Pandora's Box: The Effect of Diagnostic Disclosure on a Depressed Patient

There is a dearth of literature on the effect of disclosure of psychiatric diagnosis on treatment. A case is presented in which the therapist suggests a depressed patient may be bipolar. Three concepts are utilized to understand the resultant impasse: empathic failure (Kohut, 1984), intersubjective disjunction (Atwood & Stolorow, 1984), and projective identification and the subjugating third (Ogden, 1994). Further research is needed to work more sensitively, effectively, and responsibly in the area of diagnostic disclosure.