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Neuropsychological Testing: A Therapist Responds

Dear Ann,

 

I’ve read your last few articles on psycho-neurological testing (Oct.8-22) with interest. As a therapist who has counseled couples dealing with chronic illness, I’d like to give you another perspective.

 

            People come to doctors to get healed.  People come to counselors to get fixed.  People do not come to doctors to be told they are dying.  People do not come to counselors to be told that they cannot fix what has broken.  When a caregiver asks for counseling, they are asking for what we all ask for. Make this go away.  Bring back the spouse I married.  Make me a better person so that I can make this go away and return to the couple we were. That is what everyone expects regardless of whether it is possible or not.

 

            There is even a play that has been written and performed around the world – “I Love You, You’re Perfect, Now Change”.  That play talks about the difficulties in marriage based on things like, who hogs the covers at night or who leaves the toothpaste cap off the toothpaste.  Imagine as only you who writes all these articles about the caregiver and the “person in the chair” can, what immense changes are wanted and needed by the caregiver who lives with the “person in the chair” and how difficult the problems they cope with are in comparison to just “normal” marital conflicts.


            Sometimes, as you say, it may not be possible to achieve change. This may be because the progression of the illness no longer allows for change or because of one or both of the people in counseling are unwilling to change. But it is change we want and feel we must have.  Now imagine the doctor or the counselor who says you cannot have change, that “the person in the chair” cannot/will not change. In order to make a life for yourself, in order to survive, you need to leave.  You are told it is an option to consider. You are told that if you want change, it is your only option. You are told you can “choose to take yourself out of the marriage”.


            Not getting what we wanted so desperately, losing the hope of ever reclaiming the past is devastating. When given “leaving” as an option, most people react with anger. Most of us who are female, or those of us who become caregivers (of either gender) want to believe that we can change the person whom we live with.  We are on a mission.  And that mission is encouraged and validated by the general population who want the caregiver to be all-powerful and able to deal with whatever needs to be dealt with without imposing on the rest of society.  When the counselor says “or you could choose to take yourself out of the marriage” the caregiver does not have permission to even imagine that possibility.  The caregiver probably does not have the ability to go there without feeling enormous guilt, depression and powerlessness.


            And so the counselor has to step very carefully and cautiously through the miasma of societal expectations, religious dictates, and personal persuasion to simply help the well spouse see that this is a choice, this is an alternative.


 Miriam Kuropatwa, M.Ed. (Psych)


 


Dear Ms Kuropatwa,


Thank you for giving us a counselors’ perspective and helping us look at alternatives when change is not possible.


It must be difficult to have to deliver that kind of news to a couple and how devastating it must be for a couple to receive it. One of the risks well spouses face in counseling is the loss of that final hope – the hope that keeps most well spouses going; that there will be change for the better. Introducing the idea of leaving the marriage as a way of coping with the future must be very frightening and heartbreaking to hear. But it is an alternative that, perhaps, no one else will present. Hearing it from you allows well spouses to at least think about it, entertain it as an alternative and know there is at least one person in the world who will not condemn them should they choose that option. It must be comforting for them to know as well that they will have your support and guidance should they choose to stay. It is easier to deal with life when you have made the choice instead of it being thrust upon you. I imagine that most of your clients who discuss the option of leaving with you, whatever choice they make in the end, fare better than those who feel there is no alternative for them at all.


Thank you again for presenting us with another alternative way of coping, an alternative that is rarely seen as one by ourselves or is acceptable to those outside our lives.


Ann


 


You can contact me at annnovick@hotmail.com


 


 

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When one is blind one learns to use Braille to read. When one cannot walk, a wheelchair gives mobility. Sign language allows a mute person to speak and ocular implants assist in hearing when one is deaf. These are all compensatory strategies that help a person function despite his disability. But compensatory strategies are not just for physical problems. Understanding our psychological weaknesses and setting up our lives to ensure that we are not tempted to repeat our past mistakes, is as necessary as any aid to the disabled.

Well spouses have often discovered that their friends and relatives, despite their closeness to the situation, often don’t realize the tremendous emotional impact living with chronic illness has on the family. With the best intentions, suggestions, ideas and criticism are offered, based on the non-experience of those with healthy families. Even when the good intentioned get a taste of the difficulties, it is sometimes not enough for them to then identify and understand what the family of the chronically ill must face on a constant basis.

Over the past two weeks I have shared letters from a therapist and a well spouse. Both of the letters gave personal insights into the process of losing hope, how we react when that happens and some ways of coping when test scores, diagnosis and just simple repetitive behavior indicate that change for the better is impossible.

Dear Ann,

I’ve read your last few articles on psycho-neurological testing (Oct.8-22) with interest. As a therapist who has counseled couples dealing with chronic illness, I’d like to give you another perspective.

Dear Ann,

Your articles on the Neuro-Psychological Testing were right on (October 8-22). My husband underwent testing twice and your articles explained it things exactly the way they were. Besides the test, we also tried therapy.

Very often when we can’t face our big hurts or big loses we focus on the little ones. We can discuss those. We can cry over the small loses, be angry at the smaller hurts even though it may look trite and sound ridiculous to others.

Over the last two weeks we have been discussing one way in which well spouses can determine whether behavior displayed by their ill partners is caused by their illness or is a way they have chosen to act. We have focused on Psycho-Neurological testing, what it can tell us, as well as its pros and cons.

Last week I discussed a question that haunts many well spouses: not knowing if the difficult and often inappropriate behavior frequently displayed by their partners are caused by the disease and therefore not-controllable, or if the behavior is a choice the spouse makes and can therefore be changed. This doubt can be the source of much frustration and many marital disagreements. One way of alleviating this doubt is by having a psycho- neurological work up done. But that path is not so simple.

Printed from: http://www.jewishpress.com/sections/magazine/neuropsychological-testing-a-therapist-responds/2009/11/11/

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