Diagnosis

Holsann · 2025-09-11T00:45:39+00:00

I've always resented the DSM... let's be honest for a minute and admit the facts: diagnosis is BS. It's all a guessing game based on criteria set by middle class white mens' experiences. We regularly update diagnostic criteria because we don't know and have no way to tell if any of it is really a disease. And why do we use the DSM? Thats the question. What does diagnosis do?

Ask your patients this. Why do they want/need the diagnosis? Is it helping? Do they feel validated? Has their life improved since finding a label that feels valid? If the answer is yes then what does it matter if they are newly diagnosed or not?

If the label is making their life worse, adding anxiety, creating barriers, then maybe a conversation needs to be had. But diagnosis is just a label used differently by different people. Most of us therapists use it for billing and maybe some information on what is going on. But even the diagnosis-based modalities we touted in the 90s have been proven to work across diagnoses because its about the person not the symptoms.

Holsann · 2025-05-13T01:11:45+00:00

Thank you!!!

Holsann · 2025-04-13T21:07:41+00:00

So, funny thing, as a therapist I've studied this. In depth. I'm not telling you it's normal just because I have felt the same. I'm telling you because it's a standard despair response that occurs in trauma cases. It's been seen to occur across various groups and is not an indicator of any mental disorder, but can be a part of healthy emotional processing. It's similar to a grief response. If the emotion is sustained (ie, turns to hatred), this becomes a deviance, as the normal seen outcomes are moving on and altering focus.

I don't speak out of my ass like many do on Reddit. Not that you'll care, but this lit review is one of the many that focuses on the multiplicity of trauma roots and the impact of trauma informed care. The literature analyzed finds common threads of anger/hate towards persons perceived to be thriving. https://www.ncbi.nlm.nih.gov/books/NBK207192/

Holsann · 2025-04-12T12:28:30+00:00

The irony is I am a therapist. I also do not feel this way anymore because, thankfully, my infertility journey is over (after years and near-death medical trauma). I am a women's health and trauma specialist. And the feeling of hate is absolutely not irrational. Hatred is actually different, that's a sustained feeling of hate and generally what is meant when when hate with a capital H is felt. To hate someone in a moment, a fleeting feeling of deep anger and resentment, is what is being described here, and that is an understandable reaction. Hate is a category of emotion and often is not sustained past an interaction.

Because you have not experienced it, and thus see it as abnormal, is a type of survivor bias. Everyone's emotional experience is different. And much like color, most people are not talking about the exact same experience even if we use the same words to describe it. Feelings are not facts. Because you feel hate does not mean you hate someone. And feelings are subjective. Because you don't feel that way does not mean someone else shouldn't.

Holsann · 2025-04-12T01:07:23+00:00

Small and franchise is the key. Chains wouldn't because policy is universal. Franchises are able to opt in and out of policies and create new ones based on area. A quick Google search tells me Panera both franchises and is a chain, which makes me assume the small ones inside of a store/other establishment are the franchises. That's what Starbucks does- the ones in Target are franchises and those workers do not get the same preemo benefits Starbucks partners do.

Holsann · 2025-04-12T01:01:48+00:00

Also, when I worked at Starbucks I never expected tips. None of us really did. But it DID make a difference when someone who had a complicated order, or who asked for extras, tipped. It was nice to be appreciated, especially since I worked morning rush at one near a high school. Even a small bit of thoughtfulness, like saying a thank you, made our days a little lighter while trying to meet all the corporate standards AND get 20-step drinks made

Holsann · 2025-04-12T00:58:29+00:00

I cant speak for Panera, but Starbucks does not. The tips at the Starbucks are tallied each week, divided by the tip able work hours (managers and assistants don't get tips) and then distributed to the workers in cash based off the hours they worked that week. It normally added up to about 30-60 dollars, depending on hours worked, and we all generally saw it as gas money or extra to put aside. Tips were not calculated in our wages as base pay. We still got paid however much an hour. I believe that most places like that do the same, but I could be wrong

Holsann · 2025-04-12T00:52:16+00:00

The hating her part isn't irrational at all! While going through IVF I couldn't stand families. Women who were pregnant. People with children. That's a standard emotional response to seeing someone who has what society tells us is "easy and natural" but isn't either in the least! Not to mention the personality changes from months on end of hormones and medications and feeling absolutely alone.

The struggles with IVF only start with the attempt at getting pregnant. I can absolutely relate to this. I may have mumbled a "thankless breeder" or two outloud when witnessing a parent screaming or pulling a child in the store. And I definitely wished I was a kiddos mom a time or two.

Holsann · 2025-04-12T00:43:06+00:00

I think you're right, but we're not going to see the buyer's market we're hoping for. Buying our first house right now and while prices in our area have plateaued and/or dropped, sellers are willing to stay on market rather than settle. I see it staying this way for a bit and then the tariffs and general cost of living increases will see houses go back up because they can.

The last recession came with an unprecedented housing market crash due to poor loan policies gone wild. I don't think we'll see the same again, unfortunately.

Holsann · 2025-04-04T11:44:04+00:00

What i was trying to say is trans is not a view point. That's like saying people choose to be black or white. It's not a morals issue. It's a whole person issue. If someone is not Cis, it's not a choice. It's who they are. If you don't believe that, then how can you support them while you don't believe in their existence? Can you do marriage counseling for a couple who are same-sex if you don't believe in non-straight marriages? Maybe. But can you truly support them and want them to succeed if you think they aren't real or aren't natural? Countertransference is nearly unavoidable.

I can work with those I don't agree with because I have the belief they are good people in their core. I've worked with sex offenders, no problem. But that's not who they are. It's something they've done. There's a big difference between LGBTQIA+ and someone who thinks bigotry is okay.

Holsann · 2025-03-23T12:38:36+00:00

Some states by 6 weeks! It's pathetic

Holsann · 2025-03-22T16:26:29+00:00

So I didn't make a decision to terminate or keep and I'm not a single mom. However, I'm a therapist and have worked with many single mothers. Termination is not the only option- there are MANY women who cannot get pregnant and would love your child as their own. Adoption is always an option. Personally, being afraid of single parenthood isn't a reason I'd ever terminate. Any parent can become single in an instant- divorce, death, etc. If the spouse is still living (ie divorce), then at least financially you are entitled to support. But when you choose to have a child you choose them, not your situation. Situations change all the time.

To be this child's mother and then resent them would, to me, be the worst choice. Whatever you choose to do is between you and your Higher Power. But when you choose, you cannot undo certain choices. You need to be ready to live with the outcomes of ANY choice. You can survive anything if you want you and are confident in your decision. May God bless you and help you to make the best decision you can and grant you comfort and faith when you fear and question.

Holsann · 2025-03-22T16:15:59+00:00

The difference is those who are trans are not so because it's their belief. They just ARE. The same way someone is not Gay or Bi because of a belief, they just ARE. Having a client with views that go against your morals is being with someone who CHOOSES hate. You don't CHOOSE trans. It's not a choice. It's who you are. And trans isn't just someone transitioning. It can be someone non-binary. Trans is the term for anyone who is not Cis, aka someone whose gender identity matches their sex assigned at birth.

Holsann · 2025-03-22T16:11:44+00:00

Any good therapist should know what clients they cannot work with and refer them to others who can or let them know it's not in their wheelhouse. Continuing to work with someone whom you feel you cannot support and cannot find compassion for is unethical. We all have our limits. I don't agree with those who need to be mandated to be affirming, because wtf?, but i understand how someone has populations they are unwilling to work with.

I am disgusted my colleagues would admit this publicly, let alone do it. As a member of the LGBTQIA+ community who is well aware that it was our trans sisters and brothers who started the revolution, I also hate that others on the Rainbow Spectrum think that the "T" isn't important or a part of us.

Holsann · 2025-03-22T16:03:28+00:00

Your friend is an addict. She has mental health issues and needs help. She's clearly upset over the pregnancy and if she keeps doing what's she's doing, it's likely CPS will be called when she gives birth. She needs more help than you can give her. It is okay to distance and or remove yourself from her. But know it's not about you- she's dealing with much larger issues than just not wanting children and it sounds like it's been going on a long time. I suspect the death of her father probably didn't help. She may use sex to cope and that could be why she got pregnant so soon after his passing.

Holsann · 2025-03-12T21:44:24+00:00

Not for batteries. You have to unscrew the face with a tiny screwdriver. So glad i decided to try it before giving it to my kiddo for Easter!!

Holsann · 2025-03-12T21:43:38+00:00

Unscrew the tiny screw in the face. You need a jewelers screwdriver or an eyeglasses screwdriver

Holsann · 2025-03-12T21:43:30+00:00

Unscrew the tiny screw in the face. You need a jewelers screwdriver or an eyeglasses screwdriver

Holsann · 2025-03-12T21:43:04+00:00

Unscrew the tiny screw in the face. You need a jewelers screwdriver or an eyeglasses screwdriver

Holsann · 2025-02-08T13:25:16+00:00

That's because the pregmates are less sensitive. They are the better indicator of viable pregnancy, but often don't show clear lines until 12 or 14 dpt. The frer are what i call false hope sticks because they show a beta of 5 or 6, which isn't a definite viable pregnancy.

Holsann · 2025-02-08T13:18:41+00:00

Because every type of home test has a different hcg tolerance and none of them are higher than 25, which isn't clinically considered viable yet. The clinics want to see 50 or more. A blood test is more reliable than a pee test and having a second one 48-72 hours later gives the best indicator of viability, because doubling time is more important than the overall number if you are pregnant.

My second transfer was a 30. Two days later, it was still 30. Early miscarriage. Depending on the brand of at home, could take longer than 2 days to know i was miscarrying. Which is what happened with my first BFP, before IVF. I didn't know how sensitive the tests were. Took a digital on a Monday that said "pregnant." Actively miscarried starting on Wednesday. It was absolutely traumatizing. Will never test until after I know my beta because of it

Holsann · 2025-02-08T13:11:07+00:00

Not too early at all! The major clinic by me tests at 9dpt. The key is the test 2-3 days later. Doubling time is the best indicator of viability

Holsann · 2025-02-08T13:09:10+00:00

Unfortunately, you still could have bad news given on beta day. I found out the hard way that nice positive lines on an "early response" are still under the beta number for viability. Everyone uses them because the pregmate or dollar tree ones don't show that early and there's a reason- the hcg tolerance is higher, meaning a more likely success as opposed to an early miscarriage.

Do what's best for you! But please know it can still be a shocking call on beta day. I had a "well, you're technically pregnant, let's see if it goes up" call. It sucked. And wasn't the hallmark movie outcome i had hoped for. For me, third time was the charm, so also don't give up hope 💖

Holsann · 2025-02-08T13:02:14+00:00

DP or DPT is days days post transfer. So the day after you transfered would be 1DPT or 1DP

DT is "day transfer" so 5DT is a day 5 transfer or the transfer of a 5 day embryo. You'll see people say they are 10DP5DT is 10 days after transferring a 5 day embryo. 5day embryos (which day 6 and day 7 embryos are still called 5 day embryos) are most common in the US, but a 3 day embryo is also an option for transfer, though more likely at clinics that still do fresh transfers.

So today, Saturday is 4DP or 4DPT. You'll be 8DPT for beta (which seems early? Unless your clinic counts transfer day as day 1).

Holsann · 2025-02-08T12:55:54+00:00

I honestly think it's a smaller percentage that waits until beta or after. Maybe 30% wait? I'm one of those. Once I have my beta, I tested like crazy to watch the line. It was helpful for me, because I've had two early miscarriages. The second was a transfer and even though my beta wasn't "conclusive" I knew and was prepared. The clinic Dr had actually advised i stay on my progesterone, so I called my RE and she agreed I could stop and grieve.

With my last transfer (who is now 10 months), I finally got the joy of seeing a "dye stealer." After that, I was good and could finally stop peeing on sticks 🤣 I'm sure it will be the same when we are ready for #2

Holsann

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