Question:
Should I tell the psychatrist the truth?
I will be having my psych test soon and I have been going back and forth on an issue...Several years ago I had lost over 80lbs. and was on my way to being at my goal. While at a party, I was raped and in this downward spiral, I gained all of the weight back and thensome. My question is- how personal will they get? I don't know how they might take this info. One may say that this surgery is not for me since I lost it before and that I just need more therapy to get through the assault. I dunno. So, should I just keep it to myself? Could it hender or help? — karmiausnic (posted on April 27, 2002)
April 26, 2002
Yes! You must tell the truth. They are trained to read people, and you
could damage your cause by lying. I found in my psyc eval that the Dr was
just trying to assess how I would handle the trauma of surgery and
recovery. I discussed my abusive childhood and was as honest as I could
be. Please, for your own sake, be honest and I know everything will work
out fine. Good luck and God bless!
— Christine L.
April 26, 2002
It is really irrelevant to your weight gain that you were raped. You would
have regained the weight anyway, as 95% of the people who lose weight do.
You have assigned a 'false cause' to your weight gain. However, more to
the point, are you afraid that if you lose weight that something like that
will happen again? Just letting the shrink know that you are willing to
work in therapy as you lose weight to confront and overcome any
psychological issues that come up as a result of your weight loss is a
great way to get them on your side.
— merri B.
April 26, 2002
Hi. I am 6 months post op, lap rny. When I was a little girl, I was
sexually abused for years, by more than one family member. I know that's
why I put on layers and layers of fat. I don't need a psych consultant to
tell me that. During my evaluation, I chose not to speak of it, UNLESS I
was asked the direct question, "Were you ever sexually abused?"
I have worked through it all, forgiven the people who did it to me, all
through accepting Christ and through studying His Word. It's my business,
my life, I worked through it the best I knew how. I figured why hash it
all over AGAIN? I have never really told anyone, just applied The Word to
my particular situation. I'm signed up here under a fake name anyway so
no one really knows who I am. But no, I didn't tell a stranger, during an
evaluation. I already knew all the answers as to why I ate. I didn't need
a "professional" to tell me. But you know what? I'm okay. I'm
a survivor. And unless you forgive you will carry it with you forever. I
was a victim. It's just something they are going to write in their
notes.....and then what?
— Annie H.
April 26, 2002
You don't have to bring it up yourself, but if the psych doc asks you about
any trauma, tell the truth about it. The fact that you have lost weight
before and then gained it back is not going to prevent you from having
surgery. In fact, many of us have done that more than once.<p>Also,
you didn't say anything about getting counseling at the time of the rape.
If you have not done that, please call a rape crisis center. It is not too
late to call them and not too late to work through the emotional trauma of
the rape. You will be better off all the way around if you get
professional help from someone who has experience in treating victims of
sex assault.
— garw
April 26, 2002
I am in 100% agreement with Annie. I was sexually abused as a child and
after that point I started putting on the weight. It was my 'barrier'. I
wasn't planning on talking about it at my psych eval, but it was on the
questionaire so I was truthful. When asked I just proceeded to tell her
that I had forgiven my offender and moved on with my life. This person is
still in my life and it is a constant struggle to be forgiving, but it is
what the Lord commands, to forgive your enemies. I do find that being able
to forgive has freed me of feeling bitter and angry and I am now a much
happier, peaceful person. I explained all of this to the psych and she
said that I really have it 'together'. She said that sexual abuse is
rampant among the obese, so there is a direct link. Just be honest, and if
you need additional therapy to resolve any left over issues, do so. This
will not hinder your chances for qualifying. You have traveled a difficult
road, I pray for the best for your future.
— Cheri M.
April 27, 2002
If your primary goal is to get approved for surgery, I wouldn't bring it up
unless asked specifically. Also, even if you are questioned directly about
past sexual abuse, I wouldn't volunteer a causal connection between the
trauma and the weight regain. Try to be vague about the timing, and very
clear that your problem with obesity has been long-standing, both before
and after the rape. Unfortunately, I have heard of more than one person who
has "failed" their WLS psych evaluation because of
"unresolved sexual abuse issues." The psychologist/psychiatrist
will almost certainly think that the rape issue is important, and it is
anyone's guess how he or she will respond to that information. In a perfect
world, you could be completely open and honest, but in the real world,
mental health professionals have their own biases and gaps in
understanding. Obesity is a complex disease, and those in the mental health
field are often only aware of their little piece of the puzzle. If they can
find an "emotional" cause for the problem, they can sometimes
latch onto it at the exclusion of everything else (the
"when-you're-a-hammer-everything-looks-like-a-nail" phenomenon).
The *timing* of your weight regain was surely related to the trauma you
went through, but it very likely would have happened anyway as soon as you
experienced some other period of life stress. Your goal during this
evaluation should be to demonstrate that you are emotionally stable right
now, that you thoroughly understand the surgery and the risks, that you are
committed to the post-op lifestyle changes and follow-up care, that you
have a good support system, and that you have realistic expectations.
However, once you have your surgery, I would definitely recommend
establishing a relationship with a therapist (not the person doing your
eval) and then being completely open with your counselor about the rape and
its aftermath. You are probably going to need some significant support as
you start losing again and approaching goal. Even if you feel as if you've
dealt with the trauma of the rape, once you become smaller you may start to
feel more vulnerable and it would be good to have someone ready to help you
through that. Best wishes to you.
— Tally
April 27, 2002
I am sorry to hear about your experience; it must have been devistating.
Re your psych consultation, here is my advice...I was raped when I was 12
yo and made the MISTAKE of telling my initial psychiatrist about it, which
she used against me in a letter denying my WLS. I thought it was better to
be honest and "lay it all on the line" but I don't recommend
doing that for these one-time counseling sessions to get approval for WLS.
I wouldn't lie if asked a direct question, but definitly recommend that you
DO NOT VOULUNTEER TOO MUCH INFORMATION. The next go-round with a psych who
was more supportive went much better, but I did not share with him my rape,
the fact that I've never known my father, that I live with a gay man a la
Will & Grace, etc. etc. because these could have been traps to deny the
WLS. Am (was) I depressed? Of course I was - if I was in a ring with Mike
Tyson I'd be the heavy weight! But I am now 3 weeks post op, down 20 lbs.
doing great and physched about my future. I am not saying we should
"psych" the psychs out, but honestly, if we have done the
research and made the decision to have WLS we should be able to without bad
things in our past preventing it because some of trumped up doc. (Clearly
it's a different story for those on serious psych meds or with psych
disorders.) Anyway, I apoligize for this long answer but I am still a
little bitter about my initial psych experience...can you tell?
— rebeccamayhew
April 27, 2002
First use the psych doc your SURGEON recomends, even if it costs some extra
money. This person will be better able to get you ckleared. <P> The
MAJOR reason for rejection is being a activce alacholic. RNY and this dont
mix, the person could die. I was honest on muy evaluation. I wanted to be a
successful post op.
— bob-haller
April 27, 2002
First, I just want to say that I agree with Bob about using the
psychiatrist your doctor recommends, even if it costs more money. I used
the psychiatrist my surgeon recommended, and I had to pay the full $180.00
out of pocket (personally, I didn't think that was too expensive) because
that specific psychiatrist doesn't file claims with my insurance. Also, I
have discovered from reading this site that everybody has different
psychiatric evaluations. I didn't have to take a test or anything. My
psychiatrist just wanted to make sure I understood what WLS was all about
and how it would change my life afterwards. He didn't ask very many
personal questions, and he didn't ask if I had ever been sexually abused.
Like you, I was concerned about some questions my psychiatrist might ask
(not regarding abuse), but I decided before my evaluation to be honest
about anything he asked because, like a previous poster stated, these
people have years of training. They will be able to tell if you're lying.
One more thing I want to add: Like Merri said, you might have gained the
weight back even if you hadn't been raped, since the vast majority of
people do. I have gained 70 pounds in the past 3 years, and I have not
been sexually abused. Also, not every obese person has been sexually
abused, and many thin people have been sexually abused--I happen to know
some personally. In fact, of all the people I know who were sexually
abused, not one of them is obese. I just get so tired of people assuming
that if you're obese, you must be trying to buffer yourself from the world
because of some past trauma. I'm not saying it can't happen, but I am
saying that all people deal with their traumas in vastly different ways.
Even thin people have shi**y pasts. I'm stepping off of my soap box now.
Good luck on your evaluation, and I hope you are able to make sense out of
all the advice so many of us have given. God bless you!
— Kristie B.
April 27, 2002
I am all for telling the docs the truth, but you have to make sure that
they are pro WLS. Most psych disorders that are treatable with meds, do
not prevent a good post op experience. But current addictions such as
drugs, alcohol,smoking.,bulimia, or major eating disorder, can kill you if
you lie.
— faybay
April 27, 2002
Karen: I attempted suicide at the age of 20. When I was 27, I saw a psych.
counselor for my pre-surgery testing, and I was terrified that this
decision (made rashly, in my youth) would prevent me from being approved
for WLS. Fortunately, I chose to be honest about the incident, and I'm so
glad I did. We talked about it, and she asked questions like, "Are
you depressed anymore?" and "What are your expectations about
this surgery? Do you think it will automatically make you a happy
person?" Once we had talked things over, my counselor wrote a very
nice letter to the insurance company recommending me strongly for surgery,
saying I was a "highly functioning individual with realistic
expectations." She didn't mention a thing about my suicide attempt.
My personal opinion: honesty is always the best policy. Regards,
— Terissa R.
April 27, 2002
I wasn't saying that sexual abuse CAUSES obesity, I just said that it is
very common. I also have a friend that was sexually abused as a child and
she is VERY thin, too thin in my opinion. She has turned to other things
other than food, one being alcohol. Many turn to drugs as their way out.
Some find their relief in smoking. There are many addictions that people
have turned to for that 'high'. Also I am not saying that if someone has
or had an addiction, that they were abused. I was just saying that it is
common. I'll get off my soap box now.
— Cheri M.
April 27, 2002
I would tell the truth. If you have not dealt with the trauma of what
happened to you, then it may present a problem post-op. It is not unusual
for women who have been raped or molested to sabotage their own diets as
they see themselves getting more attractive. They do it as a way to
protect themselves. It's not as if they are consciously thinking "I
need to get bigger so I'm less attractive"; it's a fear response that
they have a hard time resisting. My PCP actually had a woman do this to
herself after bariatric surgery because of sexual trauma she experienced,
and she never did get below "overweight". You made an interesting
comment: "One may say that this surgery is not for me since I lost it
before and that I just need more therapy to get through the assault. I
dunno." What do you say? Whatever you do, be honest with yourself.
I know some people are so gung-ho about pulling the wool over the
psychologist's eyes, but take care of yourself. Most psychologists really
are there to help. Good luck :)
— [Deactivated Member]
April 27, 2002
Phschiatrists love it when we feel we have to tell the truth. They make an
issue of things, drag things out... more therapy, MORE MONEY! Anything you
say, can and WILL be used against you. But it's your choice. I prefer to be
honest in my life, but when it comes to these so called professionals,
they'll use any excuss to keep you coming back so they'll make more money.
I guess it all boils down to how bad you want surgery. Tell the truth,
there is a good chance you'll spend alot of time and money with the
phsychiatrist. So it all depends on you. If you don't want to lie, then
just don't volunteer any extra info. But being raped or sexually abused as
a child is going to raise red flags, and you can probally kiss your surgery
goodbye until you spend money and time in therapy. I know I'm in the
minority as far as my believing you should be carefull what you say. But
I've had alot of experieince with therapists as I needed to have approval
for other surgeries. And I've found them to be money hungry grubs who are
getting fat on our wallets. I'd never tell the truth to any of them again.
But that of course is your choice and how bad you really want the surgery.
If you feel you can wait, months (years?) for the surgery and feel the
therapy will help you, then great. I wish you the best. I had a bad
childhood because of sexual abuse too. But all the talk with therapists
would not help my weight problem. I needed surgery as there was'nt anything
left to try. I do hope that you can get that pain in check and on with your
life. None of us deserved that treatment. Good luck.
— Danmark
April 27, 2002
Cheri--I hope I didn't sound defensive about your previous post. If I did,
I apologize. Of course, some people probably do turn to food to cope with
sexual abuse, and I agree with you that many people turn to other things,
like drugs and alcohol. I suspect that you and I might disagree on what
causes obesity, though, and that's perfectly fine. I personally do not
think my obesity was caused by an addiction to food. I eat like every
other normal-sized individual I know--my body just stores what I eat as fat
more readily than others. As soon as I quit starving myself on a diet, the
weight piles on. And I do get defensive about that issue. But again, I
apologize if I came across too strongly.
— Kristie B.
April 27, 2002
Thank you everyonw for your comments. I want to let you know (since I
didn't go into detail on my previous post) that I have had extensive
therapy since this occurance. I was overweight for many, many years before
this had happened, so my weight gain was not brought on solely because of
it. Like someone had mentioned, I just didn't want to bring it up if this
psych might label me as something or someone I am not. I also attempted
suicide a couple of years later (had nothing to do with the rape) and I
felt that this was something to definitely keep to myself. I have learned
since then to love myself no matter my weight. I am in no way suicidal
anymore. I just want to lose weight and finally be able to feel comfortable
in my shell. I would prefer to be honest, but I am also realistic and I do
not want this doctor to decide after one- one hour session that I do not
fit the criteria for the surgery. I think I will keep it all to myself. No
need to jeopardize my chances after I have worked do hard!.......THANKS
AGAIN!
— karmiausnic
April 28, 2002
As a licensed professional counselor, it really saddens me that the
psychological profession has gotten such a lousy reputation for how we
handle it when people tell the truth. If the doctor/therapist is a good
one, any history, including suicide attempts are seen in the context in
which they occured, not as a lifelong character flaw that gives rise to the
opportunity to be judged unworthy for the episode. It is never good when
people lie or obfuscate the truth to the people who are there to help them.
And mutual trust is the basis of any helping relationship. One thing to
consider is what happens when your records are cross referenced and it is
noted that you failed to provide full information to the doctor. Are you
then 'forgetful' or 'deceptive'? I have noticed how much of the decisions
to withhold information are shame-based. As a result, I personally have
taken the stand to tell the truth and nothing but the truth and trust that
in doing so all things will work to my benefit. I would even broach the
subject with the shrink of being concerned that the opinion developed
within a one hour span could have serious negative consequences if
develooped on a less than complete understanding. That is my opinion for
what it is worth...
— merri B.
April 28, 2002
YES, you should tell the psychiatrist the truth.
The psychiatrist is not your enemy nor is he or she out to sabatoge your
desire to have WLS. However, if there is something in your history, or
psychologically that could impair you, shouldn't that be brought out? I
know what it is like to want the surgery so much you will do anything, but
take a breath and keep in mind that the pre-op evals are not just a lesson
in paperwork, but a real attempt to ensure that you will be successful in
the long run.
Be brave, be truthful! Start this journey off with honesty and you cannot
help but succeed.
Kindest Regards and Best wishes,
— Ann B.
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