I am somewhat in the testing business. No, I don’t test for Lyme disease or cancer or most things that are medical in nature even though most physical and medical ailments have an important psychological origin. In fact, I actually do a fair amount of testing in psychological matters, sometimes personality features, sometimes diagnostic features like depression and anxiety, and more than anything neuropsychological testing. Until recently, about 30% do my practice was in the business of these kinds of testing, but my style of testing is substantially different from my psychologist colleagues and very much different from a psychiatric evaluation.

I want to tell you what I actually do with a neuropsychological evaluation, which I will do a few lines later, but I want to explain the “I want to be tested” title of this blog. This title is meant to identify what is all the rage in society lately, namely being “tested” for everything from warts on your fingers to some kind of psychological disorder. This craze of a desire to be tested is partly due to the medical community selling its wares as exact and more largely due to people’s desire for some kind of exact diagnosis for what ails them in life so they can then hopefully find some exact treatment for this ailment and find some kind of cure. You might know that I did a blog a few years back entitled, “I Want to be Sick,” in which I dealt with the desire for people to find some kind of exact psychological diagnosis and some exact treatment for some exact cure. I proposed there, and I propose again here, that there is no exact diagnosis for anything psychological, not exact testing for it, no exact treatment for it, and certainly no exact cure. I call this the “magic of psychotherapy” as if you could come to me, or to any therapist for that matter, find out what is “wrong” with you (or the person you’re living with, more likely), and then find some exact treatment for this thing that is wrong. No such thing exists.

But the desire for testing for exact diagnosis, treatment, and cure remains secure in American society. Some of the experiences I have had in my office with this looking for the magic bullet include:

• A man who was found to have a certain kind of cancer, went through treatment for this cancer (radiology) and was disappointed that his oncologist said that they would have to wait a “couple of months” after the radiation to determine whether the treatment was successful. He thought he should have an MRI, a CT scan, or some blood test to determine for sure that his cancer was cured or was not cured. No such test exists. He was disappointed that the doctor said that they would just see how he was doing and then determine whether they needed to further radiation.
• Many, many people come to offices like mine seeking to be “tested for ADHD” thinking that there is some exact test to render an exact treatment and exact cure. There are no such thing. There are self-report or parent-report “tests” that you can find on the internet. There is one test, PASAT, that is a “continuous performance” test that can be helpful, and there are some DVDs out that may work. When I have someone come in for “testing for ADD,” I do a large battery of tests including IQ, neurological, and personality tests and try to arrive at a diagnosis.
• A young woman is “very concerned” about her husband’s driving because he once turned into the wrong lane and ran a stop sign at another time. I actually had done a large neuropsychological test battery previously and found very little of significance. She wanted some kind of concrete evidence of something being wrong with his brain.
• I am unfamiliar with most medical tests, like blood tests, MRIs, and CT scans, but the general understanding is that these tests are way over used and very expensive. Even blood tests do not indicate some kind of exact finding. For instance, some people can come up very high on cholesterol but show no signs of heart problems
• I just read that there is “zero evidence” that mammograms and colonoscopies are effective in accurately identifying dangerous cancer, this coming from Dr. Zorba who is on local NPR and has a regular spot in the local newspaper.
• It was valuable for me to be tested for Lyme disease, get an exact treatment, and a quick cure. I had previously contacted a clinic who said I would need to do a $1500 evaluation given my symptoms, which were primarily fatigue. I found a local group that did my Lyme test for $68, which by the way, would have cost me $300 at a medical clinic.

Deb and I regularly administer a rather large battery of personality tests, some of which we have created, and some formal tests that others have created. We find the results of this kind of testing very valuable in understanding people, primarily their normal personality characteristics, but even this testing is not exact and sometimes we find that the individual’s perception of him/herself is not what they showed on the test or what we think of them. There is the “gregarious introvert” who is introverted by nature but well-spoken, just as there is the “shy extravert” who is outgoing but shy in the sense of a bit unsure of him/self.

The testing that we do find helpful, if it is accurate can assist people in valuing their basic nature and avoid the self-critical elements of most diagnoses. I just saw a man who is a well-spoken introvert among other personality characteristic who has erroneously been diagnosed as “schizoid personality disorder” or “avoidant personality disorder” where in fact the combination of his personality characteristics is introversion, analysis, and rational thinking. Indeed, he has difficulties, particularly social and intimate difficulties, but these can be understood as “a strength to a fault.” Introversion to a fault is hiding, but introversion by its nature is quality, perception, and privacy.

So, if you want to be “tested” for something, use caution. For most diseases, testing is only partly valuable. In psychology testing for ADHD and many other so-called mental health disorders, is approximate at best. More importantly, look at your strengths, like introversion or extraversion and see that you may being operating from something “good but good to a fault.”