Personal bias and diagnostic labels.

I’m probably overthinking this, but I was wondering if my therapist’s giving me a C-PTSD diagnosis and not a BPD one could have to do with his having positive feelings about me. He admitted he likes me personally, not in a sexual way (I don’t think, anyway–and if so, I would not want to know) but he has said things like “I look forward to our sessions” and “You make my job easy” and well, I can just tell he is fond of me. As hypervigilant and over-attuned to other people’s reactions to me as I am (a very narcissistic trait, I think), I’d definitely be able to feel any negative vibes if they existed.

Would a therapist who sees the same traits in a person they like diagnose them with something non-stigmatizing or more open-ended (like PTSD or C-PTSD) and one they dislike with a highly stigmatizing label like BPD? Since diagnostic labeling is really such a subjective, unscientific thing anyway, I would guess personal feelings do play into this a lot, which is another reason why labels can be so dangerous. You could be stigmatized with a “personality disorder” even if you don’t have one if just one professional didn’t personally like you. Sometimes I think diagnostic labels aren’t even valid unless the client could be tested or evaluated by a team of different professionals who then decide together on a diagnosis. In a one-on-one client/therapist relationship where no tests are given, any diagnostic label given should probably be regarded as a matter of personal opinion. This is probably one of the reasons my therapist was so reluctant to give me a label in the first place and only gave me one because I insisted on having one.

In any case, it makes no difference whether I’m PTSD, C-PTSD, BPD, NPD, ABC or XYZ. I’m getting good trauma therapy and that’s all that matters.


17 thoughts on “Personal bias and diagnostic labels.

  1. These quotes got my attention “I look forward to our sessions” and “You make my job easy” and I am genuinely wondering if saying these things to a client are appropriate for a therapist. My first thought is that he’s got favorites and let’s those favorites know or he’s giving you the impression that you’re his favorite and maybe you are.

    He is human and I’m sure all therapists have their favorite clients. But I’m not sure it’s appropriate to mention it or give that impression to those clients.

    I mean, don’t those statements make you feel special? I’d be cautious. But then I also don’t know the rest of what he’s like except for what you write…so I know I could be wrong. It just raises a flag for me that’s all.

    Liked by 1 person

    1. Well, yes those statements do make me feel special. But my assumption is he says that to all his patients or at least the ones he likes. I could be his favorite but if I am I don’t want to know because then I’d feel like I’ve “earned” something and then I’d feel like I’d have to be on my best behavior all the time to “maintain” my “pet” status. (I know that sounds very narc-ish but it’s probably just human). It would be like earning brownie points for your teacher so you can be the pet. Of course that would work against therapy and I wouldn’t want that.

      I probably do idealize him (in fact I’m sure I do) but even if his saying such things is unprofessional, I don’t know if it’s wrong or unethical. He is fairly new in this field (he worked in another profession before) so it could just be he’s a bit green. Or he could be one of those therapists that believes in sharing (limited) feelings if he thinks it benefits the patient. Whatever it is, I’m not going to tell him to stop because I like it. 🙂 I do know he’s very ethical and aware of boundaries. If he were to cross certain ones, I wouldn’t be comfortable with that.

      Liked by 1 person

    2. You know what your comment made me think of, Tiger? Back a few months ago when you posted about your dad never allowing you to lock your bedroom or bathroom door — am I right that you couldn’t lock the bathroom, or was it just your bedroom? And even when you were a teenager, he would barge into your room unannounced any time he wanted, in order to “see what you were doing.”

      I remember I got all bent out of shape over that, thinking he was some kind of covert incestuous pervert, like my ex husband was. But you thought about it and came to the conclusion that no, he was just an over controlling a**hole. And I believe you, because I think you would know if it had been the other thing.

      As I was reading here about the things that Lucky’s therapist has said to her, about him looking forward to their sessions and that she makes his work easy, I can see why he would say those things and mean them in a healthy, therapeutic, affirming way. Just look at her blogs, how insightful and interesting her posts are. Judging by the way Lucky writes, I think she would be the kind of client that an intelligent and compassionate therapist would look forward to seeing. Especially with her incredible knowledge of all things psychological, along with her great insights and willingness to be super honest, even when it hurts — yes, these are qualities that should make a therapist’s job very easy!

      In any case, I hope Lucky knows that we are here for her, if this therapist starts going in the wrong direction. But so far I am not getting that vibe. Although, ahem, my vibes have been known to be wrong on occasion. 🙂

      Liked by 4 people

      1. Linda-
        You asked, “am I right that you couldn’t lock the bathroom, or was it just your bedroom?”

        Well, it was just my bedroom however, we didn’t have a lock on the bathroom door in the house I always defer to when talking about these things. It was that house where I did most of my growing up in…ages 10 to 20.

        That being said though, he did not barge in on any of us while in the bathroom. Seemed to be the room that commanded respect even for us kids. My mom however, got barged in by us kids and most of the time (while we were still young) she didn’t even bother closing the door.

        And yes, my antenna may be a bit too sensitive to comments like what Otter’s therapist said to her. I could be wrong and I hope I am. It just kinda sent up red…or maybe pinkish flags (lol) in my mind, that a therapist would give a client the impression that they are ‘so special.’

        I’m not saying that Otter isn’t. And no doubt with her knowledge and own insight, she is probably easy to work with.

        I hope I’m just being overly suspicious because from what she writes it does sound as though he is helping her dig even deeper.

        Liked by 2 people

  2. it gets really complicated when you might consider autism aspergers ,cen, bpd ,personal narcissistic protection of the psyche and now nvs.especially in the face of your high sensitivity.

    which for a working diagnosis validates the coerced nature of the experience of narcisstic abuse.
    Sounds like that book might be a good idea for exploring it ,please report back:)
    Your insight is priceless, i find myself googling my way back here to read further on stuff there shouldbe professionals discussing earnestly…
    Thank you luckyotter.
    healthy people have good boundaries, and know themselves sometimes it amounts to nothing more complex than that.
    but highly sensitive ? perhaps youve picked up on a spark of mutual attraction in his genuine compliments and are simply echoing his professionalism to acknowledge it but supress it.
    bit freudian but hey.

    Liked by 1 person

  3. plus yoursusceptibility to have romantic feelings for your therapist may be supressed over emphasised bonding that naturally excites you, to be cared for has a sexual element.
    i dont know the situation but requited or not it sounds like your personal or his personal genuine acknoledgement of attraction is real but not possibly sexual for either of you!
    imagine his other clients and you will seewhy hes glad to see a concientious insightful person come through his door.


  4. It is okay for a therapist to be a person for f’s sake and express feelings of caring and love. This is actually what heals, not some kind of detached pseudo intellectual disconnection. I personally left my last therapist because she lacked warmth. I am now with a therapist who is warm, who gets me and who validates me.

    Why shouldn’t a therapist have warm human feelings towards a client, especially when that warmth is deserved due to the person being a beautiful worthwhile human being.

    Liked by 1 person

    1. I agree with this, E. I would feel very uncomfortable with a cold, detached therapist. My therapist (from what I have been able to pick up) seems to be a very emotional, empathic person. Those are rare indeed. But this is exactly waht I need, I need a “surrogate parent” who really cares about me. How could reparenting/inner child work with a cold, rejecting, surrogate parent? I already been there, done that, and it didnt work out too good. I would not have been able to get so close to my own emotional core and even cry a little a couple of weeks ago in session had my therapist been detached. I can do so because I know my therapist can feel, too, and use that to help me.


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