Dr. Sarah Wahab: Courage to Begin and When / How to Start Your Therapy Journey

Episode Transcript

SPEAKER_00 (00:00):
My name is Sarah Wahhab, and I am a licensed

(00:03):
clinical psychologist.
I work in private practice inVienna, Virginia.
And I work with a wide range ofclients.
So I guess I can describe it intwo ways.
The type of diagnosises that Iwork with can range anywhere
from anxiety, depression, mooddisorders, bipolar disorder,

(00:26):
substance use disorder.
So those are the diagnoses thateither come to my practice
already with a diagnosis orthey're struggling with some of
the symptoms.
And then, and then I also work,and so the population that I
work with, these are thediagnoses.
The population is like age rangeanywhere from 13, 14 all the way

(00:49):
until older adults.
And I work with couples infamilies.
So that's my jam.
I know it's not like peopledon't think of it as like more
than one person in the room, butbecause I do conceptualize from
a family systems perspective,the first session will sit and
do like a family genogram, whichis a map of the family.
And regardless of if it's arelationship issue or a

(01:11):
diagnosis issue or a little bitof both, that is my primary
orientation.

SPEAKER_01 (01:16):
What inspired you to become a psychologist?
And then what continues to driveyour passion for helping people
get unstuck today?

SPEAKER_00 (01:22):
So it's actually like not within my family or
cultural norms to go towardsmental health.
I don't think I didn't even knowabout that sector, I think,
growing up, except for what Isaw in movies.
I was honed in on wanting to bein the helping profession and
helping people.
And the only way I knew how waswhat I was exposed to was either

(01:45):
going into like medicine ordentistry.
And so I was like, oh, I'm gonnabe dentist.
Oh, okay.
Oh, I'm gonna be a medicaldoctor, and then I can help
people in these different kindsof ways.
And after I graduated undergradfrom Mason with a biology
degree, I was like, I don't wantto teach biology.
I don't want to go into medicalschool.
What am I gonna do?

(02:06):
And what's funny is my mom, whowas an immigrant, actually did
something outside of the box forour family.
And I guess her friend was goingto a psychiatrist at the time
that was that also does talktherapy.
I remember he was trained inGeorgetown and he had this like
cultural competence likeaddition in his the title of his

(02:27):
name.
And yeah, and then I chattedwith him and he helped me see
some of the ways that I wasstuck myself, some of the tunnel
vision thinking or not beingflexible, things like that.
But the funny thing is, my workwith him was successful, and
then I was like, wow, this guy'sjob is this is a job, like I can

(02:49):
actually do this for a living.
This is so cool.
I get to help people.
I'm really interested in likedynamics and helping people see
things in a different way orfind their own solutions.
And that and then so he inspiredme, and that's how I got into
the field of psychology and kindof explored and discovered it.
And yeah.

(03:10):
And then what drives thatpassion today to keep that fire
alive?
I think what's interesting inour field, like progress doesn't
sometimes progress happens rightaway, and sometimes it happens
over time, like it's a journey.
It's really nice to be able tosee families function better,
find a way to communicate betterand just work on themselves and

(03:33):
look at themselves.
I think that's what inspires mewhen people are clients are able
to self-confront and do the hardwork.
It's hard work no matter what.
So do the hard work that isoriented towards their own
growth.
That's inspiring.

SPEAKER_01 (03:48):
That's awesome.
And it keeps you going.

SPEAKER_00 (03:50):
It keeps me going.
Yeah.

SPEAKER_01 (03:52):
You describe therapy as a collaborative journey.
Why is that partnership approachso important in your practice?

SPEAKER_00 (03:59):
It's collaborative because if you think about it, I
am like a family systemsorientation psychologist, right?
And so I do have to look at, weall have different systems in
our lives.
And that could be so the firstsystem is me and the client,
right?
And then it could be me, theclient, and their family.

(04:22):
And then there are, you know,they have school, they have
their job, they have so all ofthese things influence the
therapeutic outcome and theclient's experience.
And so the first collaborationis with me and the client,
obviously, right?
If they're working with apsychiatrist or a medical
doctor, then I collaborate aspart of that team, if that's

(04:43):
appropriate.
But I think from a differentperspective, it's collaborative
because I think a lot of people,which is totally fine, they come
into therapy thinking that I amgoing to give them advice or
tell them what to do, or and I'mjust like, you have everybody
else in your life is telling youwhat to do.
What's my opinion?
Like, how's that going to helpyou?

(05:04):
Or we just maybe start even withwhat stops them from being able
to make that decision on theirown, because clients are the
experts of their own lives.
And I really believe that thebest guidance is going to come
from within them.
And it's my job to help themnavigate that journey and uh and

(05:24):
figure out how they can continueto be in charge rather than rely
on someone to tell them what todo or advise them.
But of course, there are I I saythat m mostly in like
relationship issues anddecisions and things like that.
But there's obviously space inmy practice where if we're
dealing with OCD or theirtreatment protocols like

(05:48):
cognitive behavioral therapytechniques or dialectical
behavioral therapy techniquesthat I will pull from, depending
on, you know, the client andwhat they're presenting with or
what their needs are at thetime.
So I'm not sure if that answeredyour question.

SPEAKER_01 (06:02):
Yeah, no, that was perfect.
Many people they feeloverwhelmed, but they're
hesitant to seek therapy.
What would you say to someonewho's considering reaching out
but isn't sure if it's the righttime?

SPEAKER_00 (06:14):
Gosh, that's such a good question because I even
struggle with that in my ownpersonal life, like either me
going to therapy or consideringdo I wanna, do we need family
therapy right now?
Or do I need do one of my kidsneed help with coping?
And just the idea of, and eventhough I'm in the field and I

(06:35):
have a lot of colleagues and allthat, I get so overwhelmed with
how am I gonna find the rightprovider?
How are they gonna be the rightfit?
Is my insurance gonna cover it?
There's just so many factorsinvolved that it can be really
overwhelming.
What was your question again?

SPEAKER_01 (06:50):
Sorry, I like because it Yeah, no, that's
along the lines.
Like, what would you say tosomeone who's considering
reaching out, but they're notsure if it's the right time?

SPEAKER_00 (06:57):
Yeah, I think it will take a couple of attempts,
realistically.
And they've done research onthis that it takes people seven
years, especially couples, toget into therapy after the first
initial thought of, oh, maybe weshould go to couples therapy.
I would say you you really haveto buy into and have the desire
to want to do somethingdifferent, to want the change,

(07:19):
to feel motivated because theconsequence or the quality of
life or is motivating you tocome towards that.
So that's really important.
The other thing is like findingthe right provider and finding
the right fit.
And that goes both ways.
You want to make sure that youare aligned with the provider
that you choose in terms of theapproach that they have fits

(07:41):
your needs, their style fitsyour needs, their expertise and
experience, all of that kind offit.
Asking, I guess it ischallenging, right?
And I think the more we get theless stigmatized mental health
becomes, the more we're able toask each other for referrals.
It's not a big deal if aneighbor asks me, Hey, can you

(08:05):
recommend someone?
There's no shame around thatanymore.
So I think it is a challengingprocess.
I think moving towards it reallydoes take courage.
And I think when people aremotivated enough to want that
change for whatever reason thatis, hopefully the battle of
finding the right provider isn'thard because that's also another

(08:27):
barrier, right?
I want to go to therapy.
Okay, now who's the providerthat'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 theeasy part.
I think the hard part isdeciding.
I am looking for change, I'mlooking for to do something

(08:47):
different.
I want comfort, I want thesymptom to stop, I want to break
this cycle.
If we're at that starting point,yeah.
I think for me that's thatpresents as the biggest
challenge, not so much the workitself or understanding what
therapy is.
And so it's almost like whenthat pain is like painful

(09:08):
enough.

SPEAKER_01 (09:09):
Yeah.
But it that shouldn't, Ipersonally don't think that's
when you should be doing it.
But it sounds like that's whenit usually happens.

SPEAKER_00 (09:16):
Yeah, yeah.
And I do have clients that comein that want to enhance the
quality of their life or theyhave a work issue or an issue
with a colleague that they'retrying to resolve, and it's more
it's still therapy, but I callit like coaching.
And yeah, so sometimes there islike a really desp desperation
and sometimes it's enhancement.
It's just it's a spectrum ofthings.

SPEAKER_01 (09:38):
Speaking of which, when someone first walks into
your office, what do you wantthem to feel and experience
right away?

SPEAKER_00 (09:44):
That's such a good question because I recently
updated the space.
So this is I have I I started aparallel business this year,
therapy hub is what I call it.
And it's basically a space forlike it's a shared office space
for independent private practiceproviders to be able to either,

(10:06):
if they're early career and theywant to start leasing a space
where there's it's only formental health care providers, I
have different options for them.
But really, whether it's theproviders that are coming in to
use the shared space or myclients that are coming in, I
put effort into making it verycalming, relaxing, people can

(10:30):
feel centered.
And it just gets you in themind, right mindset to be
intentional and like about yourtime in therapy.
So that's what I'm hoping thatthey're gonna feel relaxed and
comfortable and just able tofeel centered before they start
their session.

SPEAKER_01 (10:48):
Sounds like you put a lot of thought into the
design.

SPEAKER_00 (10:53):
Uh this is a recent change and it's it's a way for
me to explore like a creativeside.
Yeah.
And it's not like I have goodtaste or anything.
I got a lot of help, but it itwas a way for me to also engage
with the community, right?
Like, how do I decorate?
How do I reach out to otherproviders to let them know about
the space?

(11:14):
What kind of consultation groupsdo I want to offer?
So it's just like a parallel tomy business.
But I also, yeah, I did put alot of thought and intention and
and I like to share that with myclients.

SPEAKER_01 (11:29):
That's awesome.
That sounds fun, actually.
Yeah.
I mean, you often talk aboutauthenticity, safety, courage.
How do these specific valuesshow up in your sessions and in
the culture that you've builtfor your practice and this new
adventure?

SPEAKER_00 (11:41):
Yeah.
So I think for the authenticitypiece, it's really hard for us
as like humans to feel safeenough to be truly 100% our
authentic selves.
And that's why when I came inhere today, I'm like, oh, I'm a
little bit nervous.
And it's because we're thinkingabout who's evaluating us, how
people are, how we're going tocome across.

(12:04):
And so, not to say that thesethings are not important or not
valuable, but how do we buildenough of a solid sense of self
and confidence so that we areable 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'rethinking so much about how you
want to present rather thanbeing more in touch with you.

(12:27):
And I think one of the thingsthat a lot of people might not
know about graduate school andtraining to become a
psychologist, I guess not allgraduate schools, but
specifically the way that I wastrained, I went through like
intense person of the therapistsupervision, which is basically
part of it was recording everysingle session and hearing it in

(12:47):
front of the entire group fortwo years.
So that's part of it.
But the other part of it is wehad to create our own family
grams.
We had to look at our own familydynamics, do our own therapy,
make sure that when we arelistening to other people's
stories and other people'sproblems and challenges, we're

(13:08):
not, or I'm not projecting myown, and that's why I don't give
opinions or I don't, and it'seasy for me not to give my
advice because it's the trainingthat I'm in charge of the
structure of the session, butour clients are in charge of
their lives.
And so in order to do this kindof work, it is really important

(13:29):
that the provider, thetherapist, has done their own
work, whether it's becausethat's where you will have an
authentic experience.
And also hopefully, becauseperson of the therapist work is
that is pretty similar to thework that we do with clients.
There's a parallel there.
So it's an interesting process.

SPEAKER_01 (13:50):
I'm writing that down because I think it's
interesting.
And I feel this is my judgmentalopinion.
Is a lot of people need to learnhow not to give their advice.

SPEAKER_00 (14:02):
Trust me, I'm giving my opinion and advice left and
right when I'm not in thetherapy room about things that
might be harmless or benign, butand sometimes there is space for
that.
My my son, I think it was likethis summer, um, he was asking
me a question about somethingabout his personal life.
And then he goes, Mama, I justneed you to tell me what I

(14:25):
should do.
I was like, I could tell youwhat I think is best for you,
but it is building this senseof, and that is part of being
authentic, right?
For him to be able to feel likeI can, he can reach out for
support, but not that I'mdirecting his life or telling

(14:46):
him what to do.
And it's not that I'm worriedthat he's gonna come blame me,
it's that I really value theskill of his independent
thinking while also gettingfeedback from people around him.
And so it's got better.

SPEAKER_01 (14:59):
Self-awareness there on his role, right?
Like on your role, what you'veallowed 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 increating lasting change, whether
in personal life, relationships,or even in the workplace?

SPEAKER_00 (15:20):
I think the more we know ourselves, the better able
we're like the better we're ableto navigate different kinds of
challenges.
Because when you come to therapyor you come for coaching or
whatever, you are we can't talkabout every single problem in
every single situation, right?
It's more about the process andabout dynamics, right?

(15:44):
So usually people findthemselves in the same pattern,
whether it's uh related to workor whether it's related to
school or their family, right?
So one common one is likeover-accommodating or directing
people or directing your kids,right?
Over directing orover-functioning, right?
A lot of couples, he's nottaking out the trash and I can't

(16:04):
stand it, so I take it out,right?
And so there are these dynamicswhen the trash might not be the
most important topic, but maybethis comes up with this client
at work where they'reoverfunctioning for their
colleagues, or it's coming upwith their kids where they're
doing their projects for them,or like just the
overfunctioning,underfunctioning dynamic in

(16:25):
relationships.
So I guess to answer yourquestion, like the lasting
change isn't gonna come fromquick fixes.
It's not gonna come from how doI get this person to calm down
as quickly as possible because Ican't tolerate their discomfort,
right?
That's not what's going to helpyou be authentic in different

(16:46):
situations or be calm.
The lasting change comes fromdoing the hard work of being
able to say, yikes, we have acontract.
I'm not supposed to take out thetrash, it's filled.
Sorry, the trash is filled.
You know what?
I'm just gonna let it sit andgive people that signed up for
this an opportunity to do itbecause just because my comfort

(17:09):
level is 75% full, somebody elsemay.
So it's 110%.
Exactly.
There you go.

SPEAKER_01 (17:16):
That is what I do.
It's not the right thing to do.
Is sweetheart, have you noticedthere's more gnats around the
trash?

SPEAKER_00 (17:21):
Oh, there you go.
That's another clever way.

SPEAKER_01 (17:24):
Yeah.
Yeah.
Thank you.

SPEAKER_00 (17:27):
There you go.
So, like some clever ways, butreally it the key is right, like
the dynamic part of that.
It's a funny example.
The dynamic part of that isself-regulation, right?
And that's knowing yourself,knowing I will get triggered by
this not being done the way thatI want it to be done.

SPEAKER_01 (17:45):
Yeah.

SPEAKER_00 (17:46):
And is it really fair for me to force someone to
do it the way I want it?
How can we, how can I calmmyself down enough to allow
other people to step up andsurprise me or not?

SPEAKER_01 (17:57):
And sounds like I need to sign up for your therapy
session.

SPEAKER_00 (18:03):
So that's one example of a dynamic.
That's a common one.
But that's that's if I'm justthinking of solutions of and
with your example, what I likeabout it, it's a little funny,
it's clever, creative.
And also you're calm.
And it's not like you'repretending to say it with
reactivity.
And that's what people pick upon.
And so if you're going towardsit with calmness, then that's

(18:26):
fine.

SPEAKER_01 (18:26):
Yeah.
Once you know the people thatyou're dealing with, what will
motivate them to do it withoutcreating like an issue?

SPEAKER_00 (18:34):
Exactly.
Yeah.

SPEAKER_01 (18:35):
How do you define success in therapy for both
yourself and your clients?

SPEAKER_00 (18:41):
Success in therapy.
It's funny because I actuallythat's one of the questions that
I ask clients during theirintake session is how would they
know if therapy was successfulfor them?
And I guess that's how I woulddefine it.
Symptoms would decrease.
And whatever goal that theyhave, they even if they don't

(19:04):
achieve it, there's a pathforward and they understand what
is getting them stuck in thebarriers that they usually get
and shifting certain parts ofthe cycle a little bit to get
them unstuck.
And I think any if we can makeprogress in any one of these
steps, I consider that successbecause it's really it takes a

(19:26):
lot for people to do this kindof work and understand the
difference between the quick fixand the lasting effects.

SPEAKER_01 (19:35):
Yeah, totally.
So moving on, practicalguidance, like for someone
feeling stuck in grief, stress,or a tough transition, what is
that first small step that theycan take toward getting unstuck?

SPEAKER_00 (19:50):
I guess like in general, getting unstuck.
There are a lot of coping skillsthat people can use.
I would say like reaching out toyour social support network,
journaling, and seekingcounseling or therapy or
consulting or coaching orwhatever you want to call it,

(20:10):
right?
Getting help that is by someonethat's trained to customize an
unstuck plan given your whateveryour life circumstances are,
considering the various systemsin your life.

SPEAKER_01 (20:29):
You had mentioned one of the hardest things is to
find the right provider.
How do you know if it's theright provider?
What are the different questionsor what should you be looking
for when you're Yeah.

SPEAKER_00 (20:40):
I think it really depends on the issue that you
are struggling with.
If you're looking for, I think alot of people get confused
between psychiatrists andpsychologists.
So if you're looking for apsychiatrist that is a provider
that went to medical school andthen they did a fellowship in or
a residency in psychiatry, andso they are board-certified

(21:01):
psychiatrists.
I guess not all of them areboard-certified.
Board certified psychiatrists iswho prescribes medication.
Psychologists are more like talktherapists, and then and they
can also do like assessments forADHD, different personality
disorders, things like that.
And then there are mental healthcare providers that are masters

(21:22):
trained, and there are a few ofthose licenses.
So there's licensed professionalcounselor, licensed marriage and
family therapist, a licensedclinical social worker.
So you might see like LMFT orLCSW, things like that.
So those, so when you look for aprovider, I think it's important
that you understand the type oflicense that the provider has

(21:43):
because sometimes it informs thetraining that they've received.
The other thing is you want tolook at the experience, right?
So if someone is looking fortreatment for eating disorder,
you want to go to someone thatspecializes in eating disorders
because that's a very specificprotocol and it's a very
specific treatment approach.
You know, it's so things likethat.

(22:05):
You want to look at like theirspecialty, their training, their
degree, their licensure, whatelse?
And then the most important, sothose are like the preliminary
things.
And then you set up a fewappointments.
I know sometimes availabilitycan be really hard and callbacks
can be hard.
So I try to do my best to fixour reputation in that area and
like my responsiveness.

(22:27):
But yeah, but so after that, youcan set up like consult calls.
Sometimes you do it by video orby phone, and and you get a
sense, like you, it's like aninterview both ways.
So when I when a client calls meor I'm returning a call and I'm
trying to get an understandingof what the issue is, there are

(22:48):
a couple of things that I'mdoing.
I want to understand what theissue is.
I want to make sure that Ianswer any questions about
therapy in general that theymight have, or about me
specifically.
And I just think of myself as aresource, right?
And then if I'm able to helpthem and if I'm able to support
them, I let them know how.
And we take it from there,right?

(23:08):
Like we have an intake session,and usually I know in like my
intake forms I say we have threesessions before we can really
decide if we want to continueworking.
It's very rare that I willrefer, I know I've switched to,
but it's very rare that I willrefer someone out after the
initial consult call, but ithappens sometimes where I'm

(23:29):
like, I don't think I'm gonna bethe person that offers the most
value for what you're lookingfor or the most resources for
what you need.
And here's another, and I'llwalk them through a warm hand
off to another provider.
There's so there's differentsteps, right?
So idea, oh, maybe I needtherapy, and then it's oh, let
me go on Google and or whateveryou go on and check or my

(23:51):
insurance or whatever.
And then, and then, oh, let memake appointments to talk to
them, and then you talk to them,and then you tell them what the
issue is, and you see based onwhat you read and their bios or
their websites who resonateswith you, their tone, their
approach, their philosophy onhow they approach therapy.
Sometimes that can be helpful,sometimes it's not actually.

(24:14):
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 phonecall with or a video consult
with someone that you like, goahead and see if they have
availability.
Schedule, go to the firstappointment.
It's just like taking the steps,but they're so unfamiliar

(24:36):
because it's all new.
It's all new.
And so I think people getintimidated by it.
Yeah.

SPEAKER_01 (24:42):
That's funny.
It feels like there's a lot ofroom for improvement within that
area.
Because even like for me, I'llsend a video.
Here's where the building is.
This is what to expect.
Yes.
Because same thing with evenjust this experience, it's new
for most of our guests.
Exactly.
But that's that's reallyinteresting.
Yeah.
My last question When clients orcolleagues look back on their

(25:03):
work with you, what do you hopethey'll say about who you are
and the differences that youmade?

SPEAKER_00 (25:09):
Oh, wow.
What do I hope they would say?
I think I hope they would saythat I made helped them somehow
with something small, right?
Like it doesn't even have to beanything significant.
If I can pass on a reframe or anunderstanding of the family

(25:30):
systems dynamic or anything thatwould help the client, and they
said, Oh yeah, I was helped bythis.
I'm happy with that.
I think that I don't know abouthow I answered that question.
I don't know.
I'll keep going.
What was the question again?
Sorry.

SPEAKER_02 (25:46):
Basically, what do you want your legacy to be?
My legacy?
Gosh.
Just a light question.
I know.

SPEAKER_00 (25:52):
I'm like, I I haven't thought about that.
I think someone that's likecompassionate, I want to be
remembered as likecompassionate, kind, helpful,
patient, non-judgmental, andjust able to make a difference,
positive difference in theirlives.

SPEAKER_01 (26:14):
Not just your patients, but also other
practitioners as well, with youryeah, uh yeah, that's right.

SPEAKER_00 (26:20):
That's a good idea.

SPEAKER_01 (26:21):
What is that called?

SPEAKER_00 (26:22):
It's called Therapy Hub.
Therapy Hub.

SPEAKER_01 (26:24):
Is it therapy hub.com?
Or what's it?

SPEAKER_00 (26:26):
No, don't I there's I need to add it to my website.
I know.

SPEAKER_01 (26:31):
So is there anything specific that I didn't ask you
about that you would like toshare?

SPEAKER_00 (26:35):
I guess the other thing, so it's a couple of I
have a couple of differentexpansions to like my
professional development lifethis year.
And so the practice and theclinical part is that's been
ongoing.
So therapy hub, and then alongthe lines of consultation
services.
So this isn't this wouldn't bepart of this wouldn't be called

(27:00):
therapy, but I offer trainingsand like professional boundary
trainings for corporations orgroups or medical practices,
dental practices that need moresupport in like the way they
handle boundaries, theexpectations, relationship
dynamics, just to enhanceemployee morale and decrease

(27:23):
like challenges and issues andsure.

SPEAKER_01 (27:27):
HRL loves HR loves you, right?

SPEAKER_00 (27:30):
Yes, exactly.
HR loves me, and I've actuallydone HR in an unofficial
capacity for many years, and Iused my psychology skills in
that just naturally.
And I think that would besomething exciting for me to go
back to with doing seminars,trainings on various topics that
are HR related.

(27:50):
Yes.

SPEAKER_01 (27:50):
Yeah, and it's so neat.
And then in our area, there's somany corporations that I'm sure
would love to have you go in andpep talk the morale.

SPEAKER_00 (27:58):
Yes.
And I've been doing that as aguest pro bono, but I'm like,
you know what?
I should probably like maybethis is like an I can make it
official, exactly.

SPEAKER_01 (28:08):
Yeah, yeah.
Thank you so much for being aguest on our podcast.
It was wonderful.
And I'll probably be reachingout to you to help me with my
overfunctioning like the waythat sounds.
My husband would probably callit something different.

SPEAKER_00 (28:24):
I didn't come up with that term, by the way, but
yes, I love it.
Thank you.
All right, thank you.