Psychoanalysis and psychiatry: the important role played by differential diagnosis in treatment management processes

Abstract

J. Chick Jr.’s case is paradigmatic when it comes to the hard time establishing differential diagnosis. He has been a heavy drinker and drug user since adolescence, and was hospitalized in psychiatric institutions several times, as well as had a vast collection of diagnoses he identified himself to. Based on what he calls his lack of identity, Chick Jr. gives significant importance to diagnoses capable of identifying him and of telling who he is. This lack of identity, which is experienced as non-existence – sometimes he says that he is dead – unfolds into a sexual identity that brings him a lot of suffering. We know that individuals are not defined by their diagnosis, even when it sometimes calms them down. In any case, differential diagnosis is extremely important to help mental health professionals manage patients’ treatment; it is what the current study aims at showing, based on the herein reported case