Understanding the Purpose of Diagnosis: A Therapist’s Perspective
Let’s Talk About Diagnosis
As a therapist over the last ten years, I have had the privilege of bearing witness to individuals’ seasons of growth, seasons of sadness, and the wrestling that happens with everything in between. It is such a meaningful journey—both personally and professionally. One area that consistently comes up in my work with clients is the topic of diagnosis. To share explicitly, or not to share explicitly?
This question is not about ethics for me, but more about acknowledging that diagnosis can bring up mixed feelings for clients—and understandably so. Diagnosis holds power, especially depending on your social location and proximity to power, privilege, and resources.
The purpose of this blog is to demystify and destigmatize diagnosis, and to encourage open conversation with your therapist—and possibly others around you.
The Origins of Diagnosis: Where It All Began
The practice of diagnosing has been around for many, many years. In fact, the term diagnosis originates from ancient Greek and Latin roots, meaning “a distinguishing,” or “means or power of discernment.”
The DSM, or Diagnostic and Statistical Manual of Mental Disorders, originated with the American Psychiatric Association (APA) in 1952 and has since undergone multiple revisions. It is a tool used by medical and psychological professionals as a system for classifying various mental health symptoms and is the standard used across the field.
The DSM provides us with a common language and reference point for understanding and communication. It also helps mental health professionals facilitate research, treatment plan, and bill insurance.
However, it's important to note that the DSM has a complex and evolving history. Its development has lacked diversity, having been primarily shaped by white, middle-class American males. Additionally, much of the data used to inform the DSM is based on this same population, leading to racial disparities in diagnosis and the potential reinforcement of systemic biases.
When a Name Brings Clarity
You can't tame what you don’t name. How many of us have heard that—or something like it—before? It’s true. We can’t begin to make sense of things that are unknown to us. Diagnosis helps provide clarity and validation for people’s experiences. It was once described to me as the scaffolding or framework by which we can start to be curious and understand our client. Diagnosis can help guide effective treatment, interventions, and tailor care in a more informed and strategic way.
Diagnosis can also be essential for gaining access to services and accommodations (e.g., in schools or workplaces). Unfortunately, we are not yet at a point where institutions and workplaces rely solely on a person’s lived experience to honor their needs. So having a standardized, widely accepted reference point like a diagnosis can be incredibly helpful.
Lastly, diagnosis helps build a shared language between client and provider.
“Trauma decontextualized in a person looks like personality. Trauma decontextualized in a family looks like family traits. Trauma decontextualized in people looks like culture.”
When Labels Limit Us
On the other side of diagnosis is the risk of stigmatization. Labels can lead clients to feel criticized, boxed in, or reduced to just a set of symptoms.
Clients are also often misdiagnosed, or their experiences pathologized unnecessarily. Once a diagnosis is assigned—especially in a professional setting such as with a doctor, mental health provider, or insurance company—it can be difficult to move away from it, even if it was incorrect.
Diagnosis can also be used too rigidly, overlooking nuance, individuality, and cultural context.
Take, for example, this story:
A mother was admitted to her local hospital while in labor. A Black female nurse witnessed the following interaction:
“The doctor said the patient was hitting her head with the palm of her hand, so she must be hearing voices,” Nika [nurse] wrote…
“This girl was patting her weave,” she concluded.
This anecdote may seem humorous or benign, but it points to a deeper issue: Women and racial and ethnic minorities are 20% to 30% more likely than white men to be misdiagnosed. That has real implications for care, access, and well-being.
Diagnosis as a Tool, Not an Identity
Diagnoses are tools—not definitions of who you are.
As a therapist, I often hear the expression: “If you’ve met one person with [insert diagnosis], you’ve met one person with [insert diagnosis].” In other words, no two people experience a diagnosis in the exact same way.
Diagnoses are most helpful when used with compassion, collaboration, and context. They should evolve with the individual—not define them permanently. Everything is constantly growing and shifting. We’re always taking in new information and allowing it to transform our understanding of ourselves, others, and the world around us.
This is true of our diagnoses, too.
For example, you may have experienced significant anxiety in childhood due to instability at home. But as an adult who is now well-resourced and autonomous, you may no longer experience anxiety symptoms—or at least not to a level that would warrant a formal diagnosis.
Things shift and change as we shift and change. It’s crucial that this truth is honored.
Let’s Have the Conversation
I encourage clients to talk openly with their therapist about how they feel about their diagnosis. Ask questions, express concerns, and be part of the process in forming or revisiting it.
Also, know that if you prefer not to have a diagnosis on record, there are ways to navigate that. The most common option is to forgo using insurance and pay out of pocket. I fully recognize that this is not financially feasible for everyone—but for those who can afford it, it’s an option worth considering.
Remember, everything can be a symptom, but not every symptom is a diagnosis and you deserve to feel safe, seen, and empowered in your care.
