Episode 22: Understanding Psychological Testing
In this episode of South of Fine, we talk with Dr. Geralyn Datz, President and Clinical Director, Southern Behavioral Medicine Associates in Hattiesburg, Miss., to get a better understanding of what psychological testing is, and what it isn’t.
EPISODE TRANSCRIPT
Rhes Low, Host:
Hey, guys. Welcome back to another episode of South of Fine. I'm your host, Rhes Low. As our regular listeners know, our goal at South of Fine is to change the stigma around mental healthcare. One of the best ways we can do this is by inviting more people to join the conversation. Come on. If you want to help our podcast get seen by more people, please subscribe to South of Fine, rate us and then share episodes with friends and family.
All right, guys. So as I mentioned, we are joined today by Dr. Geralyn Datz. Is it Geralyn?
Dr. Geralyn Datz:
It is. Geralyn Datz.
Low:
Okay, good.
Dr. Datz:
You said it perfect.
Low:
President and clinical director of Southern Behavioral Medicine Associates in Hattiesburg, Miss. Dr. Datz, thank you for joining us.
Dr. Datz:
Thank you for having me. A pleasure to be here.
Low:
Absolutely. So you're here today to discuss a somewhat ominous topic, and as I mentioned in the beginning, well actually before we pressed record, I have intentionally not done a lot of research on this topic because of a statement I'm about to make. It's in regard to what I think visually psychological testing is. So it's not a subject that I know very much about, and if I were told I needed psychological testing, I'd probably, like many of our listeners, be pretty concerned that my doctor there was something seriously wrong with me. My visual of this is a very dark asylum and electro shock therapy being hooked up to my head and whatever else. That's how I think of psychological testing. I know I'm completely wrong, but the movies have really messed me over there. It just sounds scary to me.
So, let's start this off by actually talking about what it is rather than what I think it is. So what is psychological testing, and why is it not as scary as it sounds?
Dr. Datz:
Well, first of all, I love your candor, and I do think that people come in to mental health settings and psychological testing referrals with this set of preconceived notions. And they can be ominous and they can be scary. I think this is a fantastic question.
The way I look at psychological testing and really the discipline of psychology looks at psychological testing is as assessing someone's strengths and weaknesses. So I think people see it as scary because of the word testing. Testing does not have positive associations in people's minds. At the very least, it's considered a pass/fail situation, and nobody wants to fail. Or something is deathly wrong, or as you referenced, sometimes there are these really antiquated notions of mental health that are perpetuated in the media or in movies or in jokes. But still, they're there.
The process of psychological testing is really looking at the brain. In the brain, there's cognitions, there's thoughts, feelings, behaviors. There's your reaction time, your memory, your speech. And psychological testing would encompass any or all of those things, including your personality, and your personality could have strengths and weaknesses. I mean, I know your personality's perfect, but other people's-
Low:
It is. It is perfect.
Dr. Datz:
... might not be as perfect. And we could actually assess that. We also-
Low:
We should.
Dr. Datz:
We can look at mental health, depression or anxiety and look at the severity of those types of symptoms through psychological testing. And we can also look at things that are more medical in nature like head injuries. If you had a car accident, you would expect maybe your memory or your thinking might be a little cloudy after something like that if you bumped your head. And we would want that to improve, so we would use testing. And that we really look at as sort of a compassionate environment where we're just really looking to get more information.
Low:
I was about to say it's not very invasive as far as medical procedures, right?
Dr. Datz:
Correct.
Low:
That's really cool.
Dr. Datz:
What you were referring to, and I think what we have these Hollywood images. I mean, there are-
Low:
Live and die by... Yeah.
Dr. Datz:
There are EEGs, that's like sticky pads on your heads. Those measure brain waves, and that is a form of cognitive assessment. But it wouldn't occur in this environment. That's more of a neurology or a hospital base type of treatment. So these are tests on computers, on pencil and paper still with objects like blocks, with diagrams and copying. So the vast majority of it is done at a desk, whether it be at a computer or with another person.
Low:
That sounds pretty awesome. And it sounds like one of those things that could benefit everyone, and everyone could kind of have a good time with.
Dr. Datz:
Yeah. When people come in, they're really nervous, and we make an effort to really put people at ease. A lot of times people will say, "I wish I had gotten this done sooner," particularly when people get assessed in midlife, like, "Wow, I really struggled in school, and I never knew my delayed memory was so poor." Or we might be able to recommend things that help people, and then they say, "Wow. That made such a difference. I wish I hadn't struggled for so long at work or with time management or whatever the case maybe."
Low:
Sure. That's cool. That kind of leads me to this question about... And I want to change the phrasing of this because it says if your therapist or doctor recommends psychological testing, does that mean there's something wrong with you? But that's not exactly, based upon what you're saying, it's not something that's wrong with you. It's an assessment of who you are and maybe some pitfalls that you've encountered. Is that-
Dr. Datz:
Exactly.
Low:
Okay.
Dr. Datz:
To give credence to that thought though, sometimes there are things wrong. I mean, I don't really like that term. In medicine, there is no right or wrong. There is no pass or fail. It's just you are who you are. You're born with a certain set of skills. I mean, time shapes people, and things can be overcome. I'm the wrong person to ask. I mean, I've seen people do incredible things with sets of weaknesses that you would think that would doom someone for life. So I think sometimes there are things that are wrong. Like if someone thinks, for example, with ADD, they can't figure out why they're never on time, why they're losing everything, why they can't pay attention in class, why they study and they don't perform well. So I guess you could say there's something wrong there in the person's life, but we are actually testing to get more information and more information, in my opinion, is always a good thing because then that gives us a path where we can assess things.
But in other circumstances, there might not be anything wrong. Somebody might be looking for clarity. Like they already know they have depression. But then they're in a relationship and someone says, "I think you're bipolar." And they say, "I really don't think I'm bipolar, but maybe I should go get tested." Then they get tested, and we can actually differentiate different psychological disorders from themselves. Maybe the person's on the wrong medication or maybe they need a different type of therapy for example.
So, I look at all information as good information.
Low:
Yeah, absolutely. I love everything you're saying, and it makes complete sense. It sounds to me like everyone needs to get psychological testing or maybe it should be a rite of passage. Once you graduate college, that's when all those walls start coming up and you start adulting or whatever they call it.
Dr. Datz:
Yeah. I do think it would be a very different world if we knew more about ourselves. In United States, we're not particularly introspective, and we're kind of more of an external culture. We're kind of a baptism by fire culture, and it would be helpful to know. And actually, some people do get occupational testing to kind of see what careers they might fit with better. Are you more verbal? Are you more performance oriented or whatever the case maybe?
But interestingly, the American Academy of Neurology has actually suggested that people in their 40s get baseline neuropsychological testing because dementia is so prevalent. What happens is when people are referred to us because we test people from 16 to 90, and when people are referred to us with memory problems, 55 and up or 65 or 75, I have no baseline for that person. So, when they tell me, "My memory used to be great," I'm just going on their self-report. I don't have any evidence of that. Actually, their memory may have been good to them, but it might actually have just been average or above average in the general population.
So, in any event, the American Academy of Neurology suggested that everyone get tested in their 40s so that you can have that baseline. So that when you do start to lose it, you'll know how much you're losing or how much you're not losing or where you were to begin with. That would really revolutionize health care honestly because we're always trying to guess basically at what the past was.
Low:
So how far along is that in becoming... How far out do you think? Never. That's amazing idea. I love it.
Dr. Datz:
I think we're pretty far from it. It would take a pretty large campaign and probably a lot of participation from primary care to start talking to people and say, "Hey, have you ever thought about getting tested?" But maybe it will, and insurance needs to accommodate it. Some insurances make it very, very easy, and others make it harder. So there's a lot of variability in terms of insurance coverages.
Low:
I think it's a great age though because that's the point where you start having to get real check-ups. That should, as you said, be a part of that.
Dr. Datz:
Mm-hmm.
Low:
I also like that you mentioned introspection. Our audience knows it. For most of my life, I was in the entertainment industry as an actor and part of that training is you better know yourself quite well in order to understand others better and empathize better. And you recognize your faults, and you understand how they affect your life. There's all this whole thought process that I guess you guys are even going even further in determining how we can be introspective and live a better life. You guys are mainly working with 16-year-olds to what age?
Dr. Datz:
90
Low:
To 90. Wow. So what does that look like when you have someone in that realm, 80s to 90s? What are you working on?
Dr. Datz:
That's a great question. I would have the same question. But a physician might refer for any number of reasons. So there are high functioning people in their 80s and 90s, and I've seen them. I hope I am one of those people.
Rhes Low:
Me too.
Dr. Datz:
So usually it's a neurologist referring because a formerly high functioning parent is being brought in by a family member, like a daughter or a son, and there's been a sudden decline or confusion or there's been a fall. Most of the time it's a fall. There's been a fall where somebody hit their head or tripped or fell down the stairs or something of that nature and now momma's not the same or daddy's not quite the same. They don't know is this going to pass? Did it have a severe impact? Is it just a headache? That kind of thing.
It's not too late, which I know is the feeling. Like, "Well, why bother to get assessed maybe of Alzheimer's at that age?" Like I said earlier, we really try to be compassionate and do the least possible testing that the person needs to get the answers that we're looking for. But I mean, our geriatric clients, they're often fantastic. We have a great time with them. We help their family members.
We end up doing a lot more than the testing. The testing sounds so clinical and ominous. But of the testing, and I think one of our strengths is, we do treatment planning after that. So after we talk about what the results are, now can momma or daddy be left alone? Can they drive? We work with their treatment team to talk about all of these things. What could we be doing more of to reduce the depression that came during the pandemic or when people stopped going to church or being social and all of the things that were important?
There's something called pseudo-dementia, Rhes, which is someone looks like they're developing dementia because their memory's failing and they're tripping over their words. They are just not as sharp as they used to be. But it's depression.
Low:
Really?
Dr. Datz:
We assess their memory and it's rock solid. But they still aren't functioning the way they used to, and I tell people to never underestimate the impact of things like depression and anxiety because they will hijack your brain and make you look quite ill sometimes, cognitively, when in fact it's a medical condition that affects your emotions. But your emotions are also in your mind and in your brain, and those affect the transmission of information, the encoding of information, the encoding of information into long term memory. So it's kind of a sophisticated algorithm.
Low:
Based upon what you just said, and I'm not going to try to repeat it because it was so articulate, how important is physical activity to enhancing that or helping?
Dr. Datz:
I would say very important. It's one of our primary recommendations for individuals for almost everything. There's data on exercise remediating depression and anxiety. There's data on exercise remediating attentional difficulties. There's data on exercise remediating dementia level impairment, memory issues. There's data on exercise remediating sleep and insomnia. There's data on exercise remediating stress and stress induced illness, things like constipation and agitation and panic attacks. I mean, just almost every intersection that you can think of exercise has data in terms of reducing symptoms. That's not magic. When we move the body, the brain and the body are connected by the spinal cord. So there is no separating the head from the body. So when the heart rate goes up, when the muscles change, this changes neurotransmitters. It changes hormones, and those are all part of that equation that makes us who we are.
Low:
Yeah. We've had this discussion several times on the show about how a physical check-up is important. In our society, we think about physical check-up, but we don't put that importance on that mental check-up or that psychological testing that we're particularly talking about. But they're symbiotic. The same thing.
Dr. Datz:
Absolutely. Yeah. The mind and the body can't be separated, and mental health is physical health.
Low:
Yeah. I'm trying to beat that point home to everybody that's listening. One day, we'll all get it. Give me a few examples about what you're looking for during these psychological tests.
Dr. Datz:
Yeah. So as I mentioned, we're looking at brain function, and if I may, I'd like to use a metaphor. In our lives, if we have a problem with our vehicle, our car, most cars nowadays are basically computers, advanced computers. And you might get a message on your dashboard that says, "Check engine soon," or some sort of mysterious symbol. You take it to the mechanic, and they hook it up to a computer that diagnoses your car and says, "The carburetor is off," or there's a seal or there's a problem in X, Y, Z place.
Psychological testing is a lot like that. We are bringing you in and we are testing all the different parts of your brain. Can you put these blocks together in this way? How fast? Okay, that means that part of your brain is working fine. Can you remember these words? Okay, that means that part of your brain is working fine. Can you remember these words an hour later? Okay, that means your delayed memory is working fine or not working fine. Can you do sophisticated tasks? Can I teach you something totally new and can you learn it? How long does it take you to learn it? And then can you redo it for me pretty quickly?
The way that psychological testing works is say for example you were having yourself tested, you would be compared to other men your same age, born and raised in the United States that had the exact same level of education as you. So it's like being in a room with 5,000 other guys your age, and you kind of look around. You all grew up with the same songs and the same education and the same kind of culture, and are you on par with those men in every way or in some ways? Are you stronger than them in certain domains, and do you have weaknesses compared to those men? So when we give a result, actually you're not being compared to me. You're not even being compared to females. Most of the tests compare males to males, or if there's no gender differences, then it would be males and females.
But I think a lot of people don't appreciate how specialized it is. By the time we come to a conclusion, it's pretty robust.
Low:
Yeah. I don't want to be compared to females because you guys are a lot smarter than we are and thoughtful and detail oriented.
Dr. Datz:
There'd be a lot of weaknesses there, is that what you're saying?
Low:
Yeah. It'd be like weakness, weakness, weakness. I definitely don't need that. I live in a dream world, Dr. Datz. So I think I have a lot of strengths, but they're probably all weaknesses.
Dr. Datz:
Don't we all. Don't we all.
Low:
I love that. It goes back to the reason that I use the word invasive earlier is that you are so skilled at what you're doing, you know each part of the brain and you know what each task you're asking someone to do is being utilized in each part of that brain. So without going into... Because we commonly think, I think, as a layman, we commonly think that we have to go to-nothing against neurologists that are amazing-a neurologist and get some sort of invasive-and maybe that's not the right word, but it's a visual-orientation of what our brain looks like and where it's synapsing properly. But you can do that by moving blocks around.
Dr. Datz:
Yes. Actually, and neurologists know this. I think invasive is a far term. So if you went to a neurologist, they might refer you to a psychologist for this type of testing. What they would do would be blood work because we want to know if your blood is right. If you're having thyroid problems, that can affect your thinking and B12 and other things, too many things to get into. But they'll do blood work. They'll do an MRI sometimes, which is a big noisy machine that you have to sit in. If you're claustrophobic, it's not fun. And you might need medication to hang out in there. You might have that other test that we mentioned before, the EEG, which is the sticky pads on your head that measures various types of brain waves. So it is more on you, in you, and I would consider that invasive. This is more with you, collaborative.
Neuropsychological testing is considered the gold standard for differentiating various types of disorders, and the imaging really tells us what disorders there. So if there's plaques in the brain, it's Alzheimer's. If there are small vessel changes, small vessel disease. If there are vascular changes, it's vascular dementia. There's different ways. There's five different kinds of dementias and then other issues. It might be a brain injury or an aneurysm or a tumor. So the pictures will tell us that.
But just like going to the mechanic, you really can't look at the engine all the time and see exactly what's causing something. If you ever had that problem, like I have a noise and it sounds like a ta-ta-ta-ta-ta, you got to drive it and hook it up and figure it out. That's what the neuro site testing is doing is really driving down to the causes in the gears.
Low:
Yeah. That is really well put. I'm kind of fascinated and kind of at a loss for words because if I could push a button just let you keep talking about this, stream of consciousness, that would be awesome. Okay. So let's get back to the questions on hand. So why is it important to see a specialist for psychological testing? We kind of covered that.
Dr. Datz:
Well, I had a comment on that.
Low:
Yeah, sure. Why is it important to see a specialist for psychological testing?
Dr. Datz:
Well, the reason that I think it's important to discuss that is people sometimes think they're getting tested when they're not. So a lot of people will come to our practice and they'll say, "Oh, I had testing." We'll say, "Oh great. What was it?" They'll say, "Well, I did this yes/no thing with another person. They gave me a personality test." But they never really got psych testing, what we call standardized testing. So standardized testing is actually controlled by boards, like it's usually a doctoral level person who's allowed to administer it, and also the testing publishers, they check to see if they're selling their publication or their use of their test to a doctoral level person because they don't consider people with master's level training or bachelor's level training as equipped to really give a fair and balanced use of the test.
Low:
So I wanted to ask you about Southern Behavioral Medical Associates. You're the president and clinical director. How far is your guys reach in that area?
Dr. Datz:
Pretty far. So we're located in Hattiesburg, but I'm licensed in three states, Mississippi, Alabama, and Louisiana. And also, right now because we're still during the pandemic, we have permission to treat people all over the United States. That will probably end at some point. But yeah, normally you would need to be licensed in the state that you're conducting an assessment in, and we do a fair amount of tele-health, always have, even before the pandemic because we treat individuals in rural areas and micropolitan.
Low:
Oh, that's great. Great. I just wanted anybody that's in the listening area or throughout the nation to know that you're available, and your expertise is within their grasp because it's mighty fine from my point of view.
Dr. Datz, thank you so much for being with us. It has been quite a pleasure.
Dr. Datz:
Thank you for having me.
Low:
If you have questions about mental health and the COVID-19 pandemic that you'd like our providers to answer in a future episode, please email southoffine@righttrackmedical.com. And if you'd like more information about Right Track Medical Group or the South of Fine Podcast, please visit righttrackmedical.com.
Thanks to our production team Kelley Hunsberger, Caitlyn Clegg, Carol Ann Hughes, Aleka Battista, and Rhes Low. A special thanks Squadcast for providing superior remote interview services.
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