Why is the label important?

Part of an ongoing series about life with complex post-traumatic stress disorder

Therapists, at least in my experience, seem reluctant to give people labels. Maybe it distracts people from doing the work that they need to on themselves, or tags them in the system in a deleterious way, I don’t know. But in my experience, labels are absolutely crucial to getting the right resources and support, from coaches to medicine to just about everything else. I am proud to be in the camp where I can proclaim that hey, I have PTSD and CPTSD: that means that I’ve been through some stuff, and like anyone else, I deserve kindness and understanding.

But here’s why it’s particularly important to have one, to me.

1. This cluster of symptoms means I fit into a box, that is understandable, has treatment options, has been studied by people somewhere, and most importantly, means I’m not crazy.
2. This is now something where there is a community of support, books, YouTube videos, blogs, and Instagram accounts that I can be a part of. When you don’t have an official diagnosis, it’s easy to feel like an impostor, and people with CPTSD often already have serious impostor syndrome and low self-esteem.
3. I needed it to apply for grant funding to subsidize specialized, expensive, ongoing therapy.
4. I needed it to tell my PCP and psychiatrist to be put on the right medications.
5. I needed it to have on hand for my office, to explain why a desk facing into a hallway where people walk past all day and can see my computer screen would be very bad for my productivity, as someone who struggles with hypervigilance and would constantly be jumping, startled, and off balance.
6. I needed it to be understanding with myself when previously I just told myself, I just wasn’t trying hard enough, that I should be able to just calm down, to just be nice, and so on. Without knowing I have a diagnosable illness that has literally altered the structure of my brain, I was constantly hating myself for not being strong enough to not have symptoms. It was like yelling at myself for years for not being able to stop puking when I had the flu. No one can do that.
7. I needed it to explain to my significant other what resources might be right for getting family support. Because, telling them labellessly I was working on anger or stress management just made me sound like I couldn’t control myself, and was so vague they did not have any of the right information on trauma for the first ten years of our relationship. It caused so much damage when we did not know what was happening, that I want to be absolutely clear what is happening to everyone who matters to me, now — so that they can support me when I need it, and we can understand each other day-to-day.
8. It legitimizes the trauma that I experienced as serious enough that it actually hurt me and deserves some letters. It shows me that someone else believes in my experience and that it was bad enough to leave scars. You would never, ever see a doctor waffling about whether to put a code on your chart that says, broken arm, needs a cast. People who have experienced trauma have often had literal bruises, and emotional broken arms, but no one has ever been able to see these wounds to sign a cast, bring over a casserole, or report the people who were hurting them. This can lead to a strange dissonant duality of experience, where everyone treats you like you should be fine, and when you’re not, it can feel like a personal failing.
9. When people hesitate to put diagnoses in writing, I appreciate their caution and reserve, but it makes me question my own experience of pain the same way my abusers gaslighted me. They told I shouldn’t be in pain because nothing was wrong, even while they constantly hurt me. Until I had my letter part of me still thought, I’m just a wimp, and someone being unwilling to take the time to write a few sentences on a page made me think that either a) they’re not confident in the diagnosis b) I somehow secretly strong armed them into it or c) they thought I was just overreacting, and they threw a label on me they didn’t really mean so I’d shut up and go away.
10. I would need it to apply for a therapy dog. Woof woof!

So therapists, if someone asks you to run through trauma questionnaires, please do it even if you don’t think it’ll be needed. And if they ask for a simple diagnosis letter, don’t give them the fifth degree about why. As a form of receipt for your work, it’s really none of your business, and it can be transformative for people who get one. It’s like someone at the statehouse asking, “Why do you need a marriage certificate to be married? Isn’t it the same if you just have someone say words in front of you?” No, no it’s not. Not in the eyes of all the bodies you need to formally recognize your marriage, and not in the eyes of the bride and groom.

If you’re seeking a diagnosis, most Ph.D. psychologists, psychiatrists, and neuropsychology clinics are trained in mental health diagnoses. Note that clinical testing or interviews with family/friends may be required.