All About Therapy w/ Family Physician Dr. Yona Saperstein- Episode 50 – Season 4 Wrap-Up
Welcome back to the All About Audiology podcast. I’m your host, Dr. Lilach Saperstein and on this show, we don’t just talk about audiology, about x’s and o’s, about audiograms and all the tests that we do. We actually want to know, what does audiology have to do with YOU?! With your life, with your child, with your loved ones.
So, today’s episode is going to be an All About YOU! episode. I would like to talk about therapy. We constantly hear about how are we going to care for our children, how are we going to keep up with their intense schedule of all their interventions, especially if your child has a diagnosis or several diagnosis. You’ve got PT and OT, physical therapy and occupational therapy. Maybe they have a reading specialist, maybe they have an extra tutor. Maybe they have an orthopedist and all their medical specialists, from GI to pulmonogoly and cardiology. The list is going to go on and on of all the things that you are managing for your child’s health. You will go to the ends of the earth to make sure that your child will be healthy and safe and supported and get all the services that they deserve, all in vision and in pursuit of your child having an awesome life.
So, my question to you is, what are you doing for yourself with as equal amount of passion and love to care for YOU? I talk to a lot of parents, parents whose children have hearing loss, other chronic illnesses, and disability. It’s so clear to me that there is this kind of burden placed on a parent, parents in general, but especially in the special needs community saying, you need to prioritize self care. And it’s your problem that you don’t get the support and the resources that you need. You just need a bubble bath, like, no! That’s why I think this topic, truly from my heart, is about therapy and we’re actually going through a little series here of the podcast focusing on mental health.
I would like to invite a very special guest, someone I love very, very dearly. This is the other Dr. Saperstein, haha, my husband, Dr. Yona Saperstein. He is a family physician and together, the end of medical school is when we met. He was at the end of medical school. I was starting my audiology graduate school and so, together we were also building our marriage, having children and working through med school and residency. So, we have really gone through a lot together, a lot of different challenges and changes, an international move, career changes, all that stuff and a lot of support for each other, mostly for me. Hahaha. Mostly you supporting me.
But it is time for a little personal deep dive because I feel so connected to the listeners, I feel so connected to my followers. The show is growing and I want to get a little vulnerable in a way that’s going to be really valuable to you and helpful to you. So, let’s jump in!
Dr. Lilach Saperstein: “Welcome Yona, hello. Why don’t you introduce yourself to all my friends.”
Dr. Yona Saperstein: “Hello everybody. I’m Dr. Yona Saperstein. I am the husband of your well-known and beloved host, Lilach. As Lilach said, I am a family doctor. I work at a public clinic in Israel. So, basically the reason that Lilach had asked me to be on the podcast is because I had actually come home today and told a story and the story goes like this:
Around a week ago, I got a call to do a virtual visit, because of the corona virus epidemic, a vast majority of my visits are over the phone. So, I get a request for a phone visit and I called the guy. He’s a guy in his thirties and he works as a security guard. He says, ‘Doctor, for the past couple of months, I feel like I have had a lot of symptoms of depression and anxiety. I’m a normal person and I know how to deal with it but I feel like I’ve had a lot of depression and anxiety. Doctor, can you please give me a referral to see a psychologist and get therapy?’
I told him that he was very brave and that a lot of times, people who are going through this thing, how therapy is very helpful for these symptoms and a lot of times, it is actually good enough as a treatment in and of itself for anxiety and/or depression. So, I sent him a referral to somebody who was covered under his plan and went on my merry ways to the next patient.
Around a week later, that was today actually, I get another request to call the same patient. He says, ‘Doctor, I’m working as a security guard and I might change jobs. Does the fact that I’m seeing a therapist, are they going to see that if I change jobs, are they going to see that for the next security agency that I work for? Is that going to make me a bad candidate because I am seeing a therapist?’ “
LS: “And especially, you should mention that for a lot of these jobs, government jobs, security jobs, they’ll do an extensive background check. So, then you’ll have to sign off and they could get access to your medical records and all sorts of things.”
YS: “So, I told the patient that, ‘On the one hand, I do not work in the field of security or government so I can’t really tell. But on the other hand, anybody who is in the medical field of like any sort would know that somebody who is feeling feelings like these, depression or anxiety or something is not right, that therapy is the smartest thing that they can do to take care of themselves. And the people who are seeing therapists are actually a lot more healthy and self aware and have a lot more inner mental and physical health, than those who hide their traumas, push their traumas down and refuse to seek therapy. They are probably the ones who need it the most, and in my opinion would be less of a candidate for a security job.’
So, this is what I said to the patient over the phone. I can hear him say, ‘hmm, that’s a very interesting point.’ So, that was the point of the story as to why Lilach invited me on to her podcast. I give you back my wife.”
LS: “Yeah, this is kind of an impromptu episode that we’re just recording, like we were just talking at the end of the day, where I said, what did you do today, and he said, ‘Oh, I have a story.’ I’m like wait, could you just say that whole thing again, but say it on the podcast. Because not all doctors are caught up with the fact that trauma lives in your body, and you carry it and it comes with you everywhere you go. It’s not that therapy is the only way to kind of process these things and move forward but a lot of times, it’s really just having that time to talk to someone, whose whole entire job is just to listen and reflect you and help you come up with your own coping strategies.
It’s kind of like being able to hear yourself say things out loud and think about, hey did I think that? I wasn’t aware I was thinking that. Maybe that’s the underlying thought that’s been coming with me, maybe that’s why I screamed at my kid. Or maybe that’s why I have a hard time, like I’m always anxious when we go on drives. That’s an example that’s been with us. I have some PTSD from a car accident that I had. I was like, oh wait a minute, I never put two and two together. Whenever we go on long drives, I’m not so pleasant. Hahaha. I’m like a backseat driver, right?”
YS: “I decline to comment.”
LS: “Haha, very wise, very wise. But through the process of being in therapy, I have discovered lots of things about myself which I think have only been to the benefit of myself, our marriage and our family. Would you agree?”
LS: “Haha. When you said, ‘I didn’t always think this way or I wasn’t trained necessarily to have this opinion,’ it came from being married to me. Hahaha.”
YS: “That’s true. That’s true. As in, I didn’t actually learn that in medical school. It came from life experience.”
LS: “What did you learn in medical school?”
YS: “What I did learn in medical school…”
LS: “I mean about this topic, haha.”
YS: “I did learn in medical school to memorize. In medical school, you memorize a lot. You memorize the signs of depression, you memorize the signs of anxiety and you learn that the treatment is therapy and pills. But you don’t really get to the nitty and gritty parts of how to talk to a patient and try to figure out from this story whether they need the full treatment. Or even if they don’t meet the actual qualifications of having clinical depression, if the type of patient who, based on their self reflection and their self knowledge, and what they are describing, whether they would benefit from therapy, that’s not just something you just learn by memorizing in medical school. That’s something that you get from life experience. Talking to enough people and figuring out what exactly is the best treatment. You can’t have robots practicing medicine, that’s where you actually need a human being.”
LS: “AI is probably going to take over. Artificial Intelligence.”
YS: “No, it’s not. It’s not.”
LS: “It can be used as a tool to support but the creativity, the innovation, the humanity, anyway that’s philosophy for over there. But I do really, really appreciate your input and your perspective. Like we really have been on this journey together through our training. By the way, for our listeners, I will also link in the show notes, a podcast episode that I did on a podcast called, Married To Doctors, which is a great podcast discussing the toll of the training that it takes on the spouse in many cases.
But I’m really, really emotional and grateful that I am now in a place where I can say, ‘Hey look, therapy really changed my life in a very significant impactful way.’ And I want more people to just break that stigma and be like, really, we’re still talking about that person that needs help? As if that’s a bad thing. Show me a perfect person that doesn’t have some issues or thoughts or questions or challenges. Wouldn’t it be great to have someone who is actually trained to listen and support you and hopefully you can find a good therapist, which is also a topic.
Yeah, that’s my little soapbox for today.”
YS: “I’d like to add a little point about what exactly is therapy. Lilach basically mentioned it already but I’ll kind of reiterate what I think of it. A therapist is somebody who is really, really good at listening, assuming the therapist who is actually doing their job. But a therapist is someone who is really good at listening and reflecting and understanding the person and understanding the client. You know, a lot of people are like, what will therapy do? But you know, if the person is like, alright, I think I want to go. If the person feels comfortable with the therapist, the client will basically feel comfortable telling the therapist everything that’s bothering them. The therapist will basically sit in the chair and listen, listen, listen with the body positioning and the eyes and all that stuff. Basically, showing you that they are actually listening in a way that the client actually feels comfortable to actually continue talking. And then at some point, the therapist will find a good time to reflect.
Basically to reflect upon what the client is thinking and the client will basically feel like yes, this is right. You are understanding me and sometimes just to be able to have the time to speak to someone and feel understood and feel like there is someone who is actually understanding you on a deep level, that itself is an excellent benefit for therapy for many people who feel like, oh everything is just flying on me and nobody gets me. Then the therapist will continue to reflect and try to actually train the client to understand things in a different way, such that they would be able to deal with their own emotions and stuff like that.
As Lilach said, why is that bothering you and then you try to delve to the issue. Ask a question or two, let the client continue talking. Ask another question or two, let the client continue talking. Only after a while, the therapist will then make a suggestion that will get the client to figure something out. It’s a slow process. Most people will not get all of their issues resolved in one to two therapy sessions. It’s usually a long term relationship between the client and the therapist which builds the therapeutic relationship. However, that is basically from the family doctor’s standpoint. The excellent benefit of therapy for anyone who needs it.”
LS: “That’s really helpful to be open to also being like, yay maybe someone who is close to you and went to therapy and you ask, how did it go? Are you better now? Like 45 minutes later. No, it’s going to take time and also the person themselves has to want to be on that process and commit to those sessions and commit to also reflecting on the sessions. Not only to think that this is going to be a Band-Aid and we are just going to cover it up. No, you’ve been doing that so what else can you do?”
YS: “Another point that I was going to make is that not everyone is ready for therapy. So, if you see a friend who is kind of like in a rut, you can’t just be like go see my therapist, go see my therapist. The friend might not be ready. A person has to be ready to open themselves up to the therapist.
I’ll tell another story. I had a patient come to me with itches on her hand for over ten years. The diagnosis was eczema. Basically an allergic type of reaction of itching on the hands. But she said that she has seen every dermatologist in the state of Israel and she has tried every cream in the world and nothing works. So, of course as her family doctor, I delve in and ask her some more questions. When did this start? It started when her uncle died. So, I mentioned to her that it might be in a way, I wouldn’t say psychosomatic, because a lot of times when people aren’t stressed, they actually have real, physical symptoms that can actually be diagnosed physically due to stress and changes in their mental health. I think she had real eczema but I think it was from her stress.
Okay, so then I asked her if she ever tried and had therapy. She said, yes. I had therapy once or twice and it opened up in me a lot of things that I didn’t want opened up so I stopped. So, on the one hand, not everyone is ready for therapy. Sometimes, the person isn’t ready to address their traumas. You wait until the patient or client or whoever is ready to start therapy.
Again, once a person is ready to start, the therapist has to go at the pace of the client. Sometimes, they are willing to delve really fast and sometimes not. However, on the other side of the spectrum was this story where the person tried once or twice to do therapy and wasn’t ready for it at that point. But on the other hand, you saw what happened when they did not open up their traumas, is that they basically kept it in and it exploded as physical symptoms.”
LS: “Okay, so now I’m a little worried about something but let’s talk about it the whole essential oils, think well and we’ll cure your cancer, you know that whole industry that over-promises everything. By the way these drops will cure everything you’ve had. Okay, you hear what I’m saying. There’s like a very fine line between addressing a mind/body connection and capitalizing, ie: taking advantage of people and try to sell them on the promise that this green shake smoothie with this protein powder or this oil, is going to cure you.
I’ve heard that also from the hearing loss side where people are like, we are not going to do cochlear implants or get hearing aids or anything because we are praying for a miracle. It’s like, the miracle is in the technology that is available, if that’s the direction you want to go. But the idea that these things could be cured by positive thinking, where do you fit on that question?”
YS: “Alright, very controversial topic. So, first of all, in terms of protein shakes and pills, I will usually only recommend or prescribe pills that have actually double blinded clinical trials. Which means, that this particular medicine has been shown in multiple studies where they basically have hundreds of thousands of participants in the studies, retrospective or prospective, and everything is the same about everyone except that half got the pill and half didn’t and you see a clinically significant difference which you can clearly attribute to the pill. Those are things that I will actually prescribe medicine for.
Regarding the, I was going to say snake oil, I’m not sure if that’s the right term to use, but regarding stuff that you buy in vitamin shops and stuff that they advertise online, which this shake will, again, help you and make you feel better, most…”
LS: “Yeah, it’s going to boost your productivity, make you skinny, make you an athlete, make you not crave food and also help you find the love of your life. All by buying this $45 pill. Hahaha.”
YS: “$450, Lilach. But reastically, what you have to do before buying any of these shakes and putting money into any of these highly advertised treatments, is check out the studies. Have there been double blinded study of hundreds of thousands of people, half of who took this shake, and half who took water with green food coloring and you have a clinically significant difference between the two groups? Or, you know, they have tried it on people and due to the fact there is sugar and protein, it does make a person have a boost of energy because after all, it does have sugar and protein which will give you an immediate boost of energy and because of that, you will feel better. It’s not that this particular shake has any actual clinically significant studies behind it.
So, use a little bit of critical thinking before pouring your money into the next miracle shake that you see online, because it might contain sugar and water, and you can probably get the same out of eating a shake at your local supermarket.”
LS: “Right. So, even though this conversation is quite outside the scope of all about audiology, I do think that it’s really important to talk about. Because, so many times we are willing to try things and buy things and sign up our kids for classes, and like I said in the beginning, basically try anything that is being promised as a way to help us, help our kids, help our family. But here is something that has lots and lots of evidence backing it up. That when you talk to someone and they help you work through your feelings, that actually improves your health.
That actually improves all those other parts of your life. And it’s expensive too. It does come at a cost, not only paying for it which can be very expensive, but also in terms of time and in terms of the emotional toll that the process itself takes. Sometimes, going to therapy will make you sadder or less productive for some time because you have unearthed those feelings, but it’s for a long term goal. Kind of like when we are doing physical therapy, you do a move that hurts you or makes you uncomfortable, but it’s to strengthen you.
We talk about this with the balance physical therapy for people who have balance disorders, there is one particular move, the epley maneuver that we can do but it will induce, it will make you dizzy. Somebody who has a severe case, it might even make them throw up. So, they say no, they don’t want to do the therapy. They want to go and just sit still on the couch and not do the physical therapy training because they want to avoid the consequences of it. But if they actually do it and get through it, then it can actually put all those crystals back in place and help them to then lead a functional life, that they are able to resume their normal activity that they had before the onset of the BPPV disbalance disorder.
So, any last words? I’m so happy you came on the show, I really appreciate it.”
YS: “My pleasure, Lilach. I’ve been an avid listener ever since you have came out with the show and now it’s been my absolute pleasure to now be a guest on the show. From the footsteps of many well-known and prominent people, you now have a family doctor from the north of Israel, now also getting the honor of being a guest on this show. So, thank you very much Lilach.”
LS: “Thank you very much for being the composer of our theme song.”
YS: “Actually, Lilach and I composed it together.
I played it on the electric keyboard, but Lilach and I actually composed the music together. So, Lilach also gets credit for that.”
In conclusion, don’t forget to take care of yourself. You, as the parent to a child with hearing loss, or you as an audiology student, or you as my fellow colleagues in different fields, whoever you are listening to the show, don’t forget that you have service in a lot of places in your life where you give and give and nurture and serve and love. You do a lot. You do a lot. We all do a lot and we can’t forget to also point some of that right back at ourselves.
There’s lots of different modalities for getting that but for me and many other people, I think therapy is extremely powerful and it is way, way past the time to have that still be a stigma. So, I’d love to hear your thoughts on this conversation. You can find me on Instagram, on Facebook, and on allaboutaudiology.com.
I am excited for season 5. Oh my goodness, can you imagine we are at the end of season 4?!!!! Every ten episodes when we finish out the season, I like to go back and tell you about the episodes that we had this season. You can go back and listen if you missed them.
We kicked off the season with episode 41, with just an incredible mother, Madeline Cheney from The Rare Life podcast who came and shared about her journey with her son Kimball. Just so much from the heart with so much vulnerability about her journey, the struggles that she’s had and sharing her wisdom with other parents going through what she’s been going through.
Episode 42, I kicked off our student office hours, which are on the first Wednesday of every month and that’s where students from around the world, come and do a Q and A session with me. Plus case studies or a presentation about a specific topic. That has been going on the first Wednesday of every month since July, August and September. The next one is going to be on the first Wednesday of October, on October 7th. So, be in touch students. Send me a DM. Come and join the office hours if you are interested. There is also a possibility to get recordings from our previous sessions if you are interested by becoming a patron of the podcast at patreon.com/allaboutaudiology.
In episode 43, I was so honored to speak with Genia Stephens who has tons of experience with disability advocacy. We talked about creating a vision for your child’s life. This is such an important episode that I think any parent should really have a listen to and think about the concepts we talked about because they can help you in creating a vision for your child’s life. What is the point of all the parenting effort that we put in without having a direction to go in, without knowing where we are trying to go. It was definitely a very meaningful conversation for me and I hope that you will go back to episode 43 and check it out.
In episode 44, I talked about the online support group for moms which was followed by episode 45 with the lovely Dr. Melissa Karp who shared so much information and practical tips and knowledge about auditory processing disorder and sound sensitivities. That is an episode you should definitely check out if you want to learn more about misophonia or the ways that we process what we hear, beyond just receiving the sound, beyond what our ears do, what does our brain then do with the information that we receive. That is episode 45.
Then the next three episodes were personal stories of people overcoming, of people sharing their personal experiences. Episode 46 was with Courtenay Turner who talked about being born with congenital hearing loss due to rubella. Now she is like an all star fitness, amazing, resilience person who I really enjoyed hearing her story.
Episode 47 was long awaited episode and I’m so glad we were able to get it out. That was with Dr. Saunja Burt, an incredible, incredible audiologist that I have learned so much from, from the podcast but also outside of the podcast. Dr. Burt was the first black audiologist to earn the AuD degree. She shared her personal journey to the AuD, to becoming an audiologist. A lot of tips for students in there and we also touched on the systemic barriers that exist in education and in healthcare for black people, indigenous people, and people of color.
These are conversations that we have to be having. That it is incredibly important for us not to continue to live in some kind of denial of what is happening in our world but to deny that they are occurring, even in our own spaces, in our educational institutions and as healthcare providers. These are things that we must address, that we must educate ourselves on and learn about the experiences of our patients and colleagues and friends when they share them with us and also it’s not their responsibility to do that. So, I want to thank Dr. Burt for coming on the show and sharing her story with us.
In the episode that followed, episode 48, we heard from Jacquelyn Briggs about her unilateral hearing loss and becoming a cochlear implant user after she lost the hearing in one ear due to a car accident. What a journey. How much wisdom, how much inspiration and now she works with children who she can relate to in a very unique way. Children who use hearing aids or cochlear implants and she’s a teacher who incorporates lots of dance and music in her curriculum. That was a super fun episode and it was wonderful to meet you Jacquelyn and hear your story.
In episode 49, we got to hear another unique story with Natalia Popham about her experience having a reverse slope hearing loss. It’s more hearing loss in the lower frequencies and how that affected her ability to develop language and also her journey in learning to advocate for herself which is one of the major, major messages that I hope to impart with this show.
Like I said, you gotta take care of yourself. You got to believe that you can, believe that you deserve everything good and that your children do as well, and fight for them.
That was our season 4 wrap up. Season 5 is coming with amazing, incredible new things. I know I always use those adjectives but it’s because of my enthusiasm and excitement for what is coming. Stay tuned for more!