On The Importance Of Feeling Useless

Recently I was being trounced in a game of Call Of Duty 3:  Modern Warfare 3.  Not only was I having a difficult time understanding the lingo and mechanics of the game, the controls for this first person shooter were bewildering to me.  I found myself staring down at the controller more than at the screen.  Why couldn’t I remember what the A button did? Over the course of the week, I was also informed that Halo 4, Assassin’s Creed, and Paper Mario: Sticker Star are also here or on the horizon.

I wasn’t sure when I was going to find the time to try all of these.  I was already behind.  Skyrim had new DLC, Minecraft had different updates for both PC and the XBox 360 versions, and the Secret World and Guild Wars 2 had both been preempted by the latest World of Warcraft : Mists of Pandaria expansion.  And what about Salem?  I had gotten a beta key for that, didn’t that make me obligated to try a little more?  And I won’t even go into the iPad and iPhone games, but Baldur’s Gate was just 3 weeks away…

I write all this because I have found that readers and colleagues often assume that because gaming is an area of clinical practice and focus of mine, that I am up on all of the latest games.  If you have been imagining that I always know what every MMO gamer is talking about, or can jive with adolescents about the finer points of COD: MW3 (Call of Duty: Modern Warfare 3) and how it differs from Max Payne, you are in for a rude awakening.

I can relate to every therapist who has sat with a patient and said no repeatedly to “Do you know about” questions involving video games.  I can relate to every colleague with thumbs of lead who plays with (against) their patients on XBox.  I too struggle against the countertransference urge to display my “hipness.”  And boy am I tempted sometimes to throw up my hands and say I am so over the latest thing.

But I don’t throw up my hands because I recognize that it is a defense against feeling useless.  Who wants to feel slow, clumsy, behind the times?  Feeling useless coincides with feeling powerless, devoid of meaning or hope, and isolation.  For me, that feeling of uselessness is touching the water’s bottom:  It’s where I kick off.  Uselessness is almost always the feeling that precedes determination for me and the moment when I am closest to getting going again.  Here are just a few reasons why feeling useless can be important:

1.  Feeling useless reminds me of how my patients often feel.  Regardless of age, gender or walk of life, I have sat with people who experience feelings of utter uselessness.  Most kids feel useless in school at one point or another.  Adults tend to embrace amnesia when it comes to remembering how dumb education can make you feel before you feel smart.  They have forgotten what it was like to be called last for the kickball team, or draw and erase and draw until your paper ripped.  And the population of Baby Boomers can feel useless as they sense the impatiences of their younger colleagues in the workplace:  You talk too slow, drive too slow, and why don’t you just retire?  Meanwhile, younger adults send out resume after resume and spend more hours in sweatpants as they feel that they and their education are both useless.  Parents send their children off to college and experience the empty nest, or send them off to war and experience a more terrifying version of uselessness.  We need to remember how it feels to be useless if we are going to stay empathically attuned to our patients.

2. To recognize that you are feeling useless is to begin to wake up.  At least it can be, because the sense of being useless is completely irrational.  There is nobody, not one person on the planet who has nothing to give of themselves.  There is no such thing as a useless person, it is a cognitive distortion.  And the minute we recognize that distortion we can begin to use our observing ego to ask ourselves “who is this who is telling me I am useless?”  Whoever it is, the media, a parent, an old tape running in our head, or all of the above, it is just wrong.  And that’s ok, because we’ve been wrong before, and now that we know it we can begin to gently guide our thinking back to a more rational place.  If this sounds like meditation, that’s probably because it is.

3.  To feel useless is only a feeling.  Sure feelings are important, and a powerful part of human experience.  But they are only one part of human experience.  Thinking and behavior are two other parts.  We can use feeling useless to motivate ourselves.  We can use it as a barometer for our overall mental health.  We can also use it as a defense to stay stuck, or to attempt to elicit pity from others.  There are all sorts of ways we can use a feeling, and they aren’t all necessarily, well, useful.  Or we can just sit still for a bit, because being just a feeling, feeling useless will float by and be replaced by another feeling, and another and another…

So if you are a therapist, and you notice yourself feeling useless, you are one step closer to coming to your senses.  You can become more mindful of how unpleasant the feeling is, and mindful of how your patient may feel when they experience it.  You can remember it is only a feeling, and become curious about it and why it is coming up.  And you can consciously decide how to use it or cope with it, rather than unconsciously act out in response to it.

To return to my video game example, here’s how I used it.  I noticed the feeling and said to myself, “That’s how my patients experience themselves sometimes.”  From there I went on to think, “That’s how the therapists I consult with about technology experience themselves sometimes.”  Interesting information, and it helped me pause a moment more.  And when I sat with it more it occurred to me that there was some symbolic content that had come up in a session recently that I’d overlooked.  And then it occurred to me to write this blog, and as I wrote the first paragraph I remembered how video games are a form of social media, and how my friend Susan Giurleo often reminds me that we don’t need to be on every single platform of it to be technically savvy.  From that stream of consciousness, and more importantly, from my feeling of uselessness, came this post.  And I have no doubt that at least a few of my colleagues will find it useful, which totally debunks the useless Mike theory.

What about you?  What has elicited a feeling of uselessness for you lately?  What is that feeling about, and what are you going to do with it?


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When Wallflowers Attack

Back in graduate school, my group therapy professor once said to me, “early risk-takers are often scapegoated by the group.”  This comment came on the heels of yours truly taking a risk in the group, a group of psychotherapists in training.  I learned two things in that group class on that day.  The first was that early risk-takers are often scapegoated.  The second was that we therapists can be just as cruel with our comments as anyone else.

This is something that many of my supervisees encounter when they start to put themselves out there, especially on the interwebs.  They are stunned when the blog post they write elicits comments that are sometimes shocking in their nastiness.  They are confused as to why this happens, and what to do about it.  If you are beginning to use social media to build your psychotherapy practice, write newsletters, prepare a public speaking campaign or just write a blog, this post is for you.

The internet has made it easier to be both impulsive and anonymous, and emboldened some people to hurl invectives.  I call these people the wallflowers.  These are the people in any given group who are afraid to take risks or stand out, and resent those who are brave enough to do so.  They are quietly resentful, and more often than not envious of people who are not quiet.  I’m not talking about introverts here, but rather a particular group who stand on the sidelines seething.

These are the people who send you a nasty email at 2:00 AM criticizing your post for a spelling error, or the folks who text really ugly comments to you after you post something on a listserv they don’t like.  They’re the people who make personal attacks on your workshop evaluation in the guise of constructive criticism, or bait you in discussion groups by deliberately misconstruing your words.  Yes, I’m not making this stuff up, all of these things and worse have come at me by email, Twitter, Facebook, blog comment, and text message.  The majority of the time it will be behind the scenes of whatever arena you’re in, so that you can see it and the larger group can’t.  Consciously or unconsciously, wallflowers are counting on you not passing these barbs on to the larger group.  Nobody likes a tattletale.

So what do you do about them?

First, take a second and calm down, and note that the intensity of your response is probably an indicator that this is out of the ordinary.  Next, try to find a trusted friend or family member that you feel comfortable sharing it with, and ask them what they make of it.  Supervisors are often really helpful here.  Often they will react more strongly then you did, which gives you another clue its a wallflower attack.  Your inclination may be to try to learn something from the comment.  I’m going to say something that may go against the therapist grain here–Dismiss the comment and the wallflower.  Don’t bother trying to make this into a growth opportunity, there are plenty of other growth opportunities out there for you.  Don’t give this your energy.

In my experience this is very hard to do, because therapist wallflowers have a lot of skills to hook you.  They bring their therapeutic arsenal and try to come at you as a therapist, by analyzing or interpreting you.  Don’t fall for it.  Just because you both speak the same language doesn’t mean you have to have a conversation with them.  Therapy is a specialized and voluntary form of conversation, and anyone who tries to inflict this on you unasked is using their Jedi therapy powers for ill.

This is your reminder.

This is the price you will have to pay for being an innovator and a risk taker.  Early risk takers are often scapegoated.  You didn’t do anything wrong, you were just putting yourself out there.  And every time you do that, you will run the risk of a wallflower attack.  Don’t overprocess it, move on.  And definitely don’t let it stop you.  Remind yourself that the reason they had anything to attack you about is because you’re doing something they wish they could, creating.  Anyone can ping off a blog post, or fire off a Tweet in reaction, but it will only be a reaction, not a standalone.

Remind yourself that your ideas are precious.  I’m not trying to sound New Agey here.  What I mean is that the fact that you had something to put out there is not to be taken for granted or underestimated.  You could have not had the inspiration for that workshop or podcast, but you had it.  All over the world there are people who have not given awareness to ideas, throughout history millions of good ideas have never been expressed or seen the light of day.  Not you.  You did it!  And if you stop taking risks the wallflowers win, and the prize is one less idea in the world.  Yippee.

I know this can be hard to do, trust me.  And the technology we have today has made it even easier for wallflowers to attack.  It’s sort of like that sense of invincibility drivers get when they are encased in the protection of their cars.  Shake it off.  Share it with someone you trust for perspective.  Dismiss it.  Stay focused.  You can take time to smell the roses, but don’t get distracted by the wallflowers.


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Technology and Time Management: Some Simple Tips

Sometimes people get the impression from my presentations, book, or this blog that I think that there is no such thing as too much use of video games, social media & technology, so let me set the record straight.  I do think that there is such a thing as problem usage.  One of the first questions I get when I speak to therapists, educators or parents usually is, “how much time spent playing video games, texting, or using Facebook is too much?”  The concern is real and understandable, but the problem is the way the question is framed.

Other than sleep, and maybe meditation, I can’t think of any activity that is good to do for 8 hours straight on a regular basis.  Nothing, not gaming, sitting on an airplane, playing hopscotch, calisthenics, drinking alcohol or water, studying, or mowing the lawn, will be without adverse effects if you do it constantly for 8 hours straight.  What makes most things problematic is not the quantity of time, but the quality of your life as a result of the usage.  If you were to play hopscotch for any length of time such that it lost you your job, ruined your school performance, jeopardized your relationships with loved ones, or made you feel more negatively about yourself, those qualitative concerns are what would make it problematic.  That said, another qualitative factor in determining whether using technology has become problematic for you can be its impact on your time management skills.

I strongly suspect that people have had time management challenges for as long as there have been sundials.  And we do know from history that each introduction of a new technology is followed by an exponential increase in its use, which in turn creates feelings of overwhelm.  And these feelings of being overwhelmed are what necessarily precede our developing the mental, physical and technological skills to manage the new use.  The earliest known book indexes showed up about 150 years after the printing press, and were preceded by 50 years of increasing overwhelm as Europe’s book collection grew from approximately 30,000 to over 20 million.  (And no doubt, even as knowledge and the arts grew so rapidly, there were members of the population who had little interest in learning to read, and would have criticized time wasted reading that could have been put to better use, like tilling the fields or baking bread.)

So here we are again, with a proliferation of technology and the demonization, confusion, and yes, real problems that come with it.  Two years ago the average amount of time adults in the U.S. spent online was 13 hours excluding email, and with the advent of the iPad it has undoubtedly increased from there.  Fortunately, people are starting to talk about ways to reflect on the way we use technology, such as Howard Rheingold in his new book, Net Smart.  Which is important, because we’ve passed the point where using technology is optional, at least if you want to live and work in the U.S.  So here are a few tips I thought I’d pass on that I and people I work with have found helpful in learning to how to manage your time and tech use:


  1. First, figure out what thing is the most time suck for you, because it varies.  For some people it is going on Facebook, for others it’s gaming.  Personally, I don’t think I spend more than 30 minutes a week on Facebook, because it isn’t my “thing.”  On the other hand, I need to do something about the 2,500 unread emails in my box.
  2. Next, drill down into that technology and figure out what particular elements are taking up the most time.  Saying “I spend hours on Facebook or Google+” is pretty meaningless, because these platforms have such varied functionality.  Are you on FB chatting?  Reading updates? Playing Farmville?  Take a few minutes to reflect on what you do and how much time it tends to consume.
  3. Consider Chunking.  Remember how I said my email was my biggest time suck?  When I really feel overwhelmed, I begin setting aside a couple of 30 minute blocks to read carefully and respond thoughtfully to emails.
  4. If you’re a therapist, I suggest you take a lesson from your voicemail, and begin using an auto-responder.  They are pretty universally available through either your webmail settings or your software.  I do think we have a responsibility to our patients to let them know that their message has been received, and told that if this is an emergency they should not wait for a reply, but go to the ER or call 911.
  5. Peter Bregman, a blogger for the Harvard Business Review, makes the excellent suggestion of having two lists for your day.  The first one lists the things you need to pay attention to that day.  The second one is lists the things you need NOT to pay attention to.  Many of us have a really hard time making priorities.  We think that everything needs to be attended to, and sure, if you put something on the NOT list, you will miss out on something.  It doesn’t feel good or easy to set priorities, because that is the nature of prioritizing.
  6. To the above lists, I suggest that you apply my own (non-patented) Postit Rule.  Quite simply, the Postit Rule is that any list needs to fit legibly on a regular sized Postit, or be shortened.  If I cannot print the items on my list legibly on one side of a postit, then more things need to go on the “NOT attending to” list.  Experience has proven that if I don’t do this I won’t get everything done anyway, because even though “dither and complain about how busy I am” never shows up on either list, it somehow seems to consume a lot of time.
  7. For gamers who are having a hard time logging off, I suggest a PostIt that is taped up to the edge of your monitor saying something like “Just win?  Maybe now’s a good time to log off.”
  8. For gamers who are interested in doing some self-reflection, I suggest you do this experiment:  Keep a pad and pen near the place you’re playing.  Tell yourself (and others if you’re grouped) that you are going to log off the next fail, not as a rage quit, but as an exercise.  Then, when you lose, log off and spend 10-15 minutes writing down the thoughts, feelings, and impressions that come up immediately after a fail.  Does it feel infuriating to lose?  Urgent? Funny? A relief?  What thoughts do you catch running through your mind?  After you’ve reflected a minute, put it away, but take it out and reread it an hour later and a day later.  What do you think of it now?
    You may have noticed that the above strategies don’t depend for the most part on advanced technology, but rather putting tangible reminders in your field of vision during the day.
    That said, there are several apps and sites that may help you get a handle on your time as well:
  1. If you surf a lot, consider using a news aggregator.  One Howard Rheingold recommends is NetVibes, which is very customizeable.  I find it a little too overwhelming, and I surf mostly on my iPad rather than a desktop, so I use  the App Flipboard.  It has a nice intuitive interface and allows me to read and share material very easily from within it.  Or you can try Google’s Feedburner or FeedDemon.
  2. If you haven’t tried Evernote yet, especially on the latest iPhone, you are missing out on another good time-saver for non-confidential sorts of info.  Evernote stores your notes, lists, pictures, and webpages so you can access them on any computer.  It makes what you save searchable, and best of all IMHO in the latest iPhone you can dictate notes.  If you’re a student or work with students, I recommend StudyBlue as well.

These are just some of the things out there that can help you achieve more mindfulness and organization.  Because in my opinion the hours counting and addiction labeling is dodging the real issue, how to increase our own mental abilities to become self-reflective and intentional in our use of technology.  Notice what you are attending to, increase the space between thinking and doing, and I’ll bet you find yourself a better gamer, blogger, worker, student, or other user of technology.


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This week I had the opportunity to meet with a group of college students who are on academic probation.  There were supposed to be over 20 in the class, and 10 showed up, 5 late.  One of the the things I was struck by initially was how subdued they were, and I suppose I can’t blame them.  The class they are in, on how to succeed in school, meets twice a week in different locations at the college, half the time in a basement computer lab even though they won’t be using the computers.  If they don’t pass this class they are out of the school altogether.  There was something discouraging about the whole setup.

When I asked them how many of them played video games, they all did.  Most of them had played their favorite game as recently as this past week.  And when I went through the room and asked each what they liked playing, I was taken by how for a moment their face would brighten and they’d smile, even make eye contact.  Probably the most memorable moment for me came after I shared with them the statistic that 80% of the time we play a video game we are failing at it, and asked them to think with me about why we can tolerate failure so much in video games yet have so little tolerance of failure in other parts of our lives such as school.  What was different with a video game?

One student, I’ll call him John, raised his hand and said, “I might win.”

What a sad commentary on what education can do to students who don’t fit a certain mold.  Somewhere along the line, John and thousands like him have lost a sense of optimism, a sense that they even have a chance to win at life.  And yet, throughout the one and a half hours I was with these students, every one of them participated, had really interesting comments, argued and engaged with me.  The last holdout was a guy in the back row.  I asked him what he had learned so far today about video games and our discussion.

He sunk a little into his seat, and said, “I’m drawing a blank.”

“Let’s take a minute,” I said, “and let’s assume optimism.  Because you can add something to this discussion.  I know you can.  What have you learned in here today?”

Long pause.

And then he said, “self confidence.”

I should add, and did say to the class then, that we hadn’t even brought up that key concept to academic success yet.  If he hadn’t have added it, we might not have ever gotten it into our discussion.  Each of them had unique ideas, worthwhile ideas, not all of which we agreed with, but ideas nonetheless.

It takes optimism to risk answering a question in class, start a business, go to therapy, or play a video game.  Without optimism we won’t risk trying and failing, and without trying and failing there can be no innovation.

Take a second and think about the world around us.  Is it perfect in every way, or would you like some things to change?  If you think it is perfect we’re done here.

But if you think that the world can be a better place, for people and all sentient beings, then you’re thinking something needs to change.  Maybe you think racism needs to change.  Maybe you think poverty and starvation needs to change.  Maybe you need to be a better parent or partner, or learn more about something in school.  Maybe you want a better job, or want to create a work of art.  Maybe you want to better understand what it all means and how to fit in?  Maybe you want your daughter to have a better life with more respect, maybe you want your son to have a better future.  Maybe you want a war, all war, to stop.

Nothing gets better without change, and risk of failure.  But to risk failure we need to think we can win.  To fail and try again we need to think we could win this time.  Optimism improves resilience and changes our body, according to dozens of studies done by Seligman and other positive psychologists.  And optimism can create a more conducive learning environment.

Optimism, in my opinion is not simple delusion, or a brain defect, as some would say.  Yes, we might fail, but let’s not let that get in the way of making an effort.  Yes there is a lot of suffering and injustice in the world.  We’d better get busy.

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Protect Your Online Privacy: Start Blogging!

Many therapists have lamented about the lack of privacy the internet has created.  More to the point in my view, the internet has taken away the veil of secrecy psychotherapy has frequently sought refuge behind.  It used to be that the anonymity of large urban areas, or the possibility of a commute to the suburbs insulated therapists from their patients after the analytic hour came to a close.  I friend of mine once went for years before discovering that Therapist A, who had referred him to Therapist B when treatment was stymied, was actually married to Therapist B.  They did not share last names, but my friend in a moment of high curiosity and low impulse control drove over to Therapist A’s home address and discovered Therapist B’s name there as well.  He terminated therapy thereafter.

For myself, I learned that privacy is to a large extent illusory, not from the internet, but from my first job.  I worked in a community mental health center on a 13 mile long by 7 mile wide island which was 2 1/2 hours by boat from the mainland.  You get used to a diminished sort of privacy on an island.  I couldn’t avoid my patients if I wanted to, unless I wanted to avoid the library, most restaraunts, coffeeshops, the beach, or the one movie theater we had in the winter.  Nor could I find privacy in limiting the type of work I did there.  The Community Mental Health Center was the only one on the island.  We were responsible for, and I did, school counseling, Psychiatric hospitalizations (which involved flying with often psychotic people in a Cesna six-seater airplane,) outpatient therapy, Alcohol counseling and DUI classes, drug testing, and court-ordered counseling for domestic violence perpetrators.  I can still remember how when a colleague and I went out to dinner at a local pub one night one-third of the people at the bar left.  It wasn’t just my privacy that was affected here.

You have a choice in situations like that.  You can hide out in your house with a cat and television (which I did at first) or you can start living your life in the community and negotiate boundary crossings on a case by case basis (which I settled upon as my strategy.)  I learned to cultivate a sense of never-too-uptight-never-too-relaxed when I was in public.  It became second nature in many ways.

When I moved to Cambridge, MA, it felt very anonymous by comparison.  But as many practitioners in “The most opinionated zipcode in the US” will tell you, Cambridge is really a village in many ways.  I still ran into people, and by this time, technology was becoming more of a factor.

As Thomas Friedman has observed, “The World Is Flat” in the 21st century.  Globalization and technology have removed many of the barriers to, and some would say protections from, knowing each other.  Our patients can Google us, Yelp hangs up a business page of us whether we like it or not, and are often only one Facebook friend away from connecting with us.

Even if you want to make the poor business decision of staying off the internet in terms of a website, eventually your contributions to the Democratic Party, your address, and notes about you in your alumni magazine are still going to find their way out to the world.  We’re all on an island today.

So what can you do?  Well, my advice is to start blogging.  I know sounds counterintuitive, but it makes sense on a number of levels:

1.  Buddhism tells us to move into the places that scare you.  We exert so much energy trying to avoid things, find a spot where we can stay safe and stop the awkward and uncomfortable learning process.  And yet we ask our patients to do the exact opposite so often: to look underneath those rocks, descend into the depths of the psyche, face their fears.  Our obsessive quest for privacy is perhaps not that different.

2.  Make the internet work for you.  One of the best ways to protect your privacy is to generate a lot of content that you consciously know is public-facing.  Google “Mike Langlois, LICSW” for example.  Go ahead, I’ll wait.  What came up probably is pages of my website, professional picture, Youtube videos, and blog posts.  Dig a little deeper and you’ll see me commenting on a few blogs.  This is the practice of radical transparency.  All of that content was written with all of you in mind, my patients, colleagues, friends, family members, potential coaching clients, high school classmates, potential employers, my future children and grandchildren and the FBI.  The way Google and other search engines work, the more content I put out there that is public, the further back any unintentional pieces about me will be.  By embracing that the world is flat I have learned to cultivate a style that I can negotiate in my work life while still feeling authentic.  And it is great advertising, or fair warning, if you are considering working with me.

3.  Radical transparency protects your patient’s privacy as well.  Whether we like it or not, therapists are finding themselves on review sites like Yelp.  Yes, anyone can post a review, and no, Yelp will not taking it down if you ask.  More importantly, your patients might not understand the ramifications for their privacy or PHI if they post a review.  Keeley Kolmes has great resources on this, and you are welcome to use my version of her version as well.  Take a look:

Notice that half of my allotted space is not advertising, but a direct message to any potential commenters.  Rather than hide out and try to get Yelp to take my name down, I have used it as a platform to market my business, model what I feel is ethical professional standards, and provide some information to patients in the spirit of informed consent.  Do I want to get bad reviews?  Of course not, who does?  But that is not an excuse to hide my head in the cybersand.

4. Last, but not least, get over your bad self.  Sometimes listening to our colleagues you would get the feeling that they are dealing with the paparazzi, not the public.  Sure patients and others may be curious about your life, but really most people in the blogosphere just aren’t that interested.  On a good day, my blog gets 200 views, on an amazing day last August I got 689 views.  There are 7 billion people on the planet.  Feel free to correct my math here but according to my calculations that means on a busy day 0.000009842857142857142% of the people on the planet are checking out my most visible presence on the internet.

Am I saying you should blog for the sake of blogging? No.  I am saying that there is a Copernican revolution going on in the 21st century, and therapists need to join it.  Rather than avoiding technology and the internet we need to start understanding it and harnessing it.  You can be googled whether you like it or not.  Yelp doesn’t care about contaminating your transference.

Being professional is about how we rise to the occasion of Web 2.0, not deciding to skip out on the party.

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The Uses of Disenchantment

Magic fulfills the wish that we could have powers to be beyond who we sadly suspect we are. As children, magic explains the inexplicable nature of external forces (i.e. parents, teachers, death) and internal ones (unconscious drives, nameless attachments, inconsolable sorrows and consuming rages.)

Anyone who plays WoW, Elder Scrolls, or Dungeons & Dragons, knows that enchanted weapons and armor are valuable items to be gotten. They raise our stats, make us stronger, more intelligent agile, or resistant to harm. They fulfill the wish that we could be more than we are.

That being the case, the profession of Enchanting is a very valuable one to master. To do so is to be able to craft our own items for use or to sell. And to master the skill requires not only enchanting practice, but also the act of disenchantment.

Disenchantment is the breaking down of an enchanted item into its component reagents. In Skyrim this consists of taking the enchanted item and destroying it, which allows you to discover the enchantment. So, for example, if you come across an Iron Battleaxe of Scorching, you have a choice. You can enjoy your new battleaxe which will add fire damage to the physical damage you do using it. Or you can disenchant it, and learn how to imbue any weapon with the ability to do fire damage.

In World of Warcraft disenchanting items is necessary to provide you with the reagents, or raw materials, to do other enchantments. Learning the enchantment is done separately, by training or reading a recipe, but disenchantment is still necessary to break down enchanted items into components you can use for other enchantments. Enchantment operates in the domain of creation and destruction, attachment and loss. I can remember feeling many the hesitation as I was about to take an Epic staff I’d used for months and dissolve into Abyss Crystals. Even though I knew that I was going to get a new weapon with a strong enchantment out of it, disenchantment required sacrafice.

Many patients labor under the illusion that the purpose of therapy is to make you feel good. I have always maintained that that is not true. Therapy is not about making you feel good, but rather about learning how to not to feel good. It’s about learning how to experience and tolerate those unpleasant feelings in a different way than we’ve learned to previously. People abuse substances, food, sex, and yes, occasionally video games because they cannot tolerate feelings that don’t feel “good.” Who wants to feel inconsolable sorrow, thwarted passion, grief, terror, or hopelessness?

And so people come to us wanting symptom reduction, not character building; relief, not the raising of unmentionable wishes and fears to consciousness. At first, we often provide those other things to be sure. A compassionate ear to listen, a calming influence, a holding environment. But in the end, therapists are alchemists and enchanters: Nothing new can be created by our patients without something being destroyed. Something must be given up to create something else.

Consider this: Neurosis is like an enchanted armor that we can no longer use. Maybe we have outgrown it. Maybe it never really fit well but it was the best compromise we could come up with. Maybe it buffed up our strength stats when we really needed more intelligence to play our class effectively. For whatever reason, it is no longer helping us, in fact it has created distress.

Symptom reduction alone won’t solve this problem. It may alleviate our distress for the moment, relieve pain enough to create the “space” between feeling and behavior so that we can begin to do the longer-term work.

That’s where disenchantment comes in. We need to take the item, the neurotic conflict, and break it down into the components that create it. What is the wish and the worry? What causes the guilt? Just what are we so afraid of that we can’t look at it directly?

This doesn’t always have to be painful, and therapists shouldn’t use this as a justification for brutality. But to think that the process of therapy is not going to be uncomfortable and difficult; is not going to take some time and hard work is pretty much delusional. If our enchantments could have gotten us any farther we wouldn’t have given them up. Most addicts and alcoholics would have used longer if they could have. If they could have enjoyed one more binge, party or high, they would have.

Insurance companies love to focus on symptom reduction, and a narrow view of what evidence-based treatment really is. Symptoms are problems to be solved, rather than signposts pointing towards underlying issues. And although this is short-sighted, it is understandable: 10 sessions costs a lot less than weekly sessions. And yet, the most recent research I’ve read indicates that psychodynamic therapy is as effective as CBT and other therapies, and in fact more effective in sustaining longterm change.

Bruno Bettelheim, a psychoanalytic thinker, is perhaps best known for his book The Uses of Enchantment. In it he discusses how the themes of fairy tales often symbolize the real emotional and psychological struggles that children go through. Through the projections of stories, children are able to work through their fears in remote and tolerable ways. In a similar way, Klein speaks of the paranoid-schizoid position where the parent is split into good and bad objects, the fairy godmothers and evil witches of fairy tales.

Disenchantment, from a Kleinian lens, leads to the depressive position. It is where we hopefully get to, despite the depressing name, that point when we realize that people are not either all-good, or all-bad, but both good and bad, nurturing and depriving, gratifying and frustrating. In other words, human. The world seems less magical in some ways, and that is experienced as a loss. Sounds depressing, eh? So what is gained?

There is a practice in Tibetan Buddhism called tonglen. In this form of meditation, you begin by touching the tender spot of whatever is sorrowing or distressing to you. Say you’ve lost your loved one. Allow yourself to feel that grief for a moment, really feel it. What an awful wrenching feeling that is. You may reflect that nobody should have to feel what you’re feeling right now. And yet, all over the world, there are those who have felt that, may be feeling it even as you are right now. So you breathe in, and imagine breathing in all of that grief as if for that moment you could take it into your heart so that nobody else would have to feel it. And then you imagine yourself breathing out comfort and security and everything that is the opposite of grief and suffering to the world and to all those in it who need it. You reverse the cycle of trying to avoid pain and grasp pleasure, and in doing so generate compassion.

That is the use of disenchantment; breaking down our fantasies that we can avoid pain and transmuting it into compassion for others. Imagine if you were to really accept that everyone is human and fallible and mortal. If you were able to walk around tomorrow and remain conscious that everyone you meet is dying, would you treat them in the same way as you did today?

Interested in working with me online or in person? Check out the Gamer Therapy and Work With Me Pages!

And if you want to learn more about gaming and psychotherapy, you can always buy my book

Not All Failure Is Epic

In gaming there is a concept known as the “Epic Fail.”  Roughly translated this means, a failure so colossal, so unbelievable in its nature, that it will go down in history as epic.  Epic failure can be extremely frustrating in the moment, but is almost always funny in retrospect.

Recently I was playing Dark Souls, and I was trying to down two bosses known as the Belltower Gargoyles.  Just as you get one down to half health, the other, who likes to breathe fire on you, shows up.  Oy.  I kept getting killed, which sent me back to a save point, running back up the belltower, and trying again.  What kept me going up there was that each time I was surviving a few seconds longer, and each time I was getting the gargoyle’s health down a little more.  At one point I started to consistently kill the first gargoyle before the second one finished me off.  Finally, through an unbelievable feat of mashing all the buttons, luck, and strategy, I beat them both.

The failure that kept happening was not what I would call Epic Failure.  It was certainly what Jane McGonigal et al call fun failure though.  It was failure with just enough progress mixed in that I’d say, “Oooh, you’re going to get it,” to the gargoyles and try again.  And again.  Fun failures in video games are designed to work that way.  The game can’t be so hard that the person gives up, but can’t be so easy that you don’t feel challenged.  Because if you don’t feel challenged then there is little or no sense of accomplishment.

Heinz Kohut, one of my favorite psychoanalytic thinkers, would probably have a lot to say about video games if he were alive today.  Kohut knew that failure was a part of life and human development.  In fact, he thought that therapy was full of failure.  He talked about empathic failure, when the therapist fails to respond empathically to the patient in some way.  Maybe we don’t pay attention enough to a story, or don’t remember something, or start 5 minutes late.  These are all parts of the therapist being human, and therefore being unable to stay absolutely in empathic attunement with the patient.  This kind of failure is inevitable.

Kohut goes on to say that it is not necessary to deliberately make mistakes and empathically fail our patients, because we are going to do so naturally in the course of our work with them.  In fact, to deliberately fail our patients is rather sadistic.  But usually we aren’t being sadistic when we forget something, or run late a few minutes, even though the patient may experience it that way.

So first a note to therapists here.  In the course of your work with patients you are going to fail a lot.  But not all failures are epic.  That is not to say that your patients won’t experience it that way.  That vacation you’re going on may be an epic failure on your part, as far as they are concerned.  Does that mean you cancel your flight plans?  Of course not.  Our job is initially to help the patient by understanding by empathy the epic nature of our failure from their point of view.  We try to imagine ourselves into that moment they are having.

But that doesn’t mean that we stay there.  We need to maintain some perspective, have some sense of fun failure, to keep doing our work.  By that I don’t mean have fun at our patient’s expense, but rather be able to be lighthearted enough in our introspection to say “Oops, I missed that one,” or “there I go again.”  If we can do that we are able to then refocus on the patient.  If we instead get sucked into the idea that this is an Epic Fail we will lose all perspective, and actually start focussing on ourselves rather than the patient.

Do you ever say to yourself, “I’m such a bad therapist?”  I don’t.  Of course, I also don’t say, “I’m such a perfect therapist” either.  I do frequently think, “I was not at my best today,” or, “oooh, how come I keep missing that with patients!”  This helps me keep perspective so that I can get back in the game as soon as possible.

Whether you are a therapist, a gamer or someone else who is still breathing, chances are that you are failing sometimes.  In fact, this time of year with all its’ hype and expectations about being joyful and loving families can make you feel even more like a failure.  Some examples of Epic Fail statements that we think consciously or unconsciously include:

  • I’m a terrible parent.
  • I’m a terrible daughter/son.
  • I’m a terrible sex partner.
  • I’m a terrible worker.
  • I’m a terrible cook.
  • I’m a terrible student.

and the list could go on.

If any of those sounds like you, take a moment to reflect.  Is this really an Epic Fail?  Or are you distorting things?  Chances are you are not a perfect parent, child, worker, sex partner, student or anything else.  But if you really identify this as an Epic Fail, chances are you are solidifying a form of self-identity rather than accurately appraising yourself.

Why would we do that?  Well, one reason is that we learned those messages of Epic Failure as a child.  You probably still remember a few failures that can make your stomach churn if you think of them.  But as often, I think we grasp on to solid identities, even negative ones, so we can stop working on ourselves.  I’m just X, I’m the kind of person who can’t Y, Nobody ever thinks Z about me:  These all kill our curiousity about ourselves and help us stay stuck.

Mindfulness is about fun failure.  It is about being able to look at ourselves and reflect on ourselves without going to extremes.  Mindfulness is about being able to be curious rather than judgmental, having roominess in our minds and souls rather than rigidity.  This perspective leads to “Ooooh, I’m going to get that boss down this time.”  The other leads to hopelessness.

So try to remember this as the days are getting shorter and tensions may be rising:  Not all Failure is Epic.  And if we can be right-sized about our failures we can learn from them.  We can take an interest in our thoughts, feelings and behaviors rather than judge ourselves.  If we catch ourselves saying “what kind of monster I must be to hate Aunt Myrtle,” we can perhaps think, “oops, there I go again. Isn’t it odd/interesting that I feel hatred towards Aunt Myrtle, what’s THAT about?”

Eighty-five percent of the time gamers are failing.  And yes some of those are Epic, but the gamer attitude is to view those Epic Failures as moments of camaraderie and learning.  In life outside the game, do you treat the Epic Fail that way?  Do you seek out others and try to learn from the experience, or do you isolate?  There is always some observing ego in the game Epic Fail that is often lacking in our non-game life.  And in some ways that is understandable, you can’t always reset in life outside video games.

But consider this:  Where there is life there is hope.  If this was a true Epic Fail in your life you can still learn from it in time.  Failures are inevitable, but with time and perspective they can be instructive as well.  In the end I’d say that whether you think you’ve had an Epic Failure or not what matters most is how you move on from it.  Who knows, maybe the only real Epic Fail is the one where you give up..

Note:  No real Aunt Myrtles were hated in the writing of this post.

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Radical Transparency

By now you may have read the story of the student in Manchester, NH who was arrested in his school cafeteria by a police officer who lifted him out of his seat, and forced him into a prone position on a table.  Another student captured the video, and you can see it and the story here.  Although the police handling of the situation was clearly disturbing, even more disturbing are the voices of the teachers caught trying to get the student recording to stop, and then attempted to take the phone away from him.  By his report they did make him delete a couple of pictures, but the video went undiscovered until it went viral.

It’s time we get real about transparency in the professional world.  My prediction is that the school administration will address this situation by trying to either enforce a no-cell phone policy or create a policy that prohibits the use of electronics on school grounds to record such incidents.  I hope they don’t, and use this as an opportunity to open some conversations between school staff, parents, students, and officers.  But I will be pleasantly surprised if that happens.

Professionals who work with people “in their care,” be it therapy, education or something else, often cite privacy concerns when it comes to transparency.  I’m convinced that the reality is often that they want to protect their privacy as much as if not more than that of their patients.  What happens behind closed doors is secret.

Remember that phrase “you’re only as sick as your secrets?”

Other professionals want to commute to work so they have a “private life.”  They are outraged with the amount of information available about them online, information that their patients, students, anyone, can access about them.  When I do public speaking about technology and therapy and education, I often find that privacy concerns boil down to this sort of fear and outrage.  Sure, HIPAA is brought up, but that is usually in the context of another fear, getting sued.

I practice and encourage my colleagues to practice what I call “radical transparency.”  I define Radical Transparency as engaging with technology as if it is always in the Public sphere visible to anyone.  To be clear, this does not mean either never using technology to communicate about one’s personal or professional life.  Nor does it mean telling everyone everything all the time.  Rather, radical transparency means that before you “utter” anything via technology, and before any choices you make with technology, you consider what would happen if it one day comes to light.

I’m not saying you have to like radical transparency, I’m just saying that it is time we get clear with our relationship to technology and others with it.  And I’m not saying I am perfect with it, but I try to comport myself with authenticity.  If you search online you will (hopefully) not find my public posts or comments cutting or snide.  If you somehow got hold of my emails over the past few years, what would emerge is an acerbic, funny, tart guy who is prone to arrogance and does not suffer fools gladly.  You’d find a good deal of kindness and wisdom as well, but certainly you’d find frustration, self-righteousness and negativity.  In short, you’d glimpse my human condition.  But there you have it, I am prepared to accept the revelation of any warts that may come along.

Radical transparency, I am suggesting, is not just about what you “put out there” on the internet.  It is not about gussying yourself up so you are acceptable to everyone.

Radical Transparency is about getting clear, clear with yourself.

I have found two spiritual traditions especially helpful with this idea.  The first is Buddhism, which talks about nonattachment and going to the places that scare you.  But in this post I want to focus more on the second tradition which has influenced me, and I think may have some good insights into technology and our place in the world.  That second tradition is Quakerism.

What I have learned from Quakers and my own connection to the Society of Friends, is the importance of gaining clearness, and discernment.  One quote that sums up what I am saying is from an article written by M.L. Morrison in the book Spirituality, religion and peace education.  In it she says:

“Key to a Quaker philosophy of education is the belief that each individual has the capacity for discerning the truth.  The truth does not solely come from the teacher or mentor… The process of getting clear about a particular discernment implies testing it out in a community of fellow seekers.  In this way individuals are accountable to the communities in which they live and learn and the community can support the strength and leadings of its members.” (Italics mine)

What if we started seeing the world, online and off as that sort of community?  Get clear with who you are and what you’re about.  Be authentic.  And after you have achieved a certain amount of clarity have a discerning attitude about what you put out there about yourself, and above all behave as we feel we ought.  Am I saying that we all need to adopt Buddhism or Quakerism?  Of course not.  But we need to start focussing first on who we are in the world, not who shouldn’t be videotaping us.

Technology is not going away folks.  And adolescents are rightly exploring and testing the limits of it, because they will be using it to maintain, more accurately repair, the world we have given them.  September 11th taught these kids that media can be used to bear witness to terrorism and injustice in real-time.  And since then, Youtube has proliferated with videos of the atrocities professionals have perpetrated.  I have seen a juvenile collapse walking around a courtyard of lockup, only to be kicked and ignored by the warden when he was in need of medical attention.  I have seen a college student tasered in a library.  We have seen an Iranian woman shot to death and die before our eyes.

And these images change us, and they go viral.  This is what globalization is, this is our whole planet struggling to get clear.  And there are lots of people, those in power, who want the status quo.  Keep the doors shut so people have to “go through the proper channels.”  But technology is trending towards dialogue and democracy.  You just can’t get away with being cruel unobserved and often unchallenged.  Make fun of a teen who may have Asperger’s and he’ll post a rebuttal on Youtube.

These are the same people as the teachers who try to take away the student’s cellphone, or the administrators that forced Matt Gomez to shut down his class Facebook page.  All the parents had signed off on it, but concerns about privacy were still cited.  And that again, I believe is often a professional rhetoric for “controlling access to information.”

I have worked on the inside of several school districts, and in all of them I saw stellar educators, people who were always taking risks and getting creative.  And I saw lots of lazy, verbally abusive educators there as well.  The way our education, and our mental health, systems are set up there are a lot of disempowered angry people working with even more disempowered angry people.  And many are in the middle, trying to just keep their head low and not make waves.  I know, because I have been all of these at one point or another.

This is not going to be as easy from now on.  If you swear at a student, someone’s going to record it on their phone and have it posted on Youtube before you can blink.  If you gripe about a patient on your Facebook page they’ll find it and call you on it.  And those of you who are trying to just keep out of it all, we’ll see you too.  And more importantly, you’ll see you, and when the kid you ignored being bullied because you didn’t want to deal with it that day kills himself, you’ll have to live with the guilt that thousands of people he never knew reach out to assure those like him that it gets better, while you, the person who saw him every day or week just sat there and did nothing.

Talking about patients online, getting rough with a student, shooting a woman–Yes, these are all very different events.  But they all connect around the idea of an ethics of radical transparency.  Or as Rainer Maria Rilke put it in “Archaic Torso of Apollo:”
for here there is no place
that does not see you. You must change your life.

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Fun & Failure

Early in the summer I had the opportunity to give a workshop at the University of Buffalo.  The evening before I gave it I had the opportunity to sit down and have dinner with Nancy Smyth, the Dean of the School for Social Work.  Although we’d never met before in person, the time sped by with good conversation and laughter.  Fortunately I had finished my prep for the workshop, because I was quick to crash that night.

The next day I spoke in front of a group of clinicians, caseworkers, and administrators.  The age ranged from 20s to 60s, and the discussion was so lively that the day sped by, and before I knew it, I was being ushered out of the classroom and into the car to the airport.  The workshop participants did not agree with each other (or me) on all points, but everyone said that they were walking away with me having changed their thinking about technology, video games, social media and healthcare.

Sometimes I take for granted how much fun my work is.  There is enough diversity in who I work with to keep me invigorated most days, and the balance of a portfolio career really suits me.  Being my own boss suits me as well, and this year I mixed it up a little.  I dropped one class I was teaching and took this semester off so I could focus on writing and promoting my new book.

Promoting Reset is not something I enjoy doing.  Although I coach and blog about the importance of self-promotion and what hold us back from doing it, that doesn’t mean that I enjoy doing it all the time.  But one thing I have been learning is that writing the book was the eas(ier) part.  I need to keep getting the word out about it, and sometimes I feel like I am overtaxing the patience of my Twitter followers, Google+ circles and Facebookies.  Some of these people are in multiple groups, and I can imagine that they get irritated with another post about the book.  “Enough already!” I imagine them saying.

Speaking up is not easy, and many of us actually have a much easier time speaking up for others than for ourselves.  We speak up for our clients, our kids at school, our pets when they depend on us for care.  It’s ironic that we get so good at striking blows for freedom, blogging against oppression, picketing, and political advocacy; and yet we cringe at the idea of promoting ourselves.  Perhaps that is because the former makes us feel righteous, and the latter makes us feel guilty.  I definitely enjoy advocating for technology and the people who use it with my colleagues, but I wonder if I would have promoted my book at Buffalo if it had been published then.

I’d better get used to it, because now there are more speaking engagements coming up, and having an eBook means I can’t just lug a pile of them to the the hotel and have them sit on a table.  I need to be speaking up about Reset, because no one else will.  And one thing I have also learned to do at talks is to let people in them know I enjoy speaking engagements and am available to do more.  And each time I have done that, I have gotten a lead.  Hopefully out of all of you reading this I’ll get hired to do another few.

This is such a contrast to my clinical work, where I am required to be more quiet, reflective, and other-focussed.  I am not alone in this, psychotherapy tends to require us to listen more and talk less much of the time.  It is also a safe place to “hide out” if we aren’t careful.

One of the most unfortunate lessons our current educational system teaches us is that we should hurry up and find out what we are good at, what comes easily for us, and then stick with that.  In school settings, not-knowing is considered a bad thing rather than the predecessor to curiosity.  By college we have learned to speed through any unpleasant “requirements,” and major in something that interests us.  The problem with this is that by then we have learned to take an active disinterest in things that we struggle with.  So we arrive in adulthood having learned to play to our strengths, and avoid the rest.  And whereas children are fairly powerless to avoid what they struggle with in school, adults can often construct a life that cocoons them from learning unfamiliar things.

Therapists in particular, have pushed themselves through grad school and internships, licensing tests and boards, and by the time we get licensed to do private practice we feel entitled to close the office door on outside influences.  Several times when I have been hired as a coach or consultant, I still find my clients reluctant to “come clean” about things they aren’t good at.  Some haven’t billed insurers for months because they don’t know how to do the paperwork, or a claim has been denied and they are letting the appeal sit on their desk.  Websites lie around half developed, brochures printed up but not mailed, and all of this is nothing compared to the disarray and avoidance of work/life balance.  Office hours are whenever the patient can make it, their specialty is “anxiety and depression,” and they are running themselves ragged.  And all the time, they suspect that they are really frauds awaiting discovery, and why?  Because they learned that you aren’t supposed to admit you are confused or don’t know something, let alone ask for help.

Fortunately I play video games.

As Jesper Juul points out in Fear of Failing? The Many Meanings of Difficulty in Video Games failure is more than just about not winning.  It forces gamers to readjust their perceptions.  In fact, players prefer games where they feel responsible for failing.  What’s more failure adds content to the game.  Think about what a powerful paradigm shift that is.  Failure adds content that wouldn’t be there.  What might happen if we were able to see failure in our lives as adding content?

Actually, therapists often have a lead in understanding this.  We know that empathic failures are often inevitable, and that when we successfully navigate them with our patients the relationship deepens.  The failure adds content.

So think about your life, your practice, your business or your relationship.  And look straight at where you are failing in it.  I know, it’s tough, but try it for 5 minutes, and then ask yourself, “what content is this failure adding to it?”

This is much easier to do in hindsight, which is why we need to try to practice it in the now.  Because if we don’t avoid seeing the failures, we can readjust our perceptions and progress farther.  Maybe just a small progression, but anyone who works with kids knows the importance of proximal goals.

To go back to the Buffalo speaking engagement, this began as a failure and the setting of a proximal goal.  The failure was this:  I wasn’t getting enough paid speaking engagements.  How did that add content to my life?  Well, it added the mission, should I choose to accept it, of getting more paid speaking engagements.  So I set the proximal goal of starting to let people know I was looking for them.  One night on Twitter Nancy said something complimentary about a blog post, and I quipped that she’d better hire me as a speaker before my rates went up.  A few months later I was invited to speak.  And in addition I deepened a connection, met some really cool students, and saw Niagara Falls for the first time in my life:  How’s that for added content?

So much is possible for you, your business and your life.  None of what I have described above was achieved because I have some special gene.  It took what Pema Chodron calls going to “the places that scare you.”  We are all failures at something–come out of the closet!  Over 6 billion people around you are failing and trying and failing and trying again every day.  Those that aren’t are hiding inside an ever more rigid and constricted life.  That doesn’t have to be you, and it sure as hell isn’t going to be me.

Oh, and I hope you buy my book, and I’m available for speaking engagements, so call me.  😉


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Fear Is Where You Start From

Recently I was having dinner with some colleagues, who were discussing the state of mental health and managed care.  When these conversations start I sometimes begin to sit back, because I anticipate the worst.  I expect that there will be some insurance bashing, and then discussion of how their salaries have shrunk, and how unfair the current system is, maybe a smattering of how better things used to be for our profession and concluding with uncertainty about how much longer they can stay in business.  I expected this conversation to go the same way, and was preparing to decide whether to try to advocate for another, more empowering perspective.

I was pleasantly surprised.

The conversation did indeed start with the understandable concerns of therapists trying to grapple with the seismic shifts in our careers and businesses.  But then one of them began to talk about how he was planning to change the way he did business.  Others expressed curiosity about the things he was trying, and I finally offered a couple of ideas.  When they found out that I provide consultation on building & maintaining your therapy practice, they were 100% enthusiastic and eager to hear some positive perspectives.  They were able to hear my opinions of some tough truths, that we had bought into the managed care model because we were reluctant to market our businesses and have difficult conversations with patients about payment.  No one was defensive at all, one even invited me to come talk with a local group of colleagues.  At one point they made a joke about my “secrets” for success, and I told them I am not one of those people who holds back secrets to hook people into working with me, and that they could find a lot of free info on my site.

“I was kidding about having a secret,” one told me.  “You don’t have a secret, what you have is a strategy.”

The Buddhist teacher Pema Chodron writes in her book of the same title, about going to “The Places That Scare You.” The goal of the Tibetan Buddhist practice of tonglen, or taking and sending, is to reverse the normal cycle of human existence.  Rather than seeking out things we desire and avoiding suffering, the meditation practice of tonglen asks us to imagine inhaling and taking in the suffering for all sentient beings and exhaling happiness to send it to all sentient beings.  Whether you believe in the mystical qualities of this, the principle is a useful one in that it teaches us to break the instinctual habit of trying to holding on to the things we like and get rid of the things we don’t.  A version of this is going to the places that scare you, rather than running away from them.

The clinicians I have mentioned above are well on their way to maintaining and vastly improving their private practices, and its got nothing to do with me.  They have realized that fear is real, and that it often is mistaken for the end of the line.  They get that it is the opposite.

Fear is the place you start from.

People who deny that things are changing are in my opinion in for a rude awakening.  They deny the way our profession is being challenged, the importance of emerging new technologies, and the evolving practice of psychotherapy.  They deny the things that would evoke fear in them.  This is not unique to therapists of course.  Ironically, we often work trying to help patients see the devastating impact on their lives of repressing anxiety-provoking truths.  Then we turn around and do the same things to ourselves, hoping that this change in  economics or technology is “more of the same.”  Folks in this group are in pre-contemplation of fear, they haven’t even gotten that far.

Then there are clinicians who have gotten that things are really changing, and they are terrified!  They are paralyzed and miserable, commiserating with others and talking about the way things were in the past and how much better they were then.  They see the point of fear and they think of it as the period on a life’s sentence of struggling.  This is the end of our careers, we can’t learn to use technology, therapy is a dying art form.  They give up, and go out of business in a lingering dwindling sort of way.

Fear is not the endpoint.  Fear is where you begin. Fear is where you get going and hire a coach, research and write up a business plan, take a workshop on business development, marketing or integrating new technologies.  Fear is the start of renovating your practice.  Yes there is a lot of suffering in the world, let’s get going and reduce it.

Epic Therapists know all about fear. They aren’t fearless, there’s a lot to be worried about.  Many businesses fail, money needs to be spent to make money later, there are long hours ahead and no structure but the one they give themselves.  There is a lot they don’t know, a lot they’ve never learned to do to run a business, known expenses and surprises.  But Epic is running toward that dragon, knowing this could be an epic failure, being afraid… and then doing it anyway.

Epic Therapists have learned the concept of “nevertheless.”  I am scared that my business will fail, nevertheless I am starting it.  I am afraid that I’ll rent an office full-time and not be able to find patients, nevertheless I am going to rent one.  I am afraid I’ll sound inauthentic or greedy if I talk about my business to a colleague, nevertheless I am going to talk about my business.  I am afraid no one will want to pay my fee, nevertheless I am going to set a firm “bottom line” fee for myself.  I am afraid that I won’t be able to keep up with the changes in healthcare or technology, nevertheless I am going to make a strategy.

My last post about having a secret headquarters was fun to make, and it was also serious.  We need to have a time and a place for strategizing.  We can absolutely have fun doing it, but this is serious business.  There really are things to fear in healthcare, building a private practice and starting a business.  We need to think carefully and plan, and then we need to begin.