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?


  1. Beautifully, humourously and artfully said! Process is helpful up to a point and depending on what’s on the table – but we need to get things done, and endless processing can’t replace focussed doing.

  2. Jim Finley says

    Nicely put. Each state of mind in its place – in working with clients process is key (when I saw the title of the post I was instantly ready to defend the value of a process group, for example) but at other times it’s not a good fit.

    I once had a job that was making me crazy because I was the only member of my little part of the organization that cared about things like starting and ending meetings on time and following agendas, and I didn’t care for starting meetings and conferences with silly “warm-up” games.

    Probably my military background – before I became a therapist I served for 20 years in the Marine Corps (no, I’m not like that Geico ad where Lee Ermey is the worst therapist in the world.)

    • Hi Jim, you also bring up the other piece here, which is taking a look at our personal style and temperament. Some people love those warm-up games. Others don’t. The key is to know what works for us (and, in terms of supervision and process “why?”) and our patients.

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