In 1972, I lived for a year with friends in a Victorian, wood-framed house on a commune just outside of Bellingham, Washington. We had a big canvas teepee anchored in the backyard, which looked out over hundreds of acres of forest. Our back fence was the border between the United States and Canada, and our nearest neighbor was on the Canadian side of it—a German immigrant-turned-border-guard. He lived alone in a traile, and spent hours sitting on its steps, smoking and watching the fence.
One March evening, he walked through a break in the fence and knocked on the back door. "Chinook's coming." he said, referring to the strangely warm mountain wind that occurs after an intense cold spell. "Better take down the teepee."
Snow was still on the ground, and it was bitterly cold, but he said he could smell a "snow eater," a wind that would raise the temperature by 40 degrees in minutes. He dragged me outside with him, so I could smell the wind, but sniff as hard as I could, I didn't notice anything different. That evening at dinner, we talked about his warning. We thought he was a weird old guy, but we checked anyway to make sure the teepee was anchored tightly in the frozen ground.
At 2:00 a.m., I woke up to what I thought, in my confused state, was an earthquake. The house was swaying back and forth. I ran outside, oddly warm in my thin, cotton nightgown, and watched as a strong gust swooped under the teepee, filling it like a helium balloon, easily tearing it off its anchors. Up went the teepee, over the fence to Canada. And there, in the moonlight, was my German neighbor standing on his stoop, laughing and pointing to his nose.
Today I feel somewhat like that border guard. As I talk to fellow psychotherapists, I try to warn them that those of us in private practice are in for some big economic changes. By watching how health care dollars are spent and interpreting current surveys about psychotherapists' earnings, I see disturbing financial markers. But I also see creative strategies by which therapists are already improving their practices—strategies that make me believe that we in private practice can ride out the downturns and develop business models that help us survive and thrive. To do this, we must pay attention to the market, think beyond one-off solutions, and be open to making broad, intentional changes to protect our livelihood and, ultimately, our profession. In other words, it's time to wake up and smell the wind.