Dr. Raphael Wald
Dr. Raphael Wald is a licensed neuropsychologist with a doctoral degree in psychology from the University of Hartford. Dr. Wald works with individuals of all ages and is experienced in all forms of therapy including group therapy, individual therapy, and neuropsychological assessments.
Dr. Wald specializes in treating clients who suffer from depression, anxiety, adjustment, and/or medical issues. He has worked as a clinician at Harvard – Beth Israel Deaconess Medical Center in Boston, MA; The University of Connecticut Health Center and the Veteran’s Affairs hospital in Newington, CT and conducted research for a number of years at Tufts Medical Center in Boston.
He has been published as a first author in the Journal of Experimental and Clinical Psychopharmacology, and has published a book focusing on the causes and treatment of Obsessive Compulsive Disorder. Dr. Wald is a member of the American Psychological Association, Florida Psychological Association, and National Academy of Neuropsychology.
How did you get involved in psychology in the first place? Was there a seminal moment or did it happen naturally over time?
I actually majored in economics in college and after working for a short time in business I realized I hated it. At the time I was looking for whatever the opposite was of trying to extract money out of people and I think that was trying to help people.
I did a lot of research into different kinds of fields and it seemed like – after doing the research – that psychology was the right fit for me.
How did you get involved in neuropsychology in particular?
I think it’s important for students to understand that any neuropsychologist is really just a clinical psychologist with extra training in the human nervous system. If you want to be a neuropsychologist you will learn to be a therapist along the way.
Before I began my doctoral program, I ended up getting a wonderful position in research at Tufts Medical Center in Boston and through that I became more and more interested in psychology and human behavior but also the neurological side of human behavior.
How important is it for you to have a diverse foundation in both clinical work and research psychology?
I think it is really important in order to understand what you are getting yourself into. I think psychologists can be surprised initially by how difficult it can be to conduct therapy and how much your patients rely on you.
So investigating all those different forms of psychology and really understanding what you are getting yourself into before you commit your money and effort and time is really crucial. You really have to do research and talk to people in the field so you can know what you are about to undertake.
How would you describe neuropsychology to someone who didn’t truly understand what the profession is all about?
The best way I can explain this is that a neuropsychologist is someone who evaluates and diagnoses and treats any neurological condition that affects behavior or thinking skills.
There are a lot of neurological conditions that fall under that category such as dementia, brain injury, ADHD, and strokes. Within the field of neurology, what a neuropsychologist does not touch is mostly stuff surrounding the peripheral nervous system.
It seems like some of these conditions vary greatly in severity. Do you see people on both ends of the spectrum?
Yes, I see people with both non-life-threatening conditions as well as terminal illnesses that I diagnose for the first time. So for example, I diagnosed someone this week with front temporal dementia which is a terminal illness and very, very serious form of dementia that progresses very rapidly especially in relation to Alzheimer’s.
I also diagnosed someone with ADHD which is obviously more of a chronic condition that is very treatable through medical and behavioral management. It is a very interesting field that allows you to see all different types of patients and a lot of the time you never know what you are going to see.
And what is the age range of your patients? Do you see both children and adults or do you focus on one particular age group?
I am unique because most neuropsychologists either see adults and older populations or children. I see everything because I chose to do my pre-doctoral training in geriatric and adult neuropsychology learning to diagnose and treat strokes, dementia, and brain injury. And then I did a full post-doctoral fellowship in pediatric neuropsychology. It was obviously extra work but I felt it was worthwhile. I have seen a seven-year-old patient this week and a 90-year-old patient this week as well.
The reason I decided to do both is because I like working with people of all ages. I think there are some people that work with kids and prefer not to see adults. And then there are people who work with dementia and head injury, and prefer not to see children. I really enjoy working with everyone so, it was worthwhile for me though for other people it’s not.
Do you learn from the patients as much as they learn from you?
Oh absolutely. When you are talking to someone who is in the later years of their life they have a massive amount of life experience and they just have so much to give over. When you are working with children, just to understand what they go through emotionally is an educational experience too.
When I have a parent or a school telling me how much better a child is doing, that is what you get into the field for. It is the best feeling in the world. You alter the course of a child’s life for the better and that is as good as it gets.
What are some of the things you learned through your educational experience that you are still applying to your work today?
What is important for interested people to understand is that what you learn on the job and from your supervisors doing clinical work is so much more valuable and important than what you learn in the classroom, under any circumstances.
When I am working with a patient and trying to understand their problems, I very frequently think of things that my supervisors told me about understanding people and the brain and I use that to analyze certain situations. So I think incredible supervision is the most valuable thing and that supervision is something I continue to use today.
The work you do sounds exhausting. Have you ever felt burned out? How do you balance your health with a demanding job?
One of the most important skills a psychologist of any kind should have is the ability to be personable and empathetic. But if you are the kind of person who sees someone with serious issues can’t stop thinking about it and gets emotional, it should affect you and you should feel for that person.
But if you can’t live your life because of that then you aren’t good material as a psychologist. It is something you constantly need to work on because you will get burned out. You have to be able to leave work at the office. I feel that one shouldn’t write a report at home, though many psychologists do. Don’t talk to friends about their emotional problems as a psychologist, but rather as a friend.
Refer them to people you trust if they require serious psychological help. Keep your weekends and nights for yourself and your family. It is fine to talk to your friends about their problems, but don’t let it become an ongoing thing where they are calling you all the time.
Some psychologists choose to see patients and others enter the world of academia. Why didn’t you try to enter academia and take a more hands-off approach to neuropsychology?
I did work in academia for awhile and I have published before. But I don’t think there was ever a time where I wanted to enter the field full-time. I think if you want to enter that field, you need to be motivated by the prestige and the novelty of discovering new information.
You have to understand that it can be a less steady lifestyle because if you want to be in research, then you are relying on a lot of soft money and grants. I have seen some amazing scientists lose grants and have to close their labs. It can be a very intense and occasionally disappointing lifestyle. It does have its perks, but people should go into academia with their eyes open to the challenges.
What are some of the things that disappoint you about your field? Are there certain aspects you would like to change about your field?
I think that there are certain psychologists such as myself who should be allowed to prescribe medication. There are two states in the country and the Department of Defense where psychologists are allowed to prescribe medication. There are definitely a lot of psychologists who don’t have the expertise in pharmacology.
But the psychologists who do the extra training and have the expertise should be able to provide full care for their patients and it’s upsetting to me that I cannot fully care for my patients in that way. It is something I struggle with and it bothers me a lot, but there are people in the field who are fighting for that so I would love to see that at some point.
What sort of advice do you have for people considering a career in neuropsychology?
I think the advice I would offer is that people sshouldn'tforeclose on the idea of being a psychologist. In other words, don’t come to the conclusion that you want to be a psychologist or neuropsychologist until you totally understand what you are up against.
You have to be really committed because you are going to take on another massive load of debt; you are going to have to write a dissertation. If you then find out halfway through your training that you don’t really want to be a psychologist it can be a really sad situation. Therapy is not like going in and having a chat with your buddy for 45 minutes, it’s an exhausting process emotionally and people lean on you very heavily. You need to be strong emotionally.