There were 66 comments here so I read those before posting. I was a professional counselor/psychological examiner for over 20 yrs. and had a private practice. I was a conservative then, too. I also did grief counseling.
The reason for any diagnosis is this: If a person cannot control his/her own life well enough to carry on his/her usual life, a diagnosis is usually called for to determine why this is happening - but this variant behavior must persist for a length of time to give a diagnosis. Just because the DSM V we use, gives a directive as to length of time for a diagnosis, I wouldn’t have to use that time if I thought it was too short for a patient – remember every patient is different and a cookie cutter diagnosis does not exist if the evaluator has reason to differ with the length of time stated or any other reason that would adjust that diagnosis.
As long as a person can make decisions and carry on his/her life, there is no reason for a diagnosis of anything.
Concerning the grief process: The same applies with grief. As long as the person can make decisions and carry on his/her life, there is no diagnosis pertaining to grief. Now, consider, a person stays in bed for a year because the husband died. That situation could call for a diagnosis but only if that diagnosis was required for some valid reason.
A diagnosis is not a diagnosis until it is on paper (considering a computer as paper these days). In other words, I might think in my mind the patient qualifies for a certain diagnosis but until I record that, it doesn’t exist. If I had no reason to record it, I didn’t. Also, once notes about a patient are made, they are subject to be taken to court if for some reason the patient is in court. I didn’t record notes unless the sessions were paid for by another entity, like Texas Rehabilitation or Social Security. I had the ability to remember from one session to another, the last sentence the patient said in counseling the week before and we picked up there. I protected my patient’s confidentiality that way; if I had no notes there was nothing to take to court. If I had made a recorded diagnosis, I had better be able to defend that diagnosis in court.
If a private patient came in for grief counseling, I wouldn’t immediately write down a diagnosis - that would be ridiculous. Each person deals with grief in his/her own way. One can’t put a time limit on grief as going through the process changes as time goes by and that is individual for every person. In my opinion, it is new experiences that help dull the pain of grief and eventually there are enough new experiences that the patient thinks of those intermittently with the grief – it’s not constant grief as it was and as more time and experiences happen, the time spent on grief is less and less.
The grief is gradually put in a box in the brain and the person’s life goes on. However, all the person has to do is think of what’s in that box, and the grief comes back for a time. I have gone through a number of family deaths, my husband’s the latest, and those boxes are there. When I think of one of those boxes, I still cry. We would be inhuman if those memories weren’t there. I can’t cry for long as my Yorkie insists on licking the tears and that gets messy.
So, Freepers, all psychologists and counselors are not suspect to be as most of you think. Note I left out psychiatrists. A story: a counselor worked for a psychiatrist. This counselor came to me one day and asked how I “cured” people because the psychiatrist had a patient she was seeing and the patient’s insurance was almost out and she wanted this person to get better before that happened. She had noticed my patients did not come to me for years, mainly a few months at most. I told her my counseling methods to help people “cure” themselves. In my mind, I was thinking it was a terrible thing the psychiatrist was doing – writing prescriptions and keeping the patient until the insurance ran out. My method was, get the patient able to handle his/her life without me and get out of my office as fast as possible.
I hope this helps you better understand how diagnoses are made, why they are made, and maybe you can feel better about some of us. There are even psychiatrists who care about their patients – I just wasn’t around any in my work – the ones I dealt with were insurance money freaks.
Great post! Very informative and well stated!
Thank you for your thoughtful, reasoned and well written post. Refreshing really.
As you said, grief is normal and everyone deals with it differently. However if someone is unable to function due to extreme grief or more likely the resulting depression; they can’t work, are unable to enjoy anything in life, withdraw from family and friends, even stop taking care of their homes or themselves and it persists over an extended period, weeks, months years, then that is not normal grief and counseling or even in some cases, medication is probably warranted.
My wife had one two actually over 11 years ago who missed a Serotonin Syndrome diagnoses for prescribed antidepressants. She was being treated for PTSD, Clinical Depression, and abuse. The PTSD was set off by a dentist giving her a wrong medication nearly killing her.
With that said her LCSW she began seeing 11 years has been a true Godsend.
Thanks for your well-written professional take on this issue.