Diagnostic Privilege
“He who is not angry when there is just cause for anger is immoral. Why? Because anger looks to the good for justice. And if you can live amid injustice without anger, you are immoral as well as unjust.”
Saint Thomas Aquinas
When it becomes obvious that objective truth is no longer part of our subjective reality, we must be honest about what professional privilege is and what it is doing to our community and future generations. To be a professional in an uncertain and often amoral world, people rely on ethics and law to set the tone of consensus. However, our qualitative research (O’Brien, 2023a) on trauma, dissociation, and addiction discusses how different common consensus is from common sense and how far off base psychology is with their quantitative understandings and marginalized definitions. Though we find that Western society is ripe for qualitative worldview and science, the quantitative perspective and reasoning (education, insight, and wisdom) is lacking in a common sense that consequently prevents real change from occurring. Therefore, WHI brings its audience (and citizens alike) the first of a series of literary works that we will present here to promote real change, recovery, and healing.
Wounded Healer Institute (WHI) presents an integrated meta-critical analysis of our doctoral work on the intersectionality of trauma, dissociation, and addiction (O’Brien, 2023a) by applying it to professional systems. In this meta-critical analysis, we address the new NYS Diagnostic Privilege requirements for Licensed Mental Health Counselors (LMHC). LMHCs now have to deal with changes to their professional education criteria, even though they are already educated and trained in diagnostics. This juxtaposition represents how other professions act as gatekeepers to societal development, cultural progress, spiritual connection, and communal healing. We believe that this is a result of academic elitism, classism, professional privilege, and unrecognized addiction and dissociation disorders. Our research finds that, just like trauma and dissociation, addiction is also transdiagnostic; this means that there are unidentified addictions.
The legally-based term diagnostic privilege is used by the NYS Office of Professions to demonstrate clarity on what is going on in the professional dynamics of psychology. This legal status charge prompted us to highlight our qualitative reasoning and justify the professional Healer identity, Healing process (O’Brien, 2023b), and the recovery-based profession of Healer (O’Brien, 2023c; O’Brien, 2024a; O’Brien, 2024b; O’Brien, 2024c; O’Brien, 2024d; O’Brien, 2024e). Below, the reader will find the Abstract, Dedication, Introduction, and a brief introduction to our Discussion.
Please follow the links below to obtain the complete article.
Abstract
Diagnostic privilege is a heading that government authorities use to identify the legal right a profession has to clinically diagnose. Diagnosing is an essential clinical service to provide to the public. Meeting this need is a critical aspect of any psychological profession. The professional dynamic between psychological professions, the medical model, insurances, and legal authorities are presenting a significant barrier to all Licensed Mental Health Counselors (LMHCs) ability to diagnose. Legal changes in New York State have challenged the diagnostic “privilege” of LMHCs because other professions are questioning their licensure process over a legal technicality/mistake. The major issue addressed here is the power and control dynamic between professions of psychology, law, business, and policy. These are embodied in the ethical and moral debate. The observation that professional checks-and-balances have been co-opted by other professions need to thrive is what is causing the emergence of addictive and dissociative pathology in professions. Based on our doctoral explorations (O’Brien, 2023a), we present Moral-Ethics as a solution to their unacknowledged and undiagnosed addictions and dissociation. We offer a qualitative perspective, a glimpse into our emerging dissociation-informed and recovery-informed care, and take a healing-focused stance. Discussion, conclusions, optional solutions are offered, and summary performed.
Dedication
To all who have been misdiagnosed, mislabeled, unconsciously drugged, unjustly hospitalized, lobotomized, electrocuted, legally imprisoned, poisoned, senselessly killed, or who have lost loved ones because of diagnostic privilege.
Introduction
There is a growing amount of concern amongst Licensed Mental Health Counselors (LMHC) because New York State (NYS) Department of Education (DOE), legislative, licensing, and credentialing processes are adding unnecessary new diagnostic educational criteria to an already existing and established profession. Diagnosing is a primary task of any licensed psychological-based profession engaging with the public for mental health services and is absolutely necessary for them to know if they are legally practicing within their scope of practice. This observation leaves the NYS DOE legal-level definition of diagnostic privilege questionable and worth a critical review because the established diagnostics categories are currently being theoretically and clinically challenged with the completion of our doctoral work on the intersectionality of trauma, dissociation, and addiction (O’Brien, 2023a).
In this LMHC case, our challenge to diagnostic categories is ironic because we observe that there are key psychological terms not clinically and operationally defined, which may be more related to privilege than anything else. We see that understanding addiction and dissociative denial system as key reasons why our doctoral work is an important to add to this discussion and believe that aspects of professional privilege, elitism, social injustice (e.g., ignorance of other), governmental incompetence (due to being too dependent on technology or Big Business), classism, and addictive/dissociative factors are professionally observable in recent years. Due to recent political and social historical events and reasonings, lacking common sense factors are worthy of professional critical analysis because if mass psychosis or group think has happened before, then what is unconsciously presenting in our work on dissociation and addiction will be of interest to those who seek truth, education, and freedom.
This unnecessary diagnostic distinction and educational addition will have an impact on LMHCs income potential, job access, and their future as a profession. We aim to limit how much that impacts our clientele and citizens but also to show how there is a thread of common sense that runs through our shared experience. We hope to implicitly and qualitatively communicate that to the reader throughout this writing. In this foundational (philosophical and theoretical) work, we introduce key concepts and ideas that will help readers become better acquainted with our work at large. For full context, and if readers are so inclined, they would be better served reading our dissertation first (O’Brien, 2023a).
Discussion
We have complied a list of examples (totaling 103) of how ridiculous and poorly informed psychology and the auxiliary systems-level professions are when it comes to their moral character requirement of our profession. However, we must point out the obvious. First, the actual word “moral” does not appear at all in the ACA Counseling Code of Ethics (American Counseling Association, 2014). Second, moral action is implied, not defined or elaborated upon in the ACA Counseling Code of Ethics (under the advocacy section; to speak out against individual, group, or systematic abuse of power and control). Third, the legal rationale of losing a professional license due to being “morally unfit” is extremely curious to us, particularly considering it is unclear how they are legally or psychologically measuring “moral fitness”. Whether or not they should be the ones measure it at all is another question to consider. Fourth, if the morality of professions can be questioned, then why are we not addressing moral deficiencies in politics, business, finance, law, and war? If Moral-Ethics exist, is the USA or the West following them?
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References
O’Brien, A. (2023a). Addiction as Trauma-Related Dissociation: A Phenomenological Investigation of the Addictive State. [Doctoral dissertation, International University of Graduate Studies]. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023b). Memory Reconsolidation in Psychedelics Therapy. Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023c). Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024a). Healer and Healing: The Re-education of the Healer and Healing Professions as an Advocation. Re-educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024b). Moral-Ethics. In Healer and Healing: The Re-Education of the Healer and Healing Professions as an Advocation. Re-educational and Training Manual and Guide. Chapter 14. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A., (2024c). Diagnostic Privilege: A Meta-Critical Analysis. In Healer and Healing: The Re-education of the Healer and Healing Professions as an Advocation. Re-Educational and Training Manual and Guide. Appendix 3. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2024d). Meta-Critical Analysis: The “Science” of Pseudoscience. The Re-Education of the Healer and Healing Professions as an Advocation. Re-Educational and Training Manual and Guide. Re-Educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2024e). Path of the Wounded Healers for Thrivers: Perfectionism, Altruism, and Ambition Addictions; Re-education and training manual for Abusers, Activists, Batterers, Bullies, Enablers, Killers, Narcissists, Offenders, Parents, Perpetrators, and Warriors. Re-education and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
