By Angela

Dr. Twittworth, Neuropsychologist

(Note: Events are real, names have been changed, and photos
are not real professionals described in the story.)

When I first began seeing doctors after the car accident, appointments with doctors and therapists were very difficult. I had a hard time remembering things to tell them. For example, the chain of events, doctors I was seeing, treatments received, medications I was on or had tried, questions I had. I was pretty much alone in dealing with all of this – being divorced with my youngest daughter who was in her last year of high school and living at home with me. In the past, I had no problems woman-mirror2communicating necessary information to my doctor. Now was a different story. I didn’t know who I was anymore, my body and brain did not function like they had, and that was very disconcerting.

At one point in this journey, I remember thinking that it felt as if I was starring in my own version of Invasion of the Body Snatchers. In the Hollywood rendition, people were zombie-like, devoid of emotion or thought, once their body had been taken over. For me, I could remember what I was like before and knew that I was a very changed person. The “new me” was completely foreign and I struggled to figure out who I was and how I operated. I wondered what could be done to get the “old me” back again. The professionals I had seen so far, didn’t seem to have a clue about how to help me.

I felt alone in this mission and pondered my predicament the best I could. The only thing I could figure out to do was to treat myself as if I were one of the children I worked with. First, I began with the primary belief that “All people have strengths.” When you look only at what is wrong, you doom a person to failure. People need to know they have strengths – that’s what keeps them fighting to continue battling against their challenges, what makes them feel special, that their life has meaning, that they can achieve their dreams and have a happy life.

And so started my journey of sorting out this new and changed me.

It was an odd feeling trying to observe and figure out the “new me.” I told myself that I had done this with hundreds of young children over the past 20 years, and I could do this with me. I began taking obsessive notes on the unusual symptoms I experienced and what happened before and after their appearance. I paid close attention to my language, cognitive, social-emotional, fine motor and gross motor write-notesskills, writing down what I was able to do, what I had trouble with and gave specific examples of each. I figured out my strengths, the things I could do, which I could use to help bridge my challenges. I had been working with children for so long, some things fortunately seemed to be ingrained into my entire being.

Patterns began to emerge, and I could see more clearly the things I could do and what I had problems with.

*****************************

I had been working with speech, occupational and physical therapists for a couple of months. They scheduled me for 30 minutes of each therapy 3 times a week, but quickly had to reduce the time since I could not make it through therapy. My tremors would get worse, my feet felt like I was standing in buckets of concrete when I tried to walk and I would collapse on the floor. My speech would become worse – more stuttering, I could only get out a couple of words, and I couldn’t think of words I was trying to say. I would arrive to therapy walking in with the help of my walker and would exit in a wheel chair because I was not able to walk. I would sleep the rest of that day and the next, only to start the cycle over again.

Even after reducing the length and frequency of these sessions, the therapists weren’t sure how to proceed with me because of my symptoms and extreme fatigue. The speech therapist thought it might help to have some neuropsychological testing done to determine more specific areas of deficits.

Since I did not have health insurance at the time, she suggested referring me to the Bureau of Vocational Rehabilitation (BVR). BVR would be able to refer me to a neuropsychologist for testing and would pay to have it done. I was so thankful to work with therapists who cared about helping me find answers to the problems I was experiencing. I was hopeful that this would provide some helpful information.

man-grey-hairDr. Twittworth was not a very warm person; he was lanky, balding, with a hawk-like nose, beady eyes and arrogant mannerisms. Definitely not the kind of person I would have chosen to work with. He kind of gave me the heebie-jeebies. But I didn’t have to like him – I just hoped he was good at what he did.

Before doing the tests, Dr. Twittworth spent some time asking me questions about things like my childhood, education, jobs worked, the car accident, my current life, medical problems, etc. I gave him a copy of the information I shared with my doctors and therapists – things like medications I was on, doctors I had seen or was currently seeing, treatments or therapies, and a list of the kinds of problems I was having.

While the testing took a few hours which might not seem that long for someone else, it exhausted me. The pain in my back, neck and shoulders made it hard to sit for any length of time. The tension on my head and neck increased the tremors, making it hard for me to concentrate and more prone to headaches.

The whole experience was an eye opener for me – I was shocked at some things that I noticed about myself. In the past, school was very easy for me. I had a photographic memory which made it easy for me to do so well in school; I would read something and during a test, close my eyes and turn through the pages of the book in my mind and be able to find the answer. Information I heard during class or at work would stick in my head – I’d just start thinking about the lecture or conversation and it was if I could hear it being re-played for me. These former abilities obviously played a role in me graduating 2nd in a high school class of 400 students, as well as doing so well in college and graduate school. But they were gone now.

While taking the battery of tests, I now knew what it must feel like for children who have problems with attention, concentration and sitting still in school. Tasks which were boring or didn’t have much relevance for me, I found extremely hard to pay attention. At times I felt flooded with too much information. I felt like I was drowning in words, pictures and problems. Silently I endured the suffocating feeling, wishing I could run out of the room and scream at the top of my voice. Instead, I tried hard to hold it together and just get through the barrage of tests.

My tremors came like ocean waves. They did not have the same fluid predictability, though. It occurred to me that I probably appeared to be a highly anxious person. While the shaking did increase at times when I was emotionally anxious and distraught, it also occurred at other times. During some difficult tests, the shaking would increase. Oddly, for other challenging tests my entire being seemed to kick into super-drive and the tremors wouldn’t start until after my task was complete.

I hoped this neuropsychologist and his testing would help shed some light on these issues. I would have to wait for my next meeting with my BVR counselor to obtain his report and hopefully, some suggestions. I wanted to understand what was happening and how to get back to the “old me.”

*****************************

woman-folder2Three weeks passed and it was finally time for me to find out the results of my testing. Mallory, my BVR counselor, sat at her desk scanning over some papers in a folder in front of her.

“Dr. Twittworth doesn’t feel you are ready to go back to work yet,” she informed me.

“Well, I know I’m probably not in any condition just now to go back to work, but does he say anything about what areas I’m having difficulty with? That would help me and my therapists know what to focus on. Does he give some suggestions about what to do?” I inquired, hopefully.

Mallory paused as if to figure out how to phrase her next response. “Ummmm, he feels that any attempts to return to work would not be successful at this point,” she said cautiously, emphasizing the word successful.

I was confused. “But I don’t understand what that means,” I implored. “Can you work with me or provide some kind of help? You know, like help me figure out what I should be doing now until I get better?”

“I’m sorry, Angela. You’re too high functioning for us to help you,” she replied.

Now I was really confused. “I don’t understand. You’re saying I’m too high functioning, but that I’m not ready to go back to work? And that I wouldn’t be successful? That doesn’t make any sense to me.”

“Well, we’ll close your case for now, but you can call me at any time in the future if you’d like us to re-open your case and work with you,” she said empathetically.

I sat there totally befuddled. What was I missing? I obviously wasn’t’ understanding something. Not sure what to do at this point, I asked if I could have a copy of Dr. Twittworth’s report.

“Certainly,” she said politely, and then exited the room with folder in hand. She returned within a few minutes, handing me a stapled copy of the report. As she held the door open, indicating my time was up, I thanked her. I left feeling more perplexed than I was before I got there.

As my father drove me back to my home, I glanced over the report.

“The most significant finding is on the personality inventory, the MMPI-2… Her profile is strongly positive for conversion disorder. Such individuals usually present with numerous physical complaints across organ systems, including muscle weakness, fatigue, depression, paresthesias and mental confusion, paralyses and pain syndromes. She does not appear to be consciously distorting her answers or attempting to manipulate the outcome of the evaluation. She is dramatic in clinical presentation. She truly believes her symptoms are real and physical.”

“…the stuttering and stammering are psychogenic manifestations. There is no cognitive or brain injury that causes this presentation.”

“She should be advised that though she may have had a head injury, she did not sustain a brain injury, as these two are quite separate and distinct. Even if she was momentarily dazed at the scene of the accident, a mild concussion which could have caused acute symptoms, would fully be resolved by this time, with no residual neurological effects on her thinking, memory or speech.”

“She is not ready to return to work at this time. A failed effort to return to work would be very de-motivational for her. She needs aggressive, rehabilitative psychological management, with a doctoral level person skilled in psychological rehabilitation after injury. Such professionals are not easy to find…She should submit to this rehabilitation therapy for 6 months prior to attempting to return to work I believe the long term prognosis is good, if the psychological aspects of her condition can be addressed and managed quickly. Otherwise, if her symptoms become entrenched by well-meaning but gullible professionals, and her condition could become chronic.”

I wasn’t sure what to do or who to talk to. A local brain injury support group was meeting later in the week. I had been to the group once before. I thought I fit in well with the group; many of the people described problems similar to what I was having. But now with this report…. Maybe I didn’t belong in this group. I wondered if there were support groups for people with conversion disorder.

I called the local BI contact person and told her about my recent diagnosis. She said not to worry, that I should come to the next meeting and share my experience with the other members. I did go to the next meeting and was glad I did. Much to my surprise, 8 out of 10 people had also been diagnosed with conversion disorder! A whopping 80% of the group had an injury to their head/brain and had also been diagnosed with conversion disorder! What was this…some kind of mass hysteria? Or pure ignorance on the part of professionals?

It boggles my mind how these psychologists think they can give various tests and that these tests will tell them any and all deep dark secrets submerged in the subconscious mind. They believe that these tests and the psychologist’s ultimate opinion should outweigh medical evidence, people who see you in everyday life and see the challenges you deal with, and professionals who have known you and worked with you more than 10 years. Such is the power of the neuropsychologist.

*****************************

One of my friends had retired recently. We got together occasionally and I would give her updates about was happening. I talked to her about the psychologist that BVR sent me to for testing.

“Yeah, this schmuck is NOT a medical doctor and he says I have conversion disorder. Says I think my symptoms are real, but they aren’t. Just because of some true/false questions I answered on a personality test. And he’s supposed to know this when he isn’t a doctor?” I said.

“Some of them like to think they know more than they actually do,” Mary Jane offered.

“Well, I’d diagnose Dr. Twittworth as an arrogant jerk!” I asserted.

A strange look spread over Mary Jane’s face as she said, “Dr. Twittworth? Michael Twittworth?”

“Oh, no. You know him?” I asked.

“His wife and I are friends, and we all get together for dinner frequently,” she said. “Yes, I know Michael.” She hesitated, then said, “Well, he’s …… different.”

“I’m sorry. Gosh, this is awkward,” I fumbled.

“Well, don’t worry. It’s not like this is the first time this has happened. I had another friend who always talked to me about her husband’s doctor. She referred to him as Dr. Asshole. Turns out she was talking about Michael, too, so don’t feel so bad,” said Mary Jane shaking her head. “I like him as a person, but I’d never recommend him professionally. I wouldn’t even take my dog to him,” she confided.doctor-report

The damage, however, had been done. This report became part of my medical records and followed me everywhere. It didn’t matter that my primary care doctor and therapist, both of whom knew more for at least 10 years, completely disagreed with his assessment. Other specialists to whom I was referred later, didn’t know me and accepted Dr. Twittworth’s assessment of me without question. My medical files had been forever imprinted with the “double P” brand – “Psychological Problems” or “Psychiatric Patient.” Take your pick. This was the beginning of a devastating domino effect of having medical professionals discount the physical problems I was having. All based upon the results of the MMPI-2 test (a personality test) and a psychologist’s interpretation who did not know me.

************************

About 2 ½ years later while going through the deposition phase of my personal injury lawsuit, Jayne, my lawyer’s paralegal, called me. “You won’t believe what we just discovered about Twittworth,” she said. “I was checking his license from the state psychology board and it turns out that he’s had his license suspended twice. Once in 1993 and again in 2005.”

Twittworth’s first suspension was for having an affair with one of his clients. His second suspension was for writing a report recommending suspension of a woman’s parental rights for a court custody case without ever having met or evaluating her before writing a report about her. He based his “evaluation” of this woman on an MMPI-2 which had been administered by another psychologist and maintained that the woman was “illiterate and operated at a 3rd grade level,” without considering the test’s accuracy with people who speak English as a second language.

What I find horrifying about this person who calls himself a psychologist, is that he once again has his license and is out there practicing. How many other lives has his incompetency and “low standards” hurt or destroyed? He is hired by BVR (Bureau of Vocational Rehabilitation) and SERS (School Employee Retirement System) and who knows what other organizations to evaluate individuals and give various kinds of recommendations. Have these organizations bothered to check his licensing record? Or do they not care about the “low standards” of the professionals they hire? I want to know who administers psychological tests to hired professionals like Twittworth to determine their underlying psychological issues? How do they assess their integrity, professionalism, or underlying motivations to do the kind of work they do? Or are these things not as important to these agencies as “other” things?

*******************

Before you get tested by any kind of psychologist, I hope you will learn from my mistake by taking a few minutes to check the person’s professional license to see if they have any actions taken against them. Below are directions for how this can be done.

1. Google: psychological licensure, (state where you live)

2. Look for a selection to click on that says something like “License verification.”

3. You may be asked to choose what kind of licensing you want to verify. Choose Psychology.

4. At this point, you will be asked to type in the psychologist’s first and last name, city and state.

5. The search will show the individual’s name and may indicate whether there has ever been any disciplinary action taken against the person. If this is not readily available, you may have to click on the person’s name for more information to appear.

6. Look for options titled something like “Administrative Actions” or “View Documents.”

© Angela Cramer, 2008-2009

Clipart and photos are the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com


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