Get a Second Opinion: An Input on the Impact of Diagnoses

| April 6, 2015 | 0 Comments

by Mrs. Freud

A book I am currently reading (by Prof. Dr. Pieter Duker) on the discussion of the severe impact of receiving a diagnosis of autism or ADHD and the risk of false-negative or false-positive diagnosis has reminded me of the severe impact just a diagnosis can have on a person. If one is not familiar with the process of how a diagnosis is made, its accuracy might never be questioned.

It seems to make sense that any diagnosing professional would come to the same diagnosis. But this is often not the case. Especially in psychology, a diagnosis is called clinical diagnosis, which is the subjective. The evaluator makes the decision based on the occurrence or non-occurrence of certain behaviors. Often the description of third parties is used as well, which is also subjective.

Often the diagnosis is consistent, and often there are border cases, where diagnosis is not clear. The criteria for certain diagnoses also change over time with every revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This raises the question whether it is “better” to over-diagnose or to under-diagnose. It might be clear if a life is in danger, then the utmost of carefulness is in order, but a great many diagnoses are not in that category.

With psychiatric/psychological diagnoses, there is a stigma involved and once a diagnosis is received, the recipient´s life changes. Within systems like the health care sand school administrations it can develop a life of its own.

While this might all be technical, I do want to remind everybody to be mindful of what a diagnosis means. I used to work on a government funded psychological telephone help line, I answered some 10,000 calls over the years. There I got a better picture of what a diagnosis can do to a person. Sometimes people would call who had been carrying around their diagnosis – whether it would be depression, anxiety, tinnitus, or many others, for years. They strongly identified with the symptoms and felt very disempowered by them.

In a health care system, a diagnosis is usually necessary in order to get the insurance company´s financial help and treatment. But this does not mean a person is only defined by the symptoms of the diagnosis and from then on to be on a unified predetermined path of healing. It is so important to stay in charge of whatever ails us and to make decisions that fit us and not surrender from being responsible for our own health of mind and body. After all, we know ourselves best and we live with it day in and day out.

Of course, we must include professionals, since they have knowledge and training. We want to leave room for creative ways of dealing with challenges, and bring in the statistical best ways which a professional can do. Listening to our own intuition is an essential part of being present for our own best way of healing and staying healthy. That said, it is vital not to ignore what is and what needs to be done. It also does not mean becoming untrusting or becoming a “doctor shopper.”

Try it out in your daily life, when you get stuck in an “either – or” question. Look for the third solution, then the fourth, maybe fifth. Because, like Einstein said, “We can’t solve problems by using the same kind of thinking we used when we created them.”

And it is always good to get a second opinion, because it more than doubles our options. Bringing our own wisdom and involvement on board is essential, since without it, the best professional will not succeed.

Author Sabine Starr is a psychologist licensed in Vienna, Austria, currently living and working in Mission Hills. She has written numerous articles for professional psychology journals. For further information, visit and follow her blog at; and a new social media offering is

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