A Therapist Can't Say That

For the last few weeks, I’ve been reflecting on the conversation I shared with you in episode 2.1 with Silvana Espinoza Lau about therapeutic goal setting. And what I’ve realized is that when you set out to look at the topic of setting goals in therapy in anything more than a superficial light, you relatively quickly start running into the question of what therapy is. Why, in order to examine the...

In the final episode of my last season, Therapists As Makers of Culture, I asked you to think about what kind of professional culture you want to leave behind for the next generation of therapists and clients.  We have an opportunity, with a little luck and intention and skill, to change something important about the structures of how things have been. We have an opportunity to lay the foundations...

As I've been reflecting on the conversation Dr. K Hixson and I had about clinical supervision and reflecting on the past season of this podcast, I keep coming back to the piece we stumbled upon about clinical supervisors as culture makers, culture replicators, and culture changers. It feels very fitting that we got there because this podcast itself was born out of the desire to change the culture...

When you hear the phrase “clinical supervision” what do you think of? For me, the first thing that comes to mind is stacks of paperwork - or whatever the electronic version of that is. I think of the years-long slog of racking up hours while marching towards that finish line of professional legitimacy: licensure. It's not a very alive-sounding phrase, is it - “clinical supervision?”  It sounds, we...

On episode 15, creative director and brand strategist Rachael Kay Albers said something that I have been turning over and over in my mind since: Marketing artificially accelerates the pace of human relationships. As soon as I heard her say that, something started to click for me about why therapists tend to dislike marketing, and it centers around the concept of artificiality. We see artificiality...

Here in 2022, therapists have largely resigned ourselves to the fact that we need to do some kind of marketing. We have been dragged into the world of social media, user generated content, and the imperative of the personal brand. And the necessity of marketing ourselves comes with a lot of uncertainty, discomfort, and unease. How do we market ethically? What does it actually mean to be authentic...

Two years ago, on October 8, 2020, my teacher, David Schnarch died suddenly. Anyone who knew Dave even for a few moments, could see that he had an arresting presence. Tall and broad-shouldered with high contrast, salt and pepper hair, strong features, and an electric gaze that, when focused on you, elicited the distinct and disarming feeling that he was looking into some dusty and hidden back corn...

In the last episode, Dr. Ofer Zur stated that he estimates at least 50% of board complaints in some way involve the subsequent therapist encouraging a client to initiate a complaint against a prior therapist. And most of these cases do not involve egregious misconduct or predatory behavior. Many of these cases result from misunderstandings, clients who are unreliable reporters, gray areas, differe...

Imagine you’re sitting in your office with a new client and the intake conversation turns to their previous therapist and they toss off a piece of information or a comment about something that their previous therapist did or said that really concerns you, maybe even alarms or disturbs you. How would you react? What would you do? If it occurred to you that might encourage your client to report thei...

In episode 10, Allison Aosved and I discussed exposure therapy for trauma, and the anti-exposure bias that we are seeing in the field. Today, I want to dig a little deeper into the context of that conversation, the factors that are contributing to anti-exposure bias, and how opinion on theoretical orientation inevitably shifts and swings over time, and how concerns about retraumatization and vicar...

Trauma has become a huge buzzword over the past several years. In fact, I would say that trauma is having a moment. And because trauma is having a moment, there is a glut of people out there who are chomping at the bit to tell you what the best kind of treatment for your trauma is and what you should be looking for in a trauma therapist. And this has become a prime opportunity for people to sell t...

Why do we become therapists? You wouldn’t necessarily think this is a spicy topic, but it is. Some therapists would say that we as therapists are just people who are unusually compassionate, empathetic, and giving, even selfless or altruistic.  I don’t agree. I don't think we're more inherently compassionate or giving people than anybody else. Often, we're people who took on caregiver roles in our...

There are so many ways, so many careers we can choose where helping people is the central thing. And the type of helping that we are interested in and pursue says at least as much about us, if not more, than the fact that we want to help in general. Yet, if you ask a therapist why we decided to get into this field, the answer you're most likely to get is to help people. But what are some of the ot...

Therapists are tasked with being secret keepers. The first layer of secrecy seems easy and simple. Maintaining client confidentiality. You can probably recite the limits of confidentiality off the top of your head, and you probably do it regularly during intake sessions. Everything else goes in the vault. But the vault isn’t a what, it’s a who. The vault is us. We mostly talk about confidentiality...

Moral injury. It’s a term that often evokes images of soldiers deep in the fog of war or perhaps of a surgeon in scrubs holding their head in their hands in the hallway of a hospital emergency department.  A therapist sitting quietly in their office or in the cubicle of a community mental health agency’s open office plan isn’t really what pops into most people’s heads when someone says the words “...

As therapists, we know about the power of silence and how much someone is saying when they aren’t saying anything at all.  And we know how silence around something big, like a client’s suicide attempt, sends the message that this is too big or too scary to talk about. But if we mostly all agree that therapists are responsible for doing their own self-work, it’s necessary to facilitate conversation...

It’s something of a cliché that being a therapist comes with the obligation to do your own work.  And it happens to be a cliché I agree with. And if you’re listening to this podcast, I’m guessing you do too. But what happens when the institutions and systems that train us, employ us, and regulate us act as barriers to actually doing that self-work? Today I’m talking with psychotherapist and certif...

The “good therapist” isn't necessarily the type of therapist you want to be. It's not the most actualized version of you as a therapist. It's not even necessarily a particularly effective therapist. The good therapist is about being seen as good and about being able to reassure ourselves that we are good when maybe we don't feel so sure. Maybe we bump up against the specter of the good therapist w...

I got the idea for this podcast in late 2019. I had been in the field for several years at that point. Long enough to work through the first wave of impostor syndrome, experience my first episode of burnout, bounce back from burnout, get high on the grandiosity when I realized I really was helping people and changing their lives, go through the second wave of impostor syndrome when I realized ther...

If you’re a therapist, even if you’re far from your practicum days, you can probably relate to the feeling of sitting in a session and being distracted by the thought of whether you’re living up to the standard of a good therapist. And you’ve probably had a moment where you’re sitting with a client or group and you heard something come out of your mouth and immediately thought, “That doesn’t sound...

When you became a therapist, what did you think you were signing up for? Maybe grad school prepared you for the endless introspection, the awkward intake sessions, and the pile of unfinished notes that is somehow always waiting for you, even when you were pretty sure you just finished it. Maybe you weren’t too thrown by the onslaught of personal problems your Uber driver suddenly reveals to you wh...