Guest tim5ny

Psychiatric Interview.. what NOT to say!

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Most of us here who haven't had the surgery yet are anxiously awaiting and don't want anything to screw this up for us. What can you tell me about the Psych interview? I know that a history of drug and/or alchohol addiction is definitely a block for this surgery... but what else??

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It is NOT a good idea to go into the psych eval thinking of ways to "cheat" or get around it without being truthful-- it's a requirement for a REASON after all. WLS is a huge decision that is going to alter every single aspect of your life; the purpose of the psych eval is to make sure you are emotionally prepared for those changes. NO, you don't have to be completely free of any emotional issues-- most obese people would probably qualify as being depressed, simply for what we have to go through on a daily basis-- but the psychiatrist's job is to make sure you have the skills you need to handle such a major lifestyle change. For instance, if you're diagnosed with depression, are you on meds or in therapy? Are you STABLE with those treatments? Then you're probably fine for surgery.

Think of it this way-- if they ask for blood or urine samples to see if you have diabetes or nutritional deficiencies, or if they ask for a cardiac test to make sure your heart is functioning well enough to handle surgery, would you want to find a way to "cheat" those results to make it look like you're perfectly healthy? Probably not, because "faking" those results could mean life or death in the operating room. The psych eval serves the same purpose-- if you try to lie your way through it, the only person you risk hurting is YOURSELF, and that risk is huge.

I have a relative who had WLS a few years ago, and I'm absolutely certain she lied her way through the psych eval-- she has Bipolar Disorder and refuses to seek help for it. Among other things, food was a major addiction and source of emotional comfort for her before surgery. Well guess what? It's been 3 years since surgery, she never started an exercise routine post-op, she quickly went back to eating her old favorites (bags full of potato chips and regular Coke, among other things) and in just 3 years she's put on more than half the weight she lost. It's only a matter of time before she's right back to where she started.

Had she been honest going INTO the WLS process, she could have started to get help for her Bipolar, gotten stable on some meds, and gotten some therapy to address healthier substitutions than food to soothe her emotional distress. Instead, nothing changed except the size of her stomach, and she's gone back to all her old ways.

If that's what you want, then by all means, lie your way through the psych eval. Sorry to sound harsh, but that's reality, IMHO.

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Most of us here who haven't had the surgery yet are anxiously awaiting and don't want anything to screw this up for us. What can you tell me about the Psych interview? I know that a history of drug and/or alchohol addiction is definitely a block for this surgery... but what else??

Actually, a history of drug abuse is not a block for this history, cause I had a history of drug abuse....I was upfront with my surgeon, and at my phsyc eval.....and I had surgery last Monday.....I was also very scared that it would stop my surgery, till alot of friends on here told me what I am telling you....They should look at it as, You had the strength and will power to over come your drug abuse, and that it shows you have the same will power to go through the changes that this surgery will bring to you......I wish you the best....All and all just answer the questions that they have for you, and all will be ok.....What ever you decide to tell them is on you.....but I found out that being honest was the best for me.....Good luck on your journey, and please keep us posted on how it all went at your eval.....Darlene:)

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I'm not looking to be dishonest because I don't have anything to hide. I'm a perfect candidate for this procedure physically and mentally, and I wont have any problems. I would like to know what kind of questions that they asked you. ( if my mother comes back here and replies again I'm gonna go up to my room and slam the door and never come out! )

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( if my mother comes back here and replies again I'm gonna go up to my room and slam the door and never come out! )

Every shrink's different - they're just evaluating your mental health, and if you feel like you're a perfect candidate, you probably are. I don't think anyone has come on the forum yet and said, "well, I passed everything else, but the shrink thinks I'm batso, so I can't have the surgery." Could be wrong...they might just not have spoken up, but I haven't heard of anyone denied. A few might have been delayed until they proved their stability, but it doesn't sound like that's a problem for you.

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Tim,

Many times, the surgeon just wants you to have contact with a Psychiatrist before you go through the surgery, in case you need one after the surgery. It sometimes brings up 'issues' when you lose food as a 'friend' or 'comfort'. Usually the psych just wants to make sure you don't have unrealistic expectations. PS--as the mother of a teenage boy, I LOL'd at your "slam the door and never come out" comment!

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Thanks! My sister had the surgery just over 2 years ago and could be a spokeswoman for the surgery. She's lost a tremendous amount of weight and has been so strict with herself that she has never even taken a bite of anything sweet since the day of surgery. This was a woman who used to skip good food and eat sweets for meals intentionally. She lives in NC now so I don't get to see her that often, but I have gotten alot of info from her and will continue to do so. My brother, who weighs about 350+ still believes he's gonna wake up some morning with superhuman will power enough to get thin again. That's never going to happen. With me, I see myself following in my father's footsteps who like myself had Diabetes2, Sleep Apnea(untreated), HPB,Fatty Liver, and just about every other morbidity listed. He died at 57 of a stroke, and I'm 47, so for me this is more than getting thin... it is life. I know that I will exercise once I get a little weight off because I used to be an avid runner and workout-aholic when I was lighter. I'll let you know how everything goes.

Edit: I currently use CPAP for sleep, so the "untreated" status was directed at my dad.

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You're definitely on a better path. Isn't it wonderful that we have options today so we don't have to have the fate our fathers did? Mine had several heart attacks before he was 50.

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I remember everyone telling me what to say if I was asked "Why do you want to have this surgery?". And I should say, "To be healthy, and live a longer life". NOT SKINNY! LOL

I had a few friends that were denied because they said they wanted to fit into bikini's! Too funny...good luck to you!:)

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I think they want to make sure you're fully aware that this surgery is a "tool", not a cure all, and to be sure you are going to be capable of compliance with all the new rules for eating. Don't worry about what not to say, just make sure they know that you are fully aware that this surgery is not an "easy fix", and that you are going in with eyes wide open.

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My psyche eval was 3 hours long, and then another hour follow up visit. Had to take the 562 question true/false test.. and talk about everything and anything he could think of... the good news is I passed! It was just LONG!

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I can tell you what NOT to say...like...."The voices in my head say I am I need this surgery", or "I need to look my best when I get on America's Most Wanted!!". :P Other than that, I think Honesty is the best policy!! Just be honest with them and yourself, and you will do just fine! :)

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I came to the conclusion after my psych eval that the psychologist was a total nut. When my surgeon asked me what I thought of her, I told him the truth. He asked me to give him examples. I did.

She passed me but she was obviously in her own zone and didn't hear a word I said. She spent the full TWENTY minutes of the interview asking me what I remembered that I learned from the dietitian. Strange, and very one faceted.

Tim, you are a sincere guy, and just be you. You have your sister as an inspiration and a great source of information. And you have this wonderful message board.

Claire

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The dr who did my psych eval just read questions off a questionaire for 2 hrs. A lot of the questions were like, "How much alcohol do you consume?" "Do you do drugs", Were you ever molested?", "What do you want from this surgery?" "Any suicide attempts?", and so on. They need to make sure that if there are any head issues that helped the weight go on, that they get addressed as well. Otherwise, surgery won't work. The only time I have EVER heard of the surgery not working for someone is because their demons were not put under control. BTW? I think my shrink had issues too. Is it REQUIRED that every shrink of a certain age get the Freud beard and haircut? Just leave the bunny slippers at home and you'll be fine! You sound okay to me!

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I thought mine was a joke, I can't remember the questions but I thought they were stupid and they just kept rewording the same questions. I was worried about not passing but as you will come to know I come from a long line of worryers!

It took a few hours to answer all the questions and I just took them one at a time...because this person could put a hold on my surgery I was very nervous.

But I gotta tell you when I went back for the results and he gave me the analysis of me it blew me away IT was DEAD ON>>>

I don't understand how they can take 500 weird questions and come out with your profile but they did....

but the truth is I wasn't as forth coming as I should have been...I didn't focus on the fact that I am addicted to food etc...they said I was mildly addicted...I don't feel I cheated...I just didn't want to be delayed in having the surgery. My doc office offers free unlimited visits to head doc (forever) so I knew/KNOW I will get the help I need and have lots of issues to deal with after surgery...so I plan to take advantage of the services...

BEST Wishes on your road to a healthier YOU!

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The 550 question test is called the MMPI 2. Just a tidbit of information...it was "normed" in the waiting room of a mn hospital on people waiting to see their family members. It has since been normed on all american groups except for one small group...probably left handed aborginous people in the 12 year range lol.

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Leesa.. they say that test is fool proof.. that even if you try to cheat.. you cant ;)

and its 562 questions people lol get it right! my shrink told me the groups they did the test on for the norms.. cant remember them, but I know for version 2 (which is what I had) they used groups of almost all different kinds of diagnosed mental illnesses... and compared them to the answers from people who had never been diagnosed with anything. Apparently, there are some very specific trends between different classes of mental illness.

and it pegged me too.. and I went back and changed answers to make them match ;) Still found me moderately depressed, Extremely addictive personality, and suffering from social anxiety due to fear of looking stupid.. amazing really. but a total Pain in the butt...

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My psyche eval was more of a discussion ensuring I understood the gravity of what I was about to embark on. That there are real risks and I got that. I think it was a CYA thing more than anything else.

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My own impression of the psych eval is that it is an area that has to become smoother and a better tool than it is for some of us. I was never told what my evaluation was, if in fact there as anything to tell. I wasn't improessed with mine at all, and that's really a shame. It could have been (and has been for some of you) a really good stepping stone toward successful surgery's aftermath.

I

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i feel the need to be completely honest here. I failed my first psych eval. They wanted me to commit to driving 2 hours a week to THEIR center for counseling. It was an eating disorder center. I thought it was BS especially since they couldn't tell me exactly why they didn't pass me. Bottom line I switch docs who went through a different agency...and this psych counselor actually worked with those with gastric bypass. He passed me with flying colors and was very encouraging and complimentary on my research and self exploration I had done pre op. Just beware I do think my first shot at it was an attempt to drum up some $$$$. I am so happy I switched. Also the second doc I had was wonderful in every way.

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Yep, this is exactly what I mean. There is no general rule of thumb for psych evals. And if there are very specific methods and agendas for surgeons to follow, then I think the same applies to the psych evals.

Claire

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You are wrong about the history of drug and alcohol abuse, and no that's not a block for surgery. At least it wasn't with my insurance. Janie

Most of us here who haven't had the surgery yet are anxiously awaiting and don't want anything to screw this up for us. What can you tell me about the Psych interview? I know that a history of drug and/or alchohol addiction is definitely a block for this surgery... but what else??

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Since the psych test is setup by the surgeon's staff, I doubt that they would refer their potential patients( which=$$$ for them) to a psychologist that was against the surgery, or someone who was going to be a real stickler. My sister told her interviewer that she used to be a heavy drinker, and the interviewer told her that her statement right there could be a reason to deny her the surgery, and this was at Duke University where she had the surgery.

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When I did my psych, the psychologist told me about how he denied a WLS candidate because she told him that she was a marijuana smoker - the doc apparently felt if she continued with her weed, her "muchies" would sabotage her weight loss effort ...

I am not a big fan of these evaluations as I think many (based on my experience anyway) are a joke and a waste of money.

good luck on yours just get through it so u can get on with your journey

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When I did my psych, the psychologist told me about how he denied a WLS candidate because she told him that she was a marijuana smoker - the doc apparently felt if she continued her "muchies" would sabotage her weight loss effort ...

I am not a big fan of these evaluations as I think most (based on my experience anyway) are a joke and a waste of money.

good luck on yours just get through it so u can get on with your journey

Thank you! I don't anticipate having any problems.

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