Misdiagnosis Quotes

Eighty two percent of the traumatized children seen in the National Child Traumatic Stress Network do not meet diagnostic criteria for PTSD.15 Because they often are shut down, suspicious, or aggressive they now receive pseudoscientific diagnoses such as “oppositional defiant disorder,” meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dysregulation disorder,” meaning he has temper tantrums. Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.

Bessel A. van der Kolk

A refusal on the part of psychiatrists and therapists to validate the horrors of their patients' tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable. Such a denial is, however, no longer ethical, for it is in the human capacity to dissociate that lies part of the secret of both childhood abuse and the horrors of the Nazi genocide, both forms of human violence so often carried out by 'respectable' men and women.

Felicity De Zulueta

Conviction rates in the military are pathetic, with most offenders going free AND THERE IS NO RECOURSE FOR APPEAL! The military believes the Emperor has his clothes on, even when they are down around his ankles and he is coming in the woman's window with a knife! Military juries give low sentences or clear offender's altogether. Women can be heard to say “it's not just me” over and over. Men may get an Article 15, which is just a slap on the wrist, and doesn't even follow them in their career. This is hardly a deterrent. The perpetrator frequently stays in place to continue to intimidate their female victims, who are then treated like mental cases, who need to be discharged. Women find the tables turned, letters in their files, trumped up Women find the tables turned, letters in their files, trumped up charges; isolation and transfer are common, as are court ordered psychiatric referrals that label the women as lying or incompatible with military service because they are “Borderline Personality Disorders” or mentally unbalanced. I attended many of these women, after they were discharged, or were wives of abusers, from xxx Air Force Base, when I was a psychotherapist working in the private sector. That was always their diagnosis, yet retesting tended to show something different after stabilization, like PTSD.

Diane Chamberlain

My own studies on the natural history of DID indicate only 20% of DID patients have an overt DID adaption on a chronic basis, and 14% of them deliberately disguise their manifestations of DID. Only 6% make their DID obvious on an ongoing basis. Eighty percent have windows of diagnosability when stressed or triggered by some significant event, interaction, situation or date. Therefore, 94% of DID patients show only mild or suggestive evidence of their conditions most of the time. Yet DID patients often will acknowledge that their personality systems are actively switching and/or far more active than it would appear on the surface (Loewenstein et al., 1987).R.P. Kluft (2009) A clinician's understanding of dissociation. pp 599-623.

Paul F. Dell

Do You Have DID?Determining if you have DID isn’t as easy as it sounds. In fact, many clinicians and psychotherapists have such difficulty figuring out whether or not people have DID that it typically takes them several years to provide an accurate diagnosis. Because many of the symptoms of DID overlap with other psychological diagnoses, as well as normal occurrences such as forgetfulness or talking to yourself, there is a great deal of confusion in making the diagnosis of DID. Although this section will provide you with information which may help you determine if you have DID, it is a good idea to consult with a professional in the mental health ﬁeld so that you can have further confirmation of your findings.

Karen Marshall

When a client enters therapy with a prior diagnosis, it might be difficult for the therapist to think outside of the box presented. One reason a dissociative individual might have several different diagnoses, however, is that as different parts present, they may also be presenting with diagnostic issues that are different from the host. Such differences especially make sense given the nature of DID.

Deborah Bray Haddock

Denial and minimizing is often seen in genuine PTSD and, hence, should be a target of detection and measurement.

Harold V. Hall

...when different identity states convey contradictory information and then have amnesia for what the other identity states said, the patient may be thought to be lying. This can appear to be characterological mendacity when it is not.

Elizabeth F. Howell

The SCID-D may be used to assess the nature and severity of dissociative symptoms in a variety of Axis I and II psychiatric disorders, including the Anxiety Disorders (such as Posttraumatic Stress Disorder [PTSD] and Acute Stress Disorder), Affective Disorders, Psychotic Disorders, Eating Disorders, and Personality Disorders.The SCID-D was developed to reduce variability in clinical diagnostic procedures and was designed for use with psychiatric patients as well as with nonpatients (community subjects or research subjects in primary care).

Marlene Steinberg

...the vast majority of these [dissociative identity disorder] patients have subtle presentations characterized by a mixture of dissociative and PTSD symptoms embedded with other symptoms, such as posttraumatic depression, substance abuse, somatoform symptoms, eating disorders, and self-destructive and impulsive behaviors.2,10A history of multiple treatment providers, hospitalizations, and good medication trials, many of which result in only partial or no benefit, is often an indicator of dissociative identity disorder or another form of complex PTSD.

Bethany L. Brand

DelusionsDissociative disorders, even those created by mind controllers, are not psychosis, but this program will create the most common symptom used to diagnose schizophrenia. The child is hurt while on a turntable, with people and television sets and cartoons and photographs all around the turntable. New alters created by the torture are instructed that they must obey their instructions and become the people around them, people on television, or other alters when they are told to. When this program is triggered, the survivor will hear “voices” of the people whom the "copy alters” are imitating, or will have many confused alters popping out who think they are actually other people or movie stars. The identities of the copy alters change when the survivor's surrounding change.

Alison Miller

Interestingly, the patients who presented to me self-diagnosed [with Dissociative Identity Disorder had tried to tell previous therapists of their plight, but had been disbelieved. These therapists had used fallacious "capricious criteria" (KIuft, 1988) to discredit the diagnosis; e.g., that the patient could not possibly have MPD because she was aware of the other alters [sic!].

Richard P. Kluft

The case of a patient with dissociative identity disorder follows:Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.

Donald W. Black

There needs to be a nationwide awareness programme for all NHS staff, to educate them about dissociative disorders. Diagnoses need to be more obtainable within the NHS; people's lives should be placed ahead of funding restraints and bureaucratic red tape. We need minimum standards of care and treatment agreed and implemented within the NHS to end the current nightmare of the postcode lottery—not just guidelines that can be ignored but actual regulations.

Carol Broad

Sadly, psychiatric training still includes far too little on the very serious psychiatric sequelae of childhood trauma, especially CSA [child sexual abuse]. There is inadequate recognition within mental health services of the prevalence and importance of Dissociative Disorders, sufferers of which are frequently misdiagnosed as Borderline Personality Disorder (BPD), or, in the cases of DID, schizophrenia.This is to some extent understandable as some of the features of DID appear superficially to mimic those of schizophrenia and/or Borderline Personality Disorder.

Joan Coleman

In this chapter I restrict myself to exploring the nature of the amnesia which is reported between personality states in most people who are diagnosed with DID. Note that this is not an explicit diagnostic criterion, although such amnesia features strongly in the public view of DID, particularly in the form of the fugue-like conditions depicted in ﬁlms of the condition, such as The Three Faces of Eve (1957). Typically, when one personality state, or ‘alter’, takes over from another, they have no idea what happened just before. They report having lost time, and often will have no idea where they are or how they got there. However, this is not a universal feature of DID. It happens that with certain individuals with DID, one personality state can retrieve what happened when another was in control. In other cases we have what is described as ‘co-consciousness’ where one personality state can apparently monitor what is happening when another personality state is in control and, in certain circumstances, can take over the conversation.

John Morton

God whispered, "You endured a lot. For that I am truly sorry, but grateful. I needed you to struggle to help so many. Through that process you would grow into who you have now become. Didn't you know that I gave all my struggles to my favorite children? One only needs to look at the struggles given to your older brother Jesus to know how important you have been to me.

Shannon L. Alder

Misdiagnosis Quotes

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