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  • Writer's picturepippa

Navigating a diagnosis: from ADHD or autism to bipolar disorder or borderline personality disorder

I'm often asked if I can work with someone if they've been diagnosed with a mental or physical health condition and the answer has always been a resounding YES.

A recent example is a client who was diagnosed with Borderline Personality Disorder (BPD) around a year ago. She contacted me a few months ago saying that she felt that she had been let down by the "system" which had given her this diagnosis (following a history of complex trauma) but had not been in contact with her since. She had been on a waiting list for low-cost therapy for a year.

She was understandably concerned that I would be judgemental about her diagnosis and said that she was reluctant to work with a practitioner who didn't understand her condition.

I explained that my training and experience as an integrative counsellor means that I work holistically with all my clients: it's not my role to pathologize, nor to make a judgement on anything my clients bring to our sessions.

One of the key conditions of working safely and ethically as a therapist is to contract with every client in our first sessions together. This includes drawing their attention to the limits of confidentiality, and also to say that we have an ethical responsibility to provide a safe and judgement-free space for all our clients.

I've worked with people who have been formally diagnosed with ADHD, autism (ASD), borderline personality disorder, bipolar disorder and many others including comorbidities, which is when you have two or more conditions.

I've also worked with people who suspect they have one or more of these conditions and want to talk about whether getting a formal diagnosis would be appropriate or desirable for them.

There are others who have a "lightbulb" moment during our counselling sessions that they most likely have a condition; others still who decide they want to reject the perceived "label" as they don't feel it defines them.

It can be a nuanced and sensitive issue. I'm always mindful to point out that I am not a medical expert and I ask my clients to tell me if there is a particular way they would like to work with me (such as CBT or use of terminology) and even whether we bring a diagnosis to our sessions at all.

The beautiful thing about therapy (in my eyes) is that there is no one-size-fits-all approach. I encourage all my clients to make their sessions what THEY want them to be. I'm happy to work with a solutions-focussed session one week, such as challenging a negative recurring thought... then analysing a dream the following week to engage with the unconscious. Perhaps a story writing exercise in another session, to connect with your inner child.

It's always about the person in front of me and working to keep them safe and helping them navigate their feelings, behaviour and experiences.

If you'd like to find out more about working together or have an informal chat, please get in touch.

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