Diagnosis – or pejorative labels!

Bessel van Der Kolks’ statement that ‘childhood trauma victims typically acquire five or six different unrelated diagnoses in the course of their psychiatric treatment’ started me thinking about how many I amassed.

The 1st, on November 18, 1974 was ‘Depressive Reaction in a Passive Aggressive Personality’. I was 21 and this was less than 24 hours after my hospital admission. The 2nd on January 5, 1975 was ‘Depressive Reaction in Inadequate Personality’. On June 23, 1975 it was ‘Inadequate Personality with Depressive Features’. Of course I was probably not aware of these ‘labels’ then and only learnt of them when requesting my information through Freedom of Information in 2008.

My fear of being institutionalised, and my determination that I could overcome this, saw me avoid any contact with mental health professionals, even when I first (that I know of) experienced the horror of dissociation in 1982. Desperate, I made tentative steps toward seeing someone in the late 1980s but fear prevented me from continuing. Disintegrating rapidly, I finally sought out a psychiatrist in 1990. Although I am unaware of any ‘label’ then, in 1992 he wrote that I suffered from ‘A gross personality disorder’, and was ‘socially and emotionally crippled but not a prospect for treatment or rehabilitation’.

A neuropsychologist diagnosis in 1991 was ‘she is depressed and displays marked psychological and personality problems’. In the mid 1990s a psychologist diagnosed ‘Post Traumatic Stress Disorder’ – the closest and most relevant of all so far and later changed to ‘Complex PTSD’. A Professor of Psychiatry decided it was ‘Bipolar II’ – recanted – and it wasn’t until 2010 that my psychologist began to truly listen to me and it became ‘Structural Dissociation’.

There were probably many more within those years that I did not uncover in my research. Now ‘Somatic Symptom Disorder’ and ‘Dissociative Identity Disorder’ have been added to my list so that takes me well over the 5 or 6. Are any of them correct and/or relevant and what are the implications of all these labels?

This latest report states, ‘she was highly critical of the mental health service and the professionals and perceives them to be invalidating her story and ‘‘putting me in the same box as everyone else’’. “Nobody listens to me”. “She perceives that she was given the wrong messages.”’

Is that surprising? It seems there has been little improvement in the desire to attach ‘labels’ and damage already fragile people even further.

Bessel van der Kolk writes that in his early training he was, ‘surprised by the dispassionate way patients’ symptoms were discussed and by how much time was spent on trying to manage their suicidal thoughts and self-destructive behaviours, rather than on understanding the possible causes of their despair and helplessness.’