I was visited by Mr. Delgado on Thursday morning for an initial consultation. Mr Delgado complained of not feeling himself and was having difficulty in work, and his wife was concerned because he was not his usual nurturing self as a father. Mr Delgado said, after speaking with a friend, that he believes he has one of the following disorders: Schizophrenia, Dissociative Identity Disorder, Bipolar Disorder, or PTSD.
After speaking to Mr. Delgado, I believed that he did, in fact, have some sort of disorder, as there had been a significant change in his behaviour from his normal state over the last few months. A psychological disorder can be diagnosed when there are “patterns of thoughts, feelings, or behaviours that are deviant, distressful, and dysfunctional”. He was exhibiting dysfunctional behaviour in work and was at risk of losing his job. At home, his behaviour had changed and was causing a distressful relationship with his wife and children.
Mr. Delgado had sought advice from a friend who had offered a number of possible disorders, which he could be suffering from. I wanted to thoroughly check these out before I rushed to judgement because labelling a patient with a disorder inappropriately can have significant consequences.
In a Psychology Today article, entitled “Psychological Diagnosis: Dangerous, Desirable, or Both?”, the author, Dr. Susan Heitler, discusses five reasons why labelling a patient can be counter-productive. Firstly, once someone has a label, it is difficult to see beyond the label to the person. They become the label. Secondly, they are more likely to notice the times when they act in accordance with the label and overlook the times when they do not. Thirdly, labelling someone with a psychological disorder can instil a blanket of negative feelings. Fourthly, they can cause the self-fulfilling prophecy, where the patient acts in a way consistent with the label. Lastly, but by no means least, having one of these psychological disorders can lead to treatment with pharmaceutical products, and it is important that only individuals who are in need of these medicines should get them.
As I considered the diagnosis his friend provided, I went through the symptoms for each one. Schizophrenia is defined by Myers’ Psychology for AP as “disorganized thinking and speaking (word salad), disturbed perceptions, and inappropriate emotions and actions. There are both negative and positive symptoms. Positive symptoms are the presence of inappropriate behaviours, including the classic symptoms - hallucinations (false perceptions), and delusions (false beliefs). Whereas negative symptoms are the absence of appropriate behaviours, including a toneless voice, Flat Affect (expressionless face), and Catatonia (rigid body, mute, or no movement).
Dissociative Identity Disorder is “simply a creative survival mechanism for coping with overwhelming and chronic childhood trauma.” It is expressed in the presence of two or m...