A Therapist Can't Say That

When you became a therapist, what did you think you were signing up for?Maybe grad school prepared you for the endless introspection, the awkward intake sessions, and the pile of unfinished notes that is somehow always waiting for you, even when you were pretty sure you just finished it.Maybe you weren’t too thrown by the onslaught of personal problems your Uber driver suddenly reveals to you when you mention what you do for work.Maybe you’ve even found a workaround for the lower back pain that comes from sitting in a chair all day or a way to yawn with your mouth closed in that mid-afternoon session so your client doesn’t take your drowsiness personally.But there’s some other stuff isn’t there?Probably no one told you that you might join a Facebook group for therapists and be blindsided by a gaggle of other clinicians calling you unethical in response to what you thought was an innocuous question.You might not have expected how much you’d chafe at the same old clichés being trotted out at trainings and supervision groups and on beautifully designed squares on your Instagram feed, finding yourself wondering, am I the only one who thinks everyone might not be doing their best all the time?And while you might have been warned against burnout and been told to stave it off with self-care, you weren’t prepared for the moral injury that awaited you when you entered the mental health profession, and how no amount of meditation or strolls in the woods could erase its impact.For a field that prides itself on helping people talk about things that nobody else talks about, there are a lot of things we don’t talk about. Things that don’t fit with the image of the good therapist that lives in our heads or in the heads of other therapists.Well, I’m Riva Stout and I’m ready to talk about them.On my podcast, A Therapist Can’t Say That, we’re going to be getting real about what it’s like to do this job.We’re going to unpack the clichés you’ve assumed every other therapist believes, and speak out loud the thoughts you’ve thought no other therapist has had.We’re going to let it get messy, complicated, and uncomfortable. And we’re going to say it’s okay for therapists to disagree, even in public, without immediately accusing each other of being unethical.Subscribe to A Therapist Can’t Say That on Apple Podcasts, Spotify, Overcast, or wherever you listen to podcasts. And be sure to share the show with a therapist friend you know is thinking about this stuff too.We’re always asking our clients to get out of their comfort zones. Come get out of yours and get real with me on A Therapist Can’t Say That.Learn more about Riva Stoudt:Into the Woods Counseling

If you’re a therapist, even if you’re far from your practicum days, you can probably relate to the feeling of sitting in a session and being distracted by the thought of whether you’re living up to the standard of a good therapist.And you’ve probably had a moment where you’re sitting with a client or group and you heard something come out of your mouth and immediately thought, “That doesn’t sound like something a good therapist would say.”Who is this mythical good therapist? What are their qualities and where do those ideas come from? When you think about that archetypal good therapist that you compare yourself to, is that therapist a blank slate?Does a good therapist take all the most challenging cases? Do they self-disclose? Do they diagnose and write treatment plans? Are they a quiet introvert? Do they have it all together? Nancy Jane Smith and I are talking through some of these questions today and how uncomfortable it can be when we sense we’re going out of the “good therapist” box.Nancy Jane Smith, MSEd., LPC is a Licensed Professional Counselor trainer, and author specializing in high-functioning anxiety. Nancy completed her postgraduate training in Gestalt Therapy at the Gestalt Institute of Central Ohio and is a Certified Daring Way™ Facilitator, based on the research of Dr. Brené Brown.She has over 20 years of working as a counselor and coach and most recently created Self Loyalty Schoo,l an audio-based program to help quiet high-functioning anxiety. Nancy has written 3 books with tips, lessons, and stories on reducing anxiety, most recently, The Happier Approach: Be Kind to Yourself, Feel Happier and Still Accomplish Your Goals. Listen to the full episode to hear:Why Nancy struggled to feel like a legit therapistHow norms around self-disclosure are shifting and why Nancy is open about her own anxietyHow different therapist subcultures influence the image of the good therapist and create new pressuresWhy Nancy regrets being too passive with early clients and why some therapists don’t talk enoughWhy the good therapist isn’t an effective therapistLearn more about Nancy Jane Smith:NancyJaneSmith.comThe Happier Approach: Be Kind to Yourself, Feel Happier, and Still Accomplish Your GoalsLearn more about Riva Stoudt:Into the Woods CounselingInstagram

I got the idea for this podcast in late 2019. I had been in the field for several years at that point. Long enough to work through the first wave of impostor syndrome, experience my first episode of burnout, bounce back from burnout, get high on the grandiosity when I realized I really was helping people and changing their lives, go through the second wave of impostor syndrome when I realized there were some people I really WASN’T helping, and then settle somewhere relatively comfortable between confidence and humility.When you’ve been in a field for a while, you start to get a sense of its parameters–the things you’re allowed to say, and allowed to think, the things regarded as self-evident truths that are off-limits for questioning. And if you’re like me, after a while, you start to feel really constricted. Because outside those parameters a lot of things are happening, but aren’t being talked about, and there are unallowable ideas and perspectives that might contain pieces of the truth. Truths that, if we confronted them, might actually make our work better. Listen to the full episode to hear:The first time I said something a therapist can’t sayWhy therapists aren’t supposed to admit that they have unmet needs–or that their clients might meet some of themWhy breaking down clichés and archetypes of the good therapist needs more nuance than Instagram can handleWhat’s coming up on the podcastLearn more about Riva Stoudt:Into the Woods CounselingInstagram

The “good therapist” isn't necessarily the type of therapist you want to be.It's not the most actualized version of you as a therapist. It's not even necessarily a particularly effective therapist.The good therapist is about being seen as good and about being able to reassure ourselves that we are good when maybe we don't feel so sure.Maybe we bump up against the specter of the good therapist when we have difficult clients and we genuinely feel at a loss for what to do.Maybe it's when we have something heavy going on in our personal lives and find our minds repeatedly drifting away from a client in session and back to our own problem of the week, because a good therapist wouldn't do that.Maybe the good therapist peeks through the office window judging us when we go against established norms, like when we use self-disclosure more than other therapists might think we should, or talk more in session than we think we're supposed to, or whatever else gives us the sense that we're stepping outside of bounds.And the specter of the good therapist has definitely been much more activated for almost all of us during the past two years of the pandemic.The pandemic has made the gap between who we believe we should be as therapists and who we actually are much, much harder to bridge. Listen to the full episode to hear:How the good therapist archetype creates dishonesty in the name of professionalismWhy therapists aren’t any more equipped than most people to address collective traumaWhy we need to think beyond the good therapist archetype to meet the increasing uncertainty of the futureLearn more about Riva Stoudt:Into the Woods CounselingInstagram

It’s something of a cliché that being a therapist comes with the obligation to do your own work. And it happens to be a cliché I agree with. And if you’re listening to this podcast, I’m guessing you do too.But what happens when the institutions and systems that train us, employ us, and regulate us act as barriers to actually doing that self-work?Today I’m talking with psychotherapist and certified leadership coach, Rebecca Ching. In addition to therapy and coaching, Rebecca also has extensive experience with supervision, teaching, and advocacy in the mental health field and we’re going to dig into dysfunctional mental health workplace culture, how we got here, and why it’s so hard to change it.Rebecca Ching is a psychotherapist, leadership developer, writer, speaker, and host of The Unburdened Leader podcast, where she goes deep with leaders on how the burdens they carry inspire their life’s work, how they still threaten to take them out, and how they rise from them.Unburdened Leadership™ is the work Rebecca has honed to take leaders and entrepreneurs through so that they can have greater impact and legacy.She is also the CEO and founder of Potentia Family Therapy, Inc. and is a Certified Daring Way™ Facilitator and Consultant and Certified Internal Family Systems Therapist and IFS Approved Supervisor.Rebecca also leads, Rebecca Ching Leadership Coaching and Consulting, and is where she develops leaders through coaching and workshop experiences.Listen to the full episode to hear:How grad school, licensure requirements, and low wages pave the way for early-career burnout Why the professional culture of mental health needs to acknowledge the wounds that lead people into the fieldHow the current educational and licensing systems create barriers to clinicians without financial privilegeWhy the emphasis on efficiency from leadership, funders, and the culture leads to therapists who can’t or won’t do self work Learn more about Rebecca Ching, LMFT, PCC, Certified IFS Therapist:RebeccaChing.comThe Unburdened LeaderInstagram: @rebeccachingmftFacebook: @rebeccachingmftLearn more about Riva Stoudt:Into the Woods CounselingInstagram

As therapists, we know about the power of silence and how much someone is saying when they aren’t saying anything at all. And we know how silence around something big, like a client’s suicide attempt, sends the message that this is too big or too scary to talk about.But if we mostly all agree that therapists are responsible for doing their own self-work, it’s necessary to facilitate conversations around the decision-making that precedes a serious event or to simply check in on a clinician.Because we know that in the aftermath of a crisis event, when a therapist says they’re fine, there’s some work to be done.Yet there is a culture of silence from supervisors that contributes to the dysfunctional workplaces in mental health. Silence imbues the event with shame and inhibits the capacity to do self-work.So what stops supervisors from supporting their clinicians after a crisis?Content warning: This episode contains frank discussion of suicide.Listen to the full episode to hear:How supervisors fail their clinicians when they respond to crises with silenceHow silence is tied to the precarity of funding in community mental healthWhy the conflicting agendas of the multiple stakeholders in mental healthcare make clinician professional development and self-work an uphill battleWhy systemic overhaul of the mental health field is necessary, and maybe inevitableLearn more about Riva Stoudt:Into the Woods CounselingInstagram

Moral injury.It’s a term that often evokes images of soldiers deep in the fog of war or perhaps of a surgeon in scrubs holding their head in their hands in the hallway of a hospital emergency department. A therapist sitting quietly in their office or in the cubicle of a community mental health agency’s open office plan isn’t really what pops into most people’s heads when someone says the words “moral  injury.” But maybe sometimes it should be.As therapists, we are in daily intimate contact with the moral complexity of human beings. And we also have front row seats to the profound moral failings of the large systems that we and our clients regularly have to  navigate.Today, I'm talking with Dr. K Hixson, a dear friend, colleague, and mentor of mine, as well as a community treasure in our therapist community here in Portland. Dr. Hixson and I get into some of the big factors that contribute to moral injury among therapists like individualism and the burdens of excessive responsibility that we place onto individual clinicians, and how the larger systems that we operate within prevent us from living out our own values, both as clinicians and as regular humans. Listen to the full episode to hear:How the concept of burnout can turn systemic failures into individual problemsHow the shortage of therapists contributes to moral injury in the fieldWhy therapy can’t be divorced from the context of politics, capitalism, climate change, etc.How the individualized medical and insurance model of care fails clinicians and patientsLearn more about Dr. K Hixson:WebsiteLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:What is Moral Injury - Syracuse University Moral Injury Project

Therapists are tasked with being secret keepers.The first layer of secrecy seems easy and simple. Maintaining client confidentiality. You can probably recite the limits of confidentiality off the top of your head, and you probably do it regularly during intake sessions.Everything else goes in the vault. But the vault isn’t a what, it’s a who. The vault is us.We mostly talk about confidentiality from the client’s perspective. The absolutely crucial nature of it, the ethical dilemmas that come up when we have to breach it, how the client’s understanding of confidentiality impacts the therapeutic process… All very important things.But we rarely talk about what confidentiality means for therapists beyond a set of rules or ethical puzzles to navigate.What does it really mean for us as therapists to be the bearers of all of this confidential information about other human beings? Content note: References to interpersonal traumasListen to the full episode to hear:How bearing witness to the capacity for human beings to cause harm challenges our illusions and contributes to moral injuryWhy the disruption of our expectations of human beings as moral agents has the possibility of being generative, for ourselves and for our clientsWhy our institutions need to support the passage of intergenerational knowledge among therapistsHow therapists experience traumas intrinsic the work and as a result of the systems we work inLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:A Therapist Can’t Say That Ep. 6: Carrying the Weight of Moral Injury with Dr. K HixsonA Therapist Can’t Say That Ep. 4: Doing Our Own Work: Mental Health and Workplace Culture with Rebecca Ching, LMFT, PCC, Certified IFS Therapist

There are so many ways, so many careers we can choose where helping people is the central thing.And the type of helping that we are interested in and pursue says at least as much about us, if not more, than the fact that we want to help in general.Yet, if you ask a therapist why we decided to get into this field, the answer you're most likely to get is to help people.But what are some of the other deeper, more complicated, maybe less flattering answers to why we became therapists? And why is it important to look at those reasons up close?Today I’m joined by Ben Fineman and Carrie Wiita, co-hosts of the Very Bad Therapy podcast, where they not only feature client stories about negative experiences with therapy, but they also call into question a lot of the conventional wisdom about what makes therapy effective and what makes therapists skillful.We’re discussing the reasons we become therapists, consciously and unconsciously, and how that shows up in the therapy room for us and for our clients.Ben Fineman is the co-host of the Very Bad Therapy podcast. He works as the Clinic Director of Sentio Counseling Center and the Chief Operating Officer of Sentio University, two new nonprofit organizations which use the emerging science of Deliberate Practice to improve the quality of therapist training and education. Ben is also an Associate Marriage and Family Therapist in the state of California.Caroline Wiita is a marriage and family therapist trainee in Los Angeles, California. Her interests include the professional development of therapists, postmodern approaches to psychotherapy, and the finer points of cheap wine. She also runs MFT California, an online catalog of marriage and family therapy (MFT) programs in California, and offers personal coaching for anyone thinking about becoming an MFT.Listen to the full episode to hear:Why we need to interrogate our reasons for becoming therapists beyond altruismThe cultural assumptions and scripts we interact with when we tell people we’re therapistsHow our self-presentation impacts our relationships with our clients and how we can use that to generate positive outcomesHow our conscious and unconscious motivations for doing this work show up in the therapy roomLearn more about Very Bad Therapy:Very Bad TherapyFacebook: @VeryBadTherapyLearn more about Riva Stoudt:Into the Woods CounselingInstagram

Why do we become therapists?You wouldn’t necessarily think this is a spicy topic, but it is.Some therapists would say that we as therapists are just people who are unusually compassionate, empathetic, and giving, even selfless or altruistic. I don’t agree.I don't think we're more inherently compassionate or giving people than anybody else. Often, we're people who took on caregiver roles in our families of origin and we learned to give in order to get, and ultimately, we’re no less selfish than anyone else.But if you say that out loud in a group of therapists, as I have, they will bristle. Unless it’s on Facebook or Twitter, and then it will be a flame war.The first answer is obviously the more flattering version - the version that’s been run through Instagram filters. The second answer might not be as flattering, but it might be more real.Why does it matter what we think our reasons are for becoming therapists? Why do we need to accept the less flattering portrait of ourselves?Because whether we acknowledge it or not, it’s in the room with our clients.Listen to the full episode to hear:Why the grandiosity of thinking we’re more compassionate or altruistic is a problem for our work as cliniciansHow attachment to the self-belief that we are especially compassionate is connected to moral injury, burnout, and shameWhy we have to acknowledge that making sense of people often motivates us at therapistsWhy it’s necessary to interrogate our relationship to power and influence in our roles as therapistsLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:Episode 06: Carrying the Weight of Moral Injury with Dr. K HixsonEpisode 07: The Poison and the Cure: Expanding Our Understanding of the Wounded HealerEpisode 08: Why We Become Therapists with Ben Fineman and Carrie Wiita

Trauma has become a huge buzzword over the past several years. In fact, I would say that trauma is having a moment.And because trauma is having a moment, there is a glut of people out there who are chomping at the bit to tell you what the best kind of treatment for your trauma is and what you should be looking for in a trauma therapist. And this has become a prime opportunity for people to sell their own theoretical orientation or opinion on trauma therapy, not as if it's an opinion or a theoretical viewpoint, but as if it's simply a statement of fact about trauma treatment in general.That theoretical difference being the schism between trauma therapists who believe that exposure, meaning a direct confrontation with the content of a traumatic memory, is a crucial part of trauma treatment and those who believe that it's not only not necessary, but that it is dangerous or potentially harmful.There is a shift towards the viewpoint that exposure is harmful in the context of trauma, when in fact it can be, and very often is, a powerful and life changing intervention and the backbone of the work that many of us do in treating trauma. And I'm concerned that clients may be being dissuaded from accessing kinds of treatment that could make a massive positive difference in their lives. Today, I'm talking with Allison Aosved, a clinical psychologist who specializes in prolonged exposure therapy for PTSD and does a lot of supervision and training in that modality.I wanted to talk with her about the importance of trauma exposure and some of the factors that may be contributing to increasing anti-exposure bias in this field.Listen to the full episode to hear:How the research on exposure therapy is affirming it as an effective treatment for PTSD and a range of other disordersHow the fear of exposure therapy causing destabilization or retraumatization for clients isn’t borne out in the researchWhy the isolation of private practice can make therapists risk-averse in their treatmentWhy distress and discomfort shouldn’t be confused with dangerHow exposure helps uproot shame around traumatic experiencesThe role of informed consent in exposure therapyLearn more about Riva Stoudt:Into the Woods CounselingInstagram

In episode 10, Allison Aosved and I discussed exposure therapy for trauma, and the anti-exposure bias that we are seeing in the field.Today, I want to dig a little deeper into the context of that conversation, the factors that are contributing to anti-exposure bias, and how opinion on theoretical orientation inevitably shifts and swings over time, and how concerns about retraumatization and vicarious trauma may be impacting therapists’ ability to truly help their clients heal.Because my concern in the context of anti-exposure bias is that many people may be missing out on some of the potential transformative impact of trauma therapy when they don't have access to exposure-based methods that do utilize the narrative, and that access to these modalities is becoming increasingly limited.Listen to the full episode to hear:How differences in generational cohorts may be influencing view on exposure-based modalitiesWhy our field is so prone with pendulum swings of prevailing opinion on treatment and best practicesWhy therapeutic rupture and client buy-in may be major contributing factors to adverse experiences with exposure therapyHow anti-exposure bias increases opportunities for avoidance and therapist-client collusionHow clients’ positive outcomes influence the impact of vicarious traumaLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:A Therapist Can’t Say That Ep 10: Leave No Stone Unturned: The Healing Opportunity of Exposure Therapy with Allison AosvedRevolutionizing Trauma Treatment: Stabilization, Safety, & Nervous System Balance, Babette Rothschild

Imagine you’re sitting in your office with a new client and the intake conversation turns to their previous therapist and they toss off a piece of information or a comment about something that their previous therapist did or said that really concerns you, maybe even alarms or disturbs you.How would you react? What would you do?If it occurred to you that might encourage your client to report their former therapist to the licensing board, you are far from alone.Today, I’m talking with Dr. Ofer Zur about what he calls subsequent therapist syndrome, a surprisingly common phenomenon where a client makes a licensing board complaint against a prior therapist based on the advice or encouragement of their new therapist.Dr. Ofer Zur is a psychologist, ethics professor, and consultant on ethical, clinical, and forensic matters in psychotherapy. He has a great deal of experience with the board complaint process and all of the reasons why therapists get embroiled in it, and the various outcomes of the process.We’ll discuss a variety of factors that influence our perceptions of prior therapists, the interprofessional dynamics at play that make it so hard for therapists to simply say to each other, “I disagree,” and how context complicates our perceptions of ethicality.Listen to the full episode to hear:Why context and relationship are vital to understanding the actions of a prior therapistThe enormous influence of risk management on perceptions of clinical standards and minimizing harmHow the wide spectrum of theoretical orientation makes therapists more likely to see each other as negligent or unethicalWhy it’s worth it to connect with your clients’ prior or next therapistsLearn more about Dr. Ofer Zur:DrZur.comLearn more about Riva Stoudt:Into the Woods CounselingInstagram

In the last episode, Dr. Ofer Zur stated that he estimates at least 50% of board complaints in some way involve the subsequent therapist encouraging a client to initiate a complaint against a prior therapist.And most of these cases do not involve egregious misconduct or predatory behavior.Many of these cases result from misunderstandings, clients who are unreliable reporters, gray areas, differences in theoretical orientation that result in disagreement about the use of therapeutic practices, or poorly handled therapeutic ruptures of the sort that all of us have been, or will be guilty of, at some point in our careers.So of course, I keep asking myself why.Why is this phenomenon so common in our field? Why are therapists so frequently getting involved in the complaint process against other therapists? And what is it about our field that makes this more likely compared to other professional fields with board complaint processes?Today, I’m digging into the contributing and converging factors that may explain just what it is about therapists that makes this phenomenon possible.Listen to the full episode to hear:How the savior complex that drives many of us into this field may motivate therapists to encourage clients to initiate board complaintsHow risk management mentality and differences in theoretical orientation converge in our perceptions of harmHow professional isolation and the uncertainty inherent in this work contribute to subsequent therapist syndromeWhy curiosity and building real community may be the antidote to our unhealthy professional cultureLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:Episode 08: Why We Become Therapists with Ben Fineman and Carrie WiitaEpisode 12: Subsequent Therapist Syndrome with Dr. Ofer Zur

Two years ago, on October 8, 2020, my teacher, David Schnarch died suddenly.Anyone who knew Dave even for a few moments, could see that he had an arresting presence. Tall and broad-shouldered with high contrast, salt and pepper hair, strong features, and an electric gaze that, when focused on you, elicited the distinct and disarming feeling that he was looking into some dusty and hidden back corner of your soul.I have tried and failed to pay tribute to Dave before, but in this episode, I will attempt it again through my personal recollections of his work, and how his training and methodology impacted me and my practice.Content note: This episode contains somewhat detailed references to sexuality and mention of fertility treatment.Listen to the full episode to hear:How I first encountered Dave’s work in the self-help section of a new age storeWhy I booked a flight to Germany for a training before even reading the book it would be based onThe vulnerable, though anonymous, share that made me feel profoundly seenLearn more about Riva Stoudt:Into the Woods CounselingAbout RivaInstagramResources:Passionate Marriage: Love, Sex, and Intimacy in Emotionally Committed Relationships, David SchnarchBrain Talk: How Mind Mapping Brain Science Can Change Your Life & Everyone In It, David Schnarch

Here in 2022, therapists have largely resigned ourselves to the fact that we need to do some kind of marketing. We have been dragged into the world of social media, user generated content, and the imperative of the personal brand. And the necessity of marketing ourselves comes with a lot of uncertainty, discomfort, and unease.How do we market ethically? What does it actually mean to be authentic in our marketing? Is there any way to do this without feeling icky or like we’re selling ourselves?And our discomfort with the idea of marketing in and of itself makes us easy marks for people selling certainty, selling relief from our anxiety about marketing, and we can end up buying into cookie cutter strategies that don’t work.Which isn’t to say all standard marketing advice is bad–it helped me grow a thriving practice–but there is something deeper to consider about how and why therapists struggle with this process, and how we contend with it.Which is why I’m talking to Racheal Kay Albers, Creative Director and Brand Strategist at RKA Ink. I wanted to talk to Rachael specifically, because she puts the experience of marketing in 2022 into a much-needed historical and sociological context that gives voice to the way marketing grinds up against our values and our senses of ourselves.Rachael Kay Albers is a creative director and brand strategist for businesses that burn the rulebook. When she's not helping brands set fire to the box instead of thinking inside it, she writes about the intersection of branding, pop culture, tech, and identity. She also hosts the podcast, Marketing Muckraking, where she explores what brand culture is doing to us — and what to do about it. Listen to the full episode to hear:How social media skews our concept of how long marketing–or therapy–should take before we see resultsWhy your brand is about how your audience perceives and remembers you, not your logoWhy we have to go deeper than fill-in-the-blank “about me” and “who I treat” to make potential clients feel seen and safeWhy marketing can be surprisingly emotionalA way to think about niche that goes beyond ideal client profilesWhy the pursuit of ethical marketing means leaving money on the tableLearn more about Rachael Kay Albers:RachaelKayAlbers.com RKA Ink Marketing Muckraking PodcastInstagram: @rachael.kay.albersYouTube: @RKAInkTikTok: @rachaelkayalbersTwitter: @rkainkFacebook: @rachaelkayalbersConnect with Rachael on LinkedInLearn more about Riva Stoudt:Into the Woods CounselingInstagram

On episode 15, creative director and brand strategist Rachael Kay Albers said something that I have been turning over and over in my mind since:Marketing artificially accelerates the pace of human relationships.As soon as I heard her say that, something started to click for me about why therapists tend to dislike marketing, and it centers around the concept of artificiality.We see artificiality as phony or fake, as standing in opposition to authenticity. And therapists love to see ourselves as being driven by authenticity. We want to get under the external layers and into the real, raw stuff. It’s what we do.It’s not exactly a revelation that the primary complaint I hear from therapists about marketing is that it feels fake or superficial or inauthentic.But Rachael’s comment made me realize it goes deeper than that. And it can’t be remedied by telling us to just be authentic or ethical or don’t be a slime ball and overpromise results.What’s really happening is that we accurately perceive that marketing manipulates and speeds up the pace of our relationships with our clients. And we do not like that.But the more I think about it, the more I ask myself, aren’t we doing that anyway by the very nature of the work we do? Isn’t there a layer of artifice inherent and necessary to the work that we do?Listen to the full episode to hear:What aspects of our relationships with clients our marketing speeds up and why that’s not the worst thingWhy artifice and authenticity are not opposites, or mutually exclusive in our practicesHow a measure of artifice can actually facilitate authenticity and be in alignment with our integrityLearn more about Riva Stoudt:Into the Woods CounselingAbout RivaInstagramResources:A Therapist Can’t Say That Ep 15: Is Ethical Marketing Possible? with Rachael Kay Albers

When you hear the phrase “clinical supervision” what do you think of?For me, the first thing that comes to mind is stacks of paperwork - or whatever the electronic version of that is. I think of the years-long slog of racking up hours while marching towards that finish line of professional legitimacy: licensure.It's not a very alive-sounding phrase, is it - “clinical supervision?”  It sounds, well, clinical. And then - “supervision,” not really most people's idea of what sounds like a great time. It conjures up visions of surveillance, of being put under a microscope. Or from the supervisor's side, of being the teacher with the whistle on the playground who has to watch all the kids at recess and make sure nobody cracks their head open falling off the monkey bars.But if we extricate ourselves from the trap of looking at clinical supervision through the lens of bureaucratic hoop-jumping and box-checking, if we divest from centering risk management in our clinical and supervisory relationships, if we can tolerate our anxiety about someone falling off the monkey bars here and there,  if we can do that, we can see something more profound in the space that's left.In this dance of apprentice and mentor, we are building professional lineages that will shape the culture of our profession potentially long after we are no longer around. So what kind of culture do we want to shape? Today I'm speaking again with my dear friend, colleague, and mentor Dr. K Hixson about clinical supervision.Dr. Hixson has made clinical supervision and training supervisors a cornerstone of their practice, and the conversation you're going to hear us having today is born out of a shared vision for what clinical supervision has the potential to be.Listen to the full episode to hear:The power of good clinical supervision to help early career therapists learn and unlearn, and repair relationships to power post-grad schoolWhy clinical supervisors need to let go of their perception of themselves as the expert in order to develop excellenceWhy risk tolerance–not risk aversion–is an essential quality for clinical supervisorsWhy supervisors need to consider the impact they have in shaping the culture of early career and future therapistsLearn more about Dr. K Hixson:WebsiteLearn more about Riva Stoudt:Into the Woods CounselingInstagram

As I've been reflecting on the conversation Dr. K Hixson and I had about clinical supervision and reflecting on the past season of this podcast, I keep coming back to the piece we stumbled upon about clinical supervisors as culture makers, culture replicators, and culture changers.It feels very fitting that we got there because this podcast itself was born out of the desire to change the culture of our profession. And as I've been sitting with that over the past few weeks, I’m becoming more aware of how important I think it is that as therapists–all of us, clinical supervisors or not–we cultivate an understanding of ourselves as makers of culture.And while it may not come naturally to us to think of ourselves as makers of culture, human culture is made by humans.We are all producing or reproducing that every day within our spheres of influence. And of course, the bigger that sphere and the greater your influence within that sphere, the more power you have as a maker or unmaker or reproducer of culture.And we know from Spiderman that with great power comes great responsibility.So the question remains, what kind of culture do we want to make?Listen to the full episode to hear:Why all therapists need to recognize the power and influence we wield, no matter the size of our practicesHow to think of culture in terms of lineages of interpersonal influenceThe shifts in therapists’ professional culture that I hope we will makeLearn more about Riva Stoudt:Into the Woods CounselingAbout RivaInstagramResources:The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients, Irvin YalomMaxine Hong Kingston

In the final episode of my last season, Therapists As Makers of Culture, I asked you to think about what kind of professional culture you want to leave behind for the next generation of therapists and clients. We have an opportunity, with a little luck and intention and skill, to change something important about the structures of how things have been. We have an opportunity to lay the foundations for a different, hopefully better, culture of therapy that we’d like to leave behind for whoever comes next.I want to make a professional culture where we challenge ourselves and each other to stretch our capacities to hold complexity.In this conversation with Silvana Espinoza Lau, we’re discussing some of those complexities.We’re talking about how we determine and assess where we’re actually trying to go with clients when we embark on the journey of therapy with them, the importance of paying attention to all of the different and sometimes competing agendas that inform a client’s stated goals, and how we can use connection and curiosity as our guideposts.Silvana Espinoza Lau (she/her/ella), is a healer and settler in unceded Kalapuya land of the Champinefu band. She holds several privileged and marginalized identities that inform the way she supports people. Experiencing an oppressive system, that at times told her she did not belong, has given her enough empathy to support people who have felt othered, unseen, underserved, and underrepresented.She loves to support individuals who feel as the representatives of their culture, or who feel in between cultures. She especially likes to support BIPoC, a population that has been largely underserved and asked to adjust to Western norms.Even though she believes in anti-oppression, decolonization, and liberation, her hope is to move towards dismantling and recreating therapy as centering the people who have been forced to exist at the margins due to our current oppressive systems.Listen to the full episode to hear:The complex set of factors that impact how therapists approach goal-setting before a client even gets in the room, from education to pressure from insurance companiesWhy we need to acknowledge the biases and agendas we bring to our practice, and the wider context of cultural agendas that impact our clientsWhy measured progress is not the same as real healing, especially within oppressive systemsHow to lean into curiosity and connection when working with clients with differing identitiesLearn more about Silvana Espinoza Lau: Seventh Self Consulting@ecolonizeyourpractice on InstagramLearn more about Riva Stoudt:Into the Woods CounselingInstagramResources:Pedagogy of the Oppressed, Paulo Freire