Testing Average

I finally got my report from my neuropsych testing.  Oh, I had the results more than a month ago,  and posted about it. But I got the physical report, which I was unable to read while I was there (partly because I wanted my sister’s opinion on the report, and partly because the post-doc I was meeting with had to get his supervising psychologist’s approval on it, which he had been unable to do prior to our meeting last month.

Now, I will admit that he (and most other people reading a report like this) where the worst issue is a “low average” score (the Brief Cognitive Status Exam [BCSE] which is scored opposite most others, with the top performing as Average, and Low Average being essentially the 2nd best score), and most scores were “high average” there would be some confusion at why I would consider that to be proof that I have a certain amount of cognitive loss from my own personal baseline.

While I have always perceived myself to be the least intelligent person in my family of origin, that doesn’t mean that I am stupid.  Everyone in our family has consistently tested above average.  Even with my father’s mini-strokes, he has only lost 1-2 standard deviations from the mean his premorbid condition. The family’s IQs are between 95th and 99th percentile.

So, yes, even with all of this testing, and being told that I obviously have no cognitive decline because I test as “average” I do have an issue.  I haven’t been average before, so testing as average now means I’ve got a decline.

Whether it is an expected level of decline based on my age (cognitive ability can become less just by age), or is a situation that may or may not go away is anybody’s guess.  But I would need far more in-depth testing to even get an idea of exactly what decline there is.

And it doesn’t help that the main test involved is completely invalid for anyone with chronic pain.

In fact, the clinical diagnosis of Somatic Symptom Disorder is problematical because:

  1. My awareness of my symptoms are part and parcel of having chronic pain. It is impossible to evaluate how much energy I have to complete a given task without a strong awareness of my body’s functioning.
  2. My emotional state relating to my body and the chronic pain issues I have is rather pessimistic, because of two separate issues:
    1. There is unlikely to be any “cure” for my chronic pain, because it is caused by damage to bone and cartilage.  Therefore I can only expect further degeneration.
    2. The best attitude I have about my chronic pain I have been able to experience has been simple acceptance of my own limitations. Do I get depressed about it sometimes? Of course, no one can always have a positive attitude about everything. But, I don’t wallow in self-pity about it.
  3. The DSM-5 defines SSD as including excessive and disproportionate thoughts, feelings and behaviors regarding those symptoms.” The problem always happens with anyone who has what is considered an “invisible” illness.  Someone who is physically healthy wouldn’t have the same kind of awareness of limitations as someone who has to constantly be aware of and able to asses our ability to do anything at any given moment.  Sadly, most of the psychology community has not necessarily gotten to a point where they really do understand the emotional average when dealing with someone with a chronic physical illness. In fact, I’ve referred to the Spoon Theory” to define my life living with chronic pain, and have had therapists look at me with a blank, questioning look.

The issue comes down to the fact that unless I’m that aware of EVERY choice I make, I can easily run out of spoons.  And having the severe depression and anxiety means I have far less spoons than I should have because I have run a constant deficit of spoons for decades living with my ex.  That means I technically don’t have ANY spoons for today, and am continuing to run that deficit.  The only thing I can do is have mercy on myself, and if my body says, “Look, you idiot.  We need sleep RIGHT NOW!” I have to listen to it.  If I don’t listen, it means that my recovery is actually going to take longer because I’m adding to the deficit.

That DOES NOT make me a hypochondriac.  It makes me someone who has a chronic, yet invisible, illness.

And yes, writing this blog does take at least one spoon.  If it requires research, it can take more than one. And more often than not, when I miss a day, it’s because I’m all out of spoons.  And it is also why if I get more ideas for a post, that I schedule ahead so that I can be a little more lackadaisical about posting.


Categories: Body Health, General Contemplation | Tags: , , , , , , , , , | Leave a comment

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