Episode 163: Personal Identity in Private Practice Ownership [featuring Sara Stanizai]

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Transcript

PATRICK CASALE: Hey, everyone. You're listening to another episode of the All Things Private Practice podcast. I'm your host, Patrick Casale. I'm joined today by Sara Stanizai, LMFT, she/her, is a speaker, coach, licensed therapist who founded Prospect Therapy to create queer and trans-affirming practices that focus, specifically, on serving first-generation American and immigrant communities.

As a queer first-gen herself, Sara's clinical and professional work focuses on serving the Afghan diaspora, specifically, fellow African American women, through retreats, group experiences that help participants find community and reconciliation with self, culture, and ancestry. Very, very cool stuff, in California, if I didn't mention that, happy to have you on. And thank you for coming on nice and early in your day.

SARA STANIZAI: Thanks, Patrick. I'm happy to be here too.

PATRICK CASALE: Are you one of those people like myself, like when someone's reading your bio you kind of go into a associative state, or, like, kind of zone out and cringe at all?

SARA STANIZAI: Absolutely not. I love my bio, and I'm very proud of it, and I love when people talk about me in front of me.

PATRICK CASALE: Okay, oh, good, okay. I'm picking up on, like, the sarcasm there, picking up on subtle social cues is not my strength.

SARA STANIZAI: That's actually not sarcasm. Actually, I'm a celebrity in my own mind. And so, you know, that is my bio. I wrote it. I'm proud of it. And I'm here for it.

PATRICK CASALE: That's a perfect segue into what we're going to talk about, that is, we kind of came on here and found some ideas off each other before we started recording. And I think the one that really stood out was when I stumbled upon your coaching website, and it really highlights and emphasizes your identity work that you do. And I think that stuff is so powerful and understated.

Can you tell me a little bit about any of the identity stuff that isn't in your bio that you feel like is super important to mention? And why is identity work so important for the work that you're doing, not just in your group practice, but your coaching business as well?

SARA STANIZAI: Thanks for asking that. And I appreciate you saying that because I feel like all of my personal private information is out on the internet, so I don't know how much more of my identity is not out there. And, you know, I put it out there, so I'm okay with it.

But I think when you are trained to be a therapist or just to go into this field, the thing that so many of us was drilled into our heads was stay private, stay a blank slate, don't tell anybody anything. And that also has its benefits. Like, I personally don't like knowing anything about my therapist, so I get the benefits of it.

But I think for a lot of us, honestly, I think it's kind of a generational thing. I think the wave of therapists that I'm in really learned not to put our personal information out there. And so, even having a little bit like, where's your family from, or are you an only child? I mean, an argument can be made that any personal thing about you is too much information.

And so, when I set out to kind of build my practice and my professional career, and it just kind of started coming out of me. I don't even know if it was a conscious decision. I'm sure it was, but I kind of couldn't help myself. I think that it's impossible to separate our own lived experience and our own identities from any work that we do, but particularly, this work. It informs how we approach clients, how we approach mental health, how we approach groups, or even speaking on a stage, all of that stuff. So, I figured, if it's going to be there I might as well use it.

PATRICK CASALE: Yeah, I agree with you 100%. And I think, obviously, there can be this mentality in our profession where it's like, "Oh man, like just any amount of disclosure is just not appropriate."

And I'm not someone who buys into that at all. I think that feels like we're approaching therapy from like a colonistic perspective. And I think it's also this reality that if we're working with anybody who identifies within any marginalized group, especially, that has any intersectionality with another marginalized group, identity work is so crucial. And I think that we create relatability, we create accessibility in a lot of ways. And just a simple sheer mention of this is where I'm from, this is how I identify, can really create safety for people who are reading a very brief page on a website.

SARA STANIZAI: Yeah, I think that's true. I also think there's some not-so-great things about it. But, you know, I will say that a lot of people will message me and just say, "Hey, I've never seen the words bisexual, Muslim, Afghan, Americans together on a page. I really appreciate this." Even if they don't share those identities it does build a little bit of trust, or yeah, relatability.

But, you know, I've also seen that where people who maybe aren't ready to embrace parts of their identity and they see someone else doing it, it can cause some fear and anxiety. It can make people feel even jealous or, and, of course, these aren't conscious feelings, but it can make people like stay away. Like, I'm not ready to go there.

And the other thing I see a lot, sometimes, you know, obviously, I love working with other Afghans, but I work with a lot of other Asian clients in particular. And sometimes it's too close to home where, particularly, other Afghans who might be, like, even close in age to me, or a little bit younger will feel like, one, we might be related, which is entirely possible. But two, it can feel like they're in therapy with their like, bitchy big sister or whatever.

And so, sometimes a lot of people come to me and say, "Well, it's close, but it's not too close. So, you get my culture, you get this part of who I am, but I don't feel like I'm seeing my family." So, there's definitely, definitely positives to it, but it's not only positive.

PATRICK CASALE: Yeah, I'm glad you mentioned that there are drawbacks. And I think another drawback, right? Is there's legitimate safety concerns for self-identifying on the internet or in general, so, especially, for people of color, especially, for people who are part of the queer communities, there's safety concerns to just say, like, this is who I am, this is how I identify. So, I think it's important to pick and choose those spots of this is when I feel safe, this is when I feel comfortable. Does the intent outweigh the risk? And I think that's probably stuff that has to be processed pretty consistently.

SARA STANIZAI: Yeah, I think it's important, too, that, you know, I always say, if you want to work with Afghan clients, if you want to work with queer clients, whatever clients you want to work with, it's not enough to just also be that thing yourself. You know, sometimes that can get in the way, and people think, "Well, I get it. I don't have any more to learn." Or, "I don't have to listen to my client. I know what that experience is like."

And so, you know, I try to really emphasize not only do myself and the other therapists who work for me, we do have lived experience, but we also have, you know, plenty of clinical training and experience, and are constantly learning too. And people forget that it's not enough to just have one or the other, I think.

PATRICK CASALE: Super important point. I know for myself, you know, identifying autistic ADHD, that's not enough to just stop there and say, "This is how I move through life." Right? Like, now all of a sudden I know everything about neurodivergent culture, and I'm going to understand and relate to everyone's experiences.

And I think that also means you have to do some deconstruction. I know that I've also had to unlearn things from living in an inherently ableist society. I've had to unlearn language, I've had to unlearn stigma and stereotype even post-diagnosis. So, it's a constant work in progress, and it's not as easy or as it's not like a situation where I get to just proclaim that on a bio, and then, all of a sudden it's like, okay, I know everything about my culture that I identify within. And I think that's important to constantly be like analyzing, relearning, unlearning, and having accountability around mistakes even when those things happen.

SARA STANIZAI: And having an answer or having an approach to even further self-disclosure. Because, you know, of course, the therapist would say, "Hey, I'm ADHD too. And well, what does that mean for you? And please client tell me, like, what part of this is important to you?" And you know, they have every right to ask us back.

PATRICK CASALE: Absolutely.

SARA STANIZAI: And sometimes, you know, therapists feel protected, or like, well, I want to self-disclose up until it gets uncomfortable for me, and then I can rely on, "Well, I'm not supposed to do that. That's not how I was trained." And so, we just back off.

And so, I think, you know, even if you don't have a great answer yet, you should have an understanding of like, whether you should be answering that question or not and how to approach it. But I believe clients do have every right to ask us questions back.

PATRICK CASALE: Yeah, you know, I don't want my therapeutic process to just feel like, basically, just a sounding board in its entirety, unless that's what the client is really requesting because, you know, I know for myself and for so many others, grad school and even in some community mental health settings, it was kind of drilled into our heads, like, this is how you are a therapist, this is how you're not. And there was a very like, big delineation about, like, this is what is unethical, this is what's unethical, this is what's unethical.

And there were so many things that feel like they fell into that bucket where it was like, "But I didn't think therapy was supposed to be robotic. Like, aren't we in the nature of creating relational work and relational safety?" So, it's really challenging to do that if you're feeling like, I have to present in this environment in only this way, and it really doesn't allow, in my opinion, to create vulnerability and safety for the client if you're not willing to go deeper.

SARA STANIZAI: That's true. I think as therapists, we do have a responsibility to self-disclose ethically, and sometimes that does mean disclosing, and sometimes it means not. And we can't answer that in this interview, that is part of what is the art and science of therapy, knowing when to ask my client, like, why is that important to you versus knowing when to just spit it out? You know?

PATRICK CASALE: Absolutely.

SARA STANIZAI: Because, like I said, I started this interview by saying, I don't want to know anything about my therapist. Everything I know about my therapist is against my will, and I'm just kidding. But as we build that relationship, knowing what is safe for your client and getting to the need underneath that question, that is kind of what makes somebody a really good therapist.

But what most people don't know is I actually started my therapeutic career working in forensics, working in jails, and in diversion programs. And so, when you go into county jail, you don't exist. There is nothing about you. So, it's just funny to me that that was the beginning of my career and now I'm kind of completely opposite.

PATRICK CASALE: Yeah, it's interesting, like the trajectories of our career paths and in mental health. And I think that just is kind of cool because it does highlight how constantly we as humans and professionals are evolving, and growing, and changing. And I know where I set out in my career is not where I ever thought I would be now.

And looking back at it, like, I can viscerally remember and think about mistakes that I made, like when I was maybe a peer support or a qualified professional. And maybe I used too much self-disclosure. Maybe the boundaries got blurred sometimes because I was working in people's homes, and it was a lot of supervision and consultation to unlearn a lot of stuff that really wasn't therapeutically relevant.

So, I do think a lot of times people get into this profession to heal themselves through the work that they do, and that's really not the way that we should be approaching this work at all.

SARA STANIZAI: I 100% agree that this work can be healing for us. I know my work definitely is, but that has to be the icing on the cake, that is like a really lovely byproduct of it. I like to think that when I think back to my cohort in graduate school, the people who were doing that kind of didn't make it through. The people who were like, you just came to therapy school because you wanted therapy, but you didn't want to do the work of therapy. You just wanted to, like, learn all the textbook stuff so you could do therapy on yourself. And you realized you can't do that. I might [INDISCERNIBLE 00:16:21] a little bit. But yes, I think that when you come to this profession, I think almost everybody comes to it because we have some pain and something that we're trying to work through, but don't use your clients to do that.

PATRICK CASALE: It's more like case consultation and supervision is crucial, and it's so challenging when it's like, "Okay, once you become fully licensed you're kind of autonomous in terms of, like, how you have accountability in place." And it's like, "Oh, get 40 CEUs in a two to three-year period and you're good." I don't think that's enough, especially if we're really trying to constantly grow. So, it's just one of those things that's… I think it's a constant process, and we constantly have to reevaluate these things and just challenge ourselves as we grow professionally too.

SARA STANIZAI: Yeah, that's true.

PATRICK CASALE: But yeah, just talking about ongoing learning as we go. And I think that informs kind of like the kinds of leaders we want to be, too. So, I know before we started recording, like, you own a group practice, you wanted to talk a little bit about the culture creation, and you also wanted to talk about, like, when clinicians say, "I want to start a group practice, but it's because I want to make more money." Same reaction, by the way.

SARA STANIZAI: Oh, my gosh. Okay, we'll edit that laugh down to a normal length because I just laughed for 27 minutes. Just kidding. I am so sorry. I do not want to laugh at people's hopes and dreams. Sometimes I will see people say like, "Hey, I'm thinking of bringing on an employee. Like, what are some tips and tricks that you wish you knew?" And I'm like, "This requires more than a Facebook post ma'am."

PATRICK CASALE: Yeah.

SARA STANIZAI: Like, oh, you sweet summer child. That being said, I'm incredibly proud of my group practice and I love it. I love the people who work there. I love the work we all get to do. And I have had a solo practice and a group practice. Group is exponentially more work, and more stressful, and more uncertainty, and obviously, yes, I'm the boss, but you are less in control when you have so many people.

But I think everything has its own season. And I also have colleagues who were solo, went to group, went back to solo, and it's kind of like when I got divorced a few years ago I'm like, "Congratulate me because I made the right choice for myself at this time. It's not…" You know, people feel sort of bashful, or they're like, "Oh my gosh, I couldn't do it." I'm like, "No winning is knowing, like, what you want to do and then doing it even if you're getting all this pressure to just kind of keep things the same."

But yeah, I think the evolution of my own group practice has been, it's kind of mirrored… Like, my own personal journey has been very much a part of that. I think I started like six sentences there, but…

PATRICK CASALE: No, I'm following you, and I think you're right. I think sometimes we have to be willing to let something go if it's just not for us. I think we struggle with that, you know, a lot of time. I think when people come to me for coaching and they're like, "I want to start a group practice because I'm getting so many referrals, I want to refer in instead of out. I want to make more money." I'm always like, "Okay, well, let me tell you all the reasons that may not happen. Let me talk to you about how much work goes into this. Do you want to be a leader, a mentor, a boss, a coach? Like, what do you want your role to be? Or do you simply want to just make more money?"

If that's the case, I'm probably going to try to dissuade you from moving in that direction and maybe pursue coaching or some other form of revenue building because group practice ownership is not for the faint of heart a lot of the time.

And I think I spend more time than not, like, worried about my clinicians, worried about their day-to-day, worried about do they have enough clients to make enough money for the needs, like, that they have, for the goals that they have. All the stresses that comes with employing and managing humans. I mean, it is not cut and dry.

So, I definitely think there's a lot of nuance there too, and it's not as simple as like, "Well, I just want to refer in instead of out and make more money."

SARA STANIZAI: You know what? You know what I just thought of? Is I would describe it the way I describe like group therapy to people, to therapists, especially, in saying group therapy or family therapy is not just individual therapy with multiple people in the room. You're not just doing therapy with nine people at the same time. You're doing therapy with the entire group, and you see how the dynamic changes, even with a couple. Even if you have two or more people in the room, you realize how that changes, the dynamic between you and each person and your responsibility.

And so, I'm actually going to start asking people that, "Hey, I want a group practice." And I'll say, "Hey, do you love couple's therapy?" And they'll be like, "No, I hate it." And I'll be like, "Cool."

PATRICK CASALE: So [CROSSTALK 00:21:52] this.

SARA STANIZAI: Yeah.

PATRICK CASALE: That's a good analogy, honestly. That's actually like a good way to re-contextualize that for people who are thinking about it. Because you're right, there's so many dynamics that you then have to be a part of, and support, and navigate, and I think that is something that we often lose sight of.

I have a lot of ideas right now, but you just mentioned groups. I know you have, like, groups that you do. And one that you mentioned before we started. So, I would love to hear a little bit about that as well because I think that highlights, again, as we were talking about identity and work that we're doing, it's obviously a major component of that group and that creation.

SARA STANIZAI: Oh yeah, you're right. So, what I'm really excited about right now is I'm running the eldest daughter's group, which it's mostly a peer support group with some coaching, and I run it through my coaching practice. It's not specifically a therapy group, but it's really for anybody who is an eldest daughter, even if you're not the oldest kid, if you're the firstborn daughter in a family of any culture, I kind of think we're the middle managers of our family, which is a really hard place to be. In many families the firstborn daughter is not only responsible for making sure she is excelling, and doing great, and is not causing any problems, but also, is parenting her siblings, and is parenting her parents, and is sort of their personal assistant in a lot of ways.

And the thing that gets pushed to the bottom of the priority list is ourselves so chronically that people grow up and become very much of service. They will say, "I'm just an empath." Or, "I'm just a people pleaser." Or whatever language you want to use for it, but the common denominator is, if someone sits you in a room and says, "Well, what is it that you want?" It's radio silence, they don't know how to answer that question.

And something I've noticed as I do these, kind of, I just do, like, little screening, interviews and conversations with people who are interested in joining is so many little sisters will message me and say, "My sister needs this." So many siblings will send it to me. Will say, like, "Hey, I really want my sister to go to this, but I think she's going to get offended that I sent it to her."

And when I talk to the eldest daughters, I mean, it is like pulling teeth. It is like torture to get them to be, like, do something for themselves. And I'll say, "Hey, so this is what the group is about." And they're like, "Oh my gosh, this resonates. I totally feel that way." "So, do you think it's something you want to do?" "Well, I don't know. I mean, what's the schedule again? How much is it? Like, who else is going to be…" "Well, I don't know." And like, "Hey, do you have a hard time committing to stuff that's literally just for you?" And they're like, "Yeah, I do." Like, in front of me, I'm seeing how hard it is for people to take care of themselves.

PATRICK CASALE: Absolutely, that makes total sense. And I think that's such a great offering. I mean, I know friends, and colleagues, and family members who could benefit from something like that, and who often are, like, you're right, parenting the parents, parenting the siblings, like overly responsible, had to grow up really quickly. And [CROSSTALK 00:25:26]-

SARA STANIZAI: And I would also add that sometimes I think it's a little bit short-sighted, but I think sometimes people think the antidote to that is to just be selfish and don't care about people.

PATRICK CASALE: Right.

SARA STANIZAI: No, don't do that. Like, it's beautiful to want to help your family, and you can keep doing all of that stuff. We just want to add some other things to the mix, including maybe some discernment and making sure that your voice is also being heard. Don't just be a bitch.

PATRICK CASALE: Fair, fair. That's a very good point that probably often gets lost in some of it too, when you're like trying to reclaim some of yourself and prioritize your needs. So, it sounds like a really cool offering.

Podcast, group practice owner, coach, group facilitator. You're doing a lot and it's really freaking cool. And-

SARA STANIZAI: [INDISCERNIBLE 00:26:25].

PATRICK CASALE: Yeah, I mean, and again, looking back to, like, the times when you're like working in the jails it's like, "Did I ever foresee this happening in my career?" And yeah, [CROSSTALK 00:26:36]-

SARA STANIZAI: Absolutely not.

PATRICK CASALE: …not either. So, really cool to highlight and amplify and just to illuminate, like, what is possible in this career path for people. And I think some of that is like figuring out who you are, not just as a clinician, but in terms of humanity, too.

SARA STANIZAI: Yeah.

PATRICK CASALE: Anything you want to share with the audience about things that you have coming up, things you want to promote, where they can find you? Any of that stuff.

SARA STANIZAI: I just got so contemplative, didn't I? I just sort of… when you said that, like where you came from 15 years ago, and the work I'm doing now, and I kind of can't believe it. Cute. Go me. And go everybody else who's doing what they want to do, too.

PATRICK CASALE: It's freaking huge. I think it should be celebrated, you know? So, congratulations on everything that you've created.

SARA STANIZAI: I love it. You asked me where people can learn more about my work. So, the best way, honestly, if you're on Instagram, follow me @prospecttherapy. I run that page. If you can't tell it is not a service, it's me posting all kinds of stuff on there. But you can also learn more about my group practice, Prospect Therapy, which is in Long Beach, California. The website is prospecttherapy.com. And for all of my own coaching, if you're interested in business coaching, if you want to book me to speak at your event, things like that, if you want to join one of my peer support groups, you can go to my own website, which is sarastanizai.com.

PATRICK CASALE: Thank you for that. And all of that info will be in the show notes so everyone has easy access to all of what Sara just listed.

I know we've been trying to make this happen for a while, and I just want to say thank you for making the time and bearing with my schedule, and coming on earlier than you'd probably like to. So, thank you so much for coming on and sharing some of your story.

SARA STANIZAI: No, it's my pleasure. If I didn't want to, I would have bailed. Thanks, Patrick.

PATRICK CASALE: Same, same, same way. You're welcome. To everyone listening to the All Things Private Practice podcast, new episodes are out on Saturdays on all major podcast platforms and YouTube. Like, download, subscribe, and share. Doubt yourself, do it anyway. And we'll see you next week.