and understood; otherwise how can treatment be effective?

Is this something that resonates with you?

Perhaps what this is what your therapist meant...?

Only one way to find out. Make sure you ask for clarification next session - or via email. There is a valid reason why this concerned you. Why do you think it does?

thanks,
HD7970ghz

Hmmm. I can very much understand and relate to this. I am starting with a new Trauma T tomorrow who specializes in certain dx. I am seeing her because my current T who I have been seeing for 4 years feels she is not exactly qualified to provide the type of assistance I need. That said...I am/was a very good actress for a long time. I have only just recently started to come to terms with some stuff. I have had many diagnoses over the years. I will see a new Psych next week as well, to discuss the meds I am on and whether the dx my psych nurse had written is the correct one. It's important...because for example medications for bipolar might be different than meds (or no meds) for dissociation.

ASK him next time. And try not to overthink it. It can be a difficult subject...because for someone like me, I present as quite normal and it confuses many people including providers who until recently I never let see the real me. As someone who can easily fall down the google rabbit hole though...maybe try not to read any more about the condition and focus on what is going right. You are in treatment. You are willing to ask and look and be open and get help. You are among others who can relate. So you are not alone.

Let us know how it goes!
FearLess47

FearLess47 brings up some good points. The other part of diagnosis is that we can find something that fits so well and in our desperation to understand our ailments and to heal - we begin to believe that we are our illness. Make sure not to lose yourself in the googling as is mentioned by Fearless47, as that can lead to all kinds of additional issues.

Diagnosis takes a long time to make. It is usually made through patterns of behavior over a long period of time. That is why continuity of care by multiple therapists can be so effective in reaching an accurate diagnosis.

But we know ourselves best. If something truly resonates, and you have read literature and relate to fellow sufferer's stories - then by all means tell your therapist how you feel about it.

Thanks,
HD7970ghz