Is your Practice Busy or Hectic?

This time of year the reply I often get from colleagues when I ask how their business is going is “Busy!”  This is often said with shortness of breath, decreased blinking, and other physiological signs of anxiety.  At the college I teach at, I often see my fellow faculty members commiserating with each other about how busy they are there.  I think lots of us are busy, but I think it is time to re-evaluate if we are really busy, or hectic.

The way I differentiate between busy and hectic is simple: ROI and organization.  When I am busy, I have most of my clinical hours filled, am up to date on my billing, know which week I am teaching on the syllabus, and returning phone calls or emails within 24 hours.  I am also eating and sleeping well.  That’s “busy.”  When I am “hectic” I am thinking “oh my god I have too many patients to see;” forget to do my billing (or avoid it;) unfocussed when I get ready to teach; and start “saving” (read sitting on/avoiding) voicemails and emails.  I also feel more of a pull to commiserate, to tell people how “busy” I am.  For me, talking about how busy I am when I could be doing something more productive is usually a sign that I am hectic, not busy.

Once you have started to feel more stress in your practice, pause immediately and ask yourself if this is a prod from your psyche to take care of yourself.  Have you done that?  Good, if the answer is you haven’t, and that you don’t have time to because you are too busy, you’re being hectic.

Now knock it off.

Really, I am suggesting it is that simple.  Other than an opportunity to review for self-care there is NO ROI on being hectic.  You won’t get more patients, you’ll get less. You won’t have more time by worrying or commiserating, you’ll have less.  You may derive a sense of self-importance from how crazy things are, but you aren’t really impressing anyone, including if you are honest, yourself.  So put down the cross, we need the wood.

Here’s a suggested checklist if you are still unsure whether you are being “busy” or “hectic:”

  • I miss appointments or double-book
  • I haven’t eaten today
  • I am avoiding the phone and email
  • I have complained to 2 or more people that I am busy
  • I feel like I am working too much, and making less than I usually do
  • I am behind on billing patients
  • I have open times for patients but can’t find the time to schedule intakes
  • I hate my office
  • I’m feeling cranky and dissatisfied with my clinical work
  • I can’t remember the last time I had a non-therapy conversation with a friend, or if I can it was over 24 hours ago
  • I feel a sense of dread when I think about work

You may notice that some of these can also be signs of burnout:  This is not a coincidence.  I firmly believe that if you don’t learn to distinguish between being hectic and busy, your business will fail.  It will fail because you burn out, and or because you sabotage your income streams to the point where you have to close up shop and go work for someone else.  And if you do that, you can guarantee they’ll help you learn the difference between busy and hectic the hard way.

So this weekend, take 15 minutes to sit and reflect, is my practice busy or just hectic?  And if you don’t think you have 15 minutes to do that this weekend, you already have your answer.  🙂

What Do You Do Wholeheartedly?

Photo Courtesy of Jamie R.

Being city dogs, Emerson (left) and Boo (right) rarely get to run off-leash.  Recently I was able to take them to an open field that was enclosed, and the above picture shows the result.  Boo especially pours her heart and soul into running.  When she has the space to open up, she amazes us all with her energy, focus and concentration.  At eight years old, she is just as fast as she was 5 years ago.

My dogs are great therapists and coaches.  They are great therapists because they remind me of the power of mindfulness.  When they run, they aren’t worrying about dinner or money or what they need to do next.  They run.  They are great coaches because they do what they love without fear.  They don’t hold “just a little bit” of their energy back, “just in case.”

Obviously I would be a horrible pet companion if I let those two off-leash just anywhere.  They could get hurt if the space was not enclosed.  The same goes for my business, I can’t just go dashing off willy-nilly most of the time.  I can’t go off every insurance panel at once, or double my fee; there is a place for care and caution.  But there are spaces I put into place where I have the safety to just barrel forward, I need those.  Those moments when I am fully focussed and engaged with something, to hell with caution.  Those moments when I feel wholeheartedly how powerful I can be, how alive I am.

Do you have those moments in your practice?  When you are in “the zone?”  I am sure many of you do.  And I am referring specifically to your business and psychotherapy.  Too often we think that “real life” is lived outside of our work, clinical or entrepeneurial.  We view those things as the ends to the means of having time to do what we really want.  Bad idea.

Say you work 40 hours a week, which has 168 hours in it.  That is a quarter of your life. Have you really made the decision to give up on finding meaning and energy and purpose for a quarter of your life?  Assuming you sleep that probably leaves you only half your lifeweek left.  I’m not giving up that much time without a fight.  And that’s what we do when we say things like, “They pay me to do this, that’s why they call it work.”  It’s just like when a patient says, “that’s just the way I am.”  We’re really saying in both cases, “I give up.”

So if you are going to work each day at some agency feeling numb, or opening your office door much of the time with a sense of dread, maybe it is time to invite your lifeforce in.  Even if it is only a few fenced-in hours or a day, give yourself the space to take something and run with it.  I can honestly say that most of the time, every day, I enjoy my work.  I never, I repeat, never think about retirement, other than some financial planning for it.

You probably saw where I was going with this a while back:  When was the last time you opened up and went full throttle in your practice?  When was the last time you gave your single-pointed mindfulness and drive to your business?  Why do you hold yourself back?

Want a Private Practice in the 21st Century? Get a Thick Skin.

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Many therapists go into the psychotherapy field because we are sensitive to the feelings and behaviors of others.  In the clinical session, this is very important.  Even if you aren’t a Self Psychology-oriented treater, empathic attunement is crucial to understanding your patient and meeting them “where they’re at.”  People often come to therapy hoping for and expecting a corrective emotional experience, and usually that is an unspoken part of the therapy contract.  Patients desire to be understood and heard; therapists strive to understand and listen.  In this, sensitivity to what the other is communicating is key.

This is not always recognized by those outside our profession:  Many times when we are asked what we do, and when we reply that we are therapists, we hear, “Oh I could never do your job, I’m too sensitive.”  Yeah, I can do this job because I’m a really callous asshole.  I don’t ever say that in reply, usually I don’t mention I’m a therapist (if someone asks me what I do I usually leave it at, “I do interiors.”)

However, there is a place for insensitivity in owning a private practice, and that is what I want to talk about today.  Many of you are excited to begin practicing in a Web 2.0 environment.  You have your Twitter account, your professional Facebook presence, etc.  But are you psychologically ready for what comes next?

Recently I did a blog on Gamer-Affirmative therapy.  It got many positive responses that I don’t remember clearly, but one negative one of course stuck with me.  The colleague wrote on a bulletin board, “…it’s just a PR stunt. “Gay affirmative-Transgender affirmative- bla bla bla” Don’t use it…sounds stupid.”


I could get huffy, refer the person to my earlier blog on managing your online presence, but I’m not going to do that.

What’s more, if I have a thick skin, I can look at the comments more objectively, see if they are pointing out something of value to me, something about an idea or plan I hadn’t anticipated.  If they do, good deal!  If they don’t, can I let it bounce off and move on to the next one without ruminating about it too much?

If you are planning on venturing out here with your practice, are you prepared?  Can you take the good with the bad?  Can you shake off the hurtful comments?  Better yet, can you learn from them? Sure we’d like everyone to communicate on the web in a respectful, polite way.  They don’t.  Can you deal with this and move on?  If you find yourself scrolling down to that comment or email and reading it for the umpteenth time and you haven’t learned anything from it or calmed down, you are not dealing with it and moving on.

Last word, don’t rush this:  If you aren’t sure that your idea or practice focus is “ready for prime time,” who can you share it with that you trust will be more compassionate?

Oh, and if you want to donate to the International Rhino Foundation, click on the photo!  🙂

Don’t Be Afraid to Evolve


image courtesy of Pharyngula at

I was toying with a new browser today, Rockmelt.  It looks like it is going to be an important development in social media, in that it will begin to merge web browsing with social networking.  Rockmelt integrates all of your accounts in one place, and allows you to surf while being able to see what your networks are up to.  It also allows you to streamline how you post.  Twitter, Facebook, LinkedIn, blogs, it will make Web 2.0 even MORE interactive.

It scares me.

Not for the reasons you may think.  I think that it will make managing your online presence easier, and also require you to be more thoughtful about how you organize yourself.  But it isn’t the thinning of these boundaries that I am talking about.  What scared me when I downloaded RockMelt was that it’s newness overwhelmed me.  New graphics, new concept in user interface, I spent 10 minutes on before I had to switch it off.

I tell you this because I want you to know that I get how difficult change can be.  We talk that talk with our patients, but it is interesting how soon that concept goes out the window when we are dealing with technology.  We read folks like Pema Chodron about our desire to always find a refuge from change, yet we hesitate to apply that wisdom towards our relationship with technology.  We try to get solid, say things like, “I’m too old to learn,” or “I’ve found something that works for me, you can’t learn everything.”  We create these extremes that we use to justify not budging an inch.

It’s a good thing that when we were in the primordial ooze we didn’t have that option so much.  We couldn’t rationalize, “I am too fishy to be an amphibian,” some of us just jumped.  Later we didn’t say, “I can climb trees and gather fruit, who needs tools, you can’t learn everything;” some of us looked around.  At least that’s how I imagine it, there probably were some Luddites even then.

Don’t be afraid to evolve, or at least if you’re like me, don’t let that fear immobilize you.  If you start to feel too solid, too old or too dumb, move through it.  If you start to feel too comfortable, pepper that comfort with a little curiosity.

Rockmelt makes me uneasy, but it makes me feel excited too, because when it starts getting widespread I think people are going to be amazed.  And when I figure out how to unlock its potential I am pretty sure I’ll be amazed.  And when my one of you consults with me about building a more cutting edge Web 2.0 practice, I want to know what I am talking about.  So it’s “lean into the fear and discomfort” for me!

What are you being too solid about in your private practice?  What will you lean into this week?

Content is King, Quality is Queen

photo courtesy of Flickr

Colleagues who are connected to me via LinkedIn, Facebook, or this blog have probably noticed by now that you get a lot of communications from me, sometimes daily. I Tweet at you, send you newsletters, advertise upcoming workshops and webinars, and post blog updates. I do this for a couple of reasons; the first and probably obvious one is that I want to stay on your radar. I want you to be talking to someone about their patient who does some gaming thing and be able to say, “Hey, there’s this therapist, Mike Langlois, who does workshops and consults on gaming, let me give you his email.”

The second reason I do all the communication is that it helps keep me honest. Here’s how: I truly don’t believe in putting things in your email or website that is worthless. I really do stand behind everything I send you with the conviction of its value. Because that in my opinion is the major thing that separates the professional from the spammer. Web 2.0 has given us dozens of new ways to throw messages at each other instantly, frequently and from anywhere. What has not kept pace with that is content. So that is why I say content is king, and I am convinced that the next shift we will see in the Web 2.0 world is when people get tired of the bells and whistles and even more discerning about the content. This goes hand in hand with why privacy will never go out of style even on the internet, but that’s a blog for another time. Now I certainly get the occasional “unsubscribe,” and I confess that enthusiasm sometimes has me err on the side of risk, and get a note saying my material is not appropriate for the discussion group in question. But I have never gotten feedback to date that there is no value in the material, that it lacks content. That day may come, but it hasn’t yet.

But if content is King, then the other member of the Royal Family, Quality, is queen. Sure, sending you any article published on the APA website is content, but that isn’t what makes it quality. What makes it quality is that it has been filtered to you through the lens of my discernment. If you look at my blogs and newsletter you will notice some general trends and areas of interest in what I call to your attention. Hopefully my Tweets have that as well. Quality is the flavor of my discernment that filters the content I send you.

This is not to say that other articles are not high-quality, follow Psych Central on Twitter and you’ll see hundreds of quality articles, essays and posts each week. But I don’t want you emailing me to consult with you on couple’s treatment, not my area of expertise. I want you to keep me in mind for a few specific things: Web 2.0 psychotherapy, gamer-affirmative therapy, psychodynamic theory, GLBT, diversity and social justice. Even that is too much for a niche, but those are what I am good at and innovative about, those are my best qualities as a consultant and therapist. What quality do you bring to your patients, your practice, and your business? What will make you stick in our minds, for when we really need you and no one else?

How Do You Want to Be Remembered?

photo courtesy of

Recently, a bulletin board I participate on had a thread that really made me think.  A colleague posted a copy of an email she’d received from a third colleague.  The email was basically an introduction, a brief explanation of the therapist’s practice, and concluded with an invitation to visit her website and hoping to receive referrals.  The string of comments that ensued were mostly, although not completely, negative.  But I was struck by how openly critical many of the folks who replied were.  And what was even more striking than people referring to the email as unprofessional was how quickly several of these professionals began to say hurtful and insulting things to each other.  Personally I always applaud emails like the one in question, as I think it takes guts to self-promote, but I accept that other people have variations in opinion.  What I had a harder time accepting is the negative quality of the discussion.

A related incident occurred over the past few weeks with my blog.  A colleague began emailing me after each blog pointing out typos or grammatical errors.  I was a bit surprised, but at least she was taking the time to read it.  The last email was a bit more frustrating, in that she started the email criticizing my latest post and then asked for free consultation!  Still, I replied with a brief and polite answer to her question.  I wasn’t expecting a thank you or anything, but I was really surprised at what happened next.  When I posted a note to a listserv I am on with a link to my next blog post, which said, “You may find this blog post of interest,” she posted to the listserv saying simply, “No Mike.”

I tell you these two incidents to remind you that every time you post anything with colleagues you are also building your online presenceEverything we read tells us something about you. If you post something sarcastic you let us know that you are sarcastic.  If you post something clinically astute we know you are clinically astute.  When you post an article link you tell us that you are keeping abreast of research, as well as your areas of interest.  When you post online about a patient you tell us that you talk about your patients online.  And when you don’t play well with others you tell us about how it might be to collaborate with you on a case.

If you are mindful of this and are doing things the way that is in keeping with your professional style and identity, great.  There are lots of different ways to be in the world.  My point is to make sure you are mindful about how you are presenting yourself, because your online presence is everything out here!

Sometimes I get the impression that the same sense of narcissistic invulnerability we acquire when we get behind the wheel of our car happens when we get online.  We feel protected by a sense of anonymity and the asynchronous communication.  We say things that we might never say to the colleague’s face if we were in the same room.  We sacrifice sensitivity for the opportunity to seem witty or clever in front of our peers, even if it hurts someone.  We forget there are people behind the screens, or we decide we don’t care.  I am sure I have done it too, nobody is perfect.  But please think about what you are doing, because it can be really detrimental to building your business.

Take a look at the last 5 posts you made out here in Web 2.0.   What do they say about you?  If they were the only things a potential colleague or patient knew about you what might they think?  How do you want to be remembered?

Showing Up for No Shows

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Every therapist I know has to deal with the inevitable missed appointment.  This blog is not about how to set up your cancellation policy, explain it to patients, and most importantly adhere to it.  If you are interested in my basic thoughts about that you can surf on over to my site for my cancellation policy and download the intake form which has it, as well as email me with questions.

No, today I want us to think about how you show up for your no shows.  Most therapists I know use their no shows to play a game of “catch-up.”  They catch up with notes, catch up with phone calls, catch up with emails, catch up on the news, catch a few ZZZzzzzs in the chair.  Note the progressive nature of the catch-ups:  It goes from things you really should have dedicated time in your week/day for and easily degenerates to self-care before you know it.

I never thought I’d use the phrase degenerates into self-care, but there you have it.  And I say it because on a meta level it is actually not self-care in the long run. Ok, I have times during the week, a few 90 minute blocks that I have built in to have my “catch-ups.”  And if I get all my work stuff finished in the first 30 minutes, which I usually do, I go on to some self-care extras, like a walk on the Charles River near my office, surfing the net, reading on my Kindle or a quick nap.  But these are extras, I schedule self-care time in my week regularly, even color-coding it on my Outlook calendar so I have dedicated times for that.  So if you have your self-care scheduled, and you have your “catch-ups,” scheduled, that leaves your no shows.

No shows are used for me as additional times to work on my ongoing projects to build my business beyond the office.  They include:

  • Blog posts like this one
  • Research for my newsletter
  • Writing a syllabus to propose to teach at the colleges I teach
  • Writing a workshop application for CEUs
  • Videotaping a webinar or short web feature to post on my blog or site
  • Tweeting some of my required Tweeting (I try to Tweet 4 times a day, 2 original tweets, 2 retweets of quality content from others)
  • Surfing Technorati or Mashable to keep abreast of recent developments in the blogosphere
  • Designing some Freebies I give away to promote a webinar or workshop
  • Creating a workshop for helping therapists deal with managed care
  • Test-driving new (or new to me) online games like Everquest, Aion, or Civilization V
  • Checking out new apps for the iPhone or iPad

Those are all things I have done in the past month or so when I have a no-show.  They allow me to continue to work on the overall business plan I have and get me started on projects that I used to complain I had no time for.  I don’t waste time seething that I’m losing money or call a colleague to complain.  From the business perspective, the only negative in a no show is the “no” at the beginning of that phrase.  As Bettye LaVette would say, I’ve got my own Hell to raise.

How about you?  How do you show up for your no shows?

The Demon of Comparison

"Saint Anthony" Tempted by Master of the Osservanza

Have you ever noticed how comparison and resentment go hand in hand?  I was reminded of this again when a new bout of it erupted on a listserv I follow.

One therapist began speaking about how s/he was on the phone with an insurance company for a claim, and began to ask them about their salary, and whether they, like the therapist had not seen an increase in it since the 1990s.  This prompted a bevy of emails back and forth to the tune of, “Yeah, we should find out how much they make, what they’re salary structure is” and of course the inevitable, “it is terrible that their executives make X amount of dollars.”

Really?  Do you really want to be like the executives of a managed care company?

I know that I often blog here about how it is important to cultivate a business sense, so this may sound like a contradiction, but there is a vast difference between learning from businesspeople and emulating the ones we consider are doing unconscionable acts.  Therapists often seem to want to have it both ways, we want to have the money and ease we imagine the “fat cats” at HMOs have, but we want to decry them as monsters.  You can’t have it both ways, or either, if you want a profitable yet socially just practice.

What I think we often see here is good old fashioned projection, namely, projecting whatever part of ourselves we either find unacceptable or yearned for.  Many of our colleagues have strong ambivalence about getting paid for helping, listening, and emotional labor.  Sometimes we disown the parts of ourselves that see what we do as valuable, worth every penny, amazing.  The way we disown this is to judge it as greed, and project our greediness onto someone else we can despise.  The CEOs of insurance companies make great targets, when we look at the financial reports they deliver to their Board of Directors.

But when we project these things on the customer service rep, or care advocate, we miss the mark in many ways.  Probably the most important way is that we act out our aggression with a worker who is not making anywhere near the money a CEO makes.  And those customer service people aren’t uncaring, their doing a job for a company and often protecting themselves from the assaults they receive via irate therapists all day.  Did it ever occur to you that the call the person on the other end of the phone just before you was someone haranguing them about how much they make and how greedy and unfeeling they are?

Look, I’m not trying to make excuses for the bureaucratic nature of managed care.  The point I am making is that splitting is a primitive defense, even when the target has a big ol’ bulls-eye on it.  More importantly, it doesn’t help your practice.

We have to befriend the part of us that wants to make money by listening to it, and using it to motivate our creativity.  If the only way we can access that is by “pinging” off a projection of the “greedy” other, we are staying stagnant.  If you are looking to an insurance company, customer service rep, or CEO to recognize you’re value you are wasting your time.  Go look in the mirror, that’s who you’ve got to get to recognize you.  Can you look that person in the eye and say, “I want to make a good living, and I am valuable?”

Remember, each of you IS a CEO, of your own business.  If you aren’t happy with your salary, what are you doing to grow the business that has been entrusted to you by yourself?

The Truth? You Can Handle The Truth.

photo courtesy of

One of my favorite quotes from Pema Chodron is when she explains the first Noble Truth of Buddhism:  “Existence is Suffering.”  In her book When Things Fall Apart she writes:

The first noble truth of the Buddha is that when we feel
suffering, it doesn’t mean that something is wrong. What
a relief. Finally someone told the truth. Suffering is part of
life, and we don’t have to feel it’s happening because we
personally made the wrong move.

Patients often come to me to hoping therapy will make them feel good.  I tell them that that is not what psychotherapy is for.  Psychotherapy is not aimed at making you feel good:  Psychotherapy helps you learn how to not feel good, at least the way I practice it.  Because the truth is out, there is suffering in the world, and in our lives.  Can we learn how to not feel good?  How to sit with what feelings arise without eating, starving, cutting, drinking, smoking, sexing our way out of it?  Although I didn’t coin the phrase “Don’t just do something, sit there,” my patients often hear it for the first time in our work together.

When I consult with therapists on how to build their practice, or how to use technology, you’d be surprised how much shame, anger and sadness can come up for them.  A lot of times they have been avoiding looking at how they do the business part of their work, as if it were completely divorced from their fears of failure, grandiose defenses, and ethical quandries.  It takes courage to get to the tender spot that is hurting their business.  We have to weave our way past the following bugbears:

“I don’t do this for the money, I do it for the patients.”

“I don’t care if what I tell the insurance company I’m charging is what I’m actually charging, insurance companies are evil.”

“Whatever I have to do to play the game is fine, as long as I can do good work with my patients.”

“I don’t want to know how this billing, marketing, business stuff works, my practice is doing just fine.”

“I don’t know anything about Skype, and I don’t really care.”

One of the great things about working with therapists, though, is that sooner rather than later they hear the defensiveness in their words, and we settle down to not feel good together so we can clear away the shame cluttering their practice.  Generally what I find is that their shame comes down to this, see if this internal monologue sounds familiar:

“I have suffered long and hard to get where I am today.  I have worked long hours for free, spent money I didn’t have, to get an education that is often undervalued in the world.  Even before that, I was always helping people in my life, even when they were supposed to be taking care of me.  I waited for someone to notice that I was trying so hard, and finally I gave up.  I’m going to have to take care of myself, no one else will.  But even though I’ve built my life and work up around that structure, part of me waits with fear for someone to take my work and livelihood away from me.  Sooner or later they are going to figure out that I have been faking this adult thing, this independent therapist thing, and then it will be all over, and I won’t have even that.”

If any of this sounds familiar to you, if it is what lies underneath the fears and the avoidance that are gumming up your practice, please read on.

Things were difficult for you, and you didn’t do anything personally wrong to bring this upon yourself.  Things will be difficult again, and that won’t be because somebody discovers and punishes you.  Suffering is part of life, and we need to pay attention to it, but not personalize it.  The clearer you get with this the more clearly you’ll be able to look at your work and business.  And the more you do this, the more you’ll face your fears and start to practice in an integrated way, and make money.

On the other hand, if you insist on living your life and practicing your work in accordance with the narrative of fear and entitlement above, all bets are off.  Paradoxical perhaps, but maybe you have already noticed how we can manifest irrational fears into real life.  Because these fears are the ones that have you stuttering on the phone to UBH during peer reviews, or getting nervous whenever a patient or their insurance company has a billing question.  These feelings of anger and entitlement are what make you envious of your colleagues when they try something new in their practice, or promote a book, or launch an online practice.  Leave these fears unchecked and your practice will get more rigid, the walls of your office more close, and even if you never get caught for some of the business practices you do you’ll tire yourself out justifying yourself.

I love it when colleagues come to work with me and trust me to tell them the way I see it.  I love it when we get honest and the fear starts to go away.  I love the relief and the organization that comes in its place.  I see priorities shift, new models of working open up, and people rediscover why they like being a therapist.  And I see them make more money with less guilt.

You may not agree with everything I write here, and you may not see psychotherapy or business practices the same way I do.  No one, least of all me, thinks you should.  But my blog is much like working with me in person, I promise I’ll call it as I see it.  I think anything less is  a waste of your time and money and disrespectful to you.  And I won’t collude with you in your disrespecting yourself.

Process Schmocess


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We therapists are often a very process-oriented group. We come by it honestly. Maybe we grew up in environments where nobody was heard enough. Maybe we gravitated to the field because we have seen how introspection and exploration have healed the lives of our patients and ourselves. Maybe we learned early on to channel our aggression into verbal aggression. Maybe we want to try to control and slow down the immediacy of our lived experience by putting a webbing of words, a safety net of speech around it. We track the process in our sessions, help the patient process their emotion, encourage them by respecting their process of self-discovery.

Process process process.

I used to work with a lot of elementary school teachers. They were very talented and caring educators for the most part. They’d work long days at school, go home, and sometimes catch themselves saying to their spouses things like, “I need you to get ready for dinner now,” or “Let’s remember to take out the garbage” before their partner reminded them that they weren’t a first grader. By contrast, many of these teachers had husbands who were contractors, plumbers, masons or electricians. They worked long days, but they never seemed to bring their wrenches to the dinner table, use cement to help their kids with their homework, or rewire the television instead of watching it.

They knew how to put their tools down, when they aren’t appropriate to the task at hand.

You probably see where I’m going with this. We use our “self” at work in therapy in very specialized ways. That is very important. But like my teaching friends, therapists tend to approach every task as a verbal processing task. And that just isn’t the way we’re going to fight managed care or build our business. We need to start doing things in addition to talking and listening, we need to use other tools, and we need to start committing to other forms of work.

When I do a workshop on managed care, the first thing I ask people to do is go around the table and whine about it. I want participants to express their feelings of anger, frustration, worry and sadness at how their practice is inhibited by managed care. I listen carefully to each concern, all of them are heartfelt and valid.

I give us 5 minutes.

Then it is time to move on. Let’s talk strategies. Let’s plan how you can use the time you have in the day to market yourself and your work rather than fighting over a check for $60 Let’s get that negative thinking out in the open so you can see how being realistic is really being fatalistic much of the time, and then we can do the opposite and see what happens. I love these workshops, because I watch and literally see the fallen facial expression fall right off their faces. Then there is energy, then there is laughter, then they start trading cards and strategies. We stop processing feelings and start feeling like professionals and business people. They leave feeling renewed and in some cases re-educated, and I get to strike a blow for freedom.

I hope I am always clear that I respect our profession, I respect your calling as a therapist. I do. And I do respect that you have an emotional life worth talking about. But let’s put that on the back burner for a few minutes, an hour, whatever we can start out with. Because I want you to succeed at building your business, and confusing worry with effort and emotion with diligence is not a formula for success. And honestly you don’t need my help worrying, I am sure you do that fine on your own. But enough chat, what are you going to DO this week to build your practice?