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The Alimond Show
Dr. Sarah Wahab: Courage to Begin and When / How to Start Your Therapy Journey
My name is Sarah Wahhab, and I am a licensed clinical psychologist. I work in private practice in Vienna, Virginia. And I work with a wide range of clients. So I guess I can describe it in two ways. The type of diagnosises that I work with can range anywhere from anxiety, depression, mood disorders, bipolar disorder, substance use disorder. So those are the diagnoses that either come to my practice already with a diagnosis or they're struggling with some of the symptoms. And then, and then I also work, and so the population that I work with, these are the diagnoses. The population is like age range anywhere from 13, 14 all the way until older adults. And I work with couples in families. So that's my jam. I know it's not like people don't think of it as like more than one person in the room, but because I do conceptualize from a family systems perspective, the first session will sit and do like a family genogram, which is a map of the family. And regardless of if it's a relationship issue or a diagnosis issue or a little bit of both, that is my primary orientation.
SPEAKER_01:What inspired you to become a psychologist? And then what continues to drive your passion for helping people get unstuck today?
SPEAKER_00:So it's actually like not within my family or cultural norms to go towards mental health. I don't think I didn't even know about that sector, I think, growing up, except for what I saw in movies. I was honed in on wanting to be in the helping profession and helping people. And the only way I knew how was what I was exposed to was either going into like medicine or dentistry. And so I was like, oh, I'm gonna be dentist. Oh, okay. Oh, I'm gonna be a medical doctor, and then I can help people in these different kinds of ways. And after I graduated undergrad from Mason with a biology degree, I was like, I don't want to teach biology. I don't want to go into medical school. What am I gonna do? And what's funny is my mom, who was an immigrant, actually did something outside of the box for our family. And I guess her friend was going to a psychiatrist at the time that was that also does talk therapy. I remember he was trained in Georgetown and he had this like cultural competence like addition in his the title of his name. And yeah, and then I chatted with him and he helped me see some of the ways that I was stuck myself, some of the tunnel vision thinking or not being flexible, things like that. But the funny thing is, my work with him was successful, and then I was like, wow, this guy's job is this is a job, like I can actually do this for a living. This is so cool. I get to help people. I'm really interested in like dynamics and helping people see things in a different way or find their own solutions. And that and then so he inspired me, and that's how I got into the field of psychology and kind of explored and discovered it. And yeah. And then what drives that passion today to keep that fire alive? I think what's interesting in our field, like progress doesn't sometimes progress happens right away, and sometimes it happens over time, like it's a journey. It's really nice to be able to see families function better, find a way to communicate better and just work on themselves and look at themselves. I think that's what inspires me when people are clients are able to self-confront and do the hard work. It's hard work no matter what. So do the hard work that is oriented towards their own growth. That's inspiring.
SPEAKER_01:That's awesome. And it keeps you going.
SPEAKER_00:It keeps me going. Yeah.
SPEAKER_01:You describe therapy as a collaborative journey. Why is that partnership approach so important in your practice?
SPEAKER_00:It's collaborative because if you think about it, I am like a family systems orientation psychologist, right? And so I do have to look at, we all have different systems in our lives. And that could be so the first system is me and the client, right? And then it could be me, the client, and their family. And then there are, you know, they have school, they have their job, they have so all of these things influence the therapeutic outcome and the client's experience. And so the first collaboration is with me and the client, obviously, right? If they're working with a psychiatrist or a medical doctor, then I collaborate as part of that team, if that's appropriate. But I think from a different perspective, it's collaborative because I think a lot of people, which is totally fine, they come into therapy thinking that I am going to give them advice or tell them what to do, or and I'm just like, you have everybody else in your life is telling you what to do. What's my opinion? Like, how's that going to help you? Or we just maybe start even with what stops them from being able to make that decision on their own, because clients are the experts of their own lives. And I really believe that the best guidance is going to come from within them. And it's my job to help them navigate that journey and uh and figure out how they can continue to be in charge rather than rely on someone to tell them what to do or advise them. But of course, there are I I say that m mostly in like relationship issues and decisions and things like that. But there's obviously space in my practice where if we're dealing with OCD or their treatment protocols like cognitive behavioral therapy techniques or dialectical behavioral therapy techniques that I will pull from, depending on, you know, the client and what they're presenting with or what their needs are at the time. So I'm not sure if that answered your question.
SPEAKER_01:Yeah, no, that was perfect. Many people they feel overwhelmed, but they're hesitant to seek therapy. What would you say to someone who's considering reaching out but isn't sure if it's the right time?
SPEAKER_00:Gosh, that's such a good question because I even struggle with that in my own personal life, like either me going to therapy or considering do I wanna, do we need family therapy right now? Or do I need do one of my kids need help with coping? And just the idea of, and even though I'm in the field and I have a lot of colleagues and all that, I get so overwhelmed with how am I gonna find the right provider? How are they gonna be the right fit? Is my insurance gonna cover it? There's just so many factors involved that it can be really overwhelming. What was your question again?
SPEAKER_01:Sorry, I like because it Yeah, no, that's along the lines. Like, what would you say to someone who's considering reaching out, but they're not sure if it's the right time?
SPEAKER_00:Yeah, I think it will take a couple of attempts, realistically. And they've done research on this that it takes people seven years, especially couples, to get into therapy after the first initial thought of, oh, maybe we should go to couples therapy. I would say you you really have to buy into and have the desire to want to do something different, to want the change, to feel motivated because the consequence or the quality of life or is motivating you to come towards that. So that's really important. The other thing is like finding the right provider and finding the right fit. And that goes both ways. You want to make sure that you are aligned with the provider that you choose in terms of the approach that they have fits your needs, their style fits your needs, their expertise and experience, all of that kind of fit. Asking, I guess it is challenging, right? And I think the more we get the less stigmatized mental health becomes, the more we're able to ask each other for referrals. It's not a big deal if a neighbor asks me, Hey, can you recommend someone? There's no shame around that anymore. So I think it is a challenging process. I think moving towards it really does take courage. And I think when people are motivated enough to want that change for whatever reason that is, hopefully the battle of finding the right provider isn't hard because that's also another barrier, right? I want to go to therapy. Okay, now who's the provider that's gonna is there someone that can help me? Or what is therapy all about? What am I even gonna talk about? I don't have a that part's the easy part. I think the hard part is deciding. I am looking for change, I'm looking for to do something different. I want comfort, I want the symptom to stop, I want to break this cycle. If we're at that starting point, yeah. I think for me that's that presents as the biggest challenge, not so much the work itself or understanding what therapy is. And so it's almost like when that pain is like painful enough.
SPEAKER_01:Yeah. But it that shouldn't, I personally don't think that's when you should be doing it. But it sounds like that's when it usually happens.
SPEAKER_00:Yeah, yeah. And I do have clients that come in that want to enhance the quality of their life or they have a work issue or an issue with a colleague that they're trying to resolve, and it's more it's still therapy, but I call it like coaching. And yeah, so sometimes there is like a really desp desperation and sometimes it's enhancement. It's just it's a spectrum of things.
SPEAKER_01:Speaking of which, when someone first walks into your office, what do you want them to feel and experience right away?
SPEAKER_00:That's such a good question because I recently updated the space. So this is I have I I started a parallel business this year, therapy hub is what I call it. And it's basically a space for like it's a shared office space for independent private practice providers to be able to either, if they're early career and they want to start leasing a space where there's it's only for mental health care providers, I have different options for them. But really, whether it's the providers that are coming in to use the shared space or my clients that are coming in, I put effort into making it very calming, relaxing, people can feel centered. And it just gets you in the mind, right mindset to be intentional and like about your time in therapy. So that's what I'm hoping that they're gonna feel relaxed and comfortable and just able to feel centered before they start their session.
SPEAKER_01:Sounds like you put a lot of thought into the design.
SPEAKER_00:Uh this is a recent change and it's it's a way for me to explore like a creative side. Yeah. And it's not like I have good taste or anything. I got a lot of help, but it it was a way for me to also engage with the community, right? Like, how do I decorate? How do I reach out to other providers to let them know about the space? What kind of consultation groups do I want to offer? So it's just like a parallel to my business. But I also, yeah, I did put a lot of thought and intention and and I like to share that with my clients.
SPEAKER_01:That's awesome. That sounds fun, actually. Yeah. I mean, you often talk about authenticity, safety, courage. How do these specific values show up in your sessions and in the culture that you've built for your practice and this new adventure?
SPEAKER_00:Yeah. So I think for the authenticity piece, it's really hard for us as like humans to feel safe enough to be truly 100% our authentic selves. And that's why when I came in here today, I'm like, oh, I'm a little bit nervous. And it's because we're thinking about who's evaluating us, how people are, how we're going to come across. And so, not to say that these things are not important or not valuable, but how do we build enough of a solid sense of self and confidence so that we are able to be more comfortable being our authentic self? Because if you think about it, the less authentic you are, the harder life is because you're thinking so much about how you want to present rather than being more in touch with you. And I think one of the things that a lot of people might not know about graduate school and training to become a psychologist, I guess not all graduate schools, but specifically the way that I was trained, I went through like intense person of the therapist supervision, which is basically part of it was recording every single session and hearing it in front of the entire group for two years. So that's part of it. But the other part of it is we had to create our own family grams. We had to look at our own family dynamics, do our own therapy, make sure that when we are listening to other people's stories and other people's problems and challenges, we're not, or I'm not projecting my own, and that's why I don't give opinions or I don't, and it's easy for me not to give my advice because it's the training that I'm in charge of the structure of the session, but our clients are in charge of their lives. And so in order to do this kind of work, it is really important that the provider, the therapist, has done their own work, whether it's because that's where you will have an authentic experience. And also hopefully, because person of the therapist work is that is pretty similar to the work that we do with clients. There's a parallel there. So it's an interesting process.
SPEAKER_01:I'm writing that down because I think it's interesting. And I feel this is my judgmental opinion. Is a lot of people need to learn how not to give their advice.
SPEAKER_00:Trust me, I'm giving my opinion and advice left and right when I'm not in the therapy room about things that might be harmless or benign, but and sometimes there is space for that. My my son, I think it was like this summer, um, he was asking me a question about something about his personal life. And then he goes, Mama, I just need you to tell me what I should do. I was like, I could tell you what I think is best for you, but it is building this sense of, and that is part of being authentic, right? For him to be able to feel like I can, he can reach out for support, but not that I'm directing his life or telling him what to do. And it's not that I'm worried that he's gonna come blame me, it's that I really value the skill of his independent thinking while also getting feedback from people around him. And so it's got better.
SPEAKER_01:Self-awareness there on his role, right? Like on your role, what you've allowed him to. Yeah. Yeah, I'm the opposite. I'm like sweetheart. Do not do this, do not do this. That nose ring tape. Right. What does self-awareness play in creating lasting change, whether in personal life, relationships, or even in the workplace?
SPEAKER_00:I think the more we know ourselves, the better able we're like the better we're able to navigate different kinds of challenges. Because when you come to therapy or you come for coaching or whatever, you are we can't talk about every single problem in every single situation, right? It's more about the process and about dynamics, right? So usually people find themselves in the same pattern, whether it's uh related to work or whether it's related to school or their family, right? So one common one is like over-accommodating or directing people or directing your kids, right? Over directing or over-functioning, right? A lot of couples, he's not taking out the trash and I can't stand it, so I take it out, right? And so there are these dynamics when the trash might not be the most important topic, but maybe this comes up with this client at work where they're overfunctioning for their colleagues, or it's coming up with their kids where they're doing their projects for them, or like just the overfunctioning, underfunctioning dynamic in relationships. So I guess to answer your question, like the lasting change isn't gonna come from quick fixes. It's not gonna come from how do I get this person to calm down as quickly as possible because I can't tolerate their discomfort, right? That's not what's going to help you be authentic in different situations or be calm. The lasting change comes from doing the hard work of being able to say, yikes, we have a contract. I'm not supposed to take out the trash, it's filled. Sorry, the trash is filled. You know what? I'm just gonna let it sit and give people that signed up for this an opportunity to do it because just because my comfort level is 75% full, somebody else may. So it's 110%. Exactly. There you go.
SPEAKER_01:That is what I do. It's not the right thing to do. Is sweetheart, have you noticed there's more gnats around the trash?
SPEAKER_00:Oh, there you go. That's another clever way.
SPEAKER_01:Yeah. Yeah. Thank you.
SPEAKER_00:There you go. So, like some clever ways, but really it the key is right, like the dynamic part of that. It's a funny example. The dynamic part of that is self-regulation, right? And that's knowing yourself, knowing I will get triggered by this not being done the way that I want it to be done.
SPEAKER_01:Yeah.
SPEAKER_00:And is it really fair for me to force someone to do it the way I want it? How can we, how can I calm myself down enough to allow other people to step up and surprise me or not?
SPEAKER_01:And sounds like I need to sign up for your therapy session.
SPEAKER_00:So that's one example of a dynamic. That's a common one. But that's that's if I'm just thinking of solutions of and with your example, what I like about it, it's a little funny, it's clever, creative. And also you're calm. And it's not like you're pretending to say it with reactivity. And that's what people pick up on. And so if you're going towards it with calmness, then that's fine.
SPEAKER_01:Yeah. Once you know the people that you're dealing with, what will motivate them to do it without creating like an issue?
SPEAKER_00:Exactly. Yeah.
SPEAKER_01:How do you define success in therapy for both yourself and your clients?
SPEAKER_00:Success in therapy. It's funny because I actually that's one of the questions that I ask clients during their intake session is how would they know if therapy was successful for them? And I guess that's how I would define it. Symptoms would decrease. And whatever goal that they have, they even if they don't achieve it, there's a path forward and they understand what is getting them stuck in the barriers that they usually get and shifting certain parts of the cycle a little bit to get them unstuck. And I think any if we can make progress in any one of these steps, I consider that success because it's really it takes a lot for people to do this kind of work and understand the difference between the quick fix and the lasting effects.
SPEAKER_01:Yeah, totally. So moving on, practical guidance, like for someone feeling stuck in grief, stress, or a tough transition, what is that first small step that they can take toward getting unstuck?
SPEAKER_00:I guess like in general, getting unstuck. There are a lot of coping skills that people can use. I would say like reaching out to your social support network, journaling, and seeking counseling or therapy or consulting or coaching or whatever you want to call it, right? Getting help that is by someone that's trained to customize an unstuck plan given your whatever your life circumstances are, considering the various systems in your life.
SPEAKER_01:You had mentioned one of the hardest things is to find the right provider. How do you know if it's the right provider? What are the different questions or what should you be looking for when you're Yeah.
SPEAKER_00:I think it really depends on the issue that you are struggling with. If you're looking for, I think a lot of people get confused between psychiatrists and psychologists. So if you're looking for a psychiatrist that is a provider that went to medical school and then they did a fellowship in or a residency in psychiatry, and so they are board-certified psychiatrists. I guess not all of them are board-certified. Board certified psychiatrists is who prescribes medication. Psychologists are more like talk therapists, and then and they can also do like assessments for ADHD, different personality disorders, things like that. And then there are mental health care providers that are masters trained, and there are a few of those licenses. So there's licensed professional counselor, licensed marriage and family therapist, a licensed clinical social worker. So you might see like LMFT or LCSW, things like that. So those, so when you look for a provider, I think it's important that you understand the type of license that the provider has because sometimes it informs the training that they've received. The other thing is you want to look at the experience, right? So if someone is looking for treatment for eating disorder, you want to go to someone that specializes in eating disorders because that's a very specific protocol and it's a very specific treatment approach. You know, it's so things like that. You want to look at like their specialty, their training, their degree, their licensure, what else? And then the most important, so those are like the preliminary things. And then you set up a few appointments. I know sometimes availability can be really hard and callbacks can be hard. So I try to do my best to fix our reputation in that area and like my responsiveness. But yeah, but so after that, you can set up like consult calls. Sometimes you do it by video or by phone, and and you get a sense, like you, it's like an interview both ways. So when I when a client calls me or I'm returning a call and I'm trying to get an understanding of what the issue is, there are a couple of things that I'm doing. I want to understand what the issue is. I want to make sure that I answer any questions about therapy in general that they might have, or about me specifically. And I just think of myself as a resource, right? And then if I'm able to help them and if I'm able to support them, I let them know how. And we take it from there, right? Like we have an intake session, and usually I know in like my intake forms I say we have three sessions before we can really decide if we want to continue working. It's very rare that I will refer, I know I've switched to, but it's very rare that I will refer someone out after the initial consult call, but it happens sometimes where I'm like, I don't think I'm gonna be the person that offers the most value for what you're looking for or the most resources for what you need. And here's another, and I'll walk them through a warm hand off to another provider. There's so there's different steps, right? So idea, oh, maybe I need therapy, and then it's oh, let me go on Google and or whatever you go on and check or my insurance or whatever. And then, and then, oh, let me make appointments to talk to them, and then you talk to them, and then you tell them what the issue is, and you see based on what you read and their bios or their websites who resonates with you, their tone, their approach, their philosophy on how they approach therapy. Sometimes that can be helpful, sometimes it's not actually. Sometimes I read something like, oh, I don't know if this person would be a good fit. I talk to them and they're like, I don't know, it's hard with just reading. But yeah. And then if you have a phone call with or a video consult with someone that you like, go ahead and see if they have availability. Schedule, go to the first appointment. It's just like taking the steps, but they're so unfamiliar because it's all new. It's all new. And so I think people get intimidated by it. Yeah.
SPEAKER_01:That's funny. It feels like there's a lot of room for improvement within that area. Because even like for me, I'll send a video. Here's where the building is. This is what to expect. Yes. Because same thing with even just this experience, it's new for most of our guests. Exactly. But that's that's really interesting. Yeah. My last question When clients or colleagues look back on their work with you, what do you hope they'll say about who you are and the differences that you made?
SPEAKER_00:Oh, wow. What do I hope they would say? I think I hope they would say that I made helped them somehow with something small, right? Like it doesn't even have to be anything significant. If I can pass on a reframe or an understanding of the family systems dynamic or anything that would help the client, and they said, Oh yeah, I was helped by this. I'm happy with that. I think that I don't know about how I answered that question. I don't know. I'll keep going. What was the question again? Sorry.
SPEAKER_02:Basically, what do you want your legacy to be? My legacy? Gosh. Just a light question. I know.
SPEAKER_00:I'm like, I I haven't thought about that. I think someone that's like compassionate, I want to be remembered as like compassionate, kind, helpful, patient, non-judgmental, and just able to make a difference, positive difference in their lives.
SPEAKER_01:Not just your patients, but also other practitioners as well, with your yeah, uh yeah, that's right.
SPEAKER_00:That's a good idea.
SPEAKER_01:What is that called?
SPEAKER_00:It's called Therapy Hub. Therapy Hub.
SPEAKER_01:Is it therapy hub.com? Or what's it?
SPEAKER_00:No, don't I there's I need to add it to my website. I know.
SPEAKER_01:So is there anything specific that I didn't ask you about that you would like to share?
SPEAKER_00:I guess the other thing, so it's a couple of I have a couple of different expansions to like my professional development life this year. And so the practice and the clinical part is that's been ongoing. So therapy hub, and then along the lines of consultation services. So this isn't this wouldn't be part of this wouldn't be called therapy, but I offer trainings and like professional boundary trainings for corporations or groups or medical practices, dental practices that need more support in like the way they handle boundaries, the expectations, relationship dynamics, just to enhance employee morale and decrease like challenges and issues and sure.
SPEAKER_01:HRL loves HR loves you, right?
SPEAKER_00:Yes, exactly. HR loves me, and I've actually done HR in an unofficial capacity for many years, and I used my psychology skills in that just naturally. And I think that would be something exciting for me to go back to with doing seminars, trainings on various topics that are HR related. Yes.
SPEAKER_01:Yeah, and it's so neat. And then in our area, there's so many corporations that I'm sure would love to have you go in and pep talk the morale.
SPEAKER_00:Yes. And I've been doing that as a guest pro bono, but I'm like, you know what? I should probably like maybe this is like an I can make it official, exactly.
SPEAKER_01:Yeah, yeah. Thank you so much for being a guest on our podcast. It was wonderful. And I'll probably be reaching out to you to help me with my overfunctioning like the way that sounds. My husband would probably call it something different.
SPEAKER_00:I didn't come up with that term, by the way, but yes, I love it. Thank you. All right, thank you.