WTH

So today I saw my Psychologist. I had my psychiatric nurse practioner to call her so they could be on the same page. I hadnt signed a release so she couldn't but will. Anyway, I said out of curiosity why am I DDNOS because that doesn't exist in the DSM anymore and not OSDD? She said you are smarter than me. Let's look at the DSM. We went over it section by section and she said ok you just have DID not DDNOS which is on the spectrum. How does she NOT know what OSDD is and she is a Psychologist?! It was changed in 2013!!! Then how is she going to change her mind. What in the world???!!

Psychologist student here, I swear I want to yell at my teachers when it comes to dissociative disorders.

I've finished the first three years of university and I still have two years left to become a psychologist, but technically, I'm supposed to have all the basis.

We officially never heard of dissociative disorders. Not once. Well, not exactly, but they introduced derealisation and depersonnalisation only as symptoms of schizophrenia, so I don't think it counts as "talking about dissociative disorders".
Unofficially, some teachers talked about DID, but never to say something positive or true about it. One used it to illustrate the "fake memories" thing in USA, another one implied it doesn't exist.

I even had a mild argument with one of my teacher about peri-traumatic dissociation and dissociative disorders.

Inside the community of mental health professionals, when it comes to DID and dissociative disorders in general, you can consider that :
50% of them don't know it exists because no one trained them about it.
40% of them don't know it exists and/or will never be able to recognize it exists because it trigger them in some ways. You don't imagine the number of dissociative people I've met in class, teachers or students.
10% know about them but, depending on where you live, will have hard times finding any information about it.

And on a side note, psychologists aren't usually trained to use the DSM. We know about it, we learned how it works, but depending on the psychologist's approach, a psych can think it's the "only truth" or "the ultimate lie" (one of my teacher called it "the bible of the morons" and meanwhile, in another class, another teacher was trying to make us learn the criterion of depression by heart).

But the DSM is more a psychiatrist's thing.
For a lot of psychologists, DSM diagnosis are only a way to communicate with psychiatrists, and they hate it because they find it restrictive when it comes to talk about a patient. In a lot of universities, we're kind of trained to consider the patient's life, personality and history before the diagnosis, which is a bit the opposite of the psychiatrist's training, almost all about how to make a diagnosis and what treatment plan is appropriate depending on the diagnosis.

And this can be explained simply : in a lot of countries, psychologists are trained to do therapy, tests and evaluation ; meanwhile psychiatrists are trained to read the results of tests and evaluation made by the psychologist and give a diagnosis, and meds if needed.
Depending on where you live, psychiatrists can be the only ones legally allowed to give a diagnosis, while psychologists can only give a "hypothesis" which needs to be confirmed by a psychiatrist.

Like I told you when you were questioning your diagnose before: you are very lucky you have a diagnose, most people with DD don't ever get it, or the right treatment. There are tons of people with DID dx'd as schizophrenics in hospitals heavily medicated, which makes them worse, which means they are not likely to get out of there. There are several cases like that, when someone who has spent decades in hospital, gets a right diagnosis and suddenly their life changes. They're able to work, which they never have been, to have relationships, all normal things. One person like this in my country made doctors thesis about treatment of patients with DDs after she had therapy and recovered fully after decades locked up in hospital.

I got to know what I had before any professionals, and it was thru internet I learned this thing exists. I've been reading tons of books of psychology/psychiatry all my life, and they never mentioned any DDs.

Dnester wrote:So today I saw my Psychologist. I had my psychiatric nurse practioner to call her so they could be on the same page. I hadnt signed a release so she couldn't but will. Anyway, I said out of curiosity why am I DDNOS because that doesn't exist in the DSM anymore and not OSDD? She said you are smarter than me. Let's look at the DSM. We went over it section by section and she said ok you just have DID not DDNOS which is on the spectrum. How does she NOT know what OSDD is and she is a Psychologist?! It was changed in 2013!!! Then how is she going to change her mind. What in the world???!!

Welcome to The World is Stupid. You cannot trust the authorities, that's why I don't ###$ around with them anymore. Trust yourself and not them. I believe it's because organized crime would like to hide information about how the mind works. They are criminals teaching the classes.

She is supposed to be a specialist. I dont understand how she can not know this. I thought that they got knew information when things changed in the DSM. She does work for herself. Idk. I'm more concerned about the fact she can sit down with me and go over the DSM and then come to the conclusion I dont have DDNOS but DID in 5 minutes time.

Dnester wrote:I dont understand how she can not know this. I thought that they got knew information when things changed in the DSM.

Some Ts are very proactive with continuing education and others are not. The legally required amount of continuing education varies by location, and beyond that, some Ts want the latest information and some feel like their experience with clients is "good enough" - and sometimes that is true and sometimes it isn't. I also feel like a specialist should know these updates, but that isn't always the reality.

If I were in your shoes, understanding that you have limited resources, I'd try to just get as much help from the T as you can until you are able to access better treatment. You know her limitations: she is disorganized in her notes and she doesn't know what OSDD-1 is, and there are probably other things too. The treatment plan for OSDD-1 and DID are the same, and OSDD-1 is the updated diagnosis for what was DDNOS-1a and -1b, so she does have experience treating others like you. Imperfect help can be better than no help, so long as you know that she isn't the ultimate authority but still has some authority.

I've heard many people say that there is some consideration to lump DID and OSDD-1 into a single diagnosis in the future. I don't know how likely that is to come to pass, nor would that likely be very soon since it hasn't been that long since the last DSM update, but in that way it matters less which it is, though I also understand why it matters to you.

Dnester wrote:I'm more concerned about the fact she can sit down with me and go over the DSM and then come to the conclusion I dont have DDNOS but DID in 5 minutes time.

It may be that she felt put on the spot and felt stupid and knows comfortably what DID is but didn't have the confidence to absorb in a brief moment what OSDD-1 is and so just went with what she knows. That isn't great, but it is human and understandable. If you feel you would rather her take the time to familiarize herself with OSDD-1, even if it means you have to wait longer, you should let her know that. If you can email her then you could offer to send her some resources too.

-Sev3

It is very common for therapists, including experts, to "trickle truth" the client. Specifically, it is very common for clients with DID to be provided with a preliminary diagnosis of DDNOS (OSDD). The thinking seems to be DDNOS is somehow more acceptable than DID to the client or to the insurance company (US) or to National Health (UK) or to other mental health care providers.

Now that you have forced the issue by reading the DSM with her, she is being up front with you about her diagnosis. Congratulations; you have taken a big step in your journey, bringing your therapist to this point.

I just feel like she is not giving me a diagnosis I have though just saying hmm ok you have DID. The reason I say this is I dont have amnesia in everyday life. Just from childhood. I also dont feel I have distinct alters as I am always in control most of the time.

You have a dissociative disorder, that much is clear. Try to be comfortabel with it. Wheather its did or osdd. As said, the treatment is the same. To me it feeks like you are knitpicking and thats not helpfull and stears away from you real problems.

Dnester wrote:I just feel like she is not giving me a diagnosis I have though just saying hmm ok you have DID. The reason I say this is I dont have amnesia in everyday life. Just from childhood. I also dont feel I have distinct alters as I am always in control most of the time.

The criteria say that the amnesia can be only for past events--it doesn't have to be in the present. That was a change with DSM V.

That you have distinct alters is clear from your signature and what you have posted. They don't need to front to be distinct--many systems have very distinct alters who don't take control. Also, "always" in control "most of the time" is a contradiction.

And, most importantly it doesn't matter for treatment purposes and healing whether it's OSDD or DID. I'll say it again: IT DOESN'T MATTER--the treatment is the SAME.

To spend a lot of time focusing on whether it's one or the other is keeping you from dealing with the symptoms that you do have.