Paul Saks, Ph.D.

Dr. Saks received his doctorate from Adelphi University in 2007. He completed his internship at Bronx Psychiatric Center and worked there as a Supervising Psychologist until 2012; he is currently a supervising faculty member at Manhattan Psychiatric Center, where he serves on the Admission Team, the Trauma Service, Psychological Testing Service and Forensic Committee. He teaches as an adjunct instructor at several universities and sees patients for therapy and psychological testing in Forest Hills, Queens. His interests include the application of psychodynamic psychotherapy with psychosis and severe personality disorders and the analysis of parallel process in group psychotherapy. If you’d like to speak to Dr. Saks about training opportunities at MPC, feel free to contact him at 646.672.6413 or p.saks@omh.ny.gov.

“I am a psychodynamically oriented psychologist working in a State Psychiatric Center. On any given day I can find myself leading group therapy surrounded by a dragon, God the Father, Michelle Obama and Mrs. Charlie Sheen…just to name a few. I can open a chart and read histories replete with matricide, necrophilia, pedophilia and brutal self-mutilation. I have a few physical scars (sometimes things do turn violent) and a few more emotional ones. How does a psychologist begin to process and make sense of (let alone conduct therapy around) acts and experiences that are considered to be unthinkable and beyond the pale of mere words? Fortunately, coursework and clinical training at Derner provided me with a foundation that enables me to engage in a continuing learning process; currently the focus is on engaging psychotic patients while managing the psychotic system in which they are to be treated. While of course many of the specifics are far outside of the scope of what we learn in any class (I did not learn how to restrain and seclude a violent homicidal patient in any of my electives), Derner does encourage us to develop an appreciation of ideas and a flexibility of thinking that are the crucial elements for succeeding in intense environments. I am passionate about the work and take comfort in knowing that psychodynamic therapy is an efficacious modality that enables me to truly help extraordinary individuals. As a psychodynamic therapist, I attempt to find meaning through theory, and this can be transformative for my patients and colleagues alike.

“In almost a decade of clinical work with the severe and persistent mentally ill (initially in the Bronx and currently at the Manhattan Psychiatric Center) I have come to experience schizophrenia and other psychotic disorders as clusters of cognitive, sensory and affective processes that can be conceptualized with an elegant sophistication through psychoanalytic theory. In particular Klein, Bion, Winnicott, Searles and Matte-Blanco’s attempts to create an understanding of the landscape of the unconscious have been invaluable inproducing a common narrative between clinician and psychotic client. While schizophrenia may be related to epigenetic factors, the biological matrix of the disorder manifests through highly idiosyncratic, primitive defenses (such as primary withdrawal, omnipotent control and projection) that are laden with personal meanings. Medication does little in the face of fixed symptoms and the accompanying traumas produced by mental illness, and it is only in the act of attempting to translate these personal meanings into a shared language through therapy that we find hope for recovery. Contemporary psychodynamic research and modern relational theory coupled with ideas generated by resources such as the Voice Hearer’s Movement can help to inform and guide the work. Furthermore, my experience has been that other disciplines (such as psychiatry and medicine) highly value the contributions that psychology can bring to a treatment team. Individual therapy, group therapy, testing and behavior planning are all recognized to be the domains of the psychologist, and we are often brought in to work with the most “unworkable” of cases. Interns and externs quickly become valued members of the milieu. And while the system is depriving and difficult, experiences at Derner taught me how to observe and work with process, a unique perspective that only a psychologist can bring to the table. With the impending release of the DSM-V it is more important that ever for us to work in settings such as State Hospitals and to take a stand for the value of meaningful, dynamically oriented conceptualizations and courses of treatment.

“I encourage current students to seek out training opportunities with the severely and persistently mentally ill. Make the most of your experiences at hospitals and appreciate the fascinating and complicated patients whom you will have the honor of meeting. I further strongly encourage those who wish to expand upon their abilities to work dynamically with this population to apply for an externship at Manhattan Psychiatric Center; we highly value the experience, maturity and orientation that Derner students bring to training positions. Finally, consider doing your internship at an inpatient facility such as MPC; we have a long and proud tradition of accepting Derner students as interns and eventually offering them professional positions. These experiences will not be easy either emotionally or intellectually; however the contributions you can make both to the people with whom you work and the course of your own career are potentially limitless.”