Psych Eval Results

[Justmehere]

I'm upset and triggered, so this will be a ridiculously long post.

I had a psych eval for Voc Rehab. This is a government organization that helps people return to work while they are on disability. Voc Rehab did this eval because they wanted to know if I had any other diagnosis other than PTSD and if providing me more treatment for PTSD would help me be more employable than I am now, and to sort out any other types of treatment I need… It’s for a plan of returning to higher level of work, and to work more than I work now.

When doing the evaluation (which occurred over two days) I never spoke much of the trauma other than telling him it was childhood and adulthood trauma, of several varieties, and frankly, he didn’t ask much more about the trauma, and he didn’t ask much about my PTSD symptoms. I did say I have done intensive out of state PTSD treatment, and explained the somatic experiencing work I do now. I did say I had been diagnosed first at age 16, and that I only accepted the 15 years later. I did explain I have dissociative problems… I did explain a few triggers. That was it. I thought that was enough.

The evaluator and I met today to go over the results and recommendations before he writes his final report. He says I have generalized anxiety disorder and panic disorder in addition to PTSD.

He said, “You need to let the past be in the past, and work on your panic symptoms more.”

He said I should stop trauma therapy and focus on more mindfulness skills and do more CBT thought challenging. I thought this was part of good trauma therapy work.

I am all for doing more work on mindfulness anytime, but stop processing trauma? My trauma therapist says we are not done at all with processing trauma. And I’m not sure what panic or anxiety symptoms that I have that don’t relate to PTSD or trauma.all my anxiety and panic keeps getting to be less and less the more I work through and process the trauma. I told him this...

He said I just need to learn to notice emotions more, and let them go, like leaves on a river... And he repeated again the line about "let the past be in the past." (Oh yeah, because I should just snap my fingers and let the kidnapping and assault I suffered less than 18 months ago just be in the past and never have a nightmare again about it. It's just that simple. Why didn't I think of this?!)

He said I could email him any questions, and if needed, we can meet again to go over his assessment.

I just typed out a one page list of traumatic events – what others have verified that I do not remember, and the ones that I can remember. Then I typed a list of PTSD symptoms I have on a weekly if not daily basis.

I triggered myself by writing out these lists and I’m really floaty/dissociative now….

I’m not sure if I want to send the lists to him or not. I don’t even think my trauma therapist has all this so neatly laid out.

He is recommending Voc Rehab pay for more therapy more often for me, he says I am fully employable, my goals are very good ones, and was quite positive about by abilities overall. That felt really good to hear.

I don’t know if he will be recommending the type of therapy DVR should pay for or not. He did say I need to keep doing the therapy I am doing now, just more of it, which is trauma therapy….

So I’m a confused mess.

We did unexpected IQ testing, and I asked he not share those specific numbers with me. He didn’t. He did say I was “quite bright.” And apparently I might be dyslexic. Might be. But I shouldn’t worry about it until I return to grad school - something he thinks I should do.

I might be dyslexic?!

Ugh. Any advice? I am supposed to see my trauma therapist tomorrow. I have already asked her about some of these possible conclusions this guy could come up with. She thinks I will be "mostly" symptom free when our work is done, but she says it is not done at all. She says we are walking through some of the worst parts of it, and I have to keep hanging on through it. "Don't run."

What makes this all really hard is that we have all agreed on keeping my trauma therapist out of my Voc Rehab case because I need that privacy, that sense that my trauma therapy is not being overseen by an agency trying to help me be employed. I need it to be a place where I can freely share without having to think about how Voc Rehab could see something.

But I don't think any of us expected an eval that said leave the past in the past and go work on mindfulness for a random panic/anxiety disorder. I hate stupid PTSD. I hate the idea of having to "prove" I have PTSD. I don't think this evaluator even realizes I have dissociative symptoms or flashbacks. I don't remember telling him. I tried really hard to tell him as much as I could get myself to tell someone who is a stranger.

I don't mind doing work on the panic outside of the context of trauma therapy. That's totally good with me.

I do mind the recommendation that I not continue to pursue trauma therapy. I'm not asking Voc Rehab to help pay for this... so maybe it doesn't matter?

Ugh. Any thoughts or advice?

 

[scout86]

I think I'd share the results with your T. In fact, if you could get her a copy of it and let her read it for herself,it might be good. See what she says.

 

[EveHarrington]

I think I go through similar (yet different) struggles. I'll explain.

I think that if you're like me, inside of you, maybe even deep down inside of you, well you know the right path to be on. Me, I know what I need to do in order to heal. I won't get distracted with my details here, but I've been walking this path for awhile now and I know I'm going in the right direction (even if I get a little sidetracked at times). Then, along come these outside influences that try to tell me that they know better. I have my mini freak-out, get a bit upset, and then my family reminds me that I am doing the right things to heal and I should not, can not let one persons opinion throw me off track. I cannot let their views cloud what I know to be true. They are entitled to their opinions and I am entitled to leave their opinions in the dust.

This psych evaluator--- I think you should ask yourself if his opinion is greater than the many trauma experts out there who recommend going through trauma processing in order to heal. I understand it's his job to evaluate you, but if he hardly asked you about your trauma, I'd say the report is a bit inaccurate, right?

I think if you stop processing in the middle then your healing may come to a screeching halt, or greatly slow down. I believe that CBT and mindfulness are great skills to have for anxiety issues, but for PTSD, it's not really the end all and be all of treatment.

 

[Chava]

He said I should stop trauma therapy and focus on more mindfulness skills and do more CBT thought challenging. I thought this was part of good trauma therapy work.

Well, SE therapists are rarely CBT focused. But it depends on the therapist. Does your challenge your thoughts? Are the thoughts and emotions a big issue? Could you just do SE and work on mindfulness separately? That is helpful...being able to have an emotion but also pause, notice it, respond differently if needed, or just let it simply be and pass, etc.

He is recommending Voc Rehab pay for more therapy more often for me, he says I am fully employable, my goals are very good ones, and was quite positive about by abilities overall.

Great news!

I might be dyslexic?!

I might be too. I assume I do have one or more learning disabilities that were never defined. I had extra tutoring early on. I'm plenty smart enough, but struggle with certain kinds of text and do have some dyslexic traits. But I adapt. If I were to do a Ph.D. I would probably need some good structure. But I got a couple degrees okay. And probably you have adapted. If you go to grad school and find yourself struggling, now you just have more info...maybe you look into that potential piece more.

I hate the idea of having to "prove" I have PTSD. I don't think this evaluator even realizes I have dissociative symptoms or flashbacks.

I don't know how this kind of eval works at all, but one thought I had was that he might have somewhat under-estimated in your favor. Does that make sense or is that possible? Hammering the PTSD part might implicate more hoops for him and you, but seems like he trusted your ability to work (so maybe taking a softer edge to the eval?? who sees the eval?). Just a thought, not sure if that is relevant at all...but I wouldn't necessarily take it as a pure invalidation, even though I can understand that's how it feels. I wonder if there is something less concrete in this. Or he just doesn't get PTSD.

I do mind the recommendation that I not continue to pursue trauma therapy. I'm not asking Voc Rehab to help pay for this... so maybe it doesn't matter?

Probably not. Just keep doing your trauma therapy if you feel like you are on the right track. Maybe add in some mindfulness practice(s) if you don't already do (so hard for me, but I'm working on that outside of therapy).

Glad you got it done! Good work getting through that, even if nerve-racking.

 

[Friday]

final report. He says I have generalized anxiety disorder and panic disorder in addition to PTSD.

So he's not saying you don't have PTSD, correct?

& he's not a trauma therapist / doesn't specialize in PTSD, so his recommendations surrounding "how" to treat PTSD (the past is the past) you can just ignore, right?. (Okay there, you. Cardiologist says for me to do this for my heart, so I'm just going to ignore what you as a dermatologist are saying about my heart)

 

[Suzetig]

His job is to get you into work and keep you working, so he'll take the path that looks like it'll do that in the most direct way - usually through symptom management than actual healing when it comes to mental health.

In a way he's right, doing CBT and mindfulness practice would make you less symptomatic possibly fit long enough to get into work or work more etc. But it's like putting a sticking plaster on a gaping wound, it'll cover it for a little while but sooner or later you need to clean out and close up the wound. I've done CBT and it totally kept me functioning for a good period of time, but it all caught up with me and this time I've been in long term therapy with a trauma specialist which has been much slower but much more effective.

Keep doing what you know is working for you, it makes good sense to keep your therapy separate and private but take what they offer too, if it's helpful.

 

[Casey_03]

I would urge you NOT to send the list of traumatic events to him -- i think he will see that as you obsessing and that might prompt him to change his eval. As for his advice about "leaving the past in the past," I think this is just something people say when they don't know what else to say and have not experienced something like you have; they simply can't grasp your reality. But I don't think that means he is trying to invalidate your trauma or anything like that. I would just ignore his comments and vent about this to your trauma therapist. If I'm understanding correctly, this guy's only real role here is deciding whether you can go back to work, right? If that is the case, then try to just focus on the going back to work part and ignore the meaningless feedback he offers.

 

[barefoot]

I agree with the others - his job is to evaluate you (and to help you) with getting back into work, so he may be taking whichever tack he thinks will have the best outcome for you in that front.

I'd talk it through my your therapist - if it were me, I'd show her the letter/report and then talk it through so that I get her take on it.

It sounds like you feel you're on the right track with your trauma therapist, so keep doing what you're doing with that. If you want to iduc some of his suggestions, you can also try some mindfulness - either by yourself or joining a group or asking if this is something you could bring it with your therapist if you both feel that's appropriate.

I can see how this has given you a wobble. But he's not a trauma o keep doing your trauma work with the person who is and take anything else that strikes you as useful from this guy and ignore anything that isn't. Don't let this take you to a place of self-doubt or of feeling like you have to explain/justify/prove anything to him. You really don't.

Hope his evaluation helps you with what you want to do work-wise.