Let me start off by saying – I love assessment and diagnosis. It feels so good as a psychologist to walk my clients through a thorough testing process and finally give them the answers they’ve been craving for years – a solid, well-reasoned diagnosis can bring so much relief and affirmation to someone struggling through “Am I making this up?” Point is, I am a big fan of formal assessment.
That said, it rubs me the wrong way when my colleagues scoff about self-diagnosis: “They’re just saying that because they saw a Tiktok video about the disorder” or “Everyone’s a professional these days.” And part of me does empathize with this viewpoint, but over the years, I’ve seen the value and benefits of self-diagnosis – so if you’ll bear with me, I’ll explain my Unpopular Opinion that self-diagnosis can be a good thing in therapy.
The first thing a self-diagnosis tells me is that you’ve put a lot of thought into your problems. Oftentimes, clients arrive at self-diagnosis after taking multiple quizzes, journaling about their experiences, and reflecting deeply for hours on their unique circumstances. Even if they arrive at the “wrong” diagnosis, the work they’ve put in won’t go to waste! In fact, the valuable insight they bring is often a big help to kick-starting our therapy together.
For example, let’s say “Elizabeth” comes to therapy with self-diagnosed Bipolar II disorder. I ask Elizabeth how she came to that diagnosis, and right away, I get a plethora of helpful information – she tells me all about her family mental health history, the last time she went for days without sleeping, the last time she felt so depressed she couldn’t get out of bed… Whether or not I agree with Elizabeth’s self-diagnosis, the self-reflection she has done is incredibly valuable to our work together.
The second thing a self-diagnosis tells me is that you are open to sharing the vulnerable, “messy” parts of yourself that we often sweep under the rug. We can’t begin to address a problem until we know about it, and being upfront with your therapist about the shameful pieces is immensely helpful! Self-diagnosis tells me you aren’t hindered by the stigma that keeps so many of us hush-hush about our mental health, which is a positive sign for your eventual outcomes in therapy.
The third, and maybe most important, thing that self-diagnosis tells me is that you’re willing to put in the effort. In the above case, “Elizabeth” is telling me right away that she is doing her own research, and that means that when I give Elizabeth homework – articles to read or exercises to try at home, between sessions – she is likely up for the challenge. In therapy, I often say that “you get out of it what you put into it.” Even if Elizabeth doesn’t quite meet the formal criteria for that particular disorder, she has shown me she is capable of putting in the effort to make positive change and meet her therapy goals.
In summary, I might be in the minority here, but I say bring your self-diagnosis to therapy! Tell me all about the social media post you saw about a disorder and why it “clicked” for you. Be open and vulnerable about your problems, and we can find out together how to help you to cope with them.
Dr. Chelse Song was a previous Postdoctoral Fellow at EK Counseling