Dissociative suffering: should we believe a patient's word?

The article presents a clinical case of a 43-year-old patient, Jasmine, who sought psychiatric help due to "affects that interfere with life: dissociations, regressions, anhedonia, flashbacks, social phobia, asthenia, anxiety, and nightmares." The patient reported that she had consciously changed her place of residence and moved to a city "known for good psychiatrists" to receive qualified help. Over several years of "mental suffering," the patient thoroughly studied psychiatric literature, mastered scientific terminology, gained a deep understanding of the etiopathogenesis of mental disorders, and acquired knowledge of various psychotherapy and psychopharmacotherapy methods. The patient positioned herself as an expert in psychiatry. She independently identified dissociative symptoms (depersonalization, derealization, regression), and diagnosed herself with a dissociative disorder. It is concluded that modern psychiatry faces a new challenge in the objective diagnosis of mental and behavioral disorders — in particular, the widespread prevalence of self-diagnosis and the influence of patient expertise on this process. The issue of therapist trust in patient complaints is shifting from differentiating between genuine symptoms and malingering to assessing how "psychiatric literacy" impacts diagnosis.