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Psycho-Nerological Testing: What to do With the Results

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.

 

If someone has never had this type of assessment done, they will probably have no baseline from which to measure the deterioration. For many people who have not been previously tested, clinicians will make assumptions using previous employment and data given by you and your spouse in order to assume a probable baseline. For example, if the patient was a doctor or a professor before the onset of the illness, the clinician might assume that in many of the areas his client would have scored in the superior or gifted range if the test had been given prior to the illness. This is not always the case. As one well spouse told me, “Just because my husband was a doctor they assumed he would have scored in the superior range in all areas. So they felt he had really deteriorated in social skills, because he now scored in the low average range. But he always had poor social skills, even before he became ill, so I knew the decline was not as shocking as they thought. On the other hand, scoring that low for problem solving, I knew that was a drastic change, even without former testing. But at least I know where he is now and that I can’t rely on him to help me deal with situations like I used to. I guess I can’t expect him to figure stuff out for himself either.”

 

Knowing where on the spectrum a person scores now can be even more helpful to the couple if the therapist is able to translate that into specifics. With these scores, what is the ill spouse capable of doing at the present time?  What can we realistically expect? Not all therapists can translate the test data into the practical solutions you are looking for. It’s best to use a therapist familiar with chronic illness and how it affects families and not just individuals. Tell the therapist exactly what you expect to gain from the test results. “With these scores can I expect my wife to. ”   Ask if through therapy a lost skill can be relearned and just how your partner would need to go about relearning it. What is your role, as the well spouse, in the process? How do you help? What do you avoid? Is the person even able to participate and grow from couple’s therapy or will it be a waste of time? It is better to know at the onset what the ill spouse in now capable of rather than raise your hopes only to have them dashed. A spouse whose processing skills have drastically deteriorated and whose memory is failing may not be able to alter their behavior no matter how much therapy they participate in or how eager they are to involve themselves and want to change.

 

Assuming that you have shared your goals with the therapist and you have been told that therapy is reasonable in your situation, it is vital to make sure your spouse is in agreement with you. Is s/he looking for strategies to help her cope better? Is he aware how his behavior is affecting those around him?  I have seen many cases where the ill spouse goes along with the testing and therapy in order to appease their spouse only to be passive aggressive and promise change but not deliver.  The frustration, pain and anger that results from this is worse for the well spouse than before they entered therapy. That is why counseling must not only be possible despite the illness, but both people must be invested and willing to go along with the process.

 

More on this topic next week.


 


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/psycho-nerological-testing-what-to-do-with-the-results-2/2009/10/14/

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