Diagnosis Du Jour

“The heart is hopelessly dark and deceitful,
    a puzzle that no one can figure out.
But I, God, search the heart
    and examine the mind.
I get to the heart of the human.
    I get to the root of things.
I treat them as they really are,
    not as they pretend to be.”                                                                                                                                                        Jeremiah 17:9-10 (The Message)

I know early on as a young counselor, when I had many fewer “tools” than I now posses, that I needed to learn a lot. You really do finally learn some things after 45 years of practice. There is an old saying which can be applied in so many situations. “When all you have is a hammer, everything looks like a nail”.

To people young in a profession, like new counselors, we learn certain tools and techniques, and we want to apply them. Perhaps unconsciously, we anticipate things that perhaps look like a good opportunity to try out those new tools, so we may start to see things through the lens of a particular diagnosis.  

I have found over the years that there have been certain trends of “hot” diagnoses. For example, as the Diagnostic and Statistical Manual periodically changes to stay current, diagnoses change or are added. I started my career when the Diagnostic and Statistical Manual (DSM for short) was the DSM- II. We are now on DSM-5. The change from Roman numerals to cardinal numbers, does NOT reflect that in my early years we still counted in Roman numerals! They changed the numbering system for several reasons.  

Early in my career, the Vietnam war had just concluded, and we began to diagnose a large number of Post-Traumatic Stress Disorder (PTSD) diagnoses. PTSD was added in DSM-III in 1980 when there was a surge in Vietnam era veterans seeking help for the trauma they experienced.

As the years went by, other diagnoses became popular. Attention Deficit Disorder became very popular in the early 1980’s and ADHD later came along and gained much traction in the popular culture.

Later still, we saw the dramatic rise of Bipolar Disorder, formerly known as Manic-Depressive Psychosis. The DSM in those days indicated that the prevalence in the population of Bipolar Disorder was around 1.5% of the population. Yet we saw an inordinate number of diagnoses of Bipolar Disorder, and the popular culture seemed to adopt this diagnosis for every mood swing that happened in the life of people around them.

These days, there seems to be a great deal of attention paid to Narcissistic Personality Disorder. Yes, it is a thing, however, the prevalence of the disorder is well under 2% of the population.  Indeed, we all have some narcissistic traits, because we are flawed humans whose first thought is self. However, we need to be careful when tossing out diagnostic determinations when someone exhibits selfish behavior.

The popularity of these diagnoses come and go. We just need to be careful to not get caught up in a wave of popular explanations for flawed human behavior.

 After all, every one of us fits into DSM-5 diagnosis somewhere.

Prayer: Lord, we are flawed and broken, yet you love us right where we are. We are thankful for that! Amen

2 thoughts on “Diagnosis Du Jour

  1. Sometimes when I read these I start wondering if you will be diagnosing when we are together!!!😜. Stay well.

    On Wed, Dec 2, 2020 at 9:40 PM Reflections of a Counselor wrote:

    > reflectionsofacounselor posted: ” “The heart is hopelessly dark and > deceitful, a puzzle that no one can figure out.But I, God, search the > heart and examine the mind.I get to the heart of the human. I get to > the root of things.I treat them as they really are, not as they prete” >


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