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Misdiagnosis Quotes

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Misdiagnosis Quotes

“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.”

“It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. The hospital itself imposes a special environment in which the meanings of behavior can easily be misunderstood. The consequences to patients hospitalized in such an environment-the powerlessness, depersonalization, segregation, mortification, and self-labeling-seem undoubtedly countertherapeutic.”

“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.”

“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.”

“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.”

“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.”

“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.”

“My other client, whom I will call Teresa, thought Lorraine had MPD and hoped I could help her. Almost no one recognized this condition in those days. Lorraine was forty years old and had been in and out of psychiatric hospitals since she was thirteen. She had had various diagnoses, mainly severe depression, and she had made quite a few serious suicide attempts before I even met her. She had been given many courses of electric shock therapy, which would confuse her so much that she could not get together a coherent suicide plan for quite a while. Lorraine’s psychiatrist was initially opposed to my seeing her, as her friend Teresa had been stigmatized with the "borderline personality disorder" diagnosis when in hospital, so was seen as a bad influence on her. But after Lorraine spent a couple of months in hospital calling herself Susie and acting consistently like a child, he was humble enough to acknowledge that perhaps he could learn some new things, and someone else’s help might be a good idea.”

“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).”

“Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing voices is a sign of schizophrenia, that mood swings mean bipolar disorder which has to be medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The “medical model” simply does not work for dissociation, and many treatments can do more harm than good... You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help.”

“In my series, five percent presented self-diagnosed. In most cases, this was not believed by the initial clinician. I had the following unnerving experience. Prior to my first multiple personality disorder case, I did not think the condition existed. I saw a young woman who claimed to have multiple personality disorder, and dismissed her claim. She never mentioned it again. Seven years later, while doing research in multiple personality disorder, I asked her to be a control subject for a new multiple personality disorder screening protocol, since I believed she was a medication-controlled paranoid schizophrenic. A protector personality rapidly took over, cursed at me for disbelieving the patient in the first place, introduced me to other personalities, resumed control, and chastized me vehemently at great length. Thereafter, she left, never to return.”

“Delusions Dissociative 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.”

“...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.”

“What about the claim, by the PACE trial, that Graded Exercise Therapy and CBT can treat ME? This is a trial where you could enter moderately ill, get worse in the trial, and be declared ‘recovered’ at the end. Even the recent follow-up study conceded that, long-term, Graded Exercise and CBT are no better for ME than doing nothing. Investigative journalists and academics alike have dismissed the PACE trial as ‘clinical trial amateurism’. Like MS or epilepsy, which were also once wrongly believed to be psychiatric disorders, ME is a neurological disease, and the World Health Organisation lists it as such. I am too weak to walk more than a few metres, needing to lie in bed 21 hours a day. With the little energy I have, I am an ME patient activist.”

“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.”

“DID may be underdiagnosed. The image derived from classic textbooks of a florid, dramatic disorder with overt switching characterizes about 5% of the DID clinical population. The more typical presentation is of a covert disorder with dissociative symptoms embedded among affective, anxiety, pseudo-psychotic, dyscontrol, and self-destructive symptoms, and others (Loewenstein, 1991). The typical DID patient averages 6 to 12 years in the mental health system, receiving an average of 3 to 4 prior diagnoses. DID is often found in cases that were labeled as "treatment failures" because the patient did not respond to typical treatments for mood, anxiety, psychotic, somatoform, substance abuse, and eating disorders, among others. Rapid mood shifts (within minutes or hours), impulsivity, self-destructiveness, and/or apparent hallucinations lead to misdiagnosis of cyclic mood disorders (e.g., bipolar disorder) or psychotic disorders (e.g., schizophrenia).”

“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.”

“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.”

“Basic misunderstandings about DID encountered in the therapeutic community include the following: ° The expectation that all clients with DID will present in a Sybil-like manner, with obvious switching and extreme changes in personality. ° That therapists create DID in their clients. ° That DID clients have very little control over their internal systems and can be expected to stay in the mental health system indefinitely. ° That alter personalities, especially child alters, are simply regressive states associated with anxiety or that switching represents a psychotic episode. Anyone who experiences dissociation on a regular basis knows better, however. DID is not only disruptive to everyday life but is also confusing and, at times, frightening.”

“In general, fatigue is not as severe in depression as in ME/CFS. Joint and muscle pains, recurrent sore throats, tender lymph nodes, various cardiopulmonary symptoms (55), pressure headaches, prolonged post-exertional fatigue, chronic orthostatic intolerance, tachycardia, irritable bowel syndrome, bladder dysfunction, sinus and upper respiratory infections, new sensitivities to food, medications and chemicals, and atopy, new premenstrual syndrome, and sudden onset are commonly seen in ME/CFS, but not in depression. ME/CFS patients have a different immunological profile (56), and are more likely to have a down- regulation of the pituitary/adrenal axis (57). Anhedonia and self- reproach symptoms are not commonly seen in ME/CFS unless a concomitant depression is also present (58). The poor concentra- tion found in depression is not associated with a cluster of other cognitive impairments, as is common in ME/CFS. EEG brain mapping (59,60) and levels of low molecular weight RNase L (21,26) clearly distinguish ME/CFS from depression.”

“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.”

“Some psychiatric clinicians appear to be so biologically or behaviorally oriented that they do not believe in the unconscious. Others have been so indoctrinated in the Freudian psychoanalytic model that they believe all accounts of incest are fantasy. A few of the older clinicians allow pride to get in their way and refuse to believe that they may have missed the diagnosis [of Dissociative Identity Disorder] in some of their patients.”

“A wide variety of dissociative disorders including DID occur in the psychiatric population and may be misdiagnosed or underdiagnosed for a variety of reasons. Some psychiatrists believe these disorders are extremely rare and some believe that they do not exist. More research is needed, but these disorders may be more common than previously thought.”

“...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.2,10 A 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.”

“Psychologisation describes the emphasis on psychological factors where there is little or no evidence to justify it (1). It's a process where relevant findings are ignored or downplayed in favour of data from incomplete examinations, flawed research or anecdotal reports. In a clinical context, differential diagnoses may be dismissed prematurely while psychological explanations are readily accepted. Psychologisation does not refer to situations where there is sound evidence that psychological factors play a significant role, or where all the arguments are discussed and the psychological explanations are deemed the most persuasive.”

“There is no specific test for multiple sclerosis.  Its early symptoms - fatigue, loss of sensation, weakness and visual changes - are frequently misdiagnosed as psychoneurosis or an even more severe psychiatric disorder, such as hysteria, particularly in women. When doctors could find no organic cause for [Jacqueline Du Pré's] complaints, they prescribed a year's rest, and referred her to a psychiatrist... When she consulted a doctor in Australia about her tenacious fatigue and occasional double vision in her right eye, he dismissed her symptoms as "adolescent trauma" and suggested she take up a relaxing hobby.”

“The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation. Although DID is a relatively common disorder, R. P. Kluft (2009) observed that “only 6% make their DID obvious on an ongoing basis” (p. 600). - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p4-5”