HCDM 46 | Private Practice Psychologist

 

Even in this day and age of information, so many people still interchange psychologists with psychiatrists. It is time to get things straight once and for all as Richard Marn, MD sits down with private practice psychologist Sara Sadek. Sara lets us in on her career journey and why she chose her profession. She also shares the difference between a psychologist and a psychiatrist and why she initially hesitated to go into the former. She talks about her least favorite part of the profession, the common misconceptions surrounding it, and aggressive empathy. Finally, Sara lets us in on her life pre and post-COVID, how she is navigating this turbulent time, and how students thinking of becoming a psychologist could thrive in the profession.

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Psychologist: Understanding The Profession And Its Misconceptions With Private Practice Psychologist, Sara Sadek

In this episode, we’re going to talk with another wonderful person, Dr. Sara Sadek, a psychologist here in New York City. We had another psychologist who came to speak about her profession, Dr. Margaret Rutherford, in episode 41. We’re going to start having occasional guests who have similar professions from other guests. This is meant to provide a different perspective, even though they’re in the same profession, sometimes great, sometimes subtle. She’s going to talk about the difference between a psychologist and a psychiatrist, her hesitancy to pick on a psychologist in the first place and the common misconception that she calls aggressive empathy. Without further ado, let’s jump into it.

We have a wonderful guest. This is Dr. Sara Sadek, welcome.

Thanks for having me.

It’s fantastic to have you. I’m so glad you’re here. I was going to ask you to do a quick bio of yourself. Do you think you’d do that?

Sure. I am a clinical psychologist here in Manhattan. My office is in Gramercy Park. I’m a transplant. I grew up in Portland, Oregon. My undergrad is at Portland State University, where I studied Biology and Psychology. My graduate program was also in a small town outside of Portland in Newberg, Oregon, called George Fox University, where I studied PsyD, Doctor of Psychology. My internship was in Philadelphia in North Philly at Girard Medical Center. My postdoc was here in New York City under two clinicians in private practice.

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I want to ask these quick questions to give a little introduction to people about what you do. What exactly is your job title? What do you do?

I’m a clinical psychologist in private practice. I work for myself. I see an adult population. Very occasionally, I see some adolescence purely as a favor because it is not my specialty and not something I love to do, but mostly adults. A lot of Millennials and people in their 40s with basic emotional dysregulation. People with anxiety disorders or mood disorders, we call them with major depression or interpersonal distress. I also have a handful of couples therapy that I do on the side.

We talked about your quick bio at the beginning of how you got your degree. Is that the usual step that people take to achieve your professional degree?

I ended up getting my degree in Psychology after studying Biology for four years. Mostly, I ended up getting the Psychology degree by taking a bunch of Neuropsychology classes because I took more of a science route. No, I wouldn’t say that’s the normal route. I think most people just study Psychology in undergrad General Psychology, Communications, or different types of Humanity-type degrees and then apply to get into a Doctoral or Master’s program.

What is the best part of your profession?

I love working with people. I find it rewarding and humbling to be privy and sit with people who are in distress and going through vulnerable times in life. It is rewarding to see people work on themselves, try to enact changes, and break up old patterns of behavior and thoughts that are so ingrained in us. It’s wonderful to see people break out of those old habits, challenge themselves, try things differently, and get great results.

Sara, what’s the least favorite part of your profession?

My least favorite part is twofold. Since I’m in private practice by myself, I have to do my billing. It is not in my personality to have to ask people like, “Did you pay for your session?” I hate doing that. That’s probably one of my least favorite parts. I’ve learned over the years that I shoot quick emails. I don’t talk about it because it’s so awkward, like, “How was your day? Also, did you pay for your session?” I cannot do it. It’s so clunky and awkward. It’s so not in my repertoire. It’s not my skillset. Now, I just send a quick email like, “I noticed this. Can you tell me if I’m wrong? Am I wrong that you didn’t pay?” That’s my least favorite.

The other part, which is very cliché and obvious, is we hear a lot of trauma, especially when there are certain things going on in the zeitgeists of the culture. It’s like Brett Kavanaugh when he was going into the Supreme Court and they were talking about sexual misconducts. During those weeks were tough weeks for psychologists because anybody who has been sexually abused or raped in any way needs to talk about it. You go from one session to another of hearing devastating stories and sitting with those is difficult. There are parts where you hear about suffering. There are days where you might have too many patients who need to talk about hard issues that happened to them. One part of you is humbled that they would take their time to talk to you about that, but the other part is hard to sit in human suffering.

Finally, misconceptions people have about your profession?

HCDM 46 | Private Practice Psychologist

Private Practice Psychologist: It is rewarding to see people work on themselves, try to enact changes, and break up old patterns of behavior and thoughts that are so ingrained in us.

 

Probably, the biggest misconception is that we’re mind readers. If you’re chatting with us at a party or at the soccer field that we’re somehow analyzing you, we’re interested in picking you apart and figuring out how you click, what you do wrong in life, and what your problems are. That mind reader quality where it’s like, “I need to be guarded around this person because they’re going to see through me,” is a big misconception. Most psychologists that I know are easygoing and want to keep it light and fun.

That’s very eye-opening. Thank you. I’m glad we got those quick questions out of the way. It gives us a nice overview of your profession. I want to dive deeply a bit more. You talked about helping patients and dealing with the different types of patients that you take care of in different generations. What are some of the problems that you typically deal with these patients? Is it a release of depression, anxiety, or other things?

It’s a combination of a lot of things, but I would say that in my practice and it might just be a New York thing where a lot of people who come in fit a mold. There’s a type that I see. It’s mostly anxiety disorders or people who are suffering from depression. I see a lot of people of different ages who are people pleasers, perfectionists and have done everything right in life. They are motivated by a fear of disappointing others. I have a lot of intelligent and high-stress professionals that I see.

I have a lot of doctors and attorneys as patients. I have a lot of people in finance. I have a few who are in the creative industries who have all sorts of other issues, too. I see a lot of these, like, “I did everything right. I did everything great. I worked crazy hours. Look where I got to. I have a family. I have all these boxes checked, but I’m unhappy. Now, I have a panic disorder. I had a panic attack at work the other day. What is going on? I did everything right.”

With your degree, can you give medications out?

I cannot. It’s our job to refer out and that’s why we work closely with psychiatrists and sometimes general practitioners. Especially with COVID, exasperating people’s symptoms. My personal belief is if you’re having these symptoms of anxiety or depression, then that’s your body trying to tell you something. You need to change things and do things differently. If you are deeply unhappy, what do we have to fix, change, and shake up so that your body doesn’t have these big reactions?

You have times where you can’t change. You can’t change the house you’re living in, but you’re stuck in all the time. You can’t change your job. There’s a lot of job insecurity. What can you do to bump up that baseline so that you’re not experiencing the lows or these big volatility in emotions? That’s when med management is so important. I’m not somebody who’s against meds. Probably with COVID, I’ve had to refer a lot more people for med management.

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There’s one thing I asked you about before. You have a PsyD, so you’re a psychologist?

Yes.

You can also become a psychologist by getting a PhD as well. There’s also a psychiatrist, which is an MD. In your viewpoint, what’s the difference between those degrees?

A PhD is the original psychologist degree. It was a lot more based on research. I think that the schools have all evolved to be very similar now. A PsyD is a Doctor of Psychology. A PhD is a Doctor of Philosophy in Psychology. One used to be a lot more research-based.

Is it the PhD?

Yes, the PhD. The PsyD is a lot more clinical. They throw you into clinical practice right away. It’s a lot more classes on treatment planning, psychiatric disorders, and what you do specifically to treat them. My degree is the PsyD, which is more clinically focused, but I do know that a lot of PhD programs have very similar tracks now. They, too, are having clinical experience. As a psychiatrist, it’s somebody who goes to a medical school and then does a Postdoc in Psychiatry. They are responsible for the psychiatric meds.

What is your typical day like, Sara? Start to finish?

Pre-COVID versus post-COVID is a little bit different. I have two daughters. One is in grade school. One is in middle school. One of the benefits of having my own practice is that I get to schedule how I like. On my typical day, I start at 10:00 or 10:30 with patient hours. I go into my office because the nature of our jobs is private. You need intense focus, like hyper-focus, when you’re in session. For me, especially if I hear noises outside like my daughters are making lunch for themselves in the middle of a session, I am 100% distracted. That is not an option to work at home. I wish it was. By the way, no amount of threatening works to get kids to be quiet inside the house. I would have chocolate bars to get like, “If it’s silence, all of this could be yours. I could take this away.” Nothing works.

I’m fortunate that I have my own office. It’s safe and protected. Nobody comes in here and it’s my own. I don’t have a health hazard coming into the office, so I go in. In my mornings, I’m with my daughters. I get to get them ready for school. I get to hang out with them. I get to make sure that their day is scheduled and then I head out. The other piece to that is a lot of psychologists in the city work late hours because of the nature of our patients. We have a lot of high-functioning professionals who can’t come in the middle of the day.

HCDM 46 | Private Practice Psychologist

Private Practice Psychologist: As a psychologist, one part of you is humbled that they would take their time to talk to you about that, but the other part is hard to sit in human suffering.

 

Especially when pre-COVID, you can’t take time off to take the subway to come to my office for an hour and then take the additional time to get back to your office. Nobody has two hours in the middle of their day to come out. The majority of us have evening hours. Pre-COVID, I wouldn’t get home until 9:30 or 10:00 at least three times a week. My hours were complicated when it comes to most professionals. Especially when you have your own private practice, you can’t be super rigid and not work evenings.

Post-COVID, is it similar still?

It’s a little bit similar. Most people have flexibility because they’re not coming into the office. The telecommunication has opened that up where they can do a 2:00 in the afternoon session because then they can work a little bit later. They don’t have to come in. I do still have evening patients. I have half an hour between my 5:00 and 5:30. If I have a 4:00, I’ll end up 5:00. I’ll rush home so that it’s not too late and then do my 5:30, 6:30 and 7:30 from home. I can make sure everybody stays quiet and do that out of the house.

We talked about the rewarding part of your job, which is hearing how people go through their struggles and seeing how they can transform. Is there an example of a patient that stands out or situations where you’ve seen that?

There’s a lot. It never looks like this big miracle answer.

Is it like a slow-moving car crash?

Yes, exactly. Sometimes, it’s the reverse of a car crash where they’re going to the crash. You might start off with the crash, see them veer, and avoid crashes from then on. That’s our like, “We’re doing great.” I see a lot of patients in toxic relationships and people who might be in abusive relationships. From where they start out with having no self-esteem, questioning their every single move, watching them come out of those, and then slowly regain their self-confidence. They regain how they communicate with other people and how to advocate for themselves in small ways. You see this boost in themselves. This light comes on in their eyes that were dark before. There are little things like that.

If you're somebody who enjoys talking to people, hearing their stories, and collecting data on them, you will do well as a psychologist. Click To Tweet

There’s the other piece where you work with people who have severe trauma. I’ve worked a lot with people with severe sexual trauma, whether that’s with long-term molestation to repeat rape, watching them come out of those fogs, and talk about it. You see through your experience that the more that they talk about it and the more they expose themselves to those painful times that they’ve tried to repress, the more you see how the human brain works. What’s great about human nature and the human brain is it gets bored easily. What we get to see is that after talking about it a bunch of times, your brain first fires all these cylinders of anxiety, “I don’t want to talk about this. This is awful.”

After a few times, it’s like, “This is boring. Old news. I don’t want to hear about this anymore.” You no longer are triggering all of the emotional responses to those stories and memories. When you sit with patients who have been avoiding these horror stories in their lives, they procrastinate. They come to this point where they have panic attacks. They’re avoiding real-life situations, good healthy situations because they can’t tolerate any form of distress. Seeing them work through it is hard. You see how much effort they put in and how much trust they have in you to talk about those horrible things.

The more that they talk about it, the more they build up resistance to it, tolerance to that distress and come up with coping skills at work when they’re thinking about it or exposed to those things. Seeing them work through it and then come out of that and have a lighter, easier life, go and expose themselves to normal social things, allow themselves to be more vulnerable with people and have better relationships with people. Those are big wins. They don’t come that often, but when they do, you’re like, “Thank God.” It’s like water in the desert.

That’s great to be there and to be a witness to that and also be part of that as well. Would you describe work-life balance to be good?

HCDM 46 | Private Practice Psychologist

Private Practice Psychologist: There is something healing in the interpersonal connection of sitting with somebody else, being a witness to their suffering and pain, and validating it.

 

Yes, it’s a work in progress. All of us have to figure it out, especially when you work nights and you have children, a family, and a husband. You have to work out the kinks. You make time. There are a couple of days a week that I don’t fill up my schedule on purpose. I make sure that at least two days a week, I don’t have nighttime patients so I can make a proper dinner for my kids. I can feel good that they’re eating something nutritious. We have time around the dinner table. We’re able to watch a fun show together and bond because I’m not there 2 to 3 nights of the week.

I know at the beginning you talked about, “People think that you’re like a mind reader.” Are there other misconceptions people have about psychologists?

Yes. Some people have already been to therapy. They see the movie version, which is like you’re lying down. There was a little eye contact and the person is like, “Uhmm, yes,” a lot of knowing sighs, “Ohhh, I can only imagine,” a lot of aggressive empathy. People are turned off to that. The misconception piece would be that you’re only going to get the super empathic, only-talk therapy. There are a lot of therapists out there doing that more collaborative approach, which is like, “I’m noticing this pattern of behavior. What’s going on here? Let’s try to shake this up, disrupt it, and do something differently.”

In terms of the outlook of your profession, is the future for psychologists still very fruitful? What is it like?

There’s room for growth, of course. As time goes on, it doesn’t have the stigma of going to therapy that the older generations used to have that you need to be a mental case to see a shrink. Nobody has that anymore. Especially the younger generation, they’re so open with their mental health issues. They’re like, “I’m in a depressive episode. I may be bipolar.” They diagnosed themselves. They’re so open, “I’m having a hard time,” and it’s good. It’s going to open the door for normal people to start going to therapy. Again, therapy doesn’t have to be long-term. It’s not this thing that you have to be in because you have a mental disease. It can just be for six weeks. It can be for half a year. It can be to get you over a hump. It’s more approachable now as time goes on.

What type of students would best flourish in this profession?

A lot of different types of students would flourish. People just need to be honest with themselves, like, “Do you get exhausted when you talk to too many people?” There are certain things about your own personality. Know your own motivations. If you are going into the field because you have some narcissistic tendencies and you like the idea of people coming to you with their problems, that’s not going to lead to a fruitful career. People are going to feel this weird hierarchy between you and them. You’re going to find roadblocks as you move forward.

If you’re going to the field because you do have a passion for talking to people and you’ve noticed that interpersonally, it’s easy for you to relate to people, sit in people’s discomfort, and not try to jump to fix it or not tolerate people who whine too much. You have to be honest with yourself, like, “What kind of person are you? Do you love the interpersonal connection?” Especially on the clinical side, to be fruitful in this career, people have to know that you’re genuine. If you’re faking it, it’s easy to tell.

A lot of different times, you don’t have to be the super social butterfly who’s the center of attention to be in this field. If you’re somebody who enjoys talking to people, hearing their stories, and collecting data on them, like mining for data of how they behave in this situation, how they behave in there and finding it interesting, you will do well. In the end, there is something healing in the interpersonal connection of sitting with somebody else, being a witness to their suffering, to their pain and validating it. You have to be honest with yourself, like, “Are you somebody who enjoys doing that?”

We are relational creatures. The most important thing is the community and interpersonal relationships. Click To Tweet

Were you one of those kinds of people or anyone in high school where you like to hear from other people and listen to other people? How are you as a high school student?

I have a weird story when it comes to that. I’ve told you a little bit about this. It’s apprehensive to coming on the show and telling you this story. I have this weird relationship, like a love-hate relationship with Psychology. I didn’t want to be a therapist. I was told all my life, like, “I think you should be a psychologist.” I was like, “No.”

As a high school student, you were told that you would do well as a therapist?

Yes, even younger. It was weird. I worked all through high school.

What do you mean you worked all through high school?

I had side jobs. I always had a job on top of going to school. I worked as a bank teller. I also worked at a Bed Bath & Beyond-type store where you would do home furnishings, candles, and towels.

This was in high school?

This was in high school. I worked since I was fourteen. I would have strangers come up to me and say, “Ask me about a towel.” I talked to them. Within five minutes, they would tell me that they had an abortion and that they’re having a hard time that week. I was a magnet. I still don’t know why. I worked as a teller. People would come and they were like, “I’m going through a terrible divorce.” I didn’t know what to do with it, but I just said, “I’m sorry. Is there anything I can do?” My friends, family and everyone were like, “What is going on with you?”

Even in undergrad, when I’d be at a bar, we’d be talking to people and within a very short amount of time, I would know about somebody’s sexual abuse history. I’m not kidding. I would not ask about it. My friends, who were with me were like, “What is going on? This is crazy. This is insane.” I don’t know what it was, but there was always this weird quality in that. I would ask questions and then people would open up and answer them. As a high school student, I had people that I was not close with, I was not friends with, come up to me and tell me intense things about themselves, whether it was sexual history to maybe being gay or having abuse at home. I was not friends with them. They would just come and confide in me.

What would you explain in how to deal with those?

No. That was always a big thing. I was like, “What am I supposed to do with this?” I would just sit in it and say, “I’m sorry to hear that.”

I wanted to change the dynamic into little questions if you will. I’m going to jump into my rapid-fire questions. Are you ready?

Yes, I’m ready.

Favorite type of books to read?

My favorite book in the world is Pride and Prejudice. I read it once or twice a year. I think that every psychological condition and personality can be found in the characters of that book.

Favorite flower?

I love a hardy, light, long-stemmed rose.

Most important in a partner, intelligent or funny?

Funny, for sure. Life throws a lot of difficult things at you and if you don’t have humor, it is so difficult to navigate this world.

Sara, what’s your favorite season?

HCDM 46 | Private Practice Psychologist

Private Practice Psychologist: Get a job where you can be self-reliant and depend on yourself, so you don’t have to depend on other people and get the things you need.

 

Fall.

What comes easily for you that is more difficult for other people?

I have a high tolerance for human suffering. I can sit, listen, and absorb traumatic details of people’s lives. It is something that is a natural-born skillset.

If you were really hungry, would you eat a bug?

Yes, for sure. 100%.

Finally, if you’re 80 years old, what would you tell your children about life and business that would be the most important thing for them to know to get a head start?

I would tell them that we are relational creatures. The most important thing is the community and interpersonal relationships. That is number one, so you can have a great job. Get a job where you can be self-reliant and depend on yourself so you don’t have to depend on other people and you can get the things that you need. The things that matter in life are the connections that we have with others. That doesn’t mean that you have a support system that you can rely on. It means that you are regularly inconvenienced by the people that you love.

Do not make your life tailor-made for your comfort. Have it be where you're constantly making sacrifices for other people. Click To Tweet

Do not make your life tailor-made for your comfort. Have it be where you’re constantly making sacrifices for other people. When you do have moments to yourself, you enjoy them, love them, relish, and are grateful for them. Make sure that the community that you find, you can depend on them, but as importantly, they can depend on you and you establish yourself as somebody who is reliable and strong enough where people can depend on you.

Sara, where can readers go to reach you and learn more about you?

On my website, it’s simple. It’s just DrSaraSadek.com.

Sara, it was wonderful to hear about your profession and how you got there. Thank you for opening up and sharing that with us.

Thanks, Richard. Thanks for having me. It was a pleasure to speak to you.

Everybody, that’s our show. Thanks for tuning in. To learn more about our guests or other past guests, check out my website HealthCareersWithDrMarn.com or HCWithDrMarn.com. If you like what you’ve learned on this show, please go to my website and add your name and email to my email list. That way, you can get the latest announcements and news as they arise. You can also find me on Instagram @DrRichardMarn. Thank you so much for reading. I’ll catch you on the next episode.

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About Dr. Sara Sadek

HCDM 46 | Private Practice PsychologistAs a clinical psychologist, I believe that knowledge, awareness, and insight are the cornerstones of therapy. By helping increase emotional awareness and identifying their related thoughts and behaviors, I facilitate understanding of causes and triggers for anxiety, depression, and interpersonal conflict.

An appreciation of each individual’s unique background and encounters is crucial in comprehending how one relates to new information and experiences. I tailor empirically supported treatment to address emotional distress, and believe we are all active participants in our health and wellness. With the correct tools and insight, we can lead emotionally healthy, successful, and meaningful lives.

I use an existentialist and behavioral framework, with emphasis on empathic communication, compassion, and self-reliance. Research-based modalities include cbt, ipt, dbt, and act, to aid in adaptive and healing responses to emotional pain. Specialty focus on anxiety, depression, and interpersonal distress.