“The therapist hid my diagnosis from me”: is it worth doing this?

How do specialists explain their reluctance to communicate the diagnosis to the patient?

It is often argued that revealing the true diagnosis is harmful to patients. There are basically two arguments:

1. A person accepts the “label” that has been put on him and identifies with him, feeling shame. The symptoms of the disorder become part of his identity. Or he begins to justify unacceptable behavior with his diagnosis.
2. Stigmatization of mental disorders. The main reason is completely wrong ideas about them, common in society. The news that he is «one of them» can be a heavy blow to the patient. If he decides to disclose information about his diagnosis to others, he risks becoming an outcast.

Why are these arguments invalid?

• By avoiding talking about diagnosis, doctors and therapists further reinforce existing prejudices about mental disorders, from which they are supposedly trying to protect the patient. By hiding this important information, they seem to be sending a message: “The diagnosis of a mental disorder is a very serious problem.”
• Some specialists hide the diagnosis so that it does not become part of the patient’s self-image and destroy his self-esteem. But the patient still knows that he regularly visits a psychiatrist or psychotherapist, which implies the presence of mental problems and can also cause shame. The problem in this case is not in the diagnosis, but in the biased attitude of society towards psychology and psychiatry as such.
• Can only psychiatric diagnoses damage patients’ self-esteem? You might as well hide diagnoses of HIV, sexually transmitted diseases, obesity, alcoholism and drug addiction — after all, those suffering from all these disorders also face prejudice from society.
• Many people have completely wrong ideas about mental disorders, gleaned from popular culture, the Internet, advice from friends and non-specialists. Some, on the basis of this information, «make» themselves a «diagnosis», for example, of schizophrenia, bipolar or obsessive-compulsive disorder. They are sure that they will have a difficult treatment. Wouldn’t it be ethical to tell them truthful information about their true diagnosis, upcoming treatment, and prognosis?

What should a therapist do?

Here is what psychotherapist-supervisor Anthony Smith advises.

• It is worth considering how non-disclosure of the diagnosis will affect the relationship between the therapist and the patient.
• If a patient directly asks about their diagnosis, it is most likely not just curiosity. Let’s say he first came to the therapist, it seems to him that he is going crazy. It is important for him to understand what is happening to him and whether it can be dealt with. Knowing the diagnosis will only help him, he will be able to find other people with similar problems and find reliable information about his disease.
• In many cases, it is worthwhile for the therapist to offer to speak about the diagnosis himself, especially if the patient misunderstands what is happening to him.

“In most cases, the question is not whether to tell the patient about his diagnosis, but how exactly to do it. It largely depends on whether this knowledge will bring benefit or harm, ”Summarizes Anthony Smith.