my new therapist has never heard of my mental illness

People break up with their therapists all the time. People break up with their therapists in different ways (according to Lori Gottlieb, people like the ghosting method).  People break up with their therapists for a variety of reasons and many after the initial session. Going into a session with a new therapist, we all have doubts but I did not expect the therapist to never have heard of my diagnosis.

While my diagnosis is not the number-one most common mental illness, I would like to think that an educated licensed clinical social worker (LCSW) would know a thing or two about it.

Follow along with me as first I relay the critical pieces of our intake conversation and second explain WHY my decision was necessary.

The actual conversation

Me: it’s definitely connected to my obsessive-compulsive personality disorder.

Therapist: So what does your OCD look like?

Me: No, obsessive-compulsive personality disorder.  OCPD.


Therapist: *cocks her head*  Oh, I’ve never heard of that.

Me: ?????????????????????????/ cocks my head

Therapist: Alright so BLAH BLAH BLAH




Therapist: Okay wait let’s go back a second.  So what is that thing you were talking about?  Could you spell it again?


Therapist: And what is it?


Me on the inside: (what in god’s name is happening.  Am I really about to educate a LICENSED CLINICAL SOCIAL WORKER on a PERSONALITY DISORDER that is IN THE DSM-5 and one of the TEN personality disorders?)

Me: It is a personality disorder, rather than an anxiety disorder like OCD.  It’s closely connected with perfectionism, rules and rigidity, [and whatever else I said.]

Therapist: *literally nothing related, just continues on other stuff*

Therapist post-session: Does not write OCPD as my diagnosis or anywhere in my notes

My initial reaction: Giving her the benefit of the doubt

In the video you can see that I’ve rationalized this red flag and am already assuming I’ll have another session.  (That has since changed.)

Questions to self at this time

Am I going to *shut it DOWN* before experiencing how she runs an actual therapy session?

It sounds ridiculous if I say yes.  But does this?

Am I, an individual seeking therapy who just met a therapist with multiple degrees in related education who has never heard of a particular personality disorder— going to *shut it DOWN* before experiencing how she runs an actual therapy session?

100% yes.

Red Flags

*I’m operating on the assumption that familiarity with the DSM is required to have a job as an LCSW providing therapy at a legitimate health care provider.*


There is a difference between never having heard of a diagnosis and never having done extensive therapy with a patient who has this diagnosis. See what I mean? She claimed she had never heard of obsessive-compulsive personality disorder.

Does not continue education

Whether she’s been educated or not, she doesn’t continue education.  Continuing education looks like reading new studies, researching on your own, connecting with professionals across the country or internationally, attending conferences.  

Imagine studying communication, like I did in college, and then never keeping up with any of the trends or topics of discussion and still operating as if everything I learned when I was 20 years old was still the norm.

Some history

What’s now called OCPD by the DSM was first named “anal retentive character” (Please tell me why isn’t it still?! I believe we’re further stigmatizing this illness by removing that hilarious original name) by Sigmund Freud in 1908.  (Today OCPD is also called anankastic personality disorder by the World Health Organization.) 

The therapist in question was around 60, 65 years old.  OCPD was first included in the DSM-II, released in 1975.  So like…….probably WHEN this woman was studying in college or RIGHT before (meaning it should have been taught to her). But I mean, it’s so possible that my standards for education and mental health care are too high.

Alright: This from Wikipedia, which I hope she read after our session:  “The diagnostic criteria for OCPD have gone through considerable changes with each DSM modification.”  Every time there was a new edition of the DSM, OCPD criteria was altered.  There has also been some controversy with how OCPD is categorized in the A, B and C clusters of personality disorders.  Given the “considerable changes” for diagnostic criteria and the named controversy around the categorization, it kinda seems like OCPD is and/or was a hot topic of conversation in this field.

I look so good in this picture.

Side note: After the session I told my mom about the occurrence and was able to name 9 of the 10 personality disorders off the top of my head.

Is Unprepared

I come prepared to every therapy session.  It’s rare that I don’t have any notes ready.  I expect the same of my therapist.  Weeks before my appointment, I messaged the woman and brought to her attention my chart notes from my previous provider.  Given that OCPD is one of my diagnoses specifically listed in these charts, it’s obvious that she either did not read my chart or perhaps actually believed that OCPD is the same as OCD. Yep, there’s just a random letter accidentally added in the acronym, a typo carried all throughout my paperwork. 

Inadvertently reinforces the stigma of mental illness?

Does anyone else consistently doubt their diagnosis? Whether it’s your illness is real thing or if a couple of psychologists just made it up? Whether it’s debilitating or if you’re normal but just perfectionistic about your mental health? Whether you really don’t have a problem but are want help and a diagnosis is one way to get it?

I am sad to say that she made me doubt my diagnosis, the legitimacy of it. I shouldn’t have to say this, but the person you’re coming to to seek help is not the person who should make you doubt the legitimacy of your needing help.

If professionals do not know about us, how can they help us?  Do they not think we question and doubt our diagnoses?

– quote by me

Is it too much to ask?

While this particular situation of a therapist having never heard of a diagnosis may be uncommon, unfortunate experiences in therapy and mental health care are not. We need MORE and BETTER therapists and ACCESSIBLE, AFFORDABLE, EQUITABLE care country- and worldwide.

It shouldn’t be too much to ask.

P.S. in case we haven’t met…

you seem normal is a mental health medium run by 24-year-old communication professional (hello!) who… well, seems normal.  Turns out, my roommate is mental illness. Actually more like my unborn, and non-conceived baby. Because it’s like, inside of me. This is getting weird already. Topics of focus: self-awareness (we love it), mood, anger management, perfectionism, relationships & boundaries.

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