Sometimes I really struggle with diagnoses.
Mostly, I am good at diagnosing clients because I'm good at listening to clients. I am also extremely good at making sure that a person can answer a question that I need answered. Sometimes, I can make sure that the person answered in a way that was most effective for paperwork. This skill comes from... I have no idea. I don't actually encourage this skill in many other people. It's not effective in a majority of situations. I also question it's validity for myself. Essentially, I'm asking specific questions trying to get a specific type of answer so that an insurance can feel comfortable with what and why I am doing something.
The problem lies with the premise that an insurance company needs to feel comfortable with what I'm doing to help a person. Because I believe in community mental health in a capitalist culture, there is a lot of justifying that goes beyond "This person noticed a struggle, and I've been trained to help make the struggling stop"
The issue that I struggle with the most among diagnosing is that the terms are usually pretty upsetting for individuals that the term applies to. Personality Disorder implies that the human person is unable to function as a person. I avoid diagnosing people with a personality disorder even when I'm confident in that being an accurate diagnosis. Gender dysphoria is a strange and uncomfortable diagnosis for me. I feel like this is a weird psychological diagnosis because I don't have any treatment for it. I have treatment for the adjustment disorder related to coming out. I can treat the PTSD for the disordered reaction to any hate related trauma, or depression and anxiety about possibly dealing with those things. As for the "dysphoria" related to gender, therapists don't treat that, that's a medical doctor thing. I can help with self esteem, and that might be related to gender, but I am guessing that it's more related internalized messages from others.
The system is really broken, and I'm just living in it. I doubt that I would diagnose if insurance didn't require it. Which is possibly why other people are not great at diagnosis.
On a related/unreatead note. I read a wonderful book about gender identity. Which I received from NetGalley in exchange for a review.
Trans+ is a wonderful book about all the amazingly difficult things that are involved in the status and representation of someone's non binary gender. The book has medical facts, personal stories (from the authors and others) tons of additional resources and a real clarity. It breaks a muddled, confused and often argued about issue into manageable pieces. This book gives advice that should be used for all teens, and specific advice that only applies to trans individuals. Amazing book that is definitely going on my mental health therapist bookshelf and I recommend that anyone else working with trans individuals read it and recommend it as well.
Mostly, I am good at diagnosing clients because I'm good at listening to clients. I am also extremely good at making sure that a person can answer a question that I need answered. Sometimes, I can make sure that the person answered in a way that was most effective for paperwork. This skill comes from... I have no idea. I don't actually encourage this skill in many other people. It's not effective in a majority of situations. I also question it's validity for myself. Essentially, I'm asking specific questions trying to get a specific type of answer so that an insurance can feel comfortable with what and why I am doing something.
The problem lies with the premise that an insurance company needs to feel comfortable with what I'm doing to help a person. Because I believe in community mental health in a capitalist culture, there is a lot of justifying that goes beyond "This person noticed a struggle, and I've been trained to help make the struggling stop"
The issue that I struggle with the most among diagnosing is that the terms are usually pretty upsetting for individuals that the term applies to. Personality Disorder implies that the human person is unable to function as a person. I avoid diagnosing people with a personality disorder even when I'm confident in that being an accurate diagnosis. Gender dysphoria is a strange and uncomfortable diagnosis for me. I feel like this is a weird psychological diagnosis because I don't have any treatment for it. I have treatment for the adjustment disorder related to coming out. I can treat the PTSD for the disordered reaction to any hate related trauma, or depression and anxiety about possibly dealing with those things. As for the "dysphoria" related to gender, therapists don't treat that, that's a medical doctor thing. I can help with self esteem, and that might be related to gender, but I am guessing that it's more related internalized messages from others.
The system is really broken, and I'm just living in it. I doubt that I would diagnose if insurance didn't require it. Which is possibly why other people are not great at diagnosis.
On a related/unreatead note. I read a wonderful book about gender identity. Which I received from NetGalley in exchange for a review.
Trans+ is a wonderful book about all the amazingly difficult things that are involved in the status and representation of someone's non binary gender. The book has medical facts, personal stories (from the authors and others) tons of additional resources and a real clarity. It breaks a muddled, confused and often argued about issue into manageable pieces. This book gives advice that should be used for all teens, and specific advice that only applies to trans individuals. Amazing book that is definitely going on my mental health therapist bookshelf and I recommend that anyone else working with trans individuals read it and recommend it as well.
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