PA school will happily eat every relationship you have if you let it.

I brought on a licensed therapist to talk about how to keep the people in your life close while you're deep in a program that demands most of your time. Her advice is refreshingly unglamorous: communicate what's coming before it happens, and let small gestures carry the weight when big ones aren't possible.

You don't need a free weekend to keep a friendship. You need a text that says you're thinking about them. Twenty minutes of real attention beats three hours of being physically present while mentally reviewing pharm.

This applies to partners, parents, friends, and honestly to yourself too.

What we talk about:

• Why relationships strain during intense training
• Setting expectations with people before school starts
• Small, consistent gestures over grand ones
• Communicating when you're overwhelmed instead of disappearing
• Protecting a few things that aren't school
• Knowing when to ask for professional support

Resources:

Pre-PA counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Free application timeline: https://www.thepaplatform.com/services/free-application-timeline

PA Program Map: https://www.thepaplatform.com/pa-platform-map

Free personal statement worksheet: https://www.thepaplatform.com/services/free-personal-statement-worksheet-download

Mentioned in this episode:

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Today I'm talking to a professional therapist about relationships and PA school and handling all of that.

It's a good one.

Welcome to the Pre PA Club Podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

Foreign It's a new year, everyone.

Thank you so much for joining me.

I am Savannah Perry.

I'm the host of the Pre PA Club Podcast.

I am a dermatology PA as well as a Pre PA coach through the PA platform.

And I am very, very excited about this year.

If you are on our email list, you probably got kind of an update email sent out last week.

If you're not on the list, make sure you get on it because we are going to have some really cool stuff this year and the first best place to find out is on the email list because those people get dibs.

So one thing we talked about there or in the email is that as of today, we can officially announce that there will be a Southeastern Pre PA Conference this year, Atlanta, Georgia on March 28th.

So mark your calendars.

It is going to be awesome, but we have very limited spots.

So if you've listened to the podcast for a while, we are doing this in conjunction with MYPA Resource, which is a personal editing website specifically for PA school.

And you can use the code Future PA for any services from them.

And now is the time to kind of get started started on your personal statement if you're planning on applying or reapplying this cycle.

But we are very excited about the conference.

There will be more to come and more details on that, but registration will be available on this upcoming Sunday.

So if you're listening to this on January 3rd, which is the day it comes out, it will be available to register on January 5th and we'll be sending emails about that.

We'll also be posting it in the Pre PA Club.

But like I said, this first one we've only got about 100 SP spots because where we're hosting, the school we're hosting with, that's all that they're able to accommodate.

So we are very excited about it.

It should be a great conference.

And if you have any questions about that, please reach out to me directly or just email myself or my PA resource.

All right, before we jump into today's actual interview, I also want to mention PA School Prep, which is a sponsor of the podcast.

PA School Prep is a great option of an online course.

If you are about to Start school or have been accepted to PA school and kind of looking for something to make sure you keep your head in the game, keep kind of up to date on your anatomy, physiology, med terms.

That's where PA school prep comes in.

And you can also use that future PA code on that online course for a discount, the same way you can use on any of the PA platform services this year.

You know, if there's something that we can do better, that we can do for you, please reach out to me directly.

I love reading reviews and hearing your feedback there.

But if you have something that you would like for us to do differently or better or anything, just shoot me an [email protected] or on Instagram, of course.

Alright.

So today I actually got to do this interview in person with Ashley, who is a licensed student therapist.

She is awesome and so nice and I felt like I was in a little mini therapy session, but it was a lot of, a lot of fun getting a chat.

So I thought this would be a great way to start the year off just with something a little bit different because we hear from a lot of PAs and PA students, which we're going to continue doing.

But I think it can be easy to lose yourself during PA school and lose sight of relationships and all kinds of stuff.

So we're able to chat about some ways to kind of refocus and make sure that those things stay your priority, even if you are going through kind of the stress of schooling.

So we'll get into our interview with Ashley and all of the links she talks about are in the description, but you can also find her on Instagram therapybyashley.

All right, Meet Ashley.

I am Ashley Kwame and I'm a licensed marriage and family therapist here in the state of Georgia.

My focus is on treating couples and parenting as well.

So couples ranging just from premarital all the way through discernment counseling, which is more for staying discerning.

Should we stay together?

Should we not stay together?

So kind of the whole range, like the whole gamut.

Okay, so how long have you been doing that?

I've been practicing clinically for about 10 years.

Coming up on 10 years, which is a big, like, professional milestone, you know, a little scary.

Practicing for about 10 years now in private practice for the last five of those years.

Okay, so can you give us a little background on just how you got to that profession and kind of what the steps look like to get there?

Yeah, yeah.

I've always been interested in relationships, you know, starting in High school, just how they work, why some people get together with other people, what makes certain relationships work, what makes certain relationships not work.

Psychology seemed to be a really good fit for that.

Going into college.

And pretty early on in my college curriculum, I took a marriage and family systems sociology course and was introduced to Dr. John Gottman.

I don't know if you've heard of him.

He is a relationship guru and researcher.

And I could geek out over, like, all of his research forever, but I'm not going to.

Anyway, I read a few of his books and just got turned on to his research and came out of that class.

And I was like, I'm going to be a marriage and family therapist.

And I guess I felt pretty blessed in a lot of ways to be able to just kind of know, like, definitively, like, this is what I want to do.

I want to do marriage and family therapy.

I want to treat couples.

And that's just it.

So the steps to get there, then, obviously, having a college degree, I went on after that and obtained my master's in marriage and family therapy from Valdosta State University.

And then post grad school, there is a licensure process that can take, you know, about three years.

So, yeah, there's a national licensing exam that we have to take and pass.

And then you have to accumulate so many hours of direct clinical experience post grad school.

Okay.

So it took me post grad school about three years to do that.

We.

My husband Clayton, was in the military at the time and stationed in Korea.

So after grad school, I moved to Korea and had to figure out, like, how am I going to get my hours?

Like, how am I going to get this clinical experience?

And got really lucky in landing a job at an alcohol treatment center.

Oh, interesting.

There.

Yeah.

So I was able to work with soldiers and their families, which was amazing.

Very rewarding.

Interesting.

Yeah.

Okay, can you define for us or kind of compare and contrast, I guess, like therapist versus psychologist versus psychiatrist?

Yes, great question.

I get that quite a bit.

So I'll start with psychiatrist.

A psychiatrist has a medical degree.

They are an md, so they've gone through, like, residency and all of that.

They are the ones that prescribe medication.

Okay.

They can also do therapy, psychotherapy.

But the primary reason why most people go to see them is usually for medication purposes, for mental health.

And then you have your psychologists, they have a PhD, so they've gone on to get their doctorate.

But their PhD or PsyD, they've done a lot of research.

They tend to do some testing.

You'll see them in the psychological testing kind of realm and assessments.

They also do therapy as well, but they kind of.

You'll see them kind of in both.

If they're not doing testing, they're going to be doing therapy then.

Okay.

And then you have your therapists and we are master's level clinicians and we just do.

I shouldn't say just do therapy.

We do therapy.

That's the hard stuff.

Right?

I'm not going to minimize or downplay my field.

We do therapy and it's hard, but we don't do medication.

You know, management and prescribing.

Okay, that's helpful.

Okay.

So went to school, got your master's.

I actually really love psychology too.

So I took a bunch of psych classes and I think they're so interesting.

What exactly does kind of your schedule look like a day just in your job look like in the office?

In the office.

So I see roughly 16 clients a week.

I schedule 16 clients a week, which may not sound like a lot, but those sessions are an hour long, 50 minutes to an hour.

It is a lot.

Yep.

So personally I see clients Tuesday through Friday.

Mondays I reserve as my administrative day my running errands or doctor's appointments kind of thing.

But I come in and I mean I get going pretty quickly.

I allow about 30 minutes in between sessions to do paperwork, return phone calls, billing.

I'm a, I tell people that I'm a one woman show.

So I do.

I am the administrative assistant.

I am the accountant, I am the billings person, I am the therapist.

I am everything.

Sometimes my, I joke that sometimes my assistant is not gonna get her raise.

But that's you.

But that's me, right?

But yeah.

So my day from nine to I leave about 2:30 is go, go, go, go, go.

Between seeing, seeing clients, being on the computer, responding to emails, stuff like that.

And I leave the office at 2:30, 3:00 clock and then I get to be mom for the rest of the day.

Yeah, me too.

Do you have what you would say is like a typical client or do you see just a lot of different types of people?

No, I probably at this point in time have developed more of a typical client.

Early on in my, early on in my career I was seeing anybody, just whoever I could get to like come in.

I was like, yes, I will see you.

I learned that that's probably not the best way of doing it, but I think that that's a mistake that like every newbie kind of makes because we're desperate at that point.

We just Want to save lives.

At this point in time, though, I do see about 50% of my caseload is couples.

And then I see a lot of adult women, either new moms, moms with young kids, or moms who have kids that have launched.

It's actually kind of.

I don't quite know how that's come about, but I see a lot of moms who have also had kids that are adults now or have launched or really, really young.

No, like teenagers.

Yeah, I know.

I guess I'll turn into those, I'm sure, eventually.

So a lot of our listeners are.

We have a few different stages.

So we have a lot of people who are like in undergrad, going straight into grad school, may or may not be in relationships.

And then we also have, you know, people who are maybe going to.

Wanting to go to PA school as a second career and are either in relationships, whether they're married or not married, or have kids.

What?

And I guess just thinking back on my PA school experience, I saw.

We'll see.

Let me think.

I was engaged at the beginning of PA school, got married in the middle of PA school, still married.

All good.

But I saw some people start relationships and some people end them too.

And that's something I think anyone in PA school will see, is that there are going to be relationships that hit some rocky roads.

And I don't think that's necessarily what anyone wants.

But for someone in that type of environment, an intense, like, rigorous schooling, that's very time intensive, very stressful, I guess.

What advice do you have for them that they could practically do or consider to try to.

Yeah, kind of just maybe some of that discernment about where they're at, but also like helping those relationships.

Sorry, that was a loaded question.

No, no, I think that's a great question because I also remember in my graduate program it was intense and I don't want to say thankfully, but Clayton was in Korea at that time.

And in some ways that really worked to our advantage because I would get up and be gone from like 6, 7, 7:30 and get home at like 9 or 10 o' clock at night.

So there wasn't like a.

There wasn't a lot of physical time there.

So a lot of my suggestions to like young professionals or younger couples and this would go the same for even those folks that are making it a second career in established, stable relationships.

Is that.

I mean, I guess for.

I'm trying to frame this in like.

A really,.

I don't know, great way, but I'll just say it you have to talk.

Like, I was gonna try to make that sound really fancy and, like, great, but you just have to talk so many times.

Like, we get into, like, the mundane, like, you know, how was your day?

Good?

Great.

Like, awesome.

Okay.

What's for dinner?

Hey, can you clean this?

Can you pick up that?

Like that?

I mean, over time, like, that's not gonna feel so great.

Like, people lose that connection, you know, so.

So you have to talk in the sense of you have to ask questions.

For busy professionals like that.

I'm just thinking you're gonna have to be really proactive with your relationship.

It doesn't take a lot of time to send a text message.

It doesn't take a lot of time to send a quick text to say, hey, just thinking about you.

Love you.

John Gottman told you.

I'm like one of those, like, groupies.

But he talks about.

He has a great quote, and I love it.

But he says small moments done often.

And I love that because it really hits at just, you know, how small, really, moments can build up and add up over time.

So if you are putting in positive, even in small ways, small, positive things into your relationship, over time, it's going to sustain those periods of those gaps where it is a little bit harder.

You can think of it like a bank account.

If you're making more deposits into it, then it's going to carry you through rough times.

So for those busy professionals, like, send messages to your partner, let them know you're thinking about them.

Another thing I would say is that expressing gratitude and appreciation, you have to say thank you.

I know we get into this place in our marriage where it's like, our partner did that.

Okay.

Like, it comes across as almost like you take it for granted.

You know, I hear a lot of women say, like, I just feel like I'm taking for granted.

I do all of these things and I never hear a thank you.

Right.

Thank you can go a long way.

It's two of, like, the simplest but most meaningful words that you can give.

So tell your partner that you appreciate them.

If you're gone all day at clinicals or in class or what have you, and your partner is carrying a physical, like, load at home.

You should be telling them, thank you a lot.

Hey, thanks for picking up dinner.

Hey, I appreciate you doing that.

Hey, it means a lot to me.

I know I'm busy.

I know I'm gone a lot.

It means a lot that you can pick up this load while I'm out.

Say, can you say that small moments Quote again.

Yeah.

Small moments done often.

Okay.

I like small things done often.

And maybe this makes me a pessimist, but I think, like, the way you explained it was so great.

But I think it could go the other way too.

It does.

And how sometimes the negative things, and maybe those times we don't say thank you and we feel take for granted.

Like, those add up.

Yep, they do.

And then that's maybe where we get.

And then you landed my office.

Yeah.

Which is great for me.

Like, I love it, I love it, I love it.

But that's not the goal.

Or if you're like me at home, you, like, erupt in this emotional mess.

Yeah, absolutely.

No, that's really great.

And I think, like, one thing that I've told people just.

And I was in a different situation because my fiance.

Husband was in med school at the time, so we were both in school.

That's tough.

We were both busy, but we understood where each other was at.

Whereas I think sometimes the struggle comes when one person is in school and the other person is the one sitting at home, maybe not really understanding, why do you have to study all the time?

Why do you have to be gone?

Why can't you help more?

Right.

And that is what maybe can lead to some of those.

And I also, I do this with military couples.

And Clayton and I did this as well.

But, you know, we would always say, like, okay, this is a two year commitment.

You know, we can do this for two years.

And if we are both, you know, just keeping that in mind, then it doesn't makes it a little bit easier.

Yeah, there's a end point.

There's an end point.

Exactly.

Was it finish line?

Right.

There's a finish line, like, there.

And so we would talk about, you know, how, okay, we only have to do this really hard thing, which is being separated the first two years of your marriage and me in grad school, we only have to do this for two years.

And, you know, we would celebrate, like, milestones, like, okay, we made it to the first six months.

Like, you know, and we didn't really physically celebrate because we weren't together, but, you know, like, verbally, like, we would talk about it.

So I think too, like, you know, for those couples, like, talk about, like, where you are, hey, we've made it six months.

Hey, we only have to do this for another year.

Isn't that so great?

Yeah.

Have a countdown.

Well, and if you are in the same place, like, you can make time.

I know, like in school you don't have a lot of time or money.

But you can make time for those actual celebrations.

Like even if it doesn't feel like you have a lot of time, like you can grab a meal, you can and that actually do something.

Like it's you can.

I always struggled with feeling like I couldn't take time away from studying to go eat or whatever.

But like, that was silly and it wouldn't have changed anything in the grand scheme of things.

It doesn't.

And I.

Not in my schooling, but maybe in my relationships.

I've heard that, you know too, in that we don't have time.

I don't have time.

I don't have time.

I'm doing this, I can't take a break.

And there's a lot of research and this is more from like a work standpoint.

But you're gonna be way more productive if you take breaks and do things that are gonna fill you up.

So you can take a break from studying like that, you can physically do that.

It is healthy.

Your brain probably needs the gap, needs the break to go and like, you know, it's just like working out.

You need rest days.

Right, right.

So your brain needs that too.

And to your point, like your relationship is going to be with you hopefully through the long haul.

You know, that's usually the goal when we get married.

Yeah, right.

We don't usually get married to divorce later.

That's usually not the hope.

So, you know, prioritizing your relationship, you know, take those breaks, spend time together or at least if you can't, then at least do a lot of like verbal affirmations.

So on the flip side, let's say that someone is in school or new job, whatever, and that relationship is struggling.

Yeah.

And they are maybe in that discernment phase.

Is this something I want to continue?

Is it not?

What actual steps could they take?

Or would you recommend to maybe having those hard conversations or figuring those things out?

Yeah, I know that's a hard, it is hard thing to talk about, but I think it's also, it is hard,.

But it's also a reality too, you know.

And you know, I would say don't make impulsive, emotional based decisions.

When I have couples that come in and they're like, I just feel like I can't do this anymore.

Like, I just don't want to do this anymore.

You know, I encourage them, like, take a few weeks, don't make any impulsive, like permanent decisions, you know, sit with it a while.

Because sometimes those emotions come and go and I don't know about.

For you but even myself, something that I want to do or a decision, you know, if I sit on it for a little while, sometimes it can change.

Sometimes I'm like, well, okay, I didn't feel like that intense about it.

Sometimes it doesn't.

And if it doesn't, then you know, you know that it's probably the right decision.

If you've been sitting with that decision of, should I end my relationship for a while?

And it's not coming up every time you get into a fight.

You know, it's coming up like driving to class or driving to clinicals or work.

And you're like, I'm really just not happy.

Like, this isn't the relationship I want, then it probably isn't the right one for you.

For those couples that want to work it out but feel like there's a lot of just disconnection, I know time is valuable and I get a lot of young professionals that are like, Ashley, we would love to come in and see you, but we don't have the time or your hours don't jive with our schedules.

So if you can't go to therapy, which would be my suggestion, if you can't go to therapy, there are wonderful resources.

Resources online.

Now, the Gottman Institute has a lot of educational just tips, suggestions, do this, don't do this.

Things that both partners can kind of do together.

They have an app.

It's called.

I think it's called Love Maps.

It's like a deck of cards.

I have the actual physical deck of cards, but the Gottmans have turned it into now like an app where you can go through and just ask questions to try and rebuild that connection.

There's also another great place, Marriage 365, that does like online courses.

It sounds like courses are like workshops or some online coaching.

They are like huge on Instagram.

You can go there at marriage365.

But they've got tons of just resources for you.

I'm trying to send your listeners to places.

Yeah, I'll tag our list.

All of them reputable.

And not just like, you know, somebody just saying.

Somebody just saying stuff.

Right.

Those are just two.

Those would be two really great places if your clients are going to.

Or your listeners.

Sorry.

If they're going to be looking at any kind of therapy.

I would look at finding somebody that specializes in emotionally focused therapy.

Okay.

And.

Or Gottman Style Therapy.

Those would be two.

And usually clinicians will market themselves as such, but the.

Those would be two just really great forms of couples therapy that there's A lot of research in backing that model for working.

Okay, so I've heard before that everyone should be in counseling.

Is that something you agree with?

I mean.

I mean, probably at this point.

At this point in time, like.

Yeah.

Or at least try it out.

You know, some people.

There's a lot of stigma around that.

Yeah.

Well, I think there's getting less and there's more.

Talk about just mental health, which is.

Great, which is fantastic.

But you can go to therapy.

You don't have to have a mental health diagnosis to go to therapy.

Right.

Like, I see from time to time clients that are in just situational, like, difficulties, you know, whether it's their kids just launched or they're a new mom, and it's really hard to just figure out how to, like, balance life or their kids just started school.

You know, I'm trying to think of more kind of lesser kind of life difficulties that people would come to therapy, or they have, like, aging parents and it's hard.

Or they have a history of parent, you know, difficult relationships with their parents, and it's manifesting now because they have young kids, and there's lots of reasons to go.

Or you're just stressed out and, like, you're in a busy season and you're just stressed.

Yeah, Life.

Just life.

Right.

Hashtag all the things.

Right.

Life.

Yeah.

I think everyone at some point should at least go.

It's valuable, especially if you don't have close, like, platonic relationships.

If you don't have any close friendships, then, yeah, you probably.

It'd be good to seek somebody out to at least just talk.

So what happens?

So what happens in a therapy session?

And this is probably dependent on who you talk to, but, like, what could someone expect if they're like, oh, that sounds really good.

I think that would be cool for me, but I'm scared, and is it gonna be awkward?

Yeah.

Well, I mean, I would say the feelings of being, like, scared are understandable.

Right.

You're gonna go talk to a stranger about your most personal, like, intimate thoughts and feelings.

And that's a little scary.

Like, I'm a therapist, and that would scare me.

Right.

And it has.

Like, I've sought out therapy, you know, before too, and being on the other side, it was a little, like, unnerving initially.

So those feelings of being scared, like, are totally validated.

I can't speak to how everyone does it, but my first session is usually about making my clients feel comfortable wherever they are or whatever the reason is that they're coming in.

I tell people, you don't have to open up the closet and spill everything in a first session if you're not comfortable.

Some people like to rip the band aid.

Some people like to go about it a little bit more slowly.

But usually it's just.

I mean, it's a conversation.

I don't know, like, I'm not trying to get into someone's brain and, like, change their thoughts and, like, you know, I don't.

I'm not sitting here psychoanalyzing and, like, judging.

And I'm thinking of all the things that people have at least expressed to me before of what they thought it would be like.

I tell clients if they want to lay on my couch, they can just take your shoes off or put your shoes over the edge.

I don't want shoes on the couch.

But you can lay on the couch if you want.

And that's totally fine.

You can.

It's very comfortable.

Yeah.

I wish people could see your office because it's, like, super cute and comfortable.

I love it.

I love it.

But I mean, that's just how that's my style.

I'm a little bit more laid back.

I don't want to say that I'm not formal, but, you know, I really just want people to be comfortable.

The best predictor for success in therapy is the relationship that you have with your therapist.

That client therapist relationship, that rapport.

If it is good, if it's solid, if you trust your therapist, then therapy will be successful.

That's a good tip.

This is a little kind of different direction, but I know some of our listeners and pre PA people have worked kind of in mental health settings, whether that's in parts of the hospital or counseling or with kids in different ways.

What do they call them, like behavior technicians or something?

But as someone who's worked in this field for a while now, and you have probably heard and been part of some heavy stuff.

And I know personally, when I was in PA school, my psych rotation was the hardest for me.

It was just.

I was on an inpatient ward.

It was just a lot.

It was heavy.

What advice do you have for people to just not as a clinician, to not take that home with them or not let it fall completely on them, if possible.

That's tough.

I don't.

This might just be my personality, but I don't want to say that I don't take things home with me.

Because you can leave it at work.

I can leave it at work.

There are things, though, and especially once I became a parent, anything that involved small kids like Abuse or neglect, anything that involved, like, small kids, I started really having a hard time with, which was understandable.

I was a new mom, and now all of a sudden, I'm putting my kids into those situations, at least mentally.

So I had to just say, I can't do this.

Not for me.

Okay, not for me.

So stepping away, I just kind of.

Had to step away when it was too, too much.

I have a. I think a decent amount of awareness to know, like, at least right now, like, what I can handle, what I can't.

But, you know, as a clinician, and maybe this is the same for PAs, like, I had to, you know, learn very quickly.

I can't save everybody.

And it's actually not my job to save everybody.

And, you know, even a step down from save, I can't help everybody.

And not everyone's gonna actually want your help.

Everyone is gonna want my help.

Right.

I had to get out of this, like, hero mentality, and I didn't have it as bad as what I think some people may or do.

That's a lot of pressure to put on.

It is a lot of pressure.

It's a lot of pressure.

So moving out of that and kind of more of an Moving towards an acceptance place of, I'm not going to save everybody.

I'm not even going to help everybody.

And there might be some people I don't give my best to either, you know, and that's.

I say okay.

It's okay in the sense that you're human, and it's gonna happen.

So walking away.

If there are specific populations or situations, or even traumas, you know, too, like, if trauma's too big, like, don't do it.

Don't, don't.

Don't do it.

Don't put yourself in that.

You know, the other thing I would say, too, is, you know, go to therapy, talk about it.

I mean, you can't.

Obviously, you can't talk about.

And break confidentiality.

But, like, don't wait until you're frazzled and, you know, really stressed and then making, like, clinical errors, you know, that could be, you know, kind of costly to you in your career.

Like, go talk about it, like, quickly.

It's okay.

Therapists see therapists, like, you know what I mean?

Like, I saw this post the other day where it was like, doctors see doctors.

Yes.

Right.

And therapists can see therapists, like, or PAs, right.

Like clinicians, though.

We're the worst at taking care of ourselves.

Oh, yeah.

But we've got to be better about that a little bit.

Absolutely.

You cannot serve your patients well if you are not well, you know, if I'm not great mentally, emotionally, like physically, I'm not going to be a good therapist and that in fact would be doing my clients a disservice and and would be unethical and that's the same.

For me as a PA which is part of why I switch jobs, you know so gotta do what's best for us.

Absolutely.

All right, well where can everyone kind of find you and follow you and.

Yeah so I'm on Instagram therapybyashley.

My husband and I also have a page he wealthy marriage he's a financial planner and we are trying to launch into some new joint business business ventures which is exciting.

Yeah so you can find me there on Instagram I'm on Facebook Therapy by ashley my website www.therapybyashley.com as well I'll.

Link to all of that.

Thank you.

Perfect.

Thank you.

Uh huh.