Angst

Last Saturday I re-took the oral exam for licensure. Texas is one of only a handful of states, including Georgia, Louisiana, Oklahoma, West Virginia, New Jersey, Colorado & California, that still engages in this outdated, highly subjective final hoop to private practice. I passed the national written exam (EPPP) and the state jurisprudence (ethics) exam over four years ago at the Doctoral level within a few months of receiving my Master's degree. Then I finished my internship, and that pesky dissertation thingy to earn my PhD (the highest possible degree) and the last year I've been in postdoc. In most states that would be sufficient. Instead, I got to sit in front of the Inquisition and give answers to questions about an imaginary case off the top of my head instead of being able to consider all the aspects of the case beforehand - like I do every other day of my professional existence, during which I typically have a minimum of a week to mentally prepare for the the person who will spend time under my care. Neuropsychology a specialization that usually requires a referral. It's not 7-11. We just don't get walk-in traffic.

This time, I was able to manage my anxiety up front a lot better. Knowing what to expect going in went a long way toward not elevating that anxiety to the point where I was having panic attacks or feeling like I was going to vomit on the examiners (okay there were a few minutes at the beginning that I thought I might release the contents of my stomach onto the examination table but once we got underway, it wasn't so bad). I was able to conceptualize the case and articulate my considerations in a cogent manner and nailed the diagnosis (multiple sclerosis) right off the bat even though I'd been studying TBI (traumatic brain injury) because it comprises well over half of all neuropsychological issues. Then they started asking me about psychotherapy, which I don't do and I told them I would refer the patient and her boyfriend to someone else if they wanted couples' counseling. Still they insisted that I assume I had agreed to see them - together - for counseling - which I don't do. Ever. Psychoeducation...maybe a little crisis management with an appropriate referral, yes - but ongoing psychotherapy? Fuggedaboutit. Ain't happenin', pal. So I did the best I could to talk about an area that does not lie within my area of expertise. yippee.

I was able to tell them what I've done to enhance my professional skills without any trouble. In addition to telling them about keeping up with my continuing education as required, I talked about all the major assessment standardizations I worked on (WAIS-IV, WMS-IV, NEPSY-2, WNV, et cetera - my name's even in the manuals), talked about the continuing education module I wrote for NAPPP on cognitive care of the elderly, and about the presentation I did at our state psych association's convention on cognition and affect in the elderly. The older of the two nodded his head and got a look of "aha" recognition on his face. I think "Aha" guy was there - and I did seriously kick ass on that talk.

So I have to say that, also unlike last time, the two examiners were genuinely nice, friendly guys. There wasn't a Blackberry in sight. Nobody checked the two-way mirror for stray hairs or boogers and they appeared to be interested in what I had to say. When I got stuck, they tried to guide without giving the answer away. There were even several times when they said, "Good." I appreciated the positive feedback. Once when my answer was very succinct but to the point, they were looking at me kind of weird so I asked if they wanted further elaboration, "Aha" guy said, "No. Actually, that was exactly what we were looking for." I could see his score sheet and noticed several 8-point scores, so all that was good. Granted, there were some weak answers in there too, but they can't all be winners, and I just need 64 points to pass. After being escorted back to the holding room, I was dismissed within a few minutes, meaning that once again, I either failed miserably or I passed. I'll know in another 3 weeks or so when I get my notification letter.

It's that wait time that's killing me. I have a constant nagging in the pit of my stomach and every time I think of opening my results letter on the day that it arrives in the mail, I feel my blood pressure go up along with a wave of nausea that I haven't experienced since the early days of my pregnancy with The Girl. I'm having nightmares, waking up sweaty and in a panic, and am on the verge of tears at any given moment. These folks have the key to my professional future and all these years later I'm still whining and scratching at the door like a dog wanting to come in from the cold and be fed.

I've said repeatedly that Psychology is a field that eats its young. Had I known going in how treacherous the path would be, I'd have become a physician and would already have my training wheels off. The licensing process in psychology seems to be more about keeping new practitioners in a one-down position for as long as possible than anything else, and I wonder if they're really concerned with ensuring that there are enough practitioners available to serve our communities, especially in a state that is as grossly underserved as Texas. I've been formally studying psychology with the intent of becoming a psychologist since returning to college in the spring of 1997 and I cranked out 4 degrees in the next ten years. My doctoral program began in the fall of 2000. My training with actual patients began a year later. I graduated with 96 credits more than I needed for the PhD, including a concentration in neuropsychology and a 3.76 gpa to boot. That said, how much is enough?

There and Back $5

So I won a prize over at Brunhilda's. How cool is that? Although she wants to envision us Texas wimmin as all having big ol' bleached blonde bouffant hair and bright red dragon claws, I just don't fit that pattern. My makeup is pretty minimal. Hair and nails are both cropped short and the closest thing to bleached blonde as I get are the highlights The Girl talked me into awhile back that I am allowing to grow back out and the -ahem- "natural platinum" that's growing in as I get older. I own a tanning bed but plan to sell it because I haven't used it in a couple of years.

I promised a juicy, newsy post, so first things first: I survived the oral exam but won't know until around Labor Day whether I passed. The problem with the oral exam is that examinees are given ten minutes to formulate a case and talk about it for an hour with two examiners who have no knowledge of the examinee's clinical skills. They know whether or not examinees have passed when they allow us to check out, but we have to wait six weeks for the "official" letter from the state. There are only one or two other states that still do the oral exam because of the lack of reliability and validity, partly because examiners only receive 3 hours' training and the outcome is highly subjective, but Texas still hangs in there because that's the way it's always been done.

I have some misgivings about my outcome because my anxiety level was through the roof. Ordinarily, I can talk about neuropsych all day long, but Saturday I didn't feel like I could construct a coherent thought to save my life. First of all, I like to think deeply when I'm formulating a case and take into consideration as many of the potential variables as possible. That just can't be done in ten minutes. Second, the people I've trained with over the years were genuinely down-to-earth people that you wouldn't know were psychologists if they didn't tell you. My two examiners acted the psychologist stereotype. It was creeeeeppyyyy (*shudder*). We were seated in a very tiny stark white room with a table, tape recorder, a black file with my name on it, and a 2-way mirror. The examiner seated closest to said mirror kept trying to look into it to see if anyone was on the other side - either that or he was checking his hair, or to see if there was something in his teeth, I don't know. Then, he kept checking his fucking BLACKBERRY throughout my exam!! Goddammit, if I had to leave my cell phone turned off and in the waiting area, he should have been held to the same standard.

The worst part though was the questioning. I had only ten minutes to review the case, which by design, contains only limited information. I could take notes for that ten minutes but that was all. Bet your ass I filled a page in that time. Then, instead of asking one question at a time, the questions were embedded - like 2 to 4 questions all in one shot. By the time I'd get finished with the first part of the question, I'd forgotten the rest and had to ask the guy to repeat the next part - of course, he repeated the whole fucking thing. Then, they started reading the questions e - x - c - r - u - c - i - a - t - i - n - g - l - y s - l - o - w - l - y, as if they were thinking , "Wow - this one is really stupid. How the fuck she got through doctoral study is beyond us..." Either that or my mind was racing so far ahead that there was a warp in the spacetime continuum and it just seemed that way. Then, they asked me what I'd done to enhance my professional skills in the last few years. Um, duh? I just cranked out four degrees in ten years? Finished 231 credits toward a 135 credit PhD in clinical psychology with a neuropsychology concentration as the cherry on top? Did ground-breaking research in the relationship between geriatric cognitive functioning and affect? All those CE's I've taken in the last 4 years? Teaching a doctoral level hands-on Halstead-Reitan lab? Did I mention that I did all of this while juggling work AND a family AND community activism? Does any of that count? Because really, I'm not so sure because my cogitator is really fucked up right now. At any rate, we'll know by Labor Day. Meh. I'm just glad to have it over with - at least until January if I failed the goddamn thing. Fuckers.

I learned yesterday that I'll be presenting my research in geriatric cognition and affect at my state psychological association's annual convention in November. Tragic that they misspelled the title of the research on the website. Gotta remember to call them Monday to correct it. It's Dysphoria, not Sysphoria, fools.

In other news, my intro psych class is over. They were awesome and everybody got an A. I doubt I'll ever get a class that good again. The developmental psych class I was scheduled to teach for Summer II didn't make (even though I worked my butt off getting the course ready to go - upside is that at least it's ready to go next time), so my finances are looking beyond bleak right now, but I'll make it. I always do. I applied for a full time position at the community college but they wait until the last damn minute to make a decision over there, then expect you to be ready to go - like - yesterday, so I probably won't hear anything from them until mid-late August (classes start August 25).

In the interim, I've been selected to take the faculty training for a big, giant corporate university and will start this Tuesday. The recruiter wants me to teach undergraduate and graduate level courses online. We'll see how it goes. In my research though, I've noticed that they advertise for faculty pretty regularly and that there are over 20,000 - yes, kids - twenty thousand - online instructors for this school worldwide. My entry level faculty trainee class is about 250. Jeez, Louise. I can't imagine the management structure they must have in place to keep track of that many people - and that doesn't include the on-ground people or administrative staff. The picture at the top is one The Girl took the other day for my faculty profile. She said that of the dozen or so pictures she snapped that day (actually sitting on the edge of the pool with my feet in, but I cropped all that out), this one captured my personality the best. See? I told you I don't have big hair.

The Girl worked at Sonic for about 2 weeks after drum major camp and never got a chance to work more than 2 hours at one time, even though she got a "promotion" to carhop the second day. By the time we factored in a gallon of gas there & back and taxes, it wasn't worth it for her to work there. Sooo, I talked to The Man and pointed out that sad little fact and that she would never be able to save for another car if she couldn't get any hours. We agreed that she would be better off at her old job, where she could at least work a full shift and get tips from being the best little tableside guacamole girl ever. Of all the guac I've eaten there (which would be approximately a shitload), hers stands out as the best, and I'm not just saying that because I'm her mom. People she doesn't even know request her specifically to make their guacamole. She's started doing this thing she calls "Guacamole Theater," where she acts out bastardized scenes from movies with the knife and the avocado as the main characters and the other ingredients and tools (salt, lime, tomato, garlic, onion, cilantro, molcajete, pestle & spoons) play the bit parts. (Knife: "I am Inigo Montoya. You killed my father. Prepare to die." Avocado: "Ayudame! Ayudame!" After a mighty duel, Knife slices into avocado with a great squishing noise as the other ingredients shriek in terror...et cetera). That Girl is a scream, I tell ya. She's happier there, having loads more fun and making a lot more money, so everybody's happy. She even has a new car, 2 years newer, 4-door & white which we found for exactly the amount the insurance company settled back in April. All's right with her world.

The Man has a job interview Monday for a job which he is totally overqualified but it's close to home and since, despite my efforts, I'm not making shit for money, and the weather's been too dry for his hay business to get any work, somebody's gotta work around here.