Feeling in place

School is old news. I’d much rather be at work doing things that are directly helping patients than taking classes or working on my dissertation. This week marked the start of my 4th year of graduate school. Needless to say, I have some major senioritis. Being there sorta feels like going through the motions. Being at my externship comes with a different set of feelings. Even if I have to go in to work early, sit at a computer all day, and type reports or score data or whatever, I know that I’m at least making palpable progress. It’s a quicker goal to attain than finishing school, that’s for sure. But alas, I will complete one more year of classes and hopefully put myself in a position to be working full time next year and finally getting some $$$ for my efforts. That day cannot come soon enough!

I recently started reading a book that is enjoyable so far. It’s one of those books where it changes character POV’s each chapter. I like books that do that because the story comes together from many different angles. The main plot is that a senator has an affair and his family has to deal with the aftermath. Shocker, right? Lol.

Oh, one more thing. Last week, I used this computer program to score a projective test that I gave to a patient I worked with, and this program rocks my world! Not only did it calculate all the variables and indices for me, but it also spouted out a whole essay worth of test interpretations in prose. Without this program, it would have taken me hours to score the test and even more hours to come up with interpretations based on every individual score. What an asset!

H.M.

Many of you have taken a psychology course of some sort at some point in your life. But even if you haven’t, there’s still a chance you may have heard of H.M., the famous epilepsy patient who lost his ability to form new memories after a bilateral temporal lobe resection (that means they took out the key memory structures on both sides of his brain). After his surgery, his seizures were controlled, which was the primary goal, but H.M. was left with anterograde amnesia. Essentially, you could introduce yourself to him and spend a little bit of time with him, but he’ll forget you soon after. Because he was a unique case, he has been studied in the fields of neurology and neuropsychology for more than 50 years before he passed away last winter. Why am I posting this you ask? Well…his brain was obviously preserved for further scientific study and has been entrusted to the scientists at the UC San Diego Brain Observatory. As of a couple days ago, they have been streaming live video of the slicing of H.M.’s historic brain. The video is schedule to end tonight, which is why I’m not linking you to the page. But this is the link to the blog associated with the project. The information contained on the blog is very technical, and I don’t claim to understand all of it because it’s neurobiology speak and I’m a psychologist, but there are a few cool pics. I’ve viewed the video of the slicing a couple times, and unfortunately, the lab isn’t equipped with great video equipment. Much of the footage is choppy and you can’t see what they do with the slice after they make it. Still, they’ve been great about updating regarding their progress. For instance, they’ll say that they just finished the frontal lobes and are moving towards temporal-parietal regions, or something along those lines. A couple of weeks ago, I went into NYU on one of my non-externship days because they were going to do a live brain cutting. I was psyched to see it in front of my face. Unfortunately, when we got to the lab, they said they had done the cutting the day before…despite the fact that they set a scheduled time so that people can come watch. I was very disappointed, so seeing H.M.’s brain get sliced up was pretty cool although I wish the video quality was better. Someday, I will actually see a brain in real life. One day…

For those who want to read more about H.M., he’s widely cited through google and wikipedia has a good page that sums up his case as well.

Tough patients test your patience

Ok, now how clever is that subject line? Anyone? Haha, well I thought it was.

Between yesterday and today, I have gained a lot of clinical experience in my lovely field of psychology. This is not to say that I went from being a novice to an expert. Not at all. I just learned a couple things that will hopefully stick with me down the road. Yesterday, I did some neuropsych testing with a woman who was just not interested in the testing process. She was oppositional, unmotivated, and she gave up easily. I consulted a supervisor about the patient’s lack of performance on one test, expecting that I’d be told to just skip that test. However, it escalated into a whole ordeal where we had to go see the patient, explain the benefits of testing, and tell her why she needed to cooperate and perform as best as she could. The lessons I learned were that 1) supervisors are there to help and show you the way and 2) making mistakes is part of the process of learning. You just hope that you only make each mistake once or twice! I was so concerned with whether I’d be able to squeeze in all my tests that I didn’t do enough to convince this patient that it was to her benefit to work with me. I temporarily lost sight of my job to also be a clinician and not just a psychometrician, and my supervisor cleared up my tunnel vision. Did I wish that I could have taken care of this ordeal by myself? Sure! Who wouldn’t want to be self-sufficient? But as a student, I’m still learning and I have to rely on people with more experience to show me the ropes. I’m good with that though because to this point, any supervisor I’ve worked with has been great and I’ve learned so much in the last year alone.

Moving onto today. I did an intake evaluation on a woman who has an extensive psychiatric history. She has seen many professionals and I’m not sure any of them know what is wrong with her, myself included. I’m not going to describe her case, but it’s pretty easy to tell right off the bat when you’re going to begin therapy with someone who carries a lot of baggage. Some patients come in to a clinic with a straightforward case of panic attacks or phobias. Others have a couple disorders in tandem. Then there are the patients that probably qualify for many DSM diagnoses and who experience deficits across multiple areas of functioning. This last sentence describes my intake patient. So what did I learn? From her, nothing yet, but I can already predict that if I end up working with her and we make any progress in individual therapy, my confidence as a clinician will increase significantly. It’s always the difficult ones that we want to conquer the most. We feel that if we can produce any results in those who have widespread symptoms/disorders, than we’ve really accomplished something. Psychotherapy doesn’t always produce the results you hope for because of many different factors (disease severity, patient characteristics, etc), so when progress is made, you have to savor the little victories.

P.S. I know I technically put the psych column on hold, but posting about these last couple days seemed relevant to me. Maybe I’m onto something in terms of format for this column. Only time will tell.

Psych column

Hi there. This is my first post on the go. I’m coming at ya from the WordPress application on my blackberry. I’m going to keep this relatively short because otherwise my thumbs will fall off!

The reason I’m posting is because I’ve been having doubts about my psychology column. I don’t know whether I want to take the educational route (where I describe different terms or concepts) or the news route (where I report on psychology related happenings in the world). Neither really appeals too much because both are somewhat boring, or at least have the potential to be. However, I am a psychologist in training, which makes it almost silly not to include something related to my career in this blog. Maybe I could veer more towards the brain science stuff I’m used to? I don’t know. I’ve been thinking about what angle I can take, and I’ve come up empty so far. Any suggestions?

Ok…thumbs are a little stiff. Time to end the mobile post.

P.S. For all you House fans, last night’s season premiere was awesome!

New word

As part of my psych column, I’m trying a “learn a new word” feature. This may or may not be a regular part of this column because I still haven’t figured out how I want to do this column. So for today (and since I’m exhausted), I’m introducing the term “heterotopia” because I just learned it today at my externship. At the end, I’ll link you up to Wikipedia’s description of the term because they explain it in more official terms. Basically, a heterotopia in the brain means that a chunk of brain cells (neurons) have somehow ended up in the wrong place. When the brain is developing, neurons have a set program for where they are supposed to end up. Interestingly, the brain forms inside out. So instead of putting all the outer layers together first, all the inner stuff is formed first and the cell destined for the outer layers essentially have to climb over the inner layers. Nature is weird sometimes! So with this unusual process in place, sometimes cells get all confused and forget to hop off the train (or get off too late). As a result, they end up in some other place and just stay there for the duration of their lives. Sometimes they function correctly, and sometimes they don’t. It’s a toss up. Anyways, the reason I learned about this term was because when someone has a heterotopia, it is possible that they experience seizures as a symptom of the malformation in their brain. And if someone experiences seizures, then it is possible that they end up in the epilepsy center where I work. Connection made! Let me give you guys this link, and of course, feel free to do a more extensive search on the term if your heart desires.

Grey Matter Heterotopia