Since the beginning of psychology as a science in charge of the study of the mind and human behavior, numerous investigations have been carried out to determine the origins, consequences and perpetuating factors of the vast majority of psychological disorders.
But… Does this initiative to give names to psychological phenomena have any drawbacks?
The American Psychiatric Association (APA) and the World Health Organization (WHO) are two of the organizations that have invested the most time and effort in trying to understand in greater depth and provide clarification about how mental disorders work, what are the symptoms associated with each of them, how to detect them (how many symptoms must be present to be able to establish an accurate diagnosis and for how long), etc. This information is reflected in their corresponding diagnostic manuals: the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-10).
Since the 1990s, the APA and other institutions such as the National Institute for Health and Care Excellente (NICE) have also been in charge of verifying which treatments are the most effective for each type of disorder, trying to establish empirical validations of different ways of carrying out carry out a therapeutic process.
Specifically, Division 12 of the APA created a working group in 1993 on the promotion and dissemination of psychological treatments based on the conclusions of its research, leading to the development of treatment guides with a theoretical-practical basis adapted to the characteristics of each disorder.
On the other hand, NICE’s action encompasses the provision of information, education and guidance, the promotion of prevention and the proposal of ways of proceeding in primary care and specialized services.
Different perspectives from which to investigate
The main difference that we can find between one organization and another is how the APA focuses on the research of “classic” or “pure” disorders, while the NICE addresses problems that do not necessarily comply with a clinical diagnosis, but rather implements strategies to improve general mental health (pregnancies, adherence to treatment, suspicions of abuse in childhood, well-being in the elderly, etc.).
In the case of the APA, “purism” is a factor that usually limits clinical performance because it is rare for a disorder to appear in its purest and most easily recognizable form, but criteria for other disorders (comorbidity) are usually met or more complex variations present.
Therefore, in psychology today we have a wide scope for research not only on the different typologies of disorders that we can find, but also on what are the most appropriate ways to approach them (to date).
Is psychological diagnosis useful?
Usually, the procedure when some type of psychological treatment is to be carried out is start with an evaluation phase In this phase, the interview known as clinical provides us with a large amount of information about the situation of the patient in question.
Depending on the current of therapy from which each psychologist works, the interviews may have a more open or more structured format, but they will always have the objective of knowing in the greatest depth. the functioning and environment of the person in front of you
The evaluation phase can allow us to establish a diagnosis if a disorder exists, since some of the difficulties that arise in consultation (known as Z codes) are not included in the diagnostic manuals because they are considered critical situations/changes in the life cycle more than mental disorders (cases of separation, marital dissatisfaction, difficulties managing the behavior of children, grief, etc.).
In the event that a disorder exists, in the evaluation phase (in which, in addition to interviews, standardized questionnaires can be used) we will have been able to clarify the symptoms, course and evolution of the patient’s condition as well as giving a name to the experience you are living.
This diagnosis, based on what has already been mentioned, allows us in a very useful way to know what difficulty we are dealing with and to establish the most appropriate treatment method for each person, so that we address the problem in the most effective and efficient way possible.
Should we always offer a diagnosis?
As health professionals we must take into account that each person is completely different from any other and that what we would transmit to one patient may be harmful to another.
The diagnosis helps professionals to understand and clarify the situation before us, as well as to layout and plan our way of acting to solve it. However, we must be very careful when establishing diagnoses, since there are several dangers:
The label can indirectly become a definition of the person
That is, we no longer talk about “X has schizophrenia”, but rather we can say “X is schizophrenic”.
The diagnosis can lead to victimization of the patient
Whether prudent or not, establishing a diagnosis can lead to the person being absorbed by their label: “I can’t do X because I’m agoraphobic.”
Poorly detailed diagnosis can lead to a state of confusion in the patient.
If sufficient information is not provided and the patient does not understand what is really happening to them, it is very likely that they will “fill in” the information gaps with data that they can extract from less reliable sources than a health professional, generating negative and unrealistic expectations about your mental state
The Diagnostic Label Can Generate Feelings of Guilt
“I have done something to deserve this.”
Conclusion
Taking this into account, it goes without saying that it is extremely complicated for psychologists not to establish a mental diagnosis of the situation that is presented to us, since the diagnostic labels They make it easier for us to understand the information in our mental schemas
But, despite this, if the patient does not directly request a diagnosis for some reason, it is likely that he does not need to know what the name of the experience he is going through is, and he simply seeks to resolve it.
On the other hand, if we find a great insistence on “labeling” what is happening, it is important to first clarify whether the request has a solid basis in the person or can be influenced and pushed by other media with which it is related (social links, internet data, etc.).
