Could My Husband Have a Learning Disability?

In My Humble Opinion
1

My husband is a Ph.D. student in clinical psychology at a pretty well-respected institution. He has been there for three years now and recently completed his Master’s defense, which was very well-received. He isn’t having any trouble with the coursework or his lab. He has always been an excellent student and very dedicated to his work (in undergrad he was the sort who would track his daily hours of homework on a calendar in color-coded ink.) His research is incredibly thorough and well-conceived.

Since becoming a Ph.D. student (well actually, beginning with the applications process) he’s become deeply insecure about his abilities. He’s felt overwhelmed and particularly paranoid about his clinical work. I’m not sitting beside him every day watching him treat patients, but it seemed to me that he was just finally feeling the ‘‘little fish in a big pond’’ pressure that many academics go through. So I tried to help him by encouraging him to combat his irrational thoughts about not measuring up.

His predominant concern was that he felt he wasn’t learning as quickly as he should be in his clinical practice. His supervisor had apparently pointed out several times that she spends more time with him than any of her other students. When he told me this during the beginning of their working relationship, my first thought was, ‘‘Wow, what a right bitch.’’ Now maybe that’s just me being defensive, but I don’t think I would tell someone new to the clinical field that they were doing worse than everyone else. That just seems obnoxious.

But apparently he believed her. I guess it was the thing that really made him worry the most. After his successful Master’s defense he calmed down considerably. I thought all this had blown over until he went to wrap up his clinical work. His supervisor told him that she feels like he’s not learning at an appropriate pace for the amount of effort he’s been putting in or for his apparent level of intelligence. She thinks he has something wrong with his working memory or that some aspect of his cognitive ability is lagging far behind the others. She suggested he get tested for a learning disability.

His reaction to this was not what I expected. He seemed more relieved than anything else, because it confirmed his belief that something was wrong with his clinical practice. He obsessed about it for days. He decided not to do the practicum that he spent an entire year preparing for because he didn’t feel he was ready for it, and ever since then it’s been all about how he wants to get tested for a learning disability. I wouldn’t say he’s obsessed now, but I definitely feel like he’s putting more importance on the idea of a learning disability than is warranted. It’s almost as if he’s saying, ‘‘If it’s a learning disability than I don’t have to feel ashamed.’’ Like his self-worth as a psychologist is hinging on there being an objective reason for his difficulties.

I’m just really uncomfortable with the way this all seems to be going. Of course if he has an issue that can be treated, that would be great. But he’s also complained that the quality of supervision and training at his clinical practice was poor, that it’s highly unstructured and that in itself might be a reason for his poorer performance. He’s talked about this with other colleagues and his mentor and they basically feel like his supervisor has no idea what she’s talking about. I feel angry with this supervisor for screwing with his head from the very beginning and I’m honestly not sure if he’s getting closer to an answer or just allowing his insecurities to get the best of him. If this is much ado about nothing I’m going to be pretty upset about the fact that he gave up his dream practicum because some supervisor made him feel incompetent.

It’s hard for me to honestly assess him since I’ve known him so long and there are a lot of things about him that I assumed were just idiosyncrasies, but nothing profound. There are a few things that have always struck me as odd but I never considered they could be a learning disability.

  1. He conflates words a lot. Instead of ‘‘substance’’ or ‘‘sustenance’’ he’ll say ‘‘substanance.’’ He does this all the time and has no idea he’s doing it.
  2. He can’t remember anything off the top of his head. He has a very hard time with using estimates. For example, if I go to the grocery store, come home, and he asks me how much I spent, I will probably remember $123.48 down to the penny, but I’ll say, ‘‘About $125.’’ OTOH, if I ask him something similar, he is incapable of giving even an estimate, and has to look at the receipt. ‘‘About how much do we pay for car insurance?’’ He has to look it up. I don’t know if this is normal or not.
  3. He can’t remember anything unless he writes it down. He will almost never give a straight commitment for something. Even very simple requests, like ‘‘Can you take care of the dishwasher today?’’ are met with, ‘‘I’ll try to remember.’’ He writes almost everything down. He insists that he must write things down or else he will forget.

Those to me are the most unusual/jarring things, but I always just assumed they were differences between him and me, not differences between him and everyone.

OTOH, he remembers exact quotes from movies and TV shows we watched five years ago, and the specific context of those movies, and the exact issue # of his favorite comic events. So I don’t know how worried I should be. And supposing he does have a learning disability? How would that change anything? AFAIK you can’t make those go away. It’s not like he would be a different person, or his clinical work would magically be easier.

So what do you think? Typical grad school insecurity? Or something more? How can I help him deal with this?

2

Testing might not be a bad idea, and seems pretty low risk. What do you feel might be the down side of exploring this possibility?

3

I’m not sure there’s anything that can be done to improve a memory problem, but it’s certainly possible that he has a learning disability…especially if he’s over thirty. I don’t know how much things have improved since the 80s, but two of my teachers thought I might have an LD, but prevailing wisdom of the day said bright kids can’t, so my parents got “I’m sure this issue will improve” when I was in kindergarten. And I personally was told “I thought you might have a learning disability from the way you spell, but your reading comprehension tests out at the college level so you can’t have one,” the first week of seventh grade. Most likely I have some sort of phoneme problem (I don’t properly “hear” the difference between certain letters like between D and T, and letter combinations like PER and PRE) which I’ve more or less solved by rote memorization of spelling. Unfortunately, your husband’s problem sounds harder to address.

I think he should definitely be tested, though, since it’s possible that a professional can discuss ways for him to cope better as well.

4

I guess my biggest fear was if they found nothing, how he would react. I don’t think it’s the testing so much as the attitude he takes toward it. I got the distinct impression his thought process went something like, ‘‘If I have a learning disability, then I’m okay, but if I don’t I’m a complete failure for not mastering clinical work.’’

However, I did just talk to him about this, and it seems like I was misunderstanding his position. His attitude now is healthier than I suspected. He just wants to get the testing done now so that if he runs into a problem at his next clinical practice, he’ll have more information to make informed decisions. I overheard him discussing it on the phone with his father and stepmother and the conversation really seemed to upset him, but when I brought it up today he explained the conversation was upsetting just because he felt like it was pointless to talk to them about it, not because he felt ashamed.

He said that if he tests normal, his predominant feeling won’t be shame but a sense of betrayal by the program, because he feels like he’s gotten nothing of value out of his clinical practicum this year, and believes he especially would have benefited from some sort of systematic training. If he does continue to have problems in a new setting he will at least know whether it stems from a learning/cognitive issue or whether clinical work is just not his thing. This makes sense to me.

Maybe I was worried over nothing. Anyway, I am interested in hearing from people who did discover issues like this later in life.

5

It sounds like a grad school thing to me. There is a stage when you begin to feel competent, but you really aren’t. You have the knowledge but not the wisdom. A good mentor is really critical at that point. A good mentor will guide you through your thought process to help you see the pitfalls and the good points. They won’t do that every time, necessarily, but often. A bad mentor will just point out the pitfalls and give you the “correct” answer. In the end, the bad mentor ends up shutting down your development by making you feel incapable.

I’m in the biomedical sciences, so I can’t say that this is the same in clinical psych. But, it sure sounds familiar, especially since he’s acing everything not having to do with his practicum mentor.

Having said that, I don’t think it would hurt to be tested for LD also.

6

Seems like he would have encountered academic problems before now, right? It just seems strange to me that this issue would only start interfering with his performance in school now, especially in a clinical setting, where things tend to be more free form and not so rote. But maybe I’m not understanding exactly what he’s doing and how it might be completely different than other thing he’s had to pull off in his life.

If he’s having time performing, it could be that he’s choking. Overthinking things instead of letting his subconscious mind do the heavy lifting for him. But yeah, testing can’t really hurt I guess.

7

This is a grad school thing, and a clinical supervisor thing. My friends are all Ph.D.s., M.D.s, J.D.s, speech pathologists, and other degrees/professions that required a lengthy mentorship and/or supervised clinical practice. Not one of us escaped without a story about a mentor or adviser who did emotionally manipulative, borderline sociopathic things to undermine our self-confidence.

For example, my sister K, who has been generally acknowledged to be a rising star in her field (forensic pathology), had one supervisor during her residency who wrote her a terrible evaluation, saying that she was the worst student she’d ever had in a particular rotation and that K should redo that part of her residency. No one else agreed, and of course it didn’t happen in the end. But K tore herself up worrying about it.

My sister M is a speech pathologist. During her clinical training, her supervisor made her incredibly self-conscious. She told my sister that she had a speech defect and needed intensive speech therapy. M was mortified and became very anxious throughout the rest of her supervised sessions with that person, and it affected her performance. In the end, of course, M did not have a speech defect and has succeeded brilliantly in her career as a clinician.

I could give other examples as well, but I will stop here.

Unfortunately, a mentor/supervisor has a tremendous amount of power over a student. It’s not surprising to me that some mentor/supervisors sometimes succumb to the urge to wield that power against students they simply do not like, usually for quirks of personality. I think it’s far more likely that is the source of your husband’s frustration. And it’s a common frustration.

Everyone I knew in this situation picked themselves up, put the bad experience in its proper place, and moved on. It’s usually the only solution if one wants to continue to graduation. Your husband should do what it takes to make that happen for himself, but I wonder–will getting himself labeled with a learning disability help? Or is it a distraction?

8

I’m not sure that I would be particularly worried. I’ve found that I process information very differently than other people, but I suspect that each person processes things uniquely. I need to write some things down to remember them as well, (although there is some types of information which I retain perfectly without such aid) and there seems to be something about writing it down which triggers my memory, because I will often not need to refer to my notes. Consequently, I’ll take copious notes and never look at them.

Some people are much better at me at hearing bits of information and then putting it all together, but I do much better if I know the overall structure and then can fit it in.

I don’t know if this is a “learning disability” or not, but knowing how I process information has allowed me to take the necessary steps to be successful in my field, as well as to learn Japanese.

It may be that this was the first time your husband ran into a particular new circumstance, and hasn’t figured out how to process the information yet. It would be helpful if the advisory can provide more information than just “slow” in order for him to know what to work on.

9

could he be just adjusting to the regimen of PhD work? spent 1 year with that before i got married (you’re lucky in that respect) and it’s a big jump from masterals. with masterals, it’s a lot like undergraduate work; you read books and references integrally, like a novel. being able to absorb the main essence of the book was the key to being a good student (book-wise at least.)

well with doctorals, you cross boundaries. you study other fields, all of it synthesized into what you are focusing on. example, on the study of animals and man’s relation with animals, i was required to read all of the following:

the illiad and the odessey to have on insight on ancients’ relationship with their work animals.

plutarch’s lives to see who among the great figures seemed to have a consciousness for animals (obvious choice: alexander)

aristotele - descriptive biology and taxonomy

summa theologica - look for spriritual relations

darwin and cuvier - mutability and variation

dickens - the rise of mechanized industries

melville - economic impact of whaling

10

Hi, cousin!

Reminds me of my Spanish teachers writing “poor descriptions” on my essays and, when I asked “how do I enrich my descriptions?”, saying “just write them better!” Yeah, very helpful. Moron. I learned how to write descriptions from a computer programmer :stuck_out_tongue: (writing for a MUD, he was my first editor there).

11

The problem here is the supervisor might be an asshole, and might also be identifying a real issue, they’re not mutually exclusive.

Retrieving memories and successfully memorising something can be two separate issues, ie retrieval works fine once its in, but getting it in takes more work than for other people. The needing to write notes thing for even very mundane could be a sign of working memory issues, or just perfectionism or anxiety.

But calling it a possible learning disability is a bit of a stretch given his current academic level, more likely any issue is only one relative to his current competition. At the very least he must have worked out quite successful ways to work around it (like the notes), and there may be other workarounds he would learn about if an issue is identified.

But the problem here seems to be as much about the meaning being attached to whether he has an issue or not, as much as the issue itself - if he doesnt have a disability, he is still a very successful student, and the worst that is happening is he is having difficulties as he goes to a new level of study. Is he aware of impostor syndrome?

Sounds like that might be part of the problem.

Otara

12

Do the idiosyncracies get worse as he gets more stressed? It sounds more that he has an anxiety issue rather than a learning issue, and it sounds like he’s in a high-stress environment that would exacerbate his anxious tendencies. But then I’m wildly guessing here. Good luck with the testing.

13

Yes, he definitely gets worse when he’s stressed. I’m not sure he would qualify for a diagnosis of OCD but I definitely think he has compulsive tendencies - he admits that himself. He is overall a very mentally healthy person but for some reason when it comes to this program he really does have a lot of anxiety.

Otara I agree with you re: imposter syndrome, and yes he’s familiar with it but it doesn’t of course, apply to his situation. :rolleyes:

14

Bolding mine.

I don’t know how helpful this may be, but my husband does these things as well and he was diagnosed long ago with ADD. He can remember the Konami code and the theme song to every single cartoon from his childhood but remembering to wash the dishes is very difficult. He needs a list to follow each day or he simply won’t remember what needs to get done. Whether or not that is part of the ADD or a different issue I don’t know, but it might be worth getting your husband tested for that.

All that being said, I don’t think it sounds like any particular learning disability is the problem here. It sounds more like his being uncomfortable in the environment in which he is working/learning and that is causing him to fall into some sort of anxiety feedback loop. My guess is with a different mentor/instructor he would find himself picking this up very quickly.

15

Given your overall description of the situation it does not sound like your husband has a leaning disability, plenty of very bright people process information just the way he does. Look a your list again and see how close he comes to the absent minded professor stereotype. A stereotype that is not altogether incorrect.

Your husband does sound like he is somewhat insecure and a bit emotionally needy, and probably needs (or seems to need) a lot of handholding and reassurance from his advisor. For better or worse this personality type irritates the hell out of some people, and I’m going to guess his advisor is one of them.

If she is not the handholding type this is probably driving her up a tree, and she’s lashing out at him with this “learning disability” red herring to get him to (in her view) straighten up. The fact that he is almost eager to glom onto receiving this diagnosis indicates he really does like his crutches.

I think this is less of a learning disability scenario and more of an attitudinal issue. Chronically insecure people are irritating to others regardless of how intelligent they are. They are especially irritating when you reach of level of academic performance when you are really supposed to be past your anxieties and all about getting your work done.

I suspect this whole scenario is more emotional and attitudinal than intellectual, but unless he can get past his insecurity he’s going to have major issues. His advisor may be a bitch, but if he’s not pulling himself up by his own bootstraps at this level she may have a point.

16

Your husband could be my long lost twin brother.
My experience in grad school was very similar.
Not sure if it helps but I’ve seen a few doctors and therapists and the consensus seems to be that I have a mild case of autism, possibly Aspergers. Take from that what you will.

17

Right. That’s kind of how I’ve always viewed it. Brilliant but quirky.

My husband is not a very emotionally needy person. It’s not like he pesters other people with feelings of insecurity - that’s an honor reserved for me. :slight_smile: His problem in clinical work seems to stem from the fact that he has a difficult time remembering details. He finds it difficult to discuss case details with his supervisor even when he has just seen a client. This is why she has had to take more time with him - to point out what he’s missed or what he should have known. By his own admission, ‘‘I make a lot of rookie mistakes.’’ If there is a genuine cognitive issue at all, it would be with his memory or his ability to assimilate new information.

I also think it’s a legitimate thing to expect some sort of training for a clinical practicum. In my very brief experience as a clinical therapist intern, I didn’t receive any training either - they just said, ‘‘Go talk to this person.’’ You can master the theory of an intervention in your head, but when you’re faced with a living and breathing, complex person, it can be very challenging to apply those principles in a concrete way. That’s where training can be really effective.

That said, I do agree with you that something attitudinal is at play here. There’s definitely some kind of anxiety-feedback loop as pbbth suggests. Even if there is something legitimately off about his learning ability, the anxiety certainly can’t be helping.

18

Remember that a learning disorder is generally a descriptive diagnosis. It simply describes a set of behaviors that enough people have found disruptive enough to seek help for. Anyone who has a condition that is incompatible enough with the learning tasks they need to do does, definitively, have a learning disorder, whether it matches the official list or not.

These labels can be useful for talking about it with others, narrowing down which interventions might be useful, and asking for special accommodations. But having or not having a diagnosis doesn’t make something more or less “real” or “legitimate.” There is no magic line between “normal variation” and “learning disorder.” It’s not a black and white thing. “Learning disorder” is just a handy way of lumping together people whose brains work a certain way, and it doesn’t mean that people’s brains can’t work in totally different ways that don’t fall into one of them, or that some people’s way of thinking really just isn’t great for some types of tasks.

So label or not, your husband can do exactly what he’d do if someone said “Oh, you have the typical signs of __________.” Look at the points where he has trouble, and try some interventions. See what works for him.

I think it is also important to consider that your husband may just not have a gift for clinical work. I imagine it is like being a teacher- some people really take a shine to it, and others will never be great at it no matter how hard they try. I get the impression (from this and other threads) that your husband does not have a high tolerance for ambiguity. He seems to gravitate towards the clear and quantifiable. For a number of reasons, that’s not the skillset that works best in clinical therapy.

It’s tough for a generally smart and successful person to admit that there are some things they are not going to be successful at, but it happens sometimes. Having a gift for academics can sometimes be a curse, because it becomes very easy to become a perfectionist, and expecting perfection of yourself is mentally exhausting and rarely works out well.

19

A few thoughts for olives:

  1. Like a whole bunch of others in this thread, I can confirm that the journey to a Ph.D. is one filled with stress and an unhealthy dose of self-doubt.

  2. Maybe your husband has a short-term memory problem, or he could just be absent-minded. Hard to tell over the Internets. :slight_smile:

  3. What concerns me most is that he seems to be losing sight of his ultimate goal, and the steps he needs to take toward it, i.e. not doing the practicum. It’s one thing if he’s decided that that’s not the path he wants to follow, but otherwise he needs to keep pushing ahead as best he can, even as he investigates the possibility of a learning disability.

20

Just adding a datapoint: when my dad was sick and dying, all of the above totally applied to me. I was preoccupied with worry and trying to absorb/learn a lot about his illness. It was like part of my brain was always running some kind of thinky sub-routine chruning out stress and over-thinking scenarios.

For me the “verbal conflations” were like your example, but also things like combining two words, so “baseball bat” would come out as “basebat” and if I was holding a pitcher of juice and I needed a glass, I would probably say: “I need a juice” because juice was what was right in front of me.

It was like I’d become the world’s worst multi-tasker. After my father died and my stress levels eventually went back to normal, all the weird brain-cramps went away too. It was like the stress had created mental fatigue.