This week I was at the dentist, and the appointment probably took twice as long as it was supposed to. This was because as I was waiting in the dentist chair, I was playing Denki Blocks on my iPhone when the assstant came in. She found the game interesting, and confessed to me that she didn’t know how to download games on her new iPhone. And as I was explaining how to do that, the dentist came in and he talked about how his children weren’t allowed to play games on the iPhone because they discouraged socializing. So then of course I explained that there was research that suggested very differently. He listened quietly and I said, “maybe I shouldn’t be arguing with someone who is about to put a drill in my mouth.”
“No, no,” he said. “It’s just that I’m thinking about what you said, and I haven’t thought about it that way before.” All three of us had an ongoing conversation between all the stages of filling a cavitiy, about smartphones, digital literacy, gaming. And at the end of it I noted how clearly this is a topic for our times if all of us can be talking and listening intently about it for such a long period of time.
In college, one of my creative writing teachers once said, “What interests you is interesting.” I think there is a lot of truth in this in general, and specifically when it comes to psychotherapy and running a business. I feel extremely fortunate to be in a portfolio career that allows me to pursue my interests and take an interest in the psyche and society. Not everybody has an easy or clear path to this in our society. Some self-help gurus make it sound like all you need is a burning interest to become the happy and successful, which is absolutely not true. There are millions of talented people out there that start off with less privilege and opportunity, and more stressors due to race, gender, poverty, or living in an ableist culture. But what I do think my professor was on to was the idea that often what interests you can be a strong motivator to yourself and exciting to others.
A supervisee and I recently were discussing the possible meanings and messages that could be conveyed in leaving a voicemail for a patient. After discussing this for 30 minutes, I interjected by saying, “Can I just take a step back and point out what a weird profession we’re in that we can spend so much time talking about this?” We both laughed at this, and it was true, but the time had gone by so fast because we were mutually interested in the subject.
Enthusiasm, in its original meaning, was taken from the Greek enthousiasmos, which came from enthousiazein, to be possessed from within by a spirit or god. That sense of a powerful force from within that can fill one with energy and ideas and lose track of time is at work in all of the stories above. It is not the only ingredient to having a successful business, but I believe it is an essential one. We need to be able to geek out about what we do, to go on at length about it. Hopefully we can do so in an engaging way, but we need to be able to lose a bit of self-consciousness to be able to focus properly on our patients, our work, and our business.
Frequently I consult with therapists who come to me because they want to grow their practice. A few of them say that, but what they really mean is that they want to make more money and work less. That is not in itself a bad thing, but for some it is an attempt at compromise. For they have grown tired or disinterested in what they are doing. They feel trapped in their work, not interested in it. They are afraid that they are too old to change, or don’t have anything else they can do. Some dream about a time they’ll retire and write a novel. But for now they are consigned to sit silently and voicelessly in their office. They grow bored and resentful of their patients, who if they are lucky, escape. This vicious cycle can go on for years.
The same holds for supervision. I have heard from a lot of supervisees about supervisions where it’s all about the paperwork, or the liability, or the billable hours. I’ve heard supervisors lament how they don’t have time to focus on talking about the dynamics of therapies, as if that was “extra” stuff! My experience is that these comments are voiced midway or at the end of a progression towards burnout. First the supervisor feels overwhelmed by the “musts” of paperwork and filing 51As, and then the supervision shifts to only being about those. Next, the supervision gets defined as merely being about that, so that the supervisee sees the supervisor rushing down the hall or on the phone, pausing to ask, “Anything we need to talk about?” If there is no crisis the student feels pressured and becomes trained to say no, there isn’t. And now that supervision is only about crises and paperwork, it becomes something everyone wants to avoid because it is boring, lifeless. There is no enthusiasm.
I would suggest this is ultimately a setup for malpractice. Supervisees trust supervisors who seem interested in them. Over and over I have heard that supervisees have a hard time connecting or trusting supervisors who are “just business,” or cheerleaders. Yes, supervisees don’t want a supervisor who lets them talk for an hour and then says, “sounds like you handled that well.” This bears saying, because sometimes we unconsciously or consciously try to substitute affirmation for engagement and interest. If you’re a supervisor, don’t do it, because your supervisees can smell it a mile away. If you’re vacant, they know it. If you are filled with the spirit of interest, they know that as well.
I’ve had colleagues tell me how clever I am to have found the niche I have, which drives me crazy frankly. I didn’t choose to focus on technology, gaming and social media in therapy because I saw a vacuum. I was just lucky that there was one. I chose these areas of specialty because I am a total geek about them. I could play or talk about video games for hours. I can’t talk about Twitter or Google+ without getting animated. I see their influence everywhere, read vociferously about them on my “free” time. I wrote a book about it which I charge $2.99 for. When asked to teach a class on clinical practice I declined, and said, “No, but I’ll write a syllabus and teach a class for social work and technology.” Any of you who have taught at the graduate level know that teaching from a pre-existing syllabus is easier and less time-consuming than writing and proposing a pilot course. But I was enthusiastic about the topic, which fueled my work ethic. And this has set up a virtuous cycle, where I get more recommendations for reading or TED Talks than I can handle, and referrals to work with those patients.
I’d be lying if I said I didn’t hope someday to become famous or rich, but it is more likely that I will make a decent living and have a modest reputation. Because as I said there are thousands, no millions of people out there who have talents and interests to share with the world. I’m just grateful I got lucky enough to be one of the ones who got the chance to do it.
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