Stuff Happens: The Personal Side of Private Practice

Over the course of running a professional private practice, it is inevitable that difficult "stuff" will happen in one's personal life.

We know this as therapists, we see it with our clients, and we experience it in our various life responsibilites. Yet our unique positions as clinicians in this sometimes taxing work, often does not allow for personal struggles and disclosure within our professional roles.

When the ripples, waves or tsunamis arrive, we cannot (and should not) discuss our personal challenges with our therapy clients.

If we work in a solo practice, it can be isolating as there may not be other clinician friends to discuss our hurts and fears with.

And, some therapists share that even though they work within a group practice, or belong to professional organizations, they feel too vulnerable to share about a current struggle. I've had coaching clients say to me, "Mari, what if I am judged. What if I open up to my colleagues, and then they don't want to refer to me because of this situation?"

I find this to be one of the most heartbreaking aspects of this field that I love so much. Why is it that therapists know how to support clients heal and move out of shame and pain, but don't always know how to do this well for self or for others in our profession? Yes, most of us have good friends and family members who love us, and are willing to lend an ear, but if they are not in the clinical field, it is sometimes hard to convey what we therapists experience, especially given client confidentiality and the inability to talk about our "work" in the same way other professionals are able to do.

Personal Pain, Professional Shame?

Beyond the challenge of running a business, therapists in private practice have rich personal lives that bring joy, sorrow, happiness and exhaustion - and everything in between. Sometimes one's personal life cruises along at a steady pace, no big highs or lows, some joy and excitement, followed by the mundane.

And sometimes...stuff happens. Unexpected stuff. Heartbreaking stuff. Infuriating stuff. Shaming stuff. Scary stuff. Deflating stuff. Hurtful stuff.

People or pets we love get sick, or they die. Or we get sick. Relationships have their ups and downs, or end. Kids we love drive us nuts or struggle more deeply than our clients. We get fired, or a project deadline comes and goes, then comes and goes again. We don't pass the test, or get the position, or the employee screws up. We don't make the money we had hoped, or as soon as we had hoped, and bills pile up. A colleague or a group treats us poorly, a client takes his or her life, someone doesn't pay, a project we poured our heart into goes belly up, we support a colleague's dream, extend encouragement, and then...they don't return this when we ask for their support.

Some therapists deal with anxiety, depression, or an addicted spouse or partner. Or they are the recovering addict trying to stay sober. It can be challenging to be present with clients and run a busy practice when crappy stuff happens.

And, guess what? None of us is exempt from crappy life chapters.

Must Be Nice to Take a 5th Week Off

During a recent phone call with a colleague friend who is going through his own stormy season, I was once again reminded of how important self care is. When (not if) the hard stuff and life storms arrive in whatever form, we must take care of self. This may mean a return to therapy, or scheduling a medical appointment, or taking regular time off. This may even mean taking a leave of absence, or asking for support. We know this, we teach this, we preach this as counselors. But, too many of us don't always practice this.

Many of you know that I take every 5th week off - meaning, I see both clinical and coaching clients 4 weeks in a row, and then I take a 5th week off to work on other creative endeavors and income streams such as writing and speaking. And most importantly, my 5th week off is a time for me to step out of my clinical and coaching roles, to get into nature, to reconnect with self and with God. To hang out with my guy, or get together with friends, or just have a PJ day where I do nothing but prattle around in my garden or home with my pets and music. 

What many people don't know is that I made this choice on the heels of a health scare. For most of my 40s I had been juggling my professional roles, building a busy practice, burying two estranged adopted parents who had died in the late stages of Alzheimers, a dear friend passed away, my beloved dog Jack died, I was dealing with relationships challenges, along with some wonderful successes like a best selling book, paid public speaking, and a popular e-book and clinical forms and materials to support our clinical community.

Yet, during this incredibly busy decade of professional and personal highs as well as challenges, I did not take regular time off. In fact, as difficult as this is to admit here, for the sake of transparency, there were 4 years in a row where I did not take a vacation. Not one week, not two weeks, and certainly not every 5th week. In fact, truth be told, I pretty much worked every day. If I wasn't seeing clients, I was doing some other out of office business task.

Eventually this non stop pace caught up with me. What I could do in my 20s and 30s, I could no longer do in my late 40s. And one day, while waiting on a car>to take me to the airport>to catch a plane>to check into a hotel>to present at yet another conference...I found I could not get a full breath of air in my lungs. I was 47 years old, in good shape, no medication, no allergies, no asthma, blessed with great health.

And...I could not breathe.

I recall leaning over a chair in my living room wondering if I was having a heart attack, "Is this what all of the articles are describing?" I thought to myself. I felt as if I were breathing through a straw.

Now, I'd like to share that I cancelled the conference, made an apology to the organization, rushed myself into the ER. But, I did not. Instead, I got into the car>walked on to that plane>checked into that hotel>and I presented at the conference all the while hardly able to breathe. I came home early, and I collapsed. I cancelled my sessions the following week only at the insistence of my partner. I made an appointment with my doctor only at the insistence of my sister. My guy drove me to the doctor for a chest x-ray and a battery of tests the following week.

The results came a few days later, "Mari, you are in great health. But you are stressed. Your adrenal system is stressed. You are working too many hours. And stress, even the good kind, will wreak havoc on a person's body. What you need to do is take some regular time off, and enjoy your life. Maybe you need to check in with a therapist and figure out why it is your are working so hard at this unrelenting pace."

Facing the Fears

Wait? What? Stress? Me? A therapist going to therapy to take care of one's self? What a novel idea! And so, I made the call to my therapist and over the next year, I began processing nearly a decade's worth of unresolved grief and frustration, something I had been trying to out run. I also addressed hidden pockets of perfectionism and co-dependency that had started rearing its ugly head again. It was during this year that I made a decision to begin to take every 5th week off.

Was I scared? Yes, yes I was. I was really scared. I have to pay my own mortgage and bills. I am not married to a rich man, and I don't have family to fall back on. Even though my practice was generating a very nice income...I still contended with what I called, "my inner shopping cart lady",  my fear of one day becoming penniless and homeless. As a former foster care kid, I know that feeling up close and personal. Foster care kids, children from impoverished homes, or women who have had to support themselves know this trauma of the shopping cart lady very well. It is a deep rooted fear that I have worked hard to overcome. And one that I especially love helping my clinical and coaching clients heal.

Yet, the calmer more confident part of me, the healthier part of me, the bad ass boss babe part of me, gently reminded my fearful parts, "Mari, it is going to be OK. You have run two other successful businesses in the past, you took time away from those businesses, and the roof did not fall in. You have been on your own since 16, you have savings and retirement, you have minimal debt. You can take time for yourself and your business will not fall apart. You are not going to be homeless on the streets!"

And I started to trust my intuition on taking this time off.  Slowly at first, and then, over that first year of 5th weeks off, more and more solidly every year.

In the beginning of this new way of working, I was also worried about what my clients might think about my 5th week off.  "What if they need me that week?" or "What if they don't want to work with me any longer?" or "What if my colleagues judge me?" were the immediate concerns that sat in the shadows whispering their dire warnings.

The good news is once I walked through these fears and doubts, I realized that if a client was truly struggling and needed a session during my 5th week, I could provide this via phone, or I could have them meet with a colleague. My taking regular time away also modeled self care for my clients. It allowed clients to integrate the work we had done the previous month. And it gave clients a little breathing room with therapy fees (as I am fee for service vs. insurance). Clients began to share that this week away allowed them to miss our work together and/or to notice the good progress they had been making in their healing journey.

Creating a policy that includes regular time off for one's practice in not only possible, it is profitable. Profitable? Yes, profitable in that you can begin to develop other income streams - such as writing a book, or paid public speaking, or facilitating a workshop, retreat or webinar.

And, developing a practice policy is not a punishment for clients. I learned that I can let clients know clearly at the start that this is my policy at Growth Counseling Services. My 5th week is clearly outlined in my intake forms with a reminder that if the client needs a higher level of support, I will be happy to refer to a therapist with more time available.

I am happy to report than nearly 7 years later, in addition to my 5th week off, I also take 2 weeks of in the summer (no work at all, only play), and I take a month during December. Yes, a month. Did I make this happen overnight? No, I did not. Did the vacation fairy suddenly show up and sprinkle magical dust on my life? Nope, she did not (but magical fairy dust would be a great perk!). Instead my practice policy evolved over time with hard work and determination. It was a slow on ramp to a different way of working. And it is the very best gift I have given myself as a therapist.

Find Your Tribe or Tribe Mates

Perhaps parts of my story resonate with you as well. Maybe you are in a beautiful season of abundance, and take regular time for yourself. Or maybe you are in a shit storm. Or maybe you are somewhere in between. Perhaps you haven't taken regular time for yourself...ever. Maybe a 5th week, while sounding great, is not possible for you at this time. If not, then how about every 12th week? Or how about scheduling at least a week in the summer and a week at the end of the year? It's all about starting somewhere. Don't end up where I was a few years ago, out of breath, overwhelmed, and completely disconnected from my body. Figure out a pace that includes balance and regular injections of fun!

I have also learned that one of the most important aspects of infusing health and well being into one's practice is not to negatively compare your practice with another colleague's practice. Or if you do (we are only human after all) to not allow the head gremlins to start talking trash, "She always does so well at everything, why not me?"; "His life seems perfect, mine sucks!"; "They have it all together, I'm falling behind!" We have all felt this before (well, at least I have). What I refuse to do is to allow those thoughts to then become covert or overt behaviors where I treat a colleague with less kindness or professional generosity, or give them the cold shoulder because I am feeling a sense of scarcity or insecurity.

To that end, I think it is valuable to find other therapists that you can trust and build relationships with, those who will support your professional dreams. Having a trusted tribe or even a couple of tribe mates is so incredibly important in this work.

Perhaps joining a therapy support group is a first start, a hiking club, or even a professional coaching group if you are wanting to create other income streams (i.e. an e-book, on line course, webinar, workshop, etc) in order to free up your time. I facilitate an on line coaching Facebook group for therapists called, "Like A Boss!" - this is a self paced 4 month process where I help 25 therapists create multiple income streams beyond the one-on-one clinical hour. We have so much fun in our "LAB" group and the clinicians I help are heart centered, non-competitive, creative and willing to be of support!   We cheer each other on and remind one another of the importance of balance and self care. Our current group is filled, and our next Like A Boss! group starts in January of 2017.  If you are reading this and need some support and encouragement in this area, you may take a look here - and join us if it sounds like fun!

Supporting One Another vs. Competing with One Another

This is what I know: We are going to have shitty days and shitty seasons as business owners. We are going to see colleagues kicking ass and taking names, and other colleagues struggling along on feet of clay. And we are going to find ourselves in both roles from time-to-time.

When we are in a season of abundance, when we are soaring on shiny wings...that is the time to support other colleagues from our abundance the best that we are able to. Oh, and by the way, this doesn't mean only supporting others who are struggling. When we are in our best place, it means that we also want to encourage and help colleagues who are soaring as well. Don't withhold support out of a place of competition or envy. It's really not a good look, and frankly, it only blocks the blessings from coming your way.

While we are on this somewhat taboo topic, frankly, this is one of the most unhealthy parts that I sometimes witness in our community. It's easy to reach down and offer support to someone who may be struggling, there are all kinds of benefits in doing that. But linking elbows with another colleague whose star is on the rise, that can be a challenge for a lot of therapists. Instead of feeling inspired by colleagues who are doing well in their season of abundance, instead of understanding that those colleagues are finally reaping the rewards of years of hard work, one may feel a sense of envy, or competitiveness. It happens to the best of us. We are not perfect robots living in a Stepford world.

However, our humanness is not an excuse for unkindness. Sadly, I have seen colleagues close off their hearts or turn their backs on those who are doing well, "Her book isn't that great, I could have done better"; "I worked with him, and he isn't all that as a coach"; "I don't want to help promote her, she gets enough attention as it is"; "His keynote speech was boring, what's the big deal?"; "Why should we pay her for her coaching time/speaking time/presentation time? She's doing fine financially and should be happy to help out!"; "I'd swallow my tongue before giving him a compliment!"; "I don't want to share about her work, she's my competition."

Unfortunately, I have heard people in our therapeutic community say these things (or even worse) about other therapists who are doing well. It comes from their own pain, yet this contributes to an undercurrent of scarcity thinking within our ranks. It is so disheartening to witness or experience this, and yet, I have learned to keep a wide berth with the envious Irmas, fearful Freds, and jealous Jennies. I am polite, I am professional, and I send them thoughts of peace and kindness, but I have very good boundaries with that kind of energy. I don't respond to snarky, and you shouldn't either. Shake it off baby! Find those colleagues who celebrate, support and share about the good work you are doing when you are first starting out, and will support and share about the good work you are doing when you are successful too. These are the folks to create relationships with!

You are the Sky. Everything Else is just the Weather.

In closing, this is not easy work my clinical peeps. This is a challenging industry we have entered into as private practice therapists and business owners. Isn't it time to find our joy again? To schedule in time off? Let's not lose our humor and hearts. Let's rise above feelings of unhealthy competition or envy. And instead, let's invest in self care and create meaningful lives. Let's support one another, both those who are struggling and those who are soaring. Let's jettison the gossip and notice what informs our own insecure behaviors...and then be willing to make a change.

And, let's encourage each other in seeking therapy when needed, when facing personal challenges, or just scheduling regular time for self care and enjoyment! If this former work-a-holic perfectionist can do it, I promise, so can you!

If you are "in" on creating a movement of support and kindness with in our community, and incorporating more self care, please share below in the comments, "I'm in!" - let's put our collective energy into creating abundance of health, finances, balance, joy, and compassion.

Are you in?

Kindly and imperfectly in support of YOUR good work and abundance, and without judgement for your "stuff",

Mari