Speaker A: Welcome to the therapist burnout podcast, episode 67 today. Therapist. I have a guest, Shulamit Behr. Lev Tove. I am so grateful to have her on the podcast, and she’s going to share a little bit about her burnout story and also just a little bit about entrepreneurship, money mindset, money drama that I think we’re in right now as therapists and healthcare professionals and people who are trying to find different ways to make money, perhaps. Shulamit, tell me your born out story.
Speaker B: Once upon a time, I was running a thriving group practice, and it was August 2020, actually, and completely unrelated to Covid. You know, everything was looking great on the outside, but on the inside, I was a wreck because as many folks who run, who are in solo practice or who run group practices, running a business is hard on your mental health because you’re wearing all the hats. And most of us are still providing direct client service.
And so things really came to a head in the space of a week, really, where I, you know, my beloved and I, we don’t have the kind of relationship where we fight over taking over, the. Taking out the garbage.
But I. I bit his head off about something like that. But worse than that, a team member had made a mistake, and instead of speaking to the team member privately, I address the mistake in front of the whole team, which is very poor leadership, but also pretty harmful interpersonally.
Right. And it just is not behaving like, if we think about what it is as therapists that we’re trying to accomplish in our work, it’s completely out of alignment with our values.
And so at the time, I was thinking that I was legitimate in having these feelings and in discussion with my own therapist, he was like, well, yes, you’re reasonably frustrated and upset, but the fact, the. The way you’re behaving in response to that is a problem. It’s a symptom of something bigger.
I think you need to take a stress leave. Hmm. And as I was considering that, you know, I saw the rightness really, of what he was saying, that the.
The mental health toll, the stresses of the business were too much for me. And the proof of that is in the lack of sleep, the headaches, the body aches, and.
And the way I was behaving with my team and with my beloved, the most important relationships, really, in my life. So after consideration, in fact, I didn’t take a stress leave.
I exited the business, and then after that, took a month of stress leave because it was Covid. I’d been saving to go to Cuba. But I took my Cuba money and had a month of stress leave instead and then returned to solo practice, which is much more manageable for my mental health.
Speaker A: Yeah, I mean, I don’t, I haven’t really talked with someone much about a group practice. And I have people that maybe want to start a group practice because they’re trying to get out of one to one.
And in my mind I’m like, that seems like more on your plate.
Speaker B: It can be more on your plate. It’s not. It doesn’t have to turn out that way. That doesn’t have to be everybody’s story. And that’s part of the reason for the work that I do now is so that I’m a therapist for entrepreneurs.
And my favorite entrepreneurs are solo practitioners or group practice owners. Because it doesn’t have to be that way for you like it was for me. And at the same time.
Yes. Unless you’re really keen on running a business, it can be a lot more work. That’s true.
Speaker A: Yeah.
Well, you know, I, I think, you know, reflecting back on my story, you know, a lot of my story was I had a solo practice that I. It was Covid.
It was so many things. There were so many layers. But part of that was I just felt like I couldn’t do that anymore. And I think about, for therapists, maybe they’re in an agency, maybe they’re are thinking about private practice, but they don’t want to burn out.
They don’t want to set up the same systems that they came from, which.
Speaker B: Yes, yes.
Speaker A: Are not great.
And I wonder if I had gone into it with a really solid understanding of business, with understanding my capacities and how much money I actually needed to make for this to be sustainable, maybe I could have made it. But I think therapists come into this without education and business.
You know, all the things. You know this. Right. But I’m just wondering from your perspective, like, what do you think it takes for a therapist to make it in solo practice and not feel like they’re isolated, they’re alone, they can do it, they can make money.
So I just put a lot out there, but I’ll let you take a piece of it.
Speaker B: Well, I would say picking up on the theme of money, we talked about this off mic before we started the recording.
The Clonts, Ted and Brad Klontz, who are two psychologists in the US who have done research into the psychology of money, looked at what professions score the poorest in terms of financial. Well, being emotional. Well, being around financial psychology can you guess what the lowest scoring group was?
Speaker A: I, I think I don’t have to guess. I’m sure it’s us.
Speaker B: Mental health professionals. Yes.
And we come from a tradition, you know, especially if you’re in particular a social worker, where it’s a noble profession. Our roots were in do gooders in the early 1900s and it was, it was meant to uplift and it was volunteer privileged women and social work kind of grew out of this social change, noble pursuit.
By implication, of course, we’re not supposed to be making money.
Speaker A: Right.
Speaker B: Also, the vast majority of mental health professionals are women.
And the social role around women’s work, the social scripts around women’s work, is that it has less value than men’s work, care work has less value than production.
And so when we come into, as therapists, into business for ourselves, we’re carrying all these ideas about money.
And we also have our care for our clients and our concern for folks who are quite realistically multiply disadvantaged, having to find the funds to pay for services. And all these things come down on us and make it very difficult without examination and without personal, what we might call money psychology or mindset work around money.
It makes it difficult for us to even conceive of how we could sustainably earn a living. And especially if we come from the agency or the nonprofit world where we’re consistently underpaid anyway.
It’s a whole lot of baggage that when, if you come into business with this stuff unexamined, you don’t even begin to know how to structure your business in such a way as to support you in your day to day needs. Right?
Speaker A: Yeah.
Speaker B: So I would say first of all there it’s kind of two pronged. You want to get support around what, what popularly is called your money mindset. But I would look at a person who’s well grounded in the psychology of money, rather than some money mindset expert, a therapist who understands psychology and money, who understands mental health and money, and concurrently to get some education around money that’s accessible, education around money that’s meant for especially women, so that you’re not shamed and blamed and intimidated out of asking questions, so that you can understand because it’s not that hard. What stands in the what’s in the way is our shame and our discomfort.
And if you can take that two pronged approach of getting the information you need in a, in a, in an accessible way and getting the support for shifting your thinking after caring for your feelings and your emotions around money, then you’re set up to thrive in your private practice.
Speaker A: Yeah. I think it just reminds me of Rachel Rogers when you talk, because I, you know, I think I read her book probably two to three times.
Speaker B: Yeah.
Speaker A: For myself, just to try to internalize some of these beliefs and the research in the early part of that book where she talks about most women and just the history of us holding money, like women just have not held money until very recently.
So, so I think of. And I’ve talked about my grandmother. My grandmother, you know, had a little job. You know, she worked at J.C. penney’s, which is a department store here in the U.S.
i don’t even know if they’re still open. I don’t. I think they might have closed.
But that was just like her little money, right? Her little money.
Speaker B: Same.
Speaker A: Had a little job right on the side. Yeah. And that was, that was new for.
Speaker B: You know, it was only. I forget at what period, but I think it was only in the 80s when women could have credit cards and, and get a loan without being co.
Signed. Like it was very recent that women could be independent with their money. And another aspect of women’s money is that we are told to save, not to ask for more.
So women are told, don’t have the latte, don’t have the avocado toast, don’t buy the pretty dress. Right.
Speaker A: Spending too much.
Speaker B: Right.
Nothing’s the matter with spending, just like nothing’s the matter with saving, except that when spend. When saving is all you’re told to do and you’re shamed for spending. Women need to be empowered to ask for more, to make big asks, to say what they need to thrive and flourish, not just their very basic. Have their very basic needs met. But even in personal finance, women are told to save and men are told to invest and take risks in the market so that they can get greater returns over time.
And women are told, spend less and save your money. And this, these, this way of thinking comes through when women then set up businesses.
Speaker A: Yeah, yeah, I think. And I just know it in myself. When I started my business, it was very much out of scarcity. I had a son who had heart surgery and I was like, okay, this is a way I can work and, and still work and hopefully be there for my kiddo.
And I started really messy and really scared.
Speaker B: Yeah. Well, most people do.
Yes, most people do. There are two categories in the entrepreneurship research of entrepreneurs. There are entrepreneurs by choice and entrepreneurs out of necessity. And most women. And most entrepreneurs, most small business owners are out of necessity.
And the majority of women do it because they need the flexibility.
So they, they don’t. They work much harder than they ever did at a job. But because they can work at night when everybody’s gone to sleep, because during the day they want to be available for whatever needs there are.
Right. Women choose to work for themselves because they can’t get this kind of flexibility in an employed in a 9 to 5. Right.
Speaker A: Yeah. And again, we hadn’t had to make these choices until just recently either. You know, women typically had stayed home with children. And so I think, you know, these, these present generations that are still working, it’s like wrestling with these decisions, I think is really tricky. Number one. And then going into business, not really having a solid understanding of money, of finance, of business in general, which we aren’t given in our education as therapists or psychologists. I think I had like, I don’t know. No, I didn’t even have a semester. I was like, did I have a semester class? No, it was, I think that was more like program development or something.
But there’s majority of therapists going to private practice. But yet we have no business.
Speaker B: There’s no business component to our training. Yes.
Speaker A: Like I was talking to a chiropractor and they were saying like, oh, there’s this huge business component to their training. They teach them how to start their practice, how to. Because most of them, they know, go into private practice.
And I was like, oh, well that’s nice that you have.
Speaker B: But I think, I think that that reveals the way our programs are structured. Social workers, psychologists, psychotherapists. The way our programs are structured reveal assumptions about women’s work. Again.
Speaker A: Yeah, right.
Speaker B: We’re not, it’s not assumed that we’re going to be independent. It’s assumed that we’re going to be salaried at some nonprofit or some community agency or at a hospital or something like that.
What do we need to know about money?
Speaker A: Yeah.
So how would you suggest someone who is. Maybe they’re like, I am really unsure about money. I know I need to make more money. And I think for my audience especially, they are either looking to get out of one to one.
They’re looking possibly to start a private practice. Most of them are burnout.
Speaker B: Yeah. They’re just done. Absolutely. They’re just done.
Speaker A: They’re just done. So they’re figuring out, can I make, can I do something else maybe or look for another job. So what would you encourage them to think about? Either money wise or just entrepreneurship wise, what they might want to think about.
Speaker B: I think Something you brought up when you were talking about your reason for beginning your private practice, which was out of scarcity.
Speaker A: Yeah.
Speaker B: Right. I think you mentioned the word scarcity. And it’s really important to recognize the impact of scarcity on the brain because scarcity registers in the organism like any other threat. Scarcity of time, scarcity of love, scarcity of belonging, scarcity of money, scarcity of food, any kind of scarcity.
And also if you grew up in a climate of scarcity of any of these things, then you’re going to be, your nervous system is going to be just like in trauma survivors. Right. Your nervous system is going to be much more attuned to the adversity that you went through.
So to recognize that scarcity.
There’s a lot of talk in the world when we think about, when we, when you’re looking online about money, stuff about scarcity mindset. And you just need to think abundantly and like.
Right, same, same.
Scarcity. Psychology is a real thing.
Speaker A: Yeah.
Speaker B: And it’s adaptive, it’s about survival.
And so when you, you’re faced with scarcity, your brain is going to respond a certain kind of way.
And so when you’re thinking about. Because when you’re feeling stuck in your job and burnt out and wanting to leave but finding no way to leave, there’s this experience of being trapped, but also this experience of scarcity, like there are no options, there are no choices.
And the scarcity around money. This is the only way I can pay my bills and put food on my table.
So when your money, when your brain gets in the scarcity mindset, it does a thing called tunneling, where it’s focused only on the immediate moment and all the long term. And this is not unique to scarcity. It’s, it’s a, it’s something that happens when the mind is under threat, when the, when the organism is under threat.
But applied to money, you know the, they call it tunneling, where your focus is only on the immediate survival needs. And so that’s why sometimes it’s hard for folks when you’re feeling burnt out and stuck and desperate to go, but afraid that you can’t see any other option, that you can’t think creatively about what else I might do.
You can’t even look for work on the weekend because you’re just so head down, feet on the floor, trying to manage your day to day.
So I would say the very first thing is to get some support, maybe from a peer, maybe from a therapist, maybe from somebody you trust to talk this over with to offer your organism some care around its survival needs and how it’s activated for survival now.
And what also can happen is people will shame and blame themselves for the actions that they take under scarcity.
Right. So at the same time as you might want desperately to leave, you might also be engaging in some really crappy self talk around.
You know, you’re a smart person. What’s, what’s the matter with you? Why can’t you come up with a solution? Why aren’t you looking for work but you’re under such stress that on the weekend all you can do is collapse and you know, doom scroll or watch Netflix.
These are all in the moment tunnel based strategies to help you cope with rights, what’s right in front of you.
Speaker A: Yeah.
Speaker B: So whatever you can do to support yourself in moving, like expanding what falls in the tunnel or shifting out of the tunnel and into a wider vision of things can really support you then in, because in, in finding a way forward.
And I would say it’s almost impossible to do by yourself because of the amount of dysregulation and how the brain behaves when it’s, when it’s dysregulated. It’s, it’s better to get some support even just from a peer who gets what you’re going through and is, is willing to listen supportively so that you can kind of come to yourself and see beyond the tunnel.
Speaker A: Yeah.
Speaker B: So that then you can begin to develop some really creative solutions to the problem that’s facing you. That’s where I would say to start with some good old self compassion and support.
Speaker A: I always say, you know, I talk to a lot of burnout therapists and they want the answer, you know, Jen, what is the job that I can get? What is my bridge job?
What is the la la la la, what is it? And I, you know, is it, you know, I’m going to do a utilization review job. Is it this? I’m like, I don’t know what it is.
What I do know is that you’re really overwhelmed, you’re over taxed. And what I do know is the opposite, the positive opposite of depletion is creativity.
Speaker B: Yeah.
Speaker A: So we cannot access creativity when we are in chronic depletion. So being able to create that space, you know, is like that. I always say, like there’s not going to be one thing that does it and that’s with anything like a therapist. We know this. Right. We know that change does not happen miraculously.
Most often it can. I’ve seen, you know, I was an EMDR therapist and I’ve actually seen some symptoms completely alleviate.
Speaker B: Yeah.
Speaker A: And so I have seen it happen. And so, yes, we can have breakthroughs, but oftentimes that change is going to come from like that small daily action of like, okay, I’m going to like, put up my phone at night and just give myself more rest.
I’m going to, you know, make that coffee chat with a friend and I’m going to keep making the slow, deliberate action to try to, you know, I think of like a ship that needs to turn.
A big ship.
Speaker B: Yes, yes. It takes, it’s by increments, by little degrees.
Yeah.
Also one little turn. Yes, we do want the change now. But I would say, you know, I’m, I’m actually horrified when I think of the number of therapists I know who don’t have therapists.
Yeah, we therapists need therapists.
We absolutely need somebody to help us metabolize what it is as stewards of trauma, to use a term from Laura van der New Lipski, who wrote a book by the same name.
As Stewards of Trauma. We need someone who can help us with our stewardship.
And when you have your therapist, your therapist is the person who can help you go through the decision making process, through the, the compassion process, the process that enables you to brainstorm and think creatively about what your ne next steps might be.
A life coach can also do it. But I think as therapists we need more than just the coaching because of the weight of the work that we do. And I’m, you know, it’s just much more accessible for many of us to, to get a therapist, especially if we’re employed right then many of us have benefits and so we can work with the therapist, but to have someone help us do the creative brainstorming and you can say, even if that isn’t something your therapist does, you can say to the therapist, this is what I need from you.
I need your support for creative brainstorming so I can, I can problem solve. And they should be able to meet you in that.
Speaker A: Yeah, I mean, definitely. I mean, I, I think I’ve used my, used my therapist. I’ve had the same therapist, you know, for five years and has seen me go through all the iterations of everything.
Okay, maybe I’m going to lunch intensives or maybe I’m going to start a group or maybe, you know, as I was thinking of what I can do to make my practice work and so I definitely leaned on her, I, I had a therapist, a coach, a pt you know?
Yeah, I had, I feel like all the things, all the things that, to kind of make those, those shifts that we, I think that we need to.
Speaker B: Make because we’re simply stronger with support. We are just stronger with support. There’s such a theme about rugged individualism that pervades particularly the US but it’s also present in Canada. And I just can’t say enough, loudly enough, strongly enough how much stronger we are when we are well supported.
Speaker A: Yes. Yeah. And I think for therapists, I don’t, especially for those in solo practice, I don’t think it was their intention to be an island.
Speaker B: No.
Speaker A: But they found themselves on an island. It’s like what I was in school and I had all this support and I was in an agency or I was, you know, wherever I was.
For me, I worked in neuro rehab and, and then I landed in private practice and I was like, what, what, what happened to my friends and my colleagues?
Speaker B: It’s so isolating.
Speaker A: And so I think if you’re doing it, it’s, it does, it does create another layer of making sure you’re intentional about getting that support somewhere.
Speaker B: Yes. Well, when I talk to entrepreneurs about their mental and emotional well being, I talk, we talk about how you should have a business plan for your business. And in your business, just like it has a marketing plan and a financial plan and a cash flow forecast and all those kinds of things, it also has to have a mental health plan for the founder. That’s you. And as therapists, we need formal ways of checking in with ourselves. And so we need to know what our warning signs are and we need to be checking in with ourselves on a regular enough basis.
Hopefully weekly. Hopefully. Every therapist takes a few moments.
We should take like five minutes once a week to check in with ourselves to know and we should, we should have kind of like a checklist of what are, how we know we’re doing well and how we know we’re doing poorly and when we’re doing well to recognize that and to recognize what is it that’s supporting us in doing well and when we’re doing poorly, how we know that we’re doing poorly and what it is that we’re missing that we need to reinstitute or that we need to engage newly to help us so that we can do well.
When we don’t check in with ourselves, you know, then we find were smack up against the wall and we’re like, how, how did I even get here? And that was my story in my business. I wasn’t Checking in with myself.
I didn’t. Even though I had therapy, it was, it was.
I wasn’t thinking of checking in with myself in the context of the business aspect. You know, I was metabolizing, like difficult moments with clients. I was metabolizing difficult client stories, you know, the pain and distress I was feeling around being a listener for those things, you know, and during COVID especially, we’re. We’re never supposed to be therapists for people, support people who are having things going on with them that are alive in us at the same time. But in Covid, none of us had any choice. We just had to do it.
And so I was working on that, but I was completely oblivious to the daily check ins about where. And you may have talked about the window of resilience before. Where am I in my window of resilience?
How close am I to the top or bottom? And what do I need to do to get myself back into the middle? We need these check ins.
Speaker A: Hey, therapist popping in here to remind you to sign up for the pen pal list.
So my therapist pen pal list is where I talk to you about more vulnerable things, even on this podcast about burnout, about stories from my life, things that coming up for me with my clients, my therapist clients, and when I’m just learning more and more about burnout and really about being alive, about living.
And so I write back and I am also sending you first anything that I might be offering, free offers or paid offers that are forthcoming. So sign up for the pen pal list. The link is right at the top of the show. Notes back to your program.
And again, I think I go back to what you said. I don’t think we can do that for ourselves in solo practice. I think we need that community, we need that support, some kind of cadence of human, like person to person, eyeball to eyeball time with another human where we’re connecting and just someone that can check in with us just to know,how are you doing? A lot of us are working more virtually. I mean, at the time in Covid, I, I was, I had an office mate. But they actually, they came into the field March of 2020 and subsequently left.
Speaker B: Oh, man.
Speaker A: Like the next year. It was just, you know, a lot of therapists I’ve heard from started around the time of the pandemic and just now are feeling really crispy because they’re just like, I, I probably didn’t start very sustainably because I remember that energy that we have, we all had during that time as therapists, at least for myself. Was like, you know, first all my clients didn’t come in for about two months.
And so I was like, oh, our clients aren’t going to come in. I didn’t get any more referrals. And then scarcity comes up, right? Yes, there’s not going to be enough clients, there’s not going to be enough work.
And so whatever clients called starting in May, it was like, I’ll take them, I’ll bring it on. Yep, yeah, I can do that session. Yep. Keep going, keep going, keep going.
I didn’t think about the pacing and I talk about pacing so much because I come from Neurorehab. And so I worked with people with brain injuries and their pacing was a necessity or they would literally be in the bed for the half of the day.
And I think for the entrepreneur, for the therapist, I mean, now that I’ve been through a pretty dramatic burnout episode a couple years ago, I can end up being wiped out for a day or know half a week where I have low energy or I have a depressive episode.
And so I know I have to do these things now or.
Speaker B: Well, I think those of us who have had burnout experiences are like the canaries in the coal mine.
Because the prevalence of burnout in our profession really reveals a weakness of the profession, a weakness in the way that we are trained, a weakness in the discourse around. You know, what I noticed in my program was that there was a lot of lip service to self care, but the program was extraordinarily demanding at the master’s level.
Self care was not built into the program. We were expected to, to, to engage with therapy or support on our own time. But I don’t know about you, but like with what time exactly?
You know, there just wasn’t any. Between notes and clients and classes and placement, like there just wasn’t.
And. But the idea is that if you engage in enough self care, you will be okay and that if you’re not okay, it’s your fault because you didn’t engage in enough self care.
Speaker A: And that’s still the response. That’s still the response I hear.
Speaker B: Yeah. And in thinking about this and understanding, especially after again reading Laura Van Dene Lipsky’s book,
Mental Health Challenges are inherent in the practice of therapy of mental health care. Yeah, it’s, it’s, it’s a part of the work and it’s a part of being a human doing this work.
So given what we need is a training that acknowledges the inevitability of these things and gives us a structure that supports our well being, but also supports us and doesn’t blame us when we do have difficulty.
You know, and it was through my thinking about burnout as a therapist that I came to what I talked to about entrepreneurs, which is mental health challenges are inherent in entrepreneurship as well.
And when you break down, it’s not a personal individual failing, it’s a function of the way this work is structured and the systems and processes we come into. So in agency work, the moral injury that we experience, the pace of work, the overloaded caseload, the implication that we should actually be fine with all this, and then the blame and shame that’s given when we don’t do well, like we are the canaries in the coal mine.
This is, this is the expression of a systemic problem coming through us as individuals.
The burnout. Say this again in our practice.
Speaker A: Oh, I love that. The expression. Say it for me.
Speaker B: When an individual burns out, that’s an individual expression of a systemic issue.
We don’t see the system. The system is invisible. What we see is the individual burning out.
Speaker A: Yeah. And they’re to blame.
Speaker B: They’re to blame. Absolutely. And what I like the image of a mushroom because a mushroom is not just the one mushroom that we see above the ground. The organism, the mushroom organism extends for kilometers underground and we see one mushroom.
And when we see. And the tree is the same, you see one tree. But we know that there’s a network underground that is the tree organism or the mushroom organism.
And burnout is like that. Individual expressions of systemic issues are like trees or mushrooms. Unless we know to look underground, we think it’s a mushroom, we think it’s one therapist who burned out.
But when we see one therapist who burns out, we need to realize, wait a minute, there’s an organism that extends for kilometers underground?
Speaker A: Yeah. Yeah. I mean, I think I’ve been talking often about the systemic issues that are inherent in our field.
Speaker B: Yeah.
Speaker A: I also don’t think that therapists who are in solo practice see themselves often as entrepreneurs. No, that’s right. I wonder if you could speak a little bit to, you know, I, I know some of the research on mental health in entrepreneurs.
Just if we’re just talking about mental health and entrepreneurship, take therapists out of it, but just talk a little bit about that and, and what we see from the research or what you see from your work.
Speaker B: Well, there are, there are, there’s a bunch of interesting information, the first of which, the grandfather of research into entrepreneurship and mental health is Dr. Michael A. Freeman. He’s a psychiatrist And a psychologist who conducted research at, I think it was Berkeley in 2015.
And he found that 49% of entrepreneurs have at least one diagnosis. I think if I’m getting that information right, but I’ll give you the link to the study and you can put it in the show notes for people to double check.
But interestingly, he talks about two aspects. He says what we bring to the party and what the party brings to us.
What the party brings to us is the inherent high stress, the isolation that entrepreneurs face. There are all kinds of the high stakes, the high demand, the being a leader.
The nature of that work has an impact on your mental and emotional well being. That’s what the party brings to us. But entrepreneurs also, interestingly, come from a pool of people in the general population that are predisposed to mental health challenges.
And he has, he’s done a more recent research, which I can’t cite, but I’ll send you the link as well and we’ll put it in the show notes into the dopaminergic systems that express through entrepreneurship, including ADHD and bipolar disorder.
And that folks who are entrepreneurs.
He says entrepreneurship is an expression of the neurodiversity connected with the dopaminergic systems in the brain.
So that one expression of this neurodiversity is entrepreneurship on the one end and diagnosed and institutionalized mental illness on the other end.
He noticed that many of the entrepreneurs that he studied, if they didn’t have a diagnosis, they had a close family member who had a diagnosis. And we know that neurodivergence runs in families as well.
Right. So it’s just so interesting to look at how these things combine. And also so many women, as you talked about before, from the circumstances in their lives, will establish businesses. And this is as much the case for solo practitioners that our life baggage leads us to establish businesses.
For example, women of underestimated groups who’ve experienced micro, so called microaggressions in the workplace, like racial trauma is a thing. And when you’re done, you know, when you see racial trauma and you decide, this is it, I’m done with it, and you open your own private practice.
But you, you’re you, this lives in you, your trauma lives in you, and you bring that to your practice. So there are, it’s such a complex constellation of factors that show up around mental health and business, whether you’re a therapist or not.
But all the more so if you’re a therapist because of the mental health impacts of being a therapist.
Speaker A: Yeah.
Speaker B: So it’s very complex and very rich. And all of that is an argument to get support.
Speaker A: All of it’s an argument to get support.
Speaker B: Yes.
Speaker A: Yeah. And, and I think,
you know, I often thought about, and I did, I’ve done like series on what I could, what I would do if I could do it over again. If a therapist wants to thrive in entrepreneurship or in private practice.
So I’m wondering if you could give any tips or learned lessons from what you’ve seen and what you’ve learned in being successful. If they want to do this, if that’s their.
Speaker B: Well, when I started out and when you start out, you don’t have a lot of money. So there are two really great books and again, I’ll give them, I’ll give the links and you can put them.
I can’t remember the name of the author. I think her first name is Lynette. But she has a book and a workbook. And I worked through those two books, the book and the workbook.
I was already practicing because I mean, you gotta eat. So I was already, you know, I had my shingle up, I was seeing clients. But in the course of the first two years I went with another therapist friend who’s also establishing her own private practice and we worked through the book and workbook together and that gave us some of our business foundations.
There’s another excellent book that was actually written by a Canadian about how to establish your mental health practice in Canada. But there are many things, the systems and structures apply regardless of your location. So I’ll give you the links and they give you the sort of behind the scenes systems and structures and processes that you need so that your business doesn’t make you nuts.
One of the most simple examples that I can think of is the idea of a canned response where you often get inquiries. It’s the same questions over and over and over again.
So when you write your response that you have it ready to copy paste because the basic information, my fees, my hours, whatever you might need, like what your designation is for insurance purposes, inviting people to check with their, their insurance company, it doesn’t matter what their issue is, you’re always going to have to share this information.
So to this day I still use a canned response. When people has an inquiry and I address them by name, I respond to what they’ve said in their inquiry. So there’s the personal relationship part that’s fresh every time from the heart.
And then the core of the message is all the information that they’ve asked me for and then, and Then I sign off having to write that every time, which in the first year and a half or so I was.
And the time it takes, it’s 5 minutes copy paste with the personalized introduction compared to 15 minutes having to think, how am I going to write this every time? And that’s a very simple system that can save you a lot of time.
And if you can set up systems and structures in your business like this, then this helps you. Because we have limited time and energy.
It’s their efficiencies that give you the resources to do the things that are really meaningful to you, like being present with clients.
Speaker A: Yeah.
And I would add, if you need to hire, I know you a lot of people. Like, I didn’t hire someone in my private practice for probably five years, but I did my billing for many, many years.
And so, yeah, because I felt like I had to do everything. So I was the website, you know, I was, I was my web developer, I was the billing person, I was the, you know, janitor, everything.
And a lot of us do that. But I think at some point we have to get to a point where we do outsource. In thinking of potentially your first outsource might be home care.
It might be dropping your laundry off.
Speaker B: It might be. This is Rogers. Rachel Rogers.
Speaker A: Right.
Speaker B: Staff up. Your brilliance is with your clients. That’s why you’re doing this work.
Speaker A: Yeah.
Speaker B: Why clean your house? But again, this comes back to some of the mindset around women and women taking up space and having needs and getting their needs met.
You know, we’re supposed to be able to do all these things. And then we have also some sense of shame. I can’t do my laundry. No, you’re choosing to do your laundry.
You’re choosing to support yourself, to bring your full capacity to your practice. Or, and I would say this, even if you’re employed, you know, when you’re at a job, part of what is so debilitating for any woman who works is the double shift. Right?
Speaker A: Yes.
Speaker B: And if you’re in a position to be able to pay for support at home, buy it. Your peace of mind, your presence with your kids, your partner, your presence with your clients is worth every single penny.
Speaker A: Yes.
So good. Yeah, I, I think thinking of that, and it’s going to make you less stressed and potentially you could make more money because maybe you can see an extra client.
Because I’m not doing laundry for two to three hours. I’m not cleaning my house for two to three hours on the weekend. So I can do, you know, Admin stuff or whatever that you got to do.
Speaker B: Yeah.
Speaker A: But I think just. I wish I. That’s one of the recommendations I talk about is hire someone before you think you need to because you’re likely stressed out by admin work.
And so getting support systems is part of that. And I think, you know, apparently AI is going to save us from all this. That’s what all the bros tell me on.
Please. No, I just. My last episode was on AI and actually AI therapy chatbots. And it’s just weird I even saw something out there. What’s his name? Who? He’s a journalist and a therapist.
But he post about. They have grief therapy. They have grief chatbots where you like recreate a loved one that has passed.
Speaker B: Oh yeah.
Speaker A: And talk. So it’s not a therapy, but it’s just. I’m just like, whoa. Like this.
Speaker B: I hate to sound like an old lady, but I’m going to sound like an old lady.
In an era where we are alienated from one another and separated and what we’re suffering from is a lack of connection, a lack of 3D felt presence of other people in our lives.
Speaker A: Yeah.
Speaker B: And that a lot of the harms that people experience who come to us for therapy are interpersonal harms.
Because living under capitalism and living under the systems that we do now are. It’s harmful, it’s stressful and for some people, flat out traumatic.
What is the healing for this? The healing for this is relationship.
And so I fail to understand.
I’m not anti AI. I’m not. And at the same time replacing human presence, the facial.
What happens when we see and relate to one another and look at one another eye to eye. The soft eyes, the micro expressions on your facial structure, the breathing. Right.
Just the being together when you’re in pain and distress and you’re with another warm, alive, caring human.
That’s what’s needed, not more bots.
Speaker A: Yeah, yeah. That’s why I think a therapist will be fine. I don’t. I think we will always need therapists. They might add AI, they might, you know, have some other applications, but it won’t be a replacement for humans.
Well, speak.
Speaker B: Coming back to burnout. I think that how AI can support us in doing notes. Something that I’ve recognized about notes recently is the how they contribute to actually my depletion because I have to revisit the session every time I write the notes.
So I’m doing. Most of us are doing double sessions because in order to draw from your memory enough to sufficiently to write not to mention the cognitive labor. If you’re working with diagnostic categories and having to fill in things for insurance so that you make sure that the person gets the coverage, that’s cognitive labor. But then there’s the emotional impact of having to revisit the session. And if we didn’t have to do that kind of work because we had the support of AI in a secure, a digitally secure way that doesn’t breach confidentiality, that’s a way in which we again can mitigate the labor we do in our work so that we can be fully present for caring so that we are better, we are more well and our clients are more well. Just like getting support at home. It’s the, the more we’re supported, the better able we are to do our work and the less likely we are to burn out.
Speaker A: Yeah, I mean I, I think it will.
I just wary of, of who is behind whatever service and I think, I think they’ll get it right at some point. But I just. It’s not there yet.
Speaker B: Well, it’s early, it’s early days. But I do think the promise is there. Yeah.
Speaker A: Yeah, I saw an interesting one. It was like Quill or something. I don’t, I don’t recommend it. I don’t know. But it was more like you can say a summary and then it will generate something.
So it was interesting. I’ll have to look to more. I’m not working as a therapist anymore, so.
Speaker B: Yeah, well, my doctor was like super excited. They, they, of course they’re introducing it in their clinic, my medical doctor. And they have to tell every client at the first session when they are using the AI to make the notes about that.
So they have. Because you have to. It’s a consent based process. Right. And my doctor was so excited and she knew that I was a therapist and she was like, you gotta try this, it’s so great, blah, blah, blah.
So I mean, and this, it’s similar to what you were saying where she says it creates a summary for her and populates her notes based on her summary. So I think that that’s even a labor saver.
Speaker A: Yeah, definitely.
Speaker B: Yeah.
Speaker A: Well, we have to. I could talk to you all day, but we should wrap up for today.
What would you.
Maybe one piece of advice you would tell someone who’s in burnout right now.
Speaker B: I’ll refer to something that we’ve, we’ve talked about in implication. We’ve. It’s been implied in everything we’ve said. But I’m going to say it explicitly. There’s nothing wrong with you.
It’s not a personal failure that you’re burnt out.
It’s a result of the systems coming to bear. You’re a mushroom, right?
It’s not you, it’s the system.
And you’re the canary giving the early warning signs to the rest of us who are living unsustainably. You know, it’s just. There’s nothing wrong with you.
Speaker A: Yeah. Oh, so good. Where can people reach out if they would like to follow up with you?
Speaker B: My website, Shula Ca. S H U L A and CA for Canada, because I’m Canadian.
And if you wanted to keep in touch, I’d invite you to subscribe to my newsletter, Shula Ca Newsletter, where I talk about topics like this all the time.
I don’t run programs. I don’t do launches. I really just talk in my newsletter about things that are, like, deeply meaningful, like we’re talking about today. So I’d love to have folks join me there and we could be in dialogue when you hit reply.
Speaker A: Awesome. That’s so great. Well, I’m sure people want to reach out and hear more from you. Thank you so much for being on the podcast today.
Speaker B: Thank you for having me.
