Psych Eval

[Terri]

I go Thursday for my psychological evaluation. What do they usually do? Do they do the mmpi test? Do they just talk to you? I am sure it depends on the psychologist. I will be seeing Dr. Stote at St. Vincent's in Carmel, IN. Anyone been to see him recently? This is the only requirement my insurance has, so I am really nervous about it. I know once it is over things will hopefully happen quickly. I am rambling, sorry.

 

[JackieOnLine]

I did not have to take one, myself, so I hope you get some answers from people with experience. but I would think & hope they would want to talk to you about any eating disorder you might have.

I have binge eating disorder and went to both a NUT and a psychologist about it as a pre-op, private pay. neither one was any help to me but I tried. :wink:

not saying you have an ED, but if.

have you tried googling his name (and "forum" maybe?), see if anything shows up where patients talk about this?

ETA: if I were you, I would make a list of things you think would be helpful, if nothing else it shows you've given it some thought.

are you a virgin WLS patient? do you have strategies for dealing with stress as a post op?

 

[brooklyngirl]

From what I understand, lots of people have different experience with a psych eval. The initial one I went to, he wanted to assess depression and coping mechanisms. I went into it thinking that it was a good thing to be honest about how much my weight depressed me and negatively impacted my life, but I was wrong. I'm not saying I should've lied, but I shouldn't have let that be the focus. I got denied because he thought that I was running the risk of losing my shit post op when food was no longer available as a coping mechanism for stress. Well, it proves to me that everything happens for a reason because that led me to switch surgeons, to one who recommended the DS (and did not have a psychologist in the practice, so I saw one that actually KNEW me) and I did not crack up or end up in a psych ward. Oh yeah, and I've lost 175 pounds in just over 7 months But I digress. Make sure you can convince him/her that you have a game plan for dealing with stress and/or depression that does not involve food and that you understand the nutritional requirements (ie- protein and vitamins) plus exercise and regular blood work.

 

[Munchkin]

What BG said! Just don't act nuts and tell them what they want to hear!

 

[JackieOnLine]

aha! good answer.

my first thought was, maybe you can get something useful out of the situation. when maybe it should be, how can I avoid being denied by my insurance?

 

[Terri]

I did not have to take one, myself, so I hope you get some answers from people with experience. but I would think & hope they would want to talk to you about any eating disorder you might have.

I have binge eating disorder and went to both a NUT and a psychologist about it as a pre-op, private pay. neither one was any help to me but I tried. :wink:

not saying you have an ED, but if.

have you tried googling his name (and "forum" maybe?), see if anything shows up where patients talk about this?

ETA: if I were you, I would make a list of things you think would be helpful, if nothing else it shows you've given it some thought.

are you a virgin WLS patient? do you have strategies for dealing with stress as a post op?

I don't have an ED. I am a virgin! LOL sure haven't been able to say that in a blue moon. I am hoping that it will be about the WLS only. I am guessing that they want to make sure this is a tool, not magic. Also that I understand that I will have to get my protein in and take the supplements forever.

As far as post-op stress I have a fantastic DH and other family members that will listen. There is also a monthly local meeting. Also in addition to this forum I am on several others.

 

[Spiky Bugger]

I got in there and started diagnosing other pts and postulating about where THEY went wrong. I said I didn't think my weight was the cause of every problem I've ever had and therefore, I didn't think wls was a free ticket to Happy City. And I had read that non-compliant patients sometime develop cognitive decline and emotional issues and, truth be told, I am far more protective of my brain and my sanity than the average bear, so THAT was not something I perceived as a potential problem. And I was not afraid of body dysmorphic disorder because when I lost 50-60 pounds and would see my reflection in store windows, I thought I looked pretty good...even though I STILL needed to lose a lot of weight!

I passed the testing. And hope you do, too!

 

[Sheanie]

What they want to know is that you don't have unrealistic expectations regarding what your weight loss surgery is going to do for you. Like, it won't fix your marriage, help you win the lottery, or cure your depression. Sometimes they ask weasely questions. For instance, they ask the same question four different ways.

During my psych eval, I had an epiphany. She asked what my relationship to food was. I told her I live to eat, not eat to live. She said wow, that's deep, and we both laughed. Then I said, whenever I dieted was the only time I felt really in control of my life. But when I fell off my diet, my life also seemed to fall to shit. That was my epiphany. She didn't know squat about the DS. Then she asked what I expected from the surgery. And I told her I didn't expect it to change my life, that I expected it to force me to stop overeating. She was pleased and satisfied with that answer, and I left.

I wish they really would explain which foods contain protein, especially to the DSers. Or at least pop quiz them on protein foods. That would shed some scary light on the need for pre-op nutrition counseling.

 

[Velvetkiss]

Dr Stote did my Psych Eval, I believe he does most of the ones in Dr. Inman's practice. He will ask things not just about weight, but why you think your overweight, what you have tried in the past, what would happen if you dont get WLS, check to see if you have any mental illness by talking, he did no testing on me. I explained that if I didnt get WLS again that I would just keep on going, because slow and steady wins the race and that I had been watching what I eat and had lost weight since my last appt. He asked if he could weigh me and I let him, I got the feeling he didnt believe me, so he was surprised that i had lost 20+ lbs since my last visit and that is where our visit ended and the only thing I had to do before I could get to submit to insurance was he wanted me to get a therapist in Ohio where I am from and see them and have them send him a letter stating they saw me, that was done right away and I got submitted to insurance quickly and in less than two weeks had approval for my revision. I am now 2 1/2 weeks out from my revision from Lap Band to DS. I wouldnt worry to much.

 

[Elizabeth N.]

No, please do NOT tell them what they want to hear. Answer questions honestly and thoughtfully. If you don't have any "red flags" about your mental stability and competence, you'll be cleared.

If you get the feeling that you are being asked leading questions or that you detect bias or some kind of issue in the person doing the evaluation, SAY SO and go get an evaluation with someone else.

Most therapists are pretty good at knowing when someone is just saying stuff to get to the end of the interview.

 

[Terri]

Yes I would think these drs. know how to tell when people are being truthful and when they are saying what they think the dr. wants to hear. I figure it is going to be questions making sure I understand everything I have to do with post-op diet, the supplements for life, getting enough protein everyday and to make sure that I have tried many other attempts to lose weight.

I am probably just worried for no reason. I am anxious to get the appt over because once I am cleared with him everything goes to insurance. According to my surgeon's insurance guru, the psych eval is all my insurance co. requires. She also said they usually approve within 7 days.

 

[k9ophile]

Just my two cents worth on the psych eval... 1) I was honest and did not try to second guess the therapist. They are trained to detect BS and I got tired of playing mind games years ago because I usually lose. 2) I was in therapy before and after my WLS psych eval. I got a copy of it and shared it with my regular therapist. He was amused at my MMPI results. Just goes to show you the difference between some multiple question test and working with someone over a year or two.

In a way, I feel like my $295 and a 150 mile round trip to get examined was a rip-off. For reasons I've forgotten, I could not use the recommendation of the therapist who knew me rather well. Yet in the end it helped me get approved, so it was worth it. I just wish some other surgeries required a psych eval. It kills me to see a heart patient get a 4 vessel by-pass then smoke two packs a day.

 

[Spiky Bugger]

Just my two cents worth on the psych eval... 1) I was honest and did not try to second guess the therapist. They are trained to detect BS and I got tired of playing mind games years ago because I usually lose. 2) I was in therapy before and after my WLS psych eval. I got a copy of it and shared it with my regular therapist. He was amused at my MMPI results. Just goes to show you the difference between some multiple question test and working with someone over a year or two.

In a way, I feel like my $295 and a 150 mile round trip to get examined was a rip-off. For reasons I've forgotten, I could not use the recommendation of the therapist who knew me rather well. Yet in the end it helped me get approved, so it was worth it. I just wish some other surgeries required a psych eval. It kills me to see a heart patient get a 4 vessel by-pass then smoke two packs a day.

The last time I was supposed to take an MMRI, I refused. I had recently been diagnosed with Interstitial Cystitis...an incurable, horribly painful (like a non-stop UTI) condition that shows up for no known reason (and, if you're lucky, it goes away...at least intermittently...for no known reason.) When you have that kind of dx--you know, ANY painful, incurable little cross to bear--and are even minimally symptomatic (with stuff like non-stop pain and totally interrupted sleep and a lessening ability to do your job and no sex life and no hope for a cure), honest answers to the MMPI will get you diagnosed as nuts. That test was not standardized on a population of SICK people. So if you honestly answer like a sick person would, you will be declared nuts.

 

[k9ophile]

The last time I was supposed to take an MMRI, I refused. I had recently been diagnosed with Interstitial Cystitis...an incurable, horribly painful (like a non-stop UTI) condition that shows up for no known reason (and, if you're lucky, it goes away...at least intermittently...for no known reason.) When you have that kind of dx--you know, ANY painful, incurable little cross to bear--and are even minimally symptomatic (with stuff like non-stop pain and totally interrupted sleep and a lessening ability to do your job and no sex life and no hope for a cure), honest answers to the MMPI will get you diagnosed as nuts. That test was not standardized on a population of SICK people. So if you honestly answer like a sick person would, you will be declared nuts.

My sick and twisted mind wonders what my results would be if I took the MMPI in the throes of passing another kidney stone. I imagine that I would come across as a homicidal maniac. I have some friends with Fibromyalgia. I'll tell them to stay away from the MMPI.

 

[Elizabeth N.]

I'm loving the fantasy of taking the MMPI while passing a kidney stone and how that would totally fuck up the scales....

Here's a bit of info about the scales on the MMPI-2: http://psychcentral.com/lib/minnesota-multiphasic-personality-inventory-mmpi/0005959